Effects of preoperative maximal strength training on muscle strength and function in total knee arthroplasty: A randomized controlled trial

IF 4.6 3区医学 Q1 REHABILITATION

Annals of Physical and Rehabilitation Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI:10.1016/j.rehab.2025.102067

Mani Izadi , Tiril Tøien , Frank-David Øhrn , Otto Schnell Husby , Vigdis Kvitland Schnell Husby , Siri Bjørgen Winther , Ronan Sherman , Mathias Forsberg Brobakken , Eivind Wang , Ole Kristian Berg

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引用次数: 0

Abstract

Background

The efficacy of prehabilitation through preoperative strength training for individuals undergoing total knee arthroplasty (TKA) remains inconclusive.

Objective

The present study aimed to evaluate the effects of maximal strength training (MST) before operation on muscle strength and physical function 3 weeks following TKA.

Methods

48 individuals scheduled for fast-track unilateral primary TKA were randomized to MST (n = 24), performing 4 sets at 4 repetition maximum in seated leg press 3 times per week for 8 weeks, or control usual care (CON, n = 24). The primary outcome was bilateral leg press maximal strength. Secondary outcomes were performance-based physical function, including 10-step stair climbing, 30 s sit-to-stand, 40 m fast-paced walking, and unipedal stance tests, and self-reported physical function as knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), European quality of life 5 dimension, 5 Level, and forgotten joint score.

Results

MST improved bilateral leg press 1RM relative to body weight after intervention (mean change 0.45, P < 0.0001), and there were between-group differences in the delta changes from baseline to preoperation (mean difference 0.43, P < 0.0001) and postoperation (mean difference 0.27, P < 0.001), favoring MST. MST also led to better maintenance of postoperative stair climbing (mean difference −3.38 s, P = 0.0013). Although the MST group experienced a significant preoperative improvement in sit-to-stand (mean change 2 repetitions, P = 0.0019), walking ability (mean change −2.28 s, P < 0.001), and KOOS-PS (mean change 8, P < 0.0001), these effects did not extend to postoperative outcomes.

Conclusions

The findings indicate that preoperative MST is safe and effective in improving muscle strength and preserving stair-climbing ability for individuals undergoing TKA, positioning MST as a pragmatic prehabilitation strategy.

Clinical trial registration

NCT05892133.

查看原文本刊更多论文

全膝关节置换术术前最大力量训练对肌力和功能的影响：一项随机对照试验

背景：对于接受全膝关节置换术（TKA）的个体，术前力量训练对其康复的效果尚无定论。目的探讨术前最大力量训练（MST）对TKA术后3周肌力和身体功能的影响。方法48例计划进行快速通道单侧原发性TKA的患者随机分为MST组（n = 24），每周进行3次最多4次的坐式腿推4组，持续8周，或对照常规护理（n = 24）。主要结果是双侧腿按压的最大力量。次要结果是基于性能的身体功能，包括10步爬楼梯、30秒坐立、40米快节奏步行和单脚站立测试，以及自我报告的身体功能，如膝关节损伤和骨关节炎结局评分-身体功能简表（KOOS-PS）、欧洲生活质量5维度、5级和遗忘关节评分。结果干预后，smst改善了双侧腿压1RM相对于体重的变化（平均变化0.45,P < 0.0001），从基线到术前（平均差异0.43,P < 0.0001）和术后（平均差异0.27,P < 0.001）的δ变化在组间存在差异，有利于MST。MST还能更好地维持术后爬楼梯（平均差异- 3.38 s, P = 0.0013）。尽管MST组术前在坐姿到站立（平均变化2次，P = 0.0019）、行走能力（平均变化- 2.28 s, P < 0.001）和KOOS-PS（平均变化8次，P < 0.0001）方面均有显著改善，但这些影响并未延伸至术后结果。结论术前MST可以安全有效地改善TKA患者的肌力和保持爬楼梯能力，是一种实用的康复策略。临床试验注册号nct05892133。

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来源期刊

Annals of Physical and Rehabilitation Medicine Medicine-Rehabilitation

CiteScore

7.80

自引率

4.30%

发文量

136

审稿时长

34 days

期刊介绍： Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.