LegTutor Used in TeleRehabilitation for Knee Replacement Therapy

SHARON WORCESTER, Family Practice News Digital Network on November 17, 2011 reports from Chicago that
patients who undergo total knee replacement surgery recover just as well with postoperative, group-based, outpatient physiotherapy or a monitored, home-based physiotherapy program as with a one-on-one, outpatient center–based program, according to findings from a randomized study involving 249 patients.
With the exception of patient satisfaction with physiotherapy – which was significantly greater for the 85 patients who were randomized to one-on-one therapy and the 84 who were randomized to group-based therapy than it was for the 80 patients who received home-based therapy (mean satisfaction rates, 90%, 84%, and 73%, respectively) – no significant differences were seen in any other outcome measures during the first postsurgical year, Victoria W.M. Ko of the University of New South Wales, Sydney, and her colleagues reported in a poster at the annual meeting of the American College of Rheumatology.
For example, WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index function scores at postoperative week 10 (the primary outcome measure) were similar at a mean of 44.0, 39.32, and 35.0 in the one-on-one patients, the group-based therapy patients, and the home-based therapy patients, respectively. There also were no differences among groups in recovery of mobility as measured by a 6-minute walk distance and a timed stair test, or inHRQOL (Health-Related Quality of Life) score, knee range of motion, or patient-related overall recovery at 52 weeks, the investigators found.
Furthermore, the home-based program patients were no more likely than those in the other groups to be readmitted to the hospital or to experience any other complications.
Patient in the single-blind study were consecutive adults (mean age, 67 years) who were awaiting total knee replacement, were enrolled 2 weeks prior to surgery, and were randomized 2 weeks after surgery. During the 6-week therapy period, those who were randomized to receive one-on-one therapy or group-based therapy received 12 physiotherapy sessions, and those in the home-based program were prescribed home exercises supplemented with two sessions of one-on-one therapy and a telephone follow-up. All patients were assessed preoperatively and at postoperative weeks 2, 10, 26, and 52.
The findings are important because of the increasing volume of total knee replacement surgeries performed annually, and because home-based therapy provides a safe and more resource-efficient alternative to center-based physiotherapy, the investigators concluded. They added that this approach “will also circumvent access issues frequently associated with center-based care.
The LegTutor is being included extensively in home based physical therapy following knee replacement surgery through the use of telerehabilitation.
The LegTutor™ system has been developed to allow for functional rehabilitation of the lower extremity. The system consists of an ergonomic wearable leg brace and dedicated rehabilitation software. The LegTutor™ system, which includes the HandTutor, ArmTutor and 3DTutor, allows for a range of biomechanical evaluation including speed, passive and active range of motion and motion analysis of the lower extremity. Quantitative biomechanical data allow for objective evaluation and rehabilitation treatment follow up. The LegTutor™ rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. The exercises are designed in the form of challenging games that are suitable for a wide variety of neurological and orthopedic injury and disease.
The games challenge the patient to perform the exercise task to their best ability and to continue exercise practice.
In addition the LegTutor™ allows for isolated and a combination of knee and three directional hip treatment. The Tutor system provides detailed exercise performance instructions and precise feedback on the patients exercise performance. Controlled exercise of multi joints within the normal movement pattern prevents the development of undesired and compensatory joint movement and ensures better performance of functional tasks.
The LegTutor™ system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. See www.HandTutor.com for more information.