Effects of Sensorimotor and Core Stabilization Exercises After Total Knee Arthroplasty

February 28, 2023 updated by: Yeditepe University

Effects of Sensorimotor and Core Stabilization Exercise Programs Following Total Knee Arthroplasty : A Randomize Controlled Trial

Tha aim of the study is to investigate the effects of core stabilization and sensorimotor exercise program on range of motion, proprioception, balance and functional status in patients with total knee arthroplasty. The study lasts prospective randomized controlled trial. Participants were randomly divided into sensorimotor training (SM,n=17) and core stabilization training group (CS,n=19). The exercise training program was administered for home exercise as 3-5 times a week and for a 6-week duration.

Study Overview

Detailed Description

Objective :

To investigate the effects of core stabilization and sensorimotor exercise program on range of motion, proprioception, balance and functional status in patients with total knee arthroplasty.

Design :

Prospective randomized controlled trial

Subjects :

A total of 36 Ostearthritis patients (69.8 ± 5.1 years) who underwent unilateral knee arthroplasty. Participants were performed TKA surgery by the same physician and followed by the same therapist.

The following inclusion criteria were used: being volunteer, 50-85 age range, being diagnosed with stage 4 OA and undergoing unilateral TKA surgery. The following exclusion criteria were applied: having previous surgery history of affected lower limb, impaired hearing, vision or verbal problems, physical or mental disability, having a neurological or oncologic disease that may affect functional performance.

Patients who met inclusion criteria and were willing to join the study (n=52) were evaluated after being diagnosed with OA and before the operation at the clinic. A total 40 patients undergoing TKA surgery participated in our study and were randomly separated to the Sensorimotor Training Group (SM, n=20) and the Core Stabilization Training Group (CS, n=20). Group allocation was randomized in two blocks of 40 sealed envelopes without external marks, which were mixed and numbered from 1 to 40, containing a piece of paper with the group allocation. All participants were blinded to the treatment type. As a result, 36 patients completed the process.

Outcome Measures :

Patients were assessed on three separate occasions (presurgery, 2 weeks and 8 weeks postsurgery). The primary outcome was proprioception and seconder outcomes were range of motion, Knee Injury and Osteoarthritis Outcome Scale (KOOS), Berg Balance Test, Timed-up & Go test and Sit & Stand -Up tests.

Interventions :

Participants were randomized into two intervention groups: sensorimotor training group (SM, n=17) and Core Stabilization training group (CS, n=19). Both groups were prescribed a 6-week home based exercise programme for 3-5 sessions/week between 2 and 8 weeks postsurgery.

Study Type

Interventional

Enrollment (Actual)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Istanbul, Turkey
        • Yeditepe University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years to 85 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • being volunteer,
  • 50-85 age range,
  • being diagnosed with unilateral OA and undergoing unilateral TKA surgery

Exclusion Criteria:

  • having previous surgery history of lower limbs,
  • impaired hearing-vision -verbal problems, physical or mental disability,
  • having a neurological or oncologic disease that may affect functional performance.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Sensorimotor exercise training
SM program included combination of traditional hip and knee exercise, various balance and proprioceptive exercises.
The program included side stepping, tandem walking, perturbation exercise, overcoming mini obstacles, walking different surfaces and traditional hip and knee exercise. Participants applied these exercise as home program between postoperative second weeks and 8th weeks, 3-5 day /week , 20 25 min every session.
Other Names:
  • SM exercises
Experimental: Core Stabilization exercise training
Core stabilization exercise program contained traditional hip and knee ROM exercise combining the core stabilization as mat activities
Core stabilization exercise program was also prepared parallel to the sensorimotor training group intensity; the program contained traditional hip and knee exercise combining the core stabilization as mat activities depending on previous research.core stabilization exercise program was also prepared parallel to the sensorimotor training group intensity; the program contained traditional hip and knee exercise combining the core stabilization as mat activities depending on previous research
Other Names:
  • CS exercises

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proprioception
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Joint Position Sense(JPS) was assessed to proprioception. JPS was evaluated via ability to reproduce joint angles using position-matching with active or passive movements (21, 22). Therapist showed each reference 30 and 60 degree flexion angles passively three times, held it for 10 second and returned to starting position during sitting. Then, patients were asked to show the target angles with eyes-closed, three deviated angles were recorded and the mean of errors was used for statistics
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Range of motion (ROM)
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
The ROM of knee and hip joints were assessed bilaterally via a universal goniometer.
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Sit to Stand Test
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
The STS test was applied by recording the elapsed time between the patients who were asked to sit and stand up 5 times as fast as possible
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Timed up and Go Test
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
In the TUG test, patients were asked to stand up independently from the chair, walk 3 m, turn around and sit at the starting point; the time elapsed between them was recorded (25). The minimum 2.49 seconds change indicates good clinical properties and below the 14 sec during performance indicate higher risk of falling.
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Berg Balance Test
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Berg Balance Test was also used to assess the static balance and falling risk of the participants. The test includes 14 different tasks scored between 0-4 points. Total scores were recorded between 0-56 points, higher score indicates better balance level
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
KOOS Scale
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
KOOS consists of 42 items and five subscales: pain, symptom, activities of daily life, quality of life, sport and recreation. All questions are scored 0-4 points and subscales points are converted separately to 0-100 points. Higher point indicates no knee problems
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Tampa Scale of Kinesiophobia
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Consist of 17 items, evaluate the fear of movement.
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
Oswestry Low Back Disability Questionnaire
Time Frame: change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks
The Oswestry Disability Index is an index derived from the Oswestry Low Back Pain Questionnaire used by clinicians and researchers to quantify disability for low back pain.
change from baseline to postsurgery second weeks , change from postsurgery second weeks to eighth weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Emrah DEMİRBAŞ, Operator, Tuzla Gispir Hospital
  • Study Chair: Şule BADILLI HANTAL, PhD, Yeditepe University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 28, 2019

Primary Completion (Actual)

May 16, 2020

Study Completion (Actual)

July 1, 2020

Study Registration Dates

First Submitted

January 11, 2022

First Submitted That Met QC Criteria

February 9, 2022

First Posted (Actual)

February 21, 2022

Study Record Updates

Last Update Posted (Actual)

March 2, 2023

Last Update Submitted That Met QC Criteria

February 28, 2023

Last Verified

February 1, 2023

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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