Effects of intesive rehabilitation on functional ability after total knee arthroplasty

ABSTRACT

To evaluate the effectiveness of a pre- and post-operative intensive functional rehabilitation [IFR] program in the first three months after primary total knee arthroplasty [TKA] for severe osteoarthritis on functional ability and muscle isokinetics. Twenty severe osteoarthritis knee patients underwent primary total knee arthroplasty. They were divided randomly into 2 groups of 10 each. The first group received intensive program of rehabilitation, the second received ordinary rehabilitation program. All patients were subjected to clinical examination, functional assessment using WOMAC score, knee range of motion, 6 Minute Walk test, Timed Up and Go test, and Isokinetic Assessment, at start, 6 and 12 weeks afterwards. Total WOMAC score, pain, stiffness, and difficulty WOMAC scores showed a significant decrease after 6 and 12 weeks in both groups. The first group showed more decrease than ordinary program. Timed Up and Go test showed a significant decrease after 12 weeks in both groups p=0.003, shorter time in the first group than the second. Isokinetic parameters as peak torque and peak torque per body weight showed significant increase after 6 weeks in first group p=0.01, but not in second p>0.05. After 12 weeks there was a statistical significant increase in both groups p<0.001, higher in first group p<0.05]. Total work, average power, and maximum repetition total work showed better improvement in first group. IRP applied in the first 3 months after TKA is effective in promoting better functional ability, less pain and stiffness and results in better ROM and longer distance walked