It is important to evaluate the effectiveness of rehabilitation
programs with appropriate outcome measures. This
trial has ensured that outcome measures are included from
the three different domains of physical impairment, patient
reported measures, and physical performance measures, as
recommended by OARSI and Mizner et al. [29, 36]. This is
advantageous because many of the outcome measures for
the different domains improve at different rates postoperatively.
In the early stages after TKA surgery scores on
the patient reported outcome scales are significantly better
than preoperative scores, while functional performance outcome
measures are reduced [36]. This may be due to the
experience of pain free movement combined with the ability
to perform a previously painful and difficult activity
again resulting in high patient satisfaction and is reflected
in the high scores of patient reported outcome scales [85].
The performance-based tests demonstrate an initial reduction
in physical function in patients following TKA that is
not seen in patient-reported measures [36]. From 1 month
to 6 months postoperatively, patients’ physical performance
improves [3, 43, 83] with the highest rate of improvement
occurring in the period from 1 to 3 months compared with
the period from 3 to 6 months [43, 35]. The outcome
measures included in this trial ensure an accurate picture
of recovery will be recorded.