The Effect of Intensive Close-Kinetic-Chain Exercises on Functionality and Balance Confidence After Total Knee Arthroplasty

Objectives The aim of this study was to evaluate the effects of an additional close-kinetic-chain exercise program (CKC-PT), in conjunction with the standard physiotherapy intervention (TKA-PT), on the general health status, functionality, balance confidence, and postoperative falls of knee osteoarthritic patients who had undergone total knee arthroplasty (TKA). Patients and methods Thirty community-dwellers, aged >65 years, were randomized into equal groups. The Greek versions of the SF-36 version1.0 (SF-36v1.0-Gr), WOMAC(®) (WOMAC(®)-Gr), Activities-specific Balance Confidence scale (ABC-Greek), Timed Up and Go (TUG) test, and Berg Balance Scale were assessed preoperatively and twice postoperatively (7(th) week and 12(th) month). Non-parametric (Mann-Whitney test) and parametric (two-way analysis of variance (ANOVA) model and student t-test) analyses were used to compare the percentage changes in all variables. Results The CKC-PT group reported better (%) functional improvement (WOMAC(®)-Gr Physical­ Function subscale) and higher (%) balance confidence (ABS-Greek) at the seventh week and twelfth month as compared to TKA-PT (p<0.05). No other statistically significant differences were observed. Conclusions The implementation of a close-kinetic-chain exercise program, in addition to standard physiotherapy, may significantly increase both the functionality and balance confidence of patients who have undergone TKA. Further studies are needed to verify these findings.