scholarly journals The Role of 6-Minute Walk Test Guided by Impedance Cardiography in the Rehabilitation Following Knee Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Yangyang Lin ◽  
Xingwei Hu ◽  
Yalin Cao ◽  
Xing Wang ◽  
Yao Tong ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Intervention Group ◽  
Control Group ◽  
Non Invasive ◽  
Total Knee ◽  
6 Minute Walk Test ◽  
Minute Walk ◽  
Rehabilitation Exercise

Objective: To explore the effect of the 6-minute walk test (6MWT) guided by non-invasive cardiac output on the rehabilitation of patients with knee osteoarthritis following artificial total knee arthroplasty.Methods: About 66 patients with knee osteoarthritis planned to undergo artificial total knee arthroplasty were included from March 2019 to October 2019, and randomly assigned to the intervention group or control group. Under the guidance of a clinical rehabilitation physician, orthopedic physician, and cardiologist, a home rehabilitation exercise program based on 6MWT and non-invasive cardiac output was formulated for patients with knee osteoarthritis. The participants of the intervention group conducted full rehabilitation training supervision and guidance through the WeChat platform to ensure their rehabilitation pieces of training were completed safely and effectively. As for the control group, patients were just given rehabilitation training manuals at the time of discharge and completed the training by themselves.Results: At 6 months post-operatively, 6-minute walk distance (413.88 ± 44.61 vs. 375.00 ± 40.53 m, P < 0.05), active metabolic equivalent (4.13 ± 0.29 vs. 3.88 ± 0.27, P < 0.05), stroke volume after 6MWT (114.97 ± 12.05 vs. 98.38 ± 16.43 ml, P < 0.05), and cardiac output (11.92 ± 1.68 vs. 9.79 ± 1.82 l/min, P < 0.05) of the intervention group were significantly higher than those of the control group. The symptom evaluation scores of the intervention group were also better than those of the control group.Conclusions: The multidisciplinary post-operative rehabilitation exercise training program is beneficial to the recovery of lower limb function and the improvement of exercise capacity after knee replacement, and it also helps to improve the non-invasive hemodynamic indicators related to the cardiac function of the patient.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx.

The Effect of Preoperative Video Based Pain Training on Postoperative Pain and Analgesic Use in Patients Undergoing Total Knee Arthroplasty: A Non-randomized Control Group Intervention Study

2020 ◽  
pp. 105477382098336
Author(s):  
Ceyda Su Gündüz ◽  
Nurcan Çalişkan
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Group Intervention ◽  
Intervention Study ◽  
Intervention Group ◽  
Control Group ◽  
Total Knee ◽  
Randomized Control ◽  
Analgesic Use

This non-randomized control group intervention study was conducted to determine the effect of preoperative video based pain training on postoperative pain and analgesic use in patients undergoing total knee arthroplasty. During the study, the patients in the control ( n = 40) received routine care and the patients in the intervention group ( n = 40) received video based pain training. İt was determined that the mean postoperative pain scores of the intervention group were significantly lower and their pain management was better compared to the control group ( p < .05). The intervention group was found to use significantly less paracetamol on operation day compared to the control group ( p < .05). The intervention group was determined to benefit from non-pharmacological methods more than the control group did ( p < .05). Providing video based pain training to patients undergoing total knee arthroplasty is recommended since it reduces postoperative pain levels and increases the use of non-pharmacological pain control methods.

scholarly journals Reliability and Responsiveness of Two Physical Performance Measures Examined in the Context of a Functional Training Intervention

2000 ◽  
Vol 80 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Mary B King ◽  
James O Judge ◽  
Robert Whipple ◽  
Leslie Wolfson
Keyword(s):  
Physical Performance ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Intervention Group ◽  
Training Intervention ◽  
Control Group ◽  
Walk Test ◽  
Test Retest Reliability ◽  
6 Minute Walk Test ◽  
Minute Walk

