Immediate Effects of Low-Intensity Plantar Proprioceptive Stimulation of the Affected Limb on Stable Versus Unstable Surfaces on Modified Sit-to-Stand Time and Gait Following Total Knee Arthroplasty

NCT07840768 | Not Yet Recruiting

• 1 other identifier: 2026-05-052-002
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled study will investigate the immediate effects of low-intensity plantar proprioceptive stimulation performed on an unstable versus stable surface in patients during early rehabilitation after unilateral total knee arthroplasty (TKA). Participants will be randomly assigned to either an unstable-surface group or a stable-surface group. While seated, participants will apply low-intensity pressure through the operated foot using a standardized repeated pressing task. The unstable-surface group will perform the task with the operated foot placed on a balance pad, whereas the stable-surface group will perform the same task on a firm surface. The primary outcome will be the time required to perform a modified sit-to-stand task. Secondary outcomes will include walking performance, pain, and knee range of motion. The study aims to determine whether providing additional plantar proprioceptive input through an unstable surface can produce an immediate improvement in functional performance during early rehabilitation after TKA.

Conditions

Total Knee Arthroplasty; Postoperative Rehabilitation

Keywords

Total Knee Arthroplasty; Early Rehabilitation; Sit-to-Stand; Proprioceptive Stimulation

Outcome Measures

Primary Outcomes (1)

• Change in Modified Sit-to-Stand (mSTS) Time

  Time required to complete one modified sit-to-stand (mSTS) task will be measured in seconds. The task will be video-recorded using a smartphone at 60 frames per second and analyzed using Kinovea software. Time will be calculated from seat-off to attainment of a fully upright standing position. Participants will be allowed to use upper-extremity support as needed. Measurements will be performed before and immediately after the intervention. A shorter time indicates better sit-to-stand performance.

  Baseline and immediately after the single-session intervention

Secondary Outcomes (3)

• Change in Pain Intensity Measured by Visual Analog Scale (VAS)

  Baseline and immediately after the single-session intervention

• Change in Knee Flexion Active Range of Motion (AROM)

  Baseline and immediately after the single-session intervention

• Change in 4-Meter Walk Test (4MWT) Time

  Baseline and immediately after the single-session intervention

Other Outcomes (1)

• Tampa Scale for Kinesiophobia-11 (TSK-11) Score

  Baseline

Study Arms (2)

Unstable-Surface Group

EXPERIMENTAL

Participants will perform low-intensity plantar proprioceptive stimulation while seated, with the operated foot placed on a balance pad. The intervention consists of repeated low-intensity pressing through the operated foot on an unstable surface.

Other: Low-Intensity Plantar Proprioceptive Stimulation on an Unstable Surface

Stable-Surface Group

ACTIVE COMPARATOR

Participants will perform the same low-intensity plantar proprioceptive stimulation while seated, with the operated foot placed on a firm surface. The pressing procedure will be identical to that of the unstable-surface group except for the supporting surface.

Other: Low-Intensity Plantar Proprioceptive Stimulation on a Stable Surface

Interventions

Low-Intensity Plantar Proprioceptive Stimulation on an Unstable Surface OTHER

Participants will perform low-intensity plantar proprioceptive stimulation while seated with the operated foot placed on a balance pad. They will apply low-intensity pressure through the operated foot for 5 seconds followed by 5 seconds of relaxation. The cycle will be repeated 12 times for approximately 2 minutes.

Unstable-Surface Group

Low-Intensity Plantar Proprioceptive Stimulation on a Stable Surface OTHER

Participants will perform the same low-intensity plantar proprioceptive stimulation while seated with the operated foot placed on a firm surface. They will apply low-intensity pressure through the operated foot for 5 seconds followed by 5 seconds of relaxation. The cycle will be repeated 12 times for approximately 2 minutes.

Stable-Surface Group

Eligibility Criteria

• Age: 60 Years - 79 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 60 to 79 years.
• Patients who underwent unilateral total knee arthroplasty (TKA) and are 7 to 14 days postoperatively at the time of study participation.
• Patients who have begun independent gait training using a walker.
• Able to understand the purpose of the study and provide written informed consent.

You may not qualify if:

• Bilateral total knee arthroplasty.
• Severe neurological disease or severe peripheral nervous system disorder.
• Orthostatic hypotension.
• Postoperative cognitive impairment that makes it difficult to understand instructions or perform the study tasks.

Sponsors & Collaborators

• Sahmyook University: lead

Study Sites (1)

Choiseon Orthopedic Clinic

Naju, Jeollanamdo, South Korea

Location

Related Publications (5)

• Kittelson A, Carmichael J, Stevens-Lapsley J, Bade M. Psychometric properties of the 4-meter walk test after total knee arthroplasty. Disabil Rehabil. 2022 Jun;44(13):3204-3210. doi: 10.1080/09638288.2020.1852446. Epub 2020 Dec 5.

  PMID: 33280460 BACKGROUND

• Pua YH, Tan JW, Poon CL, Chew ES, Seah FJ, Thumboo J, Yeo SJ, Woon EL, Clark RA. Sit-to-Stand Weight-Bearing Symmetry Performance in Total Knee Arthroplasty: Recovery Curves, Correlates, and Predictive Validity With Gait Speed. Am J Phys Med Rehabil. 2022 Jul 1;101(7):666-673. doi: 10.1097/PHM.0000000000001882. Epub 2021 Oct 4.

  PMID: 35706119 BACKGROUND

• Christiansen CL, Bade MJ, Judd DL, Stevens-Lapsley JE. Weight-bearing asymmetry during sit-stand transitions related to impairment and functional mobility after total knee arthroplasty. Arch Phys Med Rehabil. 2011 Oct;92(10):1624-9. doi: 10.1016/j.apmr.2011.05.010. Epub 2011 Aug 12.

  PMID: 21839986 BACKGROUND

• Moutzouri M, Coutts F, Gliatis J, Billis E, Tsepis E, Gleeson N. Early initiation of home-based sensori-motor training improves muscle strength, activation and size in patients after knee replacement: a secondary analysis of a controlled clinical trial. BMC Musculoskelet Disord. 2019 May 17;20(1):231. doi: 10.1186/s12891-019-2575-3.

  PMID: 31101039 BACKGROUND

• Moutzouri M, Gleeson N, Coutts F, Tsepis E, Gliatis J. Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial. Clin Rehabil. 2018 Jul;32(7):888-898. doi: 10.1177/0269215518757291. Epub 2018 Feb 23.

  PMID: 29473481 BACKGROUND

Central Study Contacts

Suengwoo Kim

CONTACT

+82 10-4128-3839; obsekim22@naver.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: master's student

Study Record Dates

• First Submitted: September 20, 2026
• First Posted: September 25, 2026
• Study Start: September 7, 2026
• Primary Completion (Estimated): October 31, 2026
• Study Completion (Estimated): October 31, 2026
• Last Updated: September 25, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)