National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Back Health and Pain (1)
- Cardiovascular Conditions (3)
- Comparative Effectiveness (1)
- Digestive Disease and Health (1)
- Elderly (2)
- Evidence-Based Practice (8)
- Heart Disease and Health (3)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (2)
- Medical Devices (1)
- Mortality (2)
- Nursing Homes (2)
- Orthopedics (7)
- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Quality Improvement (1)
- Quality of Care (1)
- (-) Rehabilitation (13)
- Risk (1)
- Shared Decision Making (1)
- (-) Surgery (13)
- Transitions of Care (1)
- Transplantation (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedKonnyu KJ, Thoma LM, Cao W
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
This systematic review sought to examine evidence on the benefits and harms of prehabilitation interventions for patients scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. Evidence from 13 total knee arthroplasty studies suggested that prehabilitation may result in increased strength and reduced length of hospital stays and may not lead to increased harms; it may be comparable in terms of pain, range of motion, and activities of daily living. No evidence or insufficient evidence was found for all other outcomes after total knee arthroplasty. No evidence or insufficient evidence was found for all total hip arthroplasty outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Prehabilitation for total knee or total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):1-10. doi: 10.1097/phm.0000000000002006..
Keywords: Rehabilitation, Orthopedics, Evidence-Based Practice, Surgery
Konnyu KJ, Pinto D, Cao W
Rehabilitation for total hip arthroplasty: a systematic review.
This systematic review sought to determine the comparative benefits and harms of rehabilitation interventions for patients who had undergone elective, unilateral total hip arthroplasty (THA) for the treatment of primary osteoarthritis. Evidence from 15 studies suggested that individual rehabilitation programs may not differ in terms of risk of harm, outcomes of pain, strength, activities of daily living, or quality of life. No differences in outcomes were found between different rehabilitation programs after THA. The authors concluded that further evidence is needed to inform decisions on which rehabilitation program attributes are most effective for various outcomes.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Pinto D, Cao W .
Rehabilitation for total hip arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):11-18. doi: 10.1097/phm.0000000000002007..
Keywords: Rehabilitation, Orthopedics, Surgery, Evidence-Based Practice
Konnyu KJ, Thoma LM, Cao W
Rehabilitation for total knee arthroplasty: a systematic review.
This systematic review sought to determine comparative benefits and harms of rehabilitation interventions for patients had undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. Evidence from 53 studies suggested that diverse rehabilitation programs may lead to comparable improvements in pain, range of motion, and activities of daily living. No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period nor among various postacute rehabilitation programs. All findings were of low strength of evidence.
AHRQ-funded; 75Q80120D00001.
Citation: Konnyu KJ, Thoma LM, Cao W .
Rehabilitation for total knee arthroplasty: a systematic review.
Am J Phys Med Rehabil 2023 Jan;102(1):19-33. doi: 10.1097/phm.0000000000002008..
Keywords: Rehabilitation, Surgery, Orthopedics, Evidence-Based Practice
Graber J, Juarez-Colunga E, Thigpen C
Development of reference charts for monitoring quadriceps strength with handheld dynamometry after total knee arthroplasty.
This retrospective analysis’ purpose was to develop reference charts that describe normative quadriceps strength recovery after total knee arthroplasty (TKA) as measured by handheld dynamometry (HHD). The authors analyzed post-TKA quadriceps strength recovery using a longitudinal dataset consisting of both clinical and research HHD data. They created sex-specific models for recovery using Generalized Additive Models for Location, Scale, and Shape and reference charts from the models to display the recovery of population centiles over the first six postoperative months. They analyzed a total of 588 patient records with 1176 observations. There was a rapid increase in quadriceps strength for both sexes over the first 60 postoperative days followed by a more gradual increase over the next 120 days. They found that males appeared to demonstrate faster recovery and greater strength on average compared to females. The reference charts may aid clinicians’ ability to monitor and intervene upon quadriceps weakness-a pronounced and debilitating post-TKA impairment-throughout rehabilitation.
AHRQ-funded; HS025692.
Citation: Graber J, Juarez-Colunga E, Thigpen C .
Development of reference charts for monitoring quadriceps strength with handheld dynamometry after total knee arthroplasty.
Disabil Rehabil 2022 Dec;44(24):7535-42. doi: 10.1080/09638288.2021.1995054..
Keywords: Surgery, Orthopedics, Rehabilitation
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation: Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords: Shared Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Kittelson AJ, Loyd BJ, Graber J
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
This study investigated whether total knee arthroplasty (TKA) patients seen in routine practice who meet common exclusion criteria in clinical trials recover differently compared to research-eligible patients. Postoperative functional outcomes were compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Timed Up and Go (TUG). A total of 2,528 participants from 27 trials were compared to 474 patients from the clinical dataset. Research participants were older, with lower BMI than patients in the clinical dataset. There were no differences observed in functional recovery rate between groups, except for patients with diabetes whose TUG recovered more slowly than “eligible” patients.
