Comparative study of conventional therapy and additional yogasanas for knee rehabilitation after total knee arthroplasty

BACKGROUND: Amongst various modalities of post operative rehabilitation in a total knee replacement (TKR) surgery, this study focuses on evaluating the effect of additional yoga therapy on functional outcome of TKR patients. MATERIALS AND METHODS: A comparative study was done to compare the effects of conventional physiotherapy and additional yoga asanas, on 56 patients undergoing total knee arthroplasty due to osteoarthritis. After obtaining written informed consent, the patients were alternately assigned to two groups: Conventional and experimental. Baseline WOMAC scores for pain and stiffness were taken on third post operative day. The subjects in conventional group received physiotherapy rehabilitation program of Sancheti Institute where the study was conducted, the experimental group received additional modified yoga asanas once daily by the therapist. After discharge from the hospital, patients were provided with written instructions and photographs of the asanas, two sets of WOMAC questionnaire with stamped and addressed envelopes and were instructed to perform yoga asanas 3 days/week. Subjects filled the questionnaire after 6 weeks and 3 months from the day of surgery and mailed back. The primary outcome measure was WOMAC questionnaire which consists of 24 questions, each corresponding to a visual analog scale, designed to measure patient's perception of pain, stiffness and function. RESULTS: The results suggest that there was a significant change (P<0.05) for all the groups for pain, stiffness and function subscales of WOMAC scale. The pain and stiffness was found to be less in experimental group receiving additional yoga therapy than in conventional group on 3(rd) post operative day, 6 weeks and 3 months after the surgery. CONCLUSION: A combination of physiotherapy and yoga asana protocol works better than only physiotherapy protocol. Larger and blinded study is needed.