Walter Bily1, Carlo Franz2, Lukas Trimmel2, Stefan Loefler3, Jan Cvecka4, Sandra Zampieri5, Waltraud Kasche2, Nejc Sarabon6, Peter Zenz7, Helmut Kern8. 1. Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria. Electronic address: walter.bily@wienkav.at. 2. Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria. 3. Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria. 4. Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia. 5. 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. 6. Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria; University of Primorska, Andrej Marusic Institute, Koper, Slovenia. 7. Department of Orthopedic Surgery, Otto Wagner Spital, Vienna, Austria. 8. Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria; Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Wilhelminenspital, Vienna, Austria.
Abstract
OBJECTIVES: 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. DESIGN: Randomized controlled trial. SETTING:Outpatient rehabilitation department at a university teaching hospital. PARTICIPANTS: Patients (N=55) with TKA were randomly allocated into 2 rehabilitation groups. INTERVENTIONS: 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. MAIN OUTCOME MEASURES: 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). RESULTS: 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). CONCLUSIONS: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.
RCT Entities:
OBJECTIVES: 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. DESIGN: Randomized controlled trial. SETTING:Outpatient rehabilitation department at a university teaching hospital. PARTICIPANTS: Patients (N=55) with TKA were randomly allocated into 2 rehabilitation groups. INTERVENTIONS: 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. MAIN OUTCOME MEASURES: 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). RESULTS: 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). CONCLUSIONS: 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: Kristin J Konnyu; Louise M Thoma; Wangnan Cao; Roy K Aaron; Orestis A Panagiotou; Monika Reddy Bhuma; Gaelen P Adam; Ethan M Balk; Dan Pinto Journal: Am J Phys Med Rehabil Date: 2022-03-12 Impact factor: 3.412
Authors: Ján Cvečka; Matúš Krčmár; Dušan Hamar; Helmut Kern; Christian Hofer; Stefan Löfler; Matej Vajda Journal: Int J Environ Res Public Health Date: 2022-04-07 Impact factor: 4.614