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CompletedNCT03302832Updated Jan 27, 2020

Effectiveness of Reduced Frequency Physical Therapy in Total Knee Arthroplasty

An interventional study of Physical Therapy and In-home Exercise Equipment in Knee Osteoarthritis, Knee Arthritis and Knee Arthropathy, sponsored by Campbell University, Incorporated. Completed at 1 site in United States. Open to participants aged Up to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-01-27.

Sponsored by Campbell University, Incorporated · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
51
Allocation
Randomized
Ages
Up to 65 Years
Sex
All
01

Study summary

Rehabilitation after Total Knee Arthroplasty surgery involves physical therapy services to address limitations in range of motion, strength, and participation in normal daily activities. This investigation will compare the outcomes from standard physical therapy intervention in comparison to reduced frequency physical therapy sessions supplemented with in-home exercise equipment.

Read the detailed description

Total knee arthroplasty (TKA) is a common surgical procedure for individuals experiencing pain and reduced physical abilities related to knee pain, most commonly osteoarthritis. Common physical impairments associated with post-operative TKA rehabilitation include: reduced knee range of motion (ROM), reduced strength, reduced participation in activities of daily living, and pain. TKA surgery is routinely paired with physical therapy (PT) interventions post-operatively in order to facilitate recovery for patients electing to undergo this intervention. The Total Range Exerciser (T-REX) is a medical device aimed at reducing the need for post-operative physical therapy services while promoting outcomes.

A successful outcome after total knee arthroplasty requires symptom relief and restoration of physical function. Measurement of pain and function can be achieved through patient-reported outcomes measures and objective functional testing. The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a patient-reported outcomes measure intended to capture the individual patient's perception of progress throughout the rehabilitative process. Objective measurements of physical function are necessary to quantify the magnitude of physical impairment associated with the patient's perceived status. Physical function can be measured through standardized assessment of knee ROM, strength, and ambulation. The purpose of this study is to evaluate the effectiveness of standard physical therapy compared to reduced frequency physical therapy supplemented with the (T-REX) after in total knee arthroplasty in subjective and objective measurements of physical function.

02

Conditions studied

  • Knee Osteoarthritis
  • Knee Arthritis
  • Knee Arthropathy

Keywords

  • Total Knee Arthroplasty
  • Total Knee Replacement
03

Who can participate

Ages eligible
Up to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Individual is to undergo TKA by a licensed physician at Participating hospital group
  • Participating primary health insurance provider
  • Patient is \< 64.5 years of age
  • Willingness to participate in study protocol

Exclusion criteria

Exclusion Criteria:

  • Previous or current history of cancer
  • High risk for cardiovascular disease as determined by the American College of Sports Medicine
  • Individuals with documented mental, psychiatric, or emotional disabilities
  • Inability to read and write in English
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
51 participants (actual)

Study arms

  • Active comparator
    Standard Care Physical Therapy

    The participants randomized to the Standard Care Physical Therapy group will begin outpatient physical therapy services after discharge from inpatient care, on day 4 or 5 post-Total Knee Arthroplasty. The frequency of sessions will be 2-3 x per week for the initial 2 weeks, followed by 2 x per week until the culmination of physical therapy. The frequency and duration of sessions will be determined by the treating physical therapist based upon the clinical needs and progress of the specific participant.

    Other: Physical Therapy

  • Experimental
    Physical Therapy and in-Home Equipment

    The participants randomized to the experimental group will begin outpatient physical therapy services after discharge from inpatient care, on day 4 or 5 post-Total Knee Arthroplasty. The frequency of physical therapy sessions will be 1 x per week throughout the duration of the study period. In addition, this group will utilize in-home exercise equipment daily.

    Other: Physical Therapy · Other: In-home Exercise Equipment

Interventions

  • OtherPhysical Therapy

    Physical therapy includes both the in-person and home-based interventions prescribed for each individual participant in order to maximize overall patient outcomes including: ambulation, range of motion, strength, functional activities, pain, swelling, balance, patient safety, and other items within the scope of physical therapy practice.

  • OtherIn-home Exercise Equipment

    The in-home exercise component of the study will supplement physical therapy services. This exercise equipment will be utilized daily for up to 90 minutes as guided by the healthcare team

    Also known as: Total Range Exerciser Arc, T-REX Arc

05

What researchers measure

Primary outcomes

  1. Change in Knee Injury and Osteoarthritis Outcome Score (KOOS)

    The KOOS measurement is a patient-reported questionnaire that contains 42 questions covering 5 categories (pain, symptoms, activities of daily living, sports and recreation, and quality of life

    Time frame: Pre-surgery to 3 months post-surgery

Secondary outcomes

  1. Self-reported home exercise compliance/adherence

    Basic questions regarding the percent compliance with home exercises, amount of exercise time per week, and amount of days the participant performed exercise each week.

    Time frame: 1 month post-surgery, 2 months post-surgery, 3 months post-surgery

  2. Change in Knee Active Range of Motion (AROM)

    Measurement of the range of motion that the participant can perform (in degrees) when maximally bending and straightening the knee.

    Time frame: Pre-surgery to 3 months post-surgery

  3. Change in Knee Passive Range of Motion (PROM)

    Measurement of the range of motion (in degrees) that the participant's knee can maximally bend and straighten as a result of a manually applied movement.

    Time frame: Pre-surgery to 3 months post-surgery

  4. Change in Timed Up-and-Go Test (TUG)

    The TUG is a physical performance test that consists of the participant rising from a chair, ambulating 9 meters, turning around, returning to the chair and sitting. It is recorded in seconds.

    Time frame: Pre-surgery to 3 months post-surgery

  5. Change in 6-minute Walk Test (6MWT)

    The 6MWT is an assessment of longer duration ambulation and cardiorespiratory endurance. The test measurement is the total amount of distance that the participant ambulates within a 6-minute period.

    Time frame: Pre-surgery to 3 months post-surgery

  6. Change in 30 second Chair Stand Test (30s-CST)

    The 30s-CST is a test of strength, endurance and functional balance. The maximum number of sit to stand repetitions performed over a 30 second period represents the score for this test. Pre-test positioning includes placement of a 44 cm (17 inch) chair, measured from floor to seat surface, against a wall to inhibit movement of the chair during the test.

    Time frame: Pre-surgery to 3 months post-surgery

06

Study locations

1 site
  • EmergeOrtho
    Durham, North Carolina 27704, United States
07

References and documents

Individual participant data

Plan to share: No — No data is intended to be shared with other researchers

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03302832
Lead sponsor
Campbell University, Incorporated
Responsible party
Bradley Myers (Assistant Professor, Campbell University, Incorporated) — Principal investigator
First posted
Oct 5, 2017
Start date
Oct 1, 2017
Primary completion
Oct 1, 2019
Completion
Oct 1, 2019
Last update
Jan 27, 2020

Study contacts

Bradley Myers, PT, DPT, DSc
principal investigator · Assistant Professor

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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