Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty: A Randomized Controlled Trial

Thomas Linding Jakobsen; Henrik Kehlet; Henrik Husted; Janne Petersen; Thomas Quaade Bandholm

doi:10.1002/acr.22405

Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty: A Randomized Controlled Trial

Thomas Linding Jakobsen, Henrik Kehlet, Henrik Husted, Janne Petersen, Thomas Quaade Bandholm

48 Citations (Scopus)

Abstract

OBJECTIVE: To compare 7 weeks of supervised physical rehabilitation with or without progressive strength training (PST) commenced early after fast-track total knee arthroplasty (TKA) on functional performance.

METHODS: In total, 82 patients with a unilateral primary TKA were randomized to 2 different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA.

RESULTS: There was no statistically significant difference between the PST and CON groups in the change score from baseline to the 8-week postoperative assessment (primary end point) for the 6-minute walk test with unadjusted baseline scores (mean difference between groups: -11.3 meters [95% confidence interval -45.4, 22.7]; analysis of variance P = 0.51). There were no statistically significant or clinically meaningful differences between groups in change scores from baseline to any other time point for all secondary outcomes. The secondary outcome knee extension strength did not reach the level recorded before surgery in both groups.

CONCLUSION: Seven weeks of supervised physical rehabilitation with PST was not superior to 7 weeks of supervised physical rehabilitation without PST in improving functional performance, measured as the maximal walking distance in 6 minutes, at the primary end point 8 weeks after fast-track TKA.

Original language	English
Journal	Arthritis Care & Research
Volume	66
Issue number	12
Pages (from-to)	1856-1866
Number of pages	11
ISSN	2151-464X
DOIs	https://doi.org/10.1002/acr.22405
Publication status	Published - 1 Dec 2014

Keywords

Aged
Arthroplasty, Replacement, Knee
Female
Humans
Knee Joint
Male
Middle Aged
Osteoarthritis, Knee
Quality of Life
Range of Motion, Articular
Resistance Training
Treatment Outcome

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10.1002/acr.22405

Cite this

@article{d2fd99849dba48b289c16f272f80786c,

title = "Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty: A Randomized Controlled Trial",

abstract = "OBJECTIVE: To compare 7 weeks of supervised physical rehabilitation with or without progressive strength training (PST) commenced early after fast-track total knee arthroplasty (TKA) on functional performance.METHODS: In total, 82 patients with a unilateral primary TKA were randomized to 2 different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA.RESULTS: There was no statistically significant difference between the PST and CON groups in the change score from baseline to the 8-week postoperative assessment (primary end point) for the 6-minute walk test with unadjusted baseline scores (mean difference between groups: -11.3 meters [95% confidence interval -45.4, 22.7]; analysis of variance P = 0.51). There were no statistically significant or clinically meaningful differences between groups in change scores from baseline to any other time point for all secondary outcomes. The secondary outcome knee extension strength did not reach the level recorded before surgery in both groups.CONCLUSION: Seven weeks of supervised physical rehabilitation with PST was not superior to 7 weeks of supervised physical rehabilitation without PST in improving functional performance, measured as the maximal walking distance in 6 minutes, at the primary end point 8 weeks after fast-track TKA.",

keywords = "Aged, Arthroplasty, Replacement, Knee, Female, Humans, Knee Joint, Male, Middle Aged, Osteoarthritis, Knee, Quality of Life, Range of Motion, Articular, Resistance Training, Treatment Outcome",

author = "Jakobsen, {Thomas Linding} and Henrik Kehlet and Henrik Husted and Janne Petersen and Bandholm, {Thomas Quaade}",

note = "Copyright {\textcopyright} 2014 by the American College of Rheumatology.",

year = "2014",

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doi = "10.1002/acr.22405",

language = "English",

volume = "66",

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journal = "Arthritis Care & Research",

issn = "2151-464X",

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TY - JOUR

T1 - Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty

T2 - A Randomized Controlled Trial

AU - Jakobsen, Thomas Linding

AU - Kehlet, Henrik

AU - Husted, Henrik

AU - Petersen, Janne

AU - Bandholm, Thomas Quaade

PY - 2014/12/1

Y1 - 2014/12/1

N2 - OBJECTIVE: To compare 7 weeks of supervised physical rehabilitation with or without progressive strength training (PST) commenced early after fast-track total knee arthroplasty (TKA) on functional performance.METHODS: In total, 82 patients with a unilateral primary TKA were randomized to 2 different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA.RESULTS: There was no statistically significant difference between the PST and CON groups in the change score from baseline to the 8-week postoperative assessment (primary end point) for the 6-minute walk test with unadjusted baseline scores (mean difference between groups: -11.3 meters [95% confidence interval -45.4, 22.7]; analysis of variance P = 0.51). There were no statistically significant or clinically meaningful differences between groups in change scores from baseline to any other time point for all secondary outcomes. The secondary outcome knee extension strength did not reach the level recorded before surgery in both groups.CONCLUSION: Seven weeks of supervised physical rehabilitation with PST was not superior to 7 weeks of supervised physical rehabilitation without PST in improving functional performance, measured as the maximal walking distance in 6 minutes, at the primary end point 8 weeks after fast-track TKA.

AB - OBJECTIVE: To compare 7 weeks of supervised physical rehabilitation with or without progressive strength training (PST) commenced early after fast-track total knee arthroplasty (TKA) on functional performance.METHODS: In total, 82 patients with a unilateral primary TKA were randomized to 2 different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA.RESULTS: There was no statistically significant difference between the PST and CON groups in the change score from baseline to the 8-week postoperative assessment (primary end point) for the 6-minute walk test with unadjusted baseline scores (mean difference between groups: -11.3 meters [95% confidence interval -45.4, 22.7]; analysis of variance P = 0.51). There were no statistically significant or clinically meaningful differences between groups in change scores from baseline to any other time point for all secondary outcomes. The secondary outcome knee extension strength did not reach the level recorded before surgery in both groups.CONCLUSION: Seven weeks of supervised physical rehabilitation with PST was not superior to 7 weeks of supervised physical rehabilitation without PST in improving functional performance, measured as the maximal walking distance in 6 minutes, at the primary end point 8 weeks after fast-track TKA.

KW - Aged

KW - Arthroplasty, Replacement, Knee

KW - Female

KW - Humans

KW - Knee Joint

KW - Male

KW - Middle Aged

KW - Osteoarthritis, Knee

KW - Quality of Life

KW - Range of Motion, Articular

KW - Resistance Training

KW - Treatment Outcome

U2 - 10.1002/acr.22405

DO - 10.1002/acr.22405

M3 - Journal article

C2 - 25074397

SN - 2151-464X

VL - 66

SP - 1856

EP - 1866

JO - Arthritis Care & Research

JF - Arthritis Care & Research

IS - 12

ER -

Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty: A Randomized Controlled Trial

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