TY - JOUR
T1 - Integrated care programmes for sport and work participation, performance of physical activities and quality of life among orthopaedic surgery patients
T2 - A systematic review with meta-analysis
AU - Coenen, Pieter
AU - Hulsegge, Gerben
AU - Daams, Joost G.
AU - Van Geenen, Rutger C.
AU - Kerkhoffs, Gino M.
AU - Van Tulder, Maurits W.
AU - Huirne, Judith A.
AU - Anema, Johannes R.
AU - Kuijer, P. Paul
N1 - Correction http://dx.doi.org/10.1136/bmjsem-2019-000664corr1
PY - 2020/3/26
Y1 - 2020/3/26
N2 - Objectives Orthopaedic surgery is primarily aimed at improving function and pain reduction. Additional integrated care may enhance patient's participation in sports and work, possibly improving performance of physical activities and quality of life (QoL). We aimed to assess the effectiveness of integrated care among orthopaedic surgery patients. Design Systematic review with meta-analysis. Data source Medline, EMBASE and CINAHL (until 17 June 2019). Eligibility for selecting studies We searched for controlled studies on integrated care interventions consisting of active referral to case managers, rehabilitation with participation-based goals and/or e/mHealth, with outcomes of sports and work participation, performance of physical activities and/or QoL. Outcomes were normalised to 0-100 scales and statistically pooled. Results Seventeen articles (n=2494) of moderate quality were included reporting on patients receiving back, upper limb, knee or hip surgery. Only one study reported on return to sports and found no significant benefit. For return to work, one study did (90% vs 82%) and one did not (relative risk=1.18 (0.80 to 1.70)) observe significant benefits. Integrated care showed small effects for improving performance of physical activities (2.69 (-0.20 to 5.58); eight studies, n=1267) and QoL (2.62 (1.16 to 5.05); nine studies, n=1158) compared with usual care. Summary/Conclusion We found insufficient and inconsistent evidence for the effectiveness of integrated care for orthopaedic surgery patients regarding sport and work participation. Small effects were found for performance of physical activities and QoL. High quality research on integrated care focusing on sports and work participation is needed before integrated care can be implemented for orthopaedic surgery patients.
AB - Objectives Orthopaedic surgery is primarily aimed at improving function and pain reduction. Additional integrated care may enhance patient's participation in sports and work, possibly improving performance of physical activities and quality of life (QoL). We aimed to assess the effectiveness of integrated care among orthopaedic surgery patients. Design Systematic review with meta-analysis. Data source Medline, EMBASE and CINAHL (until 17 June 2019). Eligibility for selecting studies We searched for controlled studies on integrated care interventions consisting of active referral to case managers, rehabilitation with participation-based goals and/or e/mHealth, with outcomes of sports and work participation, performance of physical activities and/or QoL. Outcomes were normalised to 0-100 scales and statistically pooled. Results Seventeen articles (n=2494) of moderate quality were included reporting on patients receiving back, upper limb, knee or hip surgery. Only one study reported on return to sports and found no significant benefit. For return to work, one study did (90% vs 82%) and one did not (relative risk=1.18 (0.80 to 1.70)) observe significant benefits. Integrated care showed small effects for improving performance of physical activities (2.69 (-0.20 to 5.58); eight studies, n=1267) and QoL (2.62 (1.16 to 5.05); nine studies, n=1158) compared with usual care. Summary/Conclusion We found insufficient and inconsistent evidence for the effectiveness of integrated care for orthopaedic surgery patients regarding sport and work participation. Small effects were found for performance of physical activities and QoL. High quality research on integrated care focusing on sports and work participation is needed before integrated care can be implemented for orthopaedic surgery patients.
KW - intervention
KW - meta-analysis
KW - orthopaedics
KW - sport
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U2 - https://doi.org/10.1136/bmjsem-2019-000664
DO - https://doi.org/10.1136/bmjsem-2019-000664
M3 - Review article
C2 - 32341795
SN - 2055-7647
VL - 6
SP - e000664
JO - BMJ Open Sport and Exercise Medicine
JF - BMJ Open Sport and Exercise Medicine
IS - 1
M1 - e000664
ER -