Effect of core stabilization exercises on balance and quality of life among patients with total knee replacement in Gaza Strip, Palestine: a randomized controlled trial

Patients following total knee replacement (TKR) may experience persistent balance deficits and reduced quality of life, highlighting the need for rehabilitation strategies that address both knee function and postural control. To evaluate the effect of Core Stabilization Exercises on balance and Quality of life among patients with Total knee replacement. Thirty-six patients were randomly assigned to one of two groups after undergoing TKR. The intervention group received conventional physiotherapy plus Core Stabilization Exercises (CSEs), whereas the control group received conventional physiotherapy alone. Both groups received treatment three sessions per week for 6 weeks. Outcomes were assessed 48 h after surgery and before initiation of physiotherapy (early postoperative baseline), immediately after the 6-week intervention, and 4 weeks after completion of the intervention (week 10). Data were collected using the Short Form-36 for Quality of life, the Berg Balance Scale (BBS) for balance, the High-activity Arthroplasty Score (HAAS) for lower-limb function, and the Visual Analogue Scale (VAS) for pain intensity. SPSS version 26 was used for statistical analysis. Both groups showed significant improvements over time in pain intensity, lower-limb function, balance, and quality of life ( p < 0.05). The intervention group showed greater improvement in BBS scores from 35.72 ± 8.95 at baseline to 53.33 ± 1.84 at week 10, compared with 39.11 ± 8.37 to 43.33 ± 8.89 in the control group. Physical Functioning improved from 28.78 ± 1.83 to 61.90 ± 15.73 in the intervention group, compared with 29.33 ± 1.57 to 48.33 ± 12.60 in the control group. HAAS and VAS improved in both groups, but between-group differences were not significant for VAS and HAAS ( p = 0.89 and p = 0.24, respectively). No adverse events attributable to the CSE program or safety-related discontinuations were reported. After TKR, CSEs were included in the conventional knee rehabilitation program to enhance knee function, balance, quality of life, and pain management. These findings suggest that adding CSEs to conventional postoperative physiotherapy may provide additional benefits, particularly for balance and quality-of-life outcomes. However, improvements from the early postoperative baseline may partly reflect natural postoperative recovery. The Palestinian Health Research Council (PHRC). Registration number PHRC/HC/1379/23. 02/10/2023.