Document Detail

A balance exercise program appears to improve function for patients with total knee arthroplasty: a randomized clinical trial.
MedLine Citation:
PMID:  20378678     Owner:  NLM     Status:  MEDLINE    
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.
Sara R Piva; Alexandra B Gil; Gustavo J M Almeida; Anthony M DiGioia; Timothy J Levison; G Kelley Fitzgerald
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-04-08
Journal Detail:
Title:  Physical therapy     Volume:  90     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-07-15     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  880-94     Citation Subset:  AIM; IM    
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MeSH Terms
Arthroplasty, Replacement, Knee / rehabilitation*
Confidence Intervals
Disability Evaluation
Double-Blind Method
Exercise Therapy / methods*
Feasibility Studies
Intervention Studies
Pilot Projects
Postural Balance*
Treatment Outcome
Grant Support
K01 HD058035/HD/NICHD NIH HHS; KL2 RR024154-02/RR/NCRR NIH HHS; P30 AG024827/AG/NIA NIH HHS; P30-AG024827/AG/NIA NIH HHS

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