Community-based Rehabilitation and Fall Prevention Program After Total Knee Arthroplasty
- Conditions
- Knee OsteoarthritisFall
- Interventions
- Other: Fall prevention program
- Registration Number
- NCT03615638
- Lead Sponsor
- The Hong Kong Polytechnic University
- Brief Summary
Knee osteoarthritis (OA) is a common musculoskeletal disorder among older people. Since the prevalence of knee OA increases with age, it is anticipated that the prevalence and burden of knee OA will increase significantly given the aging population.
Total knee arthroplasty (TKA) is used to treat patients with severe knee OA. While TKA has been shown to improve knee pain, function and quality of life of patients with knee OA, up to 50% of patients with post-TKA may suffer from falls within in the first year after TKA. Given that Tai Chi can significantly improve the balance and function of older people, a fall prevention program may improve balance, pain, and function of post-TKA patients.
As such, the current 3-arm randomized controlled trial (RCT) aims to compare the effectiveness of a post-operative community-based fall prevention program in improving knee pain, function and balance of patients with unilateral TKA against a group of TKA patients receiving standard post-operative care, and age- and gender-matched asymptomatic controls over 1 year.
- Detailed Description
Osteoarthritis (OA) is the third most disabling musculoskeletal compliant in the world. Knee OA is the most common type of OA. Since the prevalence of knee OA increases with age, it is anticipated that the prevalence and burden of knee OA will increase significantly given the aging population.
Total knee arthroplasty (TKA) is a surgical intervention for treating patients with severe knee OA. Research has found that TKA reduces knee pain, and improves patient's function and quality of life. However, studies have also found that patients with post-TKA may be more likely to fall as compared to age- and gender-matched asymptomatic counterparts. It is estimated that around 20% to 50% of patients fall within in the first year after TKA. As such, it is essential to improve the balance of post-TKA patients.
Studies have found that Tai Chi can significantly improve the balance and function of older people. Therefore, a fall prevention program aiming at strengthening, proprioception, balance training, and behavioral modification may improve balance, pain, and function of post-TKA patients.
As such, the current 3-arm randomized controlled trial (RCT) aims to compare the effectiveness of a post-operative community-based fall prevention program in improving knee pain, function and balance of patients with unilateral TKA with a group of patients receiving standard post-operative care, and age- and gender-matched asymptomatic controls over 1 year.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 78
- Participants undergoing TKA for intervention group and usual postoperative care group
- Age- and gender-matched asymptomatic controls without knee pain in the last 12 months.
- Can speak and understand Cantonese/English.
- Living in assisted living facilities, requiring nursing care
- Medical 'red flag' conditions
- A history of cancer in the last five years
- Cauda equine syndrome
- Knee fracture
- Auto-immune disease (e.g. rheumatoid arthritis) even if they have OA
- Inflammatory or septic arthritis
- Systemic disease
- Amputation
- History of orthopedic or neurological surgery to the spine, pelvis or hips
- Neurological diseases (e.g. stroke or Parkinson's disease)
- Mini-Mental State Examination score < 24
- Depression subscale score of Depression Anxiety Stress Scales > 21
- Severe comorbidity leading to severe deterioration of quality of life or major healthcare utilization
- Osteochondritis dissecans
- Perthes' disease
- Plica disease
- Baker's cyst
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Fall prevention group Fall prevention program Fall prevention program
- Primary Outcome Measures
Name Time Method Chinese version of Knee Injury and Osteoarthritis Outcome Scale 1 year A 42-item questionnaire with 5 subscales to assess pain, symptoms, activities of daily living, sports and recreation function, and knee-related quality of life
- Secondary Outcome Measures
Name Time Method Chinese version Falls Efficacy Scale - International 1 year To examine a person's confidence in avoiding a fall during 16 non-threatening activities of daily living.
Chinese version geriatric depression scale 1 year It consists of 15 questions to assess depression in older people
Number of post-operative trips/falls 1 year To quantify the number of trips/falls over 1 year after TKA
Physical Activity Scale for the Elderly 1 year It evaluates leisure, physical, household and work-related activities over the last 7 days
11-point numeric pain rating scale 1 year This scale quantify pain on a scale of 0 to 10. Higher the scores, higher the pain intensity
Chinese version Insomnia Severity Index 1 year It assesses sleep problems and related difficulties
Trial Locations
- Locations (2)
Yan Chai Hospital
ðŸ‡ðŸ‡°Hong Kong, Hong Kong
Queen Mary Hospital
ðŸ‡ðŸ‡°Hong Kong, Hong Kong