Abstract Background and Purpose. The reliability and responsiveness of 2 physical performance measures were assessed in this nonrandomized, controlled pilot exercise intervention. Subjects. Forty-five older individuals with mobility impairment (mean age=77.9 years, SD=5.9, range=70–92) were sequentially assigned to participate in an exercise program (intervention group) or to a control group. Methods. The intervention group performed exercise 3 times a week for 12 weeks that targeted muscle force, endurance, balance, and flexibility. Outcome measures were the 8-item Physical Performance Test (PPT-8) and the 6-minute walk test. Test-retest reliability and responsiveness indexes were determined for both tests; interrater reliability was measured for the PPT-8. Results. The intraclass correlation coefficient for interrater reliability for the PPT-8 was .96. Intraclass correlation coefficients for test-retest reliability were .88 for the PPT-8 and .93 for the 6-minute walk test. The intervention group improved 2.4 points and the control group improved 0.7 point on the PPT-8, as compared with baseline measurements. There was no change in 6-minute walk test distance in the intervention group when compared with the control group. The responsiveness index was .8 for the PPT-8 and .6 for the 6-minute walk test. Conclusion and Discussion. Measurements for both the PPT-8 and the 6-minute walk test appeared to be highly reliable. The PPT-8 was more responsive than the 6-minute walk test to change in performance expected with this functional training intervention.

scholarly journals Comparison of Short-Term Efficacy of Total Knee Arthroplasty Versus Arthroscopy in Chinese Patients with Knee Osteoarthritis

2020 ◽  
Author(s):  
Xiaolin Jia ◽  
San Cai ◽  
Wei Hu ◽  
Qiang Gan ◽  
Mingquan Zhou
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Scientific Basis ◽  
Knee Function ◽  
Chinese Patients ◽  
Control Group ◽  
Total Knee ◽  
The Difference ◽  
Experimental Group

Abstract Background: The purpose of this study was to compare the improvement of knee function in patients with knee osteoarthritis who underwent total knee arthroplasty and arthroscopy in China, and to provide a scientific basis for the application of clinical total knee arthroplasty in knee osteoarthritis.Methods: A total of 160 patients with knee osteoarthritis who were admitted to Chinese hospital from January 2017 to December 2018 were studied. They were divided into experimental group and control group according to their willingness of treatment. The control group was treated with arthroscopy and the experimental group was treated with total knee arthroplasty. All patients were followed for a period of 6 months. The knee joint function score (HSS), visual analog scale (VAS), and anxiety self-assessment scale (SAS) scores before and after surgery were compared between the two groups. Results: The proportion of "excellent or good" in the efficacy of the experimental group (91.25%) was higher than that of the control group (72.50%), and the difference was statistically significant (χ2=9.476, P<0.05). The HSS score of the experimental group was higher than that of the control group (P<0.05), while the VAS and SAS scores were lower than those of the control group (P<0.05). The scores of various SF-36 scales in the experimental group were higher than those in the control group after operation (P<0.05).Conclusions: Total knee arthroplasty was considered effective in treating patients with knee osteoarthritis that meet the indications, and is beneficial to improve knee function and reduce pain in patients. The surgical treatment also reduced the level of anxiety and effectively improve the quality of life of patients. Further investigation of its clinical application on treatment of knee osteoarthritis is warranted.

Short-Term Effects of Isometric Quadriceps Muscle Exercise with Auditory and Visual Feedback on Pain, Physical Function, and Performance after Total Knee Arthroplasty: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Yasutaka Kondo ◽  
Yoshihiro Yoshida ◽  
Takashi Iioka ◽  
Hideki Kataoka ◽  
Junya Sakamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Visual Feedback ◽  
Knee Arthroplasty ◽  
Acute Pain ◽  
Intervention Group ◽  
Quadriceps Muscle ◽  
Control Group ◽  
Muscle Exercise ◽  
Short Term ◽  
Total Knee

AbstractSevere acute pain after total knee arthroplasty (TKA) may cause delay in muscle strength and functional recovery, and it is a risk factor for chronic postoperative pain. Although pharmacological approaches are the typical firstline to treat acute pain; recently, nonpharmacological approaches such as exercise have been increasingly applied. The purpose of this investigation was to evaluate the effects of a rehabilitation program involving isometric quadriceps exercise with auditory and visual feedback to improve the short-term outcome after TKA. Sixty-two patients, planning a primary unilateral TKA, were randomly assigned to either an intervention group (n = 31) involving isometric quadriceps exercise with auditory and visual feedback in usual rehabilitation after TKA or a control group (n = 31) involving a standardized program for TKA. Patients in the intervention group performed the isometric quadriceps muscle exercise using the Quadriceps Training Machine from 2 to 14 days after TKA instead of the traditional quadriceps sets. Pain intensity, isometric knee extension strength, range of motion, timed up and go test (TUG), 10-m gait speed, 6-minute walking distance, the Western Ontario and McMaster University Osteoarthritis index (WOMAC), the hospital anxiety and depression scale, and the pain catastrophizing scale were assessed before TKA (baseline) and 1 to 3 weeks after TKA. Pain intensity significantly decreased in the intervention group than in the control group at 1 (p = 0.005), 2 (p = 0.002), and 3 (p = 0.010) weeks after TKA. Greater improvements in TUG (p = 0.036), 10-m gait speed (p = 0.047), WOMAC total score (p = 0.017), pain (p = 0.010), and function (p = 0.028) 3 weeks after TKA were observed in the intervention group. These results suggest that isometric quadriceps exercises with auditory and visual feedback provided early knee pain relief, possibly leading to better improvements in physical performance, and patient's perception of physical function in the early stages of postoperative TKA. Further studies should investigate whether this short-term effect is sustainable.

