Wu Zugui, Wang Yi, Li Congcong, Li Junyi, Chen Weijian, Ye Zixuan, Zeng Ziquan, Hong Kunhao, Zhu Yue, Jiang Tao, Lu Yanyan, Liu Wengang, Xu Xuemeng
The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China.
Front Surg. 2022 Jul 21;9:879593. doi: 10.3389/fsurg.2022.879593. eCollection 2022.
There is an increasing interest in preoperative strength training for promoting post-operative rehabilitation, but the effectiveness of preoperative strength training for clinical outcomes after total knee arthroplasty (TKA) remains controversial.
This study aims to systematically evaluate the effect of preoperative strength training on clinical outcomes before and after TKA.
We systematically searched PubMed, Cochrane Library, Web of Science, and EMBASE databases from the inception to November 17, 2021. The meta-analysis was performed to evaluate the effects of preoperative strength training on clinical outcomes before and after TKA.
Seven randomized controlled trials (RCTs) were included ( = 306). Immediately before TKA, the pooled results showed significant improvements in pain, knee function, functional ability, stiffness, and physical function in the strength training group compared with the control group, but not in strength (quadriceps), ROM, and WOMAC (total). Compared with the control group, the results indicated strength training had a statistically significant improvement in post-operative knee function, ROM, and functional ability at less than 1 month and 3 months, and had a statistically significant improvement in post-operative strength (quadriceps), stiffness, and WOMAC (total) at 3 months, and had a statistically significant improvement in post-operative pain at 6 months. However, the results indicated strength training had no statistically significant improvement in post-operative strength (quadriceps) at less than 1 month, 6, and 12 months, had no statistically significant improvement in post-operative pain at less than 1 month, 3, and 12 months, had no statistically significant improvement in post-operative knee function at 6 and 12 months, and had no statistically significant improvement in post-operative physical function at 3 months.
Preoperative strength training may be beneficial to early rehabilitation after TKA, but the long-term efficacy needs to be further determined. At the same time, more caution should be exercised when interpreting the clinical efficacy of preoperative strength training for TKA.
术前力量训练对促进术后康复的关注度日益增加，但术前力量训练对全膝关节置换术（TKA）后临床结局的有效性仍存在争议。
本研究旨在系统评价术前力量训练对TKA前后临床结局的影响。
我们系统检索了从数据库建立至2021年11月17日的PubMed、Cochrane图书馆、Web of Science和EMBASE数据库。进行荟萃分析以评估术前力量训练对TKA前后临床结局的影响。
纳入7项随机对照试验（RCT）（n = 306）。在TKA即将进行前，汇总结果显示，与对照组相比，力量训练组在疼痛、膝关节功能、功能能力、僵硬程度和身体功能方面有显著改善，但在力量（股四头肌）、关节活动度（ROM）和西部安大略和麦克马斯特大学骨关节炎指数（WOMAC）（总分）方面无改善。与对照组相比，结果表明力量训练在术后不到1个月和3个月时，对膝关节功能、ROM和功能能力有统计学显著改善，在术后3个月时，对力量（股四头肌）、僵硬程度和WOMAC（总分）有统计学显著改善，在术后6个月时，对术后疼痛有统计学显著改善。然而，结果表明力量训练在术后不到1个月、6个月和12个月时，对力量（股四头肌）无统计学显著改善，在术后不到1个月、3个月和12个月时，对术后疼痛无统计学显著改善，在术后6个月和12个月时，对术后膝关节功能无统计学显著改善，在术后3个月时，对术后身体功能无统计学显著改善。
术前力量训练可能有利于TKA后的早期康复，但长期疗效有待进一步确定。同时，在解释术前力量训练对TKA的临床疗效时应更加谨慎。
