1000 Section - Effect of Group Exercise after Total Knee Arthroplasty

Objectives : To examine whether the addition of a group exercise program to conventional postoperative rehabilitation improves the home discharge rate and functional recovery in patients undergoing total knee arthroplasty (TKA) under an institution-specific postoperative non–weight-bearing protocol, and to explore factors associated with home discharge.

Design: This retrospective cohort study included patients who underwent total knee arthroplasty at a single institution. Participants were classified into a conventional rehabilitation group and a group exercise group. Postoperative rehabilitation followed an institution-specific protocol that included a non–weight-bearing period until postoperative day 7. Clinical and functional outcomes were compared between groups, and multivariate logistic regression analysis was performed to identify factors associated with home discharge.

Results: A total of 62 patients were included (conventional rehabilitation group, n = 41; group exercise group, n = 21). Baseline characteristics did not differ significantly between groups. The home discharge rate was significantly higher in the group exercise group than in the conventional rehabilitation group (42.9% vs. 14.6%, p < 0.05). Time to achieve 70% of baseline Barthel Index was significantly shorter in the group exercise group (4.10 ± 1.86 vs. 4.85 ± 1.96 days, p < 0.05). Univariate analysis showed significant associations between home discharge and earlier urinary catheter removal as well as faster Barthel Index recovery. In multivariate logistic regression analysis, earlier urinary catheter removal was identified as an independent factor associated with home discharge (p < 0.05), while earlier straight leg raising achievement showed a trend toward significance. (p = 0.052)

Conclusion: Adding a group exercise program to conventional postoperative rehabilitation was associated with improved functional recovery and a higher home discharge rate after total knee arthroplasty under an institution-specific non–weight-bearing protocol. Group exercise may be a feasible adjunct to support early recovery and discharge in acute care settings.