Evidence map›Paper›PMID 27401004›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

Efficacy and safety of home-based exercises versus individualized supervised outpatient physical therapy programs after total knee arthroplasty: a systematic review and meta-analysis.

Mariano Florez-García, Fernando García-Pérez, Rafael Curbelo, Irene Pérez-Porta, Betina Nishishinya, Maria Piedad Rosario Lozano, Loreto Carmona

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 6 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 6 syntheses or guidelines pooled it, 69 citations in OpenAlex.

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  16. Optimal Duration of Physical Therapy Following Total Knee Arthroplasty.Geriatric orthopaedic surgery & rehabilitation · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Mariano Florez-GarcíaRehabilitación, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Fernando García-PérezRehabilitación, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Rafael CurbeloInstituto de Salud Musculoesquelética, Calle Conde de la Cimera, 6, 28040, Madrid, Spain.
Irene Pérez-PortaRehabilitación, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Betina NishishinyaPrograma de doctorado en Ciencias de la Educación y el Deporte de la Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Barcelona, Spain.
Maria Piedad Rosario LozanoAgencia Andaluza de Tecnologías Sanitarias, Seville, Spain.
Loreto CarmonaInstituto de Salud Musculoesquelética, Calle Conde de la Cimera, 6, 28040, Madrid, Spain. loreto.carmona@inmusc.eu.
Hospital Universitario Fundación Alcorcón · ESInstituto de Salud Musculoesquelética · ESAgencia de Evaluación de Tecnologías Sanitarias · ESFC Barcelona · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of the present study was to evaluate the efficacy and safety of non-supervised home-based exercise versus individualized and supervised programs delivered in clinic-based settings for the functional recovery immediately after discharge from a primary TKA.

methodsMedline, Embase, Cochrane, and PEDro databases were screened, from inception to April 2015, in search for randomized clinical trials (RCT) of home-based exercise interventions versus individualized and supervised outpatient physical therapy after primary TKA. Target outcomes were: knee range of motion (ROM), patient-reported pain and function, functional performance, and safety. Risk of bias was assessed with the PEDro scale. After assessing homogeneity, data were combined using random effects meta-analysis and reported as standardized mean differences or mean differences. We set a non-inferiority margin of four points in mean differences.

resultsThe search and selection process identified 11 RCT of moderate quality and small sample sizes. ROM active extension data suitable for meta-analysis was available from seven studies with 707 patients, and ROM active flexion from nine studies with 983 patients. Most studies showed no difference between groups. Pooled differences were within the non-inferiority margin. Most meta-analyses showed significant statistical heterogeneity.

conclusionShort-term improvements in physical function and knee ROM do not clearly differ between outpatient physiotherapy and home-based exercise regimes in patients after primary TKA; however, this conclusion is based on a meta-analysis with high heterogeneity. LEVEL OF EVIDENCE: I.

Indexed as

Exercise TherapyPhysical Therapy ModalitiesAmbulatory CareArthroplasty, Replacement, KneeHumansRecovery of FunctionSelf CareTreatment OutcomeExerciseHome-basedMeta-analysisOsteoarthritisPost-operative careSystematic reviewTotal knee replacement

Identifiers

PMID27401004
OpenAlexW2472489600

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.