Otago Exercise in Patient With Total Knee Replacement
Condition: Total Knee Replacement
Study type: Interventional

Summary: 
      To determine the effect of Otago exercise in Total Knee Replacement
    

Detailed description: 
      Degenerative knee arthritis is one of the most common diseases in the elderly population. Age
      is the strongest risk factor for osteoarthritis. The 2010 Global Burden of Disease Study
      reports that the burden of musculoskeletal disorders is much larger than estimated in
      previous assessments and accounts for 6.8% of daily worldwide. An estimated 10% to 15% of all
      adults aged over 60 have some degree of OA. In Pakistan, 3.6% in rural and 3.1-4.6% in urban
      parts of Pakistan were found diagnosed by knee OA.

      When conservative treatments fail to control the symptoms, joint replacement is performed.
      Specifically, more than 1 million surgeries are performed every year in the United States
      (US) alone, with a total expenditure close to 13.7 billion and 28.5 billion US dollars for
      the hips and knees, respectively. The demand is expected to increase by approximately 4 time
      by the year 2030 annually more than 4000 joint have been replaced in Pakistan." Overall, the
      progress of patients after joint replacement is satisfactory. Nevertheless, a substantial
      number may present with functional and balance limitations, even 1 year after surgery.

      A cross sectional study reported that a Home-based balance and strength exercises (OEP)
      benefited older fallers with OA and gait and balance disorders by improving postural control.
      Another study has been done which suggested that elderly people who performed the OEP showed
      an increase in balance, muscle strength, and a decrease in both fall percentage and fall
      frequency. Evidence has recommended that, the OEP was more effective improving functional
      balance, muscle strength and physical health.

      A cross sectional study was conducted to evaluate the influence of specific balance-targeted
      training on the overall state of balance in older adults undergoing TKR. They concluded that
      the additional balance training program improved balance performance to a higher extent than
      a control group.

      After surgery, pain and stiffness are remarkably relieved, but functional and proprioceptive
      deficits, including limitation of lower limb mobility, difficulties in walking, and
      alterations instability and balance may remain. However, the effect of Otago exercise on
      balance are present in literature but the evidence for their influence in patients with TKR
      is narrow. So aim of this study to identify the possible role of Otago exercise program in
      particular population (TKR) and the prognosis in balance and Gait with this protocol in
      patients undergoing TKR.
    

Intervention name(s): Otago Exercise
Intervention type(s): Other
Intervention description(s): Otago exercise protocol
Strengthening exercise:
Resistance exercise for knee flexors, knee extensors, hip abductor, ankle dorsiflexors, ankle planterflexors
Balance exercise:
knee bending, backward walking, walking and turning around, sideway walking, tendem stance, tendem walking, one leg stand, heel walking, toe walking, heel to toe walking, sit to stand, stair walking
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Balance training; Total knee replacement; Otago exercise