When Pain Improves but Complex Walking Does Not

Physical therapists and physical therapist assistants who work with adults before and after total knee replacement in acute care, home health, skilled nursing, or outpatient orthopedic and geriatric settings.

Licensed physical therapists and physical therapist assistants; also useful for rehabilitation clinicians involved in post-arthroplasty care and falls-prevention programming.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports on a single peer-reviewed study and does not draw on outside evidence.

Azzam I, Rozen N, Eliyahu A, Dabby D, Elbaz A, Mor A, Krasovsky T. The Effect of Total Knee Replacement on Dual–Task Gait Performance in Older Adults. PTJ: Physical Therapy & Rehabilitation Journal. 2024;104:pzae067. Original research, published by Oxford University Press on behalf of the American Physical Therapy Association. Registered on ClinicalTrials.gov (NCT04877873).

Scope of this course

Everything stated in this course traces back to that one report. Where the authors framed a finding as uncertain, preliminary, or limited by their sample, this course says so in the same terms. Physical therapist assistants contribute to treatment under the direction and supervision of the evaluating physical therapist.

After completing this course, you will be able to:

1. Describe what the study measured in older adults before and after total knee replacement, including the walking task, the added thinking task, and the balance and pain measures used.
2. State the study's main findings: what changed after surgery, what did not change, and which measure tracked with change in the attention cost of walking.
3. Explain what the authors concluded about balance as a measure and a focus of rehabilitation after total knee replacement, and name the limits they placed on their own conclusions.

1. Start Here: how this course works and what you will get from it
2. The Podcast: Pain, Balance, and the Attention Walking Takes (about nine minutes)
3. Knee Replacement, Falls, and the Attention That Walking Demands
4. How the Study Was Run: Two Visits, Two Walking Trials
5. What Changed After Surgery: Pain, Balance, and Dual-Task Cost
6. Small Sample, Short Follow-Up: What Limits These Findings
7. Balance as a Focal Point After Knee Replacement: What the Authors Concluded
8. Key Takeaways: The Five Points Worth Repeating to a Colleague
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports on a single peer-reviewed study and does not draw on outside evidence.
2. Azzam I, Rozen N, Eliyahu A, Dabby D, Elbaz A, Mor A, Krasovsky T. The Effect of Total Knee Replacement on Dual–Task Gait Performance in Older Adults. PTJ: Physical Therapy & Rehabilitation Journal. 2024;104:pzae067. Original research, published by Oxford University Press on behalf of the American Physical Therapy Association. Registered on ClinicalTrials.gov (NCT04877873).
3. Scope of this course
4. Everything stated in this course traces back to that one report. Where the authors framed a finding as uncertain, preliminary, or limited by their sample, this course says so in the same terms. Physical therapist assistants contribute to treatment under the direction and supervision of the evaluating physical therapist.