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Movement Pattern Biofeedback Training After Total Knee Arthroplasty: A Randomized Controlled Trial.

Michael J Bade1, Cory L Christiansen1, Joseph A Zeni2

  • 1University of Colorado Anschutz Medical Campus and Eastern Colorado VA Health Care System, Geriatric Research Education and Clinical Center (GRECC), Aurora, Colorado.

Arthritis Care & Research
|December 23, 2024
PubMed
Summary
This summary is machine-generated.

A movement training program (MOVE) after total knee arthroplasty (TKA) did not improve surgical knee extension moments. However, the MOVE group showed less contralateral knee compensation during walking compared to standard rehabilitation.

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Area of Science:

  • Orthopedics and Sports Medicine
  • Biomechanics
  • Rehabilitation Science

Background:

  • Persistent movement compensations, like reduced surgical peak knee extension moments (pKEM), after total knee arthroplasty (TKA) are linked to poorer recovery.
  • These compensations may also accelerate contralateral osteoarthritis progression.
  • Effective rehabilitation strategies are needed to improve movement quality post-TKA.

Purpose of the Study:

  • To evaluate if a movement training program (MOVE) enhances movement quality and recovery post-TKA compared to standard rehabilitation (CONTROL).
  • To assess the impact of MOVE on surgical and contralateral knee mechanics.
  • To compare functional recovery metrics between the MOVE and CONTROL groups.

Main Methods:

  • A randomized clinical trial involving 138 individuals undergoing TKA.
  • Participants were assigned to either a movement training program (MOVE) or a standard rehabilitation program (CONTROL).
  • Assessments included surgical and contralateral peak knee extension moments (pKEM), functional tests (6MWT, stair climb, 30STS, TUG), strength, range of motion, and physical activity levels, measured preoperatively, at 10 weeks, and 6 months post-TKA.

Main Results:

  • No significant difference in surgical pKEM during walking between MOVE and CONTROL groups at six months.
  • The MOVE group demonstrated significantly less contralateral pKEM during self-selected gait speed compared to the CONTROL group.
  • The CONTROL group showed better performance on the Timed Up and Go (TUG) and 30-second Sit to Stand (30STS) tests at 10 weeks, but these differences diminished by six months.

Conclusions:

  • The MOVE intervention did not improve surgical pKEM post-TKA but did reduce contralateral knee compensation during walking.
  • The faster initial functional recovery in the CONTROL group warrants further investigation to determine if it reflects improved surgical knee function or increased reliance on contralateral limb compensation.
  • Movement training may offer benefits in mitigating compensatory strategies, though its impact on primary surgical knee mechanics requires further study.