4.3. Effects of Gait 
pain
After TKA, the patients experienced a decreased frequency of step length owing to slow gait speed and a decreased knee joint flexion angle during the stance and swing phases. Smith et al. [Ouellet and Moffet [This study had several limitations. We evaluated the short-term effect of CCE after 4 weeks of intervention. However, the long-term effects could not be determined owing to a lack of follow-up. Moreover, as the participants (only women) were recruited from specific countries and regions, the results cannot represent all patients who underwent TKA. Additionally, we could not control the drugs and injections used for pain control in the in-patient unit. Therefore, in a future study, considering these limitations, a long-term exercise plan should be implemented for all patients who underwent TKA, and it should be confirmed whether the impact of CCE is effective throughout the follow-up. Additional studies are needed to provide evidence to support CCE training in patients who underwent TKA.