The Difference Between Rehabilitation With or Without Strength Training After Total Knee Replacement
Condition: Osteoarthritis, Knee
MeSH terms: Osteoarthritis, Knee
Study type: Interventional
Phase: Phase 2

Summary: 
      Background and purpose:

      In the early phase after a total knee replacement (TKA), patients experience a decrease in
      leg muscle strength with up to about 80%. This considerable loss of muscle strength is
      related to reduced functional performance at this point in time. As the loss of muscle
      strength and functional performance is most pronounced early after TKA, rehabilitation
      including strength training initiated early after TKA seems a logical choice. However,
      tradition and fear of symptom exacerbation, such as increased knee joint swelling, knee pain
      and slow recovery of knee joint range of motion, have typically precluded strength training
      early after TKA.

      Hypothesis:

      Our hypothesis is that the effect of early rehabilitation including strength training will be
      greater than rehabilitation without strength training. If the hypothesis is confirmed,
      strength training early after TKA could be implemented directly into clinical rehabilitation
      practice.

      Participants and methods:

      Seventy participants with a unilateral TKA, between the age of 18 to 80 years, who understand
      and speak Danish, have given informed consent, will be included in this study.The study is a
      single-blinded randomized controlled study, where the participants receive supervised 1)
      rehabilitation with or 2) rehabilitation without strength training in 7 weeks. All components
      of the rehabilitation program (balance-, and mobility training etc.) are the same in both
      groups except the strength training exercises. Instead of the strength training exercises,
      the group without strength training spend more time on warm-up exercises, mobility- and
      balance exercises. The rehabilitation program lasts 1 hour per session, and will be performed
      twice per week. The participants perform a test battery 4 times from before to 6 months after
      the TKA. The test battery assesses the participants' walking ability, leg strength, knee
      pain, knee joint swelling- and range of motion, and self-reported function and quality of
      life.

      Ethical issues:

      From a pilot study conducted in the beginning of 2010, the investigators found, that strength
      training initiated early after TKA seems feasible, and does not increase knee joint swelling
      and knee pain. None of the financial supporters, or any of the authors, have any potential
      conflicts of interest with regard to the study.
    


Intervention name(s): Rehabilitation with strength training; Rehabilitation without strength training
Intervention type(s): Other; Other
Intervention description(s): The rehabilitation programme lasts 1 hour per session, and is performed twice per week for 7 weeks. The rehabilitation program consists of balance-, mobility- and functional training exercises etc. In addition, the participants perform unilateral (operated leg) knee-extensions and leg presses in 2 sets for each strength training exercise, using relative loads of 12 RM (week 1), 10 RM (weeks 2-5), and 8 RM (week 6-7). All sets are performed to failure.; The rehabilitation programme lasts 1 hour per session, and is performed twice per week for 7 weeks. The rehabilitation program consists of the same balance-, mobility- and functional training exercises etc. as used in the other experimental arm.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Arthroplasty, Replacement, Knee; Resistance training; Physical Therapy Modalities; Randomized Controlled Trial