Structured Rehabilitation Program for Patients With Total Knee Replacement

NCT04694625 | Completed

• 1 other identifier: REC/Lhr/20/1041/M. Arsalan
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be a randomized controlled trial. This study will be conducted in Horizon Hospital Lahore. A sample size of 26 patients will be taken. Patients will be divided into two groups by lottery method. Group A will be treated with Structured Rehabilitation program along with conventional physiotherapy while Group B will be treated with conventional physiotherapy only. Both groups will receive treatment for 4 weeks,3 sessions per week. The outcome measures Numeric pain rating scale(NPRS),6 minutes' walk test and Womac scale will be measured at baseline and at the end of 4th week. Data will be analyzed by SPSS 25.

Conditions

Knee

Keywords

Knee pain; knee Replacement; Degenerative knee disease

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS)

  NPRS is a segmented version of Visual Analogue Scale (VAS). It consists of number from 0 to 10. Patient selects a number that best reflects his/her pain intensity where 0 is no pain and 10 is maximum pain. For construct validity, NPRS was highly correlated to Visual Analogue Scale (VAS) (0.86-0.95). The test-retest reliability of this scale is recorded to be 0.96. (Hawker et al. 2011)

  4th week

• 6 Minute walk test

  The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise. The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions. Main strengths of the 6 MWT stem from its simplicity in concept and performance, low cost, ease of standardization, and acceptance by test subjects, including those who are deconditioned, elderly, or frail.

  4th week

• WOMAC SCALE

  The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints. The WOMAC measures five items for pain (score range 0- 20), two for stiffness (score range 0-8), and 17 for functional limitation (score range 0-68).\[2\] Physical functioning questions cover everyday activities such as stair use, standing up from a sitting or lying position, standing, bending, walking, getting in and out of a car, shopping, putting on or taking off socks, lying in bed, getting in or out of a bath, sitting, and heavy and light household duties.

  4th week

Study Arms (2)

Structured rehabilitation program

EXPERIMENTAL

Structured rehabilitation program \& conventional physical therapy

Other: Structured Rehabilitation Program; Other: Conventional Physical Therapy

conventional physical therapy

ACTIVE COMPARATOR

conventional physical therapy

Other: Conventional Physical Therapy

Interventions

Structured Rehabilitation Program OTHER

Early Function Phase (Protective phase) week 1 Progressive Function Phase (Recovery Phase) 2nd and 3rd week Advance Function Phase (Activity Phase) 4th week

Structured rehabilitation program

Conventional Physical Therapy OTHER

• Rapid post-operative mobilization • Range of motion exercises started • Passive extension by placing pillow under foot • Flexion-by dangling the leg over the side of bed • Muscle strengthening exercises • Weight bearing is allowed on 1st post-operative

Structured rehabilitation program; conventional physical therapy

Eligibility Criteria

• Age: 50 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patient with unilateral or bilateral total knee replacement through medial parapatellar approach.

You may not qualify if:

• Patients awaiting revision TKR
• Post traumatic patients planned for TKR
• Those with non-degenerative joint diseases
• Patients got infected after operation

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Horizon Hospital Lahore

Lahore, Punjab Province, Pakistan

Location

Related Publications (15)

• Antony-Leo AP, Arun-Maiya G, Mohan-Kumar M, Vijayaraghavan PV. Structured Total Knee Replacement Rehabilitation Programme and Quality of Life following Two Different Surgical Approaches - A Randomised Controlled Trial. Malays Orthop J. 2019 Jul;13(2):20-27. doi: 10.5704/MOJ.1907.004.

  PMID: 31467647 BACKGROUND

• Willis-Owen CA, Brust K, Alsop H, Miraldo M, Cobb JP. Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee. 2009 Dec;16(6):473-8. doi: 10.1016/j.knee.2009.04.006. Epub 2009 May 22.

  PMID: 19464898 BACKGROUND

• Nussenzveig TC. Pain management after total joint replacement and its impact on patient outcomes. AORN J. 1999 Dec;70(6):1060-2. doi: 10.1016/s0001-2092(06)62213-8. No abstract available.

