Preoperative Strength Training in Patients With Total Knee Arthroplasty - Full Text View

Purpose

The purpose of this study is to investigate if preoperative strength training will result in faster recovery and higher level of function six weeks after total knee arthroplasty (TKA).

Condition	Intervention
Osteoarthritis, Knee	Other: Preoperative strength training

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Effect of Preoperative Strength Training on Postoperative Quadriceps Strength and Ability of Function in Patients With Total Knee Arthroplasty in Fast Track Regi

Resource links provided by NLM:

MedlinePlus related topics: Knee Replacement Osteoarthritis

U.S. FDA Resources

Further study details as provided by University of Aarhus:

Primary Outcome Measures:

Primary outcome: Sit-to-stand test [ Time Frame: Change from Baseline 6 weeks preoperative in Sit-to-Stand at 6 weeks postoperative ] [ Designated as safety issue: No ]
Ability of function test

Secondary Outcome Measures:

Isokinetic: Quadriceps 60 gr./sek [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Muscle strength test in dynamometer
Isokinetic: Hamstrings 60 gr./sek [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Muscle strength test in dynamometer
Isometric: Quadriceps (70 gr. flexion) [ Time Frame: 6 weeks and 1 week before the operation and 11 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Muscle strength test in dynamometer
Isometric: Hamstrings (20 gr. flexion) [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Muscle strength test in dynamometer
Rate of force development (flexion and extension) [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Muscle test in dynamometer
Timed Up and Go [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Ability of function test
10 meter walk test [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Ability of function test
6 minute walk test [ Time Frame: 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Ability of function test
Knee injury and Osteoarthritis Outcome Score (KOOS) [ Time Frame: 6 weeks and 1 week before operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Disease-specific questionnaire
Oxford Knee Score (OKS) [ Time Frame: 6 weeks before the operation and 6 weeks after ] [ Designated as safety issue: No ]
Disease-specific questionnaire
EuroQol-5 dimensions (EQ-5D) [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Generic questionnaire for self-rated health
Short-Form Health Survey (SF 12) [ Time Frame: 6 weeks before the operation and 1 year after ] [ Designated as safety issue: No ]
Generic questionnaire for self-rated health
Background data questionnaire [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Questionnaire about pain, medicine use, alcohol intake, smoking, education, job
Range of motion of the knee [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Extension of the knee Flexion of the knee
Body mass index [ Time Frame: 6 weeks and 1 week before the operation, 1 week, 6 weeks, 12 weeks and 1 year after the operation ] [ Designated as safety issue: No ]
Weight/height2

Estimated Enrollment:	70
Study Start Date:	January 2012
Estimated Study Completion Date:	December 2013
Estimated Primary Completion Date:	October 2013 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Preoperative strength training Progressive strength training on group basis four weeks before the operation and progressive strength training on group basis four weeks after the operation	Other: Preoperative strength training Progressive strength training on group basis (not more than 3 subjects) 3 sessions weekly starting 4 weeks before the operation, in total 12 sessions Strength training 3 sessions weekly 4 weeks postsurgery Other Names: Strength training Preoperative training
No Intervention: Living as usual The patients are living as usual the last 4 weeks before operation

Detailed Description:

Reduced strength of the quadriceps muscle is a common clinical finding in patients with Knee Osteoarthritis and this seems to play a central role in the development of the disease. The strength of the quadriceps muscle have been shown to be reduced by 20-40% as compared to age-matched healthy controls and this decrease in muscle strength have been closely associated with a reduced level of function and increase of pain. Furthermore, it has been demonstrated that the preoperative strength of the quadriceps muscle in patients undergoing TKA, is associated with the level of function one year after surgery. Compared to the level before the operation, an additional operation-induced reduction of the strength of the quadriceps muscle up to 60% as has been demonstrated. Presumably, an optimizing of the strength of the quadriceps muscle could counteract the impact of the expected postoperative loss of muscle strength to such an extent that the loss will be of less clinical significance. It is hypothesized that an optimizing of the strength of the quadriceps muscle may have a favorable effect on the postoperative rehabilitation program and shorten the period of convalescence.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Planned TKA at the Aarhus University Hospital or Region Hospital Silkeborg,
Living in Aarhus Municipality,
Primary knee osteoarthritis or secondary osteoarthritis after meniscectomy or ligament injury

Exclusion Criteria:

Unstable blood pressure,
Neuromuscular or neurodegenerative disease,
Comprehension or dementia problems

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01647243

Contacts

Contact: Birgit Sørensen Skoffer, MPH

+45 50 42 28 30

BSkoffer@dadlnet.dk

Locations

Denmark
Aarhus University hospital	Recruiting
Aarhus, Denmark, 8000
Contact: Birgit Sørensen Skoffer, MPH +45 50 42 28 30 BSkoffer@dadlnet.dk
Principal Investigator: Birgit Sørensen Skoffer, MPH

Sponsors and Collaborators

University of Aarhus

Investigators

Study Chair:

Kjeld Soeballe, Professor

Aarhus University Hospital, Department of orthopaedic, Tage Hansensgade 2, 8000 Aarhus C

More Information

No publications provided

Responsible Party:	University of Aarhus
ClinicalTrials.gov Identifier:	NCT01647243 History of Changes
Other Study ID Numbers:	M-20110181
Study First Received:	July 13, 2012
Last Updated:	July 20, 2012
Health Authority:	Denmark: Danish Dataprotection Agency

Keywords provided by University of Aarhus:

Knee osteoarthritis
Total knee arthroplasty
Preoperative training
Strength training

Additional relevant MeSH terms:

Osteoarthritis
Osteoarthritis, Knee
Arthritis

Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases

ClinicalTrials.gov processed this record on May 21, 2013