Effect of Early Supervised Rehabilitation on Musculoskeletal Tumour Society Rating Score and Knee Range of Motion in subjects with Endoprosthetic Reconstruction of Proximal Tibia: Pilot study

Maria Steffy, Sumesh Kumar (2019) Effect of Early Supervised Rehabilitation on Musculoskeletal Tumour Society Rating Score and Knee Range of Motion in subjects with Endoprosthetic Reconstruction of Proximal Tibia: Pilot study. Masters thesis, College of Physiotherapy, Christian Medical College, Vellore.

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Abstract

BACKGROUND: Proximal tibia is the second most common site for the bone osteosarcoma and giant cell tumor. Several studies confirm the efficacy and success of endoprosthetic replacement as a limb-sparing technique for the treatment of osteosarcoma and other malignant bone tumors. However, the functional status after megaprosthetic reconstruction around the knee is strongly dependent on the competence of the knee extensor mechanism. Although early mobilization and gait training are important factors essential to assure successful rehabilitation, there are no reports on the outcomes following early supervised rehabilitation once the surgery is performed. Therefore in this study we aim to find out if early supervised rehabilitation in patients with Endprosthetic Reconstruction of Proximal Tibia (EPRPT) improves knee joint function and mobility and if there is any change in the outcomes at 3 months follow-up. OBJECTIVES: 1. To investigate the effect of early supervised rehabilitation in patients with EPRPT. 2. To find out if there is any change in the outcomes at 3 months follow-up. DESIGN: Pre test and Post test Experimental Design. METHODOLOGY: Six subjects with a mean age of 26.17 ±10.68 years were included after a written consent. Subjects who have been posted for EPRPT surgery were assessed pre-operatively for Musculoskeletal Tumour Society Score (MSTS), knee range of motion (ROM), limb girth of thigh and calf, tightness at knee, strength of the knee muscle and 6 minute walk test. On the 3rd post op day outcomes were measured. From the 3rd post op day the patient received one session of supervised physiotherapy for 45 minutes including active Mobilization of the Knee, Strengthening of Hip, Knee and Ankle and progressive gait training for 5 days a week up to 1 month. Assessment was done at the end of each week up to 1 month and follow-up assessment at 3 months post surgery. The data obtained was analyzed to find out if outcomes improved with early supervised rehabilitation in patients with endoprosthetic reconstruction of proximal tibia. The follow up data was analysed to find out if there is any change in the outcomes after 3 months post surgery. Outcome Measures: Primary Outcome measures: • Knee Range of Motion (ROM). • Musculoskeletal Tumour Society Score (MSTS). Secondary Outcome measures: • Hamstring tightness. • Muscle girth. • Knee muscle power. • 6 minute walk test. RESULTS: The results showed a significant improvement in the Knee range of motion and the MSTS score following 4 weeks of early supervised rehabilitation (p value < 0.05). Despite the early rehabilitation Hamstring tightness was statistically significant at 4 weeks post EPRPT. (p value < 0.05) Knee muscle power improved significantly post EPRPT (p value < 0.05). The girth of calf reduced and the girth of thigh did not show much reduction. The 6 min walk distance improved by third month clinically but was not significant statistically. CONCLUSION: Early and supervised physiotherapy post EPRPT significantly improved the MSTS score. The knee range of motion improved significantly with early supervised rehabilitation. The MSTS score and the Knee range of motion were maintained at 3rd month follow-up.

Item Type: Thesis (Masters)
Additional Information: Reg.No.2717130321
Uncontrolled Keywords: Proximal tibia tumour, knee megaprosthesis, Physiotherapy, MSTS score.
Subjects: PHYSIOTHERAPY > Physiotherapy in Orthopaedics
Depositing User: Ravindran C
Date Deposited: 22 Sep 2019 15:27
Last Modified: 22 Sep 2019 15:27
URI: http://repository-tnmgrmu.ac.in/id/eprint/11548

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