The purpose of the study is to determine the effectiveness of new interventional approaches in the early postoperative phase following total knee arthroplasty (TKA). It is assumed that active training programs are more effective in improving physical function than the passive standard-of-care therapy.
The major objectives of rehabilitation after TKA are the early regain of range of motion (ROM) and mobilization of the patient. Continuous passive motion (CPM) is frequently used as part of the postoperative care regime following TKA with the aim to increase knee joint mobility and improve postoperative recovery despite little conclusive scientific evidence. Conflicting research findings have generated an ongoing debate on its usage. As the greatest loss of function occurs in the first month following TKA, it is surprising that the ROM therapy during hospital stay is still carried out passively. A passive mobilization of the knee joint with CPM does not encourage the patients to actively participate in their rehabilitation. Research on the effectiveness of active ROM exercises added to standard physiotherapy during the short in-hospital period is lacking so far.The objective of this study is to compare the passive clinical standard therapy (CPM) with different active training programs (controlled active motion, CAM). It was hypothesised that the CAM therapies are more effective in improving physical function than the CPM therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
standard-of-care therapy (control intervention); Patients receive three 30 minutes CPM applications (unilateral op-leg) each day from the second postoperative day until 1 day prior to discharge.
Patients receive three 30 minutes CAM applications (unilateral op-leg) each day from the second postoperative day until 1 day prior to discharge.
Patients receive three 30 minutes CAM applications (bilateral alternating) each day from the second postoperative day until 1 day prior to discharge.
Department of Orthopedics, University Medicine Rostock
Rostock, Germany
range of motion
Time frame: change from baseline (before surgery) to discharge (9 days post surgery)
neuromuscular function
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
joint position sense
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
motor function
stair climbing test, timed up and go test
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
cognitive functioning
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
physical activity
over a period of 7 days using the activPAL activity recording system.
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
pain
visual analogue scale (VAS)
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
swelling
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
length of hospital stay
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)
quality of life
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36-item Short Form Health Survey (SF-36)
Time frame: change from baseline (before surgery) to discharge (9 days after surgery)