Article

Patients with total knee arthroplasty (TKA) have impaired balance and
movement control. Exercise interventions have not targeted these impairments in
this population. The purposes of this study were: (1) to determine
the feasibility of applying a balance exercise program in patients with TKA, (2)
to investigate whether a functional training (FT) program supplemented with a
balance exercise program (FT+B program) could improve physical function compared
with an FT program alone in a small group of individuals with TKA, and (3) to
test the methods and calculate sample size for a future randomized trial with a
larger study sample. DESIGN: This study was a double-blind, pilot randomized
clinical trial. SETTING: The study was conducted in the clinical laboratory of an
academic center. PARTICIPANTS: The participants were 43 individuals (30 female,
13 male; mean age=68 years, SD=8) who underwent TKA 2 to 6 months prior to the
study. INTERVENTIONS: The interventions were 6 weeks (12 sessions) of a
supervised FT or FT+B program, followed by a 4-month home exercise program.
MEASUREMENTS: Feasibility measures included pain, stiffness, adherence, and
attrition. The primary outcome measure was a battery of physical performance
tests: self-selected gait speed, chair rise test, and single-leg stance time.
Secondary outcome measures were the Western Ontario and McMaster Universities
Osteoarthritis Index and the Lower Extremity Functional Scale. RESULTS:
Feasibility of the balance training in people with TKA was supported by high
exercise adherence, a relatively low dropout rate, and no adverse events. Both
groups demonstrated clinically important improvements in lower-extremity
functional status. The degree of improvement seemed higher for gait speed,
single-leg stance time, and stiffness in the FT+B group compared with the FT
group. LIMITATIONS: Due to the pilot nature of the study, differences between
groups did not have adequate power to show statistical significance. CONCLUSIONS:
There is a need for conducting a larger randomized controlled trial to test the
effectiveness of an FT+B program after TKA.

Langue : ANGLAIS