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.

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

2020 ◽  
Author(s):  
Omer Ayik ◽  
Mehmet Demirel ◽  
Fevzi Birisik ◽  
Ali Ersen ◽  
Halil I. Balci ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Peak Torque ◽  
Thigh Muscle ◽  
Controlled Study ◽  
Total Work ◽  
Isokinetic Muscle Strength ◽  
Total Knee

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

scholarly journals The Effect of Comorbidities and Age on Functional Outcomes After Total Knee Arthroplasty in the Octogenarian: A Matched Cohort Study

2018 ◽  
Vol 9 ◽  
pp. 215145931876950 ◽  
Author(s):  
Eric Wei Liang Cher ◽  
Kae Sian Tay ◽  
Karen Zhang ◽  
Seang Beng Tan ◽  
Tet Sen Howe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Oxford Knee Score ◽  
World Health ◽  
Control Group ◽  
Knee Score ◽  
Life Expectancy At Birth ◽  
Total Knee ◽  
The Impact

Introduction: According to the World Health Organization data repository, the average life expectancy at birth for Singapore in 2015 has risen to 83.4 years, and many octogenarians (OG) remain active socioeconomically. The aim of this study is to compare the improvement and the impact of comorbidities on functional recovery after total knee arthroplasty (TKA) between OG and their younger counterparts. Methods: This is a retrospective study of prospectively collected data from a single institution arthroplasty register. Between January 2006 and December 2011, 209 OG with primary knee osteoarthritis underwent TKA. Each OG (mean age 82 ± 2.1) was then carefully matched to a younger control group (YG, mean age 66 ± 4.5). Their postoperative outcomes measured include Oxford Knee Score (OKS), SF36-Physical Function (SF-PF), and knee society rating score comprising of Knee Score (KS) and Function Score (FS). Their respective degrees of improvement were compared and adjusted for their baseline comorbidities, measured using the Deyo-Charlson Comorbidity Index (D-CCI). Results: There were more comorbidities among the OG ( P < .05). Both groups saw the largest improvement ( P < .05) during the first 6 months. There was no statistical significance between their improvement for OKS, KS, and FS between baseline and 6 months and OKS, FS, and SF-PF between 6 and 24 months. Adjusted for D-CCI using linear regression, the above results remained largely unchanged. Discussion: In our study, both groups showed significant improvement across all functional outcomes, especially during the first 6 months. The improvement observed in OG at 6 and 24 months was comparable to that of YG, despite an overall higher baseline D-CCI. Conclusions: Total knee arthroplasty is a viable treatment option for the OG, offering good functional outcomes and results at 6 and 24 months when compared to their younger counterparts.

scholarly journals Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study

2021 ◽  
Author(s):  
Silvia J. Mrotzek ◽  
Shahir Ahmadi ◽  
Alexander von Glinski ◽  
Alexis Brinkemper ◽  
Mirko Aach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Continuous Passive Motion ◽  
Control Group ◽  
New Therapy ◽  
Total Knee ◽  
Hybrid Assistive Limb

Abstract Introduction The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients’ range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. Materials and methods Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. Results OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. Conclusions In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.

scholarly journals Effects of balance training on functional outcomes after total knee arthroplasty: a systematic review and meta-analysis of randomized controlled studies

2020 ◽  
Author(s):  
Wang Chen ◽  
Zheng-Hao Hu ◽  
Jian-Ning Sun ◽  
Ye Zhang ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Weighted Mean Difference ◽  
Body Height ◽  
Balance Training ◽  
Cochrane Library ◽  
Control Group ◽  
Randomized Controlled Studies ◽  
Total Knee

Abstract Background: Many previous studies have compared the effects of preoperative balance training and non-balance training on daily performance and knee functional outcomes after surgery, however, whether preoperative balance training is more beneficial to patients is still a big debate. Comparing the postoperative joint and daily function of balance training and non-balance training is the main purpose of our study.Methods: Cochrane library, Pubmed and Web of Science databases searched by us, and searched again before submitting our submission. This mete-analysis included 22 studies that directly compared postoperative performance and functional outcomes after training group (TG) and control group (CG). We used the software endnote X9 for data selection, and the software Review Manager 5.3 for data analysis to make funnel plots and forest plots.Results: The pooled data indicated that balance training significantly improved 2/6 MWT (2/6-min walk test) (weighted mean difference (WMD) = 25.17, 95% confidence interval (CI) 12.88 to 37.46, P < 0.0001), gait speed (WMD = 0.15, 95% CI 0.10 to 0.19, P < 0.00001), TUG (timed up and go) (WMD = 1.02, 95% CI 0.75 to 1.29, P < 0.00001), BBS (berg balance scale) (WMD = 1.79, 95% CI 0.50 to 3.08, P = 0.006), FHR (ratio of functional reach distance to body height) (WMD = 9.34, 95% CI 6.69 to 11.98, P < 0.00001), TCS (WMD = 1.20, 95% CI 0.86 to 1.53, P < 0.00001), early stage vitality (WMD = 14.41, 95% CI 13.53 to 15.30, P < 0.00001) and KOOS (Knee Injury and Osteoarthritis Score) sysptoms (WMD = 6.34, 95% CI 2.07 to 10.60, P = 0.004), middle stage function (WMD = 5.85, 95% CI 0.13 to 11.56, P = 0.04).Conclusion: Preoperative balance training improved partial postoperative daily performance and knee functional outcomes in patients with total knee arthroplasty.

