The strongest predictor of the use of homecare for the terminal episode of TKR rehabilitation was the presence of two to four other adults in the house in addition to the patient, although there appeared to be a slight positive relationship with older age. An association, albeit weak, between patient age and use of homecare as the terminal site of PT is expected. Older patients are more likely to experience difficulty using outpatient facilities due to limited community ambulation or access to transportation. The presence of two to four other adults in the home as a predictor of homecare as the terminal site may reflect a lifestyle choice in which other family demands limit the ability of a patient to pursue additional physical therapy services in an ambulatory care setting. Further research is needed to fully explain the physical and social factors that dictate patientsâ choices of rehabilitation services. Research is also needed to identify optimal rehabilitation strategies that meet the patientâs needs and preferences.
Wide practice variation is also apparent in the content of PT services provided during the terminal rehabilitation experience. The only interventions consistently reported were exercises to restore range of motion and exercises for the quadriceps. Although therapists consistently documented active quadriceps exercises, there was little uniformity in the form or use of resistance or progressive strengthening regimens.
Carol A. Oatis, Variations in Delivery and Exercise Content of Physical Therapy Rehabilitation Following Total Knee Replacement Surgery: A Cross-Sectional Observation Study
Last date updated on July, 2014