The Effect of Combined Balance Exercise on Knee Range of Motion, Balance, Gait, and Functional Outcomes in Acute Phase Following Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Ethical Statement
2.3. Study Design
2.4. Experimental Procedure
2.5. Training Program
2.5.1. Combined Balance Exercise
2.5.2. General Physical Therapy
2.6. Outcome Measures
2.7. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Week | Exercise Program | |||
---|---|---|---|---|
1st week | ||||
Exercise | Seated torso rotations | Sit to stand | Shift weight to one side | Step-ups and step-downs |
Practice | Each 10 reps/2 sets | Each 10 reps/2 sets | Each 10 reps/2 sets | Each 10 reps/2 sets |
2–3rd week | ||||
Exercise | Trunk rotations while standing | Side step-ups and downs | Standing on one leg while holding onto a walker | Lifting knees high and walking forward |
Practice | Each 10 reps/2 sets | Each 10 reps/2 sets | Each 10 reps/2 sets | Each 10 reps/2 sets |
4th week | ||||
Exercise | Side step-ups and step-downs | Figure-eight walking | Heel raises while walking with a walker | Using a walker to perform up-and-down movements |
Practice | Each 10 reps/2 sets | Each 1 min/2 reps | Each 1 min/2 reps | Each 10 reps/2 sets |
Week | Exercises | Practice |
---|---|---|
1–2nd week | Knee range of motion exercises in a seated position Leg extension exercises while lying down Leg lifting exercises while lying down Ankle dorsiflexion/plantarflexion exercises | Each 5 s/10 reps/5 sets |
3–4th week | Knee range of motion exercises in a seated position Knee extension exercises with resistance in a seated position Knee flexion exercises while standing Knee extension with resistance while standing Hip abduction exercises while standing. | Each 5 s/10 reps/5 sets |
Characteristics | CBE Group (n = 19) | Control Group (n = 19) | X2/t (p) |
---|---|---|---|
Age (years) | 73.6 (4.8) a | 72.3 (4.6) | 0.865 (0.393) |
Affected side (Rt/Lt) | 8/11 | 10/9 | 0.422 (0.516) |
Height (cm) | 154.8 (3.9) | 152.5 (7.1) | 1.248 (0.222) |
Weight (kg) | 63.7 (7.9) | 60.5 (8.6) | 1.185 (0.244) |
BMI (kg/m2) | 26.5 (2.6) | 25.9 (3.0) | 0.585 (0.562) |
BMD (T-score) | −2.3 (1.2) | −3.3 (2.4) | 1.562 (0.127) |
Hypertension, N (%) (Yes/No) | 14 (73.7%)/5 (26.3%) | 12 (63.2%)/7 (36.8%) | 0.487 (0.485) |
Diabetes mellitus, N (%) (Yes/No) | 11 (57.9%)/8 (42.1%) | 10 (52.6%)/9 (47.4%) | 0.106 (0.744) |
Hyperlipidemia, N (%) (Yes/No) | 13 (68.4%)/6 (31.6%) | 9 (47.4%)/10 (52.63%) | 1.727 (0.189) |
Depression, N (%) (Yes/No) | 3 (15.8%)/16 (84.2%) | 2 (10.5%)/17 (89.5%) | 0.230 (0.631) |
Variable | CBE Group (n = 19) | Control Group (n = 19) | p-Value | Time | Group | Time × Group | ||
---|---|---|---|---|---|---|---|---|
F(p) | F(p) | F(p) | η2p | |||||
WOMAC Pain | Pre-test | 12.26 (3.72) a | 13.22 (2.42) | 0.309 | 197.336 (0.000) | 7.307 (0.010) | 6.523 (0.015) | 0.153 |
Post-test | 6.11 (1.85) | 9.05 (1.68) | ||||||
Mean difference | 6.16 (2.77) | 4.26 (1.66) | 0.015 | |||||
p-value | 0.000 | 0.000 | ||||||
WOMAC Stiffness | Pre-test | 5.74 (1.09) | 5.37 (1.16) | 0.322 | 100.940 (0.000) | 1.290 (0.264) | 11.814 (0.001) | 0.247 |
Post-test | 3.05 (0.97) | 4.05 (0.97) | ||||||
Mean difference | 2.68 (1.29) | 1.32 (1.15) | 0.001 | |||||
p-value | 0.000 | 0.000 | ||||||
WOMAC Physical Function | Pre-test | 44.47 (7.567) | 43.11 (6.315) | 0.549 | 264.960 (0.000) | 0.578 (0.452) | 4.879 (0.034) | 0.119 |
