Effects of Adding Biofeedback Training to Active Exercises After Total Knee Arthroplasty

Shanb, Alsayed Abdelhameed; Youssef, Enas Fawzy

doi:10.1142/s0218957714500018

Cited by 9 publications

(19 citation statements)

References 32 publications

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“…We found 14 studies (Bade, 2017, Fransen, 2017, Heikkilä, 2017, Kauppila, 2010, Madsen, 2013, Minns Lowe, 2012, Moutzouri, 2018, Schache, 2019, Vuorenmaa, 2014, Moffet, 2015, Petterson, 2009, Shanb, 2014 reported strength data from various outcome measures including isometric and isokinetic knee extension and knee flexion strength, and quadricep and hamstring strength and torque, among others (Table 45). Studies typically used a dynamometer to measure strength and presented strength data variably (Newtons [N], kilograms [kg], torque normalized to body weight [Nm/kg] and others; for each, higher values indicate greater strength).…”

Section: Muscle Strengthmentioning

confidence: 99%

“…Post-acute rehabilitation interventions were delivered by physical therapists in 28 of the 32 studies. Four remaining studies did not report who delivered the rehabilitation intervention (Li 2015, Demircioglu 2015, Shanb 2014. Three studies had either additional personnel deliver one arm of the intervention (an athletic trainer for one arm in Piva 2019, a Tai Chi instructor for one arm in Li 2019) or a component of the intervention in combination with the physical therapist (a psychologist delivered the cognitive-behavioral component in .…”

Section: Post-acute Phase Rehabilitationmentioning

confidence: 99%

“…Interventions were delivered in various settings (and often, in combinations of settings). Ten studies evaluated one or both rehabilitation arms in outpatient settings exclusively , DeJong 2020, Lenguerrand 2020, Liao 2015, Pua 2017, Petterson 2009, Shanb 2014, Petersen 2018. Four studies evaluated one or both rehabilitation arms at home exclusively (Li 2015, Minns Lowe, 2012, Moutzouri, 2018, Moffet, 2015.…”

Section: Post-acute Phase Rehabilitationmentioning

confidence: 99%

“…We found 26 studies that reported on body structure and function outcomes following postacute rehabilitation, with various comparators: 17 studies ( , Bade 2017, Fransen 2017, Heikkilä 2017, Kauppila 2010, Lenguerrand 2020, Li 2015, Liao 2015, Liao 220, Madsen 2013, Minns Lowe 2012, Monticone 2013, Moutzouri 2018, Schache 2019, Vuorenmaa 2014) compared novel rehabilitation programs with various comparators (less intensive rehabilitation or no care); one study ) compared different (hypothesized equivalent) rehabilitation programs, no studies compared rehabilitation programs with different timing and/or intensity; four studies , Moffet 2015, Tousignant 2011) compared rehabilitation programs delivered in different settings or by different personnel, and five studies (Demircioglu 2015, Petterson 2009, Peterson 2018, Shanb 2014) compared rehabilitation programs with or without an adjunctive modality (Tables 42 to 47). The outcome domains included: symptoms, pain, range of motion, muscle strength, energy and vigor, and emotional functioning.…”

Section: Body Structure and Function Outcomes Following Post-acute Rehabilitationmentioning

confidence: 99%

“…Vuorenmaa 2014 reported patients randomized to home exercise had significantly improved isometric knee flexion (but not extension) (MD NR; P=0.009) compared with patients randomized to control (no additional guidance after baseline measurements). Of the remaining four studies (that compared rehabilitation in different settings or with or without an adjunctive modality) only one study (Shanb 2014) reported improved strength. Shanb 2014 reported patients randomized to active exercise training and biofeedback had significantly improved performance of quadricep isometric peak torque at 4 months following surgery (P=0.01)…”

Section: Muscle Strengthmentioning

confidence: 99%

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Prehabilitation and Rehabilitation for Major Joint Replacement

