Fernando Domínguez-Navarro1,2, Antonio Silvestre-Muñoz3,4, Celedonia Igual-Camacho1,3,2, Beatriz Díaz-Díaz1,3,2, Jose Vicente Torrella3, Juan Rodrigo3, Alfonso Payá-Rubio3, Sergio Roig-Casasús1,2,5, Jose María Blasco6,7,8. 1. Departament de Fisioteràpia, Universitat de València, Carrer Gascó Oliag 5, 46010, Valencia, Spain. 2. Group of Physiotherapy in the Ageing Process: Social and Health Care Strategies, Valencia, Spain. 3. Hospital Clínic y Universitari de València, Avd. Blasco Ibáñez 13, 46010, Valencia, Spain. 4. Departament de Cirurgia, Universitat de València, Avd. Blasco Ibáñez, 46010, Valencia, Spain. 5. Hospital Universitari y Politècnic La Fe, Avd. de Fernando Abril Martorell, 106, 46026, Valencia, Spain. 6. Departament de Fisioteràpia, Universitat de València, Carrer Gascó Oliag 5, 46010, Valencia, Spain. Jose.Maria.Blasco@uv.es. 7. Group of Physiotherapy in the Ageing Process: Social and Health Care Strategies, Valencia, Spain. Jose.Maria.Blasco@uv.es. 8. IRIMED Joint Research Unit (La Fe - UV), Valencia, Spain. Jose.Maria.Blasco@uv.es.
Abstract
PURPOSE: To investigate the effects of including balance training in a preoperative strengthening intervention on balance and functional outcomes in patients undergoing total knee replacement (TKR) and compare these effects to those induced by preoperative strengthening and no intervention. METHODS:Eighty-two subjects scheduled for TKR were randomly allocated into the strengthening (ST, n = 28) group: a preoperative lower limb strengthening intervention; the strengthening + balance (ST + B, n = 28) group: same intervention augmented with balance training; and the control group (n = 26). The Berg Balance Scale (BBS) and the function in daily living subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-ADL) were the primary outcomes. The secondary measures included balance and mobility, self-reported status, and knee function. The outcomes were assessed at baseline, 1 week before surgery, and 2, (primary endpoint), 6 and 52 weeks after surgery. RESULTS: Compared with the controls, the participants in the ST and ST + B groups presented significant improvements from baseline to the end of the preoperative intervention in BBS (p = 0.005) and KOOS-ADL (p < 0.001). At 6 weeks post-surgery, the knee extensor strength values were similar in the two treatment groups and significantly higher than that in the controls. Overall, the participant outcomes in all groups stabilized at 1 year after surgery. CONCLUSION: A preoperative strengthening intervention, regardless of whether it is complemented with balance training, enhances strength but not balance or functional outcomes at 6 weeks after surgery. Patients are expected to present similar performance at 1 year postoperatively, but adequately statistically powered trials are needed to confirm the findings. LEVEL OF EVIDENCE: II. TRIAL REGISTRATION: NCT02995668.
RCT Entities:
PURPOSE: To investigate the effects of including balance training in a preoperative strengthening intervention on balance and functional outcomes in patients undergoing total knee replacement (TKR) and compare these effects to those induced by preoperative strengthening and no intervention. METHODS: Eighty-two subjects scheduled for TKR were randomly allocated into the strengthening (ST, n = 28) group: a preoperative lower limb strengthening intervention; the strengthening + balance (ST + B, n = 28) group: same intervention augmented with balance training; and the control group (n = 26). The Berg Balance Scale (BBS) and the function in daily living subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-ADL) were the primary outcomes. The secondary measures included balance and mobility, self-reported status, and knee function. The outcomes were assessed at baseline, 1 week before surgery, and 2, (primary endpoint), 6 and 52 weeks after surgery. RESULTS: Compared with the controls, the participants in the ST and ST + B groups presented significant improvements from baseline to the end of the preoperative intervention in BBS (p = 0.005) and KOOS-ADL (p < 0.001). At 6 weeks post-surgery, the knee extensor strength values were similar in the two treatment groups and significantly higher than that in the controls. Overall, the participant outcomes in all groups stabilized at 1 year after surgery. CONCLUSION: A preoperative strengthening intervention, regardless of whether it is complemented with balance training, enhances strength but not balance or functional outcomes at 6 weeks after surgery. Patients are expected to present similar performance at 1 year postoperatively, but adequately statistically powered trials are needed to confirm the findings. LEVEL OF EVIDENCE: II. TRIAL REGISTRATION: NCT02995668.
Authors: Stian Langgård Jørgensen; Signe Kierkegaard; Marie Bagger Bohn; Per Aagaard; Inger Mechlenburg Journal: Front Sports Act Living Date: 2022-07-14
Authors: Anna M Anderson; Benjamin T Drew; Deborah Antcliff; Anthony C Redmond; Christine Comer; Toby O Smith; Gretl A McHugh Journal: Syst Rev Date: 2022-09-02