What Augmented Physical Activity and Empowerment Can Bring to Patients Receiving Total Knee Replacement: Content, Implementation, and Comparative Effectiveness of a New Function-Tailored Care Pathway in a Routine Care Setting

被引：16

作者：

van der Sluis, G. ^{[1
]}

Goldbohm, R. A. ^{[2
]}

Bimmel, R. ^{[3
]}

Garre, F. Galindo ^{[4
]}

Elings, J. ^{[5
]}

Hoogeboom, T. J. ^{[6
,7
,8
]}

van Meeteren, N. L. U. ^{[2
,8
]}

机构：

[1] Nij Smellinghe Hosp, Dept Physiotherapy, NL-9202 NN Drachten, Netherlands

[2] TNO, Hlth Life, Leiden, Netherlands

[3] Nij Smellinghe Hosp Drachten, Dept Orthoped & Traumatol, NL-9202 NN Drachten, Netherlands

[4] Vrije Univ Amsterdam, Ctr Biostat, Amsterdam, Netherlands

[5] Diakonessenhuis Hosp Utrecht, Dept Physiotherapy, Utrecht, Netherlands

[6] Maastricht Univ, Med Ctr, Dept Epidemiol, NL-6200 MD Maastricht, Netherlands

[7] CAPHRI Sch Publ Hlth & Primary Care, Maastricht, Netherlands

[8] Ctr Care Technol Res, Maastricht, Netherlands

来源：

BIOMED RESEARCH INTERNATIONAL | 2015年 / 2015卷

关键词：

FAST-TRACK HIP; JOINT ARTHROPLASTY; VALIDITY; MOBILITY; RELIABILITY;

D O I：

10.1155/2015/745864

中图分类号：

Q81 [生物工程学（生物技术）]; Q93 [微生物学];

学科分类号：

071005 ; 0836 ; 090102 ; 100705 ;

摘要：

Background. In the routine setting of the 20-bed orthopaedic ward of a regional hospital in Netherlands, we developed, implemented, and evaluated a new, function-tailored perioperative care pathway for patients receiving total knee replacement (TKR), aimed at faster functional recovery by reduction of inactivity and stimulation of self-efficacy of the patients. Methods. To assess effectiveness, we compared, using prospectively collected data from medical files, patient groups before (n = 127) and after (n = 108) introduction of the new care pathway with respect to time to recovery of physical functioning during hospitalisation (five milestones), length of hospital stay (LoS), referrals to an inpatient rehabilitation facility, and readmissions. Multivariable regression was used to adjust results for differences between the two groups in preoperatively assessed risk factors for delayed recovery. Results. Comparison of patient groups before (n = 127) and after (n = 108) introduction of the tailored care pathway showed that the tailored rehabilitation pathway decreased the time to recovery of physical functioning (from 4.5 to 4.1 days, P < 0.05), the mean LoS (from 5.2 days to 4.2 days, P < 0.01). Conclusion. We demonstrated that the introduction of a function-tailored care pathway shortens the hospital stay and accelerates the recovery of physical functioning.

引用

页数：8