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80 APPENDICES Physiotherapy KCE reports vol. 40 References from the literature on rehabilitation of total knee replacement Reference Type of reference General description Critical appraisal National Institutes of Health (NIH) Consensus Development Panel on Total Knee Replacement, 2004 (75) Continuous passive motion following total knee arthroplasty (76) Pre-operative education for hip or knee replacement (85) NIH position statement based on the report of an expert consensus panel. Cochrane systematic review Cochrane systematic review Position statement on total hip replacement in general. No section specifically focusing on rehabilitation. Only randomized controlled trials (14) were included in this meta-analysis. This Cochrane review focuses specifically on the effectiveness of continuous passive motion (CPM) following total knee arthroplasty. After systematic search of the literature, 14 eligible RCTs were included in this meta-analyses (952 patients) Systematic reviews of RCTs on effectiveness of preoperative education to improve postoperative outcomes and reduce anxiety. Inclusion of 9 eligible RCTs (782 patients). Outcome variables: length of hospital stay, pre- and post-operative anxiety level, days needed to be able to recover standing and stair climbing Expert consensus References search and selection procedures specific to this references not available in the text. NIH Consensus and State-of-the- Science Statements are prepared by independent panels of health professionals and public representatives, based on (1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), (2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session; (3) questions and statements from conference attendees during open discussion periods that are part of the public session; and (4) closed deliberations by the panel during the remainder of the second day and morning of the third. no to be rated no to be rated Does pre-operative physiotherapy Systematic Review A systematic review of 5 included eligible RCTs to Cochrane Va form:
KCE reports vol. 40 APPENDICES Physiotherapy 81 improve outcomes from lower limb replacement surgery ? (77) Continuous passive motion following primary total knee arthroplasty: short-and long-term effects on range of motion (86) Does a pre-operative exercise programme improve mobility and function post-total knee replacement : a mini-review (87) Review article : knee flexion after total knee arthroplasty (88) Exercise recommendations after total joint replacement: a review of the current literature and proposal of scientifically based guidelines (78) Continuous passive motion (CPM): Theory and principles of clinical application (89) Effectiveness of Continuous Passive Motion and Conventional Physical Therapy After Total Arthroplasty: A randomised evaluate the effectiveness of pre-operative physiotherapy programme on outcome following total knee replacement. A great heterogeneity in terms of control intervention, blinding procedure was noted. Methodological quality also varied widely among studies. Systematic Review Systematic review of 15 eligible included RCTs on the efficacy of continuous passive mobilisation on range of motion (mobility). Great heterogeneity was noted among the studies in terms of blinding procedure, control intervention, outcome measures and quality in general. However, there does no seem to be a relationship between study quality and outcome for the studies Systematic Review included in this review. This mini-review of 2 RCTs (60 patients) evaluates the effectiveness of pre-operative exercise in improving the mobility and function of adult patients undergoing total knee replacement. The two studies had a number of methodological weaknesses. Hence, conclusions and recommendations available in the studies must be viewed with caution. Review Review of 13 RCTs on factors affecting or predicting final maximal knee flexion achieved after total knee replacement. Review This article presents a literature review of the current recommendations that can be made about physical activities and sports after total joint replacement. Negative or no answer possible for questions 5, 6, 7, 8 of the Va form. Critical appraisal not pursued as quality seems unacceptable. Cochrane Va form: Negative or no answer possible for 4 out of the 8 first questions of the Va form. Critical appraisal not pursued as quality seems unacceptable. Recommendations seem applicable to Belgian situation Cochrane Va form: Negative or no answer possible for 6 out of the 8 first questions of the Va form. Hence, conclusions and recommendations available in the studies must be viewed with caution. Cochrane Va form: Negative or no answer possible for questions 3,4,5,7,8. Recommendations seem applicable to Belgian situation Cochrane Va form: Negative or no answer possible for questions 3,4,5,7,8. Recommendations seem applicable to Belgian situation. Review Cochrane Va form: Negative or no answer possible for 6 out of the 8 first questions of the Va form. Recommendations seem RCT RCT (82 patients) conducted to compare the effectiveness of 3 in-hospital rehabilitation programs with and without continuous passive applicable to Belgian situation. Pedro 8/10
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