AB1495 THE QUALITY OF REPORTING IN RANDOMIZED CONTROLLED TRIALS OF STRENGTHENING EXERCISES IN TOTAL KNEE ARTHROPLASTY

Abstract

Background: End-stage knee osteoarthritis (KOA) is a signifcant health issue worldwide resulting in severe pain and disability. Total knee arthroplasty (TKA) leads to signifcant improvements in pain and the performance of functional activities such as walking for patients with end-stage KOA. Although TKA reduces pain and improves perceived function, patients continue to exhibit reduced muscle strength, voluntary muscle activation, and functional performance even years after surgery (1). In addition, quarantine, and related social restrictions due to the current Covid-19 pandemic may have affected the recovery of patients undergoing TKA due to limited access to exercise, physiotherapy, face-to-face follow-up, and medical services (2).Limited recovery after TKA will require intensive rehabilitation programs in the future. Strengthening exercises(SE) are the most effective intervention for improving muscle strength and functionality and have been recommended in the guidelines for KOA management and in clinical reviews for TKA rehabilitation (3). Randomized controlled trials (RCTs) are the gold standard for assessing the effects of health care interventions. However, RCTs may yield misleading results if they lack methodological rigors(4). RCTs provide the highest quality clinical evidence in the selection of the SE method to be applied (5). However, there are no studies examining the quality of RCTs related to SE in patients with TKA. Objectives: The aim of this study was to assess the reporting quality of RCTs of SE in patients with TKA. Methods: RCTs published between 2002 and 2021 were sourced from clinical trial registers, PubMed, and the Cochrane Reviews. RCTs were included if they involved SE in patients who underwent TKA. Analysis was carried out with two assessment tools: PEDro scale and 9-items from CONSORT(6). In addition, we have identifed some key methodological elements and examined their relationship to their methodological quality. Results: We found 35 RCTs that included SE in individuals with TKA. The mean PEDro score was 6.40 ± 1, 73. The most common defcient PEDro Items were: Blinding of all therapists who administered the therapy (14,2 %: 5/35 trials), allocation was concealed (31,4 %; 11/35 trials), blinding of all subjects (31,4 %: 11/35 trials). The most common defcient CONSORT Criteria were: Statistical adjustment for multiple primary outcomes (40 %; 14/35 trials), funding sources (40 %; 14/35 trials) and identifcation as a randomized trial in the title (62,85%; 22/35 trials). Of the key methodological factors we identifed, only exercise duration (weeks) was associated with PEDro score (R2 =.169, p<0.01). Conclusion: Our results show that the quality of reporting in the literature on RCTs of SE in patients with TKA is insufficient. In order to increase muscle strength after TKA, the lack of face-to-face programs due to COVID-19 should be eliminated with telerehabilitation methods, video conferencing platforms and virtual reality applications, and high-quality RCTs should be planned where these programs are examined.