Feasibility and effect of a Wearable Motion Sensor Device in Facilitating In-Home Rehabilitation Program in Patients After Total Knee Arthroplasty: a Preliminary Study (Preprint)

BACKGROUND Total knee arthroplasty (TKA) is an effective procedure for patients with end-stage knee osteoarthritis. Postoperative rehabilitation programs are essential for facilitating functional recovery after TKA. However, clinical results vary because of inconsistent patient compliance. OBJECTIVE This study aimed to verify the feasibility of a treatment model that involves applying a wearable motion sensor device (MSD) to assist patients in performing home-based exercises after TKA. METHODS The MSD comprised inertial measurement unit–based sensors and mobile apps for patients and physicians, which allowed for knee mobility tracing, home-based exercise support, and progress monitoring. The interrater reliability of knee mobility measurements was assessed using the intraclass correlation coefficient (ICC). Different knee flexion angles and the time spent for completing the 5-times sit-to-stand test (5TSST) in 12 healthy participants were measured by 2 experienced physicians and using the MSD, and their results were compared using ICC. A pilot prospective control trial was then conducted, in which 12 patients following TKA were allocated to 2 groups: the home-based exercise group and the MSD-assisted rehabilitation group. Changes in knee range of motion, pain, functional score (assessed using the Western Ontario and McMaster Universities Arthritis Index), performance (tested using 5TSST), and exercise completion rates were compared between the groups over 2 months of follow-up. RESULTS Knee flexion at different angles and the time spent for completing 5TSST measured using the MSD exhibited excellent reliability compared with the physician measurements (ICC range: 0.996 and 0.996 respectively). Furthermore, patients in the MSD-assisted rehabilitation group reported higher exercise completion rate within 2 months of the in-home exercise program compared with participants in the home-based exercise group, which lead to more favorable outcomes in the knee extension angle and maximal and average angular velocity in 5TSST. CONCLUSIONS MSD-assisted home-based rehabilitation following TKA is a useful treatment model for telerehabilitation because it enhances patients’ compliance to training, which improves functional recovery. This method helps overcome critical obstacles in home-based physiotherapy among patients after TKA. Therefore, this study has crucial implications for patients and health systems.

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Concept Verification of a Remote Automatic Scoring System for Evaluating Knee Function after Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0040-1710568 ◽

2020 ◽

Author(s):

Haohua Zhang ◽

Yixin Zhou

Keyword(s):

Total Knee Arthroplasty ◽

Data Acquisition ◽

Knee Arthroplasty ◽

Scoring System ◽

Knee Function ◽

Motion Sensor ◽

Significant Difference ◽

Cloud Server ◽

Total Knee ◽

Automatic Scoring

AbstractThe Knee Society Score (KSS) is the most commonly used scale for evaluating postoperative pain and physical function after total knee arthroplasty (TKA). However, this scale requires clinic visiting, which is not quite convenient. Our concept verification study demonstrated a remote automatic system for evaluating knee function after TKA using the KSS. The remote scoring system consists of two modules for data acquisition, an application for patients, a cloud server, and an application for doctors. The kinematic data are collected by the data acquisition modules and transmitted to the patient application via Bluetooth. The data acquisition module contains a motion sensor, a microcontroller unit, a power supply, and a Bluetooth module. The motion sensor consists of an accelerometer, a gyroscope, and a geomagnetic sensor, all of which are three-axis instruments. Using the nine-axis data, the three-dimensional (3D) angles are calculated according to the theory of attitude and heading reference system. The KSS score is calculated using a scoring algorithm in the patient application and transmitted to the doctor application through the cloud server. The knee function of 10 patients treated with unilateral TKA was evaluated by both a doctor and the remote scoring system. The consistency in KSS between the doctor and the system was analyzed using the paired t-test. The remote scoring system successfully recorded knee function data and transmitted the scores from the patient application to the doctor application through the cloud server. There was no significant difference in the KSS scores evaluated by the doctor and that by the system (p = 0.326). This remote automatic scoring system provides a reliable and convenient method for evaluating knee function after TKA at home.

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Force-plate analyses of balance following a balance exercise program during acute post-operative phase in individuals with total hip and knee arthroplasty: A randomized clinical trial

SAGE Open Medicine ◽

10.1177/2050312116675097 ◽

2016 ◽

Vol 4 ◽

pp. 205031211667509 ◽

Cited By ~ 8

Author(s):

Pankaj Jogi ◽

Aleksandra Zecevic ◽

Tom J Overend ◽

Sandi J Spaulding ◽

John F Kramer

Keyword(s):

