Effects of Leg-Press Training with Moderate Vibration on Muscle Strength, Pain, and Function after Total Knee Arthroplasty: A Randomized Controlled Trial

Publication date: Available online 4 January 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Walter Bily, Carlo Franz, Lukas Trimmel, Stefan Loefler, Jan Cvecka, Sandra Zampieri, Waltraud Kasche, Nejc Sarabon, P. Zenz, H. Kern
ObjectivesTo examine the effects of a time saving leg-press training program with moderate vibration on strength parameters, pain, and functional outcomes of patients following total knee arthroplasty in comparison with functional physiotherapy.DesignRandomized controlled trial.SettingOutpatient Rehabilitation Department at a University Teaching Hospital.ParticipantsPatients (n=55) with primary total knee arthroplasty (TKA) were randomly allocated into two rehabilitation groups.InterventionsSix weeks after TKA, participants either underwent isokinetic leg-press training combined with moderate vibration (LP, n=26) of 15 minutes duration per session, or functional physiotherapy (PT, n=29) of 30 minutes per session. Both groups received therapy twice a week for a period of 6 weeks. Participants were evaluated at baseline (6 weeks after TKA) and after the 6 weeks rehabilitation program.Main outcome measuresThe main outcome measure was maximum voluntary contraction (MVC) of the involved leg. Secondary outcome measures were pain assessed with a visual analogue scale (VAS), range of motion (ROM), stair test (ST), timed up and go test (TUG), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).ResultsBoth groups (LP and PT) showed statistically significant improvements in MVC of knee extensors measured on the knee dynamometer (LP from 0.8 ± 0.06 to 1.0 ± 0.09 Nm/kg BW, PT from 0.7 ± 0.06 to 0.9 ± 0.06 Nm/kg BW, p<.05), and in closed kinetic chain on the leg-press (LP from 8.9 ± 0.77 to 10.3 ± 1.06 N/kg BW, PT from 6.7 ± 0.54 to 9.1 ± 0.70 N/kg BW, p<.05), as well as pain at rest (LP from 2.0 ± 0.36 to 1.3 ± 0.36 VAS and PT from 1.2 ± 0.28 to 1.1 ± 0.31, p<.05), WOMAC and functional measurements after 6 weeks of training. There was no significant difference between the two groups concerning strength, pain, and functional outcomes after training (p>.05).ConclusionsIsokinetic leg-press training with moderate vibration and functional physiotherapy are both effective in regaining muscle strength and function after TKA, however, isokinetic leg-press training is considerably less time consuming.



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