The Effect of Progressive Dynamic Balance Training on Physical Function, The Ability to Balance and Quality of Life Among Elderly Women Who Underwent a Total Knee Arthroplasty: A Double-Blind Randomized Control Trial

Abstract

Total knee arthroplasty (TKA) is used to treat end-stage osteoarthritis. However, this surgical procedure affects the mechanical receptor function and impairs the ability to balance. Dynamic balance training has been reported to improve stability and self-confidence and safely yield increased physical activity. This study aimed to investigate the effect of dynamic balance training on physical function, the ability to balance and quality of life among patients who underwent TKA. Thirty-eight participants were assigned to either the progressive dynamic balance training (PDBT) with physical therapy group (n = 19) or the control group (n = 19). The experimental group undertook a dynamic balance program with physical therapy for 30 minutes per day, five times per week for six weeks, while the control group undertook physical therapy only. A continuous passive motion exercise was performed for 20 minutes after training by both groups. The outcomes were evaluated using the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, pain pressure threshold (PPT), range of motion (ROM), Knee Outcome Survey-Activities of Daily Living (KOS-ADLS), Multifunction Force Measuring Plate, timed up and go (TUG) test and Short-Form Health Survey 36 (SF-36). Physical function (WOMAC Osteoarthritis Index, ROM and KOS-ADLS score) and the ability to balance (TUG test score, confidence ellipse area, path length and average velocity) significantly improved (p < 0.05) in the experimental group compared with the control group. In contrast, the physical component summary score for the SF-36 regarding quality of life significantly improved (p < 0.05); however, the mental component summary score for the SF-36 and PPT did not significantly differ between the groups. Therefore, we suggest that PDBT with physical therapy has positive effects on physical function, the ability to balance and quality of life among patients who underwent TKA.

Dysfunction in dynamic, but not static balance is associated with risk of accidental falls in hemodialysis patients: a prospective cohort study

“…Balance training included in endurance resistance programs has been shown to improve postural balance in HD patients [ 31 ]. It has been reported that dynamic balance training improved TUG, quality of life, and physical function in the elderly women underwent total knee arthroplasty [ 32 ]. Together with our results, the intervention in dynamic balance function might reduce fall incidence, possibly improving total physical functions in HD patients.…”

Effect of moderate exercise on osteoarthritis

“…Balance training allows the patient to regain their center of gravity and minimize the base of support during unstable movements, thereby reducing the risk of accidental falls. Although approaches to balance training are diverse and vary among occasions and conditions, its role in reducing the risk of falls in OA is well established ( 111 , 112 ). Clinical trials have shown that balance training can effectively improve joint function and stability, proprioception, and reduce rocking and pain symptoms in OA patients ( 111 , 113 ).…”

“…Although approaches to balance training are diverse and vary among occasions and conditions, its role in reducing the risk of falls in OA is well established ( 111 , 112 ). Clinical trials have shown that balance training can effectively improve joint function and stability, proprioception, and reduce rocking and pain symptoms in OA patients ( 111 , 113 ). In summary, the characteristics of balance training enhance an OA patient’s balance ability, stabilize their motor function, and reduce their risk of falls, thereby reducing adverse events.…”

Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis

“…Balance training can improve walking ability and balance performance, alleviate pain, as well as enhance physical function ( Doma et al, 2018 ). Furthermore, progressive and dynamic balance training has a better effect than conventional physiotherapy on improving physical function, range of motion, and balance for patients with KOA ( Lee et al, 2021 ). Biodex balance training is better than traditional exercise programs to improve functional performance, stability, and body sensation, and to reduce swaying and pain in patients with KOA ( Javed et al, 2021 ).…”