Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study

Objective: Unilateral strength training has been shown to be more effective than bilateral training to increase strength in healthy people. The aims of this study were to test the feasibility of unilateral strength training during total knee arthroplasty (TKA) rehabilitation and compare it with sta...

Full description

Bibliographic Details
Main Authors: Markus Tilp, Sebastian Ringler, Herwig Mariacher, Dietmar Rafolt
Format: Article
Language:English
Published: Medical Journals Sweden 2023-04-01
Series:Journal of Rehabilitation Medicine
Subjects:
Online Access:https://medicaljournalssweden.se/jrm/article/view/3987
_version_ 1797844202464215040
author Markus Tilp
Sebastian Ringler
Herwig Mariacher
Dietmar Rafolt
author_facet Markus Tilp
Sebastian Ringler
Herwig Mariacher
Dietmar Rafolt
author_sort Markus Tilp
collection DOAJ
description Objective: Unilateral strength training has been shown to be more effective than bilateral training to increase strength in healthy people. The aims of this study were to test the feasibility of unilateral strength training during total knee arthroplasty (TKA) rehabilitation and compare it with standard bilateral training. Methods: Twenty-four TKA patients from an inpatient rehabilitation programme were randomly assigned to unilateral and bilateral strength training groups. Both groups completed 6 strength training sessions during 3 weeks of rehabilitation. Isometric strength, knee joint flexibility, knee circumference, chair rise and walking abilities, and perceived exertion and pain were assessed before and after the training period. Results: Both training groups increased isometric strength of both legs (+17–25%) and flexibility of the affected leg (+7.6%). Improvements in isometric strength of the healthy leg (+23% vs +11%) and flexibility of the affected leg (+10.7% vs +4.5%) were greater in the unilateral training group. Chair rise and 2-min walk test results improved in both groups, to the same extent. Perceived exertion decreased only in the unilateral training group (–20%), while perceived pain did not change in either group. Conclusion: This study showed the feasibility of unilateral strength training in TKA rehabilitation. Strength and flexibility improved similarly or better with unilateral strength training compared with standard bilateral strength training. Future studies should analyse the efficacy of prolonged unilateral strength training following TKA. LAY ABSTRACT The rehabilitation process following a total knee replacement surgery is aimed at regaining strength and flexibility of the knee joint and improving the movements of daily living, such as walking and standing up from a chair. However, to date, it is not known which kind of strength training is most effective in achieving this aim within a rehabilitation programme. During standard rehabilitation, both legs are trained. The current study tested whether training of the affected leg only is feasible, and compared it with standard strength training of both legs. Training the affected leg only resulted in greater improvements in flexibility and similar or greater improvements in strength. Both types of training resulted in improvements in walking and standing up from a chair. In conclusion, strength training of the affected leg only is a feasible alternative to standard strength training with both legs in total knee replacement rehabilitation.
first_indexed 2024-04-09T17:18:32Z
format Article
id doaj.art-967867923f0e46b5b287df4c067c18ed
institution Directory Open Access Journal
issn 1651-2081
language English
last_indexed 2024-04-09T17:18:32Z
publishDate 2023-04-01
publisher Medical Journals Sweden
record_format Article
series Journal of Rehabilitation Medicine
spelling doaj.art-967867923f0e46b5b287df4c067c18ed2023-04-19T08:42:10ZengMedical Journals SwedenJournal of Rehabilitation Medicine1651-20812023-04-015510.2340/jrm.v55.3987Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot StudyMarkus Tilp0Sebastian Ringler1Herwig Mariacher2Dietmar Rafolt3Institute of Human Movement Science, Sport and Health, University of Graz, GrazInstitute of Human Movement Science, Sport and Health, University of Graz, Graz; Maria Theresia Klinik, Bad Radkersburg, AustriaMaria Theresia Klinik, Bad Radkersburg, AustriaCenter for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria Objective: Unilateral strength training has been shown to be more effective than bilateral training to increase strength in healthy people. The aims of this study were to test the feasibility of unilateral strength training during total knee arthroplasty (TKA) rehabilitation and compare it with standard bilateral training. Methods: Twenty-four TKA patients from an inpatient rehabilitation programme were randomly assigned to unilateral and bilateral strength training groups. Both groups completed 6 strength training sessions during 3 weeks of rehabilitation. Isometric strength, knee joint flexibility, knee circumference, chair rise and walking abilities, and perceived exertion and pain were assessed before and after the training period. Results: Both training groups increased isometric strength of both legs (+17–25%) and flexibility of the affected leg (+7.6%). Improvements in isometric strength of the healthy leg (+23% vs +11%) and flexibility of the affected leg (+10.7% vs +4.5%) were greater in the unilateral training group. Chair rise and 2-min walk test results improved in both groups, to the same extent. Perceived exertion decreased only in the unilateral training group (–20%), while perceived pain did not change in either group. Conclusion: This study showed the feasibility of unilateral strength training in TKA rehabilitation. Strength and flexibility improved similarly or better with unilateral strength training compared with standard bilateral strength training. Future studies should analyse the efficacy of prolonged unilateral strength training following TKA. LAY ABSTRACT The rehabilitation process following a total knee replacement surgery is aimed at regaining strength and flexibility of the knee joint and improving the movements of daily living, such as walking and standing up from a chair. However, to date, it is not known which kind of strength training is most effective in achieving this aim within a rehabilitation programme. During standard rehabilitation, both legs are trained. The current study tested whether training of the affected leg only is feasible, and compared it with standard strength training of both legs. Training the affected leg only resulted in greater improvements in flexibility and similar or greater improvements in strength. Both types of training resulted in improvements in walking and standing up from a chair. In conclusion, strength training of the affected leg only is a feasible alternative to standard strength training with both legs in total knee replacement rehabilitation. https://medicaljournalssweden.se/jrm/article/view/3987knee replacementinpatient rehabiliationwalk testchair risebilateral deficitfeasibility
spellingShingle Markus Tilp
Sebastian Ringler
Herwig Mariacher
Dietmar Rafolt
Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
Journal of Rehabilitation Medicine
knee replacement
inpatient rehabiliation
walk test
chair rise
bilateral deficit
feasibility
title Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
title_full Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
title_fullStr Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
title_full_unstemmed Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
title_short Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training – A Randomized Controlled Pilot Study
title_sort unilateral strength training after total knee arthroplasty leads to similar or better effects on strength and flexibility than bilateral strength training a randomized controlled pilot study
topic knee replacement
inpatient rehabiliation
walk test
chair rise
bilateral deficit
feasibility
url https://medicaljournalssweden.se/jrm/article/view/3987
work_keys_str_mv AT markustilp unilateralstrengthtrainingaftertotalkneearthroplastyleadstosimilarorbettereffectsonstrengthandflexibilitythanbilateralstrengthtrainingarandomizedcontrolledpilotstudy
AT sebastianringler unilateralstrengthtrainingaftertotalkneearthroplastyleadstosimilarorbettereffectsonstrengthandflexibilitythanbilateralstrengthtrainingarandomizedcontrolledpilotstudy
AT herwigmariacher unilateralstrengthtrainingaftertotalkneearthroplastyleadstosimilarorbettereffectsonstrengthandflexibilitythanbilateralstrengthtrainingarandomizedcontrolledpilotstudy
AT dietmarrafolt unilateralstrengthtrainingaftertotalkneearthroplastyleadstosimilarorbettereffectsonstrengthandflexibilitythanbilateralstrengthtrainingarandomizedcontrolledpilotstudy