To investigate the effects of knee exercises and movement symmetry training with laser visual feedback on knee flexion and extension, and functional mobility in patients after TKA.
Thirty-two patients with TKA, aged 60-84, were randomized into the intervention group (n=16) who received TKA rehabilitation protocol with laser visual feedback and the control group (n=16) who received a TKA rehabilitation protocol alone within two weeks. The knee exercises with laser visual feedback in the intervention group consisted of isometric quadricep exercise, straight leg raises (SLR) exercise, knee flexion and extension exercises in sitting, terminal knee extension exercise in supine and standing, and movement symmetry training. The knee flexion and extension angles were analyzed by video camera and Kinovea program version 0.9.5. The timed up and go test (TUG) were applied to assess functional mobility. Analysis of Covariance (ANCOVA) was used to analyze the knee flexion and extension angles, and TUG between groups. Repeated measure analysis of variance (ANOVA) was used to compare the knee flexion and extension angles between preoperative and postoperative day (POD) 0, 7, and 14 and TUG between preoperative and POD 7, and 14.
The intervention group exhibited significantly more knee flexion and extension than the control group on POD 7 and 14 (flexion on POD 7= 87.04, 73.86 degree, POD 14= 101.72, 89.53 degree; extension on POD 7= 8.28, 12.74 degree, POD 14= 5.27, 9.98 degree, p0.001). Between POD 0 and 7, as well as between POD 0 and 14, there was a statistically significant increase in knee flexion and extension in the intervention group compared to the control group (p0.001). On POD 14, the intervention group was able to extend their knee more than on the day before surgery (5.27, 9.01 degree, p0.001). Additionally, the TUG test in the intervention group required significantly less time than those in the control group on POD 14 (36.55, 28.91 sec, p0.001). The TUG test on POD 7 and 14 took significantly more time than those on preoperative day in both groups (p0.05). However, the TUG test on POD 14 in the intervention group required nearly as much time as before surgery, compared to those in the control group (p0.05).
TKA rehabilitation protocol including knee exercises and movement symmetry training with laser visual feedback can improve knee flexion and extension angles and functional performance after TKA.
Laser visual feedback can be applied in TKA rehabilitation protocol to guide movement and motivate the patients during knee exercises and functional training.
TKA
TUG
