The Effect of Intensive Close-Kinetic-Chain Exercises on Functionality and Balance Confidence After Total Knee Arthroplasty

Abstract

The aim of this study was to evaluate the effects of an additional close-kinetic-chain exercise program (CKC-PT), in conjunction with the standard physiotherapy intervention (TKA-PT), on the general health status, functionality, balance confidence, and postoperative falls of knee osteoarthritic patients who had undergone total knee arthroplasty (TKA). Patients and methodsThirty community-dwellers, aged >65 years, were randomized into equal groups. The Greek versions of the SF-36 version1.0 (SF-36v1.0-Gr), WOMAC ® (WOMAC ® -Gr), Activities-specific Balance Confidence scale (ABC-Greek), Timed Up and Go (TUG) test, and Berg Balance Scale were assessed preoperatively and twice postoperatively (7 th week and 12 th month). Non-parametric (Mann-Whitney test) and parametric (two-way analysis of variance (ANOVA) model and student t-test) analyses were used to compare the percentage changes in all variables. ResultsThe CKC-PT group reported better (%) functional improvement (WOMAC ® -Gr Physical Function subscale) and higher (%) balance confidence (ABS-Greek) at the seventh week and twelfth month as compared to TKA-PT (p<0.05). No other statistically significant differences were observed. ConclusionsThe implementation of a close-kinetic-chain exercise program, in addition to standard physiotherapy, may significantly increase both the functionality and balance confidence of patients who have undergone TKA. Further studies are needed to verify these findings.

Effect of Combined Kinematic Chain Exercise on Physical Function, Balance Ability, and Gait in Patients with Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial

“…Olagbegi OM et al [ 31 ] applied CCE to patients with osteoarthritis for a 12-week period. The results showed significant differences in average daily pain, pain before walking, and pain after walking ( p < 0.05).…”

“…For the 2nd to 3rd week of training, two sets of 10 reps were performed, including quadriceps setting while sitting, getting up and down from a chair, standing up and off heels, stepping up and down from a step box forward and sideward, and wall squatting. In the 4th week of training, getting up and down from a chair, stepping up and down from a step box forward and sidewards, hip abduction exercise while standing, and mini squats with a walker were performed in two sets of 10 reps for each movement, and two sets of one rep of toe gait were performed for 1 min [ 25 , 30 , 31 ]; the whole routine was performed for 30 min with a rest period of 30–40 s between sets ( Table 1 ).…”

Adding Weight Shift Training to Weight Reduction Decreases the Risk of Falling in Obese Women

“…Consequently, these exercises enhance stability, balance, muscular strength, power, and coordination in functional loading postures. 20 Jain et al assessed stability after training with the BBS for 6 wks in 30 participants with chronic ankle instability. After training, the overall, anteroposterior, and mediolateral stability indices were significantly improved.…”

“…Weight shift exercises stress noncontractile soft structures, including joint capsules, ligaments, and tendons. Consequently, these exercises enhance stability, balance, muscular strength, power, and coordination in functional loading postures 20 . Jain et al assessed stability after training with the BBS for 6 wks in 30 participants with chronic ankle instability.…”

“…The results of the current study regarding postural stability coincided with other studies. [18][19][20][21] Rajgor and Solanki studied the efficacy of balance exercises on postural instability in 30 young, obese adults (18-25 yrs). The findings revealed improvements in static and dynamic balance.…”