Acceptability and feasibility of a community-based strength, balance, and Tai Chi rehabilitation program in improving physical function and balance of patients after total knee arthroplasty: study protocol for a pilot randomized controlled trial
Author: Cathy W T Lo1, Matthew A Brodie2, William W N Tsang3, Chun-Hoi Yan4, Priscillia L Lam5, Chun-Ming Chan6, Stephen R Lord2, Arnold Y L Wong7
Affiliation:
1 Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
2 Neuroscience Research Australia, University of New South Wales, Randwick, Sydney, Australia.
3 Department of Physiotherapy, The Open University of Hong Kong, Hong Kong SAR, China.
4 Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, China.
5 Department of Physiotherapy, Queen Mary Hospital, Hong Kong SAR, China.
6 Department of Orthopaedics and Traumatology, Yan Chai Hospital, Hong Kong SAR, China.
7 Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China. arnold.wong@polyu.edu.hk.
Conference/Journal: Trials
Date published: 2021 Feb 11
Other:
Volume ID: 22 , Issue ID: 1 , Pages: 129 , Special Notes: doi: 10.1186/s13063-021-05055-5. , Word Count: 352
Background:
The rate of falls in patients after total knee arthroplasty (TKA) is high and related to lower limb muscle weakness and poor balance control. However, since routine post-TKA rehabilitation is uncommon, it is paramount to explore alternative strategies to enhance balance and physical functioning in post-TKA patients. As Tai Chi is a proven strategy for improving balance in older people, the proposed study aims to determine the feasibility and acceptability of a 12-week community-based post-TKA multimodal Tai Chi program and to collect preliminary data with respect to the efficacy of such a program in improving balance and physical functioning in post-TKA patients as compared to usual postoperative care.
Methods:
A single-blinded 2-arm pilot randomized controlled trial will recruit 52 community-dwelling post-TKA patients (aged > 60 years) in Hong Kong. In addition, 26 untreated asymptomatic controls will be recruited for comparison purposes. The TKA patients will be randomized into either a 12-week multimodal Tai Chi rehabilitation group or a postoperative usual care group (26 each). Participants will perform the outcome assessments at baseline, 6, 12, 24, and 52 weeks after TKA, while asymptomatic controls will have the same assessments at baseline, 12, and 52 weeks after baseline. The rate of recruitment, retention, and attrition, as well as adherence to the intervention, will be measured and used to determine the feasibility of the study and whether a full-scale effectiveness trial is warranted. Further, qualitative interviews will be conducted to explore the acceptability and possible barriers to the implementation of the intervention. Primary and secondary outcomes including both patient-reported surveys and performance-based tests will be compared within and between groups.
Discussion:
The study will determine the feasibility and acceptability/potential efficacy of community-based rehabilitation for post-TKA patients and assess whether the intervention has the potential to be assessed in a future fully powered effectiveness trial. The findings will also be used to refine the study design and guide the conduction of a future definitive randomized controlled trial.
Trial registration:
ClinicalTrials.gov NCT03615638. Registered on 30 May 2018. https://clinicaltrials.gov/ct2/show/NCT03565380.
Keywords: Balance; Coordination; Falls; Lower limb muscle strength; Multi-faceted intervention; Prevention; Rehabilitation; Tai Chi; Total knee replacement.
PMID: 33573664 DOI: 10.1186/s13063-021-05055-5
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