Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 6/2009

01.06.2009 | Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty

Reversing Muscle and Mobility Deficits 1 to 4 Years after TKA: A Pilot Study

verfasst von: Paul C. LaStayo, PhD, PT, Whitney Meier, DPT, OCS, Robin L. Marcus, PhD, PT, OCS, Ryan Mizner, PhD, MPT, Lee Dibble, PhD, PT, ATC, Christopher Peters, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 6/2009

Einloggen, um Zugang zu erhalten

Abstract

Muscle and mobility deficits can persist for years after a total knee arthroplasty (TKA). The purposes of this study were (1) to determine if 12 weeks of rehabilitation with resistance exercise induces increases in muscle size, strength, and mobility in individuals 1 to 4 years after a TKA; and (2) to compare the muscle and mobility outcomes of a traditional resistance exercise rehabilitation program with a rehabilitation program focused on eccentric resistance exercise. Seventeen individuals (13 women, four men; mean age, 68 years; age range, 55–80 years) with either a unilateral or bilateral TKA (total of 24 knees) were included in this matched and randomized repeated-measures rehabilitation pilot trial. Increases in quadriceps muscle volume and knee extension strength followed 12 weeks of eccentric exercise. Improvements were also noted in four mobility tests. Similar improvements were noted in the traditional group in two mobility tests. An increase in muscle size and strength and an improvement in levels of mobility can occur after 12 weeks of resistance exercise in older individuals 1 to 4 years after TKA. When the exercise mode focuses on eccentric resistance, the muscle growth response is greater as is the improvement in important mobility tasks.
Level of Evidence: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Berman AT, Bosacco SJ, Israelite C. Evaluation of total knee arthroplasty using isokinetic testing. Clin Orthop Relat Res. 1991;271:106–113.PubMed Berman AT, Bosacco SJ, Israelite C. Evaluation of total knee arthroplasty using isokinetic testing. Clin Orthop Relat Res. 1991;271:106–113.PubMed
2.
Zurück zum Zitat Berth A, Urbach D, Awiszus F. Improvement of voluntary quadriceps muscle activation after total knee arthroplasty. Arch Phys Med Rehabil. 2002;83:1432–1436.PubMedCrossRef Berth A, Urbach D, Awiszus F. Improvement of voluntary quadriceps muscle activation after total knee arthroplasty. Arch Phys Med Rehabil. 2002;83:1432–1436.PubMedCrossRef
3.
Zurück zum Zitat Brown I, Renwick R, Raphael D. Frailty: constructing a common meaning, definition, and conceptual framework. Int J Rehabil Res. 1995;18:93–102.PubMedCrossRef Brown I, Renwick R, Raphael D. Frailty: constructing a common meaning, definition, and conceptual framework. Int J Rehabil Res. 1995;18:93–102.PubMedCrossRef
4.
Zurück zum Zitat de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res. 2008;466:2201–2208.PubMedCrossRef de Groot IB, Bussmann HJ, Stam HJ, Verhaar JA. Small increase of actual physical activity 6 months after total hip or knee arthroplasty. Clin Orthop Relat Res. 2008;466:2201–2208.PubMedCrossRef
5.
Zurück zum Zitat Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, LaStayo PC. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov Disord. 2006;21:1444–1452.PubMedCrossRef Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, LaStayo PC. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov Disord. 2006;21:1444–1452.PubMedCrossRef
6.
Zurück zum Zitat Dickstein R, Heffes Y, Shabtai EI, Markowitz E. Total knee arthroplasty in the elderly: patients’ self-appraisal 6 and 12 months postoperatively. Gerontology. 1998;44:204–210.PubMedCrossRef Dickstein R, Heffes Y, Shabtai EI, Markowitz E. Total knee arthroplasty in the elderly: patients’ self-appraisal 6 and 12 months postoperatively. Gerontology. 1998;44:204–210.PubMedCrossRef
7.
