title: Early progressive strength training to enhance recovery after fast-track total knee arthroplasty: a randomized controlled trial.
abstract: OBJECTIVE
  To compare 7 weeks of supervised physical rehabilitation with or without progressive strength training (PST) commenced early after fast-track total knee arthroplasty (TKA) on functional performance.
  
  
  METHODS
  In total, 82 patients with a unilateral primary TKA were randomized to 2 different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA.
  
  
  RESULTS
  There was no statistically significant difference between the PST and CON groups in the change score from baseline to the 8-week postoperative assessment (primary end point) for the 6-minute walk test with unadjusted baseline scores (mean difference between groups: -11.3 meters [95% confidence interval -45.4, 22.7]; analysis of variance P = 0.51). There were no statistically significant or clinically meaningful differences between groups in change scores from baseline to any other time point for all secondary outcomes. The secondary outcome knee extension strength did not reach the level recorded before surgery in both groups.
  
  
  CONCLUSIONS
  Seven weeks of supervised physical rehabilitation with PST was not superior to 7 weeks of supervised physical rehabilitation without PST in improving functional performance, measured as the maximal walking distance in 6 minutes, at the primary end point 8 weeks after fast-track TKA.
authors: Lundbeck Foundation Centre for Fast-Track Hip and Knee Arthroplasty, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark.
authors: Thomas Linding
authors: TL
authors: Jakobsen
authors: Henrik
authors: H
authors: Kehlet
authors: Henrik
authors: H
authors: Husted
authors: Janne
authors: J
authors: Petersen
authors: Thomas
authors: T
authors: Bandholm
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome