Ann Rehabil Med.  2017 Oct;41(5):816-827. 10.5535/arm.2017.41.5.816.

Effects of Early Combined Eccentric-Concentric Versus Concentric Resistance Training Following Total Knee Arthroplasty

• Suh MJ
• Kim BR
• Kim SR
• Han EY
• Lee SY

• KMID: 2440809
• DOI: http://doi.org/10.5535/arm.2017.41.5.816

Abstract

OBJECTIVE
To investigate the effects of early combined eccentric-concentric (ECC-CON) or concentric (CON) resistance training following total knee arthroplasty (TKA).
METHODS
Patients who underwent a primary TKA were randomly assigned to an ECC-CON group (n=16) or a CON group (n=18). All patients received early, progressive resistance training with five sessions per week for 2 weeks starting 2 weeks after TKA. Isometric knee flexor and extensor strength of the surgical and non-surgical knees, instrumental gait analysis for spatiotemporal parameters, 6-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Timed Stair Climbing Test (SCT) were used to evaluate performance-based physical function. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and EuroQOL five dimensions (EQ-5D) questionnaire were used to evaluate self-reported physical function and self-reported quality of life. All patients underwent these evaluations before and 1 month after TKA.
RESULTS
The ECC-CON group showed clinically meaningful improvements in extensor peak torque (PT) of the non-surgical knee, gait speed, and 6MWT from preoperative values. The CON group had an increase in H/Q ratio of the surgical knee and improvement in SCT-ascent postoperatively. Both groups showed significant improvements in WOMAC-Pain, function, and EQ-5D scores. Although extensor PT of the surgical knee did not reach the preoperative level in either group, the postoperative change was significantly less in the ECC-CON group than the CON group.
CONCLUSION
Early combined ECC-CON resistance training minimizes the loss in quadriceps strength of the surgical knee and improves endurance and gait speed after TKA.

Keyword

Osteoarthritis; Knee; Arthroplasty; Replacement; Rehabilitation

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Gait
Humans
Knee
Ontario
Osteoarthritis
Quality of Life
Rehabilitation
Resistance Training*
Torque

Figure

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  Fig. 1 The concentric knee extension (A) and flexion (B) exercise using air resistance machines.

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  Fig. 2 The eccentric exercise using recumbent eccentric (A) and concentric (B) ergometer.

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