| Autor: |
Justine M, Naylor, Victoria, Ko, Steve, Rougellis, Nick, Green, Rajat, Mittal, Rob, Heard, Anthony E T, Yeo, Anne, Barnett, Danella, Hackett, Chris, Saliba, Nicole, Smith, Martin, Mackey, Alison, Harmer, Ian A, Harris, Sam, Adie, Lynette, McEvoy |
| Rok vydání: |
2011 |
| Předmět: |
|
| Zdroj: |
Journal of evaluation in clinical practice. 18(3) |
| ISSN: |
1365-2753 |
| Popis: |
Knee range of motion (ROM) at discharge from acute care is used as a clinical indicator following total knee replacement (TKR) surgery. This study aimed to assess the clinical relevance of this indicator by determining whether discharge knee ROM predicts longer-term knee ROM and patient-reported knee pain and function.A total of 176 TKR recipients were prospectively followed after discharge from acute care. Outcomes assessed included knee ROM and Oxford knee score post rehabilitation and 1 year post surgery. Discharge ROM and other patient factors were identified a priori as potential predictors in multiple linear regression modelling.A total of 133 (76%) and 141 (80%) patients were available for follow-up post rehabilitation [mean postoperative week 8.1 (SD 2.7)] and at 1 year [mean postoperative month 12.1 (SD 1.4)], respectively. Greater discharge knee flexion was a significant (P0.001) predictor of greater post-rehabilitation flexion but not 1-year knee flexion (P0.083). Better discharge knee extension was a significant predictor of better post-rehabilitation (P = 0.001) and 1-year knee extension (P = 0.013). Preoperative Oxford score and post-rehabilitation knee flexion independently predicted post-rehabilitation Oxford score, and gender predicted 1-year Oxford score. Discharge ROM did not significantly predict Oxford score in either model.The finding that early knee range predicts longer-term range provides clinical evidence favouring the relevance of discharge knee ROM as a clinical indicator. Although longer-term patient-reported knee pain and function were not directly associated with discharge knee ROM, they were associated with ROM when measured concurrently in the sub-acute phase. No causal effect has been demonstrated, but the findings suggest it may be important for physiotherapists to maximize range in the early and sub-acute periods. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
Plný text