Authors (including presenting author) :
Cheng WF, Wong CKM, Tsui ASK, Poon MWY
Affiliation :
Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
Total Knee arthroplasty (TKA) is one of the orthopaedic interventions for patients with arthroplasty of the knee joint that reliably alleviates pain and improved functions after operation. Yet, patients with TKA may still have some difficulties in performing functional activities, such as walking stairs. This may result from altered kinematic patterns, which were found closely associated with hip and core muscles dysfunctions (Gaffney & et al. 2016). Hence, to optimize the treatment outcomes, multimodal muscle training targeting at multi-joint and core muscle and functional-based closed kinetic chain training were introduced to facilitate patients’ functional recovery.
Objectives :
To evaluate the effectiveness of multimodal PT Training Program on improving physical and functional outcomes for the patients with total knee replacement surgery
Methodology :
Retrospective review was employed. Patients who received total knee replacement (TKR) and completed out-patient PT training in the Hong Kong Buddhist Hospital from 3 January to 30 November 2020 were analyzed. Outcome measures such as Numeric Pain Rating Scale (NPRS), Active Range of Motion (AROM), functional performance using Timed Up & Go test (TUG), Single Leg Stand test (SLS) and Functional Reach test (FR) as well as self-rated functional ability using Lower Extremity Functional Scale(LEFS) were evaluated. Comparison was performed upon first out-patient visit and upon the completion of the Program.
Result & Outcome :
One hundred and ten patients, aged from 54 to 82 years were analyzed. 76 percent was female. Upon the completion of the program, improvements were shown for all the outcome measures. For the physical outcomes, there was a significant reduction of pain in NPRS from 3.2±1.4 to 1.6±1.2 (p< 0.001) and significant improvement in knee flexion range from 89.6±10.6 to 100.0±12.1 degrees (p< 0.001). For functional performance, TUG significantly improved from 23.6±10.9 to 15.1±5.4 seconds (p< 0.001), whereas SLS for operated side improved from 3.3±4.8 to 8.4±9.2 seconds(p< 0.001). Significant improvement in FR from 21.6±7.2 to 26.4±6.2 cm (p< 0.001) was shown as well. For the self-rated functional ability, significant improvement was found in LEFS from 37.2±12.7 to 48.9±13.4 (p< 0.001). Among the daily functional activities, all patients expressed having improvement specifically in stair climbing.
Multimodal muscle training was shown to have superior effect in physical and functional recovery of patients after knee replacement surgery and could better equip patients the ability for handling daily activities, including stair climbing.
