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Efficacy of a 12-month, monitored home exercise programme compared with normal care commencing 2 months after total knee arthroplasty: a randomized controlled trial
Vuorenmaa M, Ylinen J, Piitulainen K, Salo P, Kautiainen H, Pesola M, Hakkinen A
Journal of Rehabilitation Medicine 2014 Feb;46(2):166-172
clinical trial
8/10 [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: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the efficacy of a delayed home exercise programme compared with normal care after primary total knee arthroplasty. DESIGN: Single-blind, prospective, randomized, controlled trial. PARTICIPANTS: A total of 108 participants (61% females, mean age 69 years (standard deviation 8.7)), were randomized to a home-based exercise group (EG, n = 53) or to a control group (CG, n = 55). METHODS: Two months post-operatively, the EG received a home exercise programme, while the CG received no additional guidance. The outcome measurements were: pain and disability, measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); health-related quality of life (HRQoL), measured using the Short Form-36 questionnaire (SF-36); maximal walking speed; isometric knee muscle strength; and the Timed Up and Go (TUG) test. Measurements were made at baseline and at 12 months thereafter. RESULTS: At the 12-month follow-up, maximal walking speed (p < 0.001) and knee flexion strength (p = 0.009) were significantly greater in the EG. Both groups showed similar improvements in all of the WOMAC subscale scores, the SF-36 summary scores and the TUG time. CONCLUSION: Home-based training was not superior to normal care with regard to pain, disability or HRQoL, but resulted in greater improvement in objectively measured physical performance.

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