Toe grip strength training improves gait performance and prevents falls in patients after total knee arthroplasty

Abstract

Falls after total knee arthroplasty (TKA) are common in knee osteoarthritis patients due to advanced age and implant-induced sensory function changes. We reported the influence of toe grip strength (TGS) on falls in knee osteoarthritis patients. This study aimed to determine whether TGS training after TKA is related to the screening assessment and incidence of falls. Elderly patients undergoing unilateral TKA were divided into TGS training (T-group) and control groups (C-group). Six types of training were conducted on bilateral toes. The primary outcomes were changes (Δ) in TGS and Timed up and go test (TUG) time from preintervention to 12 weeks post-intervention. Secondary outcomes involved several factors, including the occurrence of falls. T-group had a shorter TUG and stronger bilateral TGS than C-group. ΔTUG time was significantly correlated with ΔTGS on the affected side. There were significantly fewer falls in T-group than in C-group between 3 and 12 months after TKA. TGS training was useful in improving walking ability and preventing falls in postoperative TKA patients. The advantage of TGS training is that it is an unoperated muscle function, so the intervention can be conducted safely without specialist supervision unless the toes are impaired.