Simultaneous Physiotherapy and Orthopedic Surgeon Interdisciplinary Care (SPOSIC)

NCT ID: NCT05664724

Last Updated: 2022-12-27

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-02-28
• Study Completion Date: 2024-08-31

Brief Summary

This study will test a protocol to implement simultaneous physiotherapy and orthopedic surgeon interdisciplinary care for patients undergoing knee replacement surgery. These interdisciplinary sessions will help tailor personalized goals, involving the patient as a key member of the team.

Detailed Description

The purpose of this project is to test a quality improvement protocol to improve outcomes following knee arthroplasty surgery utilizing simultaneous physiotherapy and orthopedic surgeon interdisciplinary care. In an era of increasing demands on health care budgets, it is vital to improve quality of care without substantially increasing its cost. This study will focus on a quality improvement strategy that aims to redeploy existing resources to achieve higher quality care without substantially altering costs. This interdisciplinary approach involves establishing a high functioning team that includes the patient as a pivotal member and builds collaboration in the pre-operative period that can be leveraged in the post-operative period to achieve optimal outcomes. This differs from traditional, siloed care for knee arthroplasty.

Participants will be involved in usual care surrounding knee arthroplasty which includes education sessions and pre-habilitation pre-operatively and rehabilitation post-operatively. Participants will also attend two interdisciplinary sessions at 2 months and 1 month prior to surgery to outline expectations, explore patients' questions and concerns, set expectations for the next interdisciplinary session, and ensure goal congruence between all members of the team. At each of these sessions a physical assessment will also be completed by the orthopedic surgeon and physiotherapist. Following surgery, participants will attend four more interdisciplinary sessions at 2 weeks, 6 weeks, 3 months, and 6 months post-operatively. These sessions will address safety and medical issues, revisit patient expectations, reinforce care team expectations, focus on a personalized rehabilitation plan, and ensure goal congruence between the various team members. The physical assessment will also be repeated.

The objectives of the study are as follows:

1. Evaluate the feasibility (e.g., recruitment and retention, administrative and participant burden, lived experiences) of treating knee arthroplasty patients through a novel interdisciplinary program aimed to optimize recovery among patients; and

2. Estimate the size of the program's effect on biopsychosocial outcomes among community-dwelling individuals undergoing knee arthroplasty and rehabilitation.

The hypotheses of the study are as follows:

1. The protocol will establish proof-of-concept, and demonstrate sufficient feasibility to support a future full-scale multi-site RCT.

2. Simultaneous physiotherapy and orthopedic surgery interdisciplinary care (SPOSIC) will improve the primary outcome of functional disability, as measured by the 12-item Oxford Knee score (OKS), and improvements will also be shown in the secondary outcomes of pain, participation in social roles, health-related quality of life, and mobility.

Conditions

Osteoarthritis, Knee; Arthritis

Keywords

arthroplasty; rehabilitation; interdisciplinary

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Receives interdisciplinary sessions

Interdisciplinary care by a team that includes: orthopedic surgeon, physiotherapist, a patient navigator, and the patient

Group Type: EXPERIMENTAL

Receives interdisciplinary sessions

Intervention Type: BEHAVIORAL

Along with usual care, participants receive six interdisciplinary sessions at 2 months and 1 month pre-operatively and 2 weeks, 6 weeks, 3 months, and 6 months post-operatively attended by an orthopedic surgeon, a physiotherapist, a patient navigator, and the patient. The pre-operative interdisciplinary sessions will outline expectations, explore patients' questions and concerns, set expectations for the next interdisciplinary session, and ensure goal congruence between all members of the team.

Along with usual care during the post-operative period, participants will receive interdisciplinary sessions that address safety and medical issues, revisit patient expectations, reinforce care team expectations, focus on a personalized rehabilitation plan, and ensure goal congruence between the various team members.

Interventions

Receives interdisciplinary sessions

Along with usual care, participants receive six interdisciplinary sessions at 2 months and 1 month pre-operatively and 2 weeks, 6 weeks, 3 months, and 6 months post-operatively attended by an orthopedic surgeon, a physiotherapist, a patient navigator, and the patient. The pre-operative interdisciplinary sessions will outline expectations, explore patients' questions and concerns, set expectations for the next interdisciplinary session, and ensure goal congruence between all members of the team.

Along with usual care during the post-operative period, participants will receive interdisciplinary sessions that address safety and medical issues, revisit patient expectations, reinforce care team expectations, focus on a personalized rehabilitation plan, and ensure goal congruence between the various team members.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. 19 years of age or older

2. Expecting to undergo knee arthroplasty surgery within 12 months

3. Pain or functional limitation due to the musculoskeletal condition

4. Able to walk 10 meters without physical assistance

5. Able to tolerate 50 minutes of activity (including rest breaks, as needed)

6. Have adequate cognitive-communicative ability to participate (based on clinical judgment of the research team)

7. Able to provide informed consent

Exclusion Criteria

1. Are living in long-term care

2. Have significant neurological conditions

3. Are medically unstable

4. Have medical condition(s) significantly impacting lower extremity function

• Minimum Eligible Age: 19 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Interior Health

INDUSTRY

Sponsor Role: collaborator

University of British Columbia

OTHER

Sponsor Role: lead

Responsible Party

Brodie Sakakibara

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Brodie Sakakibara, PhD

Role: PRINCIPAL_INVESTIGATOR

The University of British Columbia

Central Contacts

Holly Wise

Role: CONTACT

Phone: 250.558-9140

Email: holly.wise@interiorhealth.ca

Brodie Sakakibara, PhD

Role: CONTACT

Email: brodie.sakakibara@ubc.ca

Other Identifiers

SPOSIC

Identifier Type: -

Identifier Source: org_study_id