Variations in Delivery and Exercise Content of Physical Therapy Rehabilitation Following Total Knee Replacement Surgery: A Cross-Sectional Observation Study
Carol A. Oatis1*, Wenjun Li2,3, Jessica M. DiRusso4, Mindy J. Hoover5, Katherine K. Johnston6, Monika K. Butz7, Amy L. Phillips8, Kimberly M. Nanovic9, Elizabeth C. Cummings10, Milagros C. Rosal3, David C. Ayers2 and Patricia D. Franklin2
- *Corresponding Author:
- Carol A Oatis
Department of Physical Therapy
Arcadia University, 450 S. Easton Road
Glenside, PA 19038 USA
E-mail: [email protected]
Received Date: February 17 2014; Accepted Date: April 17 2014; Published Date: April 22 2014
Citation: Oatis CA, Li W, DiRusso JM, Hoover MJ, Johnston KK, et al. (2014) Variations in Delivery and Exercise Content of Physical Therapy Rehabilitation Following Total Knee Replacement Surgery: A Cross-Sectional Observation Study. Int J Phys Med Rehabil S5:002. doi: 10.4172/2329-9096.S5-002
Copyright: © 2014 Oatis CA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Prevalence of total knee replacement (TKR) is large and growing but functional outcomes are variable. Physical therapy (PT) is integral to functional recovery following TKR but little is known about the quantity or content of PT delivered. Purposes of this study were to describe the amount and exercise content of PT provided in the terminal episode of PT care following TKR and to examine factors associated with utilization and content. Methods: Subjects included participants in a clinical trial of behavioral interventions for patients undergoing primary unilateral TKR who had completed the 6-month study evaluation.PT records were requested from 142 consecutive participants who had completed their post-TKR rehabilitation, 102 in/out patient care, and 40 in homecare. Information on utilization and exercises was extracted from a retrospective review of the PT records. Results: We received 90 (88%) outpatient and 27 (68%) homecare PT records. Records showed variability in timing, amount and content of PT. Patients receiving outpatient PT had more visits and remained in PT longer (p<0.001). Exercises known in the TKR literature were utilized more frequently in the outpatient setting (p=0.001) than in home care. Records from both settings had limited documentation of strengthening progression. Conclusions: The study reveals considerable variability in timing, utilization and exercise content of PT following TKR and suggests sub-optimal exercise for strengthening. While methods we employed document variability, improved systematic PT documentation and in-depth research are needed to identify optimal timing, utilization and content of PT following TKR.