Group Physiotherapy Provides Similar Outcomes for Participants After Joint Replacement Surgery as 1-to-1 Physiotherapy

A Sequential Cohort Study

Corinne L. Coulter, Jeanie M. Weber, Jennie M. Scarvell

    Research output: Contribution to journalArticle

    37 Citations (Scopus)

    Abstract

    Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Objectives: To compare effectiveness and time efficiency of physiotherapy rehabilitation provided within a group with an individualized program provided at home for improving participants' outcomes after total joint replacement surgery. Design: Quasiexperimental sequential cohort trial with 12-week follow-up. Setting: A tertiary acute care hospital. Participants: Consecutive patients (N=51) having hip or knee replacement surgery in an 8-month period and who were able to weight-bear postoperatively. Interventions: The first group admitted to the study entered the exercise group, and patients in the following 4 months entered the home physiotherapy group. Main Outcome Measures: Primary outcome measures included the Western Ontario McMaster's University Osteoarthritis Index (WOMAC), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Timed Up & Go (TUG) test, and knee range of motion (ROM). Secondary measures included the 6-m walk test and a patient evaluation questionnaire. Staff time costs were recorded. Outcomes were recorded preoperatively or at hospital discharge, and 5 and 12 weeks postoperatively. Results: There was no difference between the 2 groups for either the WOMAC or SF-36 scores, 6-m walk test, TUG test, or ROM measures at 12 weeks (P>.05), although both groups of patients improved between hospital discharge and 12 weeks. The class group accessed more frequent physiotherapy than the home group (mean, 7.5 and 3.96 visits, respectively). The physiotherapist's time was less per patient per visit for the class group (mean, 27min direct and 10min indirect) than for the home visits (mean, 38min direct and 26min indirect). Conclusions: This trial suggests that the class-based exercise rehabilitation was the most efficient method of delivery of the physiotherapy service, without cost to patient outcomes.

    Original languageEnglish
    Pages (from-to)1727-1733
    Number of pages7
    JournalArchives of Physical Medicine and Rehabilitation
    Volume90
    Issue number10
    DOIs
    Publication statusPublished - Oct 2009

    Fingerprint

    Replacement Arthroplasties
    Cohort Studies
    Group Homes
    Outcome Assessment (Health Care)
    Articular Range of Motion
    Knee
    Ursidae
    Costs and Cost Analysis
    Exercise Therapy
    House Calls
    Physical Therapists
    Ontario
    Tertiary Healthcare
    Health Surveys
    Osteoarthritis
    Hip
    Rehabilitation
    Exercise
    Weights and Measures

    Cite this

    @article{e863cfa4c8d34ce49308fd120a731048,
    title = "Group Physiotherapy Provides Similar Outcomes for Participants After Joint Replacement Surgery as 1-to-1 Physiotherapy: A Sequential Cohort Study",
    abstract = "Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Objectives: To compare effectiveness and time efficiency of physiotherapy rehabilitation provided within a group with an individualized program provided at home for improving participants' outcomes after total joint replacement surgery. Design: Quasiexperimental sequential cohort trial with 12-week follow-up. Setting: A tertiary acute care hospital. Participants: Consecutive patients (N=51) having hip or knee replacement surgery in an 8-month period and who were able to weight-bear postoperatively. Interventions: The first group admitted to the study entered the exercise group, and patients in the following 4 months entered the home physiotherapy group. Main Outcome Measures: Primary outcome measures included the Western Ontario McMaster's University Osteoarthritis Index (WOMAC), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Timed Up & Go (TUG) test, and knee range of motion (ROM). Secondary measures included the 6-m walk test and a patient evaluation questionnaire. Staff time costs were recorded. Outcomes were recorded preoperatively or at hospital discharge, and 5 and 12 weeks postoperatively. Results: There was no difference between the 2 groups for either the WOMAC or SF-36 scores, 6-m walk test, TUG test, or ROM measures at 12 weeks (P>.05), although both groups of patients improved between hospital discharge and 12 weeks. The class group accessed more frequent physiotherapy than the home group (mean, 7.5 and 3.96 visits, respectively). The physiotherapist's time was less per patient per visit for the class group (mean, 27min direct and 10min indirect) than for the home visits (mean, 38min direct and 26min indirect). Conclusions: This trial suggests that the class-based exercise rehabilitation was the most efficient method of delivery of the physiotherapy service, without cost to patient outcomes.",
    keywords = "Arthroplasty, Rehabilitation",
    author = "Coulter, {Corinne L.} and Weber, {Jeanie M.} and Scarvell, {Jennie M.}",
    year = "2009",
    month = "10",
    doi = "10.1016/j.apmr.2009.04.019",
    language = "English",
    volume = "90",
    pages = "1727--1733",
    journal = "Archives of physical medicine",
    issn = "0003-9993",
    publisher = "W.B. Saunders Ltd",
    number = "10",

    }

    TY - JOUR

    T1 - Group Physiotherapy Provides Similar Outcomes for Participants After Joint Replacement Surgery as 1-to-1 Physiotherapy

    T2 - A Sequential Cohort Study

    AU - Coulter, Corinne L.

