Comparison of recovery of mobility and self-efficacy after total knee arthroplasty based on two different protocols: A prospective cohort study.
Masashi TaniguchiYoshinori HiyamaTsukasa KamitaniMitsuhiko KuboTaku KawasakiOsamu WadaKiyonori MizunoYoshitaka MatsusuePublished in: Modern rheumatology (2019)
Objectives: The purpose of this study was to compare the recovery of mobility and self-efficacy following total knee arthroplasty (TKA) between the 5-day and the 28-day protocol. This prospective cohort study was carried out at two hospitals.Methods: In total, 104 patients who underwent TKA were enrolled. The primary outcomes measured were Life Space Assessment (LSA) for mobility and modified-Gait Efficacy Scale (mGES) for self-efficacy. Knee Society Score (KSS) was used to estimate the functional outcomes. These assessments were performed in all patients preoperatively, and at 1, 3, and 6 months postoperatively. After calculating the propensity score using covariates, such as patient characteristics, LSA, mGES, and KSS at baseline, propensity score-adjusted multivariate analysis of covariance (MANCOVA) was performed.Results: MANCOVA revealed significant differences in LSA and mGES, but not in KSS, between the two protocols. The adjusted means of LSA and mGES in the 28-day protocol were significantly greater than those in the 5-day protocol in all the postoperative assessments.Conclusion: Mobility and self-efficacy were greater following the 28-day protocol than the 5-day protocol after TKA. Our findings suggest that the modified treatment procedure for improving mobility and self-efficacy is necessary to introduce the early discharge protocol in Japan.
Keyphrases
- total knee arthroplasty
- randomized controlled trial
- end stage renal disease
- ejection fraction
- newly diagnosed
- total hip
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- patients undergoing
- type diabetes
- adipose tissue
- skeletal muscle
- metabolic syndrome
- minimally invasive
- single cell
- chronic pain
- patient reported
- data analysis