Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, C/ Gasco Oliag 5, 46010, Valencia, Spain.
National Research Centre for the Working Environment, Copenhagen, Denmark.
Knee Surg Sports Traumatol Arthrosc. 2019 Apr;27(4):1057-1066. doi: 10.1007/s00167-018-5246-2. Epub 2018 Oct 25.
This study investigates the effectiveness of preoperative high-intensity strength training (with a special emphasis on lower limb muscle strength and secondarily on balance training) on postural control after TKA.
Forty-four subjects (7 men, 37 women, and mean age 66.7 ± 3.9 years) scheduled for unilateral TKA for osteoarthritis (OA) participated in this randomized-controlled trial. Each patient performed two postural control tests: Romberg test with eyes open and closed. These tests were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3), and finally 3 months after TKA (T4). The intervention group completed an 8-week training program 3 days per week prior to surgery, while the control group received no intervention.
The Center of Pressure area (COP) was lower (i.e., better score) for the intervention group at T2, T3, and T4. The anteroposterior range of COP with eyes open was lower in the intervention group at T2, T3, and T4 and with eyes closed at T2. The medial-lateral standard deviation of COP with eyes open was lower in the intervention group at T2 and T4 and with eyes closed at T2 and T3. The anteroposterior standard deviation of COP with eyes open did not change, while that with eyes closed the intervention group showed lower score at T2.
Preoperative high-intensity strength training is effective for improving postural control before and early after TKA. Recommendations should include preoperative strength training, and not only balance training, to speed-up recovery of postural control after TKA.
本研究旨在探讨术前高强度力量训练（特别强调下肢肌肉力量，其次是平衡训练）对 TKA 后姿势控制的效果。
44 名受试者（7 名男性，37 名女性，平均年龄 66.7±3.9 岁）因骨关节炎（OA）接受单侧 TKA，参与了这项随机对照试验。每位患者进行了两项姿势控制测试：睁眼和闭眼 Romberg 测试。这些测试在手术前 8 周（T1）、训练 8 周后（T2）、TKA 后 1 个月（T3）和最后 3 个月（T4）进行评估。干预组在手术前每周进行 3 天的 8 周训练计划，而对照组未进行干预。
干预组在 T2、T3 和 T4 时的压力中心（COP）面积较小（即得分较高）。睁眼时 COP 的前后范围在 T2、T3 和 T4 时以及闭眼时在 T2 时，干预组较小。睁眼时 COP 的左右标准差在 T2 和 T4 以及闭眼时在 T2 和 T3 时，干预组较小。睁眼时 COP 的前后标准差没有变化，而闭眼时，干预组的得分较低。
术前高强度力量训练对 TKA 前和早期的姿势控制改善有效。建议包括术前力量训练，而不仅仅是平衡训练，以加快 TKA 后姿势控制的恢复。
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