Usual care (UC) and game ready (GR) treatment protocols
TKA, UC
Both treatment groups commenced their intervention on day 0 upon their return to the ward after their TKA and continued for a period of two weeks (spanning the in-patient and early out-patient setting). The UC group underwent regular icing (bag of crushed ice) along with tubigrip static compression (on average 17 mmHg) [GRProBoth groups followed a 2-week protocol of either ice plus tubigrip (UC) or use of the GR device for a period of 20 min, 6 times a day, with an off time of at least one hour between applications. Specific application times were not set but the regime was to commence first thing in the morning, and with patients requiring a one hour “off” period between sittings the intervention times were dispersed between morning, afternoon and evening. Patients were provided a logbook to keep track of their routine and to assist them in complying to the frequency protocol. The GR device was set on a low pressure (cycle of 5–15 mmHg) for days 0–5 and then a medium pressure (cycle of 5–50 mmHg) from days 6–14. A standardised temperature of 5 °C was used which was well tolerated by all patients. The physiotherapist initially set up the GR device controls for the patient in hospital and instructed them how to use and adjust the system as needed. While in hospital both interventions were initiated by nursing and physiotherapy staff and then carried on by the patients themselves on discharge.