Journal of Convergence for Information Technology (융합정보논문지)

Convergence Society for SMB (중소기업융합학회)
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The Effects of Active Exercise Program using Sling on the Pain and Balance Following Total Knee Replacement

슬링을 이용한 능동 운동프로그램이 무릎 관절 전치환술 환자의 통증과 균형에 미치는 영향

  • Received : 2021.12.16
  • Accepted : 2022.02.20
  • Published : 2022.02.28
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Abstract

This study was conducted to investigate the effect of the active exercise program using sling on the pain and balance of total knee replacement patients. Subjects were 20 patients who received total knee replacement and are hospitalized, 10 patients in each group were randomly assigned to a group (CPM group) that applied only CPM (Continuous passive motion) and a group (CSG) that combined CPM with a active exercise program using sling. CG was performed CPM 5 days a week, CSG performed CPM 2 days a week and a active exercise program using sling 3 days a week, and each intervention was performed for 40 minutes a day for a total of 4 weeks. Pain was evaluated using VAS (Visual analog scale), and balance was measured using BT4 (Balance training 4) to measure C90 area, trace length, and Sway average velocity with eyes open and closed. As a result, there was a significant decrease in pain in both groups, and there was also a significant difference in the amount of change between groups. In balance, all variables except C90 of CG showed significant changes after intervention, and there was a significant difference between C90 and Vel with eyes closed in the amount of change between groups. Therefore, we believe that CPM and active exercise program using sling are effective interventions to reduce pain and improve balance in total knee replacement patients.

본 연구는 슬링을 이용한 능동 운동프로그램이 무릎 관절 전치환술 환자의 통증과 균형에 미치는 영향을 알아보고자 실시하였다. 대상자는 무릎 관절 전치환술을 받고 입원 중인 환자 20명이며, 수술 후에 CPM (Continuous passive motion) 만을 적용하는 집단 (CPM group; CG)과 CPM과 슬링을 이용한 능동 운동프로그램을 병행하는 집단 (CPM with active exercise program using sling group; CSG)으로 10명씩 무작위로 배치되었다. CG는 CPM을 주 5일, CSG는 CPM을 주 2일, 슬링을 이용한 능동 운동프로그램을 주 3일 실시하였고, 각 중재는 하루 40분씩 총 4주간 실시하였다. 통증은 VAS(Visual analog scale)을 이용하여 평가하였고, 균형은 BT4 (Balance training 4)를 이용하여 C90 area, Trace length, Sway average velocity를 눈을 뜬 상태와 감은 상태로 측정하였다. 그 결과, 두 집단 모두 통증에서 집단 내에서 유의하게 감소하였고, 집단 간의 변화량에서도 유의한 차이가 있었다. 균형에서 CG의 C90을 제외한 모든 변인이 중재 후 유의한 변화가 있었으며, 집단 간 변화량에서는 눈을 감은 상태의 C90과 Vel에서 유의한 차이가 있었다. 따라서 CPM과 슬링을 이용한 능동 운동프로그램을 함께 시행하는 것은 무릎 관절 전치환술 환자의 통증 감소와 균형 향상에 효과적인 중재라고 생각한다.

Keywords

References

  1. Health Insurance Review & Assessment Service & National Health Insurance Service, (2021). 2020 National Health Insurance Statistical Yearbook. Seoul : Kyungsung.
  2. J. H. Yu & H. J. Lee. (2016). Effects of motivational interviewing intervention for patients with total knee replacement. Journal of Muscle and Joint Health, 23(3), 139-151. DOI : 10.5953/JMJH.2016.23.3.139
  3. S. J. Park & J. H. Lee. (2016). Effect of joint mobilization and kinesio taping on pain, range of motion, and knee function in patients with knee osteoarthritis. The Korea Society of Physical Therapy, 28(5), 279-285. DOI : 10.18857/jkpt.2016.28.5.279
  4. H. S. Min, Y. H. Jung, E. S. Kim, S. H. Kim & Y. J. Choi. (2011). Effects of muscle strengthening exercise program on pain, fatigue, physical function in elderly women with total knee arthroplasty. Journal of Muscle and Joint Health. 18(2), 203-214. DOI : 10.5953/JMJH.2011.18.2.203
  5. The Korean Orthopaedic Association. (2019). Rehabilitation after total knee arthroplasty [Internet]. Seoul: Korean Orthopaedic Association. https://www.koa.or.kr/info/index_10_7.php
  6. S. H. Lee, Y. J. Kim, H. J. Baik & J. H. Kim. (2006). A comparison of patient-controlled epidural analgesia and continuous epidural analgesia after total knee arthroplasty in elderly patients over 60 years of age. Korean Journal of Anesthesiology. 50(3), 285-291. DOI : 10.4097/kjae.2006.50.3.285
  7. R. N. Maniar, J. V. Baviskar, T. Singhi & S. S. Rathi. (2012). To use or not to use continuous passive motion post-total knee arthroplasty presenting functional assessment results in early recovery. The Journal of Arthroplasty. 27(2), 193-200. DOI : 10.1016/j.arth.2011.04.009
  8. M. Synder, P. Kozlowski, M. Drobniewski, A. Grzegorzewski & A. Glowacka. (2004). The use of continuous passive motion (CPM) in the rehabilitation of patients after total knee arthroplasty. Orthopedia, Traumatologia, Rehabilitacja. 6(3), 336-341. PMID: 17675995.
  9. S. Milne et al. (2003). Continuous passive motion following total knee arthroplasty. Cochrane Database of Systematic Reviews. (2), CD004260. DOI : 10.1002/14651858.CD004260
  10. J. A. Herbold et al. (2014). Randomized controlled trial of the effectiveness of continuous passive motion after total knee replacement. Archives of Physical Medicine and Rehabilitation. 95(7), 1240-1245. DOI : 10.1016/j.apmr.2014.03.012
  11. W. H. Gage, J. S. Frank, S. D. Prentice & P. Stevenson. (2008). Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations. Gait & posture, 27(2), 286-293. DOI : 10.1016/j.gaitpost.2007.04.006
  12. J. O. Kim, B. J. Park, H. K. Lim & K. H. Noh. (2006). Balance in Patients After TKA. Knee Surgery & Related Research, 18(2), 167-174. UCI(KEPA) I410-ECN-0102-2009-510-000015171
  13. J. H. Yu, S. M. Jeong & H. S. Park. (2013). The Effect of 3 Balance Training Programs on Improving Capabilities of Balancing among Some Female Students. The Journal of the Korea Institute of Electronic Communication Sciences, 8(4), 619-629. DOI : 10.13067/JKIECS.2013.8.4.619
  14. G. C. Gauchard, G. Vancon, P. Meyer, D. Mainard & P. P. Perrin. (2010). On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis. Gait & posture, 32(2), 155-160. DOI : 10.1016/j.gaitpost.2010.04.002
  15. M. V. Radomski & C. A. Latham. (2008). Occupational therapy for physical dysfunction. Baltimore, MD [etc.] : Wolters Kluwer/Lippincott Williams & Wilkins.
  16. R. S. Hinman, M. A. Hunt, M. W. Creaby, T. V. Wrigley, F. J. McManus & K. L. Bennell. (2010). Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis care & research, 62(8), 1190-1193. DOI : 10.1002/acr.20199
  17. S. R. Piva, P. E. Teixeira, G. J. Almeida, A. B. Gil, A. M. 3rd. DiGioia, T. J. Levison & G. K. Fitzgerald. (2011). Contribution of hip abductor strength to physical function in patients with total knee arthroplasty. Physical therapy, 91(2), 225-233. DOI : 10.2522/ptj.20100122
