Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: a randomized controlled trial

Objective: To evaluate the effectiveness of additional balance training on mobility and function outcome in patients with knee osteoarthritis after total knee replacement. Design: A prospective intervention study and randomized controlled trial. Setting: A university-based teaching hospital. Participants: Patients who received total knee replacement surgery were recruited sequentially from the orthopedic department. They were randomly assigned to either the experimental group or control group. Interventions: The control group received conventional function training for eight weeks. The experimental group not only received the same conventional training as the control group, but also received additional balance exercises in each admission. Main outcome measures: Before and after training we took the following measurements: distance of functional forward reach; duration of single leg stance; timed sit-to-stand test; timed up-and-down stair test; timed 10-m walk; timed up-and-go test; and the Western Ontario and McMaster Universities Osteoarthritis Index score. Results: 58 patients in the experimental group with a mean (SD) age of 71.4 (6.6) years and 55 in the control group with mean (SD) age of 72.9 (7.3) years, completed the study. After eight-weeks intervention with additional balance exercises, the experimental group demonstrated significant changes in 10-m walk (P < 0.001, 95% confidence interval (CI): 3.6 to 4.4 seconds) and in timed up-and-go (P < 0.001, 95% confidence interval: 2.6 to 3.4 seconds) tests. Significant changes of all other measures and Western Ontario and McMaster Universities Osteoarthritis Index score were also observed in the experimental group (all P < 0.001). Conclusion: Additional balance training exerted a significant beneficial effect on the function recovery and mobility outcome in patients with knee osteoarthritis after total knee replacement.