Effectiveness of a Community-based Multi-modal Tai Chi Rehabilitation Program for Patients After Total Knee Arthroplasty

The Hong Kong Polytechnic University

Status: Completed

Conditions: Total Knee Arthroplasty

Treatments: Other: 12-week community-based multi-model Tai Chi rehabilitation program; Other: Usual post-operative care; Other: Untreated asymptomatic controls

Study type: Interventional

Funder types: Other

Identifiers

NCT03565380

HSEARS20171225001AW

Details and patient eligibility

About

The rate of falls in patients after total knee arthroplasty (TKA) is high and related to lower limb muscle weakness and poor balance control. However, since routine post-TKA rehabilitation is uncommon, it is paramount to explore alternative strategies to enhance balance and physical functioning in post-TKA patients. As Tai Chi is a proven strategy for improving balance in older people, the proposed study aims to determine the feasibility and acceptability of a 12-week community-based post-TKA multimodal Tai Chi program and to collect preliminary data with respect to the efficacy of such a program in improving balance and physical functioning in post-TKA patients as compared to usual postoperative care.

Full description

This is a single-blinded 2-arm RCT. TKA participants will be randomized to either a 12-week community-based rehabilitation program starting at 12 weeks after TKA, or usual post-operative care without outpatient physiotherapy. A third group of asymptomatic controls will be recruited to provide comparisons at various time points. All post-TKA participants will undergo five clinical assessments: 1 week before TKA, and at 6, 12, 24 and 52 weeks after TKA. The untreated asymptomatic controls will be assessed at baseline, and 12 and 52 weeks from baseline

Enrollment: 53 patients

Sex: All

Ages: 60 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. 60 years or above;
2. candidates for primary unilateral TKA who are placed on the TKA waiting list for less than 1 month before their surgery;
3. living independently in the community

Exclusion criteria

1. living in assisted living facilities, requiring nursing care, or planning to reside away from the hospital district within 1 year.
2. unstable medical conditions,
3. fracture of lower limbs,
4. malignancy in the last five years,
5. lower limb prosthesis/amputation,
6. congenital defect that is considered to cause the present complaint,
7. systemic inflammatory and autoimmune diseases,
8. previous osteotomy,
9. neurological diseases (e.g. Parkinson's disease, stroke),
10. blindness, revision TKA,
11. complications after primary TKA,
12. cognitive impairment with a Mini-Mental State Examination score < 19
13. prior experience in practicing Tai Chi exercise for at least 3 months

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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53 participants in 3 patient groups

Patients with intervention

Experimental group

Description:

12-week community-based Tai Chi rehabilitation program starting at 12 weeks after TKA

Treatment:

Other: 12-week community-based multi-model Tai Chi rehabilitation program

Patients without intervention

Experimental group

Description:

usual post-operative care

Treatment:

Other: Usual post-operative care

Asymptomatic controls

Experimental group

Description:

untreated asymptomatic controls

Treatment:

Other: Untreated asymptomatic controls