The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
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Effect of Joint Mobilization with Movement for Ankle Joint Inversion on Knee Pain, Ankle Joint Range of Motion, Balance, and Gait: Total Knee Arthroplasty Patients

발목관절 안쪽번짐에 대한 움직임을 동반한 관절가동술이 무릎 통증, 발목 관절가동범위, 균형, 보행에 미치는 영향: 무릎관절 전치환술 환자를 대상으로

  • Received : 2024.07.22
  • Accepted : 2024.08.21
  • Published : 2024.08.30
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Abstract

Background: This study aimed to investigate the effects of joint mobilization with movement (MWM) on pain, ankle joint range of motion, balance, and gait in patients who underwent total knee arthroplasty (TKA) and exhibited ankle joint inversion. Methods: We divided 35 patients who had undergone TKA into experimental and control groups. The intervention involved a 40-min session three times a week over 4 weeks. The control group received general physical therapy, ankle pumping exercises, Q-setting exercises, knee joint range of motion exercises, and gravity-controlled gait training. In addition to these treatments, the experimental group received MWM to evaluate knee pain, ankle joint angle, balance, and gait pre- and post-intervention. Results: Both groups experienced a decrease in pain levels, with no significant difference between the groups. Both groups also showed a significant decrease in ankle joint inversion angle, with notable differences between them. Additionally, both groups significantly increased their mean dorsiflexion angles and balance, with a significant difference observed between the groups. Although walking decreased in both groups, there was no significant difference observed between them. Conclusion: The group that received MWM treatment showed significant effects on inversion angle, dorsiflexion angle, balance, and gait. These results provide valuable insights into the potential benefits of MWM as a post-TKA intervention, while highlighting the importance of long-term follow-up studies on post-TKA lower limb alignment interventions.

Keywords

References

  1. Bae CH, Jung YW, Lee DW, et al. The effect of sling exercise on muscular strength and range of motion in female patients who received total knee replacement. Journal of the Korea Academia-Industrial cooperation Society. 2014;15(7):4395-4403. https://doi.org/10.5762/KAIS.2014.15.7.4395.
  2. Bae SY, Kim HC, Park YS, et al. Radiologic evaluation of change of ankle joint after total knee arthroplasty. J Korean Foot Ankle Soc. 2007;11(2):135-140.
  3. Basnett RC, Michael JH, Todd JW, et al. Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. Int J Sports Phys Ther. 2013;8(2):121-128.
  4. Byun JE. The Correlation between Preoperative Lower Extremity Alignment and Hindfoot Alignment in Total Knee Arthroplasty Patients. Ulsan University. Master Thesis. 2012.
  5. Chung MS, Kwak HS, Effects of a muscle strengthening exercise program after total knee arthroplasty. J Korean Acad Soc Nurs Educ. 2008;14(1):20-29. https://doi.org/10.5977/JKASNE.2008.14.1.020.
  6. Dennis DA, Komistek RD, Mahfouz MR, et al. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 2003;(416):37-57. http://doi:10.1097/01.blo.0000092986.12414.b5.
  7. Ensini A, Catani F, Leardini A, et al. Alignment and clinical resylt in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2006;457:156-162. https://doi.org/10.1097/BLO.0b013e3180316c92.
  8. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with with a view to prevention. Arthritis Rheum. 1998;41(8):1343-1355. https://doi.org/10.1002/1529-0131(199808)41:8<1343::AID-ART3>3.0.CO;2-9.
  9. Gefen A. Megido-Ravid M, Itzchak T, et al. Analysis of muscular fatigue and foot stability during high-heeled gait. Gait Posture. 2002;15(1):56-63. http://doi.org/10.1016/So996-6362(01)00180-1.
  10. Haaker RG, Stockheim M, Kamp M, et al. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res. 2005;433:152-159. https://doi.org/10.1097/01.blo.0000150564.31880.c4.
  11. Keenan MA, Peabody T, Gronley J, et al. Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis. J Bone Joint Surg Am. 1991;73(2):237-247.
  12. Kim SY. Comparison of the difference of weight-bearing distribution between subjects with low back pain and healthy subjects. Physical Therapy Korea. 2001;8(1):1-8.
  13. Kim HS, Jeong YH. A Comparison of knee and ankle coronal plance alignment according to quadriceps exercise method in early phase of total knee arthroplasty: Lower extremity isometric co-contraction and quadriceps isolated isometric contraction. Phys Ther Korea. 2016;23(1):20-30. https://doi.org/10.12674/ptk.2016.23.1.020.
  14. Konradsen L. Factors contributing to chronic ankle instability. Kinaesthesia and joint position sense. J Athl Train. 2002;37(4):381-385.85.
  15. Lim SJ. The Effects of Balance and Ability in the Pre-Post Operation Patients with Degenerative Knee Osteoarthritis After Bio-feedback Exercise. Daegu University. Master Thesis. 2010.
  16. Min HS, Jung YH, Kim ES, et al. Effects of muscle strengthening exercise program on pain, fatigue, physical function in elderly women with total knee arthroplasty. Journal of muscle and joint health. 2011;18(2):203-214. https://doi.org/10.5953/JMJH.2011.18.2.203.
  17. National Health Insurance Service. Main Surgery Statistical Yearbook 2022. 2023. https://www.nhis.or.kr.
  18. Ouellet D, Moffet H. Locomotor deficits before and two months after knee arthroplasty. Arthritis Rheum. 2002;47(5):484-493. https://doi.org/10.1002/art.10652.
  19. Piva SR, Gil AB, Almeida GJ, et al. A blance exercise program appears to improve function for patients with total knee arthroplasty: A randomized clinical trial. Phys Ther. 2010;90(6):880-894. https://doi.org/10.2522/ptj.20090150.
  20. Rand JA, Coventry MB. Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop Relat Res. 1998;232:168-173.
  21. Saari T, Tranberg R, Zugner R, et al. Changed gait pattern in patients with total knee arthroplasty but minimal influence of tibial insert design: Gait analysis during level walking in 39 TKR patients and 18 healthy controls. Acta Orthop. 2005;76(2):253-260. http://doi.org/10.1080/00016470510030661.
  22. Saragaglia D. More than 20 Years Navigation of Knee Surgery with the Orthopilot Device. In: Abedin-Nasab MH, Editor. Handbook of Robotic and Image-guided Surgery. Elsevier. Amsterdam. 2020;425-441.
  23. Schai PA, Thornhill TS, Scott RD. Total knee arthroplasty with the PFC system. Results at a minimum of ten years and survivorship analysis. J Bone Joint Surg Br, 1998;80(5):850-858. https://doi.org/10.1302/0301-620x.80b5.8368.
  24. Skelton DA, Nina B. Exercise and injury prevention in order people. Scand J Med Sci Sports. 2003;13(1):77-85. https://doi.org/10.1034/j.1600-0838.2003.00300.x.
  25. Song HB, Park GH. Effects of muscle energy technique on knee extensor muscle strength, knee range of motion, balance, and walking ability in elderly women during the chronic phase after total knee replacement. Kor Acad Ortho Man Phys Ther. 2021;27(2):55-67. https://doi.rog/10.23101/kaompt.2021.27.2.55.
  26. Steffen TM, Hacker TA, Mollinger L. Age-and gender-related test performance in community dwelling elderly people: Six-minute walk test, berg balance scale, timed up & go test, and gait speeds. Phys Ther. 2002;82(2):128-137. http//doi.org/10.1093/ptj/82.2.128.
  27. Tallroth K, Harilainen A, Kerttula L, et al. Ankle osteoarthritis is associated with knee osteoarthritis. Conclusions based on mechanical axis radiographs. Arch Orthop Trauma Surg. 2008;128(6)555-560. https://doi.org/10.1007/s00402-007-0502-9.
  28. Wagner DR, Tatsugawa K, Parker D, et al. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High Alt Med Biol. 2007;8(1):27-31. https://doi.org/10.1089/HAM.2006.0814.
  29. Yoon JD, Lee JN. The effects of ankle mobilization with movements on the ankle range of motion, balance, and gait of patients after total knee arthroplasty. Kor Acad Ortho Man Phys Ther. 2021;27(1):52-62. https://doi.org/10.23101/kaompt.2021.27.1.51.
  30. Yun JY, Lee JK. Effects of a thera-band exercise program on pain, knee flexion ROM, and psychological parameters following total knee arthroplasty. J Korean Acad Nurs. 2015;45(6):823-3. http//doi.org/10.4040/jkan.2015.45.6.823.