The effect of body mass index on functional outcome of patients with knee arthroplasty with and without hip abductor muscle strengthening: six months Follow-Up of a Randomized Pilot Study.

Abstract

As with aging, the prevalence of knee arthroplasty surgery has also increased. Similarly with age obesity has also increasing in parallel way. Many studies have been speculating that abductor muscle strength has more effect on the outcome of patients with knee arthroplasty when included in physiotherapy intervention, but no studies demonstrated the influence of BMI (body mass index) on the outcome comparing with and out abductor muscle strengthening in physiotherapy intervention. The aim of this study isto investigate the effect of BMI on the physiotherapy interventions with and without hip abductor muscle strengthening. This randomised pilot trial was carried out at Vagdevi College of physiotherapy, Warangal. The study participants are classified for elective TKR (total knee replacement) were randomised to normal weight group and obese group. Further both groups are subdivided into standard physiotherapy group and abductor strengthening plus standard physiotherapy group. All the group subjects underwent FIM (functional independent measure)score, abductorstrengthening and six minute walk test at various intervals and followed for six months. All the groups showed improvements in functional outcome irrespective of BMI indicating BMI has minimal effect on the functional outcomes following TKR. The study concludes that hip abductor groups had greater effect on knee function than the standard conventional standard physiotherapy protocol irrespective of BMIeffect.

Effectiveness and therapeutic validity of physiotherapeutic exercise starting within one year following total and unicompartmental knee arthroplasty for osteoarthritis: a systematic review

“…Joint ROM was reported in degrees and measured during both active and passive movement in 20 articles [32, 34-41, 43, 44, 47, 48, 52-54, 59, 60, 62, 64]. Hip abductor [34,57,60], quadriceps muscle [33,57,[59][60][61], and hamstrings [33,57,59] strength were evaluated in three, five, and three articles, respectively. Strength values were measured in these units of measurement: pounds, kilograms, Newton normalized to BMI, and Newton-metres/kilograms.…”

“…The following generic measuring instruments were also used frequently: Short Form Health Survey 12 (SF-12) [33,54,60], Late-Life Function & Disability Instrument (Late-Life FDI) [67,68], 5-level EQ-5D [67,68], Oxford knee score (OKS) [54,67,68], Physical Activity Scale for the Elderly (PASE) [67,68], Short Form Health Survey 36 (SF-36) [43,44,52], and Lower Extremity Functional Scale (LFSE) [60,65]. The Functional Independence Measure (FIM) [34], sleep efficiency score [35], KSS [41], and Canadian Occupational Performance Measure (COPM) [63] were reported in one article each.…”

“…The majority (32%) of the physiotherapeutic exercises the IG received were landbased and performed in the patient's home environment [32,39,40,45,48,51,52,61,63,64,67,68]. The physiotherapeutic exercises given to the IG were mostly inpatient (30%) [36-38, 41, 44, 47, 57, 59, 60, 62, 65], and to a lesser amount outpatient (19%) [34,35,42,46,50,53,58]. In 16% of the studies, the intervention received was both outpatient and home-based [33,43,[54][55][56]66].…”

“…Also, 3% did not report the setting of the given physiotherapeutic exercises for the IG [49]. The CGs received their interventions mostly in outpatient settings (30%) [34,35,40,48,50,51,53,58,61,62,67], followed by inpatient settings (27%) [36-38, 41, 44, 47, 49, 57, 59, 60] and homebased settings (16%) [32,39,42,54,55,66]. In 11% of the articles, the CG received both outpatient and homebased interventions [33,43,46,56], while in 3% of studies a combination of inpatient and home-based interventions [45] was used.…”