  18. J. S. Yoon. (2016). The effect of quadriceps isometric exercise method on pain, muscle strength and balance of early phase of total knee arthroplasty patients. Master's thesis. Daegu University. Daegu. http://www.riss.kr/link?id=T14224003
  19. Y. J. Son. (2019). Immediate effect on muscle strength after quadriceps muscle fatigue regarding applying directions of kinesiology tape on the patella.. Master's thesis. Dong-eui University, Busan. http://www.riss.kr/link?id=T15063342
  20. J. H. Lee. (2010). Effect of lower extremity patterns of proprioceptive neuromuscular facilitation on pain and balance in total knee replacement. Master's thesis. Daegu University. Daegu. http://www.riss.kr/link?id=T12138739
  21. K. B. Lim. (2009). The effect of balance and pain in the osteoarthritis patients after bio-feedback and strengthening exercises. Maste'sr thesis. Daegu University. Daegu. http://www.riss.kr/link?id=T11846479
  22. T. P. Stitik, R. J. Kaplan, L. B. Kamen, A. N. Vo, A. A. Bitar & V. C. Shih. (2005). Rehabilitation of orthopedic and rheumatologic disoder. 2. Osteoarthritis assessment, treatment, and rehabilitation. Archives of Physical Medicine and Rehabilitation. 86 (Suppl 1), S48-S55. DOI : 10.1016/j.apmr.2004.12.010
  23. J. F. Sarwark. (2010). Essentials of musculoskeletal care. 4th ed. Park JH, Lee YJ, translator. Rosemount, IL : American Academy of Orthopaedic Surgeons.
  24. J. K. Lee. (2008). Effects of Fitness Profiles and the Correlations between Falling Risk and Fitness Variables in the Elderly Women by Sling Exercise Program. Journal of Sport and Leisure Studies, 32. 1119-1126. UCI : G704-000763.2008..32.089 https://doi.org/10.51979/KSSLS.2008.05.32.1119
  25. W. T. Gong. (2015). Effects of bridge exercises with a sling and vibrations on abdominal muscle thickness in healthy adults. Journal of back and musculoskeletal rehabilitation, 28(4), 645-649. DOI : 10.3233/BMR-140560
  26. A. H. Saeterbakken, R. van den Tillaar & S. Seiler. (2011). Effect of core stability training on throwing velocity in female handball players. Journal of strength and conditioning research, 25(3), 712-718. DOI : 10.1519/JSC.0b013e3181cc227e
  27. A. Mau-Moeller, M. Behrens, S. Finze, S. Bruhn, R. Bader & W. Mittelmeier. (2014). The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study. Health and quality of life outcomes, 12, 68. DOI : 10.1186/1477-7525-12-68
  28. M. D. Kim, H. S. Ku, E. J. Lee, H. J. Lee, C. H. Jeong & D. H. Lee. (2015). Comparison of Trunk Stabilization Muscle Activity According to Change of the Sling Height and Hip Abduction, Adduction during Bridging Exercise. Korea Academy Industrial Cooperation Society. 588-590. URL: http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE07217732
  29. G. E. Park & T. K. Han. (2018). The Effect of Acute Neck Sling Exercise on the Range of Motion, Muscle Strength, Visual Analog Scale in University Students. The Korean Journal of Sport. 16(1), 415-422. https://www.earticle.net/Article/A325232
  30. C. H. Bae, Y. W. Jung, D. W. Lee & S. H. Cho. (2014). The Effect of Sling Exercise on Muscular Strength and Range of Motion in Female Patients who Received Total Knee Replacement. Journal of the Korea Academia-Industrial cooperation Society. 15(7), 4395-4403. DOI : 10.5762/KAIS.2014.15.7.4395
  31. D. H. Seong, S. D. Yoon, S. H. Kim, J. S. Jang, S. H. Lee & G. D. Park. (2017). The Effect of Sling Exercise and Proprioceptive Neuromuscular Facilitation on Foot Pressure and Range of Motion after Total Knee Replacement - Case Study -. Korean Journal of Sports Science 26(5), 1335-1343. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE07257289 https://doi.org/10.35159/kjss.2017.10.26.5.1335
  32. E. C. Huskisson. (1974). Measurement of Pain. The lancet, 304(7889), 1127-1131. DOI : 10.1016/S0140-6736(74)90884-8
