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.
Data sources:
Literature from nine databases.
Review 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.
Conclusion:
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.
DaigleMEWeinsteinAMKatzJNLosinaE. The cost-effectiveness of total joint arthroplasty: a systematic review of published literature. Best Pract Res Clin Rheumatol2012 Oct; 26: 649–658.
2.
KrummenauerFWolfCGuntherKPKirschnerS. Clinical benefit and cost effectiveness of total knee arthroplasty in the older patient. Eur J Med Res2009; 14: 76–84.
3.
SloverJEspehaugBHavelinLIEngesaeterLBFurnesOTomekI. Cost-effectiveness of unicompartmental and total knee arthroplasty in elderly low-demand patients. A Markov decision analysis. J Bone Joint Surg Am2006; 88: 2348–2355.
4.
JonesCAPoharS. Health-related quality of life after total joint arthroplasty: a scoping review. Clin Geriatr Med2012; 28: 395–429.
5.
LauRLGandhiRMahomedSMahomedN. Patient satisfaction after total knee and hip arthroplasty. Clin Geriatr Med2012; 28: 349–365.
6.
FortinPRClarkeAEJosephLLiangMHTanzerMFerlandD. Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum1999; 42: 1722–1728.
7.
FortinPRPenrodJRClarkeAESt-PierreYJosephLBelisleP. Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee. Arthritis Rheum2002; 46: 3327–3330.
8.
RaschADalenNBergHE. Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop2010; 81: 183–188.
9.
RossiMDBrownLEWhitehurstM. Knee extensor and flexor torque characteristics before and after unilateral total knee arthroplasty. Am J Phys Med Rehabil2006; 85: 737–746.
10.
WeiglMAngstFStuckiGLehmannSAeschlimannA. Inpatient rehabilitation for hip or knee osteoarthritis: 2 year follow up study. Ann Rheum Dis2004; 63: 360–368.
11.
BadeMJKohrtWMStevens-LapsleyJE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Orthop Sports Phys Ther2010; 40: 559–567.
12.
WalshMWoodhouseLJThomasSGFinchE. Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys Ther1998; 78: 248–258.
13.
de BeerJPetruccelliDAdiliAPiccirilloLWismerDWinemakerM. Patient perspective survey of total hip vs total knee arthroplasty surgery. J Arthroplasty2012; 27: 865–869.
14.
HamiltonDHendersonGRGastonPMacDonaldDHowieCSimpsonAH. Comparative outcomes of total hip and knee arthroplasty: a prospective cohort study. Postgrad Med J 2012; 88: 627–631.
15.
WestbyMD. Rehabilitation and total joint arthroplasty. Clin Geriatr Med2012; 28: 489–508.
16.
WyldeVBlomAWWhitehouseSLTaylorAHPattisonGTBannisterGC. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty2009; 24: 210–216.
17.
ClarkBCTaylorJL. Age-related changes in motor cortical properties and voluntary activation of skeletal muscle. Curr Aging Sci2011; 4: 192–199.
18.
FinkBEglMSingerJFuerstMBubenheimMNeuen-JacobE. Morphologic changes in the vastus medialis muscle in patients with osteoarthritis of the knee. Arthritis Rheum2007; 56: 3626–3633.
19.
ReardonKGaleaMDennettXChoongPByrneE. Quadriceps muscle wasting persists 5 months after total hip arthroplasty for osteoarthritis of the hip: a pilot study. Intern Med J2001; 31: 7–14.
20.
PetersonMDGordonPM. Resistance exercise for the aging adult: clinical implications and prescription guidelines. Am J Med2011; 124: 194–198.
21.
Di MonacoMCastiglioniC. Which type of exercise therapy is effective after hip arthroplasty? A systematic review of randomized controlled trials. Eur J Phys Rehabil Med2013; 49: 893–907.
22.
PozziFSnyder-MacklerLZeniJ. Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med2013; 49: 877–892.
23.
LiberatiAAltmanDGTetzlaffJMulrowCGotzschePCIoannidisJP. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med2009 ;151: W65–94.
24.
American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc2009; 41: 687–708.
25.
MaherCGSherringtonCHerbertRDMoseleyAMElkinsM. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther2003; 83: 713–721.
26.
de MortonNA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother2009; 55: 129–133.
27.
SuettaCAndersenJLDalgasUBergetJKoskinenSAagaardP. Resistance training induces qualitative changes in muscle morphology, muscle architecture, and muscle function in elderly postoperative patients. J Appl Physiol2008; 105: 180–186.
28.
SuettaCClemmensenCAndersenJLMagnussonSPSchjerlingPKjaerM. Coordinated increase in skeletal muscle fiber area and expression of IGF-I with resistance exercise in elderly post-operative patients. Growth Horm IGF Res2010; 20: 134–140.
29.
SuettaCMagnussonSPRostedAAagaardPJakobsenAKLarsenLH. Resistance training in the early postoperative phase reduces hospitalization and leads to muscle hypertrophy in elderly hip surgery patients—a controlled, randomized study. J Am Geriatr Soc2004; 52: 2016–2022.
30.
SuettaCAagaardPMagnussonSPAndersenLLSipilaSRostedA. Muscle size, neuromuscular activation, and rapid force characteristics in elderly men and women: effects of unilateral long-term disuse due to hip-osteoarthritis. J Appl Physiol2007; 102: 942–948.
31.
SuettaCAagaardPRostedAJakobsenAKDuusBKjaerM. Training-induced changes in muscle CSA, muscle strength, EMG, and rate of force development in elderly subjects after long-term unilateral disuse. J Appl Physiol2004; 97: 1954–1961.
32.
