title: Progressive resistance training before and after total hip and knee arthroplasty: a systematic review.
abstract: 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.
  
  
  METHODS
  Literature from nine databases.
  
  
  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. Data on patient characteristics, training regime, controls, and outcome measures were extracted.
  
  
  RESULTS
  Four RCT studies on PRT and THA including 136 patients and three RCT studies on PRT and TKA including 284 patients were identified and rated according to the PEDro scale. The general methodological quality of the studies was low. No adverse events were reported in any of the studies. Weak evidence of a beneficial effect of PRT before and/or after THA on muscle strength and functional capacity was found. No effect of PRT before TKA on muscle strength and functional capacity was found. The results of postoperative PRT were too heterogeneous to allow conclusions.
  
  
  CONCLUSIONS
  PRT is safe and feasible before and/or after THA. PRT is safe, but the methodological quality of existing evidence permits no conclusion on the effectiveness of PRT before and/or after TKA.
authors.affiliation: Institute of Clinical Medicine, Aarhus University, Denmark Department of Physical and Occupational Therapy, Aarhus University Hospital, Denmark bss@mph.au.dk.
authors.forename: Birgit
authors.initials: B
authors.lastname: Skoffer
authors.affiliation: Section of Sport Science, Department of Public Health, Aarhus University, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Dalgas
authors.affiliation: Orthopaedic Research Centre, Aarhus University Hospital, Denmark.
authors.forename: Inger
authors.initials: I
authors.lastname: Mechlenburg
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D016206:Databases, Bibliographic; D006801:Humans; D053580:Muscle Strength / Q000502:physiology*; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D055070:Resistance Training / Q000379:methods*
keywords: Exercise therapy; functional capacity; hip replacement; knee replacement; muscle strength; weight training