scholarly journals Effects of Phased Rehabilitation Programs after Total Knee Arthroplasty: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Jing Chao ◽  
Mingzhu Lee ◽  
Qi Gong ◽  
Xuehua Bai ◽  
Peilei Yang
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Postoperative Care ◽  
Control Group ◽  
Randomized Controlled ◽  
Rehabilitation Programs ◽  
Sf 36 ◽  
Total Knee ◽  
The Mean

This multi-center, single-blinded, randomized controlled study assessed the efficacy of phased exercise rehabilitation programs in patients who underwent a total knee arthroplasty (TKA) and investigated suitable exercise types, intensities, and frequencies for patients undergoing postoperative rehabilitation. Between January and March 2018, 494 patients who had undergone TKA were treated at two medical centers. Patients were randomized and allocated to the rehabilitation group (n=330) or the control group (n=164; treated with postoperative care). The 100-mm Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), range of motion, and Short-Form 36 (SF-36) scores were assessed and compared between the two groups. The average WOMAC score was 84.40&plusmn;15.20 in the rehabilitation group and 108.30&plusmn;3.90 in the control group (p=0.009). The mean VAS score was 2.54&plusmn;0.16 in the rehabilitation group and 2.87&plusmn;0.31 in the control group (p=0.024). Furthermore, the range of motion was 125.02&plusmn;6.20 in the rehabilitation group and 116.40&plusmn;1.40 in the control group (p=0.017). The mean SF-36 score was 105.40&plusmn;21.50 in the rehabilitation group and 83.70&plusmn;5.01 in the control group (p=0.043). This study suggests that the phase rehabilitation program could be more effective at improving pain, knee function, and quality of life than condition postoperative care after TKA.

Improved Early Postoperative Range of Motion in Total Knee Arthroplasty Using Tranexamic Acid: A Retrospective Analysis

2018 ◽  
Vol 32 (02) ◽  
pp. 160-164
Author(s):  
Michael Boin ◽  
Andrew Froehle ◽  
Matthew Lawless ◽  
Jedediah May ◽  
Matthew Dorweiler
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Control Group ◽  
Treatment Groups ◽  
Significant Difference ◽  
Total Knee

AbstractThe use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has become common practice. Recent literature has demonstrated a reduction in postoperative knee swelling and drain output while using TXA. Our purpose is to analyze the range of motion (ROM) following TKA in patients who received TXA compared with a control group. We hypothesize that patients treated with TXA will have improved early postoperative ROM when compared with controls. A retrospective chart review was performed for patients who underwent TKA from 2010 to 2012 performed by a single orthopaedic surgeon. Patients were stratified into three cohorts by route of TXA administration including intravenous (IV), topical, and a control group. Dependent variables analyzed included extension, flexion, and total arc ROM on each postoperative day (POD), average ROM across all three postoperative days, as well as pre-to-postoperative differences in ROM. Demographic data were recorded for each patient. A total of 174 patients were included for analysis, 75 controls and 99 receiving TXA. A significant difference was found between the treatment groups and the control for all variables (for each, p ≤ 0.002). There were no significant differences in ROM between the IV and topical TXA treatment groups (for each, p ≥ 0.558). A multivariate analysis demonstrated no significant difference between the groups in complication rate or demographic variables. The use of TXA may improve early postoperative ROM following TKA.

scholarly journals Using electroacupuncture to recover muscle strength in knee osteoarthritic patients after total knee arthroplasty: a study protocol for a double-blinded, randomized and placebo-controlled trial

2020 ◽  
Author(s):  
Hui Xu ◽  
Bingxin Kang ◽  
Yulin Li ◽  
Jun Xie ◽  
Songtao Sun ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Knee Arthroplasty ◽  
Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Acupuncture Points ◽  
Total Knee ◽  
Double Blinded

Abstract Background: Total knee arthroplasty (TKA) has recently become an almost irreplaceable and effective means to relieve pain, reconstruct knee motor function and improve the quality of life of patients with end-stage knee osteoarthritis (KOA). However, the muscle strength after TKA is usually difficult to recover. Although electroacupuncture (EA) can enhance the muscle strength of lower extremity, there is hardly any literature on the effect of EA on the muscle strength of lower extremity in patients after TKA. To address this problem, this trial is intended to evaluate the efficacy of EA after TKA for recovering the muscle strength of lower extremity, esp. in the early post-TKA period.Methods/design: This is a double-blinded, randomized and controlled trial. It will be conducted between January, 2020 and June, 2020. A total of 94 participants with KOA will have undergone unilateral TKA and they will then be randomized into a treatment group and a control group, viz. the EA group and the sham EA group. The former will receive EA at acupuncture points of ST37, ST36, SP10 and SP9. The latter, the control group will receive sham EA at sham locations for the acupuncture points of ST37, ST36, SP10 and SP9. The participants will be given 5 sessions of treatment per day for 2 weeks. The primary outcomes include a change in the amount of muscle strength and the Hospital for Special Surgery (HSS) score at the second week from a baseline (POD 3). The secondary outcomes include a 6-minute walking test, Numerical rating scale (NRS), the Hamilton Anxiety Scale and additional use of analgesia. The additional outcomes include incidence of analgesia-related side effects and rate of participant satisfaction. Blinding of the participants will also be assessed. The participants will be asked to guess whether they have received EA after the latest intervention. Adverse events of EA will be documented and assessed throughout the trial.Discussion: EA is helpful for the recovery and enhancement of muscle strength of the lower limb after TKA.

Sign in / Sign up

Export Citation Format

Share Document