  PMID: 10635429 BACKGROUND

• Skrejborg P, Petersen KK, Beck J, Ulrich M, Simonsen O, Nielsen PT, Arendt-Nielsen L, Laursen M. Investigating the Effect of Perioperative Chlorzoxazone on Acute Postoperative Pain After Total Hip and Knee Replacement Surgery. Clin J Pain. 2020 May;36(5):352-358. doi: 10.1097/AJP.0000000000000805.

  PMID: 31977370 BACKGROUND

• Mohammad HR, Kennedy JA, Mellon SJ, Judge A, Dodd CA, Murray DW. The clinical outcomes of cementless unicompartmental knee replacement in patients with reduced bone mineral density. J Orthop Surg Res. 2020 Jan 31;15(1):35. doi: 10.1186/s13018-020-1566-2.

  PMID: 32005197 BACKGROUND

• Levinger P, Bartlett JR, Bergman NR, McMahon S, Menz HB, Hill KD. The discrepancy between patient expectations and actual outcome reduces at the first 6 months following total knee replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2019 Jul;27(7):2042-2050. doi: 10.1007/s00167-018-5210-1. Epub 2018 Oct 8.

  PMID: 30298413 BACKGROUND

• Fraenkel L, Benjamin Nowell W, Stake CE, Venkatachalam S, Eyler R, Michel G, Peters E. Impact of Information Presentation Format on Preference for Total Knee Replacement Surgery. Arthritis Care Res (Hoboken). 2019 Mar;71(3):379-384. doi: 10.1002/acr.23605.

  PMID: 29799668 BACKGROUND

• Beswick AD, Dennis J, Gooberman-Hill R, Blom AW, Wylde V. Are perioperative interventions effective in preventing chronic pain after primary total knee replacement? A systematic review. BMJ Open. 2019 Sep 6;9(9):e028093. doi: 10.1136/bmjopen-2018-028093.

  PMID: 31494601 BACKGROUND

• Wainwright TW, Immins T, Antonis JHA, Taylor H, Middleton RG. Can the introduction of Enhanced Recovery After Surgery (ERAS) reduce the variation in length of stay after total ankle replacement surgery? Foot Ankle Surg. 2019 Jun;25(3):294-297. doi: 10.1016/j.fas.2017.12.005. Epub 2017 Dec 21.

  PMID: 29409177 BACKGROUND

• Ghosh A, Chatterji U. An evidence-based review of enhanced recovery after surgery in total knee replacement surgery. J Perioper Pract. 2019 Sep;29(9):281-290. doi: 10.1177/1750458918791121. Epub 2018 Sep 13. No abstract available.

  PMID: 30212288 BACKGROUND

• Ibrahim MS, Alazzawi S, Nizam I, Haddad FS. An evidence-based review of enhanced recovery interventions in knee replacement surgery. Ann R Coll Surg Engl. 2013 Sep;95(6):386-9. doi: 10.1308/003588413X13629960046435.

  PMID: 24025284 BACKGROUND

• Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br. 2010 Sep;92(9):1253-8. doi: 10.1302/0301-620X.92B9.24394.

  PMID: 20798443 BACKGROUND

• Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, Rasmussen S. A Randomized, Controlled Trial of Total Knee Replacement. N Engl J Med. 2015 Oct 22;373(17):1597-606. doi: 10.1056/NEJMoa1505467.

  PMID: 26488691 BACKGROUND

• Bade MJ, Struessel T, Dayton M, Foran J, Kim RH, Miner T, Wolfe P, Kohrt WM, Dennis D, Stevens-Lapsley JE. Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2017 Sep;69(9):1360-1368. doi: 10.1002/acr.23139. Epub 2017 Aug 13.

  PMID: 27813347 BACKGROUND

• Barker KL, Beard D, Price A, Toye F, Underwood M, Drummond A, Collins G, Dutton S, Campbell H, Kenealy N, Room J, Lamb SE. COmmunity-based Rehabilitation after Knee Arthroplasty (CORKA): study protocol for a randomised controlled trial. Trials. 2016 Oct 13;17(1):501. doi: 10.1186/s13063-016-1629-1.

  PMID: 27737685 BACKGROUND

Study Officials

• Saima Zahid, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 3, 2021
• First Posted: January 5, 2021
• Study Start: January 10, 2021
• Primary Completion: July 10, 2021
• Study Completion: July 20, 2021
• Last Updated: August 24, 2021

Record last verified: 2021-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)