The study focuses on a specific population of people with chronic pain after TKA. The developed methodology (result) can be used for evaluation after interventions in the long term. Comparators are therapeutic exercise and surgical intervention. The results can be measured after implementation in practice. For the study, the order in which the methodology was evaluated was not necessary: the participants shared their responses, independent of each other. Each reaction was assessed separately, and conclusions were drawn from similar data. The number was small (3 people), which was not enough to exclude bias. The opinion of participants who responded positively about the program was considered, and the methodology was further modified for the new request. In the second round of the study, their opinion was also considered. Still, the participant with negative feedback was not included in the calculations and was excluded from the second round ((Rognsvag et al., 2021, p. 6). Further, 69 people were studied under this program, and their opinions were considered.
It is hard to tell if the participants were completely blind to the interventions they were given. But investigators and people assessing outcomes were not blinded to these interventions. All participants had a similar diagnosis and had the same baseline of what they needed to do for the study. There was a pronounced division in the field for the first design round: two men and one woman, but this did not seem to have a substantial effect on the study results. Differences between patients during program implementation: non-surgical version and for upcoming TKA surgery. A clear study protocol consisted of 10 modules developed in the first phases, used for ten weeks. Follow-up intervals were the same: every other week, physical therapists called participants and discussed changes regardless of whether they had undergone surgery (Rognsvag et al., 2021, p. 8). There were no additional interventions to differentiate the groups, except for the preceding TKA surgery.
The results were presented as a new methodology for rehabilitation after TKA surgery. The study reports the results vaguely, with no statistical differences after the technique. There is no data obtained by physical therapists after call sessions. The study does little to address the direct effect of the program and does not provide verifiable results. Although the paper’s purpose was to design a new program, criteria for evaluating it have not been created. Perhaps a bias is present, justified by the difficulty of identifying changes. The accuracy is questionable because the study contains phrases such as “the program improved self-efficacy” (Rognsvag et al., 2021, p. 10). It is insufficient to evaluate the effectiveness fully: confidence intervals were also not mentioned because there were no statistical tests. It is rather difficult to assess the benefits of the intervention, as it is more of a theoretical analysis of the rehabilitation technique. There probably could be no accidental harm to the participants, as the method is aimed at relaxation exercises. Effects were also not reported, and cost-effectiveness was not considered: lip service was given to the differences between the techniques.
It is likely that the methodology developed is suitable for many therapy groups because it combines a priori valuable exercises. However, there are no verifiable results of its use, so I would not use it without more research. Interactive rehabilitative practices are not available to every patient: although this study contains essential elements, not always patients can replicate them. The limiting factor is often time and social conditions, so it is worth reconsidering its format and how information is transferred to implement such practice (Rognsvag et al., 2021, p. 8).
First, I would call the study unfinished because there is no statistically reliable data to support the effectiveness of the new technique. Yes, new emphases are made, but the observed effect was not measured, which raises questions about the use of such interventions in one’s practice. Some elements (e.g., relaxation strategies) would be helpful in my organization because, in my opinion, they are not enough. However, quick and easy implementation of such practices is impossible because there is no evidence of effectiveness.
Rognsvag, T., Lindberg, M. F., Lerdal, A., Stubberud, J., Furnes, O., Holm, I., Indrekvam, K., Lau, B., Rudsengen, S., Skou, S. T., & Badawy, M. (2021). Development of an internet-delivered cognitive behavioral therapy program for use in combination with exercise therapy and education by patients at increased risk of chronic pain following total knee arthroplasty. BMC Health Services Research, 21. Web.