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Characteristics of Patients With Satisfactory Functional Gain Following Total Joint Arthroplasty in a Postacute Rehabilitation Setting

Hershkovitz, Avital, MD1,3; Vesilkov, Marina, MD1; Beloosesky, Yichayaou, MD2,3; Brill, Shai, MD1,3

Journal of Geriatric Physical Therapy: October/December 2018 - Volume 41 - Issue 4 - p 187–193
doi: 10.1519/JPT.0000000000000120
Research Reports

Background and Purpose: Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA.

Methods: This was a retrospective study of 180 patients with TJA admitted during 2010-2013. The main outcome measures were the Functional Independence Measure (FIM), the Montebello Rehabilitation Factor Score (MRFS) on the motor FIM, and the Timed Get Up and Go Test. Satisfactory functional gain was defined as an mFIM MRFS score above median score. Comparisons of clinical and demographic characteristics between patients who achieved a satisfactory functional gain versus those who did not were performed by the Mann-Whitney U test and the χ2 test.

Results: The proportion of patients who achieved a satisfactory functional gain was similar in the total knee arthroplasty and total hip arthroplasty (THA) groups. The most significant characteristic of patients who achieved a satisfactory functional gain was their admission functional ability. Age negatively impacted the ability to achieve a satisfactory functional gain in patients with THA.

Conclusion: Functional level on admission is the best predictive factor for a better rehabilitation outcome for patients with TJA. Age negatively affects functional gain in patients with THA.

1Department of Geriatrics, Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel.

2Department of Geriatrics, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.

3Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Address correspondence to: Avital Hershkovitz, MD, Department of Geriatrics, Beit Rivka Geriatric Rehabilitation Center, 4 Hachamisha St, Petach Tikva 49245, Israel (avitalhe@clalit.org.il).

The authors declare no conflicts of interest.

Robert Wellmon was the Decision Editor.

© 2018 Academy of Geriatric Physical Therapy, APTA
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