In-home Versus Hospital Preoperative Training for Patients Undergoing Total Knee Replacement

Study Overview
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Brief Summary
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In this work the importance of the potentiation and recovery of the balance with a physiotherapeutic intervention that begins in the early preoperative phase is compared with the conventional postoperative rehabilitation. The objective is to evaluate the influence of a muscle enhancement protocol in which a specific work of balance is included, with the physical benefits that this entails for the evolution of the patient. It also seeks to verify if the teaching and recommendation of exercises at home as preparation and conditioning for the intervention of ATR is effective, and to what extent, compared to a guided training in the hospital.

Official Title
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In-home Versus Hospital Preoperative Training for Patients Undergoing Total Knee Replacement

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Preoperative training (hospital)
* Other: Preoperative training (home)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects with severe knee osteoarthritis that have not been operated before of total knee replacement. The score in Berg scale must be greater than 21. The score of the Mini-Mental State Examination must be equal or greater than 20. Once the informed consent is read and explained, patients must accept and agree to participate in the study. Exclusion Criteria: Post-surgical infection of the operated knee. Pathology of central origin (i.e. cerebellar) that could interfere with balance or strength Vestibular pathology that could interfere with balance

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Non-active comparator | |
| Active Comparator: Balance-Proprioception (Hospital)<br>Preoperative training (hospital) | Other: Preoperative training (hospital)<br>* Preoperative hospital training<br>|
| Experimental: Balance-Proprioception (Home)<br>Preoperative training (home) | Other: Preoperative training (home)<br>* Preoperative in-home training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee injury and Osteoarthritis Outcome Score (KOOS) | Self-reported functionality assessment | change from baseline to the week before surgery, 2 and 6 weeks after surgery | 
| Berg Balance Scale (BBS) | Overall state of balance. Balance among older people with impairment in balance function by assessing the performance of functional tasks from the total score achieved in the 14 items test | change from baseline to the week before surgery, 2 and 6 weeks after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed Up and Go Test (TUG) | Dynamic balance assessment. Also points at the risk of falling. Time of getting up from a chair, walk three meters, come back and sit again, measured in seconds | change from baseline to the week before surgery, 2 and 6 weeks after surgery | 
| Knee Range of Mobility (ROM) | Knee Range of Mobility (Flexion, Extension) in degree | change from baseline to the week before surgery, 2 and 6 weeks after surgery | 
| Quadriceps Strength | Electronic dynamometer in Newton | change from baseline to the week before surgery, 2 and 6 weeks after surgery | 
| Euro Quality of Life 5 Dimension | Quality of Life assessment | change from baseline to the week before surgery, 2 and 6 weeks after surgery |