Abstract
Total knee arthroplasty (TKA) is used to treat end-stage osteoarthritis. However, this surgical procedure affects the mechanical receptor function and impairs the ability to balance. Dynamic balance training has been reported to improve stability and self-confidence and safely yield increased physical activity. This study aimed to investigate the effect of dynamic balance training on physical function, the ability to balance and quality of life among patients who underwent TKA. Thirty-eight participants were assigned to either the progressive dynamic balance training (PDBT) with physical therapy group (n = 19) or the control group (n = 19). The experimental group undertook a dynamic balance program with physical therapy for 30 minutes per day, five times per week for six weeks, while the control group undertook physical therapy only. A continuous passive motion exercise was performed for 20 minutes after training by both groups. The outcomes were evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, pain pressure threshold (PPT), range of motion (ROM), Knee Outcome Survey-Activities of Daily Living (KOS-ADLS), Multifunction Force Measuring Plate, timed up and go (TUG) test and Short-Form Health Survey 36 (SF-36). Physical function (WOMAC Osteoarthritis Index, ROM and KOS-ADLS score) and the ability to balance (TUG test score, confidence ellipse area, path length and average velocity) significantly improved (p < 0.05) in the experimental group compared with the control group. In contrast, the physical component summary score for the SF-36 regarding quality of life significantly improved (p < 0.05); however, the mental component summary score for the SF-36 and PPT did not significantly differ between the groups. Therefore, we suggest that PDBT with physical therapy has positive effects on physical function, the ability to balance and quality of life among patients who underwent TKA.
Highlights
Total knee arthroplasty (TKA) is used to treat patients with end-stage osteoarthritis who experience pain and struggle to perform activities of daily living owing to having degenerative knee joints [1,2]
TKA can improve the quality of life of patients, some may experience a decrease in their proprioception and the ability to balance after surgery [3] and there is a significant incidence of unsatisfactory post-operative outcomes [4]
For the baseline physical function, balance and quality of life scores, no significant differences were found between the groups (p < 0.05)
Summary
Total knee arthroplasty (TKA) is used to treat patients with end-stage osteoarthritis who experience pain and struggle to perform activities of daily living owing to having degenerative knee joints [1,2]. TKA can improve the quality of life of patients, some may experience a decrease in their proprioception and the ability to balance after surgery [3] and there is a significant incidence of unsatisfactory post-operative outcomes [4]. Thirty-seven percent of patients have limited improvement in their function at first year post-surgery. Patients who have undergone TKA can have functional limitations with impaired motor control and ability to balance. During TKA, some tendons and capsules are tightened to restore the joint space that has deteriorated owing to osteoarthritis. A few ligaments are removed to restore the intracapsular
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