Effects of Post-operative Exercises provided by Peer Volunteers to Patients after Knee Arthroplasty

Abstract

<h3>Research Objectives</h3> To investigate the short-term outcomes at discharge of patients who receive additional post-operative rehabilitative exercises provided by peer volunteers after Total Knee Arthroplasty (TKA). <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> Tertiary teaching hospital, in a specialized orthopedic ward. <h3>Participants</h3> A convenience sample of 476 consecutive adult patients who had undergone a primary elective unilateral TKA. <h3>Interventions</h3> An intervention group received a standardized post-operative rehabilitative exercise protocol taught and supervised by peer volunteers in additional to standard physiotherapy (N = 309), compared to a control group receiving standard physiotherapy alone (N = 167). Enrollment in the intervention group was based on peer availability and the patient's willingness to participate. <h3>Main Outcome Measures</h3> We recorded the discharge outcomes, which were the pain score (numerical pain rating scale), passive knee flexion and extension range-of-motion, length of hospitalization, ability to perform an unassisted straight leg raise of the operated leg, ambulation distance, ability for independent walking, walking aids required, discharge destination and adverse events. <h3>Results</h3> There were no statistical differences in the baseline characteristics of both groups, with the exception of ambulation distance (p = 0.016). After adjustment for baseline differences, linear regression models revealed that patients in the intervention group had an increased discharge passive knee flexion range-of-motion of 7.89 degrees (95% Confidence Interval [CI] = 5.47 to 10.33; p < 0.001). There were no significant differences for the other outcome measures between the intervention and control group. No adverse events were reported in both groups. <h3>Conclusions</h3> A rehabilitative exercise program by peer volunteers is feasible and safe after TKA in addition to standard physiotherapy, and is associated with improved knee flexion range-of-motion on discharge. <h3>Author(s) Disclosures</h3> None to declare.