February 2015

Progressive strengthening improves function after total knee arthroplasty

In the moment: Rehabilitation

By Jordana Bieze Foster

Patients who do progressive strengthening exercises after total knee arthroplasty (TKA) are significantly more likely than those who do conventional rehabilitation to have normal-range functional outcomes at one year, according to research from the University of Delaware.

Investigators performed functional assessments in 205 TKA patients at three to four weeks and one year postsurgery; 165 patients did six weeks of progressive strengthening while 40 patients received standard-of-care rehabilitation. Functional assessment included the timed up and go (TUG), stair climbing, and six-minute walk tests; quadriceps strength was also assessed. Normal outcome range was defined by the 95% confidence interval for each test in a group of 63 healthy controls.

At one year, the percentage of patients within normal range was significantly higher for the progressive strengthening group than the standard of care group for quadriceps strength, the TUG test, and the stair climbing test, according to Frederico Pozzi, PT, a graduate student in the Biomechanics and Movement Science Program at the university, who presented the findings in February at the APTA Combined Sections Meeting.


Pozzi F, Snyder-Mackler L, Zeni J. Effectiveness of a progressive strengthening rehabilitation protocol in restoring function 1 year following total knee arthroplasty. J Orthop Sports Phys Ther 2015; 45(1):A34.

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