Mirror Therapy as an Adjunct to Rehabilitation Following Total Knee Arthroplasty

Purpose: To examine the effectiveness of mirror therapy combined with standard care physical therapy on knee range of motion (ROM), pain levels, and physical function in individuals following a total knee arthroplasty (TKA).

Background: Following a TKA, patients often present with numerous impairments including joint stiffness, pain, decreased strength, and impaired mobility. These limitations can inhibit functional progress during rehabilitation and recovery. Mirror therapy is a potential treatment option that may assist in reducing these impairments and improving recovery following TKA.

Study Activities: Active and sham group activities will add-on to the physical therapy session and are considered part of standard care, with no change to the current billing process. Both groups will participate in ROM activities, consistent with standard PT care, as part of a billable treatment. The active group with do standard practice ROM activities while looking at a mirror and the sham group will perform ROM activities without a mirror.

Interventions:

• Treatment will start within 2 weeks (14 days) of the total knee replacement.
• There will be 8 sessions within a 4-week time frame.

Data Analysis: Demographic information will be reported using descriptive statistics. Analyses will use linear mixed-effects models with fixed effects for Group, Time, and the Group × Time interaction, and with subject-level random effects to account for repeated measures. The primary inference will be the Group × Time interaction.

Inclusion criteria

• Candidates that have been screened and deemed eligible for a TKA and received a TKA 14 days or less post operation.
• English speaking
• Able to understand and follow instructions
• Has at least 5 degrees of knee extension to 100 degrees of knee flexion AROM on the contralateral knee
• Able to perform unilateral stance on contralateral side for at least 5 seconds (balance assistance allowed)
• Able to perform exercises

Exclusion criteria

• Post-surgical complications (DVT, infection, nerve injury, vascular injury)
• Pain rating on NPRS no more than a 4/10 on the contralateral LE
• Significant scar or deformity of the contralateral LE
• Visual impairments causing an inability to see the reflection in a mirror