Effects of combination therapy on the movement function of lower extremity after total knee arthroplasty in the elderly / 中国组织工程研究

ABSTRACT

BACKGROUND: Electromyographic biofeedback therapy has been reported to contribute to the functional recovery of the lower limb after arthroplasty.OBJECTIVE: To compare the effect of different rehabilitation therapies on the movement function of lower limb in elderly patients after total knee replacement.METHODS: Totally 153 patients undergoing total knee replacement were randomly divided into conventional,electromyographic biofeedback and combination groups (n=51 per group), and then subjected to the conventional rehabilitation training, electromyographic biofeedback at the quadriceps femoris, and conventional rehabilitation training,electromyographic biofeedback plus body weight supported treadmill training, respectively. At 8 weeks after treatment,the movement function of lower limbs, activities of daily living and balance abilities, range of flexion-extension of the knee joint, walking ability, Hospital for Special Surgery of the lower limbs, as well as the Lower Extremity Functional Scale scores were evaluated. Besides, the Visual Analogue Scale scores, surface electromyogram of the quadriceps femoris at rest and in activity, co-contraction ratio of antagonistic muscle when ankle dorsiflexion, Fugl-Meyer assessment,modified Barthel index, Berg Balance Scale, and Holden walking function classification were detected.RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores after treatment in the combination group were significantly lower than those before treatment, in the conventional and electromyographic biofeedback groups (P < 0.01).(2) The Hospital for Special Surgery and Lower Extremity Functional Scale scores in the combination group were significantly higher than those in the conventional and electromyographic biofeedback groups (P < 0.05). (3) The surface electromyogram values, co-contraction ratio of antagonistic muscle, Fugl-Meyer assessment, modified Barthel index,range of flexion-extension of the knee joint, maximum step length and velocity as well as Holden walking function in the combination group were significantly superior to those in the conventional and electromyographic biofeedback groups (P < 0.05). (4) These results indicate that combination therapy is able to significantly improve the movement function and muscle strength of the lower limb, and enhance the postoperative rehabilitation for the elderly after total knee arthroplasty.