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Trial registered on ANZCTR
Registration number
ACTRN12614000190606
Ethics application status
Approved
Date submitted
13/02/2014
Date registered
21/02/2014
Date last updated
1/04/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Short term benefits of prehabilitation for Total Knee Joint Replacement (TKJR)
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Scientific title
For people undergoing total knee joint replacement, does undergoing prehabilitation lead to better short term outcomes compared to not undergoing prehabilitation?
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Secondary ID [1]
284092
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None
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Universal Trial Number (UTN)
U1111-1153-3082
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Total Knee Joint Replacement
291166
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Condition category
Condition code
Musculoskeletal
291500
291500
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0
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Osteoarthritis
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Physical Medicine / Rehabilitation
291544
291544
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prehabilitation consists of at least 4 (and maximum 8) physiotherapy sessions prior to TKJR surgery. The prehabilitation sessions consist of exercises aimed at increasing strength and range of motion about the knee. Education regarding the processes and expectations following a TKJR are discussed and participants practice using pick up frames and crutches to increase familiarity with methods of mobilising post surgery. The sessions are aimed at improving overall fitness, mobility, strength and confidence leading into having TKJR surgery.
Prehabilitation will aim to be 2 sessions per week for 4 weeks prior to surgery, with each session lasting 30-45 minutes (depending on progress in each session).
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Intervention code [1]
288786
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Rehabilitation
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Comparator / control treatment
Usual practice prior to TKJR surgery (i.e. no physiotherapist led intervention)
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Control group
Active
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Outcomes
Primary outcome [1]
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Time until ready for discharge from physiotherapy.
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Assessment method [1]
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Timepoint [1]
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Post surgery, the treating physiotherapist will assess the participant each day as part of routine practice. When the appropriate assessments reach the required level the patient will be considered ready for discharge from physiotherapy.
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Secondary outcome [1]
306854
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Length of stay
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Assessment method [1]
306854
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Timepoint [1]
306854
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Length of stay will be assessed at discharge (i.e. time from surgery to discharge)
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Secondary outcome [2]
306855
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Knee Osteoarthritis Outcome Score (KOOS)
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Assessment method [2]
306855
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Timepoint [2]
306855
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Discharge and 3 months post discharge
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Eligibility
Key inclusion criteria
Patients undergoing an elective TKJR at St Vincent's Private Hospital in Kew, Victoria, Australia..
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Minimum age
40
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Bilateral TKJR’s/Unicompartmental Knee Replacements (UKR)
UKR
Significant co-morbidities likely to affect recovery from surgery i.e chronic condition – COPD, MS, Cardiac Condition, severe mental illness, ID, Alzhemier’s.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Subjects are invited to participate at a pre-admission appointment. Subjects nominate whether they choose to undergo prehabilitation or not. This is usual practice at the hospital where the trial will be undertaken.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Subjects nominate whether they will undertake the intervention or not. This is in line with usual practice at the hospital where the trial will take place.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Comparison of the rehabilitation and non-prehabilitation groups mean time to readiness for discharge, comparison of the mean length of stay between same groups, comparison of mean KOOS scores on discharge and 3 months later. In order to detect a difference of 0.5 days, with a SD of 3 days, 46 participants are needed per group to detect a difference with 95% confidence and 80% power. To allow for drop outs this number has been rounded up to 100.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
10/03/2014
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
2087
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St Vincent's Private Hospital - Fitzroy
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Funding & Sponsors
Funding source category [1]
288721
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Self funded/Unfunded
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Name [1]
288721
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Unfunded
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Address [1]
288721
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Unfunded
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Country [1]
288721
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Physiotherapy
Faculty of Medicine, Nursing and Health Sciences
Peninsula Campus, Monash University
McMahons Rd
Frankston
Vic 3199
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Country
Australia
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Secondary sponsor category [1]
287422
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None
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Name [1]
287422
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Address [1]
287422
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Country [1]
287422
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290559
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Low Risk Research Sub-committee of Human Research Ethics Committee (HREC-A)
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Ethics committee address [1]
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41 Victoria Parade Fitzroy Vic 3065
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Ethics committee country [1]
290559
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Australia
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Date submitted for ethics approval [1]
290559
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Approval date [1]
290559
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12/02/2014
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Ethics approval number [1]
290559
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LRR153/13
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Summary
Brief summary
A Total Knee Replacement (TKJR) is a common treatment for advanced osteoarthritis of the knee. Osteoarthritis is the wearing of the joint surfaces in the knee, over time becoming painful and severely limiting a person’s mobility. In a TKJR, worn joint surfaces of the knee are replaced with synthetic components, removing the source of pain and allowing a person to return to higher levels of function. However, the nature of the surgery means rehabilitation is required to allow the person to return to previous levels of activity. A TKJR is an elective procedure with a long wait list in the public hospital system. Individuals with private health insurance can avoid a long wait for surgery and have the procedure conducted in a private hospital, with insurance covering the majority of the costs for surgery. Private health insurance also commonly covers some of the costs associated with physiotherapy treatment and rehabilitation. Prehabilitation is the practice of exercising prior to a procedure to increase the strength and function of the body in order to speed up recovery after surgery. In the case of a TKJR, prehabilitation equates to increasing knee joint flexion, increasing strength in the muscles around the knee and improving general cardiovascular fitness. The ultimate aim of prehabilitation is to speed the recovery after surgery through the strengthening of major muscles groups beforehand. It is current practice at St Vincent's Private, Kew, that patients undergoing a TKJR are given the option to undertake prehabilitation or not. This research aims to determine whether prehabilitation in a private hospital setting improves short -term outcomes after TKJR.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
46250
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Dr Ross Iles
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Address
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Department of Physiotherapy
Faculty of Medicine, Nursing and Health Sciences
Peninsula Campus, Monash University
McMahons Rd
Frankston
Vic 3199
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Country
46250
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Australia
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Phone
46250
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+61 3 99044119
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Fax
46250
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Email
46250
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[email protected]
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Contact person for public queries
Name
46251
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Ross Iles
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Address
46251
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Department of Physiotherapy
Faculty of Medicine, Nursing and Health Sciences
Peninsula Campus, Monash University
McMahons Rd
Frankston
Vic 3199
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Country
46251
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Australia
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Phone
46251
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+61 3 99044119
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Fax
46251
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Email
46251
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[email protected]
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Contact person for scientific queries
Name
46252
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Ross Iles
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Address
46252
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Department of Physiotherapy
Faculty of Medicine, Nursing and Health Sciences
Peninsula Campus, Monash University
McMahons Rd
Frankston
Vic 3199
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Country
46252
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Australia
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Phone
46252
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+61 3 99044119
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Fax
46252
0
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Email
46252
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Basic results
No
365798-(Uploaded-18-11-2019-09-27-41)-Basic results summary.pdf
Documents added automatically
No additional documents have been identified.
Download to PDF