The Effects of Balance Training on Balance Performance and Functional Outcome Measures Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Doma, Kenji; Grant, Alan; Morris, Jodie L.

doi:10.1007/s40279-018-0964-7

Cited by 41 publications

(31 citation statements)

References 44 publications

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“…Current meta-analysis performed publication bias, subgroup analysis, and subgroup analysis for overall function. Doma et al [22] indicated that balance training improved walking capacity, balance-specific performance, and functional outcome measures for elderly individuals following total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials

Mao

2019

J Orthop Surg Res

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BackgroundTo investigate whether the clinical effects of balance training were improved in hip fracture patients.MethodsElectronic databases which included PubMed, Embase, Web of Science, and the Cochrane Library up to December 2018 were searched. High-quality randomized controlled trials (RCTs) and prospective clinical controlled studies were selected based on inclusion criteria. Stata 12.0 was used for the meta-analysis. Standard mean difference (SMD) with 95% confidence interval (CI) was used to assess the effects.ResultsFinally, 9 studies with 872 patients (balance training = 445, control = 427) were included in our meta-analysis (published between 1997 and 2018). Compared with the control group, balance training group showed a significant increase in overall function (SMD = 0.59, 95% CI [0.25, 0.93], P = 0.001), gait speed (SMD = 0.63, 95% CI [0.19, 1.07], P = 0.005), lower limb strength (SMD = 0.73, 95% CI [0.50, 0.95], P = 0.000), activities of daily living (ADLs) (SMD = 0.97, 95% CI [0.61, 1.34], P = 0.000), performance task scores (SMD = 0.41, 95% CI [0.21, 0.61], P = 0.000), and health-related quality of life (HRQoL) scores (SMD = 0.32, 95% CI [0.16, 0.47], P = 0.000).ConclusionsOur meta-analysis revealed that the balance training group has improved overall physical functioning, gait, lower limb strength, performance task, and activity of daily living than the control group. More high-quality and large-scale RCTs are needed to identify the optimal regimen of balance training after hip fracture.

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Section: Discussionmentioning

confidence: 99%

Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials

Mao

2019

J Orthop Surg Res

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“…This meta-analysis carried out a subgroup analysis and assessed the risk of publication bias for all the studies. Doma et al [ 24 ] reported that balance training enhanced functional outcome measures, balance-specific performance, and walking capacity for elderly people who underwent overall knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Balance training can enhance hip fracture patients’ independence in activities of daily living

Chen

Yang²,

Wang³

2020

Medicine

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Background: We conducted this meta-analysis to analyze the effectiveness of balance training in improving postoperative rehabilitation outcomes in hip fracture surgery patients. Methods: The Cochrane Library, Web of Science, Embase, and PubMed electronic databases were searched from their inception to December 2018. We selected prospective clinical control analyses and high-quality randomized controlled trials (RCTs) following the inclusion standards. We used Stata 12.0 to perform the meta-analysis. Where possible, the standard mean difference (SMD) with the 95% confidence interval (CI) was determined using a random effects model. Results: Ten RCTs involving 955 hips (balance training = 487, control = 468) published between 2002 and 2019 were assessed for eligibility of inclusion in the meta-analysis. Balance training was shown to remarkably improve the aspects of quality of life associated with physical health (standard mean difference [SMD], 2.20; 95% CI, 1.63–2.78, P = .000), a fast gait speed (SMD, 1.01; 95% CI, 0.25–1.77, P = .009), and balance (SMD = 0.26, 95% CI: [0.12, 0.41], P = .000). Moreover, the balance training group showed increases in independence in activities of daily living (ADLs), performance task scores, and health-related quality of life (HRQoL) scores compared with the control group ( P < .05). Conclusion: According to the present meta-analysis, balance training improves one's independence in activities of daily living, performance tasks, lower limb strength, gait, and total physical function compared with no balance training. More high-quality RCTs with large sample sizes are required for the identification of the best balance training program after hip fracture.

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“…strengthening exercises [ 22 ], sensori-motor training (e.g. integration of proprioceptive inputs on balance and gait) [ 13 , 30 , 48 ] or electromyostimulation training [ 20 ]. The strengthening exercises were performed underloaded (coordination at 10–20% of 1-Repetition Maximum (1RM)) or at submaximal intensity (strength endurance at 30–50% of 1RM and hypertrophy at 50–80% of 1RM) and targeted muscles of the lower extremities (e.g.…”

Section: Methodsmentioning

confidence: 99%

Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial

et al. 2020

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Background The purpose of this study was to assess the effect of preoperative physiotherapy (PT) on functional, subjective and socio-economic parameters after total knee arthroplasty (TKA). Methods 20 patients (mean ± SD: age 67 ± 7 years) scheduled for TKA at Balgrist University Hospital between July 2016 and March 2017 were randomly assigned to a control (CG) or intervention (IG) group. 3 to 4 weeks prior to surgery the IG completed 5 to 9 sessions of PT containing proprioceptive neuromuscular facilitation (PNF) techniques, endurance training and individually indicated interventions. Measurements were executed at baseline, preoperative and 3 months after TKA. The primary outcome measure was the Stair Climbing Test (SCT), secondary outcome measures were the knee range of motion (ROM) and the level of physical activity using Lysholm Score (LS) and Tegner Activity Scale (TAS). The subjective and socio-economic parameters were the Patients’ Global Impression of Change (PGIC) scale, inpatient rehabilitation time, preoperative pain levels and metabolic equivalent (MET), postoperative intake of analgesics and overall costs. Results No difference between IG and CG was found for SCT (F (2/36) = 0.016, p = 0.984, η2 = 0.004). An interaction between group and time was shown for TAS (F (18/1) = 13.890) with an increase in the IG ( p = 0.002, η2 = 0.536). The sub-item “pain” within the LS presented a higher pain-level in CG (F (18/1) = 4.490, p = 0.048, η2 = 0.974), while IG showed a higher preoperative MET compared to CG ( p = 0.035). There were no other significant changes. The CG produced 21.4% higher overall costs, took more analgesics and showed higher preoperative pain levels than the IG. Conclusions Findings show that preoperative therapy improved the level of physical activity before and after TKA and resulted in a clinically relevant gain in TAS. Trial registration ClinicalTrials.gov Identifier; NCT03160534 . Registered 19 May 2017

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The Effects of Balance Training on Balance Performance and Functional Outcome Measures Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Cited by 41 publications

References 44 publications

Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials

Efficacy of balance training for hip fracture patients: a meta-analysis of randomized controlled trials

Balance training can enhance hip fracture patients’ independence in activities of daily living

Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial

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