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

2018 ◽  
Vol 32 (7) ◽  
pp. 888-898 ◽  
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.

scholarly journals EFFECTS OF FULL IMMERSION VIRTUAL REALITY TRAINING ON BALANCE AND KNEE FUNCTION IN TOTAL KNEE REPLACEMENT PATIENTS: A RANDOMIZED CONTROLLED STUDY

2020 ◽  
Vol 20 (09) ◽  
pp. 2040007
Author(s):  
SAMWON YOON ◽  
HOHEE SON
Keyword(s):  
Virtual Reality ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Function ◽  
Continuous Passive Motion ◽  
Control Group ◽  
Vr Training ◽  
Total Knee ◽  
Full Immersion ◽  
Experimental Group

Background: Recently, new methods have emerged that encourage voluntary participation by allowing patients to perform tasks, including exercises or treatments, in a virtual reality (VR) environment. Aim: This study aimed to examine the effects of full immersion virtual reality training on balance and knee function in patients who had undergone total knee replacement. Design: Single blind randomized controlled trial. Setting: Department of Physical Therapy in a rehabilitation center. Population: A total of 30 elderly patients ([Formula: see text]65 years old) who had undergone total knee replacement. Methods: Participants were randomly allocated to an experimental group ([Formula: see text]) and a control group ([Formula: see text]). The experimental group received with a continuous passive motion machine, exercise therapy, and a full immersion VR training program; the control group received only with a continuous passive motion machine and exercise therapy. Biorescue was used to test static and dynamic balance ability, and the Timed Up and Go and Western Ontario and McMaster Universities tests were used to assess knee function. Paired [Formula: see text]-tests were used to examine differences by time in each group, and independent [Formula: see text]-tests were used to examine differences between the groups. Results: In terms of within-group differences by time, both the experimental group and the control group showed significant changes in the anterior, and posterior limits of stability in both sides; static balance; and knee function. In the between-groups comparison, among static balance tests, there was a significant difference in center of mass path length in the standing position with eyes open ([Formula: see text]); among dynamic balance tests, there were significant differences in left, right, anterior, and posterior limits of stability ([Formula: see text]). Conclusions: VR training produced better early balance ability and knee function than what was seen in the control group. We believe that VR training in initial post-operative rehabilitation of total knee replacement patients may increase the rate of recovery. Clinical Rehabilitation Impact: VR exercise programs are effective in early rehabilitation after total knee replacement, and have clinical value as inexpensive methods that can promote active participation.

scholarly journals The Influence of Gait Pattern with Aids on the Patient’s Recovery in an Early Period of Total Knee Replacement

2019 ◽  
Vol 46 (2) ◽  
pp. 36-40
Author(s):  
D. Vassileva ◽  
I. Nedelcheva ◽  
S. Mindova ◽  
I. Karaganova
Keyword(s):  
Knee Joint ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Early Period ◽  
Gait Pattern ◽  
The Body ◽  
Definitive Treatment ◽  
Control Group ◽  
Total Knee ◽  
Experimental Group

Abstract Introduction: The total knee replacement is the definitive treatment for knee osteoarthritis (OA). It is an effective intervention to correct OA-related functional limitation. In such patients postoperatively are observed significant differences in the biomechanics of the two knee joints. While bearing the body weight the unoperated knee joint becomes very painful, stiff and incapable of neutral positioning. These factors significantly hamper the initial training in gait with aids in the standard locomotive stereotype immediately after surgery for knee joint replacement, where walking plays an essential role in daily activities and has varied health benefits. Aim: The aim of the study was to check whether different types of gait with aids in the early postoperative period after total knee replacement have a different influence on the recovery process. Material and methods: This study was conducted between January 2017 and July 2018 in the Department of Orthopedics and Traumatology of the University Hospital “Kanev” – Rousse. It included 56 patients with unilateral total knee replacement after gonarthrosis, divided into a control and experimental group, each of 28 patients. All patients in both groups had knee extension deficit of the untreated knee joint. The patients in both groups followed the same physiotherapy programs, performed from about the 2nd postoperative day to the 21st day when they were discharged from the department. The difference between the patients in both subgroups was their gait pattern with two axillary crutches. Results and Discussion: There were statistically significant differences between both groups. One of the most significant differences was in ROM. In the experimental group patients, flexion was improved with an average of 20° more than in the control group patients. Also, in the operated joint, the patients in the experimental group had no contracture, whereas those in the control group showed 15° at the end of the follow-up period. Conclusion: The results of the study show that the choice of gait training in the following order “crutches, operated leg, crutches, untreated leg” in patients with extensor deficiency and contracture in the untreated knee is more appropriate than the standard type of training in walking with aids.

