Efficacy and safety of home-based exercises versus individualized supervised outpatient physical therapy programs after total knee arthroplasty: a systematic review and meta-analysis.
Purpose: The aim of the present study was to evaluate the efficacy and safety of non-supervised home-based exercise versus individualized and supervised programs delivered in clinic-based settings for the functional recovery immediately after discharge from a primary TKA.Methods: Medline, Embase, Co...
| Publicado en: | Knee Surgery, Sports Traumatology, Arthroscopy Vol. 25; no. 11; pp. 3340 - 3354 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125728060&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125728060 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09422056 NRT jtl: Knee Surgery, Sports Traumatology, Arthroscopy issn: 09422056 maglogo: N pubinfo: dt: Nov2017 vid: 25 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 125728060 125728060 NLM27401004 10.1007/s00167-016-4231-x NLM27401004 125728060 ppf: 3340 ppct: 14 formats: tig: atl: Efficacy and safety of home-based exercises versus individualized supervised outpatient physical therapy programs after total knee arthroplasty: a systematic review and meta-analysis. aug: au: Florez-García, Mariano García-Pérez, Fernando Curbelo, Rafael Pérez-Porta, Irene Nishishinya, Betina Rosario Lozano, Maria Carmona, Loreto Rosario Lozano, Maria Piedad affil: Rehabilitación , Hospital Universitario Fundación Alcorcón , Madrid Spain sug: ab: Purpose: The aim of the present study was to evaluate the efficacy and safety of non-supervised home-based exercise versus individualized and supervised programs delivered in clinic-based settings for the functional recovery immediately after discharge from a primary TKA.Methods: Medline, Embase, Cochrane, and PEDro databases were screened, from inception to April 2015, in search for randomized clinical trials (RCT) of home-based exercise interventions versus individualized and supervised outpatient physical therapy after primary TKA. Target outcomes were: knee range of motion (ROM), patient-reported pain and function, functional performance, and safety. Risk of bias was assessed with the PEDro scale. After assessing homogeneity, data were combined using random effects meta-analysis and reported as standardized mean differences or mean differences. We set a non-inferiority margin of four points in mean differences.Results: The search and selection process identified 11 RCT of moderate quality and small sample sizes. ROM active extension data suitable for meta-analysis was available from seven studies with 707 patients, and ROM active flexion from nine studies with 983 patients. Most studies showed no difference between groups. Pooled differences were within the non-inferiority margin. Most meta-analyses showed significant statistical heterogeneity.Conclusion: Short-term improvements in physical function and knee ROM do not clearly differ between outpatient physiotherapy and home-based exercise regimes in patients after primary TKA; however, this conclusion is based on a meta-analysis with high heterogeneity.Level Of Evidence: I. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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