Effectiveness of Correction of Geriatric Status of Elderly Patients With Movement Consequences of Total Knee Arthroplasty Using Physical Therapy

Abstract

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.