Effectiveness of Music Listening in Patients With Total Knee Replacement During CPM Rehabilitation

2015 ◽  
Vol 18 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Chih-Chung Hsu ◽  
Wei-Ming Chen ◽  
Su-Ru Chen ◽  
Yen-Ting Tseng ◽  
Pi-Chu Lin
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Continuous Passive Motion ◽  
Control Group ◽  
Routine Practice ◽  
Music Listening ◽  
Postoperative Rehabilitation ◽  
Active Flexion ◽  
Total Knee ◽  
Experimental Group

Aim:This study investigated the effects of music listening on the anxiety, heart rate variability (HRV), and joint range of motion (ROM) of patients undergoing continuous passive motion (CPM) after total knee replacement surgery.Method:An experimental design was used. Participants in the experimental group ( n = 49) listened to music from 10 min before receiving CPM until the end of the session (25 min in total) on the first and second day following surgery, whereas participants in the control group ( n = 42) did not listen to music but rested quietly in bed starting 10 min before and throughout CPM.Results:Compared with the control group, the experimental group exhibited significantly lower anxiety levels ( p < .05) and increased CPM angles ( p < .05) during treatment and increased active flexion ROM ( p < .05) upon discharge. The low-frequency (LF)/high-frequency (HF) power ratio, normalized LF HRV, and normalized HF HRV of the two groups differed significantly, indicating that the patients in the experimental group had greater parasympathetic activity compared with those in the control group.Conclusion:Music listening can effectively reduce patient anxiety and enhance the ROM of their joints during postoperative rehabilitation. Health-care practitioners should consider including music listening as a routine practice for postoperative rehabilitation following orthopedic surgery.

The dog as a preclinical model to evaluate interface morphology and micro-motion in cemented total knee replacement

2012 ◽  
Vol 25 (01) ◽  
pp. 01-10 ◽  
Author(s):  
M. A. Miller ◽  
M. Khorasani ◽  
K. L. Townsend ◽  
M. J. Allen ◽  
K. A. Mann
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Subchondral Bone ◽  
Tibial Component ◽  
Preclinical Model ◽  
Interface Morphology ◽  
Material Interfaces ◽  
Post Surgery ◽  
Total Knee ◽  
Micro Motion

SummaryObjectives: This study investigated cemented fixation of the tibial component from a canine total knee replacement preclinical model. The objective was to determine the local morphology at the material interfaces (implant, cement, bone) and the local relative micro-motion due to functional loading following in vivo service.Methods: Five skeletally mature research dogs underwent unilateral total knee replacement using a cemented implant system with a polyethylene (PE) monobloc tibial component. Use of the implanted limb was assessed by pressure-sensitive walkway analysis. At 60 weeks post-surgery, the animals were euthanatized and the tibia sectioned en bloc in the sagittal plane to create medial and lateral specimens. High resolution imaging was used to quantify the morphology under the tray and along the keel. Specimens were loaded to 50% body weight and micro-motions at the PE-cement and cement-bone interfaces were quantified.Results: There was significantly (p = 0.002) more cement-bone apposition and interdigitation along the central keel compared to the regions under the tray. Cavitary defects were associated with the perimeters of the implant (60 ± 25%). Interdigitation fraction was negatively correlated with cavitary defect fraction, cement crack fraction, and total micro-motion.Clinical significance: Achieving good inter-digitation of cement into subchondral bone beneath the tibial tray is associated with improved interface morphology and reduced micro-motion; features that could result in a reduced incidence of aseptic loosening. Multiple drill holes distributed over the cut tibial surface and adequate pressurization of the cement into the subchondral bone should improve fixation and reduce interface micro-motion and cavitary defects.

Effect of Counseling on Quality of Life and Self-Care Agency for Patients Who are Scheduled for Total Knee Replacement

2021 ◽  
pp. 105477382110589
Author(s):  
Çiğdem Kaya ◽  
Özlem Bilik
Keyword(s):  
Quality Of Life ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Face To Face ◽  
Total Knee ◽  
Care Agency

This study aims to determine the effect of counseling on quality of life and self-care agency for patients who are scheduled for total knee replacement (TKR). The study has a quantitative and quasi-experimental design with a control group. The patients in the control group ( n = 40) received routine care. Face-to-face and telephone counseling was offered to individuals in the intervention group ( n = 39). The data was collected at face-to-face interviews by using a patient characteristics form, Quality of Life Scale, and Self-Care Agency Scale. The scores for quality of life and self-care agency in the 6th to 8th and 14th to 16th weeks after surgery were very significantly higher in the intervention group than in the control group ( p < .001). This study shows that counseling given by the nurse increases the quality of life and self-care agency of patients undergoing TKR.

scholarly journals Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial

2019 ◽  
pp. 145749691988381 ◽  
Author(s):  
A. Liljensøe ◽  
J. O. Laursen ◽  
H. Bliddal ◽  
K. Søballe ◽  
I. Mechlenburg
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Body Composition ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Diet Group ◽  
Control Group ◽  
Weight Loss Intervention ◽  
Total Knee

Background and Aims: Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery. Material and Methods: Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss. Results: The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group. Conclusion: The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.

scholarly journals Effectiveness of Hold Relax Proprioceptive Neuromuscular Facilitation Technique in Total Knee Arthroplasty

2021 ◽  
Vol 14 (4) ◽  
pp. 1919-1923
Author(s):  
Mohammad Miraj
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Conventional Treatment ◽  
Mean Difference ◽  
Control Group ◽  
Bilateral Knee ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Total Knee ◽  
Experimental Group

Proprioceptive Neuromuscular Facilitation (PNF) is a popular flexibility training, which involves stretching and contraction of the target muscle group. PNF stretching is effective among athletes for improving passive range of motion, flexibility, and performance. Patients who undergo total knee replacement surgeries exhibit pain, swelling, decreased range of motion, muscle weakness, and stiffness. This study aimed to investigate the effect of the hold relax PNF technique to improve the balance and muscle strength in subjects with a bilateral knee replacement. Sixty four patients were selected based on inclusion/exclusion criteria. The patients were allocated into two groups by random allocation. The experimental group A (n=32) received the Hold Relax PNF technique with conventional treatment whereas, the control group B (n=32) received only conventional treatment as a part of the Home Exercise Program (HEP). Outcome measures used for evaluation included the Visual Analogue Scale (VAS), Manual Muscle Testing (MMT), and Berg Balance Scale (BBS) Score for measuring pain, muscle strength, and balance respectively. Students t-test showed significant differences between variables mean scores from two groups after three weeks of intervention. There was a statistical significant (t(32) = 2.38, p = 0.02) change in the mean scores of VAS in the experimental group (mean difference pre-post=3.19) as compared to control group ( mean difference pre -post=3.19) with Cohen’s d = 2.744588. Similarly for MMT(t(32) = 0.415, p = 0.005) and BBS scores (t(32) = 2.628, p = 0.035). The result of the study suggests that the Hold Relax PNF technique is more effective than conventional treatment alone in decreasing pain as well as increasing balance and muscle strength in bilateral knee replacement patients.

scholarly journals Assessment of functional mobility and body mass index among patients with a total knee replacement: a retrospective study in Indian population

2019 ◽  
Vol 5 (4) ◽  
pp. 687
Author(s):  
Nagendra Gowtham Rayudu Yelamarthi ◽  
Raghu Yelavarthi ◽  
Rajashekhar Tati
Keyword(s):  
Body Mass Index ◽  
Total Knee Replacement ◽  
Outcome Measures ◽  
Body Mass ◽  
Knee Replacement ◽  
Functional Mobility ◽  
Functional Reach ◽  
Single Leg Stance ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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&lt;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&lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial

2020 ◽  
Vol 9 (7) ◽  
pp. 2194
Author(s):  
Chun-De Liao ◽  
Yen-Shuo Chiu ◽  
Jan-Wen Ku ◽  
Shih-Wei Huang ◽  
Tsan-Hon Liou
Keyword(s):  
Total Knee Replacement ◽  
Resistance Exercise ◽  
Older Women ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Postoperative Outcomes ◽  
Secondary Outcome ◽  
Control Group ◽  
Elastic Resistance ◽  
Total Knee

(1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T0) and postoperative at 1 month (T1; before RET) and 4 months (T2; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T1 and T2 from T0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T2, the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.

Potential role of electrostimulation in augmentation of venous blood flow after total knee replacement: A pilot study

2015 ◽  
Vol 31 (4) ◽  
pp. 251-256 ◽  
Author(s):  
Seyhan Yilmaz ◽  
Murat Calbiyik ◽  
Behice Kaniye Yilmaz ◽  
Eray Aksoy
Keyword(s):  
Blood Flow ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Femoral Vein ◽  
Venous Blood ◽  
Control Group ◽  
Venous Blood Flow ◽  
Female Ratio ◽  
Total Knee ◽  
Peak Blood

Aim To investigate the potential role of a novel electrostimulation device in augmenting the femoral vein venous blood flow following total knee replacement surgery. Material and methods A total of 30 consecutive patients undergoing total knee replacement were allocated to receive either peroneal nerve electrostimulation plus low molecular weight heparin and below-knee compression stockings (Group 1, electrostimulation group, n = 15, mean age: 63.40 ± 5.91 years, male: female ratio 9:6) or low molecular weight heparin and below-knee compression stockings alone (Group 2, control group, n = 15, mean age: 63.86 ± 7.47 years, male: female ratio 8:7). Electrostimulation was performed for 1 h in every 4 h after the operation. Peak blood velocity in the femoral vein was evaluated with Duplex ultrasonongraphy in supine position. Presence of leg edema and calf diameter was also taken into consideration as outcome measures, which were recorded both before surgery and at the time of discharge from hospital. Results Postoperative peak blood flow velocity in the femoral vein was significantly higher in electrostimulation group compared to control group (17.46 ± 2.86 cm/s vs. 13.84 ± 3.58 cm/s, p < 0.02). Electrostimulation group achieved a significant increase in peak blood flow velocity in the femoral vein after the operation (mean increase 67.48 ± 17.38%, p < 0.001). Conclusion Electrostimulation of the common peroneal nerve enhanced venous flow in the lower limb and may potentially be of use as a supplementary technique in deep venous prophylaxis following lower limb orthopedic operations.

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