Zurück zum Zitat Finch E, Walsh M, Thomas SG, Woodhouse LJ. Functional ability perceived by individuals following total knee arthroplasty compared to age-matched individuals without knee disability. J Orthop Sports Phys Ther. 1998;27:255–263.PubMed Finch E, Walsh M, Thomas SG, Woodhouse LJ. Functional ability perceived by individuals following total knee arthroplasty compared to age-matched individuals without knee disability. J Orthop Sports Phys Ther. 1998;27:255–263.PubMed
8.
Zurück zum Zitat Hortobagyi T, Devita P, Money J, Barrier J. Effects of standard and eccentric overload strength training in young women. Med Sci Sports Exerc. 2001;33:1206–1212.PubMed Hortobagyi T, Devita P, Money J, Barrier J. Effects of standard and eccentric overload strength training in young women. Med Sci Sports Exerc. 2001;33:1206–1212.PubMed
9.
Zurück zum Zitat Huang CH, Cheng CK, Lee YT, Lee KS. Muscle strength after successful total knee replacement: a 6- to 13-year followup. Clin Orthop Relat Res. 1996;328:147–154.PubMedCrossRef Huang CH, Cheng CK, Lee YT, Lee KS. Muscle strength after successful total knee replacement: a 6- to 13-year followup. Clin Orthop Relat Res. 1996;328:147–154.PubMedCrossRef
10.
Zurück zum Zitat Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6:3.PubMedCrossRef Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord. 2005;6:3.PubMedCrossRef
11.
Zurück zum Zitat Kervio G, Carre F, Ville NS. Reliability and intensity of the six-minute walk test in healthy elderly subjects. Med Sci Sports Exerc. 2003;35:169–174.PubMedCrossRef Kervio G, Carre F, Ville NS. Reliability and intensity of the six-minute walk test in healthy elderly subjects. Med Sci Sports Exerc. 2003;35:169–174.PubMedCrossRef
12.
Zurück zum Zitat LaStayo PC, Ewy GA, Pierotti DD, Johns RK, Lindstedt S. The positive effects of negative work: increased muscle strength and decreased fall risk in a frail elderly population. J Gerontol A Biol Sci Med Sci. 2003;58:M419–424.PubMed LaStayo PC, Ewy GA, Pierotti DD, Johns RK, Lindstedt S. The positive effects of negative work: increased muscle strength and decreased fall risk in a frail elderly population. J Gerontol A Biol Sci Med Sci. 2003;58:M419–424.PubMed
13.
Zurück zum Zitat LaStayo PC, Pierotti DJ, Pifer J, Hoppeler H, Lindstedt SL. Eccentric ergometry: increases in locomotor muscle size and strength at low training intensities. Am J Physiol Regul Integr Comp Physiol. 2000;278:R1282–1288.PubMed LaStayo PC, Pierotti DJ, Pifer J, Hoppeler H, Lindstedt SL. Eccentric ergometry: increases in locomotor muscle size and strength at low training intensities. Am J Physiol Regul Integr Comp Physiol. 2000;278:R1282–1288.PubMed
14.
Zurück zum Zitat LaStayo PC, Woolf JM, Lewek MD, Snyder-Mackler L, Reich T, Lindstedt SL. Eccentric muscle contractions: their contribution to injury, prevention, rehabilitation, and sport. J Orthop Sports Phys Ther. 2003;33:557–571.PubMedCrossRef LaStayo PC, Woolf JM, Lewek MD, Snyder-Mackler L, Reich T, Lindstedt SL. Eccentric muscle contractions: their contribution to injury, prevention, rehabilitation, and sport. J Orthop Sports Phys Ther. 2003;33:557–571.PubMedCrossRef
15.
Zurück zum Zitat Lombardi AV Jr, Viacava AJ, Berend KR. Rapid recovery protocols and minimally invasive surgery help achieve high knee flexion. Clin Orthop Relat Res. 2006;452:117–122.PubMedCrossRef Lombardi AV Jr, Viacava AJ, Berend KR. Rapid recovery protocols and minimally invasive surgery help achieve high knee flexion. Clin Orthop Relat Res. 2006;452:117–122.PubMedCrossRef
16.
Zurück zum Zitat Lorentzen JS, Petersen MM, Brot C, Madsen OR. Early changes in muscle strength after total knee arthroplasty. A 6-month follow-up of 30 knees. Acta Orthop Scand. 1999;70:176–179.PubMedCrossRef Lorentzen JS, Petersen MM, Brot C, Madsen OR. Early changes in muscle strength after total knee arthroplasty. A 6-month follow-up of 30 knees. Acta Orthop Scand. 1999;70:176–179.PubMedCrossRef
