title: Functional outcomes of outpatient balance training following total knee replacement in patients with knee osteoarthritis: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate whether balance training after total knee replacement surgery improves functional outcomes and to determine whether postoperative balance is associated with mobility.
  
  
  METHODS
  A prospective intervention study and randomized controlled trial with an intention-to-treat analysis.
  
  
  METHODS
  The rehabilitation center of a university-based teaching hospital.
  
  
  METHODS
  A total of 130 patients with knee osteoarthritis who had undergone total knee replacement surgery were recruited to attend an outpatient rehabilitation program. They were randomly allocated to additional balance rehabilitation and functional rehabilitation groups.
  
  
  METHODS
  During the eight-week outpatient rehabilitation program, both groups received general functional training. Patients in the balance rehabilitation group received an additional balance-based rehabilitation program.
  
  
  METHODS
  The functional reach test, single-leg stance test, 10-m walk test, Timed Up and Go Test, timed chair-stand test, stair-climb test, and Western Ontario and McMaster Universities Osteoarthritis Index were measured at baseline, eight weeks (T(1)), and 32 weeks (T(2)).
  
  
  RESULTS
  The balance rehabilitation group patients demonstrated significant improvement in the results of the functional reach test at T(1) (37.6 ±7.8 cm) and T(2) (39.3 ±9.7 cm) compared with the baseline assessment (11.5 ±2.9 cm) and Timed Up and Go Test at T(1) (8.9 ±1.2 seconds) and T(2) (8.0 ±1.9 seconds) compared with the baseline assessment (12.5 ±1.8 seconds). Moreover, the balance rehabilitation group patients exhibited significantly greater improvements in balance and mobility than did the functional rehabilitation group patients (all P < 0.001). Furthermore, improved balance was significantly associated with improved mobility at T(2).
  
  
  CONCLUSIONS
  Postoperative outpatient rehabilitation with balance training improves the balance, mobility, and functional outcomes in patients with knee osteoarthritis after total knee replacement.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chun-De
authors.initials: CD
authors.lastname: Liao
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Li-Fong
authors.initials: LF
authors.lastname: Lin
authors.affiliation: Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Huang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Lin-Chuan
authors.initials: LC
authors.lastname: Chou
authors.affiliation: Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan peter_liou@s.tmu.edu.tw.
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D019645:Arthroplasty, Replacement, Knee; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome
keywords: Total knee replacement; balance training; functional outcome; mobility