Authors (including presenting author) :
Tang CY(1), Au TK(1), Cheng CW(1), Cheung WYW(2), Chong SY(1), Fung YK(1), Leung YF(2), IP YC(1)
Affiliation :
(1) Physiotherapy Department, TKOH (2) Department of Orthopaedics and Traumatology, TKOH
Introduction :
The ultimate goals of total knee replacement (TKR) are to alleviate pain and regain quality of life. Together with conventional physiotherapy treatment, pain and functional mobility level was improved. However, patients found difficulties and lack of confidence to reintegrate to more active lifestyle activities, such as brisk walking, hiking or catching a bus. An innovative Physiotherapy STEP Class tailor-made for TKR was newly developed to further improve balance, functional agility and cope with advanced functional demand.
Objectives :
To evaluate the efficacy of Physiotherapy STEP Class on enhancement of post-operative outcomes in TKR patients.
Methodology :
TKR patients who had completed conventional physiotherapy training in TKOH with following criteria would be recruited to STEP Class: (1)Independent unaided indoor-walker; (2)Walking tolerance≥30 minutes with minimal pain/discomfort; (3)Fitness level screened by PAR-Q. Patients who fulfilled the inclusion criteria would participate five sessions of STEP Class which composes of following elements: Stability of core, Turning & pivoting, Endurance, Pacing & proprioception. Pain (NPRS), Knee injury and Osteoarthritis Outcome Score-Hong Kong Chinese version (KOOS), Timed-up-and-go test (TUG), 30-second-chair-stand test (30s-CST) and Mini-BESTest were compared between initial(Si) and final session(Sf) of STEP class. Patient who could not participate STEP Class(baseline: woSi) due to personal reason would be recruited as control group.
Result & Outcome :
From June to November 2019, 37patients (mean age 68.9+/-5.7; 12 males and 25 females) attended STEP class and 11patients (mean age 68.6+/-7.5; 2 males and 9 females) were recruited as control. There was no statistically significant difference between Si and woSi. The final session(Sf) results showed significant improvement in pain (NPRS 0.8 vs 1.9;p< 0.05), self-perception (KOOS-all domains,p< 0.05), lower limb functional strength (30s-CST 15repetitions vs 11repetitions;p< 0.05), functional mobility (TUG 8second vs 11second;p< 0.05), balance and agility (Mini-BESTest 24vs19;p< 0.05) when compared to Si. Comparing with control, STEP class showed significantly better improvement in pain(p< 0.05), self-perceived symptoms(p< 0.05), balance and agility(p< 0.05). All patients participated STEP Class were all satisfied and agreed they enjoyed a more active life after the Class. Physiotherapy STEP Class tailor-made for TKR was proved to be an effective training mode to (1)further improve balance and functional agility of post-TKR patients; (2)improve self-efficacy to cope with advanced functional needs for more active lifestyle.
