BACKGROUND:Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. OBJECTIVES: The purposes of this study were: (1) to determine the feasibility of applying a balance exercise program in patients with TKA, (2) to investigate whether a functional training (FT) program supplemented with a balance exercise program (FT+B program) could improve physical function compared with an FT program alone in a small group of individuals with TKA, and (3) to test the methods and calculate sample size for a future randomized trial with a larger study sample. DESIGN: This study was a double-blind, pilot randomized clinical trial. SETTING: The study was conducted in the clinical laboratory of an academic center. PARTICIPANTS: The participants were 43 individuals (30 female, 13 male; mean age=68 years, SD=8) who underwent TKA 2 to 6 months prior to the study. INTERVENTIONS: The interventions were 6 weeks (12 sessions) of a supervised FT or FT+B program, followed by a 4-month home exercise program. MEASUREMENTS: Feasibility measures included pain, stiffness, adherence, and attrition. The primary outcome measure was a battery of physical performance tests: self-selected gait speed, chair rise test, and single-leg stance time. Secondary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index and the Lower Extremity Functional Scale. RESULTS: Feasibility of the balance training in people with TKA was supported by high exercise adherence, a relatively low dropout rate, and no adverse events. Both groups demonstrated clinically important improvements in lower-extremity functional status. The degree of improvement seemed higher for gait speed, single-leg stance time, and stiffness in the FT+B group compared with the FT group. LIMITATIONS: Due to the pilot nature of the study, differences between groups did not have adequate power to show statistical significance. CONCLUSIONS: There is a need for conducting a larger randomized controlled trial to test the effectiveness of an FT+B program after TKA.
RCT Entities:
BACKGROUND:Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. OBJECTIVES: The purposes of this study were: (1) to determine the feasibility of applying a balance exercise program in patients with TKA, (2) to investigate whether a functional training (FT) program supplemented with a balance exercise program (FT+B program) could improve physical function compared with an FT program alone in a small group of individuals with TKA, and (3) to test the methods and calculate sample size for a future randomized trial with a larger study sample. DESIGN: This study was a double-blind, pilot randomized clinical trial. SETTING: The study was conducted in the clinical laboratory of an academic center. PARTICIPANTS: The participants were 43 individuals (30 female, 13 male; mean age=68 years, SD=8) who underwent TKA 2 to 6 months prior to the study. INTERVENTIONS: The interventions were 6 weeks (12 sessions) of a supervised FT or FT+B program, followed by a 4-month home exercise program. MEASUREMENTS: Feasibility measures included pain, stiffness, adherence, and attrition. The primary outcome measure was a battery of physical performance tests: self-selected gait speed, chair rise test, and single-leg stance time. Secondary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index and the Lower Extremity Functional Scale. RESULTS: Feasibility of the balance training in people with TKA was supported by high exercise adherence, a relatively low dropout rate, and no adverse events. Both groups demonstrated clinically important improvements in lower-extremity functional status. The degree of improvement seemed higher for gait speed, single-leg stance time, and stiffness in the FT+B group compared with the FT group. LIMITATIONS: Due to the pilot nature of the study, differences between groups did not have adequate power to show statistical significance. CONCLUSIONS: There is a need for conducting a larger randomized controlled trial to test the effectiveness of an FT+B program after TKA.
Authors: J David Curb; Clementina D Ceria-Ulep; Beatriz L Rodriguez; John Grove; Jack Guralnik; Brad J Willcox; Tim A Donlon; Kamal H Masaki; Randi Chen Journal: J Am Geriatr Soc Date: 2006-05 Impact factor: 5.562
Authors: Sara R Piva; Gustavo J Almeida; Alexandra B Gil; Anthony M DiGioia; Diane L Helsel; Gwendolyn A Sowa Journal: Arthritis Care Res (Hoboken) Date: 2017-11-02 Impact factor: 4.794
Authors: A Notarnicola; G Maccagnano; A Fiore; A Spinarelli; L Montenegro; M Paoloni; F Pastore; S Tafuri; B Moretti Journal: Musculoskelet Surg Date: 2017-10-03
Authors: Sara R Piva; Paulo E P Teixeira; Gustavo J M Almeida; Alexandra B Gil; Anthony M DiGioia; Timothy J Levison; G Kelley Fitzgerald Journal: Phys Ther Date: 2011-01-06