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Preoperative rehabilitation before total knee arthroplasty (TKA) has not been proven to be effective. Latest meta-analyzes do not find any improvement of motor performance during gait 6 months after surgery. However, most of the previous studies did not specifically target muscle atrophy to design rehabilitation protocol. Pre-operative muscle atrophy, although not systematic, is often observed. The preoperative muscles volumes of thigh muscles have been poorly identified and never used to adjust the pre operative rehabilitation strategy.
As part of the "FOLLOWKNEE" (RHU) project, which attempts to implement a personalized management of TKA and its follow-up, this study wants to explore the potential effect of adapted treatment to improve muscle force and muscle volume before TKA.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Global rehabilitation | Active Comparator | 2 hours of daily rehabilitation, 3 days per week during 4 weeks |
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| Personalized rehabilitation | Experimental | 2 hours of daily rehabilitation including at least 2 times 20 minutes of electrostimulation on atrophied muscles, 3 days per week during 4 weeks |
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| Classic rehabilitation | No Intervention | 40 minutes of rehabilitation, once a week during 4 weeks. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Personalized rehabilitation program with electrostimulation | Other | Patient with knee arthroplasty indication. After clinical assessment and a MRI measurement of muscle volume, patients start a 2 hours daily rehabilitation including 2 times 20 minutes of electrostimulation of atrophied muscles, 3 days per week during 4 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Difference of isometric strength D0-W4p | Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W4 will be calculated as follows : (QSW4p-QSD0)+(HSW4p-HSD0). Personalized rehabilitation will first be compared to classic rehabilitation and if positive to global rehabilitation. | Day 0 to Week 4 postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Difference of isometric strength D0-W4 | Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W4 (W4) will be calculated. | Day 0 to Week 4 |
| Difference of isometric strength D0-W12p |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Olivier REMY-NERIS, Pr | University hospital of Brest | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHRU de Brest | Brest | France | 29200 | France |
All collected data that underlie results in a publication.
Data will be available beginning three years and ending fifteen years following the final study report completion.
Data access request will be reviewed by the internal committee of Brest University Hospital. Requestor will be required to sign and complete a data access agreement.
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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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| Global rehabilitation program | Other | Patient with knee arthroplasty indication. After clinical assessment and a MRI measurement of muscle volume, patient start a 2 hours daily rehabilitation targeting muscles groups with strengthening and stretching exercises, 3 days per week during 4 weeks. |
|
Isometric strength of quadriceps (QS) and hamstring (HS) will be measured on isokinetic bench and the difference between D0 and W12postoperative (W12p) will be calculated. |
| Day 0 to Week 12 postoperative |
| Muscles volumes | Quadriceps and hamstring volume as well as all muscles volume of each muscles groups will be evaluated in MRI. | Day 0, Week 4, Week 2 postoperative |
| Walking speed on 10 meters | The patient will be timed when walking 10meters on a graduated corridor. They will be allowed to stop or use a technical help. | Day 0, Week 4, Week 4 postoperative, Week 12 postoperative |
| Time up and go test (TUG) | The patient must get up from the sitting position and walk three meters from the chair and then retrace his steps (turn 180 degrees) and sit down again. The time that the person puts to this activity is timed by the evaluator. | Day 0, Week 4, Week 4 postoperative, Week 12 postoperative |
| Western Ontario McMaster Osteoarthritis Index (WOMAC) | WOMAC is a medical scale for hip and osteoarthritic knee consisting of 24 questions scored between 0 and 4. The questions are about pain, joint stiffness and function. | Day 0, Week 4, Week 4 postoperative, Week 12 postoperative |
| Pain in Analogic Visual Scale (AVS) | The pain during the 5 last days will be evaluated by Analogic Visual Scale. Pain is evaluated on a scale between 0 and 10. 0 is no pain and 10 the worse pain. | Day 0, Week 4, Week 4 postoperative, Week 12 postoperative |
| D012216 |
| Rheumatic Diseases |