https://links.lww.com/PHM/B644

Care/rehabilitation"[Mesh] ) OR ((before or before) and (arthroplasty* or hip replacement* or knee replacement* or joint replacement* or total hip or total knee or total joint*) and (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or intervention* or recovery)) OR ((“Preoperative Care”[MESH] OR “Preoperative Period”[MESH]) and (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or "Rehabilitation"[Mesh] or "Physical Therapy Modalities"[ Mesh] or "physical . therapy" or physical therapy*)) OR ("Postoperative Period"[Mesh] and (rehabilitation or rehabilitation or rehabilitation or rehabilitation*)) OR ((post-surgery* or post-surgery) -surgery* or postoperative* or postoperative*) AND (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or "Rehabilitation"[Mesh] or "Physical Therapy Modalities"[Mesh] or "physical therapy" or physiotherapy*)) OR ((after or post) AND (arthroplast* or hip replacement* or knee replacement* or joint replacement* or total hip or total knee or total joint*) AND (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or. OR "Evaluation study" [Publication type] OR "Comparative study" [Publication type] OR ((comparative or intervention) AND study) OR pretest* OR posttest* OR prepost* OR “before and after” OR interrupted time* OR time series * OR intervention* OR ((quasi-experiment* OR quasi-experiment* OR quasi-experimental) and (method or study or trial or design*)) OR “real world” OR “real world” OR "Case-control studies"[ Maas] OR ( case and control) OR "Random Assignment"[Mesh] OR "Clinical Trial" [Publication Type] OR "Double-Blind Method"[Mesh]. 6 (pre-habilitation* or pre-habilitation* OR ((presurg* or preoperative* or pre-operative* or pre-operative* or early or home) and (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or "physical therapy" or replacement* or joint replacement* or total hip or total knee or total joint*) and (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or intervention* or recovery)) OR ((post-surgery* or post-surgery* or post-surgery* or postoperative *) AND (rehabilitation or rehabilitation or rehabilitation or rehabilitation* .. or “physical therapy” or physiotherapy*)) OR ((after or post) AND (arthroplast* or hip replacement* or knee replacement* or joint replacement* or total hip or total knee or total joint*) AND (rehabilitation or rehabilitation or rehabilitation or rehabilitation* or "physical therapy" or . physiotherapy*))).

Guiding Principles and Assumptions

Coding Process and Taxonomy

Determining the target of the specific content component was based on the hierarchical taxonomy and interpretation of how the component was used (eg, description of the parameters used to implement it) and other contextualizing details in the text. The latter was particularly important for specific content components that were able to address multiple goals (eg, 'step down' might address . "strengthening" and "balance-motor learning-agility"). Descriptive content was used to justify coding where discrepancies occurred and provided qualitative text for further consideration of the taxonomy.

Additional General Principles

Where a match was possible, the researcher inserted a code of '1' to indicate its presence in the cell (otherwise '0' to indicate its absence).

Adjunctive Modalities and Intervention Modifiers

Peer (or patient) led interventions are appropriate when accompanied by a professional or other trained individual. The physical location where the intervention was delivered (may overlap slightly with delivery method). Ix_well_specified_note (text = specific text describing why the intervention is/is not well specified) . Intervention i) Objective and ii) Specific Content For each arm assessed in the study, identify:.

Intervention i) Goal and ii) Specific Content For each arm evaluated in the study, determine

Strengthening (binary 0=no; 1=yes)

Calf press (two-legs) 1.5 Clamshells
Core strengthening 1.7 Deadlifts
Gluteal Sets
Heel raises – bilateral 1.10 Heel raises – unilateral
Hip extension in standing 1.20 Hip flexion in sidelying
Hip rotation external (lateral) 1.27 Hip rotation internal (medial)
Knee extension AAROM in sitting or supine (short- or long arc quad) 1.31 Knee extension in sitting or supine (long arc quad)
Knee extension in sitting or supine (short arc quad) 1.33 Knee flexion machine (Hamstring curl) one knee
Knee flexion in sitting or supine 1.37 Knee flexion in standing
Leg Press (one leg) 1.39 Leg Press (two legs)
Lunges to side (lateral lunge) 1.43 Quad sets
Quadruped arm lift 1.45 Quadruped leg lift
Quadruped arm and leg lift 1.47 Single Leg Stance (SLS)
Squats
Squats (one leg)
Standing TKE (terminal knee extension) 1.52 Step down
Step down laterally 1.54 Step lateral
Step up – forward 1.56 Step up – lateral
Straight leg raise (SLR) 1.59 Toe raises
Upper extremity strengthening 1.61 Wall slides
Wall slides - Lateral (hip AB and ADductors)
Aquatics (water aerobics, water walking) 2.2 Bike (Endurance)
Elliptical machine
Jogging in place or overland 2.5 Rowing machine
Step-ups
Stepper (upright or sitting) 2.8 Treadmill walking
Walking Code NO if
Bike (ROM)
Calf stretch with knee straight 3.5 Hamstring stretch in any position
Hip extensor stretch (knee to chest) 3.8 Hip flexor stretch
Iliotibial band (ITB) stretch in any position 3.10 Knee extension AROM
Knee extension PROM in supine 3.12 Knee extension PROM in prone
Knee flexion PROM in sitting or supine
Knee flexion AROM in any position (rectus femoris stretch) 3.16 Knee flexion PROM in prone (rectus femoris stretch)
Balance in kneeling 4.2 Balance in quadruped
Marching 4.7 Quadruped
Stepping multiple directions (grapevine) 4.11 Step down
Step down laterally 4.13 Step lateral (side step)
Car transfers 5.2 Deadlifts
Floor-to-sit or Floor-to-stand 5.4 Gait backwards
Gait downhill
Gait on uneven surfaces 5.7 Gait sideways
Gait training 5.9 Gait uphill
Gait with perturbations 5.11 Gait with resistance
Treadmill gait
Treadmill gait (retro) Code NO if
Home exercise program (HEP) 6.3 Life-style change
Pain management 6.5 Self-management
Wound care management Code NO if
Compression for edema 7.4 E-stim for pain (TENS)
Hold-relax for knee flexion/extension ROM 7.11 Massage for edema control
Massage for scar mobility
Massage/myofascial techniques for soft tissue 7.14 Mobilizations – Tibiofemeral
Mobilizations – Patellar 7.16 Biofeedback devices
Mindfulness, stress/anxiety-reduction interventions
Complementary and alternative therapies (excluding ingested or inhaled treatments)

