Darain H1, Al-Kitani A2, Jan MBA3, Gleeson N4
1Khyber Medical University, Peshawar, Institute of Physical Medicine and Rehabilitation, Peshawar, Pakistan, 2Ministry of Sport Science, Musqat, Oman, 3Rehman Medical Institute, Rehman College of Rehabilitation Sciences, Peshawar, Pakistan, 4Queen Margaret University, Edinburgh, United Kingdom
Background: The clinical and economical effectiveness of community-based rehabilitation programmes in the form of National Health Service (NHS) lay-led and self-care support programmes for some of the long-term medical conditions have been endorsed previously.
A systematic review carried out by Barlow et al. (2002) on 145 research studies from different countries and with clearly defined inclusion criterion, further endorsed the approach of community-based rehabilitation for long-term conditions such as arthritis, stroke and asthma. To the authors' knowledge, no study to date has provided a systematic evaluation of the effectiveness of community-based rehabilitation programmes designed for patients with musculoskeletal injuries, while the latter affects a large proportion of the population every year.
Purpose: The purpose of this systematic review is assess community-based rehabilitation programmes following anterior cruciate ligament reconstruction.
Methods: A systematic search for literature was undertaken (Jan 2003 until December 2013). Searches in electronic database including AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, and PsycINFO were carried out for the outcomes of randomised controlled trials involving the community-based rehabilitation programmes following ACL reconstruction. Keywords used to search for the literature were entered into the databases.
Results: The initial search produced a total number of sixty-five studies of which thirty were removed as duplicates. Keeping in mind the inclusion and exclusion criteria for this review, abstracts of the remaining thirty-five studies were further reviewed carefully to judge on the final appropriateness of the studies to be included in this review. Out of thirty five studies, thirty studies were excluded as those trials typically did not reflect comparisons of responses for the community- and the hospital-based populations while one of the remaining five studies was excluded due to non-randomisation in that trial. Only four studies fulfilled the inclusion criteria for this review. Each manuscript was then reviewed manually and its reference list was checked for additional and relevant information that might also be usefully included in this review. A total of 377 patients in the included trials for this review were randomly allocated into the hospital- and the community-based rehabilitation groups and were assessed on functional, objective and patients' reported outcome measures.
In all four trials no differences amongst the group mean scores for the patients in the hospital- and the community-based rehabilitation programmes were reported in functional (single-leg hop), objectives (quadriceps and hamstrings peak force) and subjective (IKDC, Lysholm, ACL quality of life, Tenger Scale) outcome measures.
Conclusion(s): This review suggests that the community-based rehabilitation programme is clinical-efficient in terms of achieving similar outcomes by the patients in the community to the outcomes achieved by the patients in the hospital-based rehabilitation programme at 24th week following ACL reconstruction.
Implications:
Keywords: Anterior Cruciate Ligament, community-based rehabilitation, supervised rehabilitation
Funding acknowledgements: Higher Education Commission Pakistan
A systematic review carried out by Barlow et al. (2002) on 145 research studies from different countries and with clearly defined inclusion criterion, further endorsed the approach of community-based rehabilitation for long-term conditions such as arthritis, stroke and asthma. To the authors' knowledge, no study to date has provided a systematic evaluation of the effectiveness of community-based rehabilitation programmes designed for patients with musculoskeletal injuries, while the latter affects a large proportion of the population every year.
Purpose: The purpose of this systematic review is assess community-based rehabilitation programmes following anterior cruciate ligament reconstruction.
Methods: A systematic search for literature was undertaken (Jan 2003 until December 2013). Searches in electronic database including AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, and PsycINFO were carried out for the outcomes of randomised controlled trials involving the community-based rehabilitation programmes following ACL reconstruction. Keywords used to search for the literature were entered into the databases.
Results: The initial search produced a total number of sixty-five studies of which thirty were removed as duplicates. Keeping in mind the inclusion and exclusion criteria for this review, abstracts of the remaining thirty-five studies were further reviewed carefully to judge on the final appropriateness of the studies to be included in this review. Out of thirty five studies, thirty studies were excluded as those trials typically did not reflect comparisons of responses for the community- and the hospital-based populations while one of the remaining five studies was excluded due to non-randomisation in that trial. Only four studies fulfilled the inclusion criteria for this review. Each manuscript was then reviewed manually and its reference list was checked for additional and relevant information that might also be usefully included in this review. A total of 377 patients in the included trials for this review were randomly allocated into the hospital- and the community-based rehabilitation groups and were assessed on functional, objective and patients' reported outcome measures.
In all four trials no differences amongst the group mean scores for the patients in the hospital- and the community-based rehabilitation programmes were reported in functional (single-leg hop), objectives (quadriceps and hamstrings peak force) and subjective (IKDC, Lysholm, ACL quality of life, Tenger Scale) outcome measures.
Conclusion(s): This review suggests that the community-based rehabilitation programme is clinical-efficient in terms of achieving similar outcomes by the patients in the community to the outcomes achieved by the patients in the hospital-based rehabilitation programme at 24th week following ACL reconstruction.
Implications:
- Community based rehabilitation programmes might be applied to the patients who have undergone anterior cruciate ligament reconstruction
- Community-based rehabilitation programmes are cost effective.
Keywords: Anterior Cruciate Ligament, community-based rehabilitation, supervised rehabilitation
Funding acknowledgements: Higher Education Commission Pakistan
Topic: Musculoskeletal: lower limb
Ethics approval required: No
Institution: Institute of Physical Medicine and Rehabilitation
Ethics committee: Khyber Medical University Ethics committee
Reason not required: It is a systematic review and doest not involve recruitment of patients
All authors, affiliations and abstracts have been published as submitted.
