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Rehabbing a knee replacement via the Internet may be just as good as traditional physical therapy, a study finds

January 20, 2011|By Jeannine Stein, Los Angeles Times

So much is moving to the Internet these days: shopping, television watching, coupon hunting. Here's one more: knee replacement rehab.

A study published in the Jan. 19 issue of the Journal of Bone and Joint Surgery compared a live, Internet-based rehabilitation program to a traditional one for 65 men and women who had recent knee replacement surgery. About half of the patients were randomly assigned to an outpatient physical therapy program and acted as a control group. The others did rehabilitation via the Internet with real-time sessions with a physical therapist via video, following their instructions and learning how to care for their knees (for the study, the participants did the therapy in a hospital room designed to look like an average home).

The sessions began about a week after participants were discharged from the hospital and lasted 45 minutes a week for six weeks. All participants were also encouraged to do a home exercise program twice a day.

Researchers measured how the patients did in tests of flexion range, muscle strength, pain, stiffness, function, etc.

After the six weeks, those in the Internet program had comparable results to those in the conventional rehabilitation program. They even did better in some areas, such as reducing joint stiffness.

About 581,000 total knee replacements are done in the U.S. each year, according to the American Academy of Orthopaedic Surgeons, and they expect that number to grow.

"Managing the rehabilitation needs of a growing number of total knee replacement patients presents a major challenge to physicians, physical therapists and health-policy decision-makers," said lead study author Trevor Russell in a news release. Russell, from the School of Health and Rehabilitation Science at the University of Queensland in Brisbane, Australia, added, "Alternate service-delivery models need to be considered to address these demands, improve access to services and control medical costs. Our results indicate telerehabilitation can be used successfully to achieve results comparable to traditional rehabilitation, while eliminating the obstacles faced by many patients in rural or remote areas."

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