title: Effects of Leg-Press Training With Moderate Vibration on Muscle Strength, Pain, and Function After Total Knee Arthroplasty: A Randomized Controlled Trial.
abstract: To examine the effects of a time-saving leg-press training program with moderate vibration on strength parameters, pain, and functional outcomes of patients after total knee arthroplasty (TKA) in comparison with functional physiotherapy.
  
  
  
  Randomized controlled trial.
  
  
  
  Outpatient rehabilitation department at a university teaching hospital.
  
  
  
  Patients (N=55) with TKA were randomly allocated into 2 rehabilitation groups.
  
  
  
  Six weeks after TKA, participants either underwent isokinetic leg-press training combined with moderate vibration (n=26) of 15 minutes per session or functional physiotherapy (n=29) of 30 minutes per session. Both groups received therapy twice a week for a period of 6 weeks. Participants were evaluated at baseline (6wk after TKA) and after the 6-week rehabilitation program.
  
  
  
  The main outcome measure was maximal voluntary contraction (MVC) of the involved leg. Secondary outcome measures were pain assessed with a visual analog scale (VAS), range of motion, stair test, timed Up and Go test, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
  
  
  
  Both groups showed statistically significant improvements in MVC of knee extensors measured on the knee dynamometer (leg-press group: from 0.8±.06 to 1±.09Nm/kg body weight [BW], physiotherapy group: from 0.7±.06 to 0.9±.06Nm/kg BW; P<.05) and in closed kinetic chain on the leg press (leg-press group: from 8.9±.77 to 10.3±1.06N/kg BW, physiotherapy group: from 6.7±.54 to 9.1±.70N/kg BW; P<.05) and in pain at rest (leg-press group: from 2±.36 to 1.3±.36 on the VAS, physiotherapy group: from 1.2±.28 to 1.1±.31; P<.05), WOMAC scores, and functional measurements after 6 weeks of training. There was no significant difference between the 2 groups concerning strength, pain, and functional outcomes after training (P>.05).
  
  
  
  Isokinetic leg-press training with moderate vibration and functional physiotherapy are both effective in regaining muscle strength and function after TKA; however, isokinetic leg-press training is considerably less time consuming.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria. Electronic address: walter.bily@wienkav.at.
authors.forename: Walter
authors.initials: W
authors.lastname: Bily
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria.
authors.forename: Carlo
authors.initials: C
authors.lastname: Franz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Trimmel
authors.affiliation: Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Loefler
authors.affiliation: Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia.
authors.forename: Jan
authors.initials: J
authors.lastname: Cvecka
authors.affiliation: Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria; Venetian Institute of Molecular Medicine, Dulbecco Telethon Institute, Department of Biomedical Sciences, University of Padua, Padua, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Zampieri
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria.
authors.forename: Waltraud
authors.initials: W
authors.lastname: Kasche
authors.affiliation: Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria; University of Primorska, Andrej Marusic Institute, Koper, Slovenia.
authors.forename: Nejc
authors.initials: N
authors.lastname: Sarabon
authors.affiliation: Department of Orthopedic Surgery, Otto Wagner Spital, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Zenz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria; Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Kern
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D053580:Muscle Strength; D010146:Pain / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D014732:Vibration / Q000627:therapeutic use*
keywords: Arthroplasty, replacement, knee; Exercise therapy; Muscle strength; Outcome assessment (health care); Physical therapy specialty; Rehabilitation; Vibration