scholarly journals Patelloplasty with and without circumpatellar denervation in reducing anterior knee pain in primary total knee arthroplasty: a comparative prospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 270
Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M.
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Total Knee ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> Anterior knee pain (AKP) following total knee arthroplasty (TKA) ­­­­­­is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p&lt;0.05).  Western Ontario and McMaster Universities osteoarthritis index scores were significantly  better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of  intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.</p><p class="abstract"><strong>Conclusions:</strong> There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.</p><p> </p>

Effects of an Intervention to Improve Life-Space Mobility and Self-Efficacy in Patients following Total Knee Arthroplasty

2018 ◽  
Vol 32 (10) ◽  
pp. 966-971 ◽  
Author(s):  
Yoshinori Hiyama ◽  
Tsukasa Kamitani ◽  
Kazuaki Mori
Keyword(s):  
Total Knee Arthroplasty ◽  
Confidence Interval ◽  
Knee Arthroplasty ◽  
Self Efficacy ◽  
Intervention Group ◽  
Mean Difference ◽  
Control Group ◽  
Life Space ◽  
Patient Reported ◽  
Total Knee

AbstractLife-space mobility describes the spatial areas through which an individual moves, and the frequency and need for assistance. Although patients with knee osteoarthritis (OA) have shown restricted life-space mobility, total knee arthroplasty (TKA) does not improve it beyond preoperative levels. Life-space mobility after TKA was influenced by self-efficacy for walking tasks; thus, an intervention to improve self-efficacy for walking tasks may contribute to better life-space mobility. We provided a walking event including several walking tasks as the intervention. We assessed the effect of the walking event on life-space mobility and self-efficacy for walking tasks in patients following TKA. In this nonrandomized controlled trial, patients who underwent primary TKA were recruited. After recruitment, patients who could not participate in the walking event due to scheduling conflicts were included in the control group. The walking event consisted of 3.5 km of walking course and included walking tasks as follows: crossing at the crosswalk, walking up- and downstairs without a railing, walking along dirt roads, and walking up and down a slope. The primary outcome was life-space mobility measured using Life-Space Assessment (LSA) and self-efficacy for walking tasks measured using the modified Gait Efficacy Scale (mGES). We enrolled 104 patients, of whom 36 were assigned to the intervention group and participated in the walking event. Participants in the intervention group had significantly better LSA score (adjusted mean difference between groups: 13.9; 95% confidence interval: 12.4–15.5; p < 0.001) and mGES score (adjusted mean difference between groups: 13.8; 95% confidence interval: 12.4–15.1; p < 0.001) than the control group even after adjusting for age, gender, body mass index, elapsed time from surgery, the severity of knee OA of nonoperated limb, and patient-reported functional outcome. The walking event including various walking tasks improved life-space mobility and self-efficacy in patients following TKA. It is important to design a program that can improve self-efficacy for walking tasks through mastery experiences to improve life-space mobility after TKA.

scholarly journals The Effects of Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial

2020 ◽  
Author(s):  
Mei-Chu Chen ◽  
Chiu-Chu Lin ◽  
Jih-Yang Ko ◽  
Feng-Chih Kuo
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Intervention Group ◽  
Continuous Passive Motion ◽  
Control Group ◽  
Computer Assisted ◽  
Passive Motion ◽  
Significant Difference ◽  
Total Knee

Abstract Background: Cryotherapy and continuous passive motion (CPM) are commonly used for conventional total knee arthroplasty (TKA) to reduce postoperative pain and increase of the range of motion (ROM). However, this postoperative nursing intervention remains elusive for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA) Methods: A prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n=30) and control group (n=30). The intervention group applied programed cryotherapy and CPM within one hour while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4. Results: There was no significant difference in the NRS score between the groups ( p = 0.168). The intervention group had significantly higher ROM than the control group (98 degrees vs. 91 degrees, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups ( p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm). Conclusions: Programmed cryotherapy and continuous passive motion can improve the range of motion after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA.

