Comparison of Group-based Outpatient Physiotherapy With Usual Care After Total Knee Replacement: a Feasibility Study For a Randomized Controlled Trial

Objective: To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement. Design: A feasibility study for a randomized controlled trial. Setting: One secondary-care hospital orthopaedic centre, Bristol, UK. Participants: A total of 46 participants undergoing primary total knee replacement. Interventions: The intervention group were offered six group-based exercise sessions after surgery. The usual care group received standard postoperative care. Participants were not blinded to group allocation. Outcome measures: Feasibility was assessed by recruitment, reasons for non-participation, attendance, and completion rates of study questionnaires that included the Lower Extremity Functional Scale and Knee Injury and Osteoarthritis Outcome Score. Results: Recruitment rate was 37%. Five patients withdrew or were no longer eligible to participate. Intervention attendance was high (73%) and 84% of group participants reported they were ‘very satisfied’ with the exercises. Return of study questionnaires at six months was lower in the usual care (75%) than in the intervention group (100%). Mean (standard deviation) Lower Extremity Functional Scale scores at six months were 45.0 (20.8) in the usual care and 57.8 (15.2) in the intervention groups. Conclusion: Recruitment and retention of participants in this feasibility study was good. Group-based physiotherapy was acceptable to participants. Questionnaire return rates were lower in the usual care group, but might be enhanced by telephone follow-up. The Lower Extremity Functional Scale had high responsiveness and completion rates. Using this outcome measure, 256 participants would be required in a full-scale randomized controlled trial.

Job-demand for Learning and Job-related Learning: The Moderating Effect of Need For Achievement

Purpose – The purpose of the research is to examine whether need for achievement moderates the relationship between job-demand for learning and job-related learning. Design/methodology/approach – Data were obtained from 153 participants full-time. The scales for job-demand for learning and job-related learning were developed for this research, whilst the scale for need for achievement was obtained from an external source. Hierarchical regression analysis was used in testing the hypothesized moderating effects. Findings – It was found that need for achievement moderates the relationship between job-demand for learning and job-related learning. Specifically, although job-demand for learning is correlated positively to job-related learning for both the high and the low need for achievement groups, this correlation is stronger amongst the high group. Research limitations/implications – The use of a cross-sectional design in this study prohibits inferences being drawn regarding the causal relationships between job-demand for learning, need for achievement and job-related learning. Practical implications – Job-related learning can be facilitated through increasing the need for achievement by allowing employees to establish their own learning and performance goals rather than by imposing such goals on them. The redesign of jobs to create challenges for employees is an equally important practical consideration. Originality/value – This research provides a succinct view of the relationship between an external factor, job-demand for learning, and an internal motivator, need for achievement. It emphasizes the degree to which organizations can facilitate learning through design of challenging jobs, to the extent of the individuals’ motivation.