Content validation of total knee replacement rehabilitation protocol in Indian population

Introduction: Total knee replacement (TKR) surgery has become the most successful surgery for patients with severe debilitating arthritis.The guidelines for rehabilitation progression should be tailored respecting the tissue healing parameters. Hence, the current literature states a need for protocol to mitigate these impairments and ultimately result in improved functional outcomes. Objective: The present study aimed to validate the content of TKR rehabilitation protocol in Indian population. Materials and Methods: The process of content validation involves development stage and expert judgment stage. The protocol was designed into three stages with extensive review of literature. After designing the protocol, nine experts in field of musculoskeletal Physiotherapy performed the judgemental process. The process of validation includes rating of experts in a 5 point likert grading on two parameters namely relevance and ease of performance. Based on expert’s inputs on TKR protocol, the level of agreement, content validation index and kappa value was calculated. Results: The three staged TKR protocol almost exhibited an excellent agreement on all stages. However, muscle activation exercises (except Vastus medialis obliques activation), stretching, strengthening program and functional training showed 100% agreement than other stages. Conclusion: The structured TKR protocol exhibited excellent content validity to its use in Indian population.