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In-home telerehabilitation an effective alternative to in-person care after TKA
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Recently published data indicated in-home telerehabilitation was an effective alternative to face-to-face service delivery after discharge from hospital for patients who underwent total knee arthroplasty.
In a multicenter, clinical trial, 206 patients who underwent total knee arthroplasty (TKA) were randomly divided into two groups: an in-home telerehabilitation (TELE) group and a standard face-to-face (STD) rehabilitation group. The groups were given the same rehabilitation intervention for 2 months after being discharged from hospital. Patients were evaluated by blinded investigators at baseline, during hospital discharge, and at 2 months and 4 months after discharge.
Sixteen rehabilitation sessions of 45 minutes to 1 hour were included in the intervention, with each session consisting of evaluation before and after exercise; 30 minutes of exercise; the prescription of at-home exercises to be performed on days without supervision; and therapists’ advice on controlling pain, use of walking aids and return to activity. The study’s primary outcome was patients’ response to the WOMAC questionnaire at the time of the final follow-up, whereas secondary outcomes included KOOS score, functional and strength test results, and range of motion in the knee.
Findings showed the two groups had similar functional ability as well as quality of life at the baseline assessment; however, patients in the TELE group took a bit longer to climb stairs and had greater contralateral knee extension, according to the researchers.
Compared with 100 patients in the STD group, 88 patients in the TELE group underwent at least 75% of the 16 supervised sessions. Aside from receiving in-home telerehabilitation, approximately 20% of TELE group patients received face-to-face visits at home. Six patients did not receive all 16 supervised sessions because they were dissatisfied with results and perception of a complete recovery and had poor Internet connection. After the completion of the intervention, 15 patients needed additional physical therapy sessions. According to the researchers, the difference between groups with regard to the need for additional therapy was not significant.
No patients in the TELE group reported adverse events, compared with two minor adverse events reported in the STD group. Between 2 months and 4 months after discharge, both groups reported having similar physical activity levels, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Moffet reports no relevant financial disclosures. Please see the full study for a list of all other author’s relevant financial disclosures.
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