Exercise Combined With Continuous Passive Motion or Slider Board Therapy Compared With Exercise Only: A Randomized Controlled Trial of Patients Following Total Knee Arthroplasty

Abstract

Background and Purpose. The primary purpose of this randomized controlled trial was to determine which method of mobilization-(1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE alone-achieved the maximum degree of knee ROM in the first 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups. Subjects. The subjects were 120 patients (nϭ40/group) who received a TKA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study. Methods. Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement of knee ROM and completion of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The 3 treatment groups were similar with respect to age, sex, and diagnosis at the start of the study. There were no differences in knee ROM or in WOMAC Osteoarthritis Index or SF-36 scores at any of the measurement intervals. The rate of postoperative complications also was not different among the groups. Discussion and Conclusion. When postoperative rehabilitation regimens that focus on early mobilization of the patient are used, adjunct ROM therapies (CPM and SB) that are added to daily SE sessions are not required. Six months after TKA, patients attain a satisfactory level of knee ROM and function. [Beaupré LA, Davies DM, Jones CA, Cinats JG. Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty.

Changes in pain and physical function during waiting time and 3 months after knee joint arthroplasty

“…Knee ROM, both toward flexion and extension at 3 months postoperatively was lower than the preoperative level. Previous studies have also reported a 5-15° decrease in knee flexion at follow-up during 2-6 months after surgery (28)(29)(30)(35)(36)(37). conservatively treated individuals with oA have been shown to use a smaller knee angle in AdL performance than healthy controls due to pain and stiffness (38)(39).…”

Effektivitätsvergleich aktiver kniebewegungsunterstützender Geräte mit passiven Kniebewegungsschienen für verschiedene Pathologien – eine systematische Literaturübersicht

“…Auch bei den hier eingeschlossenen Studien sollte kritisch hinterfragt werden, welcher gemessene Unterschied in der Flexion oder Extension im Gruppenvergleich als klinisch relevant gilt. MauMoeller et al [12] und Beaupré et al [9] definieren den klinisch relevanten Unterschied ab einer Differenz von 5 °. Diese wird auch in der Studie von Lenssen et al [18], die die Effektivität einer CPM Therapie evaluieren, angegeben.…”

“…Übersicht der Studiencharakteristiken. MauMoeller et al[12] und Beaupré et al[9] zusätzlich Physiotherapie. Die Studien von Friemert et al[10] und Bizzini et al[8] machten diesbezüglich keine Angaben.…”

Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

“…The functional challenges that patients face require good balance skills to prevent falls. Although post-operative exercise programs following THA or TKA may vary across various rehabilitation settings, these exercise programs typically emphasize joint range-of-motion (ROM) and muscle strengthening exercises for patients following TKA 13 – 17 or THA. 18 , 19 Balance component of mobility and physical function is not adequately addressed in these exercise programs.…”