17.
Zurück zum Zitat Meier W, Marcus RL, Dibble LE, Foreman KB, Peters C, Mizner RL, LaStayo PC. The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatric Phys Ther. 2009;32:47–52. Meier W, Marcus RL, Dibble LE, Foreman KB, Peters C, Mizner RL, LaStayo PC. The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatric Phys Ther. 2009;32:47–52.
18.
Zurück zum Zitat Meier W, Mizner RL, Marcus RL, Dibble LE, Peters C, LaStayo PC. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther. 2008;38:246–256.PubMed Meier W, Mizner RL, Marcus RL, Dibble LE, Peters C, LaStayo PC. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther. 2008;38:246–256.PubMed
19.
Zurück zum Zitat Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN. Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplasty. 2003;18:286–294.PubMedCrossRef Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN. Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplasty. 2003;18:286–294.PubMedCrossRef
20.
Zurück zum Zitat Minns Lowe CJ, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ. 2007;335:812.PubMedCrossRef Minns Lowe CJ, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ. 2007;335:812.PubMedCrossRef
21.
Zurück zum Zitat Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35:424–436.PubMed Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35:424–436.PubMed
22.
Zurück zum Zitat Mizner RL, Petterson SC, Stevens JE, Axe MJ, Snyder-Mackler L. Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol. 2005;32:1533–1539.PubMed Mizner RL, Petterson SC, Stevens JE, Axe MJ, Snyder-Mackler L. Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol. 2005;32:1533–1539.PubMed
23.
Zurück zum Zitat Mizner RL, Snyder-Mackler L. Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res.2005;23:1083–1090.PubMedCrossRef Mizner RL, Snyder-Mackler L. Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res.2005;23:1083–1090.PubMedCrossRef
24.
Zurück zum Zitat Moffet H, Collet JP, Shapiro SH, Paradis G, Marquis F, Roy L. Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil. 2004;85:546–556.PubMedCrossRef Moffet H, Collet JP, Shapiro SH, Paradis G, Marquis F, Roy L. Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil. 2004;85:546–556.PubMedCrossRef
25.
Zurück zum Zitat NIH Consensus Statement on total knee replacement December 8-10, 2003. J Bone Joint Surg Am. 2004;86:1328–1335. NIH Consensus Statement on total knee replacement December 8-10, 2003. J Bone Joint Surg Am. 2004;86:1328–1335.
26.
Zurück zum Zitat Noble BJ, Borg GA, Jacobs I, Ceci R, Kaiser P. A category-ratio perceived exertion scale: relationship to blood and muscle lactates and heart rate. Med Sci Sports Exerc. 1983;6:523–528. Noble BJ, Borg GA, Jacobs I, Ceci R, Kaiser P. A category-ratio perceived exertion scale: relationship to blood and muscle lactates and heart rate. Med Sci Sports Exerc. 1983;6:523–528.
27.
Zurück zum Zitat Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;431:157–165.PubMedCrossRef Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;431:157–165.PubMedCrossRef
28.
Zurück zum Zitat Peters CL. Soft-tissue balancing in primary total knee arthroplasty. Instr Course Lect. 2006;55:413–417.PubMed Peters CL. Soft-tissue balancing in primary total knee arthroplasty. Instr Course Lect. 2006;55:413–417.PubMed
29.
Zurück zum Zitat Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009;61:174–183.PubMedCrossRef Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009;61:174–183.PubMedCrossRef
30.
Zurück zum Zitat Ranawat AS, Ranawat CS. Pain management and accelerated rehabilitation for total hip and total knee arthroplasty. J Arthroplasty. 2007;22:12–15.PubMedCrossRef Ranawat AS, Ranawat CS. Pain management and accelerated rehabilitation for total hip and total knee arthroplasty. J Arthroplasty. 2007;22:12–15.PubMedCrossRef
31.
