Clinical trial NCT01647243: Preoperative Strength Training in Patients With Total Knee Arthroplasty
Official title: Effect of Preoperative Strength Training on Postoperative Quadriceps Strength and Ability of Function in Patients With Total Knee Arthroplasty in Fast Track Regi
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Osteoarthritis, Knee
Keywords: Knee osteoarthritis
Total knee arthroplasty
Preoperative training
Strength training
Lead sponsor: University of Aarhus
Sponsor class: OTHER
First posted: 2012-07-23
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to investigate if preoperative strength training will result in faster recovery and higher level of function six weeks after total knee arthroplasty (TKA).

Detailed description: Reduced strength of the quadriceps muscle is a common clinical finding in patients with Knee Osteoarthritis and this seems to play a central role in the development of the disease. The strength of the quadriceps muscle have been shown to be reduced by 20-40% as compared to age-matched healthy controls and this decrease in muscle strength have been closely associated with a reduced level of function and increase of pain. Furthermore, it has been demonstrated that the preoperative strength of the quadriceps muscle in patients undergoing TKA, is associated with the level of function one year after surgery. Compared to the level before the operation, an additional operation-induced reduction of the strength of the quadriceps muscle up to 60% as has been demonstrated. Presumably, an optimizing of the strength of the quadriceps muscle could counteract the impact of the expected postoperative loss of muscle strength to such an extent that the loss will be of less clinical significance. It is hypothesized that an optimizing of the strength of the quadriceps muscle may have a favorable effect on the postoperative rehabilitation program and shorten the period of convalescence.

Eligibility criteria: Inclusion Criteria:

* Planned TKA at the Aarhus University Hospital or Region Hospital Silkeborg,
* Living in Aarhus Municipality,
* Primary knee osteoarthritis or secondary osteoarthritis after meniscectomy or ligament injury

Exclusion Criteria:

* Unstable blood pressure,
* Neuromuscular or neurodegenerative disease,
* Comprehension or dementia problems

Primary outcomes:
measure: Primary outcome: Sit-to-stand test
timeFrame: Change from Baseline 6 weeks preoperative in Sit-to-Stand at 6 weeks postoperative
Secondary outcomes:
measure: Isokinetic: Quadriceps 60 gr./sek
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Isokinetic: Hamstrings 60 gr./sek
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks 12 weeks and 1 year after the operation
measure: Isometric: Quadriceps (70 gr. flexion)
timeFrame: 6 weeks and 1 week before the operation and 11 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Isometric: Hamstrings (20 gr. flexion)
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Rate of force development (flexion and extension)
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Timed Up and Go
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: 10 meter walk test
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: 6 minute walk test
timeFrame: 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Knee injury and Osteoarthritis Outcome Score (KOOS)
timeFrame: 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Oxford Knee Score (OKS)
timeFrame: 6 weeks before the operation and 6 weeks after
measure: EuroQol-5 dimensions (EQ-5D)
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Short-Form Health Survey (SF 12)
timeFrame: 6 weeks before the operation and 1 year after
measure: Background data questionnaire
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Range of motion of the knee
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
measure: Body mass index
timeFrame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
Other outcomes:
Locations:
city: Aarhus
country: Denmark
facility: Aarhus University hospital
Study officials:
affiliation: Aarhus University Hospital, Department of orthopaedic, Tage Hansensgade 2, 8000 Aarhus C
name: Kjeld Soeballe, Professor
role: STUDY_CHAIR
References:
citation: Skoffer B, Dalgas U, Maribo T, Soballe K, Mechlenburg I. No Exacerbation of Knee Joint Pain and Effusion Following Preoperative Progressive Resistance Training in Patients Scheduled for Total Knee Arthroplasty: Secondary Analyses From a Randomized Controlled Trial. PM R. 2018 Jul;10(7):687-692. doi: 10.1016/j.pmrj.2017.11.002. Epub 2017 Nov 9.
citation: Skoffer B, Maribo T, Mechlenburg I, Hansen PM, Soballe K, Dalgas U. Efficacy of Preoperative Progressive Resistance Training on Postoperative Outcomes in Patients Undergoing Total Knee Arthroplasty. Arthritis Care Res (Hoboken). 2016 Sep;68(9):1239-51. doi: 10.1002/acr.22825. Epub 2016 Jul 28.