Five times sit-to-stand test in subjects with total knee replacement: Reliability and relationship with functional mobility tests

Background: Obesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post‐TKR rehabilitation outcomes. The aim of the present study was to assess the effects of obesity on functional mobility outcomes following post‐TKR rehabilitation in Asian patients where BMI was not as high as those reported in similar studies performed other countries other than Asian.Methods: A total of 100 patients were categorized as normal weight (n=11), overweight (n=10), class I obese (n=28), or class II obese (n=32), class III obese (n=19). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2‐month and 6‐month follow-up assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single‐leg stance, ten‐meter walk, timed up and go, chair rise, and stair climbing.Results: A 4×3 (group×time) repeated‐measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2‐month and 6‐month follow-up assessments (p<0.05 for all). No significant intergroup differences at the 2‐month and 6‐month follow-up assessments were observed for any of the mobility measures except the functional reach and single‐leg stance (p<0.05).Conclusions: Patients with class II/III obesity benefit from early post‐TKR outpatient rehabilitation and respond well. Also, the patients with lower BMIs showed significant improvements and patients with a high BMI might require additional balance-based exercises in their post-TKR rehabilitation protocols.

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Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial

Clinical Rehabilitation ◽

10.1177/0269215518757291 ◽

2018 ◽

Vol 32 (7) ◽

pp. 888-898 ◽

Cited By ~ 2

Author(s):

Maria Moutzouri ◽

Nigel Gleeson ◽

Fiona Coutts ◽

Elias Tsepis ◽

John Gliatis

Keyword(s):

Exercise Training ◽

Total Knee Replacement ◽

Knee Replacement ◽

Functional Mobility ◽

Control Group ◽

Controlled Clinical Trial ◽

Sensorimotor Function ◽

Post Surgery ◽

Total Knee ◽

Experimental Group

Objective: To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. Design: A single-blind controlled clinical trial. Setting: University Hospital of Rion, Greece. Subjects: A total of 52 participants following total knee replacement. Outcome measures: The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Intervention: Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3–5 sessions/week (35–45 minutes). Results: Consistently greater improvements ( F2,98 = 4.3 to 24.8; P < 0.05) in group mean scores favour the experimental group compared to the control group: Timed Up and Go (7.8 ± 2.9 seconds vs. 4.6 ± 2.6 seconds); balance (2.1 ± 0.9° vs. 0.7 ± 1.2°); joint position error (13.8 ± 7.3° vs. 6.2 ± 9.1°); Knee Outcome Survey Activities of Daily Living Scale (44.2 ± 11.3 vs. 26.1 ± 11.4); and pain (5.9 ± 1.3 cm vs. 4.6 ± 1.1 cm). Patterns of improvement for the experimental group over time were represented by a relative effect size range of 1.3–6.5. Conclusions: Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

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