DOI QR코드

DOI QR Code

The Impact of Weight-Bearing Lower Limb Exercises on Balance and Gait in Patients Undergoing Total Knee Arthroplasty: Pre-experimental Study

  • Soo-kyung Kim (Department of Physical Education, Pusan National University) ;
  • Seok-Hyeon Joo (Department of Physical Education, Pusan National University) ;
  • Jeong-hyun Woo (Department of Physical Education, Pusan National University) ;
  • Ki-hoon Han (Department of Physical Education, Pusan National University)
  • 투고 : 2024.05.27
  • 심사 : 2024.08.19
  • 발행 : 2024.08.31

초록

Purpose: This study aimed to investigate the effects of weight-bearing exercises, including deadlifts, on the balance ability, gait patterns, and leg strength in patients who have undergone knee replacement surgery, thus emphasizing the importance of strengthening the leg muscles. Methods: The subjects included nineteen patients diagnosed with degenerative arthritis and who underwent knee arthroplasty at H Hospital in B City. Following the surgeon's recommendations and patients' consent, they were prescribed exercises starting 7 days post-surgery, 3 times a week for 8 weeks, including a 10-minute warm-up, 20-minute main exercise, and 15-minute cool-down exercises. Results: The fall index significantly decreased, indicating improved balance. The gait cycle significantly decreased, while step length increased. However, the increase was not statistically significant. Walking speed significantly increased, and step time significantly decreased. The sit-to-stand time significantly decreased, indicating improved leg strength. Conclusion: In conclusion, weight-bearing leg exercises for knee arthroplasty patients led to significant improvements in balance abilities, gait patterns, and leg strength. This signifies the need to incorporate active weight-bearing leg exercises from an early stage post-surgery. Additionally, weight-bearing leg strengthening exercises can increase the accessibility of exercises for knee arthroplasty patients, emphasizing the importance of early exercise and motivation in their treatment. Therefore, functional leg strengthening exercises, including weight-bearing routines, should be implemented early on in clinical settingsI, alongside traditional pain reduction and joint range of motion exercises, to maximize recovery outcomes and enhance overall patient mobility and quality of life.

