Pre-operative One-on-One Physical Therapy Education Improves Postoperative Function and Patient Satisfaction After Total Joint Arthroplasty

Not Applicable

Completed

• Conditions: Arthroplasty
• Interventions: Behavioral: Preoperative Physical Therapy Session; Behavioral: Group Preoperative Education Session (per the standard of care)

• Registration Number: NCT02872337
• Lead Sponsor: Hospital for Special Surgery, New York

Brief Summary

The purpose of this study was to evaluate the efficacy of a one-time, preoperative physical therapy protocol on postoperative (1) discharge disposition, (2) pain, function and stiffness and (3) patient satisfaction.

Detailed Description

Not available

Study Timeline

• Study Start: 2015-02
• Primary Completion: 2015-10
• Study Completion: 2015-11
• Study First Submitted: 2016-08-01
• Study First Submitted QC: 2016-08-18
• Study First Posted: 2016-08-19
• Status Verified: 2023-06
• Last Update Submitted: 2023-06-16
• Last Update Posted: 2023-06-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 126

Inclusion Criteria

• Subjects will be required to meet the following inclusion criteria in order to participate:

  • Unilateral Primary Knee OA or Hip OA
  • Patients at least 18 years old up to 85.
  • Undergoing surgery with one of the following study surgeons
  • Able to independently ambulate ≥ half a block with or without assistive device
  • Able to independently perform non-reciprocal stairs with or without assistive device/rails
  • Patients that plan to D/C home post TKA / THA
  • Patients that speak English only.

Exclusion Criteria

• Rheumatoid arthritis
• Psoriatic arthritis
• Juvenile rheumatoid arthritis
• Knee or Hip revisions
• Patients under 18 years of age
• Patients unwilling or unable to complete PRO instrument or study questionnaires at the specified study time points pre-operatively or post-operatively
• Bilateral TKA and THA
• Uni-condylar knee arthroplasty or Hip resurfacing
• Patellar reconstruction
• Patient on disability, workman's compensation
• Patients unwilling to participate in PEdPTWP and/or Patient education class and booklet.
• Patients that plan to D/C to rehabilitation center post TKA and THA
• Patients that do not speak English
• Patients that do not have access to computer

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Experimental (Intervention): PreopPT Group	Group Preoperative Education Session (per the standard of care)	This group will undergo the group preoperative education session. Following this session (intervention) this group underwent a one-time, one-on-one preoperative PT session. They also were given access to a web-based microsite which was customized to surgeon
Control (standard of care): No PreopPT Group	Group Preoperative Education Session (per the standard of care)	This group underwent the current of standard of care at our institution. This only includes the group preoperative education session. No further preoperative education was given.
Experimental (Intervention): PreopPT Group	Preoperative Physical Therapy Session	This group will undergo the group preoperative education session. Following this session (intervention) this group underwent a one-time, one-on-one preoperative PT session. They also were given access to a web-based microsite which was customized to surgeon

Primary Outcome Measures

Name	Time	Method
Number of In-patient Physical Therapy visits required to meet hospital discharge criteria PT	Through Study Completion, an average of 3 days	This included a review of the hospital database for hospital discharge time. At this institution PT discharge is defined as the ability to (1) independently transfer, (2) independently ambulate approximately 150 feet and (3) independently negotiate stairs (4) independent with home exercise program and activities of daily living.; All of this data was recorded from hospital records

Secondary Outcome Measures

Name	Time	Method
Hospital Length of Stay	Time from Surgery until Hospital Discharge, an average of 2-3 days	collected from a hospital database
Time to meet Physical Therapy discharge criteria	Time from Surgery to meeting PT discharge criteria, an average of 3 days	At this institution PT discharge is defined as the ability to (1) independently transfer, (2) independently ambulate approximately 150 feet and (3) independently negotiate stairs (4) independent with home exercise program and activities of daily living.
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)	This standard patient reported outcome was filled out preoperatively or at six weeks postoperatively	This standard patient reported outcome was filled out preoperatively or at six weeks postoperatively
Patient Satisfaction Scores	from two weeks prior to surgery until 6 weeks after surgery	Patient satisfaction was measured by a series of patient administered questionnaires at various stages of the study. All satisfaction questions, with the exception of the utilization of the microsites \[Yes/No\], were asked via a visual analogue scale to disagree or agree with given statements \[0-5, where 0 was strongly disagree, 3 was neutral and 5 was strongly agree\]. Patients unable to complete any forms at the time of the appointment completed the form over the phone with a co-investigator.