The purpose of the study was to evaluate the effectiveness of the developed physical therapy program on the parameters of sarcopenia in elderly people with total knee arthroplasty in the remote period after surgery. Materials and methods. During the research, 80 elderly people were examined. The control group consisted of 13 men and 15 women who did not undergo total endoprosthetic surgery of the joints of the lower limbs, without signs of sarcopenia. The comparison group consisted of 11 men and 16 women with total knee arthroplasty and diagnosed sarcopenia with low therapeutic (rehabilitation) compliance with the active rehabilitation intervention recommended based on the results of the initial examination. The main group consisted of 9 men, 16 women with total knee arthroplasty and diagnosed sarcopenia with a high level of therapeutic (rehabilitation) alliance regarding the active rehabilitation intervention recommended by the results of the initial examination. For them, a 6-month long physical therapy program was developed and implemented, which included the following elements: therapeutic exercises, functional training, massage of the lower limbs and lower back, kinesiological taping of the operated limbs; dietary recommendations; patient education. The effectiveness of the program was evaluated by the dynamics of the grip strength indicators, the Edmonton Frail Scale, and the SarQoL questionnaire. Results and discussion. In elderly patients with knee arthroplasty and sarcopenia, low strength (according to the value of grip strength), subjective physical weakness, difficulties in performing activities of daily living (according to the Edmonton Frail Scale questionnaire), were revealed, which led to a deterioration in the quality of life (according to the SarQoL questionnaire). The developed physical therapy program revealed a statistically significantly better effect on strength indicators, the state of physical weakness and quality of life parameters in comparison with the initial indicators for all studied parameters (р <0.05). Low rehabilitation compliance in elderly patients with knee arthroplasty and sarcopenia, despite being aware of the risks of this polymorbidity, was associated with a lack of improvement over a similar follow-up period. Conclusion. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and impaired performance of activities of daily life, which increases the quality of life of this contingent of patients

Objective: to evaluate the effectiveness of the developed physical therapy program on the parameters of the locomotive syndrome in elderly people with the motor consequences of total knee arthroplasty against the background of the geriatric syndrome of sarcopenia, in the remote period after the operation. Methods. 80 elderly people were examined. The control group consisted of 24 people without joint endoprostheses, with no signs of sarcopenia. The comparison group consisted of individuals with knee arthroplasty and sarcopenia with low rehabilitation compliance with regard to active rehabilitation intervention. Representatives of the main group with knee endoprosthesis and sarcopenia practiced according to a developed program of physical therapy, created taking into account the specifics of each comorbid condition. The program lasted 6 months; contained the following elements: therapeutic exercises, functional training, massage, kinesiotaping; dietary recommendations; patient education. Its purpose was: correction of the phenomena of motor stereotype violation as a consequence of total knee arthroplasty, in particular, phenomena of the locomotive syndrome, leveling of the phenomena of sarcopenia both at the level of its motor manifestations and at the level of etiopathogenesis of this geriatric condition; facilitation of activities of daily life, improvement of psycho-emotional state, and – as a result – improvement of quality of life. In the process of physical therapy, individual short- and long-term goals defined in the SMART format were consistently achieved within the framework of the patient-centered rehabilitation model. The effectiveness of the program was evaluated according to the dynamics of The Short Physical Performance Battery, Functional Gait Assessment, Fall efficacy scale, 25-question Geriatric Locomotive Function Scale. Results. In elderly patients with knee arthroplasty and sarcopenia, signs of locomotor syndrome were found in the form of impaired balance when performing simple movements (according to The Short Physical Performance Battery), violation of the normal gait stereotype and the resulting risk of falling (according to the Functional Gait Assessment), which led to awareness of the fear of falling (according to the Fall efficacy scale). The hall level of movement disorders corresponded to locomotive syndrome of the II degree (according to the 25-question Geriatric Locomotive Function Scale). The developed physical therapy program revealed a statistical improvement in the condition of patients due to the effect on the components of the locomotive syndrome due to the improvement of balance and gait parameters, reduction of the risk of falling and fear of falling compared to the initial indicators for all the studied parameters (р<0.05); however, the indicators of the control group were not reached (p>0.05). Low rehabilitation compliance in patients with knee arthroplasty and sarcopenia, despite awareness of the risks of this comorbidity, was associated with a lack of improvement over a similar follow-up period. Conclusions. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and the risk of falling, which will increase the overall effectiveness of rehabilitation measures.

The aim of the study was to evaluate the effectiveness of the influence of the developed program of physical therapy on the parameters of the geriatric status of elderly patients with motor consequences of total knee arthroplasty in the long-term period after surgery.  Material and methods. 80 elderly people were examined. The control group consisted of 24 people without joint endoprostheses with no signs of geriatric syndromes. The comparison group consisted of persons with a knee joint endoprosthesis and sarcopenia with low rehabilitation compliance with respect to rehabilitation intervention. Representatives of the main group with a knee joint replacement and sarcopenia were engaged in a physical therapy program using functional training on the Prosedos platform, therapeutic exercises, massage, kinesiology taping, nutrition correction, and patient education. The effectiveness of the program was evaluated by the dynamics of the Senior Fitness Test, Tinetti-test (Performance-Oriented Mobility Assessment), Geriatric Depression Scale, Tampa Kinesiophobia Scale.  Results. The geriatric status of the examined patients was characterized by muscle weakness (statistically significant lag in parameters of physical status - coordination, static and dynamic balance, strength, flexibility, endurance, dexterity compared to their peers according to the Senior Fitness Test, Tinetti-test), high risk of falling, kinesiophobia and psycho-emotional depression, which increases the risk of loss of autonomy and death. The developed program of physical therapy revealed an improvement in the condition of the patients of the main group due to the influence on the links of the pathogenesis of geriatric syndromes due to the improvement of balance and gait parameters, reduction of the risk of falling and fear of movements, improvement of the psycho-emotional status in comparison with the initial indicators in all studied parameters (р<0.05). The low rehabilitation compliance of patients in the comparison group, despite the awareness of the risks of poly morbidity, was associated with the lack of improvement in the condition after a similar observation period.  Conclusions. Elderly patients with the consequences of total knee arthroplasty and signs of geriatric syndromes need to develop physical therapy programs that take into account and correct the specifics of each condition, which will increase the overall effectiveness of rehabilitation measures.