Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA.
Department of Traumatology, Munich University Hospital LMU, Munich, Germany.
Knee Surg Sports Traumatol Arthrosc. 2019 May;27(5):1611-1620. doi: 10.1007/s00167-018-5217-7. Epub 2018 Oct 17.
Biofeedback following total knee arthroplasty (TKA) seems to be a feasible approach to improve rehabilitation, outcomes, mobility and reduce pain. This systematic review gives the practicing orthopedic surgeon a summary of what is available and how biofeedback affects clinical outcomes.
We reviewed the current literature regarding methods, devices and effects of biofeedback in patients who underwent total knee arthroplasty. Embase, Pubmed, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to May 2018 for the following keywords: Biofeedback OR Feedback AND Total Knee Arthroplasty OR TKA. Data were extracted according to a predefined setting (see Protocol for systematic review on PROSPEO). Devices used for biofeedback were recorded. Demographics, training methods and effects were also collected.
The search resulted in 380 potentially eligible studies from which 11 met all inclusion criteria including 7 randomized controlled trials (RCTs), 3 cohort studies, and 1 cross-sectional study. A total of 416 patients with unilateral TKA were included, with an average of 37.8 patients per study. In patients with TKA, significant improvements in activity scores or pain were reported by 9 of 11 studies. Only two of the studies reported no significant influence of the feedback on the chosen outcome parameters. Devices for biofeedback varied between studies and included the use of a goniometer, force plate, balance board, treadmill, and/or electromyography (EMG). The most common type of feedback was visual followed by audio, with one study mentioning that the audio mode was preferred by the patients as it was easier to handle. Overall, 5 out of 6 different methods demonstrated a potential value for improving mobility and decreasing pain.
This review suggests that biofeedback in early postoperative rehabilitation after TKA is effective in improving gait symmetry, reducing pain and increasing activity level. It should be noted that the great variety of devices used for feedback limits comparisons between studies.
IIa.
全膝关节置换术（TKA）后的生物反馈似乎是一种可行的方法，可以改善康复效果、提高活动能力并减轻疼痛。本系统综述为骨科医生提供了一个概述，介绍了现有的方法、设备以及生物反馈对临床结果的影响。
我们对 TKA 患者接受生物反馈的方法、设备和效果进行了文献回顾。从开始到 2018 年 5 月，我们在 Embase、Pubmed、Web of Science 和 Cochrane 对照试验中心注册库中搜索了以下关键词：生物反馈或反馈和全膝关节置换术或 TKA。根据预定义的设置（见 PROSPEO 系统评价方案）提取数据。记录使用的生物反馈设备。还收集了人口统计学、训练方法和效果等数据。
搜索结果显示，有 380 项可能符合条件的研究，其中 11 项符合所有纳入标准，包括 7 项随机对照试验（RCT）、3 项队列研究和 1 项横断面研究。共有 416 名单侧 TKA 患者纳入研究，每项研究平均 37.8 名患者。在 TKA 患者中，有 9 项研究报告活动评分或疼痛显著改善。只有两项研究报告反馈对所选结果参数没有显著影响。生物反馈设备在研究之间存在差异，包括使用量角器、测力板、平衡板、跑步机和/或肌电图（EMG）。最常见的反馈类型是视觉，其次是听觉，一项研究表明，音频模式更受患者欢迎，因为它更容易操作。总体而言，6 种不同方法中的 5 种方法显示出改善活动能力和减轻疼痛的潜在价值。
本综述表明，TKA 术后早期康复中的生物反馈可有效改善步态对称性、减轻疼痛和提高活动水平。值得注意的是，用于反馈的设备种类繁多，限制了研究之间的比较。
IIa。
