Axis Journal of Medical and Biosocial Sciences (AJMBS)

RANDOMIZED TRIAL OF DPT-GUIDED TELEREHABILITATION VERSUS CLINIC-BASED THERAPY AFTER KNEE ARTHROPLASTY

Authors

  • Akif Saeed Ch

    Author

  • Sheikh Muhammad Munir

    Author

Keywords:
Arthroplasty, replacement, knee; Patient satisfaction; Physical therapy modalities; Postoperative care; Randomized controlled trial; Recovery of function; Telerehabilitation
Abstract

Background: Postoperative rehabilitation following total knee arthroplasty is essential for functional recovery, but traditional clinic-based physiotherapy presents barriers related to travel, cost, and access. Telerehabilitation has emerged as a potential alternative, yet limited evidence exists comparing doctoral-level physical therapist-guided remote therapy with standard in-person care.

Objective: To compare the effectiveness of DPT-guided telerehabilitation versus standard clinic-based physiotherapy in improving functional recovery, reducing pain, and lowering readmission rates following total knee arthroplasty.

Methods: This parallel-group randomized controlled trial enrolled 88 adults undergoing primary unilateral total knee arthroplasty in North Punjab, Pakistan. Participants were randomly assigned to a four-week DPT-guided telerehabilitation program (five supervised home sessions weekly) or standard clinic-based physiotherapy (four weekly sessions). Primary outcomes were WOMAC physical function and timed up-and-go test assessed at baseline, four weeks, and three months. Secondary outcomes included pain, quality of life, satisfaction, and ninety-day readmission rates. Analysis followed intention-to-treat principles using independent and paired t-tests, and repeated measures ANOVA.

Results: Eighty participants completed the trial. At four weeks, the telerehabilitation group demonstrated significantly better timed up-and-go performance (10.1±1.8 vs. 11.2±2.0 seconds; mean difference –1.1 seconds, 95% CI –2.0 to –0.2, p=0.02) and lower walking pain (2.9±1.1 vs. 3.6±1.2; p=0.01). WOMAC physical function differences did not reach significance (31.2±6.4 vs. 33.5±6.9; p=0.11). Repeated measures ANOVA revealed a significant time×group interaction for timed up-and-go (F=4.8, p=0.03). Readmission rates were 5.1% in the telerehabilitation group versus 12.2% in the clinic-based group (p=0.27). Patient satisfaction favored telerehabilitation (p=0.04).

Conclusion: DPT-guided telerehabilitation was non-inferior to clinic-based physiotherapy following knee arthroplasty, offering superior early mobility gains and satisfaction. This approach represents a viable, patient-centered alternative, particularly when access to in-person care is limited.

Author Biographies
  1. Akif Saeed Ch

    Director Medical Services & Research, Hope Family Clinic & Rehab, Faisalabad, Pakistan.

  2. Sheikh Muhammad Munir

    Senior Lecturer, Ziauddin College of Physical Therapy, Ziauddin University, Karachi, Pakistan.

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Axis Journal of Medical and Biosocial Sciences
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Published
2026-03-31
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Vol. 3 No. 1 (2026): Axis Journal of Medical and Biosocial Sciences (AJMBS)
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Copyright (c) 2026 Akif Saeed Ch, Sheikh Muhammad Munir (Author)

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RANDOMIZED TRIAL OF DPT-GUIDED TELEREHABILITATION VERSUS CLINIC-BASED THERAPY AFTER KNEE ARTHROPLASTY. (2026). Axis Journal of Medical and Biosocial Sciences, 3(1), 1-16. https://axisjmbs.com/index.php/home/article/view/33