PM&R
Volume 1, Issue 8 , Pages 729-735, August 2009

The Effect of Prehabilitation Exercise on Strength and Functioning After Total Knee Arthroplasty

  • Robert Topp, RN, PhD

      Affiliations

    • School of Nursing, University of Louisville, 555 S. Floyd Street, Louisville, KY 40205†
    • Corresponding Author InformationAddress correspondence to: R.T.
    • ,
  • Ann M. Swank, PhD

      Affiliations

    • Department of Exercise Science, University of Louisville, Louisville, KY‡
    • ,
  • Peter M. Quesada, PhD

      Affiliations

    • Department of Mechanical Engineering, University of Louisville, Louisville, KY§
    • ,
  • John Nyland, EdD, PT

      Affiliations

    • Department of Orthopedics, University of Louisville, Louisville, KY
    • ,
  • Arthur Malkani, MD

      Affiliations

    • Department of Orthopedics, University of Louisville, Louisville, KY∥

Received 13 February 2009; accepted 1 June 2009.

Objective

The purpose of this study was to examine the effect of a preoperative exercise intervention on knee pain, functional ability, and quadriceps strength among patients with knee osteoarthritis before and after total knee arthroplasty (TKA) surgery.

Design

A repeated-measures design was used to compare 2 groups over 4 data collection points.

Setting and Patients

Community-dwelling subjects with osteoarthritis of the knee who were scheduled for a unilateral TKA were recruited from a single orthopedic surgeon's office and were randomized into control (n = 28) or prehab groups (n = 26).

Interventions

The control patients maintained usual care before their TKA. The exercisers performed prehabilitation exercises, which included resistance training, flexibility, and step training, 3 times per week before their TKA.

Outcome Measures

Knee pain, functional ability, quadriceps strength, and strength asymmetry were assessed at baseline (T1), at 1 week before the patients' TKA (T2), and again at 1 (T3) and 3 (T4) months after TKA.

Results

The exercisers improved their sit-to-stand performance at T2, whereas the control group did not change their performance of functional tasks and had increased pain at T2. At T3 the exercisers demonstrated improved sit-to-stand performance. The control patients at T3 exhibited decreases in pain, their 6-minute walk, surgical leg strength and an increase in their nonsurgical leg strength and leg strength asymmetry. At T4 the exercisers improved in their performance of 3 of the 4 functional tasks, decreased all of their pain measures, and increased their surgical and nonsurgical quadriceps strength. At T4 the control group improved their performance on 2 of the 4 functional tasks, decreased all of their pain measures, increased their nonsurgical leg strength, and exhibited greater leg strength asymmetry.

Conclusion

These findings appear to indicate the efficacy of prehabilitation among TKA patients and support the theory of prehabilitation.

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 
  • † Disclosure: nothing to disclose
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: nothing to disclose
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: nothing to disclose

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 This study is funded by the National Institute of Nursing Research (R01NR008135, R. Topp, PI) and the Hygenic Corporation, Akron, OH.

PII: S1934-1482(09)00552-8

doi:10.1016/j.pmrj.2009.06.003

PM&R
Volume 1, Issue 8 , Pages 729-735, August 2009

Article Tools

* Image Usage & Resolution