TOTAL DİZ PROTEZİ CERRAHİSİ SONRASI TELE-REHABİLİTASYON PROGRAMININ ETKİLERİNİN ARAŞTIRILMASI: RANDOMİZE KONTROLLÜ ÇALIŞMA

Yıl 2024, , 236 - 245, 27.08.2024

Neslihan Fırat , Nilgün Bek , Aşkın Deniz Kaya , Murat Bozkurt

https://doi.org/10.21653/tjpr.1318066

Öz

Amaç: Çalışmamızın amacı; total diz protezi (TDP) cerrahisi sonrası tele-rehabilitasyon programı (TR-FTR) ve yüz yüze fizik tedavi ve rehabilitasyon programı (YY-FTR) alan bireylerde uygulanan protokolleri fiziksel ve fonksiyonel parametreler açısından karşılaştırmak ve tele-rehabilitasyon (TR) hizmeti alanların bu hizmetten memnuniyetlerini değerlendirmekti.
Yöntem: TDP cerrahisi geçirmiş 37 birey randomize olarak TR-FTR ve YY-FTR grubu olacak şekilde ikiye ayrıldı. Çalışmaya dahil olan bireylerin diz eklem hareket açıklığı (D-EHA) universal gonyometre ile; fiziksel performansları “Zamanlı Kalk ve Yürü Testi”, “6 Dakika Yürüme Testi”, “5 Tekrarlı Otur-Kalk Testi” ile; fonksiyonellikleri “Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi” (WOMAC) ile, egzersiz programına uyumu ise “Egzersize Uyum Derecelendirme Ölçeği” ile değerlendirildi. TR-FTR’ye katılanlara “Tele-Sağlık Kullanılabilirlik Anketi” ve “Tele-Tıp Memnuniyet Anketi” uygulandı. Her iki gruba uygulanan testler ve anketler yüz yüze olarak yapıldı.
Sonuçlar: Her iki grubun da tedavi sonrası D-EHA aktif ve pasif ölçümlerinde (pasif diz ekstansiyonu hariç) (p<0,05), fiziksel performans değerlendirmelerinde ve fonksiyonelliklerinde anlamlı gelişmeler bulundu (p<0,05). Bu parametrelerdeki değişimlerin gruplar arasında benzer olduğu ve egzersize uyum açısından da anlamlı fark olmadığı bulundu (p>0,05).
Tartışma: TDP cerrahisi sonrası TR-FTR ve YY-FTR bireylerin fiziksel ve fonksiyonel parametrelerinin geliştirilmesi açısından etkilidir. TR hizmetlerinin ortopedik problemi olan bireylerde YY-FTR’ye benzer sonuçlar vermesinden dolayı kullanılmasını önermekteyiz.

Anahtar Kelimeler

Diz Protezi, Memnuniyet, Osteoartrit, Telerehabilitasyon

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

YOK

INVESTIGATION OF THE EFFECTS OF THE TELE-REHABILITATION PROGRAM AFTER TOTAL KNEE PROSTHESIS: A RANDOMIZED CONTROLLED TRIAL

Öz

Purpose: This study aimed to compare the protocols applied in individuals who received tele-rehabilitation (TR-PTR) and face-to-face physical therapy and rehabilitation (FF-PTR) program after total knee prosthesis (TKP) surgery in terms of physical and functional parameters and to evaluate the satisfaction of tele-rehabilitation (TR) service recipients.
Methods: Thirty-seven individuals who underwent TKP surgery were randomly divided into two groups: TR-PTR and FF-PTR program. The knee joint range of motion (K-ROM) of the individuals included in the study was determined by universal goniometer; physical performances were evaluated with the “Timed Get-Up-and-Walk Test”, “6-Minute Walk Test”, and “5 Times Sit-to-Stand Test”, their functionality was evaluated with the “Western Ontario and McMaster Universities Osteoarthritis Index” (WOMAC), and their compliance with the exercise program was evaluated with the “Exercise Adherence Rating Scale”. “Tele-Health Usability Questionnaire” and “Tele-Medicine Satisfaction Questionnaire” were administered to the TR-PTR group. Applications in both groups were carried out face to face.
Results: Significant improvements were found in active and passive measurements of K-ROM (except passive knee extension) (p<0.05), physical performance evaluations and functionality of both groups after treatment (p<0.05). It was found that the changes in these parameters were similar between the groups and there was no significant difference in terms of exercise adherence (p>0.05).
Conclusion: TR-PTR and FF-PTR programs are effective in improving the physical and functional parameters of individuals after TKA surgery. We recommend the use of TR services in individuals with orthopedic problems because it gives similar results to the FF-FTR program.

