Arthropathy of Knee Joint Clinical Trial
Official title:
Improving Function After Knee Arthroplasty With Weight-Bearing Biofeedback
The purpose of this study is to determine if rehabilitation using weight-bearing biofeedback training following total knee arthroplasty (TKA) is more effective than standard rehabilitation methods in promoting weight-bearing symmetry through the lower limbs during functional activities such as sit-to-stand transfers and walking. Secondary outcomes of interest include functional measures and internal moment at the hip, knee, and ankle joints during sit-to-stand and walking.
People who have had knee replacement surgery typically have worse physical function compared
to healthy people of similar age. This problem occurs despite completion of standard
rehabilitation programs. One reason for less-than-optimal restoration of physical function is
that standard rehabilitation does not effectively address habitual movement patterns that
persist after surgery. These movement patterns are characterized by patients placing less
weight on their surgical leg compared to their non-surgical leg after surgery. This
asymmetrical movement pattern has been identified by researchers and shown to not completely
resolve after knee replacement surgery, even though the surgery reliably reduces knee pain.
The persistence of asymmetrical weight-bearing during every day activity may limit the
stimulus needed for full recovery by the muscles and joints of the surgical leg. By promoting
increased loading of the surgical leg, a greater stimulus can be provided to promote better
functional recovery, compared with standard rehabilitation. As a result, people may
subsequently move more symmetrically with improved recovery of physical function. Improved
function would in turn promote the person's ability to participate in life events, limiting
disability. Considering that over 500,000 knee replacement surgeries occur in the United
States each year, maximizing functional recovery and limiting disability following surgery
are important goals.
The investigators propose a new method of exercising following knee replacement surgery. This
method involves using a commercially available game system to promote "re-loading" of the
surgical limb. The game system has games designed to allow the person playing to move objects
or characters on a screen by shifting his/her weight from one leg to another while standing
on an instrumented "balance board". The investigators have developed an exercise program to
promote shifting weight to the surgical limb, by choosing appropriate games and manipulating
the goals of those games. It is the investigators' hypothesis that early application of this
surgical leg "re-loading" intervention after knee replacement will result in meaningful
improvement in physical function by improving movement symmetry.
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