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 Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

2021 ◽  
Vol 18 (5) ◽  
pp. 2654
Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian
Keyword(s):  
Virtual Reality ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Control Group ◽  
Mirror Therapy ◽  
Cohen’S D ◽  
Cohen's D ◽  
Experimental Group ◽  
Post Therapy

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

scholarly journals Assessment of post-surgical pain after the application of ultrasound-guided percutaneous neuromodulation in total knee arthroplasty

2019 ◽  
Vol 02 (02) ◽  
pp. 092-092
Author(s):  
Martín-Macho Martínez M. ◽  
Ventero Gómez A. ◽  
Carrió Font M. ◽  
Martín Buigues A.
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Conventional Treatment ◽  
Control Group ◽  
Ultrasound Guided ◽  
Surgical Pain ◽  
Total Knee ◽  
Experimental Group

Abstract Background and Aim The use of prosthetic knee replacements currently represent an alternative for patients who suffer from severe gonarthrosis. Treatment via the technique of ultrasound-guided percutaneous neuromodulation (US-guided PNM) is a therapeutic alternative worth considering as a new tool in physical therapy for the post-surgical recovery of total knee arthroplasty (TKA). The aim of this study was to evaluate the effectiveness of treatment with US-guided PNM in the post-surgical stage among patients intervened with TKA. Material and Methods Patients were selected between February and May 2017 at the Hospital of Denia and were randomly assigned into two groups. The initial sample was 13 patients. The experimental group (n = 7) received treatment with US-guided PNM plus conventional treatment. The control group (n = 6) only received conventional physiotherapy treatment. Patients in the experimental group received an application of PNM, which consisted of an alternate low frequency current at 10 Hz¸ pulse width 250 μs, with an intensity to the pain threshold. The intervention was performed during four consecutive weeks after hospital discharge. The control group received conventional treatment based on manual therapy, active mobilization and the use of the arthromotor until 115° of knee flexion and 0° knee extension was achieved. The main clinical variables evaluated were pain, measured using the Visual Analog Scale (VAS), quality of life, based on physical and mental components, using the SF12 scale and functional assessment using the Oxford Knee Score. Lastly, pain, stiffness and functional capacity was measured using the WOMAC scale. Results Both groups obtained statistically significant results in the four variables evaluated compared to the pre-surgery stage, however, the changes were more evident in the intervention group (p < 0.05). Furthermore, no significant differences were found in the variables evaluated regarding quality of life between the experimental and control group except for the emotional component of the SF-12 scale, where the result was only significant in the experimental group treated with US-guided PNM (P < 0.05). Regarding the improvement in the health status and decreased pain in the postoperative stage after TKA, no significant differences were observed between groups (p > 0.05). Conclusion The application of the US-guided PNM technique provides greater benefits than conventional therapy for decreasing the post-surgical pain in patients who have undergone knee arthroplasty and for emotional function, evaluated using the SF-12 questionnaire.

scholarly journals Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial

2020 ◽  
Author(s):  
KHALID A ALAHMARI ◽  
Paul Silvian Samuel ◽  
Irshad Ahmad ◽  
Ravi Shankar Reddy ◽  
Jaya Shanker Tedla ◽  
...  
Keyword(s):  
Physical Activity ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Sprain ◽  
Low Frequency ◽  
Control Group ◽  
Significant Difference ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Experimental Group

Abstract BackgroundStretching is an important part of post-ankle-sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside muscle stimulation has not yet been extensively studied. Therefore the purpose of the present research is to compare the baseline, post- and follow-up effects of the proprioceptive neuromuscular facilitation (PNF) stretching technique combined with transcutaneous electrical nerve stimulation (TENS), as compared against the effects of the PNF stretching technique alone.MethodsSixty subjects with lateral ankle sprains were selected and randomly allocated to three groups: Experimental Group One (EG 1), Experimental Group Two (EG 2), and the Control Group (CG). Subjects in EG 1 received the PNF stretching technique combined with TENS. Subjects in EG2 received the PNF stretching technique alone. Both experimental groups received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, flexibility, proprioception, range of motion, muscle strength, physical activity, and balance. A mixed-model ANOVA was used to analyze the effects of time factors and groups on these outcome measures.ResultsThere was significant interaction (time and group), and the time effect for all the outcome measures (p < 0.05). Physical activity, dorsiflexion, and balance in the medial, lateral, anterolateral, and anteromedial directions did not show a significant difference between the groups. EG 1 showed significant improvement for all the outcome variables between pre- and post-treatment and follow-up when compared to the other groups.ConclusionsThe present study showed that a 12-session treatment program of 3 weeks’ duration that combines PNF stretching with low-frequency TENS for post-ankle sprain subjects, compared against PNF stretching alone, produced significant improvements in balance, proprioception, strength, and range of motion. The study also showed that the treatment effect was sustained even after treatment was ceased after the follow-up assessment in the fifth week.Trial Registration:Human Research Ethics Committee approval for the trial (approval no.: (ECM#2019-26)Clinical trial was also registered in the Clinical Trials Registry – ISRCTN 18013941

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 Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial

2021 ◽  
Vol 18 (11) ◽  
pp. 6071
Author(s):  
Jung-Ae An ◽  
Ho-Kwang Ryu ◽  
Suk-Joo Lyu ◽  
Hyuk-Jong Yi ◽  
Byoung-Hee Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Peak Torque ◽  
Test Time ◽  
Control Group ◽  
Womac Pain ◽  
Total Knee

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p < 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p < 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p < 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.

