Inger Mechlenburg

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

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BACKGROUND: Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion.

OBJECTIVE: To examine if preoperative PRT initiated 5 weeks prior to TKA would 1) exacerbate pain and knee effusion, 2) allow a progressively increased training load throughout the training period that would subsequently increase muscle strength.

DESIGN: Secondary analyses from a randomized controlled trial.

SETTING: University Hospital and a Regional Hospital.

PATIENTS: Thirty patients were scheduled for TKA due to osteoarthritis and assigned for the intervention group.

METHODS: Patients underwent unilateral PRT (3 sessions/week). Exercise loading was 12 repetition maximum (RM) with progression towards 8RM. The training program consisted of 6 exercises performed unilaterally.

MAIN OUTCOME MEASURES: Before and after each training session, knee joint pain rated on an 11-point scale, effusion assessed by measuring the knee joint circumference, and training load were recorded. The first and last training session were initiated by 1RM testing of unilateral leg press, knee extension and knee flexion.

RESULTS: Median pain change score from before to after each training session was 0 at all training sessions. The average increase in knee joint effusion across the 12 training session was mean 0.16 cm±0.23. No consistent increase of knee joint effusion after training sessions during the training period was found (p=.21). Training load generally increased and maximal muscle strength improved; unilateral leg press: 18%±30 (p=.03), knee extension: 81%±156 (p<.001) and knee flexion: 53%±57 (p<.001).

CONCLUSION: PRT of the affected leg initiated shortly before TKA does not exacerbate knee joint pain and effusion despite a substantial progression in loading and increased muscle strength. Concerns for side effects such as pain and effusion after PRT seem unfounded.

TidsskriftPM & R
Sider (fra-til)687-692
Antal sider6
StatusUdgivet - jul. 2018

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