ArticleThe Journal of bone and joint surgery. American volume2018
Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty.
Article in The Journal of bone and joint surgery. American volume, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Systematic Review of Rural and Urban Differences in Care Provided by Home Health Agencies in the United States.Journal of the American Medical Directors Association · 2022Pooled it
- Impact of social determinants of health on physical therapy utilization in home health and outpatient settings: a retrospective cohort study.Physical therapy · 2026Article
- Implementation and Evaluation of an AI-Assisted Telerehabilitation System for Postdischarge Continuation of Rehabilitative Care: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Generic versus personalized foot-ground contact models for predictive simulations of walking: Is personalization worth the effort?bioRxiv : the preprint server for biology · 2026Article
- Allocation of Postacute Care Services Differs Among Rural and Urban Patients after Colon Cancer Resection.Journal of the American College of Surgeons · 2026Article
- Trends in Rehabilitation Insurance Benefit Exhaustion Among Older Adults in the United States and Associations With Racial Identity.Physical therapy · 2026Article
- Home health utilization in the Veterans Health Administration: Are there rural and urban differences?The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Beyond Discharge Disposition: A Scoping Review on Sociodemographic Disparities in Rehabilitation Use After Hip and Knee Arthroplasty.Physical therapy · 2024Article
- Help or Hurt? The Impact of Digital Finance on the Physical Health of the Elderly in China.Healthcare (Basel, Switzerland) · 2024Article
- Scaled TelePhysical Therapy Program a Promising Option for Post-acute Care of Lower-Extremity Arthroplasty Patients.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Article
- Total Knee Arthroplasty Assessments Should Include Strength and Performance-Based Functional Tests to Complement Range-of-Motion and Patient-Reported Outcome Measures.Physical therapy · 2022Article
- Poor Recovery of Activities-of-Daily-Living Function Is Associated With Higher Rates of Postsurgical Hospitalization After Total Joint Arthroplasty.Physical therapy · 2021Article
- Home Health Rehabilitation Utilization Among Medicare Beneficiaries Following Critical Illness.Journal of the American Geriatrics Society · 2020Article
- The Impact of Home Health Physical Therapy on Medicare Beneficiaries With a Primary Diagnosis of Dementia.Journal of the American Geriatrics Society · 2020Observational
- Preoperative Activities of Daily Living Dependency is Associated With Higher 30-Day Readmission Risk for Older Adults After Total Joint Arthroplasty.Clinical orthopaedics and related research · 2020Article
- Functional outcome in home health: Do racial and ethnic minority patients with dementia fare worse?PloS one · 2020Article
- HSS@Home, Physical Therapist-Led Telehealth Care Navigation for Arthroplasty Patients: A Retrospective Case Series.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2019Article
- Ninety-day and one-year healthcare utilization and costs after knee arthroplasty.Osteoarthritis and cartilage · 2019Article
- Changes in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments, Should They Be Implemented on a Nationwide Scale?The Journal of arthroplasty · 2019Article
- Medium-Term Outcomes of Digital Versus Conventional Home-Based Rehabilitation After Total Knee Arthroplasty: Prospective, Parallel-Group Feasibility Study.JMIR rehabilitation and assistive technologies · 2019Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundHome-health-care utilization after total knee arthroplasty (TKA) is increasing. Recent publications have suggested that supervised rehabilitation is not needed to optimize functional recovery after TKA; however, few studies have evaluated patients in home-health-care settings. The objectives of this study were to (1) determine whether physical therapy (PT) utilization is associated with functional improvements for patients in home-health-care settings after TKA and (2) determine which factors are related to utilization of PT.
methodsThis study was an analysis of Medicare home-health-care claims data for patients treated with a TKA in 2012 who received home-health-care services for postoperative rehabilitation. Multivariable linear regression models were used to evaluate relationships between PT utilization and recovery in activities of daily living (ADLs). Negative binomial regression models were used to determine factors associated with PT utilization.
resultsRecords from 5,967 Medicare beneficiaries were evaluated. Low home-health-care PT utilization (≤5 visits) was associated with less improvement in ADLs compared with 6 to 9 visits, 10 to 13 visits, or ≥14 visits. Compared with low home-health-care utilization, utilization of 6 to 9 visits was associated with a 25% greater improvement in ADLs over the home-health-care episode (p < 0.0001); 10 to 13 visits, with a 40% greater improvement (p < 0.0001); and ≥14 visits, with a 50% greater improvement (p < 0.0001). The findings remained robust following adjustments for medical complexity, baseline functional status, and home-health-care episode duration. After adjustment, lower PT utilization was observed for patients receiving home health care from rural agencies (10.7% fewer visits, 95% confidence interval [CI] = 7.9% to 13.7%), those with depressive symptoms (4.8% fewer visits, 95% CI = 1.3% to 8.3%), and those with any baseline dyspnea (5.3% fewer visits, 95% CI = 3.1% to 7.5%).
conclusionsLow home-health-care PT utilization was significantly associated with worse recovery in ADLs after TKA for Medicare beneficiaries, after controlling for medical complexity, baseline function, and home-health-care episode duration. Patients who are served by rural agencies or who have higher medical complexity receive fewer PT visits after TKA and may need closer monitoring to ensure optimal functional recovery. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
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