Delaying Knee Surgery has a Detrimental Impact on Health, a New Study Finds
Patients using the VERA system participated in PT an average of 5.9 days per week, compared with 3.3 days in the traditional PT group. Eighty-eight percent of patients in the virtual PT group said they completed all assigned exercises, compared with 65 percent with traditional PT.
After 12 weeks of rehabilitation, knee function, walking speed, and other functional outcomes were similar with virtual and traditional PT. Patients in the virtual PT group reported less difficulty with knee function during sports and recreational activities.
There was no difference in physician, urgent care, and emergency room visits, but patients in the virtual PT group had fewer hospital readmissions. Safety outcomes were also similar between groups. The risk of falls was somewhat higher for patients assigned to virtual PT.
Postoperative PT is important for helping patients to regain physical function following TKA. But PT care can be challenging to access, with barriers including cost and a shortage of physical therapists. Virtual or telerehabilitation programs such as VERA might help to increase home-based access to PT for patients undergoing TKA.
The new study finds substantially lower costs in the three months after TKA for patients assigned to virtual PT, compared with traditional PT. Effectiveness and safety are similar between groups. Some outcomes might be even better with virtual PT (ie, knee function during sports/activities and rehospitalization risk), although the risk of falls may be higher.
These findings have important implications for patients, health systems, and payers and suggest that virtual PT with a telehealth therapist for remote clinical monitoring and guidance should be considered for patients after TKA." Janet Prvu Bettger, ScD, Duke University, Durham, N.C., and colleagues
Although further study to guide implementation and uptake is needed, the authors believe that virtual PT systems have the potential to improve access while lowering costs of PT for patients undergoing TKA. Source:
Wolters Kluwer Journal reference:
Bettger, P., et al. (2020) Effects of Virtual Exercise Rehabilitation In-Home Therapy Compared with Traditional Care After Total Knee Arthroplasty. The Journal of Bone and Joint Surgery . doi.org/10.2106/JBJS.19.00695 .
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