None listed
Conditions
Brief summary
Aquatic Physiotherapy has been shown to improve the ability of people to move and function following total hip and knee replacement surgery. The primary aim of this study is to examine if early commencement of aquatic physiotherapy (6 days after surgery) improves function, as compared to standard commencement of aquatic physiotherapy (typically 14 days after surgery- once the wound has healed). Patients attending undergoing total hip replacement or total knee replacement surgery at Dandenong or Moorabbin Hospital who require in-hospital rehabilitation at Dandenong Hospital or the Kingston Centre will be recruited to participate in a randomised controlled trial. One group of participants will receive aquatic physiotherapy 6 days following surgery (intervention), whilst the other group will wait 14 days to commence aquatic physiotherapy as per standard practice (control). A total of 60 people will be randomly assigned to one of these groups. The main measure used to evaluate the intervention will be the de Morton Mobility Index, a measure of walking and balance. A range of other measures will also be administered to evaluate the effect of early aquatic physiotherapy on the ability to function, length of hospital stay, pain, walking speed, quality of life, cost of wound dressings and presence of wound infections. These outcome measures will be assessed at baseline, on discharge from rehabilitation. Function, pain, quality of life, function and presence of wound infections will also be assessed at 6 weeks following surgery.
Interventions
The intervention will be early commencement of aquatic physiotherapy (six days) following total hip and total knee replacement surgery. This will occur during a standard subacute rehabilitation stay. Participants will undergo a standardised wound dressing procedure to ensure wounds have appropriate and safe waterproof cover. Participants will be provided with an ‘individualised’ program, based on the initial physical assessment performed by the treating physiotherapist, as per usual clinical
The intervention will be early commencement of aquatic physiotherapy (six days) following total hip and total knee replacement surgery. This will occur during a standard subacute rehabilitation stay. Participants will undergo a standardised wound dressing procedure to ensure wounds have appropriate and safe waterproof cover. Participants will be provided with an ‘individualised’ program, based on the initial physical assessment performed by the treating physiotherapist, as per usual clinical care. All components of the intervention will be individualised according to the participant's clinical requirement, as per standard practice. This will include duration and frequency of exercises, exercises selected and number of aquatic physiotherapy sessions. The aquatic exercises will be provided by a subacute physiotherapist. All exercises will be individually documented, including use of properties of water, such as depth of water, buoyancy, turbulence and hydrostatic pressure.
Sponsors
Sarah Milne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Undergone elective total hip or total knee replacement surgery at Dandenong or Moorabbin Hospitals 2. Able to provide informed consent to participate. 3. Admitted to Kingston Centre or Dandenong Hospital for subacute inpatient rehabilitation within 6 days of elective total hip or total knee replacement surgery. 4. Classified as a 'Monash Health Pathway C patient'.or 'Monash Health Pathway B patient'. 5. Received surgery from a Monash Health surgeon consenting for participant to participate in the study. 6. Willing to attend an appointment at Moorabbin or Dandenong Hospital, or Kingston Centre for the 6-week assessment. 7. Aged 18 years and above.
Exclusion criteria
1. Unable to provide informed consent to participate due to cognitive impairment or delirium. 2. Undergone non-elective total hip or total knee replacement surgery. 3. Received surgery from a Monash Health surgeon not consenting for participant to participate in the study. 4. Has a medical condition that precludes immersion in a hydrotherapy pool, such as severe cardiac disease. 5. Wound is oozing, unable to be adequately covered and/or is better to be left uncovered for optimal healing. 6. Pregnancy. 7. Undergone revision of a total hip or knee replacement surgery, bilateral total hip or knee replacement or unicompartmental knee replacement.
Outcome results
None listed