Hip Abductor Strengthening Improves Physical Function Following Total Knee Replacement: One-Year Follow-Up of a Randomized Pilot Study.

Karvannan Harikesavan,Shivakumar Y Shivanna,Raj D Chakravarty,Arun G Maiya,Sanjay P Hegde

doi:10.2174/1874312901711010030

Karvannan Harikesavan, Shivakumar Y Shivanna + Show 3 more

Open Access

https://doi.org/10.2174/1874312901711010030

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Abstract

Background:Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis.Objective:To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement.Methods:An observer blinded randomized pilot trial design was conducted at Manipal hospital, Bangalore, India. Participants designated for elective TKR were randomized to experimental group hip abductor strengthening along with standard rehabilitation (n=10) or control group standard rehabilitation alone (n=10). Participants followed for one year to assess physical function using performance based outcomes, such as timed up and go test, single leg stance test, six minute walk test, knee extensor strength and hip abductor strength.Result:Eighteen participants with a mean age of 63.1 ± 5.5 years (8 Males and 10 Females) completed the study. Improvement in hip abduction strength, single leg stand test was superior in hip abductor strengthening group at 3 months and 1 year when compared to standard rehabilitation alone.Conclusion:Hip abductor strengthening showed superior improvements in single leg stance test and six minute walk test. Hip abductor strengthening exercises has the potential to improve physical function following total knee replacement.

Highlights

Total knee replacement (TKR) is the most renowned surgical procedure for patients with severe knee pain and impaired function following end stage knee osteoarthritis [1, 2]
Despite more advanced and excellent surgical procedure, declined functional tasks were reported following TKR when compared to the healthy age matched controls with 15% reduced walking speed, 50% more time taken to complete stair climbing tasks and 20% less distance covered during the six minute walk test [6, 7]
Reconnoitering the modifiable factors contributing to the functional performances following TKR might help to improve performance based outcomes, one such modifiable factor is the lower extremity muscle weakness following knee osteoarthritis (OA)

Summary

Introduction

Total knee replacement (TKR) is the most renowned surgical procedure for patients with severe knee pain and impaired function following end stage knee osteoarthritis [1, 2]. Studies reported that participants showed substantial improvements in arthritis pain, but a varied physical function following TKR [4, 5]. Despite more advanced and excellent surgical procedure, declined functional tasks were reported following TKR when compared to the healthy age matched controls with 15% reduced walking speed, 50% more time taken to complete stair climbing tasks and 20% less distance covered during the six minute walk test [6, 7]. The strengthening of the quadriceps muscles was established by previous studies and proved its short-term improvements in physical function after TKR [8 - 10]. Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis

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