Jessica W Smith, Mark Cipriani Jr, Robin L Marcus and Paul LaStayo
Background: In total knee arthroplasty (TKA) recipients, losses in quadriceps’ strength in the immediate postoperative period are related to physical function and mobility. Therefore, this period should be a target of rehabilitation to prevent strength losses in the short-term. This case report describes the early post-operative changes in muscle and physical function associated with a Tai Chi inspired rehabilitation program. Case Description: A 62 year-old woman presented with bilateral OA and underwent unilateral TKA surgery in her most symptomatic knee. The subject participated in one pre-operative study visit, and a 6-week, Tai Chi inspired rehabilitation program from 4 to 10 wks post-operatively. Outcome measures, evaluated at 4 wks, 10 wks, and 6 months post-operatively, included maximum voluntary isometric contraction, lower extremity power, quadriceps force control, 6-minute walk test, timed up-and-go test, stair climbing test, gait speed, SF-36 Total Health Status Survey, and the lower extremity functional scale. Outcomes: In the surgical leg, the subject improved in all muscle and physical function measures from the pre-operative to 6-month post-operative study visit. Self-report outcome measures also improved from pre- to postoperative study visits, with the exception of the mental component summary of the SF-36 at 6 months. Discussion: The subject exhibited clinically relevant improvements in muscle and physical function in the surgical leg, suggesting that the Tai Chi inspired rehabilitation program may be an effective and safe addition to range of motion, stretching and gait exercises in the early post-operative period. These results support further exploration of this rehabilitation approach in future trials.