Core Stability Via Telerehabitation on TKA
Condition: Knee Arthropathy; Telerehabilitation
MeSH terms: Joint Diseases
Study type: Interventional

Summary: 
      Objective: To investigate the effects of core stability exercises (CSE) added to the standard
      exercises (SE) on patient-reported (PR) and performance-based (PB) outcomes in patients with
      total knee arthroplasty (TKA) followed with telerehabilitation (TR).

      Methods: The 42 patients who participated in the study were randomly divided into 2 groups
      [group 1: SE (n= 21), group 2: SE + CSE (n= 21)]. The first 8 weeks of the post-discharge
      follow-up were performed by videoconference-based TR under the supervision of a
      physiotherapist and the last 4 weeks by telephone-based TR. Functional level was assessed by
      Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain intensity by
      Visual Analog Scale (VAS), affected knee range of motion (ROM) by Copenhagen Knee Range of
      Motion Scale (CKRS), quality of life by Short Form-12 (SF-12) and World Health Organization
      Quality of Life Scale Brief Version (WHOQOL-BREF), lower extremity muscle strength by
      30-seconds Chair-Stand Test and locomotor performance by Stair Climb Test. Assessments were
      performed with TR preoperatively and at the first, second and third post-op months.
    

Detailed description: 
      At the beginning of the study, an exercise booklet and exercise videos were prepared to be
      followed throughout the follow-up period. Subsequently, a telerehabilitation (TR) system was
      established using a laptop computer, a smartphone and a camera as hardware and WhatsApp® and
      Zoom® applications as software. The surgeries of all patients participating in the study were
      performed by the same surgical team with fast-track surgical procedure. Until discharge (1
      day), a standard physiotherapy and rehabilitation (PTR) program consisting of range of motion
      and strengthening exercises, cold application, weight transfer and walking training was
      applied to both groups of patients. At the time of discharge, each patient was given an
      exercise booklet according to the intervention group.

      During the follow-up period, only the interventions included in the standard exercise (SE)
      program were applied to the SE group, while interventions included in both the SE and core
      stability exercise (CSE) program were applied to the SE + CSE group. In addition to the TR
      sessions, each patient performed the interventions belonging to the group they were included
      in as a home program (HP), 3 sessions per day for the first 8 weeks of the follow-up period.
      Patient follow-up, which started from the 1st week after discharge, continued for 12 weeks.
      The content of the follow-up process was planned to include information, assessment, and PTR
      interventions. The first 8 weeks of the follow-up period consisted of PTR sessions performed
      with video-conference-based TR method under the supervision of a physiotherapist and HP,
      while the last 4 weeks consisted of the follow-up of the walking program performed with
      telephone-based TR method.
    

Intervention name(s): standard exercises; core stability exercises
Intervention type(s): Other; Other
Intervention description(s): Standard exercises for TKA patients.; Core stability exercises for TKA patients.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This study was designed as a double-blind, randomised controlled trial.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: total knee arthroplasty; exercise; core stability; telerehabilitation; physiotherapy