The Effect of Early Progressive Isotonic Exercise Therapy on Static Balance Control of Patients with Total Knee Replacement

Purpose: Knee osteoarthritis (OA) is believed to be an important risk factor for falling. Total&nbsp;knee replacement (TKR) is a commonly used choice when other methods are not satisfactory.&nbsp;Proprioception impairment, risk of falling and balance disorder are within the main complications&nbsp;of this method. While multiple protocols have been suggested for TKR, efficacy of early isotonic exercise therapy aimed at improving body balance after TKR has not been thoroughly&nbsp;investigated. Methods: In this quasi-experimental study, ten female patients with severe OA, sampled by nonrandomized&nbsp;convenient method were randomly assigned into either &ldquo;routine&rdquo;or &ldquo;early isotonic&nbsp;exercise&rdquo; groups. The subjects were undergone TKR surgery. The rehabilitation process (being&nbsp;the same for both groups until the second week) was initiated the day after surgery and lasted for&nbsp;6 weeks. From the second week, the experimental group received progressive, isotonic exercises,&nbsp;in addition to the routine rehabilitation protocol. Static balance was assessed prior to surgery and&nbsp;after the rehabilitation process in both groups by Sharpened Romberg tests. Results: In both groups, static balance was significantly enhanced after surgery and rehabilitation&nbsp;(P<0.000). Prior to surgery the groups were indifferent according to their static balance scores&nbsp;(P=0.423) but, after surgery and rehabilitation, the patients receiving early isotonic exercise in&nbsp;addition to routine physical therapy, were significantly in better balance condition comparing the&nbsp;control group (P=0.000). Conclusion: Routine physical therapy with and without early isotonic exercise therapy enhances&nbsp;static balance but, the balance improvement was more pronounced with this type of exercise.&nbsp;Early administration of isotonic exercise therapy in addition to the routine physical therapy&nbsp;program may enhance balance and prevent fall in patients with TKR.