Effect of body mass index on knee function outcomes following continuous passive motion in patients with osteoarthritis after total knee replacement

A retrospective study

Chun De Liao, Yi Ching Huang, Yen Shuo Chiu, Tsan-Hon Liou

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. Participants and setting: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review. Intervention: All patients commenced the CPM programme immediately after surgery and continued until hospital discharge. Main outcome measures: Knee flexion, pain score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score. Design: Patients were divided into five BMI groups: normal weight (n = 59), overweight (n = 95), Class I obesity (n = 90), Class II obesity (n = 82) and Class III obesity (n = 28). All outcome measures were recorded at admission; daily during the inpatient stay; at discharge; and at 1-, 3- and 6-month follow-up assessments. Results: During CPM exercises, obese patients had a smaller initial flexion angle (P . <. 0.001) and a smaller daily increment in the CPM motion arc (P . <. 0.001) compared with patients of normal weight. Severe obesity was associated with poor knee flexion [adjusted odds ratio (aOR) 11.9, 95% confidence interval (CI) 3.49 to 40.94, . P . <. 0.001] and WOMAC physical function score (aOR 5.09, 95% CI 1.62 to 16.03, . P = 0.005) at 6-month follow-up. Conclusions: Obesity had a negative effect on progress during the CPM protocol, which commenced immediately after surgery and continued until discharge. Obesity was also associated with poorer self-reported function at 6-month follow-up.

Original languageEnglish
JournalPhysiotherapy
DOIs
Publication statusPublished - 2017

Fingerprint

Knee Replacement Arthroplasties
Osteoarthritis
Knee
Body Mass Index
Retrospective Studies
Obesity
Inpatients
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Weights and Measures
Rehabilitation Centers
Morbid Obesity
Ontario
Rehabilitation
Exercise
Pain

Keywords

  • Continuous passive motion
  • Functional outcome
  • Obesity
  • Rehabilitation
  • Total knee replacement

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

@article{c03d09b7a8f54a8d88690a30c7b1d7ff,
title = "Effect of body mass index on knee function outcomes following continuous passive motion in patients with osteoarthritis after total knee replacement: A retrospective study",
abstract = "Objective: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. Participants and setting: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review. Intervention: All patients commenced the CPM programme immediately after surgery and continued until hospital discharge. Main outcome measures: Knee flexion, pain score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score. Design: Patients were divided into five BMI groups: normal weight (n = 59), overweight (n = 95), Class I obesity (n = 90), Class II obesity (n = 82) and Class III obesity (n = 28). All outcome measures were recorded at admission; daily during the inpatient stay; at discharge; and at 1-, 3- and 6-month follow-up assessments. Results: During CPM exercises, obese patients had a smaller initial flexion angle (P . <. 0.001) and a smaller daily increment in the CPM motion arc (P . <. 0.001) compared with patients of normal weight. Severe obesity was associated with poor knee flexion [adjusted odds ratio (aOR) 11.9, 95{\%} confidence interval (CI) 3.49 to 40.94, . P . <. 0.001] and WOMAC physical function score (aOR 5.09, 95{\%} CI 1.62 to 16.03, . P = 0.005) at 6-month follow-up. Conclusions: Obesity had a negative effect on progress during the CPM protocol, which commenced immediately after surgery and continued until discharge. Obesity was also associated with poorer self-reported function at 6-month follow-up.",
keywords = "Continuous passive motion, Functional outcome, Obesity, Rehabilitation, Total knee replacement",
author = "Liao, {Chun De} and Huang, {Yi Ching} and Chiu, {Yen Shuo} and Tsan-Hon Liou",
year = "2017",
doi = "10.1016/j.physio.2016.04.003",
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journal = "Physiotherapy",
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T1 - Effect of body mass index on knee function outcomes following continuous passive motion in patients with osteoarthritis after total knee replacement

T2 - A retrospective study

AU - Liao, Chun De

AU - Huang, Yi Ching

AU - Chiu, Yen Shuo

AU - Liou, Tsan-Hon

PY - 2017

Y1 - 2017

N2 - Objective: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. Participants and setting: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review. Intervention: All patients commenced the CPM programme immediately after surgery and continued until hospital discharge. Main outcome measures: Knee flexion, pain score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score. Design: Patients were divided into five BMI groups: normal weight (n = 59), overweight (n = 95), Class I obesity (n = 90), Class II obesity (n = 82) and Class III obesity (n = 28). All outcome measures were recorded at admission; daily during the inpatient stay; at discharge; and at 1-, 3- and 6-month follow-up assessments. Results: During CPM exercises, obese patients had a smaller initial flexion angle (P . <. 0.001) and a smaller daily increment in the CPM motion arc (P . <. 0.001) compared with patients of normal weight. Severe obesity was associated with poor knee flexion [adjusted odds ratio (aOR) 11.9, 95% confidence interval (CI) 3.49 to 40.94, . P . <. 0.001] and WOMAC physical function score (aOR 5.09, 95% CI 1.62 to 16.03, . P = 0.005) at 6-month follow-up. Conclusions: Obesity had a negative effect on progress during the CPM protocol, which commenced immediately after surgery and continued until discharge. Obesity was also associated with poorer self-reported function at 6-month follow-up.

AB - Objective: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. Participants and setting: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review. Intervention: All patients commenced the CPM programme immediately after surgery and continued until hospital discharge. Main outcome measures: Knee flexion, pain score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score. Design: Patients were divided into five BMI groups: normal weight (n = 59), overweight (n = 95), Class I obesity (n = 90), Class II obesity (n = 82) and Class III obesity (n = 28). All outcome measures were recorded at admission; daily during the inpatient stay; at discharge; and at 1-, 3- and 6-month follow-up assessments. Results: During CPM exercises, obese patients had a smaller initial flexion angle (P . <. 0.001) and a smaller daily increment in the CPM motion arc (P . <. 0.001) compared with patients of normal weight. Severe obesity was associated with poor knee flexion [adjusted odds ratio (aOR) 11.9, 95% confidence interval (CI) 3.49 to 40.94, . P . <. 0.001] and WOMAC physical function score (aOR 5.09, 95% CI 1.62 to 16.03, . P = 0.005) at 6-month follow-up. Conclusions: Obesity had a negative effect on progress during the CPM protocol, which commenced immediately after surgery and continued until discharge. Obesity was also associated with poorer self-reported function at 6-month follow-up.

KW - Continuous passive motion

KW - Functional outcome

KW - Obesity

KW - Rehabilitation

KW - Total knee replacement

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