Comparison of group-based outpatient physiotherapy with usual care after total knee replacement: a feasibility study for a randomized controlled trial.
Neil Artz, Samantha Dixon, Vikki Wylde and 5 others
PMID 27068368WHAT IT FOUND
Group physiotherapy after knee replacement is feasible but recruitment was low at 37%, mainly due to travel and time commitments.
Attendance was good at 73% when travel costs were refunded. This pilot did not test if the treatment works, only if a larger trial could be run.
Key findings
01Recruitment rate was 37%, with travel and time commitments being the main reasons for declining participation.
02Attendance at the group classes was 73%, with participants reimbursed for travel costs.
03The Lower Extremity Functional Scale was more responsive than the Knee Injury and Osteoarthritis Outcome Score for measuring functional change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a feasibility study, not an efficacy trial. No statistical comparisons were made between groups, so it does not show whether the intervention works. Recruitment was low (37%), primarily due to travel and time commitments, which may limit generalizability. Participants and therapists were not blinded, which may have influenced outcomes and questionnaire completion rates. Travel costs were reimbursed for intervention participants, which is not standard practice in the UK, potentially inflating attendance rates compared to real-world settings. The sample size was small (46 participants), limiting the precision of estimates for future trial design.
Declared interests
The authors declared no potential conflicts of interest. The study was sponsored by North Bristol NHS Trust.
The easy way to misread this
Do not interpret the within-group improvements in pain and function as evidence that group physiotherapy is superior to usual care. This was a feasibility study with no statistical comparison between groups, designed only to test if a larger trial could be conducted.