Effect of Pre-surgery Neuromuscular Physiotherapy (PT)

Summary

Background:

Osteoarthritis (OA) is a common degenerative condition of large weight-bearing joints, such as the hip and knee, as well as small hand joints. Current interventions in patients with OA are limited to symptomatic pain relief and later with total joint replacement (TJR). While TJR improves function and pain, it does not fully restore function in most individuals. A key factor of functional outcome is probably conditioning before and after TJR surgery. However, this has not been studied conclusively in patients undergoing TKR surgery.

Objective:

1. Primary endpoint: To study the effect of a pre-surgery neuromuscular PT compared to an attention control program on lower extremity function measured by the Chair stands test (observed function) and the KOOS score (reported function).
2. Secondary endpoints will be muscle strength, walking time and mobility.

Hypothesis:

The investigators hypothesize that patients undergoing pre-surgery PT will be significantly quicker in performing the chair stands test and report a significant improvement in the KOOS at 3 months after surgery compared to controls.

Methods:

80 patients from a waiting list for unilateral TKR will be randomized to neuromuscular PT or an attention control group intervention in a single-blinded randomized controlled trial. Assessments will be at baseline, at 3 months after surgery and at 12 months after surgery.

Intervention:

The neuromuscular PT group will receive a minimum of 8 and a maximum of 24 training sessions; all patients, including the control group, will receive 4 sessions of the Knee School.

Significance:

Given the demographic change with an increase in the older segment of the population there will be a rise in the absolute number of TKRs. It is therefore warranted to study pre-surgery neuromuscular PT to help patients get the most out of their joint replacement.

Conditions

• Knee Osteoarthritis

Interventions

OTHER

preoperative neuromuscular training

The neuromuscular training group will receive a minimum of 8 and a maximum of 24 training sessions; as well as 4 sessions of the Knee OA School.

BEHAVIORAL

knee OA School

The education group will only receive 4 sessions of the Knee OA School.

Sponsors & Collaborators

• Kantonsspital Olten

  collaborator OTHER

• Kantonsspital Aarau

  collaborator OTHER

• Lund University

  collaborator OTHER

• Maastricht University

  collaborator OTHER

• University of Zurich

  lead OTHER

Principal Investigators

• Heike A Bischoff-Ferrari, MD, DrPH · UniversitaetsSpital Zuerich, Switzerland

• Ewa M Roos, PT, Prof Dr · University of Southern Denmark, Denmark

• Rob A de Bie, PT, Prof Dr · Maastricht University, Netherlands

• Christoph A Schwaller, MD, Dr · Kantonsspital Olten

• Marc Zumstein, MD, Dr · Kantonsspital Aarau, Switzerland

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2009-06-30

Primary Completion

2012-06-30

Completion

2013-06-30

Countries

• Switzerland

Study Locations