Open AccessThe effects of physiotherapy using proprioceptive neuromuscular facilitation techniques on the gait of patients after hip and knee arthroplasty: a case report.
Author(s) -
Antonina Kaczorowska,
Jolanta Kaboth,
Ewelina Lepsy,
Agata Mroczek
Publication year - 2021
Publication title -
medical science pulse
Language(s) - English
Resource type - Journals
eISSN - 2544-1620
pISSN - 2544-1558
DOI - 10.5604/01.3001.0015.2789
Subject(s) - gait , medicine , physical medicine and rehabilitation , physical therapy , range of motion , sagittal plane , timed up and go test , proprioception , rehabilitation , gait training , arthroplasty , gait analysis , osteoarthritis , balance (ability) , surgery , alternative medicine , pathology , radiology
Background: Gait disturbances are a major problem for patients after arthroplasty. After the surgery, walkingspeed, the rhythm of locomotion, and the length of the steps are significantly reduced. One of the therapeuticmethods used in gait re-education is proprioceptive neuromuscular facilitation (PNF).Aim of the study: This study aimed to evaluate the effects of physiotherapy using PNF techniques on thegait of patients after hip and knee arthroplasty.Case report: A 60-year-old woman with advanced osteoarthritis that received bilateral hip and right knee arthroplastieswas examined. Before and after the therapy, the following tests were performed: measurement ofthe range of motion (ROM) of hip and knees joints in the sagittal plane using a goniometer, assessment of thesymmetry of the lower limbs loading using the two scales test, assessment of the risk of falls using the “TimedUp and Go” test, assessment of balance and gait using the Tinetti test, and assessment of pain intensity usingthe visual analogue scale (VAS). Rehabilitation was comprised of 15 PNF therapies, including scapularand pelvic PNF patterns. The stabilization of the upper and lower trunk, lifting, shifting of the body’s weightfrom one foot to another, gait cycle (the stance phase and the swing phase), walking forward, backward, andsideways, and walking up/down the stairs were also used. After the therapy, the flexion ROM in both hip andknees joints was improved. The lower limb symmetry index decreased from 1.167 to 1.121, and the sum ofthe points obtained in the Tinetti test increased from 22 to 26. Pain in the joints also decreased from 6 on theVAS scale to 4. However, the result obtained in the “Timed Up and Go” test after the therapy was increased by0.5 s compared to before the therapy.Conclusions: After hip and knee arthroplasties, physiotherapy using PNF techniques improved the gaitand functional status of the patient. Continuation of this research using a larger number of patients isneeded.