Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty

Abstract

BackgroundSensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, however, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, therefore, was to firstly quantify the progression of sensorimotor function after total hip (THA) or knee (TKA) arthroplasty and, as second step, to evaluate effects of different sensorimotor training volumes.Methods58 in-patients during their rehabilitation after THA or TKA participated in this prospective cohort study. Sensorimotor function was assessed using a test battery including measures of stabilization capacity, static balance, proprioception, and gait, along with a self-reported pain and function. All participants were randomly assigned to one of three intervention groups performing sensorimotor training two, four, or six times per week. Outcome measures were taken at three instances, at baseline (pre), after 1.5 weeks (mid) and at the conclusion of the 3 week program (post).ResultsAll measurements showed significant improvements over time, with the exception of proprioception and static balance during quiet bipedal stance which showed no significant main effects for time or intervention. There was no significant effect of sensorimotor training volume on any of the outcome measures.ConclusionWe were able to quantify improvements in measures of dynamic, but not static, sensorimotor function during the initial three weeks of rehabilitation following TKA/THA. Although sensorimotor improvements were independent of the training volume applied in the current study, long-term effects of sensorimotor training volume need to be investigated to optimize training stimulus recommendations.Trial registrationClinical trial registration number: DRKS00007894

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

“…As a result, the study’s findings suggest that there would be no particular efficacy-related advantage in a cessation of exercise training early, as gains were still being accrued at 14 weeks after surgery. Interestingly, Pohl et al 27 had been unable to detect significant gains in proprioception performance after implementing short duration (3-week) sensorimotor training in patients undergoing both knee and hip replacement surgeries. So, it is not unreasonable to assume a strong link between longer duration rehabilitation programmes and good functional and/or sensorimotor outcomes.…”

The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial

“…But it might be possible that the effect of the balance training on function may not be measurable at this early stage after surgery. 35 In addition, the effects of challenging the sensorimotor system do not necessarily occur immediately; the approach is known to induce structural plasticity with a cortical and integrative effect that induces neuromuscular adaptations. [36][37][38] Given that proprioception may take time to recover after knee replacement 34 and given that proprioceptive work could bear fruit over longer periods than the one studied and be maintained for longer, 36 assessments beyond six weeks could have provided relevant information.…”

Influência da reabilitação física sobre aspectos funcionais em indivíduos submetidos à artroplastia total de quadril: uma revisão sistemática

“…Moreover, studies have documented that dynamic and isometric exercises, used as part of the physiotherapeutic treatment of THA, resulted in significant functional benefits 7,8,11,14,17,[29][30][31][32][33] . When these exercises are accompanied by balance exercises, the functional outcomes are even more positive for these patients 32,33 . Therefore, resistance exercise can improve functionality as it enhances muscle strength, which is required to execute most activities of daily living, as strength is a predictor of functional capacity 34 .…”