Effect of proprioceptive training on the postural stability of standing and gait function in post-operative unilateral total knee arthroplasty
Objective To investigate the effect of proprioceptive training on standing postural stability and gait function in unilateral total knee arthroplasty(TKA)patients.Methods From September 2022 to May 2023,43 patients with unilateral severe knee osteoarthritis undergoing TKA were selected at the Arthritis Department of Wangjing Hospital and randomly divided into the observation group(n = 20)and control group(n = 23).Patients in both groups participated in rehabilitation training for 6 weeks.The control group implemented the usual rehabilitation programme,while the observation group implemented a systematic proprioceptive training programme on the former basis.The DC-G-150-F2 plantar pressure test and 3D gait analysis system were used to assess the standing postural stability and gait function of the two groups before and 6 weeks later.Results There was no significant difference in the percentage of plantar pressure of the affected side,length,area,Sway-ML and Sway-AP in standing position with eyes open and closed(P>0.05)before treatment between the two groups.There was no significant difference in STV,GAI,affected side support phase and swing phase,stride length,stride width,stride frequency and stride speed during the walking process(P>0.05).After 6 weeks of treatment,the percentage of plantar pressure on the affected side,length,area,Sway-ML and sway-AP when standing with eyes open were significantly better in the observation group than the data before treatment,with statistically significant differences(P<0.05);The control group improved significantly in the percentage of plantar pressure of the affected side and Sway-AP compared to those before treatment,with statistically significant difference(P<0.05).Length,area and Sway-ML were all significantly better in the observation group than in the control group,with statistically significant differences(P<0.05).The observation group improved significantly in the percentage of plantar pressure of the affected side,length,area,Sway-ML and Sway-AP during standing with eyes closed compared to the data before treatment,with statistically significant differences(P<0.05);The control group improved significantly in the percentage of plantar pressure of the affected side and Sway-AP compared to the data before treatment,with statistically significant differences(P<0.05).Length,Area,Sway-ML and Sway-AP were all significantly better in the observation group than in the control group,with statistically significant differences(P<0.05).STV,GAI,affected side support phase and swing phase,stride length,stride width,stride frequency and stride speed during the walking process in the observation group were significantly improved compared with those before treatment,with statistically significant differences(P<0.05);STV,affected side support phase and swing phase,stride length,stride frequency and stride speed during the walking in the control group were significantly improved compared to those before treatment,with statistically significant differences(P<0.05).STV,GAI,affected sway phase,stride length,stride width,stride frequency and stride speed in the observation group were all significantly better than those in the control group,with statistically significant differences(P<0.05).Conclusions Proprioceptive training is effective in improving standing postural stability and gait function in patients with unilateral TKA,which should be included in the rehabilitation programme.The plantar pressure test and 3D gait analysis system should be used to conduct comprehensive and in-depth efficacy assessment for TKA patients.
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