No mention of specific content components interpreted as seeking to improve the aerobic endurance goal. One or more of the specific content components below and codes interpret this component supports the task-specific training objective (also code YES to the specific content binary 0=no; 1=yes). No mention of specific content components interpreted as seeking to enhance the task-specific training objective.

Effect modifiers

Concerns/queries

We interpreted directness based on the outcome's proximity to the clinical outcome of interest (i.e., intermediate) and whether the outcome was assessed among the individuals of interest versus. This is considered appropriate in the GRADE methods “if a meta-analysis is not feasible. or inappropriate, reviewers may consider the narrowness of the range of CIs or the significant level of p-values in the individual studies in the evidence base”.5. Assessing the strength of a body of evidence in evaluating health care interventions for the Agency for Healthcare Research and Quality's Effective Health Care Program: An update.

PMID: 15205295

F-T Adj: -

Strength
Aerobic
Balance-Motor Learning-Agility [specific exercises not defined]
Task specific training [specific exercises not defined]
Patient education 2 Home exercise program
Task specific training 8 Gait training
Flexibility 1 Ankle pumps
Balance-Motor Learning-Agility 3 Balance on unstable surface
Task specific training 1 Transfers
Strength 5 Clamshells
Strength 41 Lunges
Balance-Motor Learning-Agility 6 Marching
Patient education 1 Activities of daily living
Flexibility
Task specific training 16 Treadmill gait
Flexibility 2 Bike (ROM)
Adjunctive modality 1. Cold
Strength 8 Gluteal Sets
Strength 2. Aerobic
Task specific training 13 Sit-to-stand training
Balance-Motor Learning-Agility 9 Standing weight shifts
Strength 43 Quad sets
Aerobic 2 Bike (Endurance)
Task specific training 4 Gait backwards
Task specific training 15 Stair training
Adjunctive modality 16 Dry needling (acupuncture)
Adjunctive modality 14 Mobilizations – Patellar
Strength 3. Flexibility

Set: O. No data No data No data Late aquatic therapy. operated High INCLUSION: 1) age 18 years or more, 2) primary TKA for osteoarthritis, 3) patient living in one of three municipalities, 4) patient able to travel to the rehabilitation center.

Body Structure and Function Outcomes – Acute rehabilitation for Total Knee Arthroplasty

Symptoms

Pain

In cases where calculated confidence intervals of effect sizes were not statistically significant, but reported p values were, we considered reported p values and still bolded results. Abbreviations: Adj = adjusted, CI = confidence interval, EQ-5D = EuroQol-5D, KOOS = knee injury and osteoarthritis score, MD = mean difference, mo = month, NR = not reported, PMID = PubMed identifier, RoB = risk of bias , SD = standard deviation, VAS = visual analogue scale, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index.

Range of motion

Abbreviations: Adj MD = adjusted mean difference, CI = confidence interval, CPM = continuous passive motion, deg = degree, mo = month, NMES = neuromuscular electrical stimulation, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, ROM = range of motion, SD = standard deviation.

Strength

Abbreviations: CI = confidence interval, N = Newton, Nm = peak torque, NR = not reported, kg = kilogram, PMID = PubMed identifier, RoB = risk of bias, SD = standard deviation, SE = standard error.

Emotional functioning

Body Structure and Function Outcomes – Post-acute rehabilitation for Total Knee Arthroplasty

Arm 2 Overall RoB Outcome Measurement

Abbreviations: CI = confidence interval, mo = month, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, SF-36 = 36-Item short form survey, SD = standard deviation. Abbreviations: CI = confidence interval, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, SF-12 = 12-item short-form survey, SF-36 = 36-item short-form survey, SD = standard deviation.

Physical function and activities of daily living

Abbreviations: ACSE = active recovery sliding exercise, CI = confidence interval, CPM = continuous passive motion, IQR = interquartile range, mo = month, NMES = neuromuscular electrical stimulation, NR = not reported, PMID = PubMed identifier, RoB = risk of bias , SD = standard deviation, SF-36 = 36-item short form survey, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index. C The Iowa Level of Assistance Scale was used to assess four functional activities (moving from a lying position to a sitting position, rising from a sitting position, walking 4.57 m, and climbing and descending stairs for three steps). D The total Hospital for Special Surgery score is obtained by adding up all item scores and subtracting scores related to walking aids, loss of knee extension, and varus/valgus deformity.

Abbreviations: CI = confidence interval, CPM = continuous passive motion, mo = month, NR = not reported, ns = not significant, PMID = PubMed identifier, RoB = risk of bias, s = second, SD = standard deviation, SE = standard error.

Balance

C The time required to ascend 18 stairs (flights of 8 to 10 steps, separated by a small landing) as quickly as possible using handrails and walking aids as required. Stair climbing power was calculated using this time, combined with patient's body mass index, total stair height and ascent time.

Timed Up and Go

Abbreviations: Adj MD = adjusted mean difference, ADL = activities of daily living, CI = confidence interval, EQ-5D = EuroQual, KOS = Knee Outcome Survey, KOOS = Knee Injury and Osteoarthritis Outcome Score, LEFS = Lower Extremity Functional Scale, ma = month, NR = not reported, PMID = PubMed identifier, rec = recreation, RR = relative risk, RoB = risk of bias, SD = standard deviation, SF-36 = 36-item short form survey, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index. C We have included the sport and recreation component of the KOOS in the table of physical function as it is most related to other domains. However, as it assesses function beyond activities of daily living, it was not included in our assessment of the evidence of ADLs for the evidence profile.

D This scale is patient-reported and differs from the other performance-based measures, but specifically relates to the patient's confidence in balance and was therefore included here. Abbreviations: CI = confidence interval, CST = chair stand test, IQR = interquartile range, MD = mean difference, mo = month, n = number, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, SD = standard deviation, SE = standard error . Abbreviations: Adj MD = adjusted mean difference, CI = confidence interval, cm = centimeters, mo = month, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, s = seconds, SD = standard deviation.

D It measures the time participants maintained balance on one leg while keeping their hands on their hips.

Mobility

If the p-values were not significant, we did not highlight our calculated confidence intervals, even if they were significant. Abbreviations: 6MWT = six-minute walk test CI = confidence interval, MD = mean difference, mo = month, m = meter, NR = not reported, ns = not significant, PMID = PubMed identifier, RoB = risk of bias, SD = standard deviation, SE = standard error, W = watts. E Calculated from the time to complete the stair climbing test, the number of steps, the height of the stairs and body weight.

Participants started walking from a point 2 meters in front of the mat and stopped at a point 2 meters beyond the mat. Abbreviations: CI = confidence interval, MD = mean difference, mo = month, NMES = neuromuscular electrical stimulation, NR = not reported, ns = not significant, PMID = PubMed identifier, RoB = risk of bias, s = second, SD = standard deviation.

Quality of life

Patient satisfaction with care

Abbreviations: CI = confidence interval, EQ-5D = EuroQual, KOOS = knee injury and osteoarthritis score, mo = month, NMES = neuromuscular electrical stimulation, NR = not reported, ns = not significant, PMID = PubMed identifier, RoB = risk of bias, ROM = range of motion, SD = standard deviation, ROM = range of motion, SF-12 = 12-item short-form survey, SF-36 = 36-item short-form survey, SF- 6D = six-dimension short form, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index. The B scale combines assessment of function with pain, stability, range of motion, and muscle strength and thus combines patient-reported outcomes with clinician-assessed outcomes.

Other Patient-Reported Outcomes – Post-acute rehabilitation

Abbreviations: CI = confidence interval, HRQoL-15D = 15-dimensional instrument of health-related quality of life, IQR = interquartile range, KOOS = Knee Injury and Osteoarthritis Outcome Score, ma.

Satisfaction with care

Patient global assessment

Abbreviations: Adj MD = adjusted mean difference CI = confidence interval, KOOS = Knee injury and osteoarthritis outcome score, mo = month, NMES = neuromuscular electrical stimulation, NR = not reported, PENS = pattern electrical neuromuscular stimulation, PMID = PubMed identifier, PROMIS = by the patient reported outcomes measurement information system, RoB = risk of bias, SD = standard deviation, SF-36 = 36-item short survey, SF-6D = short six-dimensional survey, WOMAC = Western Ontario and McMaster Universities Osteoarthritis Table of Contents.

Healthcare Utilization Outcomes – Acute rehabilitation

Need for postoperative procedures

N Arm

Abbreviations: CI = confidence interval, mo = month, NA = not applicable, NR = not reported, PMID = PubMed identifier, RoB = risk of bias, ROM = range of motion.

Healthcare Utilization Outcomes – Post-acute rehabilitation

Harms From Rehabilitation

Harms