Evolution of service metrics and utilisation of objective discharge criteria in anterior cruciate ligament reconstruction rehabilitation: a retrospective cohort study with historical control in a public hospital physiotherapy department.
Kirby Tuckerman, Wendy Potts, Milad Ebrahimi and 2 others
PMID 33317636WHAT IT FOUND
A phase-based ACL rehabilitation program increased physiotherapist use of objective outcome measures and lengthened treatment duration, but did not improve rehabilitation completion rates or patient-reported knee function compared to standard care.
Key findings
01The new phase-based model significantly increased the rate of objective assessments for quadriceps strength, kinetic chain muscles, and single leg squat performance compared to standard care.
02Patients in the new model attended more physiotherapy sessions and had a longer duration of input, but rehabilitation completion rates did not significantly differ between groups.
03There were no significant differences between the groups in patient-reported knee function (IKDC) or activity levels (Tegner) at follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Retrospective design prevents determination of causality. Data collection was not blinded, and the researcher was involved in developing the service. Clinical notes were not designed for research, leading to potential misclassification bias. Low response rate for phone follow-ups limited the analysis of long-term functional outcomes. Some patients may have crossed over between models due to the date-based split. Outcome measure usage was defined as 'assessed at least once', which may overestimate adherence.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that implementing objective discharge criteria will automatically improve patient outcomes or rehabilitation completion. This study found that while assessments became more frequent, completion rates and functional scores did not improve, and the new model actually took longer to achieve certain milestones like running.