Konnyu¹,

Thoma²,

Bhuma³

et al. 2021

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Objectives. This systematic review evaluates the rehabilitation interventions for patients who have undergone (or will undergo) total knee arthroplasty (TKA) or total hip arthroplasty (THA) for the treatment of osteoarthritis. We addressed four Key Questions (KQs): comparisons of (1) rehabilitation prior (“prehabilitation”) to TKA versus no prehabilitation, (2) comparative effectiveness of different rehabilitation programs after TKA, (3) prehabilitation prior to THA versus no prehabilitation, (4) comparative effectiveness of different rehabilitation programs after THA. Data sources and review methods. We searched Medline®, PsycINFO®, Embase®, the Cochrane Register of Clinical Trials, CINAHL®, Scopus®, and ClinicalTrials.gov from Jan 1, 2005, to May 3, 2021, to identify randomized controlled trials (RCTs) and adequately adjusted nonrandomized comparative studies (NRCSs). We evaluated clinical outcomes selected with input from a range of stakeholders. We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. Meta-analysis was not feasible, and evidence was synthesized and reported descriptively. The PROSPERO protocol registration number is CRD42020199102. Results. We found 78 RCTs and 5 adjusted NRCSs. Risk of bias was moderate to high for most studies. • KQ 1: Compared with no prehabilitation, prehabilitation prior to TKA may increase strength and reduce length of hospital stay (low SoE) but may lead to comparable results in pain, range of motion (ROM), and activities of daily living (ADL) (low SoE). There was no evidence of an increased risk of harms due to prehabilitation (low SoE). • KQ 2: Various rehabilitation interventions after TKA may lead to comparable improvements in pain, ROM, and ADL (low SoE). Rehabilitation in the acute phase (initiated within 2 weeks of surgery) may lead to increased strength (low SoE) but result in similar strength when delivered in the post-acute phase (low SoE). No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period following TKA. Compared with various controls, post-acute rehabilitation may not increase the risk of harms (low SoE). • KQ 3: For all assessed outcomes, there is insufficient (or no) evidence addressing the comparison between prehabilitation and no prehabilitation prior to THA. • KQ 4: Various rehabilitation interventions after THA may lead to comparable improvements in pain, strength, ADL, and quality of life. There is some evidence of no increased risk of harms due to the intervention (low SoE). • There is insufficient evidence regarding which patients may benefit from (p)rehabilitation for all KQs and insufficient evidence regarding comparisons of different providers and different settings of (p)rehabilitation for all KQs. There is insufficient evidence on costs of (p)rehabilitation and no evidence on cost effectiveness for all KQs. Conclusion. Despite the large number of studies found, the evidence regarding various prehabilitation programs and comparisons of rehabilitation programs for TKA and THA is ultimately sparse. This is a result of the diversity of interventions studied and outcomes reported across studies. As a result, the evidence is largely insufficient or of low SoE. New high-quality research is needed, using standardized intervention terminology and core outcome sets, especially to allow network meta-analyses to explore the impact of intervention attributes on patient-reported, performance-based, and healthcare-utilization outcomes.

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Section: Muscle Strengthmentioning

confidence: 99%

Section: Post-acute Phase Rehabilitationmentioning

confidence: 99%

Section: Post-acute Phase Rehabilitationmentioning

confidence: 99%

Section: Body Structure and Function Outcomes Following Post-acute Rehabilitationmentioning

confidence: 99%

Section: Muscle Strengthmentioning

confidence: 99%

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Prehabilitation and Rehabilitation for Major Joint Replacement

Konnyu¹,

Thoma²,

Bhuma³

et al. 2021

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Postoperative Rehabilitation nach Knieendoprothetik

Valle,

Stemmler,

Baier

et al. 2024

Orthopädie

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Training with biofeedback devices improves clinical outcome compared to usual care in patients with unilateral TKA: a systematic review

Pfeufer

Gililland

Böcker

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose Biofeedback following total knee arthroplasty (TKA) seems to be a feasible approach to improve rehabilitation, outcomes, mobility and reduce pain. This systematic review gives the practicing orthopedic surgeon a summary of what is available and how biofeedback afects clinical outcomes. Methods We reviewed the current literature regarding methods, devices and efects of biofeedback in patients who underwent total knee arthroplasty. Embase, Pubmed, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to May 2018 for the following keywords: Biofeedback OR Feedback AND Total Knee Arthroplasty OR TKA. Data were extracted according to a predeined setting (see Protocol for systematic review on PROSPEO). Devices used for biofeedback were recorded. Demographics, training methods and efects were also collected. ResultsThe search resulted in 380 potentially eligible studies from which 11 met all inclusion criteria including 7 randomized controlled trials (RCTs), 3 cohort studies, and 1 cross-sectional study. A total of 416 patients with unilateral TKA were included, with an average of 37.8 patients per study. In patients with TKA, signiicant improvements in activity scores or pain were reported by 9 of 11 studies. Only two of the studies reported no signiicant inluence of the feedback on the chosen outcome parameters. Devices for biofeedback varied between studies and included the use of a goniometer, force plate, balance board, treadmill, and/or electromyography (EMG). The most common type of feedback was visual followed by audio, with one study mentioning that the audio mode was preferred by the patients as it was easier to handle. Overall, 5 out of 6 diferent methods demonstrated a potential value for improving mobility and decreasing pain. Conclusions This review suggests that biofeedback in early postoperative rehabilitation after TKA is efective in improving gait symmetry, reducing pain and increasing activity level. It should be noted that the great variety of devices used for feedback limits comparisons between studies. Level of evidence IIa. KeywordsBiofeedback • Total knee arthroplasty • Rehabilitation Abbreviations EMG Electromyography FB Feedback FTSST Five-time sit to stand test RCT Randomized controlled trial TKA Total knee arthroplasty TUG Timed up and go test VAS Visual analog scale WOMAC Western Ontario and McMaster Universities Osteoarthritis Index Following the guidelines, our systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on May 23, 2018 (registration number CRD42018095518).

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Effects of Adding Biofeedback Training to Active Exercises After Total Knee Arthroplasty

Cited by 9 publications

References 32 publications

Prehabilitation and Rehabilitation for Major Joint Replacement

Prehabilitation and Rehabilitation for Major Joint Replacement

Postoperative Rehabilitation nach Knieendoprothetik

Training with biofeedback devices improves clinical outcome compared to usual care in patients with unilateral TKA: a systematic review

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