Evidence map›Paper›PMID 34452970›Full record

Trial reportBMJ open2021

Home-based rehabilitation programme compared with traditional physiotherapy for patients at risk of poor outcome after knee arthroplasty: the CORKA randomised controlled trial.

Karen L Barker, Jonathan Room, Ruth Knight, Susan Dutton, Francine Toye, Jose Leal, Nicola Kenealy, Michael Maia Schlüssel, Gary Collins, David Beard and 5 more

Open access · goldAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 5% 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

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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  13. Effectiveness and therapeutic validity of physiotherapeutic exercise starting within one year following total and unicompartmental knee arthroplasty for osteoarthritis: a systematic review.European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity · 2023
    Review
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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

15 authors at 5 institutions in 1 country.

Karen L BarkerNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK Karen.Barker@ouh.nhs.uk.ORCID 0000-0001-9363-0383
Jonathan RoomNuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.
Ruth KnightOxford Clinicial Trials Research Unit (OCTRU), Centre Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK.ORCID 0000-0001-6810-2845
Susan DuttonOxford Clinicial Trials Research Unit (OCTRU), Centre Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK.
Francine ToyeNuffield Orthopaedic Centre Physiotherapy Research Unit, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK.
Jose LealNuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK.ORCID 0000-0001-7870-6730
Nicola KenealyNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Michael Maia SchlüsselNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Gary CollinsCentre for Statistics in Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-2772-2316
David BeardNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Andrew James PriceNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK.
Martin UnderwoodWarwick Medical School, Warwick University, Coventry, UK.ORCID 0000-0002-0309-1708
Avril DrummondDiv of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK.ORCID 0000-0003-1220-8354
Sarah LambCollege of Medicine and Health, University of Exeter, Exeter, Devon, UK.
CORKA Trial group
Nuffield Orthopaedic Centre · GBUniversity of Oxford · GBUniversity of Exeter · GBUniversity of Nottingham · GBUniversity of Warwick · GB

Funding

Cancer Research UK 27294
6 · The paper itself

Abstract

objectivesTo evaluate whether a home-based rehabilitation programme for people assessed as being at risk of a poor outcome after knee arthroplasty offers superior outcomes to traditional outpatient physiotherapy.

designA prospective, single-blind, two-arm randomised controlled superiority trial.

setting14 National Health Service physiotherapy departments in the UK.

participants621 participants identified at high risk of a poor outcome after knee arthroplasty using a bespoke screening tool.

interventionsA multicomponent home-based rehabilitation programme delivered by rehabilitation assistants with supervision from qualified therapists versus usual care outpatient physiotherapy.

main outcome measuresThe primary outcome was the Late-Life Function and Disability Instrument (LLFDI) at 12 months. Secondary outcomes were the Oxford Knee Score (a disease-specific measure of function), Knee injury and Osteoarthritis Outcome Score Quality of Life subscale, Physical Activity Scale for the Elderly, 5 dimension, 5 level version of Euroqol (EQ-5D-5L) and physical function assessed using the Figure of 8 Walk test, 30 s Chair Stand Test and Single Leg Stance.

results621 participants were randomised between March 2015 and January 2018. 309 were assigned to CORKA (Community Rehabilitation after Knee Arthroplasty) home-based rehabilitation, receiving a median five treatment sessions (IQR 4-7). 312 were assigned to usual care, receiving a median 4 sessions (IQR 2-6). The primary outcome, LLFDI function total score at 12 months, was collected for 279 participants (89%) in the home-based CORKA group and 287 participants (92%) in the usual care group. No clinically or statistically significant difference was found between the groups (intention-to-treat adjusted difference=0.49 points; 95% CI -0.89 to 1.88; p=0.48). There were no statistically significant differences between the groups on any of the patient-reported or physical secondary outcome measures at 6 or 12 months.There were 18 participants in the intervention group reporting a serious adverse event (5.8%), only one directly related to the intervention, all other adverse events recorded throughout the trial related to underlying chronic medical conditions.

conclusionsThe CORKA intervention was not superior to usual care. The trial detected no significant differences, clinical or statistical, between the two groups on either primary or secondary outcomes. CORKA offers an evaluation of an intervention utilising a different service delivery model for this patient group. TRIAL REGISTRATION NUMBER: ISRCTN13517704.

Indexed as

Arthroplasty, Replacement, KneeAgedCost-Benefit AnalysisHumansPhysical Therapy ModalitiesProspective StudiesQuality of LifeSingle-Blind MethodState Medicineadult orthopaedicsKneeRehabilitation medicine

Identifiers

PMID34452970
PMCPMC8404435
OpenAlexW3195569447

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.