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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).
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preoperative strength training | Experimental | Progressive strength training on group basis four weeks before the operation and progressive strength training on group basis four weeks after the operation |
|
| Living as usual | No Intervention | The patients are living as usual the last 4 weeks before operation |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative strength training | Other | Progressive strength training on group basis (not more than 3 subjects) 3 sessions weekly starting 4 weeks before the operation, in total 12 sessions Strength training 3 sessions weekly 4 weeks postsurgery |
| Measure | Description | Time Frame |
|---|---|---|
| Primary outcome: Sit-to-stand test | Ability of function test | Change from Baseline 6 weeks preoperative in Sit-to-Stand at 6 weeks postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Isokinetic: Quadriceps 60 gr./sek | Muscle strength test in dynamometer | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Isokinetic: Hamstrings 60 gr./sek |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Birgit Sørensen Skoffer, MPH | Contact | +45 50 42 28 30 | BSkoffer@dadlnet.dk |
| Name | Affiliation | Role |
|---|---|---|
| Kjeld Soeballe, Professor | Aarhus University Hospital, Department of orthopaedic, Tage Hansensgade 2, 8000 Aarhus C | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aarhus University hospital | Recruiting | Aarhus | 8000 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29129608 | Derived | 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. | |
| 26713665 |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D055070 | Resistance Training |
| ID | Term |
|---|---|
| D005081 | Exercise Therapy |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
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|
Muscle strength test in dynamometer
| 6 weeks and 1 week before the operation, 1 week, 6 weeks 12 weeks and 1 year after the operation |
| Isometric: Quadriceps (70 gr. flexion) | Muscle strength test in dynamometer | 6 weeks and 1 week before the operation and 11 week, 6 weeks, 12 weeks and 1 year after the operation |
| Isometric: Hamstrings (20 gr. flexion) | Muscle strength test in dynamometer | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Rate of force development (flexion and extension) | Muscle test in dynamometer | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Timed Up and Go | Ability of function test | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| 10 meter walk test | Ability of function test | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| 6 minute walk test | Ability of function test | 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Knee injury and Osteoarthritis Outcome Score (KOOS) | Disease-specific questionnaire | 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Oxford Knee Score (OKS) | Disease-specific questionnaire | 6 weeks before the operation and 6 weeks after |
| EuroQol-5 dimensions (EQ-5D) | Generic questionnaire for self-rated health | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Short-Form Health Survey (SF 12) | Generic questionnaire for self-rated health | 6 weeks before the operation and 1 year after |
| Background data questionnaire | Questionnaire about pain, medicine use, alcohol intake, smoking, education, job | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Range of motion of the knee | Extension of the knee Flexion of the knee | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| Body mass index | Weight/height2 | 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation |
| 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. |
| D012216 |
| Rheumatic Diseases |
| D005791 |
| Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D064797 | Physical Conditioning, Human |
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |