According to research presented earlier this month, physician-diagnosed symptomatic knee osteoarthritis (OA) is occurring on average 16 years earlier in life than what was previously found in the 1990’s. The research performed at Brigham and Women’s Hospital and was presented at the American College of Rheumatology Annual Scientific Meeting in Chicago.
If the trend continues, the amount of healthcare utilization and especially the number of total knee replacement surgeries may need to be performed in the near future may dramatically increase. One result of such an increase was stated to be a significant increase in health care costs in the United States.
An Epub ahead of print at the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) describes a study done comparing outcomes following Total Knee Arthroplasty (TKA; also sometimes known as TKR for ‘Total Knee Replacement’). Two rehabilitation protocols were followed by the two different groups in the study.
The two groups 8 were age and sex-matched. One group followed a standard, lower intensity rehabilitation program while the second group followed a higher intensity program that progressed as tolerated. The high intensity (HI) group had an additional month of treatments but there were already significant differences between the two groups at the 3.5 weeks post TKA. The HI group also utilized machine-based strengthening while the lower intensity group only progressed to ankle weights or resistive bands.
The study found that those in the higher intensity group had superior strength and functional outcomes while not experiencing any increase in pain or decrease in range of motion (ROM). The HI group showed significantly greater short-term and long-term strength and function as measured at 3.5 weeks, 12weeks and 52 weeks .
It’s worth noting that the study only involved a small sample size and lacked randomization and blinding. However, the researchers believe that this illustrates that larger similar studies are warranted.
The University of West Indies, School of Physical Therapy, recently conducted a study on the use of the Wii as a adjunct to physical therapy treatment for children with cerebral palsy. The study was a small one, only involving six children, but the results they found were very positive.
The Wii was chosen largely because of it’s affordability compared to other gaming consoles, making it a much more likely candidate to be purchased by the families of children requiring treatment. Compared to standard physical therapy treatment costs the Wii is very affordable.
One of the primary reasons cited for the success of using video games as therapy is because of the much greater likelyhood that the children will actually take part in the therapy. The video games, while being physically challenging, are also engaging and make the children what to do their therapy.
It is believed that the neurological connections in the brain are strengthened by the new activities offered by the ‘virtual reality’ game play and that the plasticity of the brain allows it to do some ‘re-wiring’ as a result of the mental and physical stimulation.
Although this study involved children with cerebral palsy, the researchers are excited to explore the possibilities of using the Wii with people with cardiovascular impairments as well.
The Wellnes Blog at TIME.com recently posted a story describing a study done that showed the significant benefits a of Physical Therapy program on the reduction of postpartum depression in new moms. The study was conducted by the University of Melbourne’s Physiotherapy Department and was published in the journal Physical Therapy. In it the researchers found that women in the study showed a 50% less chance of experiencing postpartum depression.
The researchers state that more studies are necessary to confirm the benefits beyond the initial month that the study followed up.
The full text can be found here. A PDF version is also available.
Clinical Orthopaedics and Related Research recently published an article entitled “Quadriceps and Hamstrings Muscle Dysfunction after Total Knee Arthroplasty.” The article discusses a study of dysfunction in the quadriceps and hamstring muscles following Total Knee Arthroplasty (TKA).
Using bilateral isometric strength tests and EMG measures of quads / hams co-activation the study found that the difference in loss of strength between the muscle groups was not significant; both were weakened equally.
The authors claim that in post TKA rehab the hamstrings are often neglected relative to the emphasis placed on quadricep strengthening and retraining. Their conclusion from this study is that the hamstrings should be included with the quadriceps as the primary focus in post total knee arthroplasty rehabilitation.