Browse > Article
http://dx.doi.org/10.26862/jkpts.2021.12.28.3.88

The effect of complex balance exercise on unstable surfaces on functional ability and daily living ability in patients with total knee arthroplasty  

Lim, Su-Ki (Dept. of Physical Therapy, Graduate School, Eulji University)
Yu, Wonjong (Dept. of Physical Therapy, Eulji University)
Publication Information
Journal of Korean Physical Therapy Science / v.28, no.3, 2021 , pp. 88-97 More about this Journal
Abstract
Purpose: Patients with total knee arthroplasty (TKA) have impaired balance and movement control. Exercise interventions have not targeted these impairments in this population. This study aimed to investigate the effect of complex balance exercises on unstable ground, on the gait, balance, and daily living ability of patients with total knee arthroplasty. Design: Randomized controlled trial. Methods: The participants consisted of 30 patients placed into two groups of 15 each: a experimental group (complex balance exercise) and a control group (physical therapy exercise). Both group exercise was applied for 3 times a week for 30 minutes for four weeks. Force plate for balance ability and Timed up and go (TUG) test were the primary outcome measures. The secondary outcome measures included 10-m walk test (10MWT) and the daily living ability using the Knee Outcome Survey Activities of Daily Living scale (KOS-ADL). Results: The result of this study showed that the experimental group had a significant difference in TUG and 10MWT than the control group, and balance was significantly different in CEA, CPL, and CAV. There was a significant difference in daily living ability between the experimental and control groups. This study confirms that the physical therapy with complex balance exercise on unstable surfaces has positive effects on balance, gait and daily living ability in patients with total knee arthroplasty. Conclusion: As a result of this study, complex balance exercise on unstable surface was more effective in improvement gait, balance and daily living ability in total knee arthroplasty. From this study, physical therapy with complex balance exercises on unstable ground may be proposed as and effective intervention method for improving gait, balance, and daily living ability in patients with early total knee arthroplasty.
Keywords
Balance; Daily living activity; Gait; Knee replacement; Total knee arthroplasty;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Akbaba YA, Yeldan I, Guney N, et al. Intensive supervision of rehabilitation programme improves balance and functionality in the short term after bilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2016;24(1):26-33.   DOI
2 Bernier JN, Perrin DH. Effect of coordination training on proprioception of the functionally unstable ankle. J Orthop Sports Phys Ther 1998;27(4):264-75.   DOI
3 Hirase T, Inokuchi S, Matsusaka N, et al. Effects of a balance training program using a foam rubber pad in community-based older adults: a randomized controlled trial. J Geriatr Phys Ther. 2015;38(2):62-70.   DOI
4 Kim YN, Lee DK. Effects of horse-riding exercise on balance, gait, and activities of daily living in stroke patients. J Phys Ther Sci 2015;27(3):607-9.   DOI
5 Matsumoto H, Okuno M, Nakamura T, et al. Fall incidence and risk factors in patients after total knee arthroplasty. Arch Orthop Trauma Surg 2012;132(4):555-63.   DOI
6 Pua YH, Seah FJ, Seet FJ, et al. Sex Differences and Impact of Body Mass Index on the Time Course of Knee Range of Motion, Knee Strength, and Gait Speed After Total Knee Arthroplasty. Arthritis Care Res (Hoboken) 2015;67(10):1397-405.   DOI
7 Shim JW, Yang SJ, Yoon HS. The effect and feasibility of knee extension assist orthosis on balance and gait in subacute stroke patients: case study. J Korean Phys Ther Sci 2020;27(3):35-44.   DOI
8 Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil 2000;81(4):409-17.   DOI
9 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.
10 Mizner RL, Petterson SC, Clements KE, et al. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty 2011;26(5):728-37.   DOI
11 Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80(9):896-903.   DOI
12 조우신, 염윤석, 양병세. 슬관절 재치환술의 원인. 대한정형외과학회지 2007;42(2):216-20.   DOI
13 Bizzini M, Gorelick M. Development of a German version of the knee outcome survey for daily activities. Arch Orthop Trauma Surg 2007;127(9):781-9.   DOI
14 Badley EM, Wang PP. Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. J Rheumatol 1998;25(1):138-44.
15 Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther 2010;40(9):559-67.   DOI
16 Segal NA, Wallace R. Tolerance of an aquatic power training program by older adults with symptomatic knee osteoarthritis. Arthritis 2012;2012:895495.   DOI
17 Crowninshield RD, Rosenberg AG, Sporer SM. Changing demographics of patients with total joint replacement. Clin Orthop Relat Res 2006;443:266-72.   DOI
18 Viton JM, Atlani L, Mesure S, et al. Reorganization of equilibrium and movement control strategies after total knee arthroplasty. J Rehabil Med 2002;34(1):12-9.   DOI
19 Han J, Waddington G, Anson J, et al. Level of competitive success achieved by elite athletes and multi-joint proprioceptive ability. J Sci Med Sport 2015;18(1):77-81.   DOI
20 Kim JW, Kang JH, Kim NJ, et al. The Effects of Olfactory Stimulation on the Balance Ability of the Elderly. J Korean Phys Ther Sci 2019;26(2):24-31.   DOI
21 Konig A, Walther M, Kirschner S, Gohlke F. Balance sheets of knee and functional scores 5 years after total knee arthroplasty for osteoarthritis: a source for patient information. J Arthroplasty 2000;15(3):289-94.   DOI
22 Kramer JF, Speechley M, Bourne R, et al. Comparison of clinic- and home-based rehabilitation programs after total knee arthroplasty. Clin Orthop Relat Res 2003;(410):225-34.
23 Niknam H, Esteki A, Salavati M, et al. Reliability of Zebris motion analysis system in healthy athletes and athletes with anterior cruciate ligament reconstruction. Asian J Sports Med 2017;8(1).
24 Gstoettner M, Raschner C, Dirnberger E, Leimser H, Krismer M. Preoperative proprioceptive training in patients with total knee arthroplasty. Knee 2011;18(4):265-70.   DOI
25 김정희. 슬관절 전치환술 후 대퇴사두근 근고정 운동의 효과[석사학위논문]. 부산가톨릭대학교; 2011.
26 Gusi N, Carmelo Adsuar J, Corzo H, et al. Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: a randomised trial. J Physiother 2012;58(2):97-104.   DOI
27 Matsusaka N, Yokoyama S, Tsurusaki T, et al. Effect of ankle disk training combined with tactile stimulation to the leg and foot on functional instability of the ankle. Am J Sports Med 2001;29(1):25-30.   DOI
28 Minns Lowe CJ, Barker KL, Dewey M, et al. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ 2007;335(7624):812.   DOI
29 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.   DOI
30 Strasser EM, Draskovits T, Praschak M, et al. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly. Age (Dordr) 2013;35(6):2377-88.   DOI
31 Sibley KM, Beauchamp MK, Van Ooteghem K, et al. Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review. Arch Phys Med Rehabil 2015;96(1):122-132.e29.   DOI
32 Rahmann AE, Brauer SG, Nitz JC. A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial. Arch Phys Med Rehabil 2009;90(5):745-55.   DOI