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Progressive resistance training and arthroplasty

Min Ji Suh, Bo Ryun Kim, Sang Rim Kim, Eun Young Han, So Young Lee
Objective: To investigate the effects of early combined eccentric-concentric (ECC-CON) or concentric (CON) resistance training following total knee arthroplasty (TKA). Methods: Patients who underwent a primary TKA were randomly assigned to an ECC-CON group (n=16) or a CON group (n=18). All patients received early, progressive resistance training with five sessions per week for 2 weeks starting 2 weeks after TKA. Isometric knee flexor and extensor strength of the surgical and non-surgical knees, instrumental gait analysis for spatiotemporal parameters, 6-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Timed Stair Climbing Test (SCT) were used to evaluate performance-based physical function...
October 2017: Annals of Rehabilitation Medicine
Birgit Skoffer, Ulrik Dalgas, Thomas Maribo, Kjeld Søballe, Inger Mechlenburg
BACKGROUND: Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion. OBJECTIVE: To examine whether preoperative PRT initiated 5 weeks prior to TKA would exacerbate pain and knee effusion, and would allow a progressively increased training load throughout the training period that would subsequently increase muscle strength...
November 9, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Peter B Jørgensen, Søren B Bogh, Signe Kierkegaard, Henrik Sørensen, Anders Odgaard, Kjeld Søballe, Inger Mechlenburg
OBJECTIVE: To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. DESIGN: Single blinded, randomized clinical trial. SETTING: Surgery, progressive resistance training and testing was carried out at Aarhus University Hospital and home-based exercise was carried out in the home of the patient. SUBJECTS: Fifty five patients were randomized to either progressive resistance training or home-based exercise...
January 2017: Clinical Rehabilitation
Lone R Mikkelsen, Annemette K Petersen, Inger Mechlenburg, Søren Mikkelsen, Kjeld Søballe, Thomas Bandholm
OBJECTIVE: To describe a progressive resistance training intervention implemented shortly after total hip arthroplasty, including a detailed description of load progression, pain response and adverse events to the training. DESIGN: Secondary analyses of data from the intervention group in a randomized controlled trial. SUBJECTS: This study reports data from the intervention group ( n = 37). INTERVENTIONS: The protocol described supervised progressive resistance training of the operated leg two days/week in addition to home-based exercise five days/week and for 10 weeks...
January 2017: Clinical Rehabilitation
Birgit Skoffer, Thomas Maribo, Inger Mechlenburg, Per M Hansen, Kjeld Søballe, Ulrik Dalgas
OBJECTIVE: To investigate the efficacy of 4 weeks of preoperative and 4 weeks of postoperative progressive resistance training (PRT), compared to 4 weeks of postoperative PRT only on functional performance, muscle strength, and patient-reported outcomes in patients undergoing total knee arthroplasty (TKA). METHODS: In total, 59 patients were randomized to 4 weeks of preoperative PRT (intervention group) or to a group who lived as usual (control group). Both groups performed 4 weeks of PRT after TKA...
September 2016: Arthritis Care & Research
A Hermann, A Holsgaard-Larsen, B Zerahn, S Mejdahl, S Overgaard
OBJECTIVE: To investigate the efficacy and feasibility of progressive explosive-type resistance training (RT) in patients with osteoarthritis (OA) of the hip scheduled for total hip arthroplasty (THA). METHOD: Randomized controlled trial (1:1) in patients diagnosed with hip OA and scheduled for THA. The intervention group (IG) performed supervised preoperative progressive explosive-type RT twice a week for 10 weeks; four exercises (hip/thigh) performed in three series each (8-12 repetition maximum)...
January 2016: Osteoarthritis and Cartilage
Emmanuel Gomes Ciolac, José Messias Rodrigues da Silva, Júlia Maria D'Andréa Greve
OBJECTIVES: This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program. METHODS: Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had their functional performance, lower-limb loading distribution and balance compared before and after 13 weeks of a twice-weekly progressive resistance training program...
