Abstract
This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p = 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p = 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p = 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.
Highlights
Osteoarthritis is a common chronic disease in elderly people aged >65 years, and patients with knee osteoarthritis experience pain, swelling, limited joint mobility, and stiffness due to inflammation of the synovial joint [1,2,3]
The purpose of this study is to investigate the effects of a preoperative telerehabilitation program with intensive training for 3 weeks on muscle strength, range of motion (ROM), and functional outcomes in patients undergoing total knee arthroplasty (TKA)
The inclusion criteria for participation in this preoperative telerehabilitation program were as follows: (1) scheduled bilateral TKA, (2) age ranging from 65 to 75 years, (3) efficient control of comorbid diseases, (4) ability to walk over 10 m without help, (5) average vision and hearing, (6) consent to voluntary participation in the preoperative rehabilitation program with prior consent from the surgeon, (7) without cognitive impairment and with good communication ability, and (8) familiarity with smartphone apps
Summary
Osteoarthritis is a common chronic disease in elderly people aged >65 years, and patients with knee osteoarthritis experience pain, swelling, limited joint mobility, and stiffness due to inflammation of the synovial joint [1,2,3]. To improve the pain and physical function of patients with knee osteoarthritis, previous studies have proposed effective physical therapy interventions, such as manual therapy, physical agent treatment, use of brace and orthoses, aerobic walking, strengthening training, balance training, homebased exercises, self-management programs, and weight reduction programs [4]. These physical therapy interventions have demonstrated valuable results, patients with end-stage knee osteoarthritis still consider undergoing total knee arthroplasty (TKA).
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