Authors (including presenting author) :
Yung WWI(1), Yung BPK(1), Chan ACM(1), Chan DWL(1), Tsui ASK(3), Poon MWY(3), Yip PSC(2), Cheng BLY(2)
Affiliation :
(1)Physiotherapy Department,Queen Elizabeth Hospital, (2)Department of Orthopaedics & Traumatology, Queen Elizabeth Hospital, (3)Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
Proprioception declines with age, and is further impaired in elderly patients with osteoarthritis of the knee joint. Proprioception of the knee joint is an important factor for establishing balance and normal gait pattern. However, joint proprioceptive deficiencies are frequently seen in patients with total knee arthroplasty (TKA) leading to their functional impairment. In spite of alleviation of pain and correction of deformity after surgery, normal gait and function are not typically achieved after TKA. The irreversible loss of joint proprioceptive function due to the disease process may be a major factor in the discrepancy between the postoperative clinical and functional outcomes. Therefore, evaluation of knee proprioception in patients with TKA might guide the physiotherapists in developing tailored rehabilitation protocols to enhance their post-operative functional mobility and optimize their recovery.
Objectives :
The aim of this study was to evaluate the association of knee proprioception to functional outcomes in patients with TKA.
Methodology :
A total of 61 patients scheduled for elective unilateral primary TKA in Queen Elizabeth Hospital (QEH) from May 2017 to October 2017 were recruited in this study. All of them received well-structured physiotherapy training from pre-operative status to post-operative hospital stay followed by out-patient training. Outcome measures including knee proprioception, pain score, knee active range of motion (ROM), Timed Up and Go Test (TUGT) and Taiwan Chinese Version of the Lower Extremity Functional Scale (LEFS) were measured within 1 week before operation, upon discharge from hospital and at 16th week after operation. For statistical analysis, Pearson’s correlation coefficient and linear regression were used to determine the association of knee proprioception to functional outcomes.
Result & Outcome :
Knee proprioception was impaired in people with knee osteoarthritis. It was significantly reduced further immediately after TKA. On completion of rehabilitation training, all knee proprioception, pain score and other functional outcomes improved. The present study demonstrated that preoperative knee proprioception was positively correlated with TUGT at 16th week after TKA (r = 0.343, p < 0.01). In addition, postoperative knee proprioception at 16th week after TKA was correlated positively with TUGT (r = 0.438, p < 0.001) and pain score (r = 0.285, p < 0.05), and negatively with LEFS (r = -0.254, p < 0.05). The linear regression model showed that preoperative knee proprioception was a significant predictor for TUGT, pain score and LEFS with R2 ranged from 0.064 to 0.192. Our results suggested that knee proprioception was a significant contributor to pain level and functional performance after TKA. Knee proprioception training appears to be of major clinical importance and should be emphasized in the clinical pathway of peri-operative rehabilitation regime to improve functional mobility.
Co-location with:
