INTENSIVE EXERCISE THERAPY ON FUNCTION AND QUALITY OF LIFE IN PATIENTS WITH TOTAL KNEE REPLACEMENT

Abstract

Background: Total Knee Replacement (TKR) is a common orthopaedic procedure aimed at relieving pain and restoring function in patients with severe knee osteoarthritis. Postoperative rehabilitation is crucial for optimizing patient outcomes. However, the comparative efficacy of routine physical therapy (RPT) versus intensive exercise therapy (IET) in the postoperative recovery phase remains under-explored. Objective: To evaluate the intensive exercise therapy compared to routine physical therapy on function and quality of life in patients following TKR. Methods: A Randomized Controlled Trial was conducted at the Department of Hidayat Physiotherapy and Rehabilitation Centre in Sukkur. The study spanned 9 months following the approval of the synopsis. Initially, the study was designed to include 58 participants across both groups. However, considering the likelihood of dropouts, an additional 20% was factored in, raising the total to 70 participants, with each group comprising 35 individuals. Intervention efficacy was assessed using the Oxford Knee Score (OKS), SF-12 Physical and Mental Component Summary scores, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) across various domains at baseline, 6 weeks, and 12 weeks postoperatively. Statistical analysis employed the Mann-Whitney U test for between-group comparisons and Chi-square tests for within-group changes, with a significance level set at P<0.05. Results: At baseline, no significant differences were observed between groups in demographic or clinical characteristics. The IET group demonstrated significantly greater improvements than the RPT group at week 6 and 12 in OKS (Week 6: RPT mean rank = 20.09, IET mean rank = 50.91, P<0.000; Week 12: RPT mean rank = 22.47, IET mean rank = 48.53, P<0.000), SF-12 PCS, and all domains of KOOS. Significant within-group improvements were noted in both groups across all outcome measures, with IET showing superior enhancements. Conclusion: Intensive exercise therapy significantly improves function and quality of life compared to routine physical therapy in TKR patients. These findings advocate for the integration of tailored, intensive exercise programs in the rehabilitation protocol post-TKR to maximize recovery.