The Effect of Proprioceptive Neuromuscular Facilitation and Tendon Vibration After Total Knee Arthroplasty

Knee Osteoarthritis Clinical Trial

Official title: The Effect of Proprioceptive Neuromuscular Facilitation and Tendon Vibration After Total Knee Arthroplasty: A Randomized Clinical Trial

Status Active, not recruiting

Clinical Trial Summary

Knee osteoarthritis is a degenerative joint disease characterized by destruction and progressive loss of articular cartilage. In an advanced stage of the disease, the patient undergoes a total replacement of the knee joint with an artificial joint (total arthroplasty). The aim of this clinical study is to investigate the effect of combining a therapeutic exercise program based on Proprioceptive Neuromuscular Facilitation (PNF) and tendon vibration in older adult patients after total knee arthroplasty (TKA). Ninety (90) adults over 65 years of age who will undergo TKA due to knee osteoarthritis will be divided into three groups of 30 people each (two intervention and one control). The participants of the first group will follow a therapeutic exercise protocol based on the PNF technique for six weeks. The participants of the second intervention group will follow the same therapeutic exercise program based on PNF and at the same time tendon vibration will be applied to the Achilles tendon for the same period. Finally, the participants of the third group (control group) will follow the conventional physical therapy postoperative treatment. The subjective perception of pain with the Numeric Pain Rating Scale (NPRS), Active Range of Motion (AROM) of knee flexion with a goniometer, functional ability with the Knee Injury Outcome Questionnaire and osteoarthritis (Knee Injury and Osteoarthritis Outcome Score, KOOS), quality of life with the Western Ontario and McMaster Universities Arthritis Index (WOMAC), balance confidence with the balance confidence (CONFbal) scale, dynamic balance with the Time Up and Go (TUG) tests and Berg Balance Scale (BBS), displacement of the center of mass by static posturography, and knee proprioception by calculating joint position sense with an isokinetic dynamometer will be assessed at the beginning of the intervention , at week 3, week 6 and six months after the end of the intervention. For the statistical analysis of the results, a two-factor analysis of variance with repeated measurements will be applied, while the statistical significance index will be set at p < .05.

Clinical Trial Description

Background: Knee osteoarthritis is a degenerative joint disease characterized by destruction and progressive loss of articular cartilage. It occurs more often in older adults and is accompanied by pain, stiffness and swelling of the knee joint, difficulty in walking, and a decrease in the functioning of the patient. In an advanced stage of the disease, the patient undergoes a total replacement of the knee joint with an artificial joint (total arthroplasty). Aim: The aim of this clinical study is to investigate the effect of combining a therapeutic exercise program based on Proprioceptive Neuromuscular Facilitation (PNF) and tendon vibration in older adult patients after total knee arthroplasty (TKA). Method: Ninety (90) adults over 65 years of age who will undergo TKA due to knee osteoarthritis will be divided into three groups of 30 people each (two intervention and one control). The participants of the first group will follow a therapeutic exercise protocol based on the PNF technique for six weeks. The participants of the second intervention group will follow the same therapeutic exercise program based on PNF and at the same time tendon vibration will be applied to the Achilles tendon for the same period. Finally, the participants of the third group (control group) will follow the conventional physical therapy postoperative treatment. The subjective perception of pain with the Numeric Pain Rating Scale (NPRS), Active Range of Motion (AROM) of knee flexion with a goniometer, functional ability with the Knee Injury Outcome Questionnaire and osteoarthritis (Knee Injury and Osteoarthritis Outcome Score, KOOS), quality of life with the Western Ontario and McMaster Universities Arthritis Index (WOMAC), balance confidence with the balance confidence (CONFbal) scale, dynamic balance with the Time Up and Go (TUG) tests and Berg Balance Scale (BBS), displacement of the center of mass by static posturography, and knee proprioception by calculating joint position sense with an isokinetic dynamometer will be assessed at the beginning of the intervention , at week 3, week 6 and six months after the end of the intervention. For the statistical analysis of the results, a two-way analysis of variance with repeated measurements will be applied, while the level of significance will be set at p < .05. Expected results: It is known that older adults with TKA present deficits in balance and knee proprioception due to the long-term functional limitations caused by the symptoms of the disease (difficutly - pain during standing and movement, impaired gait patterns). These deficits persist even after TKA, making older adutls more vulnerable to falls and future injuries. The investigators believe that the effectiveness of an exercise program based on PNF in relation to conventional treatment in Greece has not been sufficiently studied and that the PNF program that will be applied in this research will be more effective than conventional physical therapy. They also believe that the inclusion of tendon vibration in the PNF-based therapeutic exercise program will further increase the balance and proprioceptive ability of older adults while at the same time it may accelerate their recovery process. ;

Related Conditions & MeSH terms

• Knee Osteoarthritis
• Osteoarthritis
• Osteoarthritis, Knee

• NCT number: NCT05920590
• Study type: Interventional
• Source: International Hellenic University
• Status: Active, not recruiting
• Phase: N/A
• Start date: April 1, 2023
• Completion date: March 30, 2024