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Hossein Afzali , Fateme Ghiasi^* , Mohammad Hosseinifar , Hassan Namvar , Ahmadreza Asgariashtiani

Abstract

Improper distribution of foot pressure and abnormal balance on the foot in patients with total knee arthroplasty (TKA) can lead to early mechanical failure in surgery and the prosthesis. Therefore, this study aimed to investigate the effect of balance exercises on foot pressure distribution after TKA. In this randomized clinical trial, 30 subjects with total knee arthroplasty were included. The subjects were randomly divided into a routine exercise group and a balance exercise group.

The rehabilitation program was conducted for 30 minutes, 6 days a week, and for 12 sessions. Patients were evaluated before and after surgery, as well as after the intervention, were evaluated in terms of foot plantar pressure, forefoot pressure, rearfoot pressure, surface in contact with the ground in the foot, ellipse area, and center of pressure (COP) path length using a foot pressure scanning machine. Pain intensity in patients was measured using a visual analog scale (VAS). Data were analyzed using multiple ANOVA repeated measures and the Bonferroni test (P<0.05). The results showed that there is a significant difference in the foot plantar pressure distribution before and after balance exercises (p<0.05). The shift of the sole pressure from the forefoot to the rear foot was significant in the group of balance exercises (p<0.05). Also, balance exercises are more effective in reducing pain intensity compared to routine exercises (P<0.0001). The amount of pressure distribution after the intervention in both legs is not significant in the balance exercise group (p>0.05) The results show that balance exercises are effective in improving plantar pressure distribution and balance in patients with total knee arthroplasty. Additionally, balance exercises have a positive effect on achieving a proper pressure distribution on both legs. Therefore, it is recommended that in addition to routine exercises, balance exercises should also be considered in subjects with total knee arthroplasty.