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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 Sep 13

DOI: 10.23736/S1973-9087.17.04712-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Randomized controlled trial of maximal strength training vs standard rehabilitation following total knee arthroplasty

Vigdis S. HUSBY 1 , Olav A. FOSS 2, Otto S. HUSBY 3, 4, Siri B. WINTHER 2, 3

1 Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; 2 Orthopaedic Research Centre, Orthopaedic Department, Trondheim University Hospital, Trondheim, Norway; 3 Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; 4 Orthopaedic Department, Trondheim University Hospital, Trondheim, Norway


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BACKGROUND: Total knee arthroplasty (TKA) alleviates pain, but muscle strength and function is reduced for a long period postoperatively.
AIM: To investigate whether maximal strength training (MST) is more effective in improving muscle strength than standard rehabilitation (SR) after TKA.
DESIGN: A randomized, controlled study.
SETTING: Community physical therapy centers and University hospital research department.
POPULATION: Forty-one adults <75 years with primary, unilateral osteoarthritis of the knee scheduled for TKA.
METHODS: Participants were randomized to supervised MST of the lower extremities 3 times/week for 8 weeks and physiotherapy session1/week (n=21) or to SR, including physiotherapy sessions/telephone contact 1/week and writing home exercise logs (n=20). Maximal strength in leg press and knee extension, 6-minute walk test, patient-reported functional outcome score and pain were assessed preoperatively, 7 days, 10 weeks and 12 months postoperatively.
RESULTS: The MST group exceeded preoperative levels of muscle strength in leg press and knee extension by 37% and 43%, respectively at 10 weeks’ follow-up, and the increase was higher than in the SR group (p =<0.001). Strength differences persisted up to 12 months’ follow-up. At 12 months, both groups recovered to normative levels in the 6-minute walk test, with no statistically significantly difference between the groups.
CONCLUSIONS: Participants undergoing MST experienced superior increases in leg press and knee extension muscle strength compared with those managed with SR from 7 days’ to 10 weeks’ follow-up. The difference in muscle strength was maintained at 12 months’ follow- up. No differences in functional performance were found at any time-point.
CLINICAL REHABILITATION IMPACT: Exercises after TKA should be performed with high intensity and target the operated leg specifically.


KEY WORDS: Total knee replacement - Resistance training - Fast-track - Osteoarthritis

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Publication History

Article first published online: September 13, 2017
Manuscript accepted: September 12, 2017
Manuscript revised: September 4, 2017
Manuscript received: March 2, 2017

Per citare questo articolo

Husby VS, Foss OA, Husby OS, Winther SB. Randomized controlled trial of maximal strength training vs standard rehabilitation following total knee arthroplasty. Eur J Phys Rehabil Med 2017 Sep 13. DOI: 10.23736/S1973-9087.17.04712-8

Corresponding author e-mail

vigdis.schnell.husby@ntnu.no