The aim of this study is to investigate the effects of foam rolling in patients who have undergone total knee arthroplasty on pain, knee mobility, leg muscle strength, the ability to sense joint position, fear of movement, walking, balance, and the ability to perform daily activities.
A total of 26 patients, with 13 patients in each group, will be included in the study. Participants will be randomly assigned to two groups. One group will receive the routine rehabilitation program, while the other group will receive foam rolling in addition to the routine rehabilitation program.
Foam rolling and rehabilitation exercises will be taught at the Dokuz Eylül University Orthopedics and Traumatology Outpatient Clinic, and you will be asked to perform these exercises at home. The foam rolling group will perform foam rolling 6 days per week, 2 sets per day, with 3 repetitions of 60 seconds each. The control group will not perform foam rolling and will follow the routine rehabilitation program.
The standard rehabilitation program will consist of strengthening exercises in different directions for the entire leg, range-of-motion exercises, stretching exercises, and walking exercises. You will be asked to perform the exercises for 3 sets of 10 repetitions per day.
The assessments in the study will be performed at the second postoperative week (test 1), sixth postoperative week (test 2), and fourteenth postoperative week (test 3). These time points are also times when you would normally visit your doctor for routine follow-up; therefore, you will not be expected to make any additional hospital visits for the study.
The study will continue for 1 year, and each patient will be followed for 14 weeks.
Pain will be assessed using a single-question questionnaire. Walking, functional level, and leg muscle strength will be assessed using short performance tests involving sitting-to-standing and walking activities, as well as a questionnaire. Knee joint range of motion and proprioception will be assessed by measuring the angles of your knee using a ruler-like plastic device. Fear of movement will be assessed using a short questionnaire.
All assessments will take no more than 20 minutes. The results will be determined by examining whether there are differences in these measurements between the different assessment time points.
Willingness to participate in the study
Scheduled for primary total knee arthroplasty
Age 40 years or older
Body mass index (BMI) > 40 kg/m²
History of revision surgery in the knee region
Any other orthopedic or neurological condition that may cause walking or functional impairment
Presence of heart disease or uncontrolled hypertension
Parallel
Foam rolling after total knee arthroplasty
Other interventionThe foam rolling intervention will be performed for 4 weeks starting from the second postoperative week, 3 days per week, 1 set per day, with 3 repetitions of 60 seconds each.
Standard home exercise program after total knee arthroplasty
Other interventionThe control group will not perform foam rolling and will follow the standard home exercise program. The standard home exercise program will consist of lower-extremity range-of-motion exercises, isometric exercises, stretching exercises for the knee joint, and straight leg raise exercises in different directions. Participants will be instructed to perform the exercises for 3 sets of 10 repetitions per day.
Change from baseline at week 14 in knee pain
Pain will be assessed using the 10-cm Visual Analog Scale (VAS), scored from 0 (no pain) to 10 (unbearable pain).
Change from baseline at week 14 in knee range of motion
Knee range of motion will be measured using a 30-cm transparent plastic manual goniometer.
Change from baseline at week 14 in muscle strength
Maximum isometric strength of the quadriceps femoris and hamstring muscles will be measured using a hand-held dynamometer and muscle strength will also be assessed using manual muscle testing.
Change from baseline at week 14 in knee joint proprioception
Knee proprioception will be assessed using the active joint repositioning test at 30° and 60° knee flexion, with the absolute difference between the target and reproduced angles recorded.
Change from baseline at week 14 in kinesiophobia
Kinesiophobia will be assessed using the 17-item Turkish version of the Tampa Scale for Kinesiophobia. Each item will be scored using a 4-point Likert scale ranging from 1 to 4.
Change from baseline at week 14 in Timed Up and Go Test performance
Gait, balance, and functional mobility will be assessed using the Timed Up and Go Test. The patient will be asked to stand up from a chair, walk 3 meters, turn around, and sit back down. The completion time will be recorded in seconds.
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