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已发表论文
将知识转化行动框架应用于实施和评估全膝关节置换术后老年患者循证功能锻炼计划：一项混合方法研究
Authors Qin Z, Ye X , Liu H, Shen Y, Zou X, Qiu S, Wu Y, Zhan C
Received 1 July 2025
Accepted for publication 25 November 2025
Published 11 December 2025 Volume 2025:20 Pages 2515—2534
DOI https://doi.org/10.2147/CIA.S550742
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Zhi-Ying Wu
Zhuzhu Qin,1,2,* Xinxin Ye,3,* Huanju Liu,4 Yan Shen,1 Xiaoling Zou,5 Shi Qiu,6 Yuxuan Wu,1 Chenju Zhan7
1Department of Orthopedics, People’s Hospital of Deyang City, Deyang, Sichuan, People’s Republic of China; 2School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China; 3Department of Sports Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Medical Genetics, Naval Medical University, Shanghai, People’s Republic of China; 5Operating Room, People’s Hospital of Zhongjiang, Deyang, Sichuan, People’s Republic of China; 6Department of Sports Medicine, University of Malaya, Kuala Lumpur, Malaysia; 7Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chenju Zhan, Department of Nursing, Mindong Hospital of Fujian Medical University, 89 Heshan Road, Fuan, 355099, People’s Republic of China, Tel +86 13809562183, Email zhanchenju@yeah.net Xinxin Ye, Department of Sports Science, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, People’s Republic of China, Tel +86-19157731127, Email xinxinye@zju.edu.cn
Purpose: This study aimed to develop a systematic, evidence-based rehabilitation intervention tailored for elderly patients undergoing TKA, informed by stakeholders, and evaluate its impact on patient outcomes.
Patients and Methods: Guided by the Knowledge-to-Action (KTA) Framework, this study comprised two sequential phases. In the knowledge creation phase, we systematically synthesized evidence through comprehensive retrieval, critical appraisal, and integration of high-quality rehabilitation programs for elderly patients undergoing TKA from domestic and international literature. During the action cycle phase, expert panel discussions and stakeholder interviews were conducted to identify barriers and facilitators of implementation, culminating in the co-development of a finalized intervention program. A quasi-experimental study was subsequently implemented to assess its preliminary efficacy in this target population.
Results: Fourteen high-quality sources were synthesized to form 17 evidence-based recommendations across six dimensions. Through expert panels and stakeholder interviews, a structured rehabilitation program was developed, addressing key barriers and implementation strategies. In the subsequent quasi-experimental study (n = 60), patients in the intervention group showed significantly better postoperative pain control, range of motion, and knee function compared to controls (all P < 0.05), with no baseline differences between groups.
Conclusion: The evidence-based rehabilitation program significantly enhanced functional recovery parameters, and pain control efficacy compared to standard care. Implementation of this structured intervention framework demonstrates clinically meaningful improvements in early postoperative outcomes following TKA.
Keywords: elderly patients, total knee arthroplasty, functional exercise, rehabilitation, evidence-based practice, knowledge to action process framework
1Department of Orthopedics, People’s Hospital of Deyang City, Deyang, Sichuan, People’s Republic of China; 2School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, People’s Republic of China; 3Department of Sports Science, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Medical Genetics, Naval Medical University, Shanghai, People’s Republic of China; 5Operating Room, People’s Hospital of Zhongjiang, Deyang, Sichuan, People’s Republic of China; 6Department of Sports Medicine, University of Malaya, Kuala Lumpur, Malaysia; 7Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chenju Zhan, Department of Nursing, Mindong Hospital of Fujian Medical University, 89 Heshan Road, Fuan, 355099, People’s Republic of China, Tel +86 13809562183, Email zhanchenju@yeah.net Xinxin Ye, Department of Sports Science, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, People’s Republic of China, Tel +86-19157731127, Email xinxinye@zju.edu.cn
Purpose: This study aimed to develop a systematic, evidence-based rehabilitation intervention tailored for elderly patients undergoing TKA, informed by stakeholders, and evaluate its impact on patient outcomes.
Patients and Methods: Guided by the Knowledge-to-Action (KTA) Framework, this study comprised two sequential phases. In the knowledge creation phase, we systematically synthesized evidence through comprehensive retrieval, critical appraisal, and integration of high-quality rehabilitation programs for elderly patients undergoing TKA from domestic and international literature. During the action cycle phase, expert panel discussions and stakeholder interviews were conducted to identify barriers and facilitators of implementation, culminating in the co-development of a finalized intervention program. A quasi-experimental study was subsequently implemented to assess its preliminary efficacy in this target population.
Results: Fourteen high-quality sources were synthesized to form 17 evidence-based recommendations across six dimensions. Through expert panels and stakeholder interviews, a structured rehabilitation program was developed, addressing key barriers and implementation strategies. In the subsequent quasi-experimental study (n = 60), patients in the intervention group showed significantly better postoperative pain control, range of motion, and knee function compared to controls (all P < 0.05), with no baseline differences between groups.
Conclusion: The evidence-based rehabilitation program significantly enhanced functional recovery parameters, and pain control efficacy compared to standard care. Implementation of this structured intervention framework demonstrates clinically meaningful improvements in early postoperative outcomes following TKA.
Keywords: elderly patients, total knee arthroplasty, functional exercise, rehabilitation, evidence-based practice, knowledge to action process framework