Progressive Rehabilitation Following Total Knee Arthroplasty
| Status: | Completed |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 50 - 85 |
| Updated: | 10/13/2018 |
| Start Date: | July 2011 |
| End Date: | June 2018 |
The purpose of this study is to evaluate the effectiveness of a progressive resistance
rehabilitation program (PROG) after total knee arthroplasty (TKA) compared to a traditional
rehabilitation program (TRAD).
The investigators hypothesized:
- PROG will result in greater improvements in functional outcome measures such as: stair
climbing test (SCT), timed-up-and-go test (TUG), six minute walk test (6MW), the Knee
Injury and Osteoarthritis Outcome Survey (WOMAC), and knee range of motion (ROM).
- PROG will result in greater improvements in quadriceps muscle strength gains after TKA
compared to TRAD.
- PROG will result in greater improvements in muscle mass and central activation compared
to TRAD.
rehabilitation program (PROG) after total knee arthroplasty (TKA) compared to a traditional
rehabilitation program (TRAD).
The investigators hypothesized:
- PROG will result in greater improvements in functional outcome measures such as: stair
climbing test (SCT), timed-up-and-go test (TUG), six minute walk test (6MW), the Knee
Injury and Osteoarthritis Outcome Survey (WOMAC), and knee range of motion (ROM).
- PROG will result in greater improvements in quadriceps muscle strength gains after TKA
compared to TRAD.
- PROG will result in greater improvements in muscle mass and central activation compared
to TRAD.
Over 500,000 total knee arthroplasties (TKAs) are performed each year in the United States to
alleviate pain and disability associated with knee osteoarthritis (OA), and this number is
expected to grow to 3.48 million per year by the year 2030. TKA reduces pain and improves
self-reported function compared to pre-operative levels, but post-operative deficits in
walking speed (20% slower) and stair climbing speed (50% slower) can persist for years. Stair
climbing performance is the single largest residual deficit after TKA with seventy-five
percent of TKA patients reporting difficulty negotiating stairs after surgery. Collectively,
these findings suggest that current rehabilitation does not adequately target the impairments
that lead to long-term deficits in functional mobility after TKA.
The aim of the proposed trial is to evaluate the effectiveness of a progressive resistance
rehabilitation program (PROG) after TKA compared to a traditional rehabilitation program
(TRAD). The PROG intervention will involve intensive rehabilitation using progressive
resistance exercise and faster progression to functional strengthening exercises. The TRAD
intervention represents the synthesis of previously published TKA rehabilitation programs.
Our preliminary data suggest that the PROG intervention has low risk and results in improved
functional mobility and muscle strength. The investigators will measure function and strength
at six time points (pre-op; 1, 2, 3, 6, and 12 months after TKA). The investigators will also
evaluate the contribution of changes in muscle mass (atrophy/hypertrophy) and central
activation to changes in muscle strength following PROG and TRAD interventions.
alleviate pain and disability associated with knee osteoarthritis (OA), and this number is
expected to grow to 3.48 million per year by the year 2030. TKA reduces pain and improves
self-reported function compared to pre-operative levels, but post-operative deficits in
walking speed (20% slower) and stair climbing speed (50% slower) can persist for years. Stair
climbing performance is the single largest residual deficit after TKA with seventy-five
percent of TKA patients reporting difficulty negotiating stairs after surgery. Collectively,
these findings suggest that current rehabilitation does not adequately target the impairments
that lead to long-term deficits in functional mobility after TKA.
The aim of the proposed trial is to evaluate the effectiveness of a progressive resistance
rehabilitation program (PROG) after TKA compared to a traditional rehabilitation program
(TRAD). The PROG intervention will involve intensive rehabilitation using progressive
resistance exercise and faster progression to functional strengthening exercises. The TRAD
intervention represents the synthesis of previously published TKA rehabilitation programs.
Our preliminary data suggest that the PROG intervention has low risk and results in improved
functional mobility and muscle strength. The investigators will measure function and strength
at six time points (pre-op; 1, 2, 3, 6, and 12 months after TKA). The investigators will also
evaluate the contribution of changes in muscle mass (atrophy/hypertrophy) and central
activation to changes in muscle strength following PROG and TRAD interventions.
Inclusion Criteria:
- undergoing a primary, unilateral knee arthroplasty
- body mass index < 40 kg/m2
Exclusion Criteria:
- severe contralateral leg OA (< 5/10 pain with stair climbing) or other unstable
orthopaedic conditions that limit function
- neurological conditions that affect muscle function
- vascular or cardiac problems that limit function
- uncontrolled diabetes
- pregnancy
We found this trial at
1
site
Click here to add this to my saved trials
