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The Effects of End-of-range Grade A+ Mobilization Following Acute Primary TKA

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ClinicalTrials.gov Identifier: NCT02105857
Recruitment Status : Completed
First Posted : April 7, 2014
Last Update Posted : April 7, 2014
Sponsor:
Information provided by (Responsible Party):
Brigitte Jolles, MD, University of Lausanne Hospitals

Brief Summary:

The purpose of the study is to find the best way to mobilize a knee after total knee arthroplasty (TKA). In particular, the aim of this study will be to investigate the advantages of adding a gentle knee mobilization to the standard rehabilitation used by physiotherapists in this hospital after TKA.

All individuals waiting for TKA from the "Departement de l'appareill Locomoteur (DAL) - Centre Hospitalier Universitaire Vaudoise (CHUV)" will be considered for this research trial. The number of individuals necessary to complete this study is 32.

Participants deciding to take part will be given an information sheet and asked to sign a consent form. If deciding to take part, they will still be free to withdraw at any time and without giving a reason. A decision to withdraw at any time, or a decision not to take part, will not affect the standard of care they receive.

People who agree to take part will be randomly selected into 2 groups: one group will follow the standard treatment used in physiotherapy after TKA, the other group will have the same treatment and the technique of A+ mobilization in investigation added. Participants have 50% chances to be allocated to either of the groups. Before surgery, at the first and seventh day after operation, the researchers will measure the range of motion (ROM) of the replaced knee. This means that the study will last till the moment the last participant leaves the DAL - CHUV, which is estimated to be in 12 months after the first recruitment.

Individuals over 18 years old undergoing unilateral primary TKA caused by osteoarthritis will included. Exclusion criteria will be: a) insufficient French language skills to agree a written consent, b) body mass index (BMI) >40 kg/m2, c) symptomatic OA in the contralateral knee (defined as self-reported knee pain >4 on a 10-point verbal analogue scale), d) other lower extremity orthopedic problems limiting function, e) neurologic impairment or g) cognitive dysfunction.

No life-style restrictions will be requested. Patients will just need to follow the physiotherapist's usual advices during the in-hospital period at the DAL - CHUV. This study does not alter the standard procedures, patients will receive all the techniques used in physiotherapy as every other TKA patient. If allocated into the mobilization group, a specific knee splint will be positioned on the patient's knee. This position will be held for 20 minutes with the leg straight and 20 minutes bent, twice a day. The person in charge of these procedures is the principal investigator of the study, a certified orthopedic physiotherapist on the staff of the DAL - CHUV. No additional changes to patients' daily routine will be involved.

To the investigators knowledge, there are no side effects due to use of this mobilization. Nevertheless, the pain levels of every patient will be recorded to identify any differences between groups. If, during or after the clinical study, any patient will face unexpected health problems related with the study, they will be kindly asked to transmit the information to the principal investigator of the study. The mobilization technique involves no additional risk over that of standard treatment performed in the hospital. This study hypothesis that adding A+ graded mobilization combined with the standard in-hospital rehabilitation protocol will improve ROM without increasing pain.

All information collected will be kept strictly confidential. Any information used will have names and addresses removed. All data will be stored, analyzed and reported in compliance with the Data Protection Legislation of Switzerland.


Condition or disease Intervention/treatment Phase
Osteoarthritis, Knee Other: grade A+ knee mobilization Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 32 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Effects of End-of-range Grade A+ Mobilization Following Acute Primary TKA
Study Start Date : March 2011
Actual Primary Completion Date : December 2012
Actual Study Completion Date : May 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
No Intervention: Standard care
Patients receiving the standard rehabilitation protocol
Experimental: grade A+ knee mobilization
Patients receiving the standard rehabilitation protocol plus grade A+ knee mobilization
Other: grade A+ knee mobilization
grade A+ knee mobilization using the joint active systems knee device, 20minutes twice a day in knee extension and knee flexion




Primary Outcome Measures :
  1. Range of Motion [ Time Frame: From the day before surgery untill the 7th postoperative day ]
    Knee passive and active range of motion in flexion and extension using standard goniometry


Secondary Outcome Measures :
  1. Pain [ Time Frame: From de preoperative day to the seventh day after surgery ]
    pain at rest using a visual analog scale


Other Outcome Measures:
  1. Patients' destination after discharge [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 9 days ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • humans >18 years old
  • undergoing TKA per osteoarthritis

Exclusion Criteria:

  • insufficient French language skills to agree a written consent
  • body mass index (BMI) >40 kg/m2
  • symptomatic OA in the contralateral knee (defined as self-reported knee pain >4 on a 10-point verbal analogue scale)
  • other lower extremity orthopedic problems limiting function
  • neurologic impairment
  • cognitive dysfunction

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02105857


Locations
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Switzerland
CHUV
Lausanne, VD, Switzerland, 1011
Sponsors and Collaborators
University of Lausanne Hospitals
Investigators
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Principal Investigator: Luís C Pereira, MSc CHUV

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Responsible Party: Brigitte Jolles, MD, Professor, University of Lausanne Hospitals
ClinicalTrials.gov Identifier: NCT02105857     History of Changes
Other Study ID Numbers: ULausanneH
First Posted: April 7, 2014    Key Record Dates
Last Update Posted: April 7, 2014
Last Verified: April 2014
Keywords provided by Brigitte Jolles, MD, University of Lausanne Hospitals:
knee mobilazation
TKA
joint replacement
rehabilitation
Additional relevant MeSH terms:
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Osteoarthritis, Knee
Osteoarthritis
Arthritis
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases