Characteristics of Early Interventions for Pain and Function Following Lower Extremity Joint Replacement: Systematic Review.

Only 7 studies were included, and their heterogeneity in surgery type, intervention dosage, setting, and outcome measures made meta-analysis impossible. No study in the review was actually delivered by an occupational therapy practitioner, so the findings do not directly evidence OT's role. No study measured prescription opioid use as an outcome, despite this being a stated secondary objective. English-language publications only; gray literature was not searched, so unpublished null results may be missing. The exclusion of interventions without a functional or occupational component (CPM, isolated muscle training, modalities without functional training) may have omitted preparatory work that contributes to recovery. Three of the five task-oriented exercise studies found no significant difference, so the two positive results should not be read as a consistent effect.

No conflicts of interest were reported by the authors or by any individuals in control of the article's content.

Do not read the two positive task-oriented exercise studies as proof that this approach reliably improves outcomes after joint replacement. Three of the five task-oriented studies found no significant difference, the overall evidence is rated low to moderate, and none of the seven studies was actually delivered by an occupational therapist.