Prehabilitation Effect on Function and Patient Satisfaction Following Total Knee Arthroplasty

Study Overview
=================
Brief Summary
-----------------
Knee arthrosis has a high prevalence. Non-surgical treatment, such as exercise, is the first choice of treatment. However, most patients end up having a surgical procedure such as total knee arthroplasty. Following surgery with total knee replacement as much as 20% of patients report to not be satisfied with the results. It is noteworthy that this level of dissatisfaction has persisted over the last decades despite formidable progress in surgical methods and technology. Leg strength prior to surgery is associated with faster recovery post operatively, which may influence satisfaction. The investigators aim is to implement a period of strength training prior to surgery to evaluate if training prior to surgery may reduce the level of dissatisfaction post operatively.

Official Title
-----------------
Prehabilitation Effect on Function and Patient Satisfaction Following Total Knee Arthroplasty

Conditions
-----------------
Prehabilitation, Knee Osteoarthritis

Intervention / Treatment
-----------------
* Behavioral: Maximal strength training


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Knee artrosis, refered to surgery Exclusion Criteria: Kognitive disability Inflamatory disease in muscles varus/ valgus and extension deficit >15 degrees Neurological disorders

Ages Eligible for Study
-----------------
Minimum Age: 50 Years
Maximum Age: 80 Years

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

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

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

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Maximal strength training<br>eight weeks of leg press strength training prior to knee surgery | Behavioral: Maximal strength training<br>* 3 sessions/ week. leg press at  85% of one repetition maximum for 8 weeks<br>|
| No Intervention: Control<br>treatment as usual prior to knee surgery | |

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Leg press strength | The maximal weight that can be lifted once | Baseline, 1 week pre-surgery, 3week post-surgery, 12 months post-surgery. | 
| Group differences in Patient satisfaction | Satisfied with the results of knee surgery: yes/no | Change from 3 week post-surgery, 12 months post-surgery. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Voluntary activation | Force production of thigh muscle during contraction with superimposed electrical stimulation | Baseline, 1 week pre-surgery, 3week post-surgery. | 
| Change in Self reported knee function | The Knee Injury and Osteoarthritis Outcome Score - Physical Function - Short Form | Baseline, 1 week pre-surgery, 3week post-surgery, 12 months post-surgery. | 
| Change in Walking speed | 10 meter walking test | Baseline, 1 week pre-surgery, 3week post-surgery, 12 months post-surgery. | 
| Change in Chair rising ability | 30 second sit to stand test | Baseline, 1 week pre-surgery, 3week post-surgery, 12 months post-surgery. | 
| Change in Balance | unipedal stance test, postural sway | Baseline, 1 week pre-surgery, 3week post-surgery, 12 months post-surgery. |