Eficacia de la hidroterapia frente al tratamiento en gimnasio en prótesis total primaria de rodilla por osteoartritis: ensayo controlado y aleatorizado / Efficacy of hydrotherapy versus gym treatment in primary total knee prosthesis due to osteoarthritis: a randomized controlled trial

Fundamento: La fisioterapia se postula como un tratamiento eficaz tras la intervención de prótesis total derodilla (PTR) por osteoartritis. El objetivo fue valorarla eficacia de la hidroterapia frente a la cinesiterapia engimnasio durante la segunda fase de la rehabilitación depacientes intervenidos de PTR en relación a la mejora deltest de la marcha, el dolor, la rigidez, el balance articular,la fuerza muscular y la inflamación. Método: Se realizó un ensayo controlado y aleatorizado.Los pacientes intervenidos de PTR recibieron una primerafase rehabilitadora (15 sesiones de 60 minutos) en el gimnasio. En la segunda fase (15 sesiones de 40 minutos), ungrupo realizó fisioterapia en gimnasio y otro en piscina.Se valoraron (basal, tras 15 y tras 30 sesiones): capacidadfuncional, dolor y rigidez con índice WOMAC, balance articular con goniómetro, fuerza muscular con escala Lovett,y test de la marcha de 6 minutos. Resultados: Participaron 115 pacientes, 59 (51,3 %) en grupo sala y 56 (48,7 %) en grupo piscina. Tras la segunda fasede rehabilitación se observaron mejoras clínicas superiores en el grupo piscina, siendo las diferencias estadísticamente significativas respecto al dolor (p = 0,005), rigidez(p = 0,010), balance articular flexión (p = 0,027) y fuerzamuscular (p = 0,049) en la rodilla intervenida, y en el testde la marcha de 6 minutos (p = 0,002). Conclusiones: En pacientes intervenidos de PTR, la hidroterapia durante la segunda fase del tratamiento rehabilitador fue más eficaz que la fisioterapia en gimnasio enrelación a la mejora del dolor, rigidez, balance articular,fuerza muscular y resultado del test de la marcha.(AU)

Background: Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA) due toosteoarthritis. The aim was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the secondphase of treatment in TKA patients, with regard to theimproved gait test, pain, stiffness, joint balance, musclestrength and inflammation. Methods: A controlled and randomized trial was carriedout. TKA patients received a first rehabilitative phase (1560-minutes sessions) at the gym. In the second phase (1540-minute sessions), one group performed physiotherapyin a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 sessions):functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength withLovett scale, and result of 6-minute gait test. Results: A total of 115 patients participated, 59 (51.3%)in the gym group and 56 (48.7 %) in the pool group. After the second phase of rehabilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p = 0.005), stiffness(p = 0.010), joint balance (p = 0.027) and muscle strength(p = 0.049) in the operated knee, and in the result of the6-minute gait test (p = 0.002). Conclusions: In TKA patients, hydrotherapy during thesecond phase of rehabilitative treatment was more effective than gym physiotherapy in terms of improved pain,stiffness, joint balance, muscle strength and gait testing.(AU)

[Efficacy of hydrotherapy versus gym treatment in primary total knee prosthesis due to osteoarthritis: a randomized controlled trial].

BACKGROUND: Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA). The objective of the study was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the second phase of treatment in TKA patients, with regard to the improved gait test, pain, stiffness, joint balance, muscle strength and inflammation. METHODS: A controlled and randomized trial was carried out. TKA patients received a first rehabilitative phase (15 60-minutes sessions) at the gym. In the second phase (15 40-minute sessions), one group performed physiotherapy in a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 ses-sions): functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength with Lovett scale, and result of 6-minute gait test. RESULTS: A total of 115 patients participated, 59 (51.3%) in the gym group and 56 (48.7?%) in the pool group. After the second phase of re-habilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p?=?0.005), stiffness (p?=?0.010), joint balance (p?=?0.027) and muscle strength (p?=?0.049) in the operated knee, and in the result of the 6-minute gait test (p?=?0.002). CONCLUSIONS: In TKA patients, hydrotherapy during the second phase of rehabilitative treatment was more effective than gym physiother-apy in terms of improved pain, stiffness, joint balance, muscle strength and gait testing.