Force-plate analyses of balance following a balance exercise program during acute post-operative phase in individuals with total hip and knee arthroplasty: A randomized clinical trial

Abstract

Objectives: Typical rehabilitation programs following total hip arthroplasty and total knee arthroplasty include joint range of motion and muscle-strengthening exercises. Balance and balance exercises following total hip arthroplasty and total knee arthroplasty have not received much attention. The purpose of this study was to determine whether an intervention of balance exercises added to a typical rehabilitation program positively affects patients' balance.

Methods: A total of 63 patients were provided with outpatient physical therapy at their home. Patients were randomly assigned to either typical (n = 33) or balance (n = 30) exercise group. The typical group completed seven typical surgery-specific joint range of motion and muscle-strengthening exercises, while the balance group completed the typical exercises plus three balance exercises. After 5 weeks of administering the rehabilitation program, patients' balance was assessed on a force plate using 95% ellipse area of the center of pressure amplitude.

Results: Patients in the balance group demonstrated significant reduction in the 95% ellipse area for the anterior and posterior lean standing conditions (p < 0.01).

Conclusion: Balance exercises added to the typical outpatient physical therapy program resulted in significantly greater improvements in balance for participants with total hip arthroplasty or total knee arthroplasty, compared to the typical exercise program alone. Physical therapists might consider the use of balance exercises to improve balance in individuals in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty.

Keywords: 95% ellipse area; Total hip arthroplasty; balance exercises; force plate; total knee arthroplasty.

Figure 1.

Participant in two-limb standing position on the force plate for balance testing.

Figure 2.

Design and flow of participants through the trial.