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 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.

scholarly journals Efek Prehabilitation Exercise dengan Resistance Band terhadap Kekuatan Otot Kuadrisep Femoris pada Pasien Total Knee Replacement

2020 ◽  
Vol 7 (1) ◽  
pp. 46-52
Author(s):  
Ervi Ervi ◽  
Tanti Ajoe Kesoema ◽  
Robin Novriansyah
Keyword(s):  
Muscle Strength ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Quadriceps Femoris ◽  
Control Group ◽  
Quadriceps Femoris Muscle ◽  
Resistance Bands ◽  
Total Knee ◽  
Quadriceps Femoris Muscle Strength ◽  
Femoris Muscle

Pendahuluan: Prehabilitation exercise dengan resistance band merupakan latihan   penguatan otot yang aman, mudah dilakukan dan dapat dijadikan sebagai home programme pada pasien osteoartritis (OA) yang akan menjalani total knee replacement (TKR). Namun demikian, latihan ini belum lazim dilakukan di Indonesia. Penelitian ini bertujuan untuk mengetahui pengaruh intervensi prehabilitation exercise dengan resistance band terhadap kekuatan otot kuadrisep femoris pada pasien yang menjalani TKR. Metode: Penelitian randomized controlled trial dengan pre and post test. Sebanyak 16 subjek yang memenuhi kriteria dibagi secara acak ke dalam kelompok perlakuan (n=8) dan kontrol (n=8). Kelompok perlakuan mendapatkan prehabilitation exercise dengan resistance band 3x seminggu selama 4 minggu sebelum TKR, sedangkan kelompok kontrol mendapatkan terapi konvensional berupa ergocycle dan TENS (Transcutaneus Electrical Nerve Stimulation) 2x seminggu selama 4 minggu sebelum TKR. Pengukuran kekuatan otot kuadrisep femoris dilakukan 3x yaitu pada 4 minggu dan 1 minggu sebelum TKR, serta 8 minggu setelah TKR menggunakan push-pull dinamometer. Hasil: Kelompok perlakuan menunjukkan peningkatan kekuatan otot kuadrisep femoris yang signifikan pada 4 minggu ke 1 minggu sebelum TKR sebesar 3,00+1,28 (p=0,001). Peningkatan kekuatan otot pada kelompok intervensi juga terlihat pada 4 minggu sebelum ke 8 minggu setelah TKR sebesar 2,38+1,22 (p<0,001). Sebaliknya, kelompok kontrol mengalami penurunan kekuatan otot sebesar -0,88+0,79 (p=0,001) dan -0,88+1,28 (p=0,001) masing-masing pada periode 4 minggu ke 1 minggu sebelum TKR dan 4 minggu sebelum ke 8 minggu setelah TKR. Kesimpulan: Terdapat pengaruh prehabilitaion exercise dengan resistance bands terhadap peningkatan kekuatan otot kuadrisep femoris pada subjek yang menjalani operasai TKR. Prehabilitation exercise dapat digunakan sebagai alternatif latihan yang aman, mudah dilakukan serta dapat dijadikan sebagai home programme pada pasien yang akan menjalani operasi TKR. Kata kunci: Prehabilitation exercise, kekuatan kuadrisep femoris, total knee replacement.   Background: Prehabilitation exercises using resistance band is a safe and easy muscle strengthening exercise and can be used as a home programme in OA patients undergoing TKR. This exercise, however, is not commonly used in Indonesia. The this study aims to investigate the effect of prehabilitation exercise using resistance band on quadriceps femoris muscle strength in patients undergoing TKR. Methods: This study is a randomized controlled trial with pre and post-test. A total of 16 subjects who meet criteria were randomly allocated into intervention (n = 8) and control (n = 8) groups. The first group received prehabilitation exercise with resistance bands 3 times a week for 4 weeks before TKR, while the control group received conventional therapies involving ergocycle and TENS (Transcutaneous Electrical Nerve Stimulation) 2 times a week for 4 weeks before TKR. Quadriceps femoris muscle strength was measured three times at 4 weeks and 1 week before TKR, and 8 weeks after TKR using a push-pull dynamometer. Results: The intervention group shows a significant increase in quadriceps femoris muscle strength at 4 weeks to 1 week before TKR (3.00+1.28, p = 0.001). The increased quadriceps femoris muscle strength in the intervention group was also seen at 4 weeks before to 8 weeks after TKR (2,38+1,22, p<0,001). Conversely, the control group experienced a decreased quadriceps femoris muscle strength of -0.88+0.79 (p=0.001) and -0.88+1.28 (p=0.001) respectively in the period of 4 weeks to 1 week before TKR and 4 weeks before to 8 weeks after TKR. Conclusion: There is an effect of prehabilitation exercise with resistance bands on increased quadriceps femoris muscle strength in subjects undergoing TKR. Prehabilitation exercise is safe, easy and can be used as an alternative for home programme. Keywords: Prehabilitation exercise, quadriceps femoris muscle strength, total knee replacement.

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