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Pre-arthroplasty rehabilitation is effective in reducing hospital stay
Crowe J, Henderson J
Canadian Journal of Occupational Therapy 2003 Apr;70(2):88-96
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The purpose of the trial was to evaluate the effect on length of stay of individually tailored rehabilitation for clients who were undergoing hip or knee arthroplasty. METHOD: Clients (n = 133) with complex needs (comorbid conditions or limited social support) were randomly assigned to receive preoperative usual care (UC) or rehabilitation (R). Usual care clients received a single preoperative clinic visit. Rehabilitation clients were individually assessed and received multi disciplinary rehabilitation to optimize functional capacity, education about the in-hospital phase and early discharge planning. All rehabilitation subjects received interdisciplinary counseling/education focused on preparation for discharge home. The intervention for approximately half the rehabilitation clients was a single, cost-effective session, while others received physical conditioning. RESULTS: Clients receiving rehabilitation achieved discharge criteria earlier (R = 5.4, UC = 8 days) and had a shorter actual length of stay (R = 6.5, UC = 10.5 days). CLINICAL IMPLICATIONS: This preoperative, individually tailored, rehabilitation program reduced length of stay.

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