Improvement in gait pattern after knee arthroplasty followed by proprioceptive neuromuscular facilitation physiotherapy

Abstract

The aim of the study was to assess the influence of a physiotherapy program based on proprioceptive neuromuscular facilitation (PNF) on kinematic gait pattern after total knee arthroplasty. This comparative study included two groups of patients qualified for total surgical knee joint replacement due to osteoarthritis: a study group and a control group, either consisting of 28 patients of a matched age range of 55–90 years. Following surgery, 4 days after standard postoperative rehabilitation, the study patients were subjected to a 3-week-long therapist-assisted rehabilitation based on PNF principles (10 sessions of 75 min each), whereas control patients were discharged with instructions on how to exercise in the home setting. The outcome consisted of spatial-temporal gait parameters that were assessed at three time points: a day before surgery and then 1 month and 6 months after. The findings were that PNF caused substantial, sustained improvements in gait kinematics, shortening the stance phases, gait cycle duration, and double support phase and prolonging swing phase velocity, gait velocity, cadence, step length, and gait cycle length. Also, postsurgical pain was evidently less. We conclude that the individually tailored PNF rehabilitation program is superior compared to a standard recommendation of home-based physiotherapy in terms of improving gait kinematic pattern as well as psychological aspects related to pain perception in patients after knee arthroplasty.