Investigation of the effects of core stabilization exercises added to the standard exercise program on patient-reported and performance-based outcomes in patients with total knee prosthesis follow-up with telerehabilitation

The aim of this study is to investigate the effects of core stabilization exercises added to the standard exercise program on patient-reported and performance-based outcomes in patients with total knee prosthesis (TKP) followed up with telerehabilitation (TR) after surgery. 42 patients undergoing TKP surgery were randomly divided into 2 groups [Group 1: Standard Exercise Program Group (n= 21), Group 2: Standard Exercise Program + Core Stabilization Exercise Program Group (n= 21)]. A standard physiotherapy and rehabilitation (PTR) program was applied to the patients until discharge (1 day) and a home exercise program was given. After discharge to both groups; In the first 8 weeks, under the supervision of a physiotherapist, a 45-minute video conference-based TR and PTR program was applied twice a week, and a daily walking program with telephonebased TR was applied in the last 4 weeks. Group 1 was given exercises and interventions in the standard exercise program, and Group 2 was given exercises in the core stabilization exercise program in addition to Group 1. Assessments; preoperative, postoperative first, second and third months were performed with TR. The outcome measures used were; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional level, WOMAC's pain subcategory and Visual Analog Scale (VAS) for pain severity, Copenhagen Knee Range of Motion Scale (CKRS) for affected knee range of motion (ROM), Short Form-12 (SF-12) for health-related quality of life, World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) for overall quality of life, 30-s Chair-Stand Test for lower extremity muscle strength and Stair Climb Test for locomotor performance. After treatment; patients in both groups had functional levels (WOMAC), pain severity (GAS and WOMAC-Pain), affected knee flexion and extension ROM (KDES), healthrelated and overall quality of life (SF-12 and WHOQOL-BREF respectively), lower extremity muscle strength (30-s Chair-Stand Test) and locomotor performances (Stair Climb Test) were found to be statistically significant improved (p<0,05). Statistically; the core stabilization exercises added to the standard exercise program it provides additional benefits to improve functional level, affected knee extension ROM, health-related and overall quality of life, lower extremity muscle strength and locomotor performance (p<0.05), but it does not provide additional benefit to increase affected knee flexion ROM and reduce pain severity (p> 0.05) was observed. We believe that PTR programs applied with TR are effective in improving patientreported and performance-based outcomes in postoperative TDP patients. In addition, we think that core stabilization exercises added to the standard exercise program provide additional benefits to improve the functional level, affected knee extension ROM, healthrelated and overall quality of life, lower extremity muscle strength and locomotor performance, but do not provide additional benefits to increase the affected knee ROM and reduce pain severity.