Progressive Exercise After Total Knee Arthroplasty (TKA)

Study Overview
=================
Brief Summary
-----------------
Total knee arthroplasty (TKA) is performed more than 7.000 times a year in Finland most often for osteoarthritis (OA). While pain is predictably reduced, function does not typically ever reach that of age-matched, uninjured subjects. Quadriceps weakness has been implicated in the development and progression of knee OA and is a significant problem after TKA. Advance to return to normal daily activities is not sufficient to restore knee function or quadriceps strength after TKA. The aim of this study is to assess the effectiveness of progressive exercise program restoring knee strength, mobility and improving the functional outcome after primary TKA.

Detailed Description
-----------------
Many studies have shown, that after TKA pain decreased significantly, but muscle strength of the operated knee did not recover and may stay under the preoperative level. To find out the effects of progressive exercise program the investigators will perform, 6 weeks after TKA, a randomized clinical trial of lower extremity strength training using two subgroups of people: traditional exercise group and progressive exercise group.

Official Title
-----------------
Progressive Exercise After Total Knee Arthroplasty: A Randomised Controlled Trial

Conditions
-----------------
Osteoarthritis

Intervention / Treatment
-----------------
* Other: Knee muscle exercises


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: primary unilateral TKA for knee osteoarthritis Exclusion Criteria: Rheumatoid arthritis Fibromyalgia Bilateral TKA Heart or lung disease, which prevent training Unstable serious disease (cancer) Reduced cooperation (drug, alcohol abuse, mental illness)

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: exercise<br>progressive exercise, home-based exercise program, tree exercise sessions weekly, chec-up visits every third month | Other: Knee muscle exercises<br>* Home exercises three times a week, control every three months<br>|
| Active Comparator: Conventional treatment<br>Normal treatment, single guidance to home exercise | Other: Knee muscle exercises<br>* Home exercises three times a week, control every three months<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional tests, pain | Timed-Up and Go-test, Visual analogue scale (VAS) | baseline , 6 weeks after operation (start of training), after 12 months training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee muscle strength | isometric strength of quadriceps and hamstrings | baseline, 6 weeks after operation (start of training), after 12 months training | 
| Health related quality of life | SF-36 | baseline and 12 months | 
| gait analysis |  | baseline, 6 weeks postoperatively, 12 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
osteoarthritis, knee, total knee arthroplasty, exercise