Effects of action observation treatment in recovery after total knee replacement: a prospective clinical trial

Abstract

Objective: We hypothesized that self-administered action observation treatment can increase the effectiveness of inpatient rehabilitation of patients after a primary total knee replacement. Design: A pilot randomized controlled trial. Setting: Thirty-one inpatients, admitted to our Physical and Rehabilitation Medicine Department. Subjects: After a primary total knee replacement were randomly assigned to either an experimental (n=14) or control (n=17) group. Intervention: All subjects received conventional physiotherapy and were required to perform additional self-administered exercises explained in a written informative brochure. Subjects in the experimental group were asked to watch a video showing a person exercising whilst the control group watched a nature video without exercises being shown. Main outcomes measure: Changes in Visual Analogue Scale, active and passive range of motion of knee, Barthel index, Short Form-36 Health Survey, Tinetti scale, Lequesne index measurements. Results: At the end of the intervention period, the increase of the active range of motion over the active flexion and extension in the experimental group was higher than in the control group; the difference between groups was 15.6° (95%CI 5.3–24.8) and 3.4° (95%CI 1.1–5.6), for active flexion and active extension respectively; between-group effect sizes were large at post-treatment period (d>1.3). Conclusions: adding action observation training to conventional inpatient physiotherapy is associated with a greater degree of recovery in patients who have undergone a primary total knee replacement.