Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis

Abstract

Background: Optimal balance control is of paramount importance for function recovery after total joint arthroplasty (TJA). The study objective of this meta-analysis was to assess the short- and mid-term effects of proprioceptive and balance training for patients undergoing TJA.

Methods: Electronic searches were conducted from PubMed, Cochrane library, and Embase databases to identify eligible RCTs through May 2020. Standard mean difference (SMD) with 95% confidence interval (95%CI) was applied to calculate pooled effect estimates between proprioceptive and balance training and control group. Main outcomes were self-reported functionality, balance, pain, quality of life, and function (range of motion).

Results: Seven randomized controlled trials were finally included in this meta-analysis. Pooled results found that balance and proprioceptive trainings have a positive role in improving self-reported functionality at short-term after TJA. Moreover, balance and proprioceptive trainings were associated with an increase of the balance at short- and mid-term after TJA. These results were further confirmed by subgroup analysis between preoperative and postoperative administration of balance and proprioceptive trainings.

Conclusion: Our meta-analysis suggests that balance and proprioceptive trainings after TJA improved self-reported functionality and balance. These improvements were maintained at mid-terms. More research is needed to confirm balance and proprioceptive trainings for pain and quality of life for TJA.

Keywords: Meta-analysis; Osteoarthritis; Proprioceptive training.

Fig. 1

The PRISMA flowchart regarding the study selection process

Fig. 2

Risk of bias summary for the included studies. Plus sign indicates low risk of bias; minus sign indicates high risk of bias; question mark indicates unclear risk of bias

Fig. 3

Risk of bias graph for the included studies

Fig. 4

Balance and proprioceptive trainings and control on self-reported functionality

Fig. 5

Forest plot of proprioceptive trainings and control in terms of balance

Fig. 6

Forest plot of proprioceptive trainings and control in terms of pain scores

Fig. 7

Forest plot of proprioceptive trainings and control in terms of quality of life

Fig. 8

Forest plot of proprioceptive trainings and control in terms of function (ROM)

Fig. 9

Forest plot of proprioceptive trainings and control in terms of self-reported functionality at mid-term

Fig. 10

Forest plot of proprioceptive trainings and control in terms of balance at mid-term

Fig. 11

Forest plot of proprioceptive trainings and control in terms of pain at mid-term

Fig. 12

Forest plot of proprioceptive trainings and control in terms of quality of life at mid-term

Fig. 13

Funnel plot of self-reported functionality