Evidence shows that less really is more when it comes to exercising!

Josephine

NURSE DIRECTOR EMERITUS
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1. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis

There is no up-to-date national guidance to support the facilitation of early recovery using exercise-based rehabilitation. There is clearly a need for rehabilitation strategies that can enhance recovery for the majority of patients and target patients whose post-surgical experience is unfavourable. Westby and Backman highlighted the importance of utilising strategies to empower patients in the rehabilitation process. Provision of tailored rehabilitation programmes may assist in maximising individual outcome after surgery and are worthy of further research.

Conclusion

After recent primary total knee replacement, physiotherapy exercise interventions show short-term improvements in physical function. However this conclusion is based on meta-analysis of a few small studies and no long-term benefits of physiotherapy or exercise intervention were identified.

2. Early high-intensity rehabilitation following total knee arthroplasty does not improve outcomes

OBJECTIVES: To assess the clinical outcomes of a high-intensity rehabilitation program (HI) compared to those of a group of age-matched and sex-matched controls who underwent a lower intensity rehabilitation program.

RESULTS: There were no differences in knee ROM and pain between the HI and control groups at any postoperative time point.


4. Efficiency of immediate postoperative inpatient physical therapy following total knee arthroplasty

Background
The main goal of physical therapy treatment in the clinical stage following total knee arthroplasty is to prepare patients for discharge from the hospital as soon as possible after their operation. Although aggressive rehabilitation is believed to be important, evidence of effects of different exercise programmes following TKA is limited. This led to the question whether the intensity of PT (once versus twice daily) following TKA affects short-term recovery, measured as range of motion.

Methods
A randomised controlled trial compared an exercise regimen of two sessions per day with a similar programme administered once daily. Primary outcome measure was ROM.

Results
At the time of hospital discharge, there was no difference between the experimental and control groups in range of motion.

Conclusion
This study shows that in our setting twice daily PT sessions do not produce different results as daily PT sessions. It may be questioned whether multiple daily therapy sessions are needed as an in-hospital PT regimen in OA total knee patients.
 

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