Telerehab Matches Traditional Rehab for Patient Outcomes

Knee-replacement patients who undergo  telerehabilitation–an Internet-based postoperative rehabilitation program that can be conducted from home–experience the same – sometimes better -- results as those who undergo traditional rehabilitation, according to a new study published in the Journal of Bone and Joint Surgery.

The randomized controlled trial found that theoutcomes achieved via telerehabilitation at six weeks followingtotal knee arthroplasty were comparable with those after conventionalrehabilitation.

The researchers enrolled 65 patients who underwent TKA and randomized them to receive six weeks of either traditional outpatient rehab services or Internet-based outpatient rehab.

Patients in the telerehab group performed their therapy in a hospital room designed to replicate a typical home environment. Therapy sessions consisted of self-applied techniques under the guidance of the remote therapist; it also involved education in the postoperative management of the affected knee. After six weeks, the Internet-rehab group

• achieved outcomes comparable to those of the conventional rehabilitation group, and fared better in some results, including a reduction in joint stiffness.

• showed significant improvement in specific functional areas, designed to mimic their actual daily activities.

• reported a higher level of contentment with their program than those in the traditional program.
• completed an average of 2.2 exercise sessions per day compared with 1.7 exercise sessions per day in the group that received traditional rehabilitation.

When designing the study, the authors hypothesized that the outcomes via the telerehabilitation intervention would be comparable to traditional face-to-face therapy, study author Trevor Russell, PhD, School of Health and Rehabilitation Science, University of Queensland, Brisbane, Australia, explains to HealthLeaders Media.

But the findings exceeded the expectation. “The thing that surprised us was that the online therapy actually produced better results on some outcome measures such as knee stiffness. We were also surprised by how well the patients accepted the technology and adapted to the alternate service delivery model.”

Telerehabilitation is becoming a popular alternative for patients who live in remote areas and who have no access to traditional rehabilitation centers. It can improve access to services and control medical costs, according to the authors.

But other issues come in to play, too, Russell says: The question of whether certain conditions and patients are more amenable to telerehabilitation intervention than traditional therapy is an ongoing topic of research at the Telerehabilitation Research Unit at the University of Queensland.

“Obviously not every patient and condition type will be able to be addressed remotely. However, this study provides evidence that traditional service delivery methods can be modified and adapted to the Internet environment and produce sound clinical outcomes,” Russell explains to HealthLeaders Media. “Through the application of patient- and condition-specific exercise, self-administered manual therapy techniques under the video guidance of a therapist, self-management strategies and comprehensive education, we are confident that a large number of patients could be managed remotely through the use of this technology.”

Rehab following total knee arthroplasty is essential for regaining optimum function of the knee. According to the American Academy of Orthopaedic Surgeons, about 581,000 TKAs are performed each year in the United States, and experts say that number is expected to grow significantly as the population ages.