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
Highlights
Sensorimotor function is degraded in patients after lower limb arthroplasty
One-way analysis of variance (ANOVA) demonstrated no difference between the three groups with respect to age, height and body weight at baseline (Table 1)
Stabilization capacity the stability index significantly increased over time in both the anterior-posterior (p < .001, ηp2 = 0.184) and medio-lateral (p < .001, ηp2 = 0.203) directions (Fig. 2), there was no significant difference between training volumes
Summary
Sensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, 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. In the progression of osteoarthritis (OA), sensorimotor skills including proprioception [1, 2], static and dynamic balance [3], and neuromuscular control are known to degrade in response to pain avoidance and advancing inactivity. These sensorimotor deficiencies typically manifest as modified movement patterns and muscle weakness [4, 5] and have been shown to persist even after joint replacement. Zech et al [9] found that sensorimotor training improved dynamic balance in ankle sprain patients and resulted in a faster activation of hamstring muscles
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