Nikolaos Markopoulos, Thomas Apostolou, Ilias Kallistratos, Dimitrios Lytras, Paris Iakovidis
{"title":"全膝关节置换术后老年骨关节炎患者本体感觉神经肌肉易化和局灶振动的影响：一项随机临床试验研究。","authors":"Nikolaos Markopoulos, Thomas Apostolou, Ilias Kallistratos, Dimitrios Lytras, Paris Iakovidis","doi":"10.1177/10538127241304932","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative balance disorders in older adults after total knee arthroplasty (TKA) due to osteoarthritis are commonly attributed to proprioceptive joint deficits. Both Proprioceptive Neuromuscular Facilitation (PNF) and Focal Vibration (FV) can improve balance and proprioception.</p><p><strong>Aim: </strong>To examine the combination of a PNF exercise program and quadriceps tendon FV in older adults after TKA due to osteoarthritis.</p><p><strong>Methods: </strong>Ninety older adults who underwent TKA were randomly assigned to three groups of 30. The PNF Group followed a 6-week PNF exercise program starting four weeks post-surgery. The PNF + FV Group followed the same PNF program combined with FV applied to the rectus femoris and vastus medialis. The control group received instructions for a home-based exercise program. Pain (Numeric Pain Rating Scale; NPRS), knee range of motion (ROM), functional ability (Knee Injury and Osteoarthritis Outcome Score, KOOS), joint position sense (JPS), postural sway (force platform), and balance (Timed Up-and-Go; TUG test, Berg Balance Scale; BBS) were evaluated at baseline, six weeks, and six months post-intervention. A two-way repeated measures ANOVA analysis was applied with significance set at p < .05.</p><p><strong>Results: </strong>The PNF + FV group showed significant improvements compared to the control group in NPRS, KOOS, TUG, BBS, displacement parameters, and absolute error scores (p < .05). The PNF + FV group showed earlier improvements compared to the PNF group, indicating faster adjustments due to the combined effect of PNF and FV. Additionally, the PNF + FV group showed greater improvement in TUG, BBS, KOOS sport, anterior-posterior displacement distance, and absolute error scores at 25° compared to the PNF group (p < .05). PNF exercises improved knee ROM (p < .05) with no additional effect from FV.</p><p><strong>Conclusions: </strong>A 6-week protocol combining PNF exercises and FV significantly improved balance, knee joint position sense, knee functional ability, and pain intensity in older adults after TKA due to osteoarthritis. These findings suggest faster and more effective rehabilitation, potentially reducing postoperative disorders and future injury risks. Further research is needed to investigate the combination of FV and PNF.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127241304932"},"PeriodicalIF":1.4000,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of proprioceptive neuromuscular facilitation and focal vibration in older adults with osteoarthritis after total knee arthroplasty: A randomized clinical trial study.\",\"authors\":\"Nikolaos Markopoulos, Thomas Apostolou, Ilias Kallistratos, Dimitrios Lytras, Paris Iakovidis\",\"doi\":\"10.1177/10538127241304932\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Postoperative balance disorders in older adults after total knee arthroplasty (TKA) due to osteoarthritis are commonly attributed to proprioceptive joint deficits. Both Proprioceptive Neuromuscular Facilitation (PNF) and Focal Vibration (FV) can improve balance and proprioception.</p><p><strong>Aim: </strong>To examine the combination of a PNF exercise program and quadriceps tendon FV in older adults after TKA due to osteoarthritis.</p><p><strong>Methods: </strong>Ninety older adults who underwent TKA were randomly assigned to three groups of 30. The PNF Group followed a 6-week PNF exercise program starting four weeks post-surgery. The PNF + FV Group followed the same PNF program combined with FV applied to the rectus femoris and vastus medialis. The control group received instructions for a home-based exercise program. Pain (Numeric Pain Rating Scale; NPRS), knee range of motion (ROM), functional ability (Knee Injury and Osteoarthritis Outcome Score, KOOS), joint position sense (JPS), postural sway (force platform), and balance (Timed Up-and-Go; TUG test, Berg Balance Scale; BBS) were evaluated at baseline, six weeks, and six months post-intervention. A two-way repeated measures ANOVA analysis was applied with significance set at p < .05.</p><p><strong>Results: </strong>The PNF + FV group showed significant improvements compared to the control group in NPRS, KOOS, TUG, BBS, displacement parameters, and absolute error scores (p < .05). The PNF + FV group showed earlier improvements compared to the PNF group, indicating faster adjustments due to the combined effect of PNF and FV. Additionally, the PNF + FV group showed greater improvement in TUG, BBS, KOOS sport, anterior-posterior displacement distance, and absolute error scores at 25° compared to the PNF group (p < .05). PNF exercises improved knee ROM (p < .05) with no additional effect from FV.</p><p><strong>Conclusions: </strong>A 6-week protocol combining PNF exercises and FV significantly improved balance, knee joint position sense, knee functional ability, and pain intensity in older adults after TKA due to osteoarthritis. These findings suggest faster and more effective rehabilitation, potentially reducing postoperative disorders and future injury risks. Further research is needed to investigate the combination of FV and PNF.</p>\",\"PeriodicalId\":15129,\"journal\":{\"name\":\"Journal of Back and Musculoskeletal Rehabilitation\",\"volume\":\" \",\"pages\":\"10538127241304932\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-02-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Back and Musculoskeletal Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10538127241304932\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Back and Musculoskeletal Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10538127241304932","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Effect of proprioceptive neuromuscular facilitation and focal vibration in older adults with osteoarthritis after total knee arthroplasty: A randomized clinical trial study.
Background: Postoperative balance disorders in older adults after total knee arthroplasty (TKA) due to osteoarthritis are commonly attributed to proprioceptive joint deficits. Both Proprioceptive Neuromuscular Facilitation (PNF) and Focal Vibration (FV) can improve balance and proprioception.
Aim: To examine the combination of a PNF exercise program and quadriceps tendon FV in older adults after TKA due to osteoarthritis.
Methods: Ninety older adults who underwent TKA were randomly assigned to three groups of 30. The PNF Group followed a 6-week PNF exercise program starting four weeks post-surgery. The PNF + FV Group followed the same PNF program combined with FV applied to the rectus femoris and vastus medialis. The control group received instructions for a home-based exercise program. Pain (Numeric Pain Rating Scale; NPRS), knee range of motion (ROM), functional ability (Knee Injury and Osteoarthritis Outcome Score, KOOS), joint position sense (JPS), postural sway (force platform), and balance (Timed Up-and-Go; TUG test, Berg Balance Scale; BBS) were evaluated at baseline, six weeks, and six months post-intervention. A two-way repeated measures ANOVA analysis was applied with significance set at p < .05.
Results: The PNF + FV group showed significant improvements compared to the control group in NPRS, KOOS, TUG, BBS, displacement parameters, and absolute error scores (p < .05). The PNF + FV group showed earlier improvements compared to the PNF group, indicating faster adjustments due to the combined effect of PNF and FV. Additionally, the PNF + FV group showed greater improvement in TUG, BBS, KOOS sport, anterior-posterior displacement distance, and absolute error scores at 25° compared to the PNF group (p < .05). PNF exercises improved knee ROM (p < .05) with no additional effect from FV.
Conclusions: A 6-week protocol combining PNF exercises and FV significantly improved balance, knee joint position sense, knee functional ability, and pain intensity in older adults after TKA due to osteoarthritis. These findings suggest faster and more effective rehabilitation, potentially reducing postoperative disorders and future injury risks. Further research is needed to investigate the combination of FV and PNF.
期刊介绍：
The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day.
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