AHRQ-funded; HS024316.
Citation: Kittelson AJ, Loyd BJ, Graber J .
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
J Eval Clin Pract 2021 Dec;27(6):1335-42. doi: 10.1111/jep.13564..
Keywords: Orthopedics, Surgery, Rehabilitation, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Hsieh CJ, DeJong G, Vita M
AHRQ Author: Hsieh CJ
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
Researchers compared post-total knee arthroplasty (TKA) functional mobility outcomes among 3 newly-developed physical therapy protocols with a standard-of-care post-TKA rehabilitation protocol. They found no statistically or clinically significant differences in outcomes across the 4 study arms (control, treadmill, neuromuscular stimulation device, and combination intervention). As outcomes were similar among arms, they recommended that clinicians instead consider relative cost in tailoring TKA rehabilitation.
AHRQ-authored.
Citation: Hsieh CJ, DeJong G, Vita M .
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
JAMA Netw Open 2020 Sep;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571..
Keywords: Rehabilitation, Orthopedics, Surgery, Outcomes, Evidence-Based Practice
Patel DK, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
Investigators sought to characterize cardiac rehabilitation (CR) enrollment after cardiac valve surgery and its association with outcomes, including hospitalizations and mortality. Subjects were all fee-for-service Medicare beneficiaries undergoing open cardiac valve surgery in 2014, identified by inpatient diagnosis codes for open aortic, mitral, tricuspid, and pulmonary valve surgery. They found that fewer than half of Medicare beneficiaries undergoing cardiac valve surgery enrolled in CR programs, and there were marked racial/ethnic disparities among those who do. They recommend further study on barriers to CR enrollment in this population.
AHRQ-funded; HS022990.
Citation: Patel DK, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery.
JAMA Cardiol 2019 Dec;4(12):11887-1301. doi: 10.1001/jamacardio.2019.4032..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Rehabilitation, Hospitalization, Surgery, Mortality, Risk, Elderly
Balentine CJ, Kenzik K, Chu DI
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Investigators compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. They found that there was no difference in 30-day readmission rates, but post-discharge mortality was higher for patients discharged to skilled nursing facilities compared to inpatient rehabilitation.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Kenzik K, Chu DI .
Planning post-discharge destination for gastrointestinal surgery patients: room for improvement?
Am J Surg 2018 Nov;216(5):912-18. doi: 10.1016/j.amjsurg.2018.05.004..
Keywords: Hospital Discharge, Surgery, Digestive Disease and Health, Rehabilitation, Nursing Homes, Quality Improvement, Quality of Care, Transitions of Care
Bachmann JM, Shah AS, Duncan MS
Cardiac rehabilitation and readmissions after heart transplantation.
Cardiac transplant recipients always are referred to cardiac rehabilitation (CR) after transplantation, and is associated with a lower 1-year readmission risk. This study’s objective was to determine rates of CR for heart transplant recipients in the US and also 1-year readmission rates using 2013-2014 Medicare data. Out of the 2,531 heart transplant patients in the US in 2013, about 24% received Medicare coverage and were included in the study. Rates of CR utilization was only, with only 55% participating in the program. Younger transplant patients ages 35 to 49 years were less likely to initiate CR than patients 65 and older. In all groups patients did not attend all 36 prescribed sessions, with a mean of 26.7 sessions attended. The 1-year readmission risk was 29% lower for CR participation patients.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Shah AS, Duncan MS .
Cardiac rehabilitation and readmissions after heart transplantation.
J Heart Lung Transplant 2018 Apr;37(4):467-76. doi: 10.1016/j.healun.2017.0.017.
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Keywords: Transplantation, Surgery, Rehabilitation, Cardiovascular Conditions, Heart Disease and Health, Hospital Readmissions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Skolasky RL, Maggard AM, Wegener ST
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
A prospective interventional trial was conducted, to compare the effectiveness of health behavior change counseling with usual care to improve health outcomes after lumbar spine surgical procedures. The investigators found that health behavior change counseling improved health outcomes during the first 12 months after the surgical procedure through changes in rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Wegener ST .
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
J Bone Joint Surg Am 2018 Jan 3;100(1):21-30. doi: 10.2106/jbjs.17.00418..
Keywords: Back Health and Pain, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Rehabilitation, Surgery
Welsh RL, Graham JE, Karmarkar AM
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
This study examined the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. Inpatient rehabilitation facility (IRF), skilled nursing facility (SNF) concluded that patients discharged to either inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF), in comparison with those discharged to the community, had greater likelihood of readmission within 30 and 90 days.
AHRQ-funded; HS022907.
Citation: Welsh RL, Graham JE, Karmarkar AM .
Effects of postacute settings on readmission rates and reasons for readmission following total knee arthroplasty.
J Am Med Dir Assoc 2017 Apr;18(4):367.e1-67.e10. doi: 10.1016/j.jamda.2016.12.068.
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Keywords: Elderly, Nursing Homes, Hospital Readmissions, Rehabilitation, Surgery