NDLI: The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study

Content Provider	Springer Nature : BioMed Central
Author	Mau-Moeller, Anett Behrens, Martin Finze, Susanne Bruhn, Sven Bader, Rainer Mittelmeier, Wolfram
Abstract	Background The parallel-group randomized active-controlled clinical study was conducted to compare the effectiveness of two in-hospital range of motion (ROM) exercise programs following total knee arthroplasty (TKA). Continuous passive motion (CPM) is frequently used to increase ROM and improve postoperative recovery despite little conclusive scientific evidence. In contrast, a new active sling-based ROM therapy requires the activation of the knee joint muscles and dynamic joint stabilization. It was hypothesized that higher demands on muscle strength and muscle coordination during sling exercise training (ST) might be advantageous for early recovery following TKA. Methods A total of 125 patients undergoing primary TKA were assessed for eligibility. Thirty-eight patients were randomly assigned to receive ST or CPM (control intervention) during hospital stay. Patients were assessed before TKA for baseline measurement (pretest), 1 day before discharge (posttest) and 3 months after TKA (follow-up). The passive knee flexion range of motion (pFL) was the primary outcome measure. Secondary outcome measures included active knee flexion range of motion, active and passive knee extension ROM, static postural control, physical activity, pain, length of hospital stay as well as clinical, functional and quality-of-life outcomes (SF-36, HSS and WOMAC scores). Data were analyzed according to the intention-to-treat principle. Differences between the groups were tested for significance by the unpaired Student’s t test or an analysis of covariance (ANCOVA) adjusted for baseline, weight, sex, age, pain and physical activity. Results A between-group difference could be determined at posttest. The pFL was significantly higher by 6.0° (95% CI 0.9 to 11.2°; P = 0.022) in the ST group. No difference between groups in pFL was documented at follow-up. Furthermore, no significant differences could be observed for any secondary outcome measure at posttest and follow-up. Conclusions ST seems to have a clinically relevant beneficial short-term effect on pFL compared to CPM. The results support the implementation of ST in rehabilitation programs following TKA. Level of evidence Therapy, level 2b
Related Links	https://hqlo.biomedcentral.com/counter/pdf/10.1186/1477-7525-12-68.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14777525
DOI	10.1186/1477-7525-12-68
Journal	Health and Quality of Life Outcomes
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2014-05-09
Access Restriction	Open
Subject Keyword	Quality of Life Research Continuous passive motion (CPM) Postoperative physical therapy Range of motion Rehabilitation Total knee arthroplasty (TKA)
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.2/2023
5-Year Journal Impact Factor	3.9/2023

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