Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible?

TY - JOUR

T1 - Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible?

AU - Jakobsen, Thomas Linding

AU - Husted, Henrik

AU - Kehlet, Henrik

AU - Bandholm, Thomas

PY - 2012

Y1 - 2012

N2 - Purpose: To explore the feasibility of progressive strength training commenced immediately after total knee arthroplasty (TKA). Methods: A pilot study was conducted at an outpatient training facility. Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition maximum with three training sessions per week for 2 weeks. Rehabilitation was commenced 1 or 2 days after TKA. At each training session, knee pain, knee joint effusion and training load were recorded. Isometric knee-extension strength and maximal walking speed were measured before the first and last session. Results: The training load increased progressively (p < 0.0001). Patients experienced only moderate knee pain during the strength training exercises, but knee pain at rest and knee joint effusion (p < 0.0001) were unchanged or decreased over the six training sessions. Isometric knee-extension strength and maximal walking speed increased by 147 and 112%, respectively. Conclusion: Progressive strength training initiated immediately after TKA seems feasible, and increases knee-extension strength and functional performance without increasing knee joint effusion or knee pain. Implications for Rehabilitation Rehabilitation with progressive strength training initiated early after total knee arthroplasty (TKA) seems feasible. Rehabilitation with progressive strength training increases knee-extension strength and maximal walking speed without increasing knee joint effusion and knee pain during the first 2 weeks after TKA. During the progressive strength training exercises, patients with TKA may experience moderate knee pain, which seems to decrease over time. Resting knee pain before and after each training session is none to mild. The results of this pilot study are encouraging, but a larger randomized controlled trial, which compares rehabilitation with or without progressive strength training, is needed to confirm our findings.

AB - Purpose: To explore the feasibility of progressive strength training commenced immediately after total knee arthroplasty (TKA). Methods: A pilot study was conducted at an outpatient training facility. Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition maximum with three training sessions per week for 2 weeks. Rehabilitation was commenced 1 or 2 days after TKA. At each training session, knee pain, knee joint effusion and training load were recorded. Isometric knee-extension strength and maximal walking speed were measured before the first and last session. Results: The training load increased progressively (p < 0.0001). Patients experienced only moderate knee pain during the strength training exercises, but knee pain at rest and knee joint effusion (p < 0.0001) were unchanged or decreased over the six training sessions. Isometric knee-extension strength and maximal walking speed increased by 147 and 112%, respectively. Conclusion: Progressive strength training initiated immediately after TKA seems feasible, and increases knee-extension strength and functional performance without increasing knee joint effusion or knee pain. Implications for Rehabilitation Rehabilitation with progressive strength training initiated early after total knee arthroplasty (TKA) seems feasible. Rehabilitation with progressive strength training increases knee-extension strength and maximal walking speed without increasing knee joint effusion and knee pain during the first 2 weeks after TKA. During the progressive strength training exercises, patients with TKA may experience moderate knee pain, which seems to decrease over time. Resting knee pain before and after each training session is none to mild. The results of this pilot study are encouraging, but a larger randomized controlled trial, which compares rehabilitation with or without progressive strength training, is needed to confirm our findings.

U2 - 10.3109/09638288.2011.629019

DO - 10.3109/09638288.2011.629019

M3 - Journal article

C2 - 22084974

SN - 0963-8288

VL - 34

SP - 1034

EP - 1040

JO - Disability and Rehabilitation

JF - Disability and Rehabilitation

IS - 12

ER -