Acute effects of in-hospital resistance training on clinical outcomes in patients undergoing total knee arthroplasty: A randomized controlled trial

OBJECTIVE: To evaluate the acute responses, in the in-hospital setting, of intensive elastic resistance training on physical function, pain, psychosocial variables and inflammatory markers in patients undergoing total knee arthroplasty (TKA).

DESIGN: In a randomized controlled trial, 40 patients with TKA (≥55 years) were assigned to either (1) the intervention group (elastic resistance strengthening) or (2) a control group (conventional protocol). Patients performed three sessions in the hospital at 24, 48 and 72 hours after TKA. Outcome measures included: Self-administered physical function, pain intensity, kinesiophobia, catastrophizing, self-efficacy, range of motion (ROM), perceived change, test timed up and go (TUG), knee joint effusion, isometric strength, pressure pain thresholds (PPT), and inflammatory markers (levels of procalcitonin and C-reactive protein).

RESULTS: The mixed ANOVA model showed a significant group*time interaction in favor of the intervention group with a large effect size for kinesiophobia (ηp2 = 0.308;p < 0.001), catastrophizing (ηp2 = 0.242;p < 0.001) and passive ROM flexion (ηp2 = 0.167;p < 0.001), and a moderate effect size for physical function (ηp2 = 0.103;p = 0.004), pain intensity (ηp2 = 0.139;p < 0.001), TUG (ηp2 = 0.132;p = 0.001), self-efficacy (ηp2 = 0.074;p = 0.016;), active ROM flexion (ηp2 = 0.121;p = 0.002), levels of procalcitonin (ηp2 = 0.099;p = 0.005) and C-reactive protein (ηp2 = 0.106;p = 0.004).

CONCLUSION: Three sessions of intensive elastic resistance training improve physical function, perceived pain, psychosocial variables and inflammatory markers during the hospitalization period after TKA.