title: Early high-intensity rehabilitation following total knee arthroplasty improves outcomes.
abstract: METHODS
  Prospective cohort study with an age-matched and sex-matched control group.
  
  
  OBJECTIVE
  To assess the clinical outcomes of a high-intensity rehabilitation program (HI) compared to those of a group of age-matched and sex-matched controls who underwent a lower intensity rehabilitation program.
  
  
  BACKGROUND
  Total knee arthroplasty (TKA) successfully alleviates pain from knee osteoarthritis; but deficits in function can persist long term. Despite these well-known deficits, there is little evidence supporting the use of rehabilitation interventions following TKA.
  
  
  METHODS
  Eight patients, who participated in the HI program, were compared to 8 age-matched and sex-matched patients who participated in a lower intensity rehabilitation program (control group). Patients were assessed preoperatively, and at 3.5, 6.5, 12, 26, and 52 weeks postoperatively. Assessment of patients included measures of pain, range of motion (ROM), functional performance, and quadriceps strength and activation.
  
  
  RESULTS
  There were no differences in knee ROM and pain between the HI and control groups at any postoperative time point. At the 3.5-week and 12-week (end of rehabilitation) time points, the HI group had better functional performance and quadriceps strength compared to the control group (P<.05). At the 52-week time point, the HI group continued to demonstrate better functional performance compared to the control group (P<.05), along with greater quadriceps strength (P = .08).
  
  
  CONCLUSIONS
  A HI program leads to better short- and long-term strength and functional performance outcomes compared to a lower intensity rehabilitation program. The HI program did not impair knee ROM and did not result in any musculoskeletal injuries in this small group of patients.
  
  
  METHODS
  Therapy, level 2b.
authors: University of Colorado Denver, School of Medicine, Aurora, CO, USA.
authors: Michael J
authors: MJ
authors: Bade
authors: Jennifer E
authors: JE
authors: Stevens-Lapsley
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016896:Treatment Outcome