Short-Term Effect of Peer Volunteers in Providing Inpatient Rehabilitative Exercises for Patients After Total Knee Arthroplasty

Abstract

ObjectiveTo investigate the short-term outcomes at discharge of patients who receive additional postoperative rehabilitative exercises by peer volunteers after total knee arthroplasty (TKA). DesignRetrospective cohort study. SettingTertiary teaching hospital. ParticipantsA total of 476 adult patients who had undergone a primary elective unilateral TKA (N=467). InterventionsAn intervention group received a standardized postoperative rehabilitative exercise protocol taught and supervised by peer volunteers in additional to standard physiotherapy (n=309) compared with a control group receiving standard physiotherapy alone (n=167). Main Outcome MeasuresDischarge outcomes were the pain score using the Numeric Rating Scale pain score, passive knee flexion and extension range of motion (ROM), length of hospitalization, ability to perform an unassisted straight leg raise of the operated leg, ambulation distance, ability in independent walking, walking aids required, discharge destination, and adverse events. ResultsOn multivariate analysis, patients in the intervention group had an increased discharge passive knee flexion ROM of 7.89 degrees (95% confidence interval, 5.47-10.33; P<.001). There were no significant differences for the other outcome measures between the intervention and control group. ConclusionsA rehabilitative exercise program by peer volunteers is feasible and safe after TKA in addition to standard physiotherapy and is associated with improved knee flexion ROM on discharge.