| Title: |
Home-based rehabilitation programme compared with traditional physiotherapy for patients at risk of poor outcome after knee arthroplasty: the CORKA randomised controlled trial |
| Authors: |
Martin Underwood; David Beard; Sarah Lamb; Avril Drummond; Karen L Barker; José Leal; Mike Reed; Gary Collins; Andrew James Price; Francine Toye; Denise Hill; Helen Wilson; Jonathan Room; Michael Maia Schlüssel; Jane Harrison; Ruth Knight; Nicola Kenealy; Leon Palmer-Wilson; Ana Glennon; Christian Brookes; Susan Dowdle; Hazel Burt; Sarah Adcock; Justine Theaker; Gladys Nadar Arulmani; Sunil Jain; Genevieve Simpson; Gemma Knight; Tricia Monroe; Gareth Stephens; Sarah Rich |
| Source: |
BMJ Open, Vol 11, Iss 8 (2021) |
| Publisher Information: |
BMJ Publishing Group |
| Publication Year: |
2021 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Medicine |
| Description: |
Objectives To evaluate whether a home-based rehabilitation programme for people assessed as being at risk of a poor outcome after knee arthroplasty offers superior outcomes to traditional outpatient physiotherapy.Design A prospective, single-blind, two-arm randomised controlled superiority trial.Setting 14 National Health Service physiotherapy departments in the UK.Participants 621 participants identified at high risk of a poor outcome after knee arthroplasty using a bespoke screening tool.Interventions A multicomponent home-based rehabilitation programme delivered by rehabilitation assistants with supervision from qualified therapists versus usual care outpatient physiotherapy.Main outcome measures The primary outcome was the Late-Life Function and Disability Instrument (LLFDI) at 12 months. Secondary outcomes were the Oxford Knee Score (a disease-specific measure of function), Knee injury and Osteoarthritis Outcome Score Quality of Life subscale, Physical Activity Scale for the Elderly, 5 dimension, 5 level version of Euroqol (EQ-5D-5L) and physical function assessed using the Figure of 8 Walk test, 30 s Chair Stand Test and Single Leg Stance.Results 621 participants were randomised between March 2015 and January 2018. 309 were assigned to CORKA (Community Rehabilitation after Knee Arthroplasty) home-based rehabilitation, receiving a median five treatment sessions (IQR 4–7). 312 were assigned to usual care, receiving a median 4 sessions (IQR 2–6). The primary outcome, LLFDI function total score at 12 months, was collected for 279 participants (89%) in the home-based CORKA group and 287 participants (92%) in the usual care group. No clinically or statistically significant difference was found between the groups (intention-to-treat adjusted difference=0.49 points; 95% CI −0.89 to 1.88; p=0.48). There were no statistically significant differences between the groups on any of the patient-reported or physical secondary outcome measures at 6 or 12 months.There were 18 participants in the intervention group reporting ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://bmjopen.bmj.com/content/11/8/e052598.full; https://doaj.org/toc/2044-6055; https://doaj.org/article/7d646a12071149e9b30cff91318cba06 |
| DOI: |
10.1136/bmjopen-2021-052598 |
| Availability: |
https://doi.org/10.1136/bmjopen-2021-052598; https://doaj.org/article/7d646a12071149e9b30cff91318cba06 |
| Accession Number: |
edsbas.198CDD56 |
| Database: |
BASE |