Exercise therapy after TKA means less pain, improved physical function, and better quality of life

Published in Clinical Rehabilitation, 03/12/2013 Dr. Liao et al and team from Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan look at the effects of additional physical therapy and balance training on functional outcome after total knee replacement in patients with knee osteoarthritis (TKR).

By the year 2020, it is estimated that more than 3 million total knee arthroplasty (TKA) surgeries will be performed in the USA for end-stage arthritis in the knee joint.TKA Surgery shows rapid and substantial improvement in knee pain however 37% of patients have limited functional improvement 1 year after the surgery.
Common limitations include diminished walking speed, difficulty ascending and descending stairs.
This work follows up on work done by Dr. Riva and team from Department of Physical Therapy, University of Pittsburgh USA and published in Journal of American Physical therapy Association that also showed that additional balance training in people with TKA was supported by high exercise adherence with a relatively low dropout rate, and no adverse events.
Improvements in lower-extremity functional ability was shown by higher gait speed, single-leg stance time.
In Dr. Liao trial the control group received conventional function training for eight weeks and the experimental group received the same conventional training a +  additional balance exercises program.
Studies have shown the effectiveness of exercise therapy including range of motion, stretching, strengthening, and endurance exercises after hospital discharge. Home based and out patient exercise therapy improves the outcomes of patients after TKA including less pain, improved physical function, and better quality of life.
Main outcome measures were distance of functional forward reach; duration of single leg stance; timed sit-to-stand test; timed up-and-down stair test; timed 10-m walk; timed up-and-go test.



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