Department of Orthopaedic Surgery, Clinic of Orthopaedics, Rheumatology, and Dermatology, St. Olavs Hospital HF, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology NTNU, Trondheim, Norway.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020916392. doi: 10.1177/2309499020916392.
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients significantly increase muscle strength after maximal strength training (MST) initiated soon after surgery. Owing to severe postoperative pain, knee patients are anticipated to be more limited in performing heavy load exercises than hip patients. The aim of the present study was to describe pain and load progression during early MST in THA and TKA patients.
Explorative study based on secondary analyses from two randomized controlled trials: 26 THA and 16 TKA patients had their training sessions logged. They trained at 85-90% of their maximal capacity in leg press, and abduction/knee-extension of the operated leg (4 × 5 repetitions) for 8-10 weeks, initiated early postoperatively.
Knee patients experienced significantly more pain than hip patients during the training sessions ( < 0.03), however, pain before and after training was not different ( > 0.09). All patients significantly increased leg press training load until the last intervention week ( < 0.01).
This study demonstrates that TKA patients experience more pain than THA patients during training following a MST program but not more than moderate levels during or after training. Pain before and after training is not different. Both groups significantly increased load progression during the intervention. These findings indicate that both THA and TKA patients might perform MST with extensive load progression early after surgery without compromising pain. The studies were registered at ClinicalTrials.gov .
全髋关节置换术(THA)和全膝关节置换术(TKA)患者在术后早期开始进行最大力量训练(MST)后,肌肉力量显著增加。由于术后疼痛剧烈,预计膝关节患者在进行重负荷运动方面比髋关节患者受限更多。本研究旨在描述 THA 和 TKA 患者在 MST 早期的疼痛和负荷进展情况。
基于两项随机对照试验的二次分析进行的探索性研究:26 例 THA 和 16 例 TKA 患者记录了他们的训练课程。他们在术后早期以 85-90%的最大能力进行腿推和患侧腿的外展/膝关节伸展(4×5 次重复)训练,持续 8-10 周。
膝关节患者在训练过程中经历的疼痛明显多于髋关节患者(<0.03),但训练前后的疼痛没有差异(>0.09)。所有患者的腿推训练负荷均显著增加,直至最后一次干预周(<0.01)。
本研究表明,TKA 患者在接受 MST 方案后的训练中经历的疼痛比 THA 患者多,但在训练过程中和训练后并不超过中度水平。训练前后的疼痛没有差异。两组患者在干预期间均显著增加了负荷进展。这些发现表明,THA 和 TKA 患者都可以在术后早期进行 MST,并进行广泛的负荷进展,而不会增加疼痛。这些研究已在 ClinicalTrials.gov 注册。