Can Proprioceptive Knee Brace Improve Functional Outcome Following Total Knee Arthroplasty?
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Knee Osteoarthritis
- Sponsor
- Chinese University of Hong Kong
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Changes of the time of 6-meter test
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Osteoarthritis is among the most prevalent form of degenerative joint disease in arthritis. The World Health Organisation identified osteoarthritis as one of the top ten most disabling cause of disease in developed countries, and the single most common cause of disability for elderly persons. In fact, worldwide statistics for men and women over 60 years of age with signs of symptomatic osteoarthritis are estimated to be at 9.6% and 18.0% respectively. In Hong Kong, the latest census revealed that 514,000 people suffer from degenerative arthritis, representing 0.7% of the population. Although these values are much lower than the international figures reported by the WHO, it is inevitable that the prevalence of osteoarthritis will continue to rise with an increasing trend of obesity and an aging population in Hong Kong. Similar to any other chronic disease with wide prevalence, the impact of osteoarthritis translates to a substantial socioeconomic burden on a societal level.
Total knee arthroplasty has become the gold standard to manage the pain and disability associated with end-stage arthritis who have exhausted all conservative measures. Although contemporary advances in prosthesis design, surgical techniques, postoperative rehabilitation regimes have hasten patient's recovery, the restoration of proprioception and neuromuscular control is often prolonged despite solid rehabilitation regimes.
Knee bracing is one of the non-pharmacological modalities designed to evenly distribute load and provide proprioceptive feedbacks for those with knee injuries or knee pain. There are four categories of knee braces for the purpose of prophylactic, functional, rehabilitative and unloader/off-load. This study will mainly be focusing on the effects of the unloader/off-loader brace. Previous studies have demonstrated the effects on alteration of kinematic variables, including range of movement (p=0.002), speed of walking (p<0.001) and knee adduction moment (p=0.001) for knee injuries and osteoarthritis as a part of the conservative management protocol. However, there have few studies that investigated whether proprioceptive knee bracing has any role in functional recovery post total knee arthroplasty.
Investigators
Prof. Tim-Yun Michael ONG
Clinical Assistant Professor
Chinese University of Hong Kong
Eligibility Criteria
Inclusion Criteria
- •Adult (age over 18 years old) underwent Total Knee Arthroplasty within 2 to 4 weeks;
- •Adult who is able to provide written consent and compliance with treatment and assessment regime
Exclusion Criteria
- •Patients with disabilities, wheelchair dependence for mobility;
- •Underwent revision Total Knee Arthroplasty;
- •Found with complication wounds following surgery;
- •Diagnosed with comorbidities e.g. inflammatory arthritis, obesity, dermatological disorders that might affect their compliance to treatment;
- •Do not fit to the sizes of knee braces;
- •Not to given written consent and be non-compliance with the treatment and assessment regime
Outcomes
Primary Outcomes
Changes of the time of 6-meter test
Time Frame: pre-op, 6-weeks, 6-months and 12-months post-op
The 6-meter test timed walking gait test has been documented to be a valid and reliable substitute. Patients will be asked to walk a straight line of 6 meters where the time taken to complete the distance will be measured. (\<7.5 seconds is normal).
Changes of the time of Time up and go test (TUG)
Time Frame: pre-op, 6-weeks, 6-months and 12-months post-op
The Time up and go test (TUG) is to determine fall risk and measure the progress of balance, sit to stand and walking. Patients will be asked to stand up from a chair, walk as quickly as possible in their a safe and most comfortable gait until they pass to 3 meters (10 feet) end of marked course with both feet. Turn around and walk back to the chair, time will be counted to the moment until the back of patients touches the back of the chair.
Change in the range of motion
Time Frame: pre-op, 6-weeks, 6-months and 12-months post-op
The active range of motion test predicts the mobility of the joint by measuring the amount of active knee extension and flexion. Knee extension: The patient is supine. The heel of the limb of interest is propped on a bolster, assuring the back of the knee and calf are not touching the support surface. The patient is asked to actively contract the quadriceps. The amount of knee extension is recorded with the goniometer. Knee flexion: The patient is prone. The patient flexes the knee as far as possible. The amount of knee flexion is recorded with the goniometer."
Secondary Outcomes
- Knee extensor/flexor strength(pre-op, 6-weeks, 6-months and 12-months post-op)
- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)(pre-op, 6-weeks, 6-months and 12-months post-op)
- Short-form 12(pre-op, 6-weeks, 6-months and 12-months post-op)
- The Forgotten Joint Score-12(pre-op, 6-weeks, 6-months and 12-months post-op)
- Knee stability test(pre-op, 6-weeks, 6-months and 12-months post-op)
- Knee Society Function Score (KFS)(pre-op, 6-weeks, 6-months and 12-months post-op)
- Knee Society Score (KSS)(pre-op, 6-weeks, 6-months and 12-months post-op)
- Clinical Research Compliance assessment: compliance to intervention(6-weeks, 6-months and 12-months post-op)
- Clinical Research Compliance assessment: compliance to routine physiotherapy(6-weeks, 6-months and 12-months post-op)
- Patients satisfaction Survey(pre-op, 6-weeks, 6-months and 12-months post-op)