Goal setting and achievement in individualized rehabilitation of younger total and unicondylar knee arthroplasty patients - a cohort study

Publication date: Available online 22 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Suzanne Witjes, Alexander Hoorntje, P.Paul F.M. Kuijer, Koen L.M. Koenraadt, Leendert Blankevoort, Gino M.M.J. Kerkhoffs, Rutger C.I. van Geenen

Abstract

Objective

To investigate activity goals, intensity and achievement of these activity goals in younger Knee Arthroplasty (KA) patients, and to identify the differences between Total Knee Arthroplasty (TKA) and Unicondylar Knee Arthroplasty (UKA) patients.

Design

Prospective cohort study.

Setting

Department of orthopedic surgery and physical therapy practices.

Participants

48 patients aged 65 years or younger, who underwent KA.

Intervention

Rehabilitation with Goal Attainment Scaling (GAS).

Main outcome measures

GAS goals for daily life activity, work and leisure time, corresponding metabolic equivalent of task (MET) values, corrected MET values, and GAS scores at three and six months.

Results

The intensity levels of all 144 formulated activity goals were light in 16% of cases, moderate in 63% and vigorous in 21%. Intensity levels did not differ between TKA and UKA patients. Following rehabilitation using GAS, 54% of daily life activity goals, 65% of work activity goals, and 46% of leisure time activities were attained after three months. After six months, 91% of daily life activity goals, 93% of work activity goals, and 89% of leisure time activity goals were attained. Goal attainment did not differ between MET intensity levels. Higher goal attainment was achieved in the UKA group (100%) compared to the TKA patients (82%) after six months (p<0.001).

Conclusions

Younger patients aim to perform many different activities of varying metabolic intensity levels following KA. After six months of rehabilitation using GAS, in total these patients attain 91% of their preoperatively formulated activity goals, independent of the MET intensity level. After six months, UKA patients attain significantly more activity goals than TKA patients. GAS might be a useful objective outcome measure in evaluating clinical outcomes of individual KA patients.

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