DOS 2016

DOS Kongressen 2016 ·

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

Birgit Skoffer, Ulrik Dalgas, Thomas Maribo, Kjeld Søballe, Inger Mechlenburg

Department of Physical and Occupational Therapy, Aarhus University Hospital,

Denmark; Section for Sport Science, Department of Public Health, Aarhus

University, Denmark ; Rehabilitation Center Marselisborg, Department of

Public Health, Section of social medicine and rehabilitation, Aarhus University,

Denmark; Orthopaedic Research Centre, Aarhus University Hospital, Denmark ;

Orthopaedic Research Centre, Aarhus University Hospital, Denmark

Background:

Preoperative progressive resistance training (PRT) is controver-

sial in patients scheduled for total knee arthroplasty (TKA).

Purpose / Aim of Study:

To examine if PRT initiated 5 weeks prior to TKA 1)

would exacerbate pain and knee effusion and 2) would allow a progressively

increased training load throughout the training period that would subsequently

increase muscle strength.

Materials and Methods:

Thirty patients scheduled for TKA underwent unilat-

eral PRT (3 sessions/week). Exercise loading was 12 repetition maximum (RM)

with progression towards 8RM. The training program consisted of 6 exercises

performed unilaterally. Before and after each training session, knee joint pain,

effusion, 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.

Findings / Results:

Median differences of the knee pain at rest from before

to after each training session varied from 0-2. Knee joint pain after the training

session was unchanged over time, p = 0.99. Mean differences of the knee joint

circumference from before to after each training session varied from 0-0.4 cm.

Knee joint circumference after the training session was unchanged over time,

p = 0.99. Training load generally increased and maximal muscle strength im-

proved; unilateral leg press mean 18% ± 30 (p = 0.03), knee extension mean

81% ± 156 (p < 0.0001) and knee flexion mean 53% ± 57 (p < 0.001).

Conclusions:

PRT of the affected leg initiated shortly before TKA does not

exacerbate knee joint pain and effusion despite a substantial general load pro-

gression and increased muscle strength.

No conflicts of interest reported

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