Post-test | 21.79 (5.931) | 25.84 (6.585) | ||||||
Mean difference | 22.68 (7.18) | 17.26 (7.92) | 0.034 | |||||
p-value | 0.000 | 0.000 | ||||||
WOMAC Total (Score) | Pre-test | 63.95 (7.656) | 61.63 (8.908) | 0.396 | 365.912 (0.000) | 1.784 (0.190) | 12.558 (0.001) | 0.259 |
Post-test | 30.95 (6.811) | 38.95 (8.256) | ||||||
Mean difference | 33.00 (8.266) | 22.68 (9.627) | 0.001 | |||||
p-value | 0.000 | 0.000 | ||||||
PROM (°) Knee Flexion | Pre-test | 117.95 (14.24) | 122.68 (11.01) | 0.259 | 47.505 (0.000) | 0.113 (0.738) | 6.057 (0.019) | 0.144 |
Post-test | 131.95 (7.89) | 129.32 (8.37) | ||||||
Mean difference | 14.00 (11.79) | 6.63 (5.58) | 0.021 | |||||
p-value | 0.000 | 0.000 |
Variable | CBE Group (n= 19) | Control Group (n= 19) | p-Value | Time | Group | Time × Group | ||
---|---|---|---|---|---|---|---|---|
F(p) | F(p) | F(p) | η2p | |||||
CEA (mm2) | Pre-test | 279.78 (150.75) a | 345.97 (224.43) | 0.294 | 54.618 (0.000) | 5.407 (0.026) | 4.175 (0.048) | 0.104 |
Post-test | 90.30 (21.24) | 238.57 (150.32) | ||||||
Mean difference | 189.48 (140.48) | 107.39 (104.52) | 0.048 | |||||
p-value | 0.000 | 0.000 | ||||||
PL (mm) | Pre-test | 105.81 (34.75) | 127.78 (44.63) | 0.099 | 86.668 (0.000) | 6.644 (0.014) | 7.464 (0.010) | 0.172 |
Post-test | 63.86 (32.41) | 104.87 (43.36) | ||||||
Mean difference | 41.95 (23.17) | 22.91 (19.63) | 0.010 | |||||
p-value | 0.000 | 0.000 | ||||||
AV (mm/s) | Pre-test | 10.80 (3.57) | 11.71 (4.51) | 0.494 | 42.337 (0.000) | 2.979 (0.093) | 7.564 (0.009) | 0.174 |
Post-test | 6.82 (3.34) | 10.10 (4.31) | ||||||
Mean difference | 3.97 (3.01) | 1.61 (2.22) | 0.009 | |||||
p-value | 0.000 | 0.005 | ||||||
TUG (s) | Pre-test | 13.83 (2.54) | 14.39 (3.63) | −0.584 | 84.502 (0.000) | 2.465 (0.125) | 7.347 (0.010) | 0.169 |
Post-test | 10.67 (1.63) | 12.67 (2.35) | ||||||
Mean difference | 3.15 (1.37) | 1.71 (1.85) | 0.010 | |||||
p-value | 0.000 | 0.001 |
Variable | CBE Group (n= 19) | Control Group (n= 19) | p-Value | Time | Group | Time × Group | ||
---|---|---|---|---|---|---|---|---|
F(p) | F(p) | F(p) | η2p | |||||
10MWT (m/s) | Pre-test | 0.813 (0.69) a | 0.79 (0.60) | 0.726 | 40.108 (0.000) | 1.769 (0.192) | 4.288 (0.046) | 0.106 |
Post-test | 1.00 (0.89) | 0.88 (0.74) | ||||||
Mean difference | 0.187 (0.60) | 0.09 (0.47) | 0.046 | |||||
p-value | 0.000 | 0.012 |
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An, J.; Cheon, S.-J.; Lee, B.-H. The Effect of Combined Balance Exercise on Knee Range of Motion, Balance, Gait, and Functional Outcomes in Acute Phase Following Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial. Medicina 2024, 60, 1389. https://doi.org/10.3390/medicina60091389
An J, Cheon S-J, Lee B-H. The Effect of Combined Balance Exercise on Knee Range of Motion, Balance, Gait, and Functional Outcomes in Acute Phase Following Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial. Medicina. 2024; 60(9):1389. https://doi.org/10.3390/medicina60091389
Chicago/Turabian StyleAn, Jungae, Seong-Jin Cheon, and Byoung-Hee Lee. 2024. "The Effect of Combined Balance Exercise on Knee Range of Motion, Balance, Gait, and Functional Outcomes in Acute Phase Following Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial" Medicina 60, no. 9: 1389. https://doi.org/10.3390/medicina60091389