DOS Kongressen 2014 ·
115
Efficacy of preoperative progressive resistance training
on postoperative functional capacity and muscle
strength in patients undergoing total knee arthroplasty
Birgit Skoffer, Thomas Maribo, Inger Mechlenburg, Per Møller Hansen,
Kjeld Søballe, Ulrik Dalgas
Institute of Clinical Medicine and Department of Physical and Occupational
Therapy, Aarhus University and Aarhus University Hospital; MarselisborgCentret,
Danish Rehabilitation Research Centre; National Public Health and Quality Impro,
Central Denmark Region, Aarhus and Aarhus University; Institute of Clinical
Medicine and Orthopaedic Research Centre, Aarhus University and Aarhus
University Hospital; Orthopaedic Department, Silkeborg Regional Hospital;
Orthopaedic Research Centre, Aarhus University Hospital ; Section of Sport
Science, Department of Public Health, Aarhus University
Background:
Reduced knee extensor muscle strength and associated impaired
functional capacity is a common clinical finding in people with knee osteoarthri-
tis. Furthermore, knee extensor muscle strength is a strong predictor of func-
tional capacity one year after total knee arthroplasty (TKA).
Purpose / Aim of Study:
To investigate the efficacy of 4 weeks of preop-
erative and 4-week post-operative progressive resistance training (PRT) com-
pared to 4 weeks of postoperative PRT alone in patients undergoing total knee
arthroplasty. Outcomes were functional capacity, muscle strength and patient
reported outcomes.
Materials and Methods:
In a single-blinded, clinical, randomized, controlled
trial, 59 patients were randomized to 4 weeks of preoperative PRT (PRT group)
or to a control group who “lived as usual” (control group). All patients performed
4 weeks of PRT after TKA. At 6 weeks before TKA, and at 6 weeks after TKA
functional capacity, knee extensor and flexor muscle strength, patient reported
functional capacity, health related quality of life, pain scores and medication was
registered.
Findings / Results:
A significant group difference was found in favor of the
PRT group for the 30sec-sit-to- stand test (3.5± 1.2 rep; p<0.01), the timed-
up-and-go test (-1.56± 0.64 sec.; p<0.05), in knee extensor muscle strength
(19.3± 6.4 Nm; p<0.01) and in knee flexor muscle strength (16.0± 5.5 Nm,
p<0.01) when evaluated 6 weeks after TKA. No differences were found be-
tween groups on patient reported outcomes except for the KOOS sport sub-
scale (13.6± 6.6 p<0.05) favoring the PRT group.
Conclusions:
Preoperative PRT is an effective intervention improving postopera-
tive functional capacity and muscle strength but not patient reported outcomes,
without worsening pain or increasing medication in patients undergoing TKA.
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