• Chun-De Liao, Li-Fong Lin, Yi-Ching Huang, Shih-Wei Huang, Lin-Chuan Chou, and Tsan-Hon Liou.
• Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
• Clin Rehabil. 2015 Sep 1; 29 (9): 855-67.

ObjectiveTo evaluate whether balance training after total knee replacement surgery improves functional outcomes and to determine whether postoperative balance is associated with mobility.DesignA prospective intervention study and randomized controlled trial with an intention-to-treat analysis.SettingThe rehabilitation center of a university-based teaching hospital.ParticipantsA 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.InterventionsDuring 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.Primary Outcome MeasuresThe 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)).ResultsThe 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).ConclusionPostoperative outpatient rehabilitation with balance training improves the balance, mobility, and functional outcomes in patients with knee osteoarthritis after total knee replacement.© The Author(s) 2014.

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