키워드

참고문헌

  1. Cho HJ, Chang CB, Jung JW et al. Prevalence of radiographic knee osteoarthritis in elderly koreans. J Korean Knee Soc. 2009;21(4):223-31.
  2. Kang KY, Kwon WA, Kim KY. Therapeutic exercise for musculoskeletal system. Seoul, The Panmun Education, 2017:503-4.
  3. 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):823-33.
  4. Maniar RN, Baviskar JV, Singhi T et al. To use or not to use continuous passive motion post-total knee arthroplasty: presenting functional assessment results in early recovery. J Arthroplasty. 2012;27(2):193-200.
  5. Piva SR, Gil AB, Almeida GJ et al. A balance exercise program appears to improve function for patients with total knee arthroplasty: a randomized clinical trial. Phys Ther. 2010;90(6):880-94.
  6. Stitik TP, Kaplan RJ, Kamen LB et al. Rehabilitation of orthopedic and rheumatologic disorders. 2. Osteoarthritis assessment, treatment, and rehabilitation. Arch Phys Med Rehabil. 2005;86(3 Suppl 1):S48-55.
  7. Begalle RL, DiStefano LJ, Blackburn T. Quadriceps and hamstrings co-activation during common therapeutic exercises. J Athl Train. 2012;47(4):396-405.
  8. Zeni Jr J, McClelland J, Haley RM et al. Functional and biomechanical outcomes after using biofeedback for retraining symmetrical movement patterns after total knee arthroplasty: a case report. J Orthop Sports Phys Ther. 2012;42(2):135-44.
  9. Escamilla RF, Francisco AC, Kayes AV et al. An electromyographic analysis of sumo and conventional style deadlifts. Med Sci Sports Exerc. 2002;34(4):682-8.
  10. Escamilla RF, Francisco AC, Fleisig GS et al. A three-dimensional biomechanical analysis of sumo and conventional style deadlifts. Med Sci Sports Exerc. 2000;32(7):1265-75.
  11. Krajewski KT, LeFavi RG, Riemann BL. A biomechanical analysis of the effects of bouncing the barbell in the conventional deadlift. J Strength Cond Res. 2019;33:S70-7.
  12. Kim SK, Lee DY, Nam SM. Effects of visual cue deprivation balance training with head control on balance function and fall index in older people. J Kor Phys Ther. 2022;34(5):212-7.
  13. Im YT, Kang Y, Lee YS. Reliability of single leg balance test using posturography. Korean J Sports Med. 2014;32(2):120-5.
  14. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil. 2010;91(3):407-13.
  15. Kim YM, Joo YB, Park IY. Treatment methods for functional recovery after total knee arthroplasty. J Korean Orthop Assoc. 2020;55(2):117-26.
  16. Choi MJ, Han GH. The effect of 12 weeks elastic band and weight bearing exercise program on functional ankle instability in soccer club players. J Sport Sci. 2014;26:103-24.
  17. Kim YH. Kinetic analysis of climb motion on the step box of senior robic of elderly women. Korean J Sport Sci. 2016;25(5):1421-33.
  18. Michaud F, Perez Soto M, Lugris U et al. Lower back injury prevention and sensitization of hip hinge with neutral spine using wearable sensors during lifting exercises. Sensors. 2021;21(16):5487.
  19. Knoop J, Steultjens MP, van der Leeden M et al. Proprioception in knee osteoarthritis: a narrative review. Osteoarthr Cartil. 2011;19(4):381-8.
  20. Levinger P, Menz HB, Wee E et al. Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2011;19(7):1082-9.
  21. Park SY, Shin IS. Muscle strengthening effects of exercise programs for preventing falls among the elderly in Korea: a meta-analysis. Phys Ther Korea. 2011;18(3):38-48.
  22. Schwartz I, Kandel L, Sajina A et al. Balance is an important predictive factor for quality of life and function after primary total knee replacement. J Bone Joint Surg Br. 2012;94(6):782-6.
  23. Gage WH, Frank JS, Prentice SD et al. Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations. Gait Posture. 2008;27(2):286-93.
  24. Kim HS. The effect of progressive exercise on the activities of the elderly. Phys Ther Korea. 2000;7(3):19-33.
  25. Park JS, Choi EY, Hwang TY. The effects of strengthening leg muscular strength on the elderly's walking and balance ability. J Kor Phys Ther. 2002;14(2):133-44.
  26. Song HS, Lee JN, Han HJ. The effect of otago exercise program on balance, walking and falls efficacy in patients with total knee replacement. J Korean Acad Orthop Man Ther. 2020;26(1):1-8.
  27. Park J. Effects of resistance exercise with pressure biofeedback unit on the gait ability and knee joint function in subject with total knee replacement patients. J Kor Phys Ther. 2024;36(1):27-32.
  28. Neumann DA. Kinesiology of the musculoskeletal system. 2nd ed. USA, Mosby, 2002:25-40.
  29. Lutz GE, Palmitier RA, An KN et al. Comparison of tibiofemoral joint forces during open-kinetic-chain and closed-kinetic-chain exercises. J Bone Joint Surg Am. 1993;75(5):732-9.
  30. Jakobsen TL, Husted H, Kehlet H et al. Progressive strength training (10 RM) commenced imme diately after fast-track total knee arthroplasty: is it feasible. Disabil Rehabil. 2012;34(12):1034-40.
  31. Suh MJ, Kim BR, Kim SR et al. Effects of early combined eccentric-concentric versus concentric resistance training following total knee arthroplasty. Ann Rehabil Med. 2017;41(5):816-27.
  32. Hauer K, Rost B, Rutschle K et al. Exercise training for rehabilitation and secondary prevention of falls in geriatric patients with a history of injurious falls. J Am Geriatr Soc. 2001;49(1):10-20.
  33. Christensen JC, Capin JJ, Hinrichs LA et al. Gait mechanics are influenced by quadriceps strength, age, and sex after total knee arthroplasty. J Orthop Res. 2021;39(7):1523-3.
  34. Park J. Effects of repetitive sit to stand training on the knee extensor strength and walking ability in subject with total knee replacement patients. J Kor Phys Ther. 2021;33(1):34-9.
  35. Mahadevan L. The effect size statistic: overview of various choices. 2000.
  36. Kwon SD. A review of the significance testing and effect size in empirical research. J Educ Eval. 2005;18(2):1-16.