Article

Balance and proprioceptive deficits are frequently persistent after
total joint replacement, limiting functionality and involving altered movement
patterns and difficulties in walking and maintaining postural control among patients. RESEARCH QUESTION:
The goal of this systematic review was to evaluate
the short- and mid-term effects of proprioceptive and balance training for
patients undergoing total knee and hip replacement.
METHODS: This is a systematic
review of literature. MEDLINE, Embase, Cochrane Library, PEDro, and Scopus were
the databases searched. The review included randomized clinical trials in which
the experimental groups underwent a training aimed at improving balance and
proprioception, in addition to conventional care.
The studies had to assess at
least one of the following outcomes: self-reported functionality or balance
(primary outcomes), knee function, pain, falls, or quality of life. RESULTS:
Eight trials were included, involving 567 participants.
The quantitative
synthesis found a moderate to high significant effect of balance and
proprioceptive trainings on self-reported functionality and balance after total
knee replacement. The effects were maintained at mid-term in terms of balance
alone. Conversely, preoperative training did not enhance outcomes after total hip
arthroplasty. SIGNIFICANCE: The synthesis showed that, in clinical terms, balance
trainings are a convenient complement to conventional physiotherapy care to
produce an impact on balance and functionality after knee replacement. If
outcomes such as improvement in pain, knee range of movement, or patient quality
of life are to be promoted, it would be advisable to explore alternative
proposals specifically targeting these goals. Further research is needed to
confirm or discard the current evidence ultimately, predominantly in terms of the
effects on the hips and those yielded by preoperative interventions.
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Langue : ANGLAIS