Measurement of results of a special hydrotherapy during in-patient rehabilitation after implantation of a total knee arthroplasty

Aim: Based on our own previous surface EMG investigations (EMG mapping), it has been shown that disturbances in coordination, proprioception and stren gth measured before and after implantation of a total knee arthroplasty (TK A) can be treated successfully with standard physical therapy during in-pat ient rehabilitation. The objective of the present study was to evaluate the therapeutic effect of a special type of hydrotherapy. Method: 25 patients with TKA were treated for 3 weeks with a standardized hydrotherapy training during in-patient rehabilitation. Several diagnostic methods (EMG mapping, Isokinetics, Ultrasound) were applied to objectify and quantify changes in muscular coordination and strength at 4, 7, and 26 weeks postoperative. Th ese results were compared with the results of 38 TKA patients treated with a ,,standard rehabilitation program" and with the results of 20 healthy per sons. Results: EMG mapping as well as isokinetics and ultrasound permitted an objective characterization of the results. Patients treated with the spe cial hydrotherapy showed greater improvements in the investigated items of coordination and strength than patients treated with the,standard rehabilit ation program". For example, in the hydrotherapy group a significantly bett er contraction capacity of the M. vastus intermedius was measured. The inte nsive hydrotherapy was tolerated by all patients and reached good acceptanc e. Conclusion: The investigated hydrotherapy technique leads to better musc ular coordination and strength, which can provoke a better stabilization of the knee joint. Therefore, the early and intensive application of hydrothe rapy for improving coordination and strength in the rehabilitation of patie nts with total knee arthroplasty is advisable.