Abstract
The aim of the study was to assess the influence of a physiotherapy program based on proprioceptive neuromuscular facilitation (PNF) on kinematic gait pattern after total knee arthroplasty. This comparative study included two groups of patients qualified for total surgical knee joint replacement due to osteoarthritis: a study group and a control group, either consisting of 28 patients of a matched age range of 55–90 years. Following surgery, 4 days after standard postoperative rehabilitation, the study patients were subjected to a 3-week-long therapist-assisted rehabilitation based on PNF principles (10 sessions of 75 min each), whereas control patients were discharged with instructions on how to exercise in the home setting. The outcome consisted of spatial-temporal gait parameters that were assessed at three time points: a day before surgery and then 1 month and 6 months after. The findings were that PNF caused substantial, sustained improvements in gait kinematics, shortening the stance phases, gait cycle duration, and double support phase and prolonging swing phase velocity, gait velocity, cadence, step length, and gait cycle length. Also, postsurgical pain was evidently less. We conclude that the individually tailored PNF rehabilitation program is superior compared to a standard recommendation of home-based physiotherapy in terms of improving gait kinematic pattern as well as psychological aspects related to pain perception in patients after knee arthroplasty.
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References
Alice B-M, Stéphane A, Yoshisama SJ, Pierre H, Domizio S, Hermes M, Katia T (2015) Evolution of knee kinematics three months after total knee replacement. Gait Posture 41(2):624–629
Alnahdi AH, Zeni JA, Snyder-Mackler L (2011) Gait after unilateral total knee arthroplasty: frontal plane analysis. J Orthop Res 29(5):647–652
Artz N, Dixon S, Wylde V, Beswick A, Blom A, Gooberman-Hill R (2013) Physiotherapy provision following discharge after total hip and total knee replacement: a survey of current practice at high-volume NHS hospitals in England and Wales. Musculoskeletal Care 11(1):31–38
Artz N, Elvers KT, Lowe CM, Sackley C, Jepson P, Beswick AD (2015) Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC Musculoskelet Disord 16:15
Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ (2008) Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res 26(3):332–341
Bennett D, Humphreys L, O’Brien S, Kelly C, Orr JF, Beverland DE (2008) Gait kinematics of age-stratified hip replacement patients – a large scale, long-term follow-up study. Gait Posture 28(2):194–200
Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P (2012) What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2(1):e000435
Blanke DJ, Hageman PA (1989) Comparison of gait of young men and elderly men. Phys Ther 69(2):144–148
Brach JS, Studenski SA, Perera S, VanSwearingen JM, Newman AB (2007) Gait variability and the risk of incident mobility disability in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 62(9):983–988
Brosseau L, Wells GA, Tugwell P et al (2005) Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis. Phys Ther 85(9):907–971
Burns LC, Ritvo SE, Ferguson MK, Clarke H, Seltzer Z, Katz J (2015) Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review. J Pain Res 8:21–32
Casartelli NC, Item-Glatthorn JF, Bizzini M, Leunig M, Maffiuletti NA (2013) Differences in gait characteristics between total hip, knee, and ankle arthroplasty patients: a six-month postoperative comparison. BMC Musculoskelet Disord 14:176
Hamacher D, Singh NB, Van Dieën JH, Heller MO, Taylor WR (2011) Kinematic measures for assessing gait stability in elderly individuals: a systematic review. J R Soc Interface 8(65):1682–1698
Harding GT, Hubley-Kozey CL, Dunbar MJ, Stanish WD, Astephen Wilson JL (2012) Body mass index affects knee joint mechanics during gait differently with and without moderate knee osteoarthritis. Osteoarthr Cartil 20(11):1234–1242
Hausdorff JM, Rios DA, Edelberg HK (2011) Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 82(8):1050–1056
Hiyama Y, Asai T, Wada O, Maruno H, Nitta S, Mizuno K, Iwasaki Y, Okada S (2015) Gait variability before surgery and at discharge in patients who undergo total knee arthroplasty: a cohort study. PLoS One 10(1):e0117683
Kang HG, Dingwell JB (2008) Separating the effects of age and walking speed on gait variability. Gait Posture 27(4):572–577
Kiliçoğlu O, Dönmez A, Karagülle Z, Erdoğan N, Akalan E, Temelli Y (2010) Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int 30(6):739–747
Kiss RM (2011) Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 21(5):695–703
Lee A, Park J, Lee S (2015) Gait analysis of elderly women after total knee arthroplasty. J Phys Ther Sci 27(3):591–595
McClelland JA, Webster KE, Feller JA, Menz HB (2011) Knee kinematics during walking at different speeds in people who have undergone total knee replacement. Knee 18(3):151–155
Newman AB, Haggerty CL, Kritchevsky SB, Nevitt MC, Simonsick EM, Health ABC, Collaborative Research Group (2003) Walking performance and cardiovascular response: associations with age and morbidity – the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 58(8):715–720
Oatis CA, Li W, DiRusso JM, Hoover MJ, Johnston KK, Butz MK, Phillips AL, Nanovic KM, Cummings EC, Rosal MC, Ayers DC, Franklin PD (2014) Variations in delivery and exercise content of physical therapy rehabilitation following total knee replacement surgery: a cross-sectional observation study. Int J Phys Med Rehabil 5(Suppl 5):pii: 002
Peter WF, Jansen MJ, Hurkmans EJ, Bloo H, Dekker J, Dilling RG, Hilberdink W, Kersten-Smit C, de Rooij M, Veenhof C, Vermeulen HM, de Vos RJ, Schoones JW, Vliet Vlieland TP, Guideline Steering Committee – Hip and Knee Osteoarthritis (2011) Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation. Acta Reumatol Port 36(3):268–281
Stan G, Orban H (2014) Human gait and postural control after unilateral total knee arthroplasty. Mædica (Buchar) 9(4):356–360
Szöts K, Pedersen PU, Hørdam B, Thomsen T, Konradsen H (2015) Physical health problems experienced in the early postoperative recovery period following total knee replacement. Int J Orthop Trauma Nurs 19(1):36–44
Taş S, Güneri S, Baki A, Yıldırım T, Kaymak B, Erden Z (2014) Effects of severity of osteoarthritis on the temporospatial gait parameters in patients with knee osteoarthritis. Acta Orthop Traumatol Turc 48(6):635–641
Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M, Hochberg M, Hunter DJ, Kwoh K, Lohmander LS, Tugwell P (2010) OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthr Cartil 18(4):476–499
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Jaczewska-Bogacka, J., Stolarczyk, A. (2018). Improvement in Gait Pattern After Knee Arthroplasty Followed by Proprioceptive Neuromuscular Facilitation Physiotherapy. In: Pokorski, M. (eds) Rehabilitation Science in Context . Advances in Experimental Medicine and Biology(), vol 1096. Springer, Cham. https://doi.org/10.1007/5584_2018_187
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DOI: https://doi.org/10.1007/5584_2018_187
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