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Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study investigates the effectiveness of preoperative high-intensity strength training (with a special emphasis on lower limb muscle strength and secondarily on balance training) on postural control after TKA.

Methods

Forty-four subjects (7 men, 37 women, and mean age 66.7 ± 3.9 years) scheduled for unilateral TKA for osteoarthritis (OA) participated in this randomized-controlled trial. Each patient performed two postural control tests: Romberg test with eyes open and closed. These tests were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3), and finally 3 months after TKA (T4). The intervention group completed an 8-week training program 3 days per week prior to surgery, while the control group received no intervention.

Results

The Center of Pressure area (COP) was lower (i.e., better score) for the intervention group at T2, T3, and T4. The anteroposterior range of COP with eyes open was lower in the intervention group at T2, T3, and T4 and with eyes closed at T2. The medial–lateral standard deviation of COP with eyes open was lower in the intervention group at T2 and T4 and with eyes closed at T2 and T3. The anteroposterior standard deviation of COP with eyes open did not change, while that with eyes closed the intervention group showed lower score at T2.

Conclusion

Preoperative high-intensity strength training is effective for improving postural control before and early after TKA. Recommendations should include preoperative strength training, and not only balance training, to speed-up recovery of postural control after TKA.

Level of evidence

1.

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Funding

The authors did not receive financial support for this study.

Author information

Authors and Affiliations

  1. Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, C/ Gasco Oliag 5, 46010, Valencia, Spain

    José Casaña, Joaquín Calatayud, Yasmín Ezzatvar & Josep Benítez

  2. National Research Centre for the Working Environment, Copenhagen, Denmark

    Joaquín Calatayud, Jonas Vinstrup & Lars L. Andersen

  3. Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark

    Jonas Vinstrup & Lars L. Andersen

Authors
  1. José Casaña
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  2. Joaquín Calatayud
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  3. Yasmín Ezzatvar
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  4. Jonas Vinstrup
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  5. Josep Benítez
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  6. Lars L. Andersen
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Corresponding author

Correspondence to Joaquín Calatayud.

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Conflict of interest

There are no known conflicts of interest associated with this publication that could have influenced its outcome.

Ethical approval

All procedures described in this section were approved by the institution’s review board of the Clinical Hospital of Valencia (approval number: F-CE-GEva-15) and comply with the requirements listed in the 1975 Declaration of Helsinki and its amendment in 2008.

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Casaña, J., Calatayud, J., Ezzatvar, Y. et al. Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial. Knee Surg Sports Traumatol Arthrosc 27, 1057–1066 (2019). https://doi.org/10.1007/s00167-018-5246-2

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  • DOI: https://doi.org/10.1007/s00167-018-5246-2

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