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Resistance training in patients with total knee arthroplasty: a systematic review and meta-analysis [with consumer summary]
Liu H-W
Journal of Orthopaedics 2024 May;56:111-118
systematic review

BACKGROUND: Though popular after joint replacement surgery, progressive resistance training (PRT) has controversial safety and efficacy claims. Therefore, PRT's effect on early postoperative muscle strength and functional capacity following total knee arthroplasty (TKA) must be thoroughly investigated. Between May 12, 2020, and February 12, 2002, the Cochrane Library, Web of Science, and Medline databases containing pertinent literature were thoroughly reviewed for this investigation. METHODS: Out of 704 studies, 9 (TKA) met inclusion criteria for meta-analysis, involving 1021 adult patients. The analysis encompassed various post-TKA indicators at 1, 3, and 12 months, including the 6-Minute Walk Test (6-WMT), Stair Climbing Performance (SCP), leg extension strength, Timed Up and Go Test (TUG), and Sit-to-Stand (ST) repetitions. RESULTS: In TKA patients, 6-WMT within 1 month (95% CI -0.41 to 1.53), 3 months (95% CI -0.27 to 0.76), and 12 months (95% CI -0.29 to 0.66) did not show any significant differences. There were no discernible changes in ST at various time intervals, SCP, leg extension strength, and TUG at 1 month (95% CI -1.75 to 0.77), 3 months (95% CI -0.48 to 0.33), and 12 months (95% CI -0.44 to 0.35). There was no statistical difference in the incidence of adverse events between the two groups (95% CI -0.01 to 0.10). CONCLUSIONS: Early post-TKA PRT demonstrated no significant differences compared to Standard Rehabilitation (SR) regarding functional capacity, muscle strength recovery, and adverse event incidence. Therefore, PRT is a feasible option for promoting swift recovery post-total knee arthroplasty.

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