Isokinetic training of lower extremity during the early stage promote functional restoration in elder patients with disability after Total knee replacement (TKR) - a randomized control trial

Yuan-Yang Cheng; Cheng-Hsu Chen; Shun-Ping Wang

doi:10.1186/s12877-024-04778-9

Isokinetic training of lower extremity during the early stage promote functional restoration in elder patients with disability after Total knee replacement (TKR) - a randomized control trial

BMC Geriatr. 2024 Feb 19;24(1):173. doi: 10.1186/s12877-024-04778-9.

Authors

Yuan-Yang Cheng^{1

2

3}, Cheng-Hsu Chen^{3

4

5}, Shun-Ping Wang^{6

7}

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.
² School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
³ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁴ Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
⁵ Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁶ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. wsp0120@yahoo.com.tw.
⁷ Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan. wsp0120@yahoo.com.tw.

Abstract

Background: Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people.

Methods: A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC).

Results: All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups.

Conclusion: Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups.

Trial registration: Clinical trial registration number: NCT02938416.

Level of evidence: I.

Keywords: Isokinetic; Isometric; Isotonic; Timed up and go; Total knee replacement.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Arthroplasty, Replacement, Knee* / adverse effects
Exercise
Exercise Therapy / methods
Humans
Knee
Resistance Training* / methods

Associated data

ClinicalTrials.gov/NCT02938416