Total Knee Replacement: Home Rehab Gets Faster Results than Center-Based Rehab

Physical therapy following total knee replacement is common and expected, but the effectiveness of such therapy is not thoroughly documented and the impact of different sites of care and therapy protocols is still being explored in the scientific literature. Recently, Neil Artz and colleagues published a meta-analysis addressing these questions.¹ As expected, when compared to controls with minimal physical therapy, patients receiving physical therapy following a total knee replacement (TKR) realized improved pain scores and improved physical function. 

It is sometimes hypothesized that care at rehabilitation centers would be advantageous due to the availability of different equipment. The current meta-analysis concludes that in-home physical therapy achieves faster improvements in range of motion compared to center-based physical therapy, and center-based rehab has no outcome advantages over in-home rehab. The addition of hydro- therapy, additional balancing elements, or ergometer cycling did not  improve center-based therapy outcomes. ​

The meta-analysis focuses primarily on physical therapy at home – not the complete rehabilitation program sometimes available through Medicare-certified home health. A referral to Five Star Home Health, for instance, initiates a multidisciplinary in-home rehabilitation program with physical therapy for functional improvements, nursing for medication reconciliation and wound care, and occupational therapy to address habilitation. For your homebound patients, Five Star Home Health offers additional advantages. Adherence with outpatient physical therapy programs can be challenging. The Five Star Home Health program overcomes multiple barriers to adherence. Sending therapists to your patients’ homes creates an impetus to participate. The in-home nature of the rehab also overcomes transportation challenges that may exist while patients rely on others for transportation. Teaching home exercise programs and medication reminder strategies in the home promises potential for improved adherence with independent exercise recommendations and medication protocols. Finally, traditional Medicare pays 100% for TKR rehab from Five Star Home Health - overcoming any financial barriers or price resistance to wound care and rehabilitation. As long as patients do not require more than one physical therapy session per day, the home with home health services proves to be a strongly advantageous care environment. To maximize the quality of services available to your patients, please recommend Five Star Home Health.

Leading California in Preventing Patient Harm 

Medicare’s Home Health Compare shows that Five Star Home Health leads both state and nation in 88% of measures related to preventing patient harm. This means Five Star is proven to start care faster and more thoroughly address a variety of at- home risk factors.

---

References

1. Artz N, Elvers K, Lowe C, et al. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2015; 16: 15.