Comparison of the effectiveness of late-phase clinic-based and home-based progressive resistance training in female patients with total knee arthroplasty.

BACKGROUND: Early rehabilitation after total knee arthroplasty (TKA) is crucial in functional outcomes. However, considering improvements in the first six months, there may be benefits to continuing rehabilitation beyond three months postoperatively to achieve maximum functionality and strength. OBJECTIVE: The aim was to compare: (a) effectiveness of late-phase clinic-based and home-based progressive resistance training (PRT) in female patients with TKA; and (b) crude cost of both interventions and explore feasibility. METHODS: Thirty-two patients were assigned to clinic-based PRT (n = 16) and home-based PRT (n = 16) groups. A training program was performed at the clinic or at home for eight weeks. Pain, quadriceps and hip abductor strength, patient-reported and performance-based outcomes, knee range of motion (ROM), joint awareness, quality of life (QoL) were assessed at baseline (three months postoperatively) and after 8-week intervention (five months postoperatively). Feasibility and crude cost were examined. RESULTS: Exercise adherence was 100% in clinic-based PRT and 90.6% in the home-based PRT group. Both interventions improved quadriceps and hip abductor muscle strength, performance-based and patient-reported outcomes, knee ROM, and joint awareness without side effects (p < .05). Clinic-based PRT showed better results in: activity pain (p = .004, ES = -0.888); knee flexion (p = .002, ES = 0.875) and extension ROM (p = .004, ES = -1.081); chair sit-to-stand test (p = .013, ES = 0.935); joint awareness (p = .008, ES = 0.927); and QoL than home-based PRT (p < .05). CONCLUSION: Late-phase clinical-based and home-based PRT interventions may be beneficial in improving muscle strength and functionality in patients with TKA. Late-phase PRT is feasible, cost-effective, and recommended for rehabilitation after TKA.

Is there a relation between rotator cuff injury and core stability?

BACKGROUND: Strong core stabilization not only minimizes the load on the vertebral column, but also improves strength and endurance of peripheral joints, and enables the energy transfer to distal segments. Despite the current interest surrounding core stability, none of the studies investigated the effect of core stability on the formation of rotator cuff tear or healing after repair. OBJECTIVE: To determine the relationship between core stability and upper extremity functional performance in patients who underwent rotator cuff repair surgery and to compare those with healthy subjects of similar age. METHODS: Patients who underwent rotator cuff repair (RC repair group, n= 58 patient) and healthy subjects of the similar age group (control group, n= 114) were included in the study. The mean age was 55.03 ± 9.84 years in the RC repair group and 52.71 ± 6.31 years in the control group. The RC repair group took standardized rehabilitation. The rehabilitation program did not include core strength and stability exercise. Core endurance was assessed with Flexor Endurance, Prone Bridge and Supine bridge test. Disabilities of the Arm, Shoulder and Hand (DASH), Short Form-36 (SF-36) and the Close Kinetic Chain Upper Extremity Stability (CKCUES) test were used to evaluate the upper extremity functional performance. RESULTS: The core endurance (prone and supine bridge test) of the control group was statistically significantly better than the RC repair group (p⩽ 0.005). The DASH-T, SF-36 and CKCUES scores of the control group were also statistically significantly better. CONCLUSION: The neuromuscular system should be considered as a whole, and addition of the core stabilization exercises to an effective rehabilitation program after RC repair surgery may be beneficial.