Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

Purpose: To examine functional mobility status on discharge day after total knee and hip replacement surgery in post-acute care hospital setting.Methods: Eighty patients following total knee and hip replacement surgery were assessed with the de Morton Mobility Index (DEMMI), the Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOM-AC) measurements of mobility-related activity on discharge day. Demographic information comprised age, body mass index, gender, type of surgery,length of hospital stay. Since the normality of distribution of the data was not confirmed, nonparametric Mann-Whitney-U test was used for analysis.Results: Forty patients (mean age: 66.83±7.39 years) underwent total knee replacement (TKR) and 40 patients (mean age: 62.63±11.95 years) underwent total hip replacement (THR). No statistical difference was found in age, body mass index and length of hospital stay between patients (p>0.05). TKR patients had better results in mean WOMAC total score, WOMAC Physical Functioning Score and mean DEMMI total score compared to THR patients (p<0.05). TUG and Five Times Sit to Stand Test time results showed a trend of deterioration in THR patients than TKR patients. The WOMAC pain, stiffness and total scores were similar between TKR and THR patients. Discussion:Results of this study indicated that functional mobility status at discharge would be better in patients with TKR than THR. Functional mobility evaluation following lower-extremity replacement surgery before discharge should be included in acute clinical physiotherapy practice to guide to physiotherapists to design effective intervention strategies to improve mobility. Sonuçlar:Kırk hasta (yaş ort: 66.83±7.39 yıl) total diz replasmanı (TDR); 40 hasta (yaş ort: 62.63±11.95 yıl) total kalça replasmanı (TKR) cerrahisi geçirmişti. Yaş, vücut kitle indeksi ve hastanede kalış süresi açısından hastalar arasında istatistiksel farklılık yoktu (p>0.05). TDR hastalarının, ortalama WOMAC toplam ve WOMAC Fiziksel Fonksiyon skoru ile ortalama DEMMI total skoru TKR hastalarına göre daha iyiydi (p<0.05). KYT ve 5 tekrarlı sandalyeden ayağa kalkma testi zamanları TKR hastalarında TDR hastalarına oranla daha uzun olma eğili-mindeydi. WOMAC ağrı, tutukluk ve toplam skorları TKR ve TDR hastalarında benzerdi.Tartışma: Bu çalışmanın sonuçları, taburculuk sırasındaki fonksiyonel mobilitenin TDR hastalarında TKR hastalarından daha iyi olduğunu göstermiştir. Alt ekstremite replasman cerrahisini takiben taburculuk öncesi fonksiyonel mobilitenin klinikte akut fizyoterapi uygulamalarında değerlendirilmesi, fizyoterapistlere mobiliteyi geliştirici etkili uygulama stratejilerini planlaması açısından yardımcı olacaktır.Anahtar Kelimeler: Osteoartrit, artroplasti, kalça replasmanı, diz replasmanı, erken ambülasyon. Kınıklı Gİ, Güney H, Karaman A, Yılmaz K, Çağlar Ö, Yüksel İ. Functional mobility on discharge day after total knee and hip replacement surgery, Turk J Physiother Rehabil. Türk Fizyoterapi ...

Methods: Baseline data of 573 patients with knee OA of the Amsterdam-Osteoarthritis cohort were used. Upper leg muscle strength (Nm/ kg) was measured isokinetically. Activity limitations were measured with the timed Get Up and Go (GUG) test and timed Stair Climb Test (SCT), subdivided in stair-ascending and stair-descending. In order to determine whether the relationships between muscle strength and activity limitations are nonlinear, it was tested whether nonlinear (exponential) models fitted the data significantly better than linear models. Finally, linear plus constant models were used to detect thresholds. Results: Nonlinear models improved model fit compared to linear models. The improvement was 5.9, 8.2 and 5.2 percentage points for respectively the GUG, stair-ascend and stair-descend time. Muscle strength thresholds were 0.93 Nm/kg (95%CI 0.80e1.05), 0.89 Nm/kg (95%CI 0.77e1.00) and 0.97 Nm/kg (95%CI 0.86e1.09) for relationships with respectively GUG, stair-ascend and stair-descend time.Conclusions: In a large population of patients with knee OA, relationships between muscle strength and activity limitations are nonlinear (i.e., exponential), allowing detection of muscle strength thresholds. Patients with muscle strength below these thresholds might benefit more from muscle strength training to reduce limitations in daily activities than patients with muscle strength above the thresholds. Future research is needed to assess the clinical value of the thresholds determined.