Effects of sensorimotor training volume on recovery of sensorimotor function in patients following lower limb arthroplasty.
BACKGROUND
Sensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, however, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, therefore, was to firstly quantify the progression of sensorimotor function after total hip (THA) or knee (TKA) arthroplasty and, as second step, to evaluate effects of different sensorimotor training volumes.


METHODS
58 in-patients during their rehabilitation after THA or TKA participated in this prospective cohort study. Sensorimotor function was assessed using a test battery including measures of stabilization capacity, static balance, proprioception, and gait, along with a self-reported pain and function. All participants were randomly assigned to one of three intervention groups performing sensorimotor training two, four, or six times per week. Outcome measures were taken at three instances, at baseline (pre), after 1.5 weeks (mid) and at the conclusion of the 3 week program (post).


RESULTS
All measurements showed significant improvements over time, with the exception of proprioception and static balance during quiet bipedal stance which showed no significant main effects for time or intervention. There was no significant effect of sensorimotor training volume on any of the outcome measures.


CONCLUSIONS
We were able to quantify improvements in measures of dynamic, but not static, sensorimotor function during the initial three weeks of rehabilitation following TKA/THA. Although sensorimotor improvements were independent of the training volume applied in the current study, long-term effects of sensorimotor training volume need to be investigated to optimize training stimulus recommendations.


BACKGROUND
Clinical trial registration number: DRKS00007894.
Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany. torsten.pohl@tum.de.
Torsten
T
Pohl
Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany. torsten.brauner@tum.de.
Torsten
T
Brauner
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. s.wearing@qut.edu.au.
Scott
S
Wearing
Medical Park Bad Wiessee St. Hubertus, Bad Wiessee, Germany. K.Stamer@medicalpark.de.
Knut
K
Stamer
Conservative and Rehabilitative Orthopedics, Technische Universität München, Faculty for Sport and Health Science, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany. t.horstmann@tum.de.|Medical Park Bad Wiessee St. Hubertus, Bad Wiessee, Germany. t.horstmann@tum.de.
Thomas
T
Horstmann
D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000639:trends*; D015331:Cohort Studies; D005081:Exercise Therapy / Q000639:trends*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000473:pathology / Q000502:physiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D011434:Proprioception / Q000502:physiology*; D011446:Prospective Studies; D011897:Random Allocation; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome