A physical therapist-administered physical activity intervention after total knee replacement: Protocol for a randomized controlled trial

Abstract

Background. The definitive treatment for knee osteoarthritis is a total knee replacement, which results in a clinically meaningful improvement in pain and physical function. However, evidence suggests that physical activity (PA) remains unchanged after total knee replacement (TKR). Objective. The objective of this study is to investigate the efficacy, fidelity, and safety of a physical therapist-administered PA intervention for people after TKR. Design. This study will be a randomized controlled trial. Setting. The setting is an outpatient physical therapy clinic. Participants. The participants are 125 individuals who are over the age of 45 and are seeking outpatient physical therapy following a unilateral TKR. Intervention. In addition to standardized physical therapy after TKR, the intervention group will receive, during physical therapy, a weekly PA intervention that includes a wearable activity tracking device, individualized step goals, and face-to-face feedback provided by a physical therapist. Control. The control group will receive standardized physical therapy alone after TKR. Measurements. The efficacy of the intervention will be measured as minutes per week spent in moderate to vigorous PA at enrollment, at discharge, and at 6 months and 12 months after discharge from physical therapy. The fidelity and safety of the intervention will be assessed throughout the study. Limitations. Participants will not be masked, PA data will be collected after randomization, and the trial will be conducted at a single site. Conclusions. The goal of this randomized controlled trial is to increase PA after TKR. A protocol for investigating the efficacy, fidelity, and safety of a physical therapist-administered PA intervention for people after TKR is presented. The findings will be used to support a large multisite clinical trial to test the effectiveness, implementation, and cost of this intervention.