scholarly journals After Partial Knee Replacement, Patients Can Kneel, But They Need to Be Taught to Do So: A Single-Blind Randomized Controlled Trial

2008 ◽  
Vol 88 (9) ◽  
pp. 1012-1021 ◽  
Author(s):  
Cathy Jenkins ◽  
Karen L Barker ◽  
Hemant Pandit ◽  
Christopher AF Dodd ◽  
David W Murray
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Knee Replacement ◽  
Controlled Trial ◽  
Intervention Group ◽  
Oxford Knee Score ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Partial Knee Replacement ◽  
Single Blind

Background and Purpose Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient-reported kneeling ability following partial knee replacement (PKR). Subjects Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated. Methods This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7 of the Oxford Knee Score. Other factors associated with kneeling ability were recorded. These factors were scar position, numbness, range of flexion, involvement of other joints, and pain. Statistical analysis included nonparametric tests and binary logistic regression. Results A significant improvement in patient-reported kneeling ability was found at 1 year postoperatively in those participants who received the kneeling intervention. Group allocation was the only factor determining an improvement in patient-reported kneeling ability at 1 year postoperatively. Discussion and Conclusion The single factor that predicted patient-reported kneeling ability at 1 year postoperatively was the physical therapy kneeling intervention given at 6 weeks after PKR. The results of this study suggest that advice and instruction in kneeling should form part of a postoperative rehabilitation program after PKR. The results can be applied only to patients following PKR.

scholarly journals Effects of Chinese medicine on patients with acute exacerbations of COPD: study protocol for a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hailong Zhang ◽  
Jiansheng Li ◽  
Xueqing Yu ◽  
Suyun Li ◽  
Haifeng Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Chinese Medicine ◽  
Short Form ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Double Blind ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Acute Exacerbations

Abstract Background The incidence, mortality, and prevalence of chronic obstructive pulmonary disease (COPD) are high in China. Acute exacerbations of COPD (AECOPD) are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. AECOPD have been effectively treated with Chinese medicine for a long time. The aim of this proposed trial is to assess the therapeutic effect of Chinese medicine (CM) on AECOPD. Methods/design This proposed study is a multicenter, double-blind, parallel-group randomized controlled trial (RCT). We will randomly assign 378 participants with AECOPD into two groups in a 1:1 ratio. On the basis of health education and conventional treatment, the intervention group will be treated with CM, and the control group is given CM placebo according to CM syndrome. Patients are randomized to either receive CM or placebo, 10 g/packet, twice daily. The double-blind treatment lasts for 2 weeks and is followed up for 4 weeks. The main outcome is the COPD Assessment Test; secondary outcomes are treatment failure rate, treatment success rate, length of hospital stay, AECOPD readmission rate, intubation rate, mortality, dyspnea, the 36-item Short Form Health Survey, and the COPD patient-reported outcome scale. We will document these outcomes faithfully at the beginning of the study, 2 weeks after treatment, and at the 4 weeks follow-up. Discussion This high-quality RCT with strict methodology and few design deficits will help to prove the effectiveness of CM for AECOPD. We hope this trial will provide useful evidence for developing a therapeutic schedule with CM for patients with AECOPD. Trial registration ClinicalTrials.gov, NCT03428412. Registered on 4 February 2018.

scholarly journals A Physical Therapist–Administered Physical Activity Intervention After Total Knee Replacement: Protocol for a Randomized Controlled Trial

2018 ◽  
Vol 98 (7) ◽  
pp. 578-584 ◽  
Author(s):  
Meredith B Christiansen ◽  
Louise M Thoma ◽  
Hiral Master ◽  
Laura A Schmitt ◽  
Ryan Pohlig ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Physical Therapist ◽  
Controlled Trial ◽  
Definitive Treatment ◽  
Randomized Controlled ◽  
Total Knee

