A new study out of the University of Delaware encourages progressive strengthening over “standard of care” for TKA.

Researchers studied adults over 50 with recent Total Knee Arthroplasty’s (TKA). The study included 3 groups: a Progressive Strengthening group, Standard Care group, and a control group. The control group included adults over 50 who did not have a joint pathology.

Interventions began 3 weeks after TKA. The Progressive Strengthening group participated in a least 12 outpatient visits 2–3 times a week. The visits focused on strengthening exercises that were progressively adjusted to maintain maximal effort for 3 sets of 10 repetitions. The “standard of care” group participated in outpatient rehabilitation separate from the Progressive Strengthening group thatfocused on range of motion (ROM), stationary cycling, and “various straight-leg raising exercises without weights.”

Neither treatment groups achieved function equivalent to the control group. However, compared to the standard care group, the strengthening group achieved scores at or better than lower-boundary scores of the control group. These findings led authors to believe that a progressive strengthening approach can help patients with TKA achieve better clinical outcomes, allowing for better functional abilities and better quality of life.

Pozzi F, et al. Restoring physical function after knee replacement: a cross sectional comparison of progressive strengthening vs standard physical therapy.Physiother Theory Pract. 2018 Jun 7:1-12. doi: 10.1080/09593985.2018.1479475. https://www.ncbi.nlm.nih.gov/pubmed/29877749