EFFICACY OF PERTURBATION TRAINING IN IMPROVING BALANCE AND FUNCTION IN THE MANAGEMENT OF KNEE OSTEOARTHRITIS
DOI:
https://doi.org/10.15621/ijphy/2019/v6i4/185414Keywords:
Knee osteoarthritis, Perturbation training, Balance training, Timed get up and go test, Physiotherapy management, Functional reach testAbstract
Background: Subjects who are suffering from osteoarthritis of the knee will have problems including progressive loss of function, depending on walking, climbing stairs, and it may affect lower extremity functions. Balance is a major component required for the activities of daily living and functions. The objective of the study was to compare the effectiveness of perturbation training and conventional physiotherapy in improving balance and function in the rehabilitation of knee osteoarthritis.
Method: Study design was an experimental study. Thirty subjects (16 males and 14 females) suffering from knee osteoarthritis were randomized into a control group and experimental group. Fifteen subjects in the control group were treated with traditional methods like ultrasound, stretching and strengthening, and fifteen subjects in the experimental group were given perturbation training along with the conventional method. Outcome measures used were Timed get up and go test score (TUG) and Functional reach test score (FRT) scales, pre-assessed on Day 1. Each group received 14 sessions of treatment, after which post-assessment of outcome measures was done.
Results: Timed get up and go test score was reduced in both groups after training, which was statistically significant (p<.05). The functional reach test score was increased after training in both groups, which was statistically significant
(p<.05). However, comparing between groups, the experimental group showed more reduction in TUG score and improvement in the FRT score, which was statistically significant (p<.05).
Conclusion: Perturbation training given with conventional treatment was found to have a significantly better effect in improving the function of the lower extremity in OA knee subjects. However, a well-designed trial, including a larger sample size with repeated measurements, is needed to find out the effectiveness of training with perturbation in the management of knee osteoarthritis and generalize it in a larger population.
References
Van Saase, J.L.C.M., Van Romunde, L.K.J., Cats A, Vandenbroucke J.P., Valkenburg H.A.,1989 Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of Radiological Osteoarthritis in a Dutch Population with that in 10 other Populations. Ann Rheum Dis 48(1):271-280.
Davis MA, Ettinger WH, Neuhaus JM, Mallon KP. Knee osteoarthritis and physical functioning: Evidence from the NHANES I epidemiologic follow-up study. J Rheumatol 1991;18(1):591–598.
Guccione AA, Felson DT, Anderson JJ et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994;84(1):351–8.
Rothfuss J, Mau W, Zeidler H, Brenner MH. Socioeconomic evaluation of rheumatoid arthritis and osteoarthritis: A literature review. Semin Arthritis Rheum 1997;26(1):771–9.
Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: A review. Neurobiol Aging 1989;10(1):727–38.
Stelmach GE, Teasdale N, Di Fabio RP, Phillips J. Age related decline in postural control mechanisms. Int J Aging Human Dev 1989;29(1):205–23.
Jones G. Posture. In: Kandel E, Schwartz J, Jessell T, eds. Principles of neural science. New York: McGraw-Hill, 2000:816–31.
Hurwitz DE, Ryals AR, Block JA, Sharma L, Schnitzer TJ, Andriacchi TP. Knee pain and joint loading in subjects with osteoarthritis of the knee. J Orthop Res 2000;18(1):572–9.
Brocklehurst JC, Robertson D, James-Groom P. Skeletal deformities in the elderly and their effect on postural sway. J Am Geriatr Soc 1982;30(1):534–8.
Potter PJ, Kirby RL, MacLeod DA. The effects of simulated knee-flexion contractures on standing balance. Am J Phys Med Rehabil 1990;69(2):144–7.
Minor MA: Exercise in the treatment of osteoarthritis. Rheum Dis Clin North Am 1999;25(3):397–415.
Terese L Chmielewski, Wendy J Hurd, Katherine S Rudolph, Michael J Axe, Lynn Snyder-Mackler Perturbation Training Improves Knee Kinematics and Reduces Muscle Co-contraction After Complete Unilateral Anterior Cruciate Ligament Rupture Phys Ther. 2005;85(1):740 –754.
Angela Foster and Nigel Palastanga: Clyton’s Electrotherapy Theory and Practice.
A.I.T.B.S Publishers 2000;9th edition. 165-179.
Carolyn Kisner and Lynn Allen Colby: Therapeutic Exercise Foundation And Techniques. Jaypee Publishers 2003;4th edition: 506- 557.
Heather E. Stokes, Jessica D. Thompson & Jason R. Franz The Neuromuscular Origins of Kinematic Variability during Perturbed Walking Scientific Reports 2016; 1st edition.
G Kelley Fitzgerald, John D Childs: Agility and Perturbation Training for a Physically Active Individual With Knee Osteoarthritis Physical Therapy 2002;82(4).
Hall M.C, Brody LT: Therapeutic Exercises: Movement towards function.1st Edition. Williams and Wilkins 999(1):130-132
Susan.B.O’Sullivan: Physical Rehabilitation Assessment and Treatment. 4th Edition. Jaypee Brothers;2001:689-702.
Davis MA, Ettinger WH, Neuhaus JM, Mallon KP. Knee osteoarthritis and physical functioning: evidence from the NHANES I Epidemiologic Follow-up Study. J Rheumatol 1991;18(1):591–8.
Fitzgerald GK, Piva SR, Irrgang JJ. Reports of joint instability in knee osteoarthritis: its prevalence and relationship to physical function. Arthritis Rheum. 2004;51(1):941–946.
Published
Abstract Display: 1545 
PDF Downloads: 1468 How to Cite
Issue
Section
Copyright © Author(s) retain the copyright of this article.
This work is licensed under a