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The effectiveness of physiotherapy following discharge from hospital after primary total knee arthroplasty for osteoarthritis

Minns Lowe, Catherine Jane (2009)
Ph.D. thesis, University of Birmingham.

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Abstract

This thesis evaluates and explores the effectiveness of post discharge physiotherapy exercise following total knee arthroplasty (TKA) for osteoarthritis in three ways. 1. A systematic review evaluated the effectiveness of post discharge physiotherapy exercise on function, walking, range of motion, quality of life and muscle strength, for patients following elective primary TKA. Functional physiotherapy exercise interventions following discharge resulted in short term, but not long term, benefit. Effect sizes were small to moderate for function (0.33). Weighted mean differences were small to moderate for motion (2.9) and small for quality of life (1.66). 2. A randomised clinical trial compared the effectiveness of a post discharge physiotherapy intervention in improving patient function versus usual physiotherapy for patients undergoing primary TKA. No significant statistical differences were observed between the two groups for all outcomes. This early trial was underpowered and impacted upon by some important factors which could potentially have masked any treatment trends occurring in the home visit group. 3. Since blinding procedures are often assumed to indicate trial quality, the feasibility of achieving blind outcome assessment in a pragmatic physiotherapy rehabilitation trial involving older people was explored. Reasons for unblinding were explored and successful blinding rates of 81-91% were achieved.

Type of Work:Ph.D. thesis.
Supervisor(s):Sackley, Catherine M. and Barker, Karen L.
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Health and Population Sciences, Department of Primary Care and General Practice
Keywords:physiotherapy, rehabilitation, exercise, arthroplasty
Subjects:R Medicine (General)
RD Surgery
RA Public aspects of medicine
Institution:University of Birmingham
ID Code:451
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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