Preoperative Perturbation Training to Prevent Falls After Total Knee Arthroplasty
University of Illinois at Chicago
Summary
The goal of this clinical trial is to learn about preventing falls in people who have total knee replacement surgery using treadmill perturbation training. Perturbation training involves adjusting to rapid speed changes on a treadmill. The main questions it aims to answer are: * Does perturbation training improve the way that people who are planning to have total knee replacement surgery recover after treadmill test that reproduces a trip to the front or side? * Does perturbation training reduce the incidence of preventable gait-related falls during the first year after total knee replacement? Participants will: * complete surveys about their condition and fall history and take part in testing of walking ability and balance. * have a baseline gait analysis test to measure the motion of their body during normal walking. * Be randomized into two groups. One will receive fall-prevention literature. The other will receive the same literature and then take part in a two-week treadmill perturbation training program. * be contacted every two weeks for one year, and asked questions about whether they have fallen during that time. * wear a Fitbit activity monitor on their wrist for one year. Researchers will compare the number of falls from the group that only received literature to the treatment group to see if the training group has fewer falls during the year after surgery.
Description
Participants: We will recruit 196 participants who are scheduled for primary unilateral total knee arthroplasty (TKA) and can commit to 5 additional study visits. Baseline assessment: At enrollment, all participants will be assessed for a set of demographic and functional risk factors listed below 1. Age 2. Sex 3. Body mass index 4. Number of painful joints - Patient Reported Arthralgia Inventory 5. Medications that increase fall risk 6. Number of falls in the past 12 months 7. Self-reported activity level (UCLA activity score) 8. Habitual walking speed (8-meter walk test) 9. Functional Lim…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Diagnosis of endstage knee osteoarthritis requiring total knee arthroplasty (TKA). TKA scheduled within two months and able to schedule the required training visits prior to surgery. Exclusion Criteria: Potential participants will be excluded if they have dizziness or self-reported medical conditions that would be expected to affect walking and balance. These specifically include history of stroke, multiple sclerosis, Parkinson's disease, and balance disorders including positional vertigo and Meniere's disease. Other exclusion criteria include plans to undergo a contral…
Interventions
- BehavioralTreadmill-based perturbation training
The intervention consists of disturbances delivered on a treadmill that simulates tripping over an obstacle or being perturbed to the side. These disturbances require a compensatory step to respond. Through this task-specific training, participants should learn to control their trunk motion in a way that will cause them to avoid a trip or fall to the side.
- BehavioralEducation Control
Fall prevention educational material
Location
- Biomechanics and Clinical Outcomes Laboratory, University of Illinois ChicagoChicago, Illinois