Land versus water-based exercise following Total Knee Replacement
Sydney South West Area Health Service
There are no evidence-based guidelines to inform the optimal models of physiotherapy rehabilitation following total knee replacement (TKR), yet over 25,000 procedures are performed annually in Australia. Consequently, the mode, duration, performance indicators, and the associated costs of rehabilitation, vary between service providers. Institutional factors such as access to other services partly explain the variance.Water-based rehabilitation is offered at this Institution as a community pool is readily accessible, however, it is not known whether a water-based programme offers any advantage over a land-based alternative.
This randomised trial compared the effectiveness of a land and a water-based programme in the first 8 weeks following TKR. Both programmes yielded equivalent improvements in all outcomes at 8 and 26 weeks post-surgery, and patient costs associated with service access and therapist costs were comparable for both models. In this context, either programme is a smart model of care. Wider a field, our results inform clinical redesign initiatives as health institutions providing onsite hydrotherapy would need to provide evidence of superior outcomes associated with this service in order to justify the high maintenance and opportunity costs.
This project won the 2007 NSW Health Awards, Smart Choices about the Costs and Benefits of Health Services category.
The full entry document can be downloaded in the formats listed below:
- Land versus water-based exercise following TKR (Word - 515 KB)
- Land versus water-based exercise following TKR (pdf - 215 KB)
Download the Presentation ( pdf - 189 KB) from the 2007 NSW Health Expo.