Music-exercise video can improve TKA results
For years, workout videos have been a great way to get people on their feet to exercise. Now, a similar type of video can help some people get back on their feet.
According to the authors of scientific paper 501, using a music-exercise video as part of the rehabilitation protocol for patients after total knee arthroplasty (TKA) results in significantly better recovery from the surgery—as well as substantial cost savings.
“The video works in part because the patients have more fun doing the exercises,” said coauthor Thomas G. Ryan, MD. “When the program is fun and motivating, patients are more likely to actually do it.”
More than 300,000 total knee arthroplasties are performed in the U.S. each year. Following surgery, patients must perform a series of exercises several times a day. These exercises are designed to restore movement and strengthen the knee. Performing these exercises as instructed is vital to a patient’s successful rehabilitation.
To aid patients in performing their exercises each day, Dr. Ryan and his partners developed a video similar to a workout video, with an instructor demonstrating the movements and giving occasional reminders intended to help viewers do the exercises correctly and avoid injury. Their prospective, randomized study involved 46 patients (52 consecutive TKAs performed by a single surgeon, blinded to the patient’s participation). Patients ranged in age from 41 years to 84 years old (average age: 67 years old).
All patients received the same postoperative physical therapy in the hospital and were discharged when ambulatory (with a walker or crutches), usually after two or three days. Half the patients received the video along with their instruction sheet; the rest received just the physical therapy instruction sheet. Practically all (98 percent) of patients completed the satisfaction questionnaire.
Patients who used the video were able to return to their usual daily activities an average of 59 percent faster than those that did not. Objective measurements of knee status and overall function at six and eight weeks were significantly better for those using the video. In addition, 100 percent of the patients using the video said that if they needed knee surgery in the future, they would choose to use the video as part of their rehabilitation program.
On the whole, the use of the video resulted in significant improvements in patients’ understanding of the exercise program, confidence that they were performing the exercises correctly, and overall satisfaction with the rehabilitation program when compared with patients that did not use the video.
“Patients were following the instructor on the video and listening to the music instead of concentrating on how much longer they have to work, so it felt easier to do the exercises,” Ryan said. “When patients came in for appointments, they had big smiles on their faces because they were doing so well. Many said they had exceeded their own expectations for their recovery.”
All of these improvements were achieved at a substantial cost savings, due primarily to a decreased need for additional therapy during the initial eight-week period. Among patients who received the video, physical therapy costs averaged $287; among those who received just the instruction sheet, costs averaged $2,602 per patient. Extrapolating the $2,300 in savings to the total number of TKAs performed in the United States each year results in a total annual savings of $1.04 billion, with improved results for patients.
The video is available only to surgeons, hospitals, or licensed physical therapists who can then determine if it is appropriate for use for their patients. For a sample clip of the video, visit http://www.boneafideproductions.com
The authors of the video received no funds or support in the development of the video or the conduct of the study. The authors, however, do hold the copyrights and maintain control of the sale and distribution rights for the video, which may result in financial gain to them from future profits.
The research team includes Dr. Ryan, of Kalamazoo, Mich.; Blake L. Ohlson, MD, of Baltimore, and Ryan L. Adams, MPT. Mr. Adams is a consultant for Physiotherapy Associates Stryker.