Effects of Balance and Proprioceptive Training on Rehabilitation After Total Knee and Total Hip Replacement: A Systematic Review and Meta-Analysis.

OBJECTIVE

This meta-analysis aimed to compare the efficacy of balance or proprioceptive training and conventional training among older adults undergoing total hip and knee arthroplasty.

METHODS

We systematically searched PubMed, the Cochrane Library, Scopus, and Web of Science from study inception to March 8, 2025 to identify randomized controlled trials comparing the efficacy of balance or proprioceptive training with conventional training among older adults undergoing total hip and knee arthroplasty. The two methods of training were compared in terms of pain, function, and balance. We adopted a random-effects model (DerSimonian-Laird) to pool data.

RESULTS

Nineteen clinical trials with 579 individuals in the balance or proprioceptive training group and 556 individuals in the conventional training group were included in this meta-analysis. There were no significant differences between balance training and conventional training in terms of 10-min walk, average velocity, functional reach, single-leg standing, strength, timed up and go test, knee extension, knee flexion, Berg scale score, the Knee Injury and Osteoarthritis Outcome Score Activities of Daily Living subscale score, Knee Injury and Osteoarthritis Outcome Score pain score, Knee Injury and Osteoarthritis Outcome Score quality of life score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score, WOMAC physical function score, and WOMAC stiffness score. Compared with conventional training, balancing training only decreased the WOMAC total score (standardized mean difference: -0.60, 95% confidence interval [-0.95, -0.25], I2 = 39.15%) and path length (weighted mean difference: -20.84 mm, 95% confidence interval [-32.85, -8.83], I2 = 0.00%).

CONCLUSION

Balance training is not superior to conventional training for the rehabilitation of older adults undergoing total hip or knee arthroplasty.

IMPLICATIONS: Balance training should not be necessarily preferred over conventional training for the rehabilitation of patients undergoing total hip or knee arthroplasty.