title: Intensive supervision of rehabilitation programme improves balance and functionality in the short term after bilateral total knee arthroplasty.
abstract: OBJECTIVE
  To evaluate the short-term results of the rehabilitation programme with two different supervision on balance and functionality after simultaneously bilateral total knee arthroplasty (SBTKA) in patients with osteoarthritis and to compare the results with those of healthy individuals.
  
  
  METHODS
  This study was a single-blind randomized controlled study. Two exercise groups who underwent primary bilateral total knee arthroplasty (Group 1, n = 20 and Group 2, n = 20) and a control group of healthy individuals (Group 3, n = 20) included in the study. Group 1 applied exercise programme with intensive supervision of the physiotherapist for a period of 1 month (2 days/1 week). Group 2 performed exercise programme under the control of same physiotherapist twice monthly (1 day/2 weeks), and the patients were checked every week by telephone interview. Pre-operative and post-operative blind evaluations were made at first and second month. Static balance with single leg stance test, dynamic balance with timed get up & go (TGUG), functionality with walking cadence, stair climbing test (SCT) and Western Ontario McMaster Universities (WOMAC) index were assessed.
  
  
  RESULTS
  Group 1 improved statistically significantly better in terms of SLST (p = 0.0 (right), p = 0.0 (left)) and WOMAC function (p = 0.0) at first month, and SLST (p = 0.0), TGUG (p = 0.0), SCT (p = 0.0), WOMAC pain (p = 0.0), stiffness (p = 0.0) and function (p = 0.0) at second month. In Group 1, TGUG, walking cadence, SCT, WOMAC pain, stiffness and function results reached the levels of healthy individuals at second month, and SLST was better for two legs as compared to healthy individuals. In Group 2, cadence results were similar to healthy individuals at second month.
  
  
  CONCLUSIONS
  The osteoarthritis patients who had the applied rehabilitation programme after SBTKA with intensive supervision of the physiotherapist for 1 month have obtained more improvements in balance and functional parameters, and it was demonstrated that their performances approached the healthy control group values. As a clinical relevance of our study, intensive supervision of rehabilitation programme should be provided to the patients after SBTKA surgery to accomplish early balance and functional improvements.
authors.affiliation: Department of Orthopaedics and Traumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Yıldız Analay
authors.initials: YA
authors.lastname: Akbaba
authors.affiliation: Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey. ipekyeldan@gmail.com.|Fizyoterapi ve Rehabilitasyon Bolumu, Saglık Bilimleri Fakultesi, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi Bahçesi içi, Istanbul Universitesi, Demirkapı Cad. Karabal Sk., Bakırköy, 34740, Istanbul, Turkey. ipekyeldan@gmail.com.
authors.forename: Ipek
authors.initials: I
authors.lastname: Yeldan
authors.affiliation: Department of Orthopaedics and Traumatology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Nejat
authors.initials: N
authors.lastname: Guney
authors.affiliation: Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, Istanbul, Turkey.
authors.forename: Arzu Razak
authors.initials: AR
authors.lastname: Ozdincler
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005684:Gait; D006801:Humans; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation / Q000601:surgery*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D020127:Recovery of Function; D016037:Single-Blind Method
keywords: Balance; Exercise; Functional; Knee osteoarthritis; Rehabilitation; Total knee arthroplasty