title: Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible?
abstract: OBJECTIVE
  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. Rehabilitation was commenced 1 or 2 days after TKA. At each training session, knee pain, knee joint effusion and training load were recorded. Isometric knee-extension strength and maximal walking speed were measured before the first and last session.
  
  
  RESULTS
  The training load increased progressively (p < 0.0001). Patients experienced only moderate knee pain during the strength training exercises, but knee pain at rest and knee joint effusion (p < 0.0001) were unchanged or decreased over the six training sessions. Isometric knee-extension strength and maximal walking speed increased by 147 and 112%, respectively.
  
  
  CONCLUSIONS
  Progressive strength training initiated immediately after TKA seems feasible, and increases knee-extension strength and functional performance without increasing knee joint effusion or knee pain.
authors.affiliation: Department of Physical Therapy, Clinical Research Centre and Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen University Hospital, Hvidovre, Denmark. tlj26@hotmail.com
authors.forename: Thomas Linding
authors.initials: TL
authors.lastname: Jakobsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Husted
authors.forename: Henrik
authors.initials: H
authors.lastname: Kehlet
authors.forename: Thomas
authors.initials: T
authors.lastname: Bandholm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D003718:Denmark; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D055070:Resistance Training / Q000379:methods*; D013997:Time Factors