AbstractBackgroundThe definitive treatment for knee osteoarthritis is a total knee replacement, which results in a clinically meaningful improvement in pain and physical function. However, evidence suggests that physical activity (PA) remains unchanged after total knee replacement (TKR).ObjectiveThe objective of this study is to investigate the efficacy, fidelity, and safety of a physical therapist–administered PA intervention for people after TKR.DesignThis study will be a randomized controlled trial.SettingThe setting is an outpatient physical therapy clinic.ParticipantsThe participants are 125 individuals who are over the age of 45 and are seeking outpatient physical therapy following a unilateral TKR.InterventionIn addition to standardized physical therapy after TKR, the intervention group will receive, during physical therapy, a weekly PA intervention that includes a wearable activity tracking device, individualized step goals, and face-to-face feedback provided by a physical therapist.ControlThe control group will receive standardized physical therapy alone after TKR.MeasurementsThe efficacy of the intervention will be measured as minutes per week spent in moderate to vigorous PA at enrollment, at discharge, and at 6 months and 12 months after discharge from physical therapy. The fidelity and safety of the intervention will be assessed throughout the study.LimitationsParticipants will not be masked, PA data will be collected after randomization, and the trial will be conducted at a single site.ConclusionsThe goal of this randomized controlled trial is to increase PA after TKR. A protocol for investigating the efficacy, fidelity, and safety of a physical therapist–administered PA intervention for people after TKR is presented. The findings will be used to support a large multisite clinical trial to test the effectiveness, implementation, and cost of this intervention.

scholarly journals Effect of Physiotherapy on the Promotion of Bone Mineralization in Preterm Infants. A Randomized Controlled Trial.

2021 ◽  
Author(s):  
Galaad Torró-Ferrero ◽  
Francisco Javier Fernández-Rego ◽  
Juan Jose Agüera-Arenas ◽  
Antonia Gómez-Conesa
Keyword(s):  
Randomized Controlled Trial ◽  
Physical Therapy ◽  
Preterm Infants ◽  
Speed Of Sound ◽  
Repeated Measures ◽  
Bone Mineralization ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled

Abstract BackgroundPreterm infants have a low level of bone mineralization compared to those born at term, since 80% of calcium incorporation occurs at the end of pregnancy. The purpose of the present study was to investigate the effect of reflex locomotion therapy on bone mineralization and growth in preterm infants and compare its effect against other physiotherapy procedures.MethodsA randomized controlled trial carried out over four years from February 2016 to July 2020 was conducted. 52 preterm infants born at 29-34 weeks with hemodynamical stability, full enteral nutrition, and without any metabolic, congenital, genetic, neurological or respiratory disorders, were evaluated for inclusion; 6 were discarded due to exclusion criteria; finally 46 were randomized to three groups but only 76.08% completed the study: One group received reflex locomotion therapy (EGrlt); other group received passive movements with gentle compression (EGpmc); and control group received massage (CG). All treatments were carried out at the neonatal unit lasting one month. The main outcome measure was the bone mineralization measured with Tibial Speed of Sound (Tibial-SOS). A repeated measures ANOVA was used to compare the results of Tibial-SOS, and anthropometric measurements. All the personnel who carried out the measurement tests were blinded to which intervention group the patients belonged. Likewise, participants, family, and data analysts were also blinded. The physiotherapist who carried out the treatments was blinded against the objectives of the study.ResultsInfants were randomized into EGrlt (n=17), EGpmc (n=14), and CG (n=15). All groups were similar in terms of gestational age (31.8±1.18) and birth weight (1583.41±311.9), age (33.5±1.24) and Tibial Speed of Sound (1604.7±27.9), at the beginning of the intervention. At the end of the study, significant differences were found among groups in Tibial Speed of Sound [F(4,86)=2.77, P=0.049, ηp2=0.114] in benefit of EGrlt.ConclusionsThe reflex locomotion therapy has been effective in the improvement of Tibial Speed of Sound, and has been more effective than other physical therapy modalities; therefore it could be considered as one of the most effective physiotherapeutic modalities for the prevention and treatment of osteopenia of prematurity.Trial registrationClinicalTrials.gov Identifier: NCT04356807. Registered 22/04/2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04356807?cond=Physical+Therapy+to+Prevent+Osteopenia+in+Preterm+Infants&draw=2&rank=1

scholarly journals Efficacy of preoperative progressive resistance training in patients undergoing total knee arthroplasty: 12-month follow-up data from a randomized controlled trial

2019 ◽  
Vol 34 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Birgit Skoffer ◽  
Thomas Maribo ◽  
Inger Mechlenburg ◽  
Christian Gaarden Korsgaard ◽  
Kjeld Søballe ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Resistance Training ◽  
Muscle Strength ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Significant Group ◽  
Randomized Controlled ◽  
Patient Reported

