Does a weight-training exercise programme given to patients four or more years after total knee arthroplasty improve mobility: A randomized controlled trial

Aim: To investigate the effects of the home exercise therapy performed after at least four years postoperatively on skeletal muscle strength and functionality in patients with total knee arthroplasty (TKA). Methods: Sixty patients (age; 69.66 +/- 7.53, weight; 81.56 +/- 14.43 kg, 10 male, 50 female) followed up four or more years were randomly divided into two groups. An 8-week exercise program was designed for bilateral TKA patients. While the patients in one group were assigned to weighted exercise group, the patients in the other group were assigned to non-weighted exercise group. The primary outcome was the isometric muscle strength of quadriceps femoris (QF) and hamstring muscles assessed by Hand-Held Dynamometer. The secondary outcomes were the pain level, 30 s sit-to-stand test, 10 m walk test, range of motion, and the knee function score of the Hospital for Special Surgery. The assessments were performed before and after the treatment. Results: After treatment, significant differences were found in all evaluation parameters (except rest pain and range of motion) in favour of the weighted group. QF muscle strength changes (kg); weighted group: 1.99 +/- 1.70, non-weighted group: 0.51 +/- 1.14 (p = 0.000), 30 s sit-to-stand test changes (repetitions); weighted group: 3.66 +/- 2.23, non-weighted group: 1.70 +/- 1.95 (p = 0.000), 10 m walk test changes (seconds); weighted group: -2.60 +/- 1.30, non-weighted group: -0.83 +/- 3.51 (p = 0.000). Conclusion: Home exercise programs applied to TKA patients after at least four years postoperatively was effective in increasing muscle strength, decreasing severity of pain, and improving functional activities. The improvements were significantly greater in weighted compared with the non-weighted exercise group. (C) 2016 Elsevier Ireland Ltd. All rights reserved.