Total Knee Arthroplasty ◽

Total Hip Arthroplasty ◽

Knee Arthroplasty ◽

Hip Arthroplasty ◽

Force Plate ◽

Exercise Program ◽

Rehabilitation Program ◽

Total Hip ◽

Balance Exercises ◽

Total Knee

Objectives: Typical rehabilitation programs following total hip arthroplasty and total knee arthroplasty include joint range of motion and muscle-strengthening exercises. Balance and balance exercises following total hip arthroplasty and total knee arthroplasty have not received much attention. The purpose of this study was to determine whether an intervention of balance exercises added to a typical rehabilitation program positively affects patients’ balance. Methods: A total of 63 patients were provided with outpatient physical therapy at their home. Patients were randomly assigned to either typical (n = 33) or balance (n = 30) exercise group. The typical group completed seven typical surgery-specific joint range of motion and muscle-strengthening exercises, while the balance group completed the typical exercises plus three balance exercises. After 5 weeks of administering the rehabilitation program, patients’ balance was assessed on a force plate using 95% ellipse area of the center of pressure amplitude. Results: Patients in the balance group demonstrated significant reduction in the 95% ellipse area for the anterior and posterior lean standing conditions (p < 0.01). Conclusion: Balance exercises added to the typical outpatient physical therapy program resulted in significantly greater improvements in balance for participants with total hip arthroplasty or total knee arthroplasty, compared to the typical exercise program alone. Physical therapists might consider the use of balance exercises to improve balance in individuals in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty.

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Clinical Application of TCM-Characteristic Rehabilitation Program after Total Knee Arthroplasty

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16298112109484 ◽

2021 ◽

Author(s):

Xin-Xia Gao ◽

Xiong Xiao ◽

Ying Chen ◽

Li Yang ◽

Yun-Xia Zhang ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Treatment Group ◽

Knee Arthroplasty ◽

Rehabilitation Program ◽

Control Group ◽

Pain Scores ◽

Total Knee ◽

Random Number Table ◽

The Difference

Objective: To evaluate the effect of traditional Chinese medicine (TCM)-characteristic rehabilitation program on levels of pain and swelling after total knee arthroplasty. Methods: A total of 72 in-patients who recovered from total knee arthroplasty in our department were selected as the study subjects. They were divided into two groups according to a random number table: the control group (n = 36) with routine nursing and the treatment group (n = 36) with TCM rehabilitation nursing. The pain scores and joint swelling were statistically analyzed. Results: The pain scores in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05).Conclusion: The implementation of a TCM rehabilitation program for patients after total knee arthroplasty can effectively and quickly reduce the pain and swelling of the affected limb, promote the local blood circulation, and promote the quality of life of patients after rehabilitation.

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Incorporating hip abductor strengthening exercises into a rehabilitation program did not improve outcomes in people following total knee arthroplasty: a randomised trial

Journal of Physiotherapy ◽

10.1016/j.jphys.2019.05.008 ◽

2019 ◽

Vol 65 (3) ◽

pp. 136-143 ◽

Cited By ~ 2

Author(s):

Margaret B Schache ◽

Jodie A McClelland ◽

Kate E Webster

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Randomised Trial ◽

Rehabilitation Program ◽

Strengthening Exercises ◽

Hip Abductor ◽

Total Knee

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Prospective examination of pain-related and psychological predictors of CRPS-like phenomena following total knee arthroplasty: a preliminary study

Pain ◽

10.1016/j.pain.2003.08.009 ◽

2003 ◽

Vol 106 (3) ◽

pp. 393-400 ◽

Cited By ~ 140

Author(s):

Norman R. Harden ◽

Stephen Bruehl ◽

Steven Stanos ◽

Victoria Brander ◽

Ok Yung Chung ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Psychological Predictors ◽

Total Knee ◽

Preliminary Study

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Total Knee Arthroplasty for the Oldest Old

Geriatrics ◽

10.3390/geriatrics6030075 ◽

2021 ◽

Vol 6 (3) ◽

pp. 75

Author(s):

Carmen da Casa ◽

Helena Fidalgo ◽

Javier Nieto ◽

Enrique Cano-Lallave ◽

Juan F. Blanco

Keyword(s):

Total Knee Arthroplasty ◽

Emergency Room ◽

Knee Arthroplasty ◽

Hospital Readmission ◽

Oldest Old ◽

Age Groups ◽

Length Of Hospital Stay ◽

Rehabilitation Program ◽

Emergency Room Visits ◽

Total Knee

The present study describes and compares the early functional results after total knee arthroplasty (TKA) of the oldest-old population (aged over 84 years) and a randomly matched younger septuagenarian cohort so treated. We aimed to evaluate the early functional outcomes after patients’ rehabilitation and the yearly requirements for hospital readmission and emergency room visits after TKA. We noted a similar length of hospital stay for octogenarian and septuagenarian patients, and we determined that both groups of patients were improving ROM (both flexion and extension) after the rehabilitation program (p < 0.05, in all cases), but there were no significant differences between octogenarian and septuagenarian improvement of the knee function (p > 0.05, in all cases). Patients from both age groups behaved similarly in terms of mobility before starting rehabilitation and after completion of the rehabilitation program. We noted that older octogenarian patients showed a higher one-year hospital readmission rate than younger septuagenarian patients, but similar early emergency room visits for both age groups. The findings of this study allow us to conclude that advanced age in itself should not be a contraindication for TKA.

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