Effectiveness of structured exercise program on the functional outcomes in total knee replacement
P. Antony Leo Aseer, G. Arun Maiya, M. Mohan Kumar, P.V. Vijayaraghavan
Indian Journal of Orthopaedics Surgery
Total knee replacement (TKR) surgery has become the most successful surgery for patients with severe debilitating arthritis. Numerous factors influence the outcomes in TKR Post-operative physiotherapy and rehabilitation greatly influences the outcome of TKR. Despite the high incidence of TKR in recent years there is no post-operative rehabilitation approach being incorporated correctly to address the muscular and functional deficits following surgery. Objective: The main objective of the study
... s to analyze the effectiveness of structured rehabilitation program on the functional outcome of patients following total knee replacement. Materials & Methods: All patients who were planned to undergo elective primary TKR were recruited. Subjects posted for revision TKR, rheumatoid arthritis posted for TKR, immediate post-operative complications like deep vein thrombosis, signs of infection, TKR for Post-fracture cases were excluded. Eighty subjects enrolled for the study were randomly allocated to control and experimental group using simple random sampling. The control group receives standard care and experimental group receive structured exercise program comprising range of motion, staged training of quadriceps, vastus medialis strengthening exercises, early balance training and functional retraining. Outcomes including pain severity, knee joint mobility, isometric muscle strength, six minute walk test and functional outcome using KOOS scale were measured post-surgery and after 3 months follow up. Results: In experimental group, follow up measures of pain severity (p-.0001), knee joint extension range (p-.0016), isometric strength of hamstrings (p-0008) shows statistically significant results than control group. Whereas, in experimental group, follow up measures of knee flexion range (p-< .0001), isometric strength of quadriceps (p-<.0001), six minute walk test (p-< .0001), functional outcome subscale of KOOS-symptoms and quality of life (< .0001) shows statistical highly significant results than control group. Conclusion: The structured exercise program was effective in improving the primary and secondary outcomes following primary total knee replacement.