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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
70
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
Aarhus University hospital
Aarhus, Denmark
RECRUITINGPrimary outcome: Sit-to-stand test
Ability of function test
Time frame: Change from Baseline 6 weeks preoperative in Sit-to-Stand at 6 weeks postoperative
Isokinetic: Quadriceps 60 gr./sek
Muscle strength test in dynamometer
Time frame: 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
Muscle strength test in dynamometer
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation
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10 meter walk test
Ability of function test
Time frame: 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
Time frame: 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
Time frame: 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
Time frame: 6 weeks before the operation and 6 weeks after
EuroQol-5 dimensions (EQ-5D)
Generic questionnaire for self-rated health
Time frame: 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
Time frame: 6 weeks before the operation and 1 year after
Background data questionnaire
Questionnaire about pain, medicine use, alcohol intake, smoking, education, job
Time frame: 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
Time frame: 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
Time frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation