Measuring functional performance at discharge from hospital after total joint arthroplasty as a pre-requisite for planning early rehabilitation: a prognostic study.

BACKGROUND: The autonomy achieved by discharge after total knee and hip arthroplasty is important for planning early rehabilitation. PURPOSE: Describe functional performance using the Iowa Level of Assistance (ILOA) scale and investigate possible prognostic factors. METHODS: A prospective cohort study design was used. Autonomy at discharge was measured using the ILOA scale. Postoperative factors such as time to remove surgical drains, the length of hospitalization, preoperative physical therapy, and the number of physiotherapy treatments were collected. RESULTS: The sample was composed of 452 patients: 191 men (42.3%) and 261 women (57.7%). The mean ILOA score was 12.34 (SD = 5.4), representing a level of autonomy of 68.4%. Gait speed was the activity with the highest score and it ranged from 0.26 m/s to 0.32 m/s. Based on univariate and multivariate analysis, gender and age were the only significant variables to influence achieving autonomy at discharge. CONCLUSION: The rehabilitative program in its acute phase should be planned with particular attention paid to elderly women, unifying the physiotherapy protocol for total hip arthroplasty (THA) and total knee arthroplasty (TKA), reviewing the modalities of preoperative treatment sessions and with a specific training for the speed gait.