title: Does a weight-training exercise programme given to patients four or more years after total knee arthroplasty improve mobility: A randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effects of the home exercise therapy performed after at least four years postoperatively on skeletal muscle strength and functionality in patients with total knee arthroplasty (TKA).
  
  
  METHODS
  Sixty patients (age; 69.66±7.53, weight; 81.56±14.43 kg, 10 male, 50 female) followed up four or more years were randomly divided into two groups. An 8-week exercise program was designed for bilateral TKA patients. While the patients in one group were assigned to weighted exercise group, the patients in the other group were assigned to non-weighted exercise group. The primary outcome was the isometric muscle strength of quadriceps femoris (QF) and hamstring muscles assessed by Hand-Held Dynamometer. The secondary outcomes were the pain level, 30s sit-to-stand test, 10 m walk test, range of motion, and the knee function score of the Hospital for Special Surgery. The assessments were performed before and after the treatment.
  
  
  RESULTS
  After treatment, significant differences were found in all evaluation parameters (except rest pain and range of motion) in favour of the weighted group. QF muscle strength changes (kg); weighted group: 1.99±1.70, non-weighted group: 0.51±1.14 (p=0.000), 30s sit-to-stand test changes (repetitions); weighted group: 3.66±2.23, non-weighted group: 1.70±1.95 (p=0.000), 10 m walk test changes (seconds); weighted group: -2.60±1.30, non-weighted group: -0.83±3.51 (p=0.000).
  
  
  CONCLUSIONS
  Home exercise programs applied to TKA patients after at least four years postoperatively was effective in increasing muscle strength, decreasing severity of pain, and improving functional activities. The improvements were significantly greater in weighted compared with the non-weighted exercise group.
authors.affiliation: School of Physiotherapy and Rehabilitation, Dokuz Eylül University, Izmir 35340, Turkey. Electronic address: bayram.unver@deu.edu.tr.
authors.forename: Bayram
authors.initials: B
authors.lastname: Unver
authors.affiliation: School of Health, Department of Physiotherapy and Rehabilitation, Izmir University, Izmir 35350, Turkey. Electronic address: serkan.bakirhan@izmir.edu.tr.
authors.forename: Serkan
authors.initials: S
authors.lastname: Bakirhan
authors.affiliation: Department of Orthopaedics, School of Medicine, Dokuz Eylül University, Izmir 35340, Turkey. Electronic address: vasfi.karatosun@deu.edu.tr.
authors.forename: Vasfi
authors.initials: V
authors.lastname: Karatosun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D010043:Outcome and Process Assessment, Health Care; D011184:Postoperative Period; D052097:Quadriceps Muscle / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology; D055070:Resistance Training; D016138:Walking / Q000502:physiology
keywords: Arthroplasty; Exercises; Function; Knee; Late phase; Mobility; Physical therapy; Rehabilitation