Efficacy of a 12-month, monitored home exercise programme compared with normal care commencing 2 months after total knee arthroplasty: a randomized controlled trial

Abstract

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); healthrelated 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.