Integrated care programmes for sport and work participation, performance of physical activities and quality of life among orthopaedic surgery patients: a systematic review with meta-analysis

Pieter Coenen, Gerben Hulsegge, Joost G Daams, Rutger C van Geenen, Gino M Kerkhoffs, Maurits W van Tulder, Judith A Huirne, Johannes R Anema, P Paul Kuijer

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Article numbere000664
Pages (from-to)e000664
JournalBMJ Open Sport and Exercise Medicine
Volume6
Issue number1
DOIs
Publication statusPublished - 2020

Bibliographical note

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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