    AU - Weber, Jeanie M.

    AU - Scarvell, Jennie M.

    PY - 2009/10

    Y1 - 2009/10

    N2 - Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Objectives: To compare effectiveness and time efficiency of physiotherapy rehabilitation provided within a group with an individualized program provided at home for improving participants' outcomes after total joint replacement surgery. Design: Quasiexperimental sequential cohort trial with 12-week follow-up. Setting: A tertiary acute care hospital. Participants: Consecutive patients (N=51) having hip or knee replacement surgery in an 8-month period and who were able to weight-bear postoperatively. Interventions: The first group admitted to the study entered the exercise group, and patients in the following 4 months entered the home physiotherapy group. Main Outcome Measures: Primary outcome measures included the Western Ontario McMaster's University Osteoarthritis Index (WOMAC), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Timed Up & Go (TUG) test, and knee range of motion (ROM). Secondary measures included the 6-m walk test and a patient evaluation questionnaire. Staff time costs were recorded. Outcomes were recorded preoperatively or at hospital discharge, and 5 and 12 weeks postoperatively. Results: There was no difference between the 2 groups for either the WOMAC or SF-36 scores, 6-m walk test, TUG test, or ROM measures at 12 weeks (P>.05), although both groups of patients improved between hospital discharge and 12 weeks. The class group accessed more frequent physiotherapy than the home group (mean, 7.5 and 3.96 visits, respectively). The physiotherapist's time was less per patient per visit for the class group (mean, 27min direct and 10min indirect) than for the home visits (mean, 38min direct and 26min indirect). Conclusions: This trial suggests that the class-based exercise rehabilitation was the most efficient method of delivery of the physiotherapy service, without cost to patient outcomes.

    AB - Coulter CL, Weber JM, Scarvell JM. Group physiotherapy provides similar outcomes for participants after joint replacement surgery as 1-to-1 physiotherapy: a sequential cohort study. Objectives: To compare effectiveness and time efficiency of physiotherapy rehabilitation provided within a group with an individualized program provided at home for improving participants' outcomes after total joint replacement surgery. Design: Quasiexperimental sequential cohort trial with 12-week follow-up. Setting: A tertiary acute care hospital. Participants: Consecutive patients (N=51) having hip or knee replacement surgery in an 8-month period and who were able to weight-bear postoperatively. Interventions: The first group admitted to the study entered the exercise group, and patients in the following 4 months entered the home physiotherapy group. Main Outcome Measures: Primary outcome measures included the Western Ontario McMaster's University Osteoarthritis Index (WOMAC), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Timed Up & Go (TUG) test, and knee range of motion (ROM). Secondary measures included the 6-m walk test and a patient evaluation questionnaire. Staff time costs were recorded. Outcomes were recorded preoperatively or at hospital discharge, and 5 and 12 weeks postoperatively. Results: There was no difference between the 2 groups for either the WOMAC or SF-36 scores, 6-m walk test, TUG test, or ROM measures at 12 weeks (P>.05), although both groups of patients improved between hospital discharge and 12 weeks. The class group accessed more frequent physiotherapy than the home group (mean, 7.5 and 3.96 visits, respectively). The physiotherapist's time was less per patient per visit for the class group (mean, 27min direct and 10min indirect) than for the home visits (mean, 38min direct and 26min indirect). Conclusions: This trial suggests that the class-based exercise rehabilitation was the most efficient method of delivery of the physiotherapy service, without cost to patient outcomes.

    KW - Arthroplasty

    KW - Rehabilitation

    UR - http://www.scopus.com/inward/record.url?scp=70350482201&partnerID=8YFLogxK

    U2 - 10.1016/j.apmr.2009.04.019

    DO - 10.1016/j.apmr.2009.04.019

    M3 - Article

    VL - 90

    SP - 1727

    EP - 1733

    JO - Archives of physical medicine

    JF - Archives of physical medicine

    SN - 0003-9993

    IS - 10

    ER -