title: The effects of a 3-month controlled hiking programme on the functional abilities of patients following total knee arthroplasty: a prospective, randomized trial.
abstract: OBJECTIVE
  Improvements in pain, function and sports activity are the main goals of patients following total knee arthroplasty (TKA). Participation in sports has become an increasingly important contributor to patients' quality of life (QoL). Hiking is one of the most popular summer activities among elderly people in alpine regions. Consequently, this randomized controlled trial investigates the impact of a 3-month guided hiking programme on patients' functional abilities and QoL following TKA. It was hypothesized that patients who participate in this programme would demonstrate improvements in functional and QoL parameters compared with a control group.
  
  
  METHODS
  Forty-eight TKA patients were included and randomized into either the intervention group (IG; n = 25) or the control group (CG; n = 23). The IG participated in a 3-month hiking programme (2-3 times a week), whereas the CG performed activities of daily living. The stair climb test (SCT), QoL questionnaires and isokinetic force measurements were completed at three time points (i.e. pre-test, post-test, retention-test). ANOVAs for repeated measurements were conducted for the SCT results. The Friedman test and the Mann-Whitney U test were performed for the QoL parameters.
  
  
  RESULTS
  After the 3-month hiking programme, the IG achieved faster overall walking times on the SCT. The time decreased from 4.3 ± 0.6 s (pre-test) to 3.6 ± 0.4 s (post-test) for the stair ascent (p = 0.060) and from 3.6 ± 0.6 s (pre-test) to 3.2 ± 0.5 s (post-test) for the stair descent (p = 0.036). The IG showed significant improvement on some of the subscales of the Knee Injury and Osteoarthritis Outcome Score from pre-test to retention-test (p < 0.01). In the CG, no significant changes were observed (n.s.).
  
  
  CONCLUSIONS
  The results indicate moderate improvement in the functional abilities and QoL of TKA patients who participated in a 3-month guided hiking programme compared with the patients in the CG. Hiking did not have any acute detrimental effects on the TKA patients during this study period.
  
  
  METHODS
  II.
authors: Gelenkpunkt - Sport and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.|Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
authors: Caroline
authors: C
authors: Hepperger
authors: Gelenkpunkt - Sport and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria. p.gfoeller@gelenkpunkt.com.
authors: Peter
authors: P
authors: Gföller
authors: Gelenkpunkt - Sport and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
authors: Christian
authors: C
authors: Hoser
authors: Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, 6020, Innsbruck, Austria.
authors: Hanno
authors: H
authors: Ulmer
authors: Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
authors: Felix
authors: F
authors: Fischer
authors: Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
authors: Wolfgang
authors: W
authors: Schobersberger
authors: Gelenkpunkt - Sport and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.|Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
authors: Christian
authors: C
authors: Fink
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D016138:Walking
keywords: Functional performance; Hiking; KOOS; QoL; Sports; Total knee replacement; WOMAC