January 2015: Clinics
Inger Mechlenburg, Kjeld Søballe, Martin Lamm, Maiken Stilling
Hip dysplasia and femoroacetabular impingement are frequent causes of hip pain and can often be treated with joint preserving surgery to prevent secondary osteoarthritis (OA). Patient education, progressive resistance training and weight loss at a BMI > 27 kg/m(2) has documented effect on pain and function in primary hip OA. If wound infection occurs after total hip arthroplasty the patient should not be treated with peroral antibiotics but instead be referred to an orthopaedic surgeon. There is no documentation that post-operative movement restrictions prevent dislocation of hip after total hip arthroplasty...
July 21, 2014: Ugeskrift for Laeger
Birgit Skoffer, Ulrik Dalgas, Inger Mechlenburg
OBJECTIVE: To investigate the effect of progressive resistance training (PRT) on muscle strength and functional capacity before and/or after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The effects of THA and TKA upon quality of life and the rate of adverse events were also investigated. DATA SOURCES: Literature from nine databases. REVIEW METHODS: Studies were included if 1) the effect of a PRT intervention was compared with no intervention or another type of intervention; 2) the outcomes included muscle strength and/or functional capacity; 3) all participants were scheduled for or had just undergone THA or TKA; 4) they were randomized, controlled trials (RCT); and 5) only full-length papers in English were studied...
January 2015: Clinical Rehabilitation
V Di Monaco, C Castiglioni
Background: Early multidisciplinary rehabilitation can improve the recovery after total hip arthroplasty (THA). However, optimal exercise therapy has not been defined. We aimed to answer the question: "Which type and/or timing of exercise therapy is effective following THA?". Design: Systematic review. Methods: We searched four databases: MEDLINE, PEDro, Cochrane Library, and Cinahl since January 2008 till December 2012. Literature before 2008 was not searched for, because it was previously analyzed by two systematic reviews...
December 2013: European Journal of Physical and Rehabilitation Medicine
Gunay Ardali
BACKGROUND AND PURPOSE: There is no routinely prescribed protocol to address quadriceps weakness and functional impairments following a total knee arthroplasty (TKA). The purpose of this case report is to introduce and describe the early use of a daily adjustable progressive resistance exercise (DAPRE) protocol as an adjunct to standard rehabilitation to maximize quadriceps muscle strength and functional performance in an elderly homebound patient following a TKA. CASE DESCRIPTION: A 61-year-old female was referred to home care physical therapy for 6 weeks following left TKA due to functional deficits and inability to activate the weak left quadriceps muscle...
May 2014: Physiotherapy Theory and Practice
M Di Monaco, C Castiglioni
BACKGROUND: Early multidisciplinary rehabilitation can improve the recovery after total hip arthroplasty (THA). However, optimal exercise therapy has not been defined. We aimed to answer the question: "Which type and/or timing of exercise therapy is effective following THA?" DESIGN: Systematic review. METHODS: We searched four databases: MEDLINE, PEDro, Cochrane Library, and Cinahl since January 2008 till December 2012. Literature before 2008 was not searched for, because it was previously analyzed by two systematic reviews...
December 2013: European Journal of Physical and Rehabilitation Medicine
Tosan Okoro, Ashok Ramavath, Jan Howarth, Jane Jenkinson, Peter Maddison, John G Andrew, Andrew Lemmey
BACKGROUND: There is evidence of prolonged poor function in patients following total hip replacement (THR). Studies of progressive resistance training (PRT) interventions to improve function are often compared to 'standard' practice which is not well defined. This study aimed to investigate 'standard' rehabilitation care in the UK after total hip replacement (THR) as well as determine whether PRT was part of 'standard' care. METHODS: After ethical approval, questionnaire item development about rehabilitation practice was guided by a focus group interview (after informed consent) with physiotherapists (n = 4; >5 years post-qualification) who regularly treated THR patients...
March 12, 2013: BMC Musculoskeletal Disorders
Marie D Westby
The long-term outcomes following primary TJA for OA are favorable. However, surgery alone fails to fully restore physical function and address longstanding impairments associated with chronic joint disease. Older adults undergoing TJA can gain similar benefits as those who are younger; however, the elderly are at increased risk for adverse events. Frailty, more so than age, is related to suboptimal outcomes. To what extent appropriate and sufficient rehabilitation can further improve health outcomes including activity and participation and positively impact prosthesis survival and need for revision is still unclear...
August 2012: Clinics in Geriatric Medicine
Michael J Bade, Jennifer E Stevens-Lapsley
PURPOSE OF REVIEW: Previous studies on rehabilitation following total knee arthroplasty (TKA) demonstrated limited efficacy in increasing long-term outcomes. More recently, several rehabilitation approaches have demonstrated greater efficacy for increasing long-term strength and functional performance outcomes following TKA. RECENT FINDINGS: Neuromuscular electrical stimulation (NMES), applied to the surgical limb's quadriceps muscle for the first 6 weeks following surgery, has been shown to improve the speed of recovery from TKA and leads to long-term increases in strength and functional performance...
March 2012: Current Opinion in Rheumatology
Emmanuel Gomes Ciolac, Júlia Maria D'Andréa Greve
OBJECTIVES: To analyze muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. METHODS: Twenty-three community-dwelling women were divided into the following groups: older, with knee osteoarthritis and total knee arthroplasty in the contralateral limb (OKG; N= 7); older, without symptomatic osteoarthritis (OG; N= 8); and young and healthy (YG; N= 8). Muscle strength (1-repetition maximum strength test) and exercise intensity progression (workload increases of 5%-10% were made whenever adaptation occurred) were compared before and after 13 weeks of a twice-weekly progressive resistance-training program...
2011: Clinics
Thomas Linding Jakobsen, Henrik Husted, Henrik Kehlet, Thomas Bandholm
PURPOSE: To explore the feasibility of progressive strength training commenced immediately after total knee arthroplasty (TKA). METHODS: A pilot study was conducted at an outpatient training facility. Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition maximum with three training sessions per week for 2 weeks...
2012: Disability and Rehabilitation
Stephanie C Petterson, Peter Barrance, Adam R Marmon, Thomas Handling, Thomas S Buchanan, Lynn Snyder-Mackler
INTRODUCTION: changes in strength, activation, and morphology of the quadriceps femoris muscle group were assessed in 61 individuals that underwent unilateral total knee arthroplasty, with progressive postoperative strength training, for primary knee osteoarthritis. METHODS: assessments of these three parameters were made at four time points (preoperatively and 4, 12, and 52 wk postoperatively). Maximal voluntary knee extension strength was recorded using an electromechanical dynamometer, and voluntary muscle activation was measured using a burst superimposition technique...
February 2011: Medicine and Science in Sports and Exercise
Anu Valtonen, Tapani Pöyhönen, Sarianna Sipilä, Ari Heinonen
OBJECTIVE: To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. DESIGN: Randomized controlled trial. SETTING: Research laboratory and hospital rehabilitation pool. PARTICIPANTS: Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial...
June 2010: Archives of Physical Medicine and Rehabilitation
A Wayne Johnson, J William Myrer, Iain Hunter, J Brent Feland, J Ty Hopkins, David O Draper, Dennis Eggett
This study investigated the use of whole-body vibration (WBV) as an alternative strengthening regimen in the rehabilitation of individuals with total knee arthroplasty (TKA) compared with traditional progressive resistance exercise (TPRE). Individuals post TKA (WBV n = 8; TPRE n = 8) received physical therapy with WBV or with TPRE for 4 weeks. Primary dependent variables were knee extensor strength, quadriceps muscle activation, mobility, pain, and range of motion (ROM). There was a significant increase in knee extensor strength and improvements in mobility, as measured by maximal volitional isometric contraction and the Timed Up and Go Test (TUG), respectively, for both groups (p < 0...
May 2010: Physiotherapy Theory and Practice
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