Anahtar Kelimeler

Knee Prosthesis, Satisfaction, Osteoarthritis, Telerehabilitation

Proje Numarası

YOK

Kaynakça

• Li Jw, Ma Ys, Xiao Lk. Postoperative pain management in total knee arthroplasty. Orthop Surg. 2019;11(5):755-61.
• Gademan MG, Hofstede SN, Vliet Vlieland TP, Nelissen RG, Marang-van de Mheen PJ. Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview. BMC Musculoskelet Disord. 2016;17(1):1-11.
• Masaracchio M, Hanney WJ, Liu X, Kolber M, Kirker K. Timing of rehabilitation on length of stay and cost in patients with hip or knee joint arthroplasty: a systematic review with meta-analysis. PLoS One. 2017;12(6):e0178295.
• Jette DU, Hunter SJ, Burkett L, Langham B, Logerstedt DS, Piuzzi NS, et al. Physical therapist management of total knee arthroplasty. Phys Ther. 2020;100(9):1603-31.
• Hadamus A, Białoszewski D, Błażkiewicz M, Kowalska AJ, Urbaniak E, Wydra KT, et al. Assessment of the effectiveness of rehabilitation after total knee replacement surgery using sample entropy and classical measures of body balance. Entropy. 2021;23(2):164.
• Alrawashdeh W, Eschweiler J, Migliorini F, El Mansy Y, Tingart M, Björn R. Effectiveness of total knee arthroplasty rehabilitation programmes: a systematic review and meta-analysis. J Rehabil Med. 2021;53(6).
• Müller M, Toussaint R, Kohlmann T. Total hip and knee arthroplasty: results of outpatient orthopedic rehabilitation. Orthopade. 2015;44(3):203-11.
• Jiang S, Xiang J, Gao X, Guo K, Liu B. The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis. J Telemed Telecare. 2018;24(4):257-62.
• Rosen K, Patel M, Lawrence C, Mooney B. Delivering telerehabilitation to COVID-19 inpatients: a retrospective chart review suggests it is a viable option. HSS J. 2020;16(1_suppl):64-70.
• Adams JL, Myers TL, Waddell EM, Spear KL, Schneider RB. Telemedicine: a valuable tool in neurodegenerative diseases. Curr Geriatr Rep. 2020;9(2):72-81.
• Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy P, Corriveau H, et al. In-home telerehabilitation compared with face-to-face rehabilitation after total knee arthroplasty: a noninferiority randomized controlled trial. JBJS. 2015;97(14):1129-41.
• Bini S, Mahajan J. Clinical outcomes of remote asynchronous telerehabilitation are equivalent to traditional therapy following total knee arthroplasty: a randomized control study. J Telemed Telecare. 2017;23(2):239-47.
• Teo I, Thompson J, Neo Y, Lundie S, Munnoch D. Lower limb dominance and volume in healthy individuals. Lymphology. 2017;50(4):197-202.
• Alghadir A, Anwer S, Brismée J-M. The reliability and minimal detectable change of Timed Up and Go test in individuals with grade 1–3 knee osteoarthritis. BMC Musculoskelet Disord. 2015;16:1-7.
• Yuksel E, Kalkan S, Cekmece S, Unver B, Karatosun V. Assessing minimal detectable changes and test-retest reliability of the timed up and go test and the 2-minute walk test in patients with total knee arthroplasty. J Arthroplasty. 2017;32(2):426-30.
• Albalwi AA, Alharbi AA. Optimal procedure and characteristics in using five times sit to stand test among older adults: A systematic review. Medicine. 2023;102(26).
• Tiwari D, Talley SA, Alsalaheen B, Goldberg A. Strength of association between the Five-Times-Sit-to-Stand Test and balance, knee extensor strength and lower limb power in community-dwelling older adults. Int J Ther Rehabil. 2019;26(3):1-10.
• King LK, Hawker GA, Stanaitis I, Woodhouse L, Jones CA, Waugh EJ. Minimal clinically important difference for improvement in six-minute walk test in persons with knee osteoarthritis after total knee arthroplasty. BMC Musculoskelet Disord. 2022;23(1):307.
• Tüzün E, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005;13(1):28-33.
• Newman-Beinart NA, Norton S, Dowling D, Gavriloff D, Vari C, Weinman JA, et al. The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise: the Exercise Adherence Rating Scale (EARS). Physiotherapy. 2017;103(2):180-5.
• Özden F, Özkeskin M, Sarı Z, Ekmekçi Ö, Yüceyar N. The reliability and validity of the Turkish version of the telehealth usability questionnaire and the telemedicine satisfaction questionnaire in patients with multiple sclerosis. Neurol Sci Neurophysiol. 2021;38:173-9.
• Kuether J, Moore A, Kahan J, Martucci J, Messina T, Perreault R, et al. Telerehabilitation for Total Hip and Knee Arthroplasty Patients: A Pilot Series with High Patient Satisfaction. HSS J. 2019;15(3):221-5.
• Sveikata T, Porvaneckas N, Kanopa P, Molyte A, Klimas D, Uvarovas V, et al. Age, sex, body mass index, education, and social support influence functional results after total knee arthroplasty. Geriatr Orthop Surg Rehabil. 2017;8(2):71-7.
• Clement ND, Deehan DJ. Overweight and obese patients require total hip and total knee arthroplasty at a younger age. J Orthop Res. 2020;38(2):348-55.
• Giesinger K, Giesinger J, Hamilton D, Rechsteiner J, Ladurner A. Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty. BMC Musculoskelet Disord. 2021;22(1):1-9.
• Villafañe JH, Isgrò M, Borsatti M, Berjano P, Pirali C, Negrini S. Effects of action observation treatment in recovery after total knee replacement: a prospective clinical trial. Clin Rehab. 2017;31(3):361-8.
• Russell TG, Buttrum P, Wootton R, Jull GA. Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. JBJS. 2011;93(2):113-20.
• Imada A, Nelms N, Halsey D, Blankstein M. Physical therapists collect different outcome measures after total joint arthroplasty as compared to most orthopaedic surgeons: a New England study. Arthroplast Today. 2018;4(1):113-7.
• Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech. 2008;23(3):320-8.
• Kramer JF, Speechley M, Bourne R, Rorabeck C, Vaz M. Comparison of clinic-and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res. 2003;410:225-34.
• Hsiao Y-H, Chien S-H, Tu H-P, Fu JC-M, Tsai S-T, Chen Y-S, et al. Early post-operative intervention of whole-body vibration in patients after total knee arthroplasty: a pilot study. J Cli Med. 2019;8(11):1902.
• Medina-Mirapeix F, Vivo-Fernández I, López-Cañizares J, García-Vidal JA, Benítez-Martínez JC, del Baño-Aledo ME. Five times sit-to-stand test in subjects with total knee replacement: Reliability and relationship with functional mobility tests. Gait Posture. 2018;59:258-60.
• Buvik A, Bugge E, Knutsen G, Småbrekke A, Wilsgaard T. Patient reported outcomes with remote orthopaedic consultations by telemedicine: a randomised controlled trial. J Telemed Telecare. 2019;25(8):451-9.