Authors (including presenting author) :
Ng CYJ(1), Tang CY(1), Cheng CW(1), Fung YK(1)
Affiliation :
(1)Physiotherapy Department (IRS), Tseung Kwan O Hospital
Introduction :
Total knee replacement (TKR) is a common procedure for severe knee osteoarthritis, particularly in ageing population. Despite reduced knee pain, many patients still experience prolonged instability, leading to extended rehabilitation, higher healthcare costs, and increased fall or re-injury risk. Hydrotherapy provides a unique rehabilitative environment, utilizing the buoyancy of water to reduce joint stress, enhance range of motion, and improve proprioception.
Objectives :
1. To implement hydrotherapy training for patients in late TKR rehabilitation, aiming to improve symptom management, balance, and overall physical function. This supports the Hospital Authority's goal of promoting functional recovery and independence.
2. To encourage self-efficacy and self-management among post-TKR patients, fostering an active lifestyle following discharge, in line with the Hospital Authority’s strategies for empowering patients in their health journey.
Methodology :
A one-group pretest-posttest design was employed. Thirty participants, at least four months post-TKR and having completed a basic physiotherapy course, were recruited. They engaged in a four-week hydrotherapy program with one 60-minute session per week. Each session included a 10-minute warm-up, 30 minutes of exercise education, and 20 minutes of supervised practice, covering functional mobility, strength, balance, and core training. Evaluative measures included the Mini BESTest, Knee Injury and Osteoarthritis Outcome Score (KOOS), walking tolerance, Numeric Pain Rating Scale (NPRS), and Timed Up and Go Test (TUG), all assessed at baseline and after the fourth session. A patient satisfaction survey was conducted at the end of the program.
Result & Outcome :
Participants showed significant improvements in balance (Mini BESTest baseline mean: 20.18; follow-up mean: 22.56; p=0.036), walking tolerance (baseline mean: 69.6 minutes; follow-up mean: 77.8 minutes; p=0.027, Wilcoxon signed-rank test) and TUG (baseline mean: 14.6 seconds; follow-up mean: 12.8 seconds; p=0.003, paired t-test) following hydrotherapy. Subjectively, participants reported positive trends in KOOS scores. Satisfaction survey results revealed that 95.3% of participants found hydrotherapy beneficial for their condition, 91.3% felt confident in performing aquatic exercises, and 82.6% expressed an intention to continue pool exercises independently.
Conclusion
Hydrotherapy is a safe and effective rehabilitation option for individuals recovering from TKR, contributing to improvements in balance, pain reduction, and increased physical activity. Patients reported enhanced levels of physical activity and greater confidence in self-management following hydrotherapy, facilitating discharge and aligning with the strategic focus on patient empowerment and rehabilitative excellence.
