Summary

EFFECTS OF SENSORIMOTOR TRAINING IN KNEE ARTHROPLASTY PATIENTS

Abstract

Purpose

Despite the rising numbers of total knee arthroplasty (TKA), no guidelines as to best practice have been established on the rehabilitation of these patients. Following TKA, patients still present with sensori-motor-driven functional difficulties in their activities of daily living (ADL). Given this, the aim of the present study was to investigate the effects of a novel targeted sensori-motor conditioning within an environment involving patient’ self-managed care.

Methods

A sample of 52 consecutive patients [24 male, 28 female; age 71.3 ±5.3 years, 72.9 ± 5.6 (mean ± SD); height 1.66 ± 0.06 and 1.64 ± 0.08 m; weight 82.5 ± 8.95, 82.1 ± 10.3 kg] undergoing TKA were recruited in this prospective random-allocation to group trial, involving iso-volumetric sensori-motor exercise therapy (SMET) versus contemporary functional exercise therapy (FET) programme. The effectiveness of the programme was examined via assessment of functional (Timed up and Go [TUG]), balance-related, proprioceptive and neuromuscular performance indices of patients. These were assessed on 3 separate occasions [pre-surgery; 8- and 14-weeks post-TKR].

Results

Factorial analyses of variance [ANOVAs] showed significant group (SMET; FET) by leg (operated; non-operated) by test occasion (pre-surgery; 8- and 14-weeks post-TKR) interaction for outcome measures of function [TUG: F[1,49] = 16.44; p <0.005] (48 % improvement compared to control), together with superior improvements in sensori-motor and neuromuscular indices of knee performance. Results confirmed increased clinical effectiveness of SMET programme compared to FET at follow-up over time. Patterns of improvement for the SMET group over time were represented by a relative effect size range of 0.10 to 0.66. Patients’ exercise-compliance factors were found to be different amongst groups, but this hadn’t intruded on the interpretation of patients’ outcomes.

Conclusions

The effect sizes associated with the improvements of function, sensori-motor and neuromuscular performance make completely justifiable the implementation of an enhanced SMET programme as a superior mode of TKA rehabilitation that targets the residual patient’ deficits. The novelty of the programme is that it has been proven as effective, and convenient to implement in a home-based environment as a rationale use of resources.

Acknowledgements:
The authors would like to thank the MACP for partial funding of the project via a Doctorial Research award.