Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial

Moutzouri, Maria; Gleeson, Nigel; Coutts, Fiona; Tsepis, Εlias; Gliatis, John

doi:10.1177/0269215518757291

Cited by 13 publications

(54 citation statements)

References 29 publications

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“…Pain and surgery lead to a temporary loss of motor function and muscle strength, which often seems to improve in the post-operative phase, especially following a rehabilitation regimen [9][10][11][12][13][14]. When patients exhibit pain or other post-surgical complications, their rehabilitation may be compromised and result in impaired function, loss of muscle strength and poor postural control.…”

Section: Introductionmentioning

confidence: 99%

Intensive, personalized multimodal rehabilitation in patients with primary or revision total knee arthroplasty: a retrospective cohort study

Larsen

Mogensen²,

Arendt-Nielsen

et al. 2020

BMC Sports Sci Med Rehabil

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Background: Recent evidence has shown that many patients suffer from persistent pain and impaired function after primary or revision total knee arthroplasty (TKA). Post-surgical complications may in addition decrease physical performances and lead to more pain and impacted quality of life. The purpose of the study was to assess the changes in pain intensity and functional capacity among patients with post-surgical complications after TKA three weeks of intensive, personalized multimodal rehabilitation. Methods: A retrospective cohort study consisting of 217 patient of which 166 had primary TKA and 51 had revision TKA was conducted. On average, primary TKA patients and revision TKA patients were 3.7 and 2.7 months post-surgical, respectively. All patients have had post-surgical complications and were referred to an inpatient rehabilitation department, where they received a personalized three-week intensive, multimodal rehabilitation protocol. The rehabilitation consisted of sessions targeting neuromuscular function, postural control, and flexibility, sessions focusing on improving muscle strength and cardiovascular function and sessions with focus on gait retraining. The frequency of training was 2-4 sessions/day. The primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) and secondary outcomes were pain intensities measured using numerical rating scale, 6 min. walking test, stair-climbing test and range of motion for knee flexion and extension. Outcome measures were assessed at baseline upon referral and at follow-up before discharge. Results: All outcomes, except pain at rest in the revision group, improved significantly. KOOS subscales, improved 8.5 to 14.2 in the primary TKA group (p < 0.001) and 6.9 to 10.8 in the revision group (p < 0.001). For the TKA group, effect sizes were medium-to-large for all KOOS subscales, 6 min. walking test, stairclimbing test, and pain intensity during activity. For the revision group, effect sizes were medium-to-large for KOOS subscales symptoms and activity of daily living, 6 min. walking test, stair-climbing test, and knee flexion. Conclusion: Patients with post-surgical complications after primary or revision TKA experienced clinical relevant improvement in self-reported outcomes, pain relief, and improved physical performances after three weeks of personalized multimodal rehabilitation. The results suggest that an intensive, multimodal approach might be useful to obtain clinically relevant improvements.

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Section: Introductionmentioning

confidence: 99%

Intensive, personalized multimodal rehabilitation in patients with primary or revision total knee arthroplasty: a retrospective cohort study

Larsen

Mogensen²,

Arendt-Nielsen

et al. 2020

BMC Sports Sci Med Rehabil

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“…[12] Incomplete proprioceptive recovery of the knee joint, poor mobility and unstable dynamic balance are factors that increase the risk of falls in the elderly, and are also common factors that lead to difficulty in completing daily activities. [13,14] It has been reported that 25% of patients will fall within 2 years after total hip or total knee arthroplasty, [15] resulting in physical and psychological trauma and a high cost to the patient. [16] Therefore, limb balance is particularly important for the basic daily activities and safety of patients with total knee arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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

Chen

Sun

et al. 2020

Preprint

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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.

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“…Incomplete proprioceptive recovery of the knee, poor mobility and unstable dynamic balance are factors that increase the risk of falls in the elderly, and are also common factors that lead to di culty in completing daily activities. [13,14] It has been reported that 25% of patients will fall within 2 years after total joint arthroplasty, [15] resulting in physical and psychological trauma and a high cost to the patient. [16] Therefore, balance is particularly important for the basic daily activities and safety of patients with TKA.…”

Section: Introductionmentioning

confidence: 99%

Does Preoperative Balance Training Reduce Pain and Improve Joint Function in Patients After Total Knee Arthroplasty? A Randomized Controlled Trial

Chen¹,

Sun²,

Hu³

et al. 2020

Preprint

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Background Part of patients undergoing TKA did not achieve the expected physiological function results. The purpose of this study was to investigate whether preoperative balance training can reduce pain and improve joint function after TKA.Methods 100 patients with knee osteoarthritis (OA) prepared for TKA, according to the inclusion and exclusion criteria, were randomly divided into balance training group (50 patients) and control group (50 patients). The main evaluation outcomes of the study included early functional milestones, ROM, WOMAC score, keen society score (KSS), KOOS score, and complications at 1 month (baseline) and 1 day before surgery, 6 weeks (main endpoint) and 52 weeks (1 year) after surgery.Results 4 patients lost to follow-up at 1 month before surgery, 96 received planned surgery and 86 underwent a complete postoperative evaluation. After TKA, many indicators of the two groups, including WOMAC score, KSS, KOOS score, were significantly improved compared with before surgery. At 52 weeks after TKA, no statistically significant difference between the balance training group and control group in attain early functional milestones, ROM, WOMAC score, KSS, KOOS score, and complications; however, at 6 weeks after surgery, balance training group had better early benefits in stopping all narcotics (P = 0.045), relieving pain (P = 0.037), improving function (P = 0.017) and quality of life (QOL) (P = 0.028).Conclusions Although there were no difference between preoperative balance training group and control group at the 52 weeks after surgery, however, preoperative balance training can relieve pain and improve function in the early stage (6 weeks), but adequately statistically powered trials are needed to confrm the accuracy of the study resultsTrial Registration ChiCTR2000032789.

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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

Abstract: 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.

Cited by 13 publications

References 29 publications

Intensive, personalized multimodal rehabilitation in patients with primary or revision total knee arthroplasty: a retrospective cohort study

Intensive, personalized multimodal rehabilitation in patients with primary or revision total knee arthroplasty: a retrospective cohort study

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

Does Preoperative Balance Training Reduce Pain and Improve Joint Function in Patients After Total Knee Arthroplasty? A Randomized Controlled Trial

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