Zurück zum Zitat Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes. 2003;1:17.PubMedCrossRef Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes. 2003;1:17.PubMedCrossRef
32.
Zurück zum Zitat Rossi MD, Brown LE, Whitehurst M. Knee extensor and flexor torque characteristics before and after unilateral total knee arthroplasty. Am J Phys Med Rehabil. 2006;85:737–746.PubMedCrossRef Rossi MD, Brown LE, Whitehurst M. Knee extensor and flexor torque characteristics before and after unilateral total knee arthroplasty. Am J Phys Med Rehabil. 2006;85:737–746.PubMedCrossRef
33.
Zurück zum Zitat Rossi MD, Hasson S. Lower-limb force production in individuals after unilateral total knee arthroplasty. Arch Phys Med Rehabil. 2004;85:1279–1284.PubMedCrossRef Rossi MD, Hasson S. Lower-limb force production in individuals after unilateral total knee arthroplasty. Arch Phys Med Rehabil. 2004;85:1279–1284.PubMedCrossRef
34.
Zurück zum Zitat Rossi MD, Hasson S, Kohia M, Pineda E, Bryan W. Mobility and perceived function after total knee arthroplasty. J Arthroplasty. 2006;21:6–12.PubMedCrossRef Rossi MD, Hasson S, Kohia M, Pineda E, Bryan W. Mobility and perceived function after total knee arthroplasty. J Arthroplasty. 2006;21:6–12.PubMedCrossRef
35.
Zurück zum Zitat Silva M, Shepherd EF, Jackson WO, Pratt JA, McClung CD, Schmalzried TP. Knee strength after total knee arthroplasty. J Arthroplasty. 2003;18:605–611.PubMedCrossRef Silva M, Shepherd EF, Jackson WO, Pratt JA, McClung CD, Schmalzried TP. Knee strength after total knee arthroplasty. J Arthroplasty. 2003;18:605–611.PubMedCrossRef
36.
Zurück zum Zitat Stevens JE, Mizner RL, Snyder-Mackler L. Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis. J Orthop Res. 2003;21:775–779.PubMedCrossRef Stevens JE, Mizner RL, Snyder-Mackler L. Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis. J Orthop Res. 2003;21:775–779.PubMedCrossRef
37.
Zurück zum Zitat Tracy BL, Ivey FM, Jeffrey Metter E, Fleg JL, Siegel EL, Hurley BF. A more efficient magnetic resonance imaging-based strategy for measuring quadriceps muscle volume. Med Sci Sports Exerc. 2003;35:425–433.PubMedCrossRef Tracy BL, Ivey FM, Jeffrey Metter E, Fleg JL, Siegel EL, Hurley BF. A more efficient magnetic resonance imaging-based strategy for measuring quadriceps muscle volume. Med Sci Sports Exerc. 2003;35:425–433.PubMedCrossRef
38.
Zurück zum Zitat Walsh M, Woodhouse LJ, Thomas SG, Finch E. Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys Ther. 1998;78:248–258.PubMed Walsh M, Woodhouse LJ, Thomas SG, Finch E. Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Phys Ther. 1998;78:248–258.PubMed
39.
Zurück zum Zitat Wylde V, Dieppe P, Hewlett S, Learmonth ID. Total knee replacement: is it really an effective procedure for all? Knee. 2007;14:417–423.PubMedCrossRef Wylde V, Dieppe P, Hewlett S, Learmonth ID. Total knee replacement: is it really an effective procedure for all? Knee. 2007;14:417–423.PubMedCrossRef
40.
Zurück zum Zitat Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol Avon). 2008;23:320–328.CrossRef Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol Avon). 2008;23:320–328.CrossRef
Metadaten
Titel
Reversing Muscle and Mobility Deficits 1 to 4 Years after TKA: A Pilot Study
verfasst von
Paul C. LaStayo, PhD, PT
Whitney Meier, DPT, OCS
Robin L. Marcus, PhD, PT, OCS
Ryan Mizner, PhD, MPT
Lee Dibble, PhD, PT, ATC
Christopher Peters, MD
Publikationsdatum
01.06.2009
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 6/2009
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-0801-2

Weitere Artikel der Ausgabe 6/2009

Clinical Orthopaedics and Related Research® 6/2009 Zur Ausgabe

Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty

Factors Influencing Early Rehabilitation After THA: A Systematic Review

Symposium: Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty

Comparison of Outpatient versus Inpatient Total Knee Arthroplasty

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.