  33. B. Cole, E. Finch & C. Gowland. (1994). Physical rehabilitation outcome measure. Toronto : Canadian physiotherapy association.
  34. H. S. Hwang, J. H. Kim & B. R. Choi. (2017). Comparison of the effects of visual feedback training and unstable surface training on static and dynamic balance in patients with stroke. Journal of physical therapy science, 29(10), 1720-1702. https://doi.org/10.1589/jpts.29.1720
  35. C. H. Bae, Y. W. Jung, D. W. Lee & S. H. Cho. (2014). The Effect of Sling Exercise on Muscular Strength and Range of Motion in Female Patients who Received Total Knee Replacement. Korea Academy Industrial Cooperation Society, 15(7), 4395-4403. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE07213549 https://doi.org/10.5762/KAIS.2014.15.7.4395
  36. G. Borg. (1998). Borg's perceived exertion and pain scales. Champain : Human Kinetics.
  37. H. L. Ahn & M. S. Shin. (2007). The Effect of Sling Exercise Therapy on Pain Decrease and Muscle Strengthening for Low Back Pain Paitents Journal of Korean Medicine Rehabilitation, 17(4), 167-174. UCI : G704-001658.2007.17.4.005
  38. S. J. Park. (2021). The Effects of Exercise Program on Pain and Balance ability in Patients with Total Knee Replacement : Meta-analysis. Journal of the Korea Society of Computer and Information. 26(5), 119-126. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE10558726 https://doi.org/10.9708/JKSCI.2021.26.05.119
  39. M. S. Chung & H. S. Kwak. (2008). The effects of a muscle strengthening exercise program after total knee arthroplasty. The Journal of Korean Academic Society of Nursing Education. 14(1), 20-29. DOI : 10.5977/JKASNE.2008.14.1.020
  40. S. G. Ji, M. K. Kim, D. G. Lee & H. K. Cha. (2012). Effect of Task-Oriented Exercise on the Balance in Degenerative Arthritis Patients with Total Knee Replacement. Journal of the Korea Contents Association. 12(3), 222-232. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE01813189 https://doi.org/10.5392/JKCA.2012.12.03.222
  41. C. C. Jorgensen, H. Kehlet & Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. (2013). Fall-related admissions after fast-track total hip and knee arthroplast - cause of concern or consequence of success. Journal of Clinical Interventions in Aging, 8, 1569-1577. DOI : 10.2147/CIA.S52528
  42. I. Schwartz, L. Kandel, A. Sajina, D. Litinezki, A. Herman & Y. Mattan. (2012). Balance is an important predictive factor for quality of life and function after primary total knee replacement. The Journal of bone and joint surgery. British volume, 94(6), 782-786. DOI : 10.1302/0301-620X.94B6.27874
  43. W. H. Gage, J. S. Frank, S. D. Prentice & P. Stevenson. (2008). Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations. Gait & posture, 27(2), 286-293. DOI : 10.1016/j.gaitpost.2007.04.006
  44. J. Y. Bae, M. A. Gim, M. K. Kim, J. H. Choi, K. T. Yoo & S. B. Lee. (2014). The Effect of Bridging Exercises Featuring Various Knee-joint Angles on Static and Dynamic Balance. Journal of the Korea Entertainment Industry Association, 8(3), 381-390. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE02497389
  45. S. J. Hwang, N. J. Cho & J. W. Lee. (2010). Effects of Core Program Exercise on Static Balance of Females in Their Twenties. Journal of the Korean Academy of Clinical Electrophysiology, 8(1), 31-36. DOI : 10.5627/KACE.2010.8.1.031
  46. Y. H. Pua, Z. Liang, P. H. Ong, A. L. Bryant, N. N. Lo & R. A. Clark. (2011). Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis. Arthritis Care Res (Hoboken). 63(12), 1706-14. DOI : 10.1002/acr.20615. PMID: 21905251.
  47. S. J. Lim, S. H. Cho & G. S. Nam. (2016). The effects of standing balance in anteroposterior and mediolateral directions on knee strengthening in post-total knee replacement. Journal of physical therapy science. 28(1), 261-263. DOI : 10.1589/ jpts.28.261.