GilbeyHJAcklandTRTapperJWangAW. Perioperative exercise improves function following total hip arthroplasty: a randomized controlled trial. J Musculosketeletal Res2003; 7: 111–123.
33.
GilbeyHJAcklandTRWangAWMortonARTrouchetTTapperJ. Exercise improves early functional recovery after total hip arthroplasty. Clin Orthop Relat Res2003; 408: 193–200.
34.
WangAWGilbeyHJAcklandTR. Perioperative exercise programs improve early return of ambulatory function after total hip arthroplasty: a randomized, controlled trial. Am J Phys Med Rehabil2002; 81: 801–806.
35.
PettersonSCMiznerRLStevensJERaisisLBodenstabANewcombW. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum2009; 61: 174–183.
36.
AckermanINBennellKL. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review. Aust J Physiother2004; 50: 25–30.
37.
McKayCPrapavessisHDohertyT. The effect of a prehabilitation exercise program on quadriceps strength for patients undergoing total knee arthroplasty: a randomized controlled pilot study. PM&R2012; 4: 647–656.
38.
Kent-BraunJALe BlancR. Quantitation of central activation failure during maximal voluntary contractions in humans. Muscle Nerve1996; 19: 861–869.
39.
HusbyVSHelgerudJBjorgenSHusbyOSBenumPHoffJ. Early postoperative maximal strength training improves work efficiency 6–12 months after osteoarthritis-induced total hip arthroplasty in patients younger than 60 years. Am J Phys Med Rehabil2010; 89: 304–314.
40.
JohnsonAWMyrerJWHunterIFelandJBHopkinsJTDraperDO. Whole-body vibration strengthening compared to traditional strengthening during physical therapy in individuals with total knee arthroplasty. Physiother Theory Pract2010; 26: 215–225.
41.
PettersonSCBarrancePMarmonARHandlingTBuchananTSSnyder-MacklerL. Time course of quad strength, area, and activation after knee arthroplasty and strength training. Med Sci Sports Exerc 2011; 43: 225–231.
42.
BeaupreLADaviesDMJonesCACinatsJG. Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty. Phys Ther2001; 81: 1029–1037.
43.
D’LimaDDColwellCWJrMorrisBAHardwickMEKozinF. The effect of preoperative exercise on total knee replacement outcomes. Clin Orthop Relat Res1996; 326: 174–182.
44.
RodgersJAGarvinKLWalkerCWMorfordDUrbanJBedardJ. Preoperative physical therapy in primary total knee arthroplasty. J Arthroplasty1998; 13: 414–421.
45.
Silkman BakerCMcKeonJM. Does preoperative rehabilitation improve patient-based outcomes in persons who have undergone total knee arthroplasty? A systematic review. PM R2012; 4: 756–767.
46.
RooksDSHuangJBierbaumBEBolusSARubanoJConnollyCE. Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty. Arthritis Rheum2006; 55: 700–708.
47.
GillSDMcBurneyH. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomized controlled trials. Archives of Physical Medicine & Rehabilitation2013; 94: 164–176.
48.
WallisJATaylorNF. Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery - a systematic review and meta-analysis. Osteoarthritis Cartilage2011; 19: 1381–1395.
49.
JanMHHungJYLinJCWangSFLiuTKTangPF. Effects of a home program on strength, walking speed, and function after total hip replacement. Arch Phys Med Rehabil2004; 85: 1943–1951.
50.
UnluEEksiogluEAydogEAydogSTAtayG. The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study. Clin Rehabil2007; 21: 706–711.
51.
Trudelle-JacksonESmithSS. Effects of a late-phase exercise program after total hip arthroplasty: a randomized controlled trial. Arch Phys Med Rehabil2004; 85: 1056–1062.
52.
VissersMMBussmannJBVerhaarJANArendsLRFurlanADReijmanM. Recovery of physical functioning after total hip arthroplasty: systematic review and meta-analysis of the literature. Phys Ther2011; 91: 615–629.
53.
BourneRBChesworthBDavisAMahomedNCharronK. Comparing patient outcomes after THA and TKA: is there a difference?Clin Orthop Relat Res2010; 468: 542–546.
54.
KennedyDStratfordPWPaguraSMWalshMWoodhouseLJ. Comparison of gender and group differences in self-report and physical performance measures in total hip and knee arthroplasty candidates. J Arthroplasty2002; 17: 70–77.
55.
HolmBKristensenMTHustedHKehletHBandholmT. Thigh and knee circumference, knee-extension strength, and functional performance after fast-track total hip arthroplasty. PM R2011; 3: 117–124.
56.
HolmBKristensenMTBenckeJHustedHKehletHBandholmT. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil2010; 91: 1770–1776.
57.
JensenCAagaardPOvergaardS. Recovery in mechanical muscle strength following resurfacing vs standard total hip arthroplasty - a randomised clinical trial. Osteoarthritis Cartilage2011; 19: 1108–1116.
58.
JuddDLEckhoffDGStevens-LapsleyJE. Muscle strength loss in the lower limb after total knee arthroplasty. Am J Phys Med Rehabil2012; 91: 220–226; quiz 227–230.
59.
Stevens-LapsleyJEBalterJEKohrtWMEckhoffDG. Quadriceps and hamstrings muscle dysfunction after total knee arthroplasty. Clin Orthop Relat Res2010; 468: 2460–2468.
60.
MoherDPhamBJonesACookDJJadadARMoherM. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses?Lancet1998; 352: 609–613.
61.
SchulzKFChalmersIHayesRJAltmanDG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA1995; 273: 408–412.
62.
HusbyVSHelgerudJBjorgenSHusbyOSBenumPHoffJ. Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty. Arch Phys Med Rehabil2009; 90: 1658–1667.
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