Abstract
Introduction:
Rehabilitation after total knee arthroplasty (TKA) is an essential component of treatment. Various protocols and methodologies have evolved to enhance the effect of rehabilitation in the postoperative period. We prospectively evaluated the effect of using an antigravity treadmill as an alternative to routine postoperative physical therapy.
Methods:
Twenty-nine patients undergoing unilateral primary TKA were randomized to either gait training (standard outpatient physical therapy) or to the use of an AlterG® antigravity device for gait training for 2 days/week for 4 weeks for a total of 8 therapy sessions. Average age was 68 and 55% were female. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and Timed Up and Go (TUG) test were collected at baseline (first therapy session), at final therapy session and at 3 months postoperatively. The numerical rating scale (NRS) for pain was measured at baseline and at end of therapy. Adverse events and complications were recorded.
Results:
All patients completed standard therapy and antigravity treadmill protocol without adverse events. KOOS, TUG and NRS scores improved in both groups but no statistically significant difference was apparent between groups. Overall, the greatest improvement was seen in the Sports/Recreation and Quality of Life subscales of the KOOS; scores improved from 23 and 32 to 67 and 69 at 3 months, respectively. TUG scores improved from 14 seconds to 7 seconds at 3 months. Pain, as measured on the NRS, improved from 2.8 to 1.1. Subjectively, therapists reported 100% satisfaction with the antigravity treadmill for use in postoperative TKA rehabilitation.
Conclusion:
This initial study demonstrated that an antigravity treadmill device was safe and effective for outpatient postoperative TKA rehabilitation. Further studies are warranted to better define the role of this device as an alternative or adjunct to currently established TKA rehabilitation protocols.
