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

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.

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

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519420400072 ◽

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.

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Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance

Entropy ◽

10.3390/e23020164 ◽

2021 ◽

Vol 23 (2) ◽

pp. 164

Author(s):

Anna Hadamus ◽

Dariusz Białoszewski ◽

Michalina Błażkiewicz ◽

Aleksandra J. Kowalska ◽

Edyta Urbaniak ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Visual Feedback ◽

Sample Entropy ◽

The Body ◽

Control Group ◽

Knee Replacement Surgery ◽

Replacement Surgery ◽

Total Knee Replacement Surgery ◽

Total Knee

Exercises in virtual reality (VR) have recently become a popular form of rehabilitation and are reported to be more effective than a standard rehabilitation protocol alone. The aim of this study was to assess the efficacy of adjunct VR training in improving postural control in patients after total knee replacement surgery (TKR). Forty-two patients within 7–14 days of TKR were enrolled and divided into a VR group and a control group (C). The C group underwent standard postoperative rehabilitation. The VR group additionally attended twelve 30-min exercise sessions using the Virtual Balance Clinic prototype system. Balance was assessed on the AMTI plate in bipedal standing with and without visual feedback before and after the four-week rehabilitation. Linear measures and sample entropy of CoP data were analyzed. After four weeks of rehabilitation, a significant reduction in parameters in the sagittal plane and ellipse area was noted while the eyes remained open. Regression analysis showed that sample entropy depended on sex, body weight, visual feedback and age. Based on the sample entropy results, it was concluded that the complexity of the body reaction had not improved. The standing-with-eyes-closed test activates automatic balance mechanisms and offers better possibilities as a diagnostic tool.

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

Biological Research For Nursing ◽

10.1177/1099800415572147 ◽

2015 ◽

Vol 18 (1) ◽

pp. 68-75 ◽

Cited By ~ 11

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.

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

Clinical Nursing Research ◽

10.1177/10547738211058985 ◽

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.

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

Scandinavian Journal of Surgery ◽

10.1177/1457496919883812 ◽

2019 ◽

pp. 145749691988381 ◽

Cited By ~ 1

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.

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