- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03047252
Rehabilitation for Total Knee Replacement: a Novel Biofeedback System Versus Conventional Home-based Rehabilitation
Home-based Rehabilitation With A Novel Digital Biofeedback System Versus Conventional Rehabilitation After Total Knee Replacement: a Feasibility Study
The study was designed to test patient acceptance and system usability and to assess clinical outcomes of a home-based rehabilitation program using a novel kinematic biofeedback system in the rehabilitation after total knee replacement versus conventional rehabilitation, This system allows the patients to perform independent rehabilitation sessions at home, under remote monitoring from the clinical team.
The investigators hypothesize that the system will be well received by patients and that the clinical outcomes will be at least similar those of conventional rehabilitation.
This is a quasi-randomized controlled trial with active comparator. Patients will be enrolled pre-operatively and divided into 2 groups: experimental group and conventional rehabilitation group according to geographical criteria. Both groups will perform 8 weeks of rehabilitation starting between day 7 and 10 after surgery.
The experimental group will perform daily rehabilitation sessions at home using the system, under remote monitoring from a physical therapist. The conventional rehabilitation group will perform 1h rehabilitation sessions 3 times a week, at home, given by a physical therapist.
The following feasibility outcomes will be registered: enrollment rate, retention rate (drop-outs), compliance to the program, independence of use, need for therapist contact and patient satisfaction.
Clinical outcomes will be measured at weeks 4 and 8 and then at 3 and 6 months. The primary outcome will be measured in terms of patient performance in the Timed-up-and-Go (TUG) test in comparison with the pre-operative score. Secondary outcomes will be measured in terms of: b) Knee Osteoarthritis Outcome Score); c) range of motion of the knee joint.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Porto, Portugal, 4250-449
- Hospital da Prelada - Dr. Domingos Braga da Cruz
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients over 18 years old
- Clinical and imaging evidence of knee osteoarthritis
- Indication for total knee replacement according to the patient´s orthopedic surgeon
- Ability to walk unaided, with unilateral or bilateral support
- Availability of a carer to assist the patient after surgery
Exclusion Criteria:
- Patients admitted for revision of total knee replacement
- Contralateral hip or knee osteoarthritis severely limiting patient mobility and ability to comply with a rehabilitation program
- Aphasia, dementia or psychiatric comorbidity interfering with the communication or compliance to the rehabilitation process
- Respiratory, cardiac, metabolic or other condition incompatible with at least 30 minutes of light to moderate physical activity
- Major medical complications occurring after surgery that prevent the discharge of the patient within 10 days after the surgery
- Other medical and/or surgical complications that prevent the patient from complying with a rehabilitation program
- Blind and/or illiterate patients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental group
Home-based rehabilitation sessions performed with the novel digital biofeedback system. Patients will be instructed to perform exercise sessions in at least 5 days per week, but compliance to this schedule is not mandatory per protocol. |
The system will be used independently by the patients to perform rehabilitation sessions at home, under remote monitoring from the clinical team. A tailored rehabilitation program will be prescribed, based on the following principles: STAGE 1 (Weeks 0-2) Open kinetic chain exercises without added resistance: lying, sitting and standing (with support) Strengthening of hip flexors and extensors Ice pack application after each session and throughout the day as needed STAGE 2 (weeks 3-6) Open kinetic chain exercises with added resistance, progressing to closed kinetic chain exercises, with strengthening of knee flexors and extensors and knee stabilization Progression to standing exercises without support lying, sitting and standing (with support) Exercises with steps Ice pack application after each session and throughout the day as needed STAGE 3 (Weeks 7-8) Eccentric strengthening exercises Exercises involving steps Multi-directional exercises
Other Names:
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Active Comparator: Conventional rehabilitation group
Home-based rehabilitation sessions provided by a Physical Therapist, 3 times a week for 8 weeks.
Each session will have a duration of 60 minutes.
Patients will be instructed to perform additional unsupervised sessions in at least two other days, but compliance to these extra sessions is not mandatory per protocol.
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Patients will perform 3 weekly rehabilitation sessions, with a duration of 1 hour, for 8 weeks, provided by a physical therapist. The rehabilitation program will respect the following principles: STAGE 1 (Weeks 0-2) Soft tissue massage Active assisted mobilisation of the knee to increase range of motion Gait training with bilateral support Open kinetic chain exercises without added resistance Strengthening of hip flexors and extensors Ice pack application STAGE 2 (weeks 3-6) Soft tissue massage Active assisted mobilisation of the knee to increase range of motion Open kinetic chain exercises with added resistance, progressing to closed kinetic chain exercises, with strengthening of knee flexors/ extensors and knee stabilisation Gait training with progressive withdrawal of external support Ice pack application STAGE 3 (Weeks 7-8) Eccentric strengthening exercises Exercises involving steps Weight-bearing exercises on uneven surfaces Ice pack application |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in the Timed up And Go Test score
Time Frame: Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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The timed up and go requires a patient to rise from a chair walk three meters around a piece of tape and return to the chair again as quickly as possible.
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Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Knee injury and Osteoarthritis Outcome Score (KOOS)
Time Frame: Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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The KOOS is a standardized and validated patient outcome score that assesses functional limitation in patient with knee problems.
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Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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Change in Knee Range of Motion (degrees)
Time Frame: Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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Change in knee flexion/extension measured in degrees
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Baseline; 4 and 8 weeks after initiation of rehabilitation program and then at 3 and 6 months after surgery
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Enrollment rate
Time Frame: At the end of patient enrollment- up to 18 months after trial initiation
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This will be measured through the percentage of patients that actually enroll in the study after initial screening.
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At the end of patient enrollment- up to 18 months after trial initiation
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Retention rate
Time Frame: At week 8
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This will be assessed through the percentage of patients in the experimental group that complete the 8-week program
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At week 8
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Independence of use
Time Frame: For each patient, at week 8 or upon dropout.
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This will be assessed through the percentage of patients in the experimental group that require the assistance of a caregiver in interacting with the system.
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For each patient, at week 8 or upon dropout.
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Compliance
Time Frame: For each patient, at week 8.
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This will be measured by calculating the percentage of patients allocated to the experimental group that performed at least 5 weekly sessions throughout the program
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For each patient, at week 8.
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Patient Satisfaction
Time Frame: At week 8 or upon dropout.
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This will be measured in the experimental group by answering the following question: "On a scale from 0 to 10, how likely are you to recommend this intervention to a friend or neighbour?".
Scores of 9 and 10 will be considered "good", 7 and 8 "neutral" and less than 7 "bad".
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At week 8 or upon dropout.
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Fernando D Correia, MD, Sword Health, SA
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SH-TKR-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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