Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;16(1):22-28.
doi: 10.2185/jrm.2020-024. Epub 2021 Jan 5.

Feasibility and efficacy of knee extension training using a single-joint hybrid assistive limb, versus conventional rehabilitation during the early postoperative period after total knee arthroplasty

Tomokazu Yoshioka  1 , Shigeki Kubota  1 , Hisashi Sugaya  2 , Norihito Arai  2 , Kojiro Hyodo  2 , Akihiro Kanamori  2 , Masashi Yamazaki  2
Affiliations

Feasibility and efficacy of knee extension training using a single-joint hybrid assistive limb, versus conventional rehabilitation during the early postoperative period after total knee arthroplasty

Tomokazu Yoshioka et al. J Rural Med. 2021 Jan.

Abstract

Objectives: To evaluate the feasibility and efficacy of treatment for the recovery of knee joint function after total knee arthroplasty (TKA) using a robotic suit. Patients and Methods: Knee joint extension exercise sessions were started with a robotic suit (single-joint hybrid assistive limb [HAL-SJ, Cyberdyne, Inc., Tsukuba, Japan]) in one group of patients after TKA. Patients who underwent standard rehabilitation were enrolled in the control group. To evaluate feasibility and safety, we assessed the adverse events, the number of training sessions, and training time. We compared the changes in knee joint pain and extension lag (°) between the groups. Results: The average age was 71.3 ± 6.2 years in the HAL-SJ group and 74.9 ± 8.7 years in the control group. There were no severe adverse events. In the HAL-SJ group, training was performed 2.9 times, on average, and lasted 18.8 min. In the HAL-SJ group, there was a reduction in the visual analog scale (VAS) for pain after training, which was not significant. In the control group, the VAS score worsened after the sessions. The extension lag significantly improved in the HAL-SJ group after the 2nd and 3rd sessions, and this was more due to improvements in their active extension range of motion than their passive extension range of motion. Conclusions: HAL-SJ-based training is safe and effective, and leads to instantaneous improvement of extension lag, without worsening knee joint pain. HAL-SJ-based knee extension training could represent a viable novel post-TKA rehabilitation modality.

Keywords: extension lag; hybrid assistive limb; osteoarthritis of the knee; rehabilitation; total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The robotic single-joint hybrid assistive limb (knee type).
Figure 2
Figure 2
Postoperative day 10. A: Knee joint active extension motion. B: Knee joint extension motion using the single-joint hybrid assistive limb.
Figure 3
Figure 3
Changes in VAS in the HAL-SJ and control groups before and after intervention. VAS: visual analogue scale; HAL-SJ: hybrid assistive limb-single joint type; POD: postoperative day; NS: not significant; IBI: immediately before intervention; IFI: immediately following intervention.
Figure 4
Figure 4
Changes in extension lag in the HAL-SJ and control groups before and after intervention. EL: extension lag; HAL-SJ: hybrid assistive limb-single joint type; POD: postoperative day
Figure 5
Figure 5
Improvement in knee joint extension angle due to intervention in the HAL-SJ group and control group: comparison of active motion and passive motion. HAL-SJ: hybrid assistive limb-single joint type; POD: postoperative day; EL: extension lag; EA: extension angle
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chiu KY, Ng TP, Tang WM, et al. Review article: knee flexion after total knee arthroplasty. J Orthop Surg (Hong Kong) 2002; 10: 194–202 . doi: 10.1177/230949900201000215 - DOI - PubMed
    1. Nishimura A, Hasegawa M, Kato K, et al. Risk factors for the incidence and progression of radiographic osteoarthritis of the knee among Japanese. Int Orthop 2011; 35: 839–843 . doi: 10.1007/s00264-010-1073-x - DOI - PMC - PubMed
    1. Lange T, Schmitt J, Kopkow C, et al. What do patients expect from total knee arthroplasty? A Delphi consensus study on patient treatment goals. J Arthroplasty 2017; 32: 2093–2099.e1 . doi: 10.1016/j.arth.2017.01.053 - DOI - PubMed
    1. de Beer J, Petruccelli D, Adili A, et al. Patient perspective survey of total hip vs total knee arthroplasty surgery. J Arthroplasty 2012; 27: 865–9.e1, 5 . doi: 10.1016/j.arth.2011.12.031 - DOI - PubMed
    1. Zhou Z, Yew KS, Arul E, et al. Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23: 1729–1733 . doi: 10.1007/s00167-014-3212-1 - DOI - PubMed
-