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

One-on-One Physical Therapy Education Improves Postoperative Function and Patient Satisfaction After TJA

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.

Study Overview

• Status: Completed
• Conditions: Arthroplasty
• Intervention / Treatment: Behavioral: Preoperative Physical Therapy Session; Behavioral: Group Preoperative Education Session (per the standard of care)

• Study Type: Interventional
• Enrollment (Actual): 126
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

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 Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental (Intervention): PreopPT Group; 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	Behavioral: Preoperative Physical Therapy Session; This was a one-on-one preoperative physical therapy session on preoperative education. These patients were also given access to a surgery specific web-based microsite; Behavioral: Group Preoperative Education Session (per the standard of care)
Placebo Comparator: Control (standard of care): No PreopPT Group; 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.	Behavioral: Group Preoperative Education Session (per the standard of care)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of In-patient Physical Therapy visits required to meet hospital discharge criteria PT	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	Through Study Completion, an average of 3 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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	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.	from two weeks prior to surgery until 6 weeks after surgery
Time to meet Physical Therapy discharge criteria	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.	Time from Surgery to meeting PT discharge criteria, an average of 3 days
Hospital Length of Stay	collected from a hospital database	Time from Surgery until Hospital Discharge, an average of 2-3 days

Collaborators and Investigators

• Sponsor: Hospital for Special Surgery, New York

Study record dates

Study Major Dates

• Study Start: February 1, 2015
• Primary Completion (Actual): October 1, 2015
• Study Completion (Actual): November 1, 2015

Study Registration Dates

• First Submitted: August 1, 2016
• First Submitted That Met QC Criteria: August 18, 2016
• First Posted (Estimated): August 19, 2016

Study Record Updates

• Last Update Posted (Actual): June 22, 2023
• Last Update Submitted That Met QC Criteria: June 16, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: 2015-306