Purpose: Total knee arthroplasty (TKA) is the gold standard treatment for severe arthrosis, with great results in about the 80% of patients. Nevertheless, the remaining 20% complains about residual pain and functional limitations. Some studies showed no balance improvement in orthostatic position after TKA, if no specific proprioceptive training is performed. The aim of this study was to evaluate the effects of proprioceptive training in one patient with TKA using Delos Postural Proprioceptive System (DPPS; Delos, Turin, Italy). Methods: The subject was a 71-years-old female with TKA. The proprioception was evaluated before surgery, after surgery and after training, with a static monopodalic test by mean of the DPPS. Moreover, WOMAC and SPPB score were acquired. The program training consisted in different protocols, aimed to recover joint mobility and improve balance. The patient trained twice a week, for 5 weeks. Parameter considered was the Stability Index (SI) which is a score (0-100%) based on autonomy and postural instability. Results: The SI results before surgery, after surgery and after training in operated limb were respectively: 67.2%, 84.7% and 87% with open eyes; 30.1%, 27.1%, 37.9% with closed eyes. The SI in contralateral limb increased in each follow up, scores were also slightly higher than the operated limb. The WOMAC score improved along the evaluations: 38.54% before the surgery, 8.33% after surgery and 3.1% after training. SPPB results were: 6 before surgery, 9 after surgery and 12 after training. Conclusion: TKA confirmed positive effects in terms of pain reduction and physical function. Nevertheless, the SI performed in operated limb with closed eyes, which is a predictive factor for proprioceptive ability, decreased after surgery. The proprioceptive training was instead able to improve all patterns, giving a much global benefit. In future, a specific proprioceptive training could be used after standard rehabilitation.
Case Report: Proprioceptive training program in a patient with total knee arthroplasty
G. Barone;S. Zaffagnini;M. G. Benedetti;L. Bragonzoni
2019
Abstract
Purpose: Total knee arthroplasty (TKA) is the gold standard treatment for severe arthrosis, with great results in about the 80% of patients. Nevertheless, the remaining 20% complains about residual pain and functional limitations. Some studies showed no balance improvement in orthostatic position after TKA, if no specific proprioceptive training is performed. The aim of this study was to evaluate the effects of proprioceptive training in one patient with TKA using Delos Postural Proprioceptive System (DPPS; Delos, Turin, Italy). Methods: The subject was a 71-years-old female with TKA. The proprioception was evaluated before surgery, after surgery and after training, with a static monopodalic test by mean of the DPPS. Moreover, WOMAC and SPPB score were acquired. The program training consisted in different protocols, aimed to recover joint mobility and improve balance. The patient trained twice a week, for 5 weeks. Parameter considered was the Stability Index (SI) which is a score (0-100%) based on autonomy and postural instability. Results: The SI results before surgery, after surgery and after training in operated limb were respectively: 67.2%, 84.7% and 87% with open eyes; 30.1%, 27.1%, 37.9% with closed eyes. The SI in contralateral limb increased in each follow up, scores were also slightly higher than the operated limb. The WOMAC score improved along the evaluations: 38.54% before the surgery, 8.33% after surgery and 3.1% after training. SPPB results were: 6 before surgery, 9 after surgery and 12 after training. Conclusion: TKA confirmed positive effects in terms of pain reduction and physical function. Nevertheless, the SI performed in operated limb with closed eyes, which is a predictive factor for proprioceptive ability, decreased after surgery. The proprioceptive training was instead able to improve all patterns, giving a much global benefit. In future, a specific proprioceptive training could be used after standard rehabilitation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