Objective: The aim of this study was to investigate the effect of adding four weeks preoperative progressive resistance training (PRT) to four weeks postoperative PRT on patient function, muscle strength, and other outcomes 12 months after total knee arthroplasty (TKA). Design: Twelve-month follow-up data from a previously published randomized controlled trial. Setting: Aarhus University Hospital, Silkeborg Regional Hospital, and Aarhus University. Subjects: A total of 59 patients scheduled for TKA were enrolled in a single-blinded, clinical randomized controlled trial. Interventions: Participants were randomized to preoperative PRT (intervention group) or to a control group who “lived as usual” the last four weeks before TKA. The intervention group completed four weeks preoperative and four weeks postoperative PRT, whereas the control group only completed four weeks postoperative PRT. Main follow-up measures were as follows: the 30-second Chair Stand Test (primary outcome), Timed Up and Go Test, walk tests, knee extensor, and knee flexor muscle strength and patient-reported outcomes. Statistical analyses were performed according to the intention-to-treat principle. Results: No significant group differences were observed for the primary outcome 30-second Chair Stand Test (4.0 repetitions versus 2.4 repetitions, P = 0.067) or for other functional performance outcomes. The intervention group had significantly higher weight-normalized knee extensor muscle strength (0.5 Nm/kg versus 0.2 Nm/kg, P = 0.002) and knee flexor muscle strength (0.3 Nm/kg versus 0.2 Nm/kg, P = 0.042) in the operated leg when compared to the control group. No significant group differences for patient-reported outcomes. Conclusion: The study supports the use of short-term high-intensity resistance training before TKA as it induces a long-lasting effect on muscle strength, while it may have no discernible effect on functional performance.

scholarly journals Improving the Care of Children With Advanced Cancer by Using an Electronic Patient-Reported Feedback Intervention: Results From the PediQUEST Randomized Controlled Trial

2014 ◽  
Vol 32 (11) ◽  
pp. 1119-1126 ◽  
Author(s):  
Joanne Wolfe ◽  
Liliana Orellana ◽  
E. Francis Cook ◽  
Christina Ullrich ◽  
Tammy Kang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Intervention Group ◽  
Symptom Assessment ◽  
Control Group ◽  
Randomized Controlled ◽  
Patient Reported

Purpose This study aimed to determine whether feeding back patient-reported outcomes (PROs) to providers and families of children with advanced cancer improves symptom distress and health-related quality of life (HRQoL). Patients and Methods This study was a parallel, multicentered pilot randomized controlled trial. At most once per week, children age ≥ 2 years old with advanced cancer or their parent completed the computer-based Pediatric Quality of Life and Evaluation of Symptoms Technology (PediQUEST) survey consisting of age- and respondent-adapted versions of the Memorial Symptom Assessment Scale (MSAS), Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL4.0), and an overall Sickness question. In the intervention group (n = 51), oncologists and families received printed reports summarizing PROs; e-mails were sent to oncologists and subspecialists when predetermined scores were exceeded. No feedback was provided in the control group (n = 53). Primary outcomes included linear trends of MSAS, PedsQL4.0 total and subscale scores, and Sickness scores during 20 weeks of follow-up, along with child, parent, and provider satisfaction with PediQUEST feedback. Results Feedback did not significantly affect average MSAS, PedsQL4.0, or Sickness score trends. Post hoc subgroup analyses among children age ≥ 8 years who survived 20 weeks showed that feedback improved PedsQL4.0 emotional (+8.1; 95% CI, 1.8 to 14.4) and Sickness (−8.2; 95% CI, −14.2 to −2.2) scores. PediQUEST reports were valued by children, parents, and providers and contributed at least sometimes to physician initiation of a psychosocial consult (56%). Conclusion Although routine feedback of PROs did not significantly affect the child's symptoms or HRQoL, changes were in expected directions and improvements observed in emotional HRQoL through exploratory analyses were encouraging. Importantly, children, parents, and providers value PRO feedback.

Orthopädie – Teilimplantat im Knie ist kostengünstiger als die totale Variante

2020 ◽  
Vol 25 (04) ◽  
pp. 184-184
Author(s):  
Maddalena Angela Di Lellis
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Knee Replacement ◽  
Controlled Trial ◽  
Medial Compartment ◽  
Medial Compartment Osteoarthritis ◽  
Randomized Controlled ◽  
Partial Knee Replacement

Beard DJ. et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomized controlled trial. Lancet 2019; 394: 746–756 Als Operationsoptionen bei schwerer Knieosteoarthritis stehen entweder ein totaler oder ein partieller Knieersatz zur Wahl. Spezialisten sind sich uneins, welche der beiden operativen Methoden bessere Endresultate bringt. Beard et al. untersuchten die klinische und wirtschaftliche Effektivität beider Methoden und evaluierten auftretende Komplikationen, die Patientenzufriedenheit und die Kostenauswirkungen für Patienten und das Gesundheitswesen.

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