A new educational method before total knee arthroplasty to be applied in developing countries: a randomized controlled trial

2020 ◽  
Author(s):  
Marco Antonio Percope de Andrade ◽  
Guilherme Moreira Abreu e Silva ◽  
Tulio Vinicius Oliveira Campos ◽  
David Guen Kasuya Barbosa ◽  
Danilo Silva Leite ◽  
...  
Keyword(s):  
Developing Countries ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Positive Impact ◽  
Intervention Group ◽  
Public Hospitals ◽  
Control Group ◽  
Educational Method ◽  
Walk Ability ◽  
Total Knee

Abstract Background In developing countries, the illiteracy index is high in public hospitals. We describe a method in which patients are instructed before total knee arthroplasty (TKA) in a differentiated way without the necessity of reading any self-orientation. Methods To improve patient education before TKA we developed a multidisciplinary method in which an orthopedic surgeon, a nurse and a physiotherapist give the patients a differentiated orientation with specific lectures regarding the pre, intra and post-operative issues in a prospective case-control study of 79 consecutive patients undergoing primary TKA. Twenty-nine patients received the standard verbal education (control group) and 38 patients received the differentiated education (intervention group). The patients were evaluated during at least six months. Results After a 6-month follow-up period, SF-36 and WOMAC forms, VAS and range of motion improved significantly in both groups. ROM was better in the intervention group (mean and SD − 106.9 ± 5.7 versus 92.5 ± 12.1 degrees, p = 0.02). Moreover, walk ability (more than 400 meters) was improved in the intervention group compared with control group (97.4% versus 72.4%, p = 0.003). In the intervention and control groups, respectively, 10.5% and 31% of patients reported the need of some walking device (p = 0.03). Conclusions A differentiated educational program with a multidisciplinary team had a positive impact on functional outcomes, improving ROM and walk ability of patients undergoing TKA in a short-term evaluation.

scholarly journals The Effect of Early Hip-strengthening on Physical Function in Patients With Unilateral Total Knee Arthroplasty

2021 ◽  
Vol 23 (6) ◽  
pp. 912-925
Author(s):  
Mojgan Moaref Khanli ◽  
◽  
Mohammad Akbari ◽  
Ali Amiri ◽  
◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Intervention Group ◽  
Control Group ◽  
Rehabilitation Programs ◽  
Hip Muscle ◽  
Strengthening Exercises ◽  
Total Knee ◽  
Hip Strengthening

Background and Aim: Conventional post-operative rehabilitation programs focus on quadriceps strengthening and knee range of motion. However, hip muscle weakness is evident in patients with knee osteoarthritis. The present trial study aimed to investigate the effects of adding early hip muscle strengthening exercises to conventional rehabilitation programs on pain, Range of Motion (RoM), Quality of Life (QoL), and physical function in patients with unilateral Total Knee Arthroplasty (TKA). Methods & Materials: The intervention was initiated from the second day after surgery and continued for 10 sessions, 3 times a week on 24 participants in the control and intervention groups. Both research groups received Transcutaneous Electrical Neural Stimulation (TENS) and Infra-Red (IR), followed by exercises. The control group performed knee extensor and flexor strengthening and RoM exercises. The intervention group conducted hip-strengthening exercises in addition. Outcome measures included pain, knee flexion, and extension RoM, and QoL using the 36-Item Short Form Survey (SF-36), Timed Up and Go (TUG) test, Step Test, Six-Minute Walk Test (6MWT), and Hip and Knee Muscle Strength test. Ethical Considerations: This research was approved by the Research Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.1396.9511340012) and it was registered in the Clinical Trial Registration Center (Code: IRCT 20150314021459N6). Results: All outcome measures improved in both research groups. The improvement in the scores of pain (P=0.03), knee extension RoM (P=0.007), and TUG test (P=0.033) were significantly higher in the intervention group, compared to the control group. The strength of knee flexors (P=0.023), hip flexors (P=0.040), hip extensors (P=0.028), hip adductors (P=0.040), and hip external rotators (P=0.047) significantly improved higher in the intervention group. Conclusion: According to the present research results, both treatment approaches were effective on patients with unilateral total knee arthroplasty. Considering the better result of some of the outcome measures in the intervention group, the addition of hip strengthening exercises to knee exercises can be useful.

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