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Effects of preoperative telerehabilitation on muscle strength, range of motion, and functional outcomes in candidates for total knee arthroplasty: a single-blind randomized controlled trial
An J, Ryu H-K, Lyu S-J, Yi H-J, Lee B-H
International Journal of Environmental Research & Public Health 2021 Jun;18(11):6071
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 +/- 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60 degree/s extension peak torque (F[4,100] = 2.499, p = 0.047, partial-eta2 = 0.91), 180 degree/s extension peak torque (F[4,100] = 3.583, p = 0.009, partial-eta2 = 0.125), ROM (F[4,100] = 4.689, p = 0.002, partial-eta2p = 0.158), TUG time (F[4,100] = 7.252, p < 0.001, partial-eta2 = 0.225), WOMAC pain (F[4,100] = 9.113, p < 0.001, partial-eta2 = 0.267), WOMAC functional outcome (F[4,100] = 6.579, p < 0.001, partial-eta2 = 0.208), and WOMAC total score (F[4,100] = 10.410, p < 0.001, partial-eta2 = 0.294). The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.

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