Copyright: © 2026 by the authors. Licensee: Pirogov University.
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ORIGINAL RESEARCH

Using interactive technologies for rehabilitation following revision knee arthroplasty

About authors

1 Bashkir State Medical University, Republic of Bashkortostan, Ufa, Russia

2 Avicenna Tajik State Medical University, Dushanbe, Tajikistan

Correspondence should be addressed: Vladislav Nikolaevich Akbashev
Lenina, 3, Ufa, 450008, Russia; ur.liam@bka-dalv

About paper

Author contribution: Minasov BS — study concept and design, research supervision, editing; Yakupov RR — study design, data analysis, text preparation; Akbashev VN — study concept, interpretation of results, editing; Bilyalov AR — collection of clinical material, examination of patients, preparation of materials for analysis; Yevgrafov IO — rehabilitation program, collection and systematization of clinical data; Karimov KK — methodological support of the study, technical support, analysis of the obtained data; Minasov IB — interpretation of the results, text preparation and editing; Akhmeldinova AA — statistical data processing, registration of the results of the study; Salimyanova MR — literature analysis, preparation and registration of the manuscript.

Compliance with ethical standards: the study was approved by the Ethics Committee of the Bashkir State Medical University of the Ministry of Health of the Russian Federation (Minutes #2 of February 03, 2025). All procedures were performed in accordance with the requirements of the 2013 World Medical Association Declaration of Helsinki. All patients signed a voluntary informed consent form for participation in the study.

Received: 2026-03-21 Accepted: 2026-04-10 Published online: 2026-04-27
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A chronic periprosthetic infection after knee replacement typically requires two-stage treatment. However, the inter-stage rehabilitation protocol for patients with an articulating spacer has not been adequately developed. This study aimed to determine whether adding interactive biofeedback walking training on the Walker View treadmill enhances the effectiveness of a standard recovery program following the first stage of two-stage revision treatment. The prospective randomized controlled trial included 87 patients who had undergone removal of their endoprostheses and placement of articulating spacers. The treatment group (n = 43) had the standard 21-day rehabilitation program combined with Walker View sessions, while the control group (n = 44) only followed the program. We assessed knee joint movement volume, quadriceps EMG amplitude, stride length, walking speed, postural stability, and SF-36, WOMAC, and KSS scores. By the end of the rehabilitation course, the results registered in the treatment group were better than in the control group: flexion — 78 ± 6° versus 71 ± 7° (p = 0.01); EMG amplitude — 179 ± 16 versus 165 ± 16 μV (p = 0.01); step length — 54.2 ± 5.0 versus 49.5 ± 5.0 cm (p = 0.01); walking speed — 0.70 ± 0.05 versus 0.65 ± 0.05 m/s (p = 0.02); overall stability — 80 ± 8% versus 72 ± 7% (p = 0.01); physical component SF-36 — 51 ± 8 versus 47 ± 7 points (p = 0.01). The differences in WOMAC and KSS scores were insignificant (p = 0.06 and p = 0.07). The inclusion of Walker View sessions in the inter-stage rehabilitation program yields more pronounced improvements in mobility, neuromuscular function, walking, and balance restoration.

Keywords: rehabilitation, knee joint, biofeedback, revision arthroplasty, periprosthetic infection, Walker View, two-stage revision arthroplasty, articulating spacer

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