Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study

被引:5
作者
Graber, Jeremy [1 ,2 ]
Churchill, Laura [2 ]
Struessel, Tamara [2 ]
O'Malley, Shane [3 ]
Bade, Michael [1 ,2 ]
Stevens-Lapsley, Jennifer [1 ,2 ]
机构
[1] VA Eastern Colorado Hlth Care Syst, VA Eastern Colorado Geriatr Res Educ & Clin Ctr G, Aurora, CO USA
[2] Univ Colorado, Dept Phys Med & Rehabil, Phys Therapy Program, Aurora, CO USA
[3] VA Eastern Colorado Hlth Care Syst, Phys Med & Rehabil Serv, Aurora, CO USA
关键词
Delphi study; health care delivery; health care utilization; patient preference; rehabilitation; total knee arthroplasty; value-based health care; SHARED DECISION-MAKING; TOTAL HIP; CARE; OUTCOMES; SURGERY; QUALITY;
D O I
10.2519/jospt.2023.11840
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
center dot OBJECTIVE: There is no consensus for how to use rehabilitation visits after total knee arthroplasty (TKA). We sought to develop expert recommendations for outpatient rehabilitation visit usage after TKA. center dot DESIGN: Delphi study. center dot METHODS: First, we developed a broad list of preliminary visit usage recommendations, which were specific to patients' recovery status (ie, slow, typical, or fast recovery) and time since surgery. We then invited 49 TKA experts to participate on a Delphi panel. During round 1, we surveyed panelists regarding their level of agreement with each preliminary recommendation. We conducted additional Delphi rounds as needed to build consensus, which we defined using the RAND/ UCLA method. We updated the survey each round based on panelist feedback and responses from the previous round. center dot RESULTS: Thirty panelists agreed to participate, and 29 panelists completed 2 Delphi rounds. The panel reached consensus on recommendations related to visit frequency, visit timing, and the use of telerehabilitation. The panel recommended that outpatient rehabilitation should begin within 1 week after surgery at a frequency of 2 times per week for the first postoperative month regardless of recovery status. The panel recommended different visit frequencies depending on the patient's recovery status for postoperative months 2 to 3. The panel agreed that telerehabilitation can be recommended for most patients after TKA, but not for patients recovering slowly. center dot CONCLUSION: We used the Delphi process to develop expert recommendations for the use of outpatient rehabilitation visits after TKA. We envision these recommendations could help patients decide how to use visits based on their own preferences.
引用
收藏
页码:566 / 574
页数:9
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