Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

Abstract

Objectives:To determine the effectiveness of balance exercises in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty.Methods:Patients who had total hip arthroplasty (n = 30) or total knee arthroplasty (n = 33) were seen in their residence 1–2 times per week for 5 weeks. At the first post-operative home visit, patients were randomly assigned to either typical (TE, n = 33) or typical plus balance (TE + B, n = 30) exercise groups. The TE group completed seven typical surgery-specific joint range-of-motion and muscle strengthening exercises, while the TE + B group completed the typical exercises plus three balance exercises. Patients were assessed before and 5 weeks after administering the rehabilitation program using four outcome measures: (1) the Berg Balance Scale, (2) the Timed Up and Go test, (3) the Western Ontario McMaster Universities Osteoarthritis Index, and (4) the Activities-specific Balance Confidence Scale.Results:Post-intervention scores for all four outcome measures were significantly improved (p < 0.01) over baseline scores. Patients who participated in the TE + B group demonstrated significantly greater improvement on the Berg Balance Scale and the Timed Up and Go tests (p < 0.01).Conclusion:Balance exercises added to a typical rehabilitation program resulted in significantly greater improvements in balance and functional mobility compared to typical exercises alone.

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients

“…The American Academy of Orthopedic Physicians predicts that the number of total knee replacement surgeries will increase sixfold between 2005 and 2030. [40][41][42][43][44][45][46][47] The choice of replacement prosthesis in TKA depends on the severity of knee joint damage and a patient's demographic characteristics and medical history. Replacement knee prostheses should provide high flexion with minimal load-bearing surface wear and osteolysis.…”

Balance a few years after total hip replacement

“…Such patients also show deficits in muscle strength, function and physical activity compared to healthy adults [2]. Therefore, such persons face increased risk of falls [3]. In such cases total hip replacement (THR) is generally the treatment method of choice [4].…”

“…Balance control is required not only to maintain postural stability but also to ensure safe mobilityrelated activities during daily life, such as standing while performing manual tasks, rising from a chair, walking and turning[3,36]. The persistence of degenerative hip joint disease produces in most cases progressive deterioration of postural control, which is associated with[10] decreased range of motion in the hip joints, reduced muscle strength and pain felt during walking or running.…”

Einsatz und Bedeutung von Seilzügen in der Medizinischen Trainingstherapie am Beispiel Hüft-Totalendoprothese – eine Expertenperspektive

“…Schache et al [29] zeigen in einer Studie, dass ein zusätzliches Krafttraining durch Übungen wie isometrische Kniebeuge, dynamische Kniebeuge, Beinpresse und Ausfallschritte zu einem herkömmlichen physiotherapeutischen Programm das Outcome bei Hüft-TEP Patienten deutlich verbessert. Andere Trainingsmittel wie Radergometer oder Gleichgewichtstraining bewirken ebenso positive Effekte auf die Funktion und Schmerzwahrnehmung [16,20,25]. Darüber hinaus fanden Nankaku et al [22] heraus, dass ein Training der Hüftaußenrotation effektiv die Kraft der Abduktoren steigert und sich positiv auf die Gehfähigkeit auswirkt.…”

“…Es ist an dieser Stelle darauf hinzuweisen, dass hier der Fokus auf der Nutzung des Seilzugs lag. Verschiedene Untersuchungen zum postoperativen Training nach Hüft-TEP zeigten ebenso die Effektivität anderer Trainingsgeräte zur Verbesserung der Funktion und Schmerzreduktion [16,19,20,29].…”