Satisfactory adherence to the Dutch physical therapy guideline for patients with a total knee arthroplasty. A survey study involving 103 specialised physical therapists

• Published in: Musculoskeletal care Vol. 22; no. 2; pp. e1909 - n/a
• Main Authors: Kornuijt, Anke, Weegen, Walter, Agricola, Rintje, Lenssen, Ton
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-06-2024
• Subjects: adherence; Adult; Aerobics; Arthroplasty, Replacement, Knee - rehabilitation; Cross-Sectional Studies; Exercise; Female; guideline; Guideline Adherence - statistics & numerical data; Humans; Joint replacement surgery; Male; Middle Aged; Netherlands; Physical fitness; Physical therapists; Physical Therapists - standards; Physical Therapists - statistics & numerical data; Physical therapy; Physical Therapy Modalities - standards; Physical Therapy Modalities - statistics & numerical data; Practice Guidelines as Topic; rehabilitation; survey; Surveys and Questionnaires; total knee arthroplasty; Netherlands; total knee arthroplasty; survey; rehabilitation; physical therapy; adherence; guideline
• ISSN: 1478-2189; 1557-0681
• DOI: 10.1002/msc.1909

Objective
To explore and gain more insight into the usual preoperative and postoperative physical therapy (PT) treatment of patients with a total knee arthroplasty (TKA) among Dutch physical therapists experienced with TKA rehabilitation. Secondly, to evaluate physical therapists' adherence to guideline recommendations for postoperative rehabilitation.
Methods
In this cross‐sectional study, physical therapists working in primary care within a designated Dutch hospital's catchment area were surveyed online. The survey queried PT treatment approaches before surgery, during hospitalisation, and after surgery. All data were analysed descriptively. When both education and all recommended exercise modalities were used postoperatively, therapists were considered fully adherent with the Dutch clinical practice guideline.
Results
One hundred and three therapists participated, representing a response rate of 58%. Postoperative PT treatment was applied by all therapists, of which 65 (63.1%) were fully adherent to the guideline. Partial adherence was mainly due to not using the aerobic exercise modality. Furthermore, beyond the modalities recommended in the guideline, a range of PT interventions were used. Preoperative treatment was applied by 73 therapists (70.9%). These 73 indicated that only a median of 20% (IQR 10%–40%) of their patients received preoperative PT.
Conclusions
This study revealed satisfactory adherence to guideline recommendations on postoperative management of patients with a TKA among experienced physical therapists. Aerobic exercises were utilised less often or with inappropriate intensity. Correct adherence to guideline recommendations on aerobic exercise training can result in more physically active individuals and important general health benefits.