Effects of telerehabilitation-implemented core stability exercises on patient-reported and performance-based outcomes in total knee arthroplasty patients: randomised controlled trial

Abstract

ABSTRACT Background Face-to-face access to exercise programs, including standard exercises (SE) and core stability exercises (CSE), can be challenging for many total knee arthroplasty (TKA) patients. Objectives To investigate the effects of adding CSE to SE on patient-reported and performance-based outcomes in TKA patients using telerehabilitation (TR). Methods Group 1 (SE, n = 21) and Group 2 (SE+CSE, n = 21). Follow-up included videoconferences (1–8 weeks) and telephone calls (9–12 weeks). Assessments (preoperatively and at 1st, 2nd, and 3rd postoperative months) included; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): functional level, Visual Analogue Scale (VAS): pain intensity, Copenhagen Knee Range of Motion (ROM) Scale (CKRS): knee ROM, Short Form-12 (SF-12) and World Health Organization Quality of Life Brief Version (WHOQOL-BREF): quality of life, 30-s Chair-Stand Test: muscle strength, and Stair Climb Test: locomotor performance. Results All assessments showed a significant improvement after treatment in group 1 (p < .001, Cohen’s d = 0.315 to 0.959) and group 2 (p < .001, d = 0.445 to 0.901). There was no significant difference between groups in knee flexion ROM (p > .05). Group 2 achieved better results in functional level (p = .001 to 0.003,d = −0.334 to 1.207), pain intensity (p = .030,d = −0.334), knee extension ROM (p = .015,d = −0.374), quality of life (p = .001 to 0.046,d = −0.308 to −1.366), muscle strength (p = .002 to 0.016,d = −0.779 to −1.030), and locomotor performance (p = .004 to 0.009, d = 0.404 to 0.954). Conclusion SE and SE+CSE via TR enhance patient-reported and performance-based outcomes in post-operative TKA patients, with CSE providing additional benefits. These results support using CSE in TR programs for TKA and encourage further research on TR.