Kubo Yusuke, Fujita Daisuke, Sugiyama Shuhei, Takachu Rie, Sugiura Takeshi, Sawada Masahiro, Yamashita Kohtaro, Kobori Kaori, Kobori Makoto
Department of Rehabilitation Medicine, Kobori Orthopedic Clinic, Hamamatsu, JPN.
Department of Physical Therapy, Fukuoka International University of Health and Welfare, Fukuoka, JPN.
Cureus. 2024 Jul 13;16(7):e64466. doi: 10.7759/cureus.64466. eCollection 2024 Jul.
Background/Objectives Enhancing preoperative quadriceps strength and mitigating quadriceps strength loss due to total knee arthroplasty (TKA) is crucial for post-TKA recovery. This study compared the safety and effect of a four-week preoperative regimen of low-load resistance training with blood flow restriction (LLRT-BFR) with those of low-intensity resistance training with slow movement and tonic force generation (LST) on the pre- and postoperative quadriceps strength in patients undergoing TKA. Methods In this randomized controlled trial, 22 patients were assigned to either the LLRT-BFR (n=11) or LST (n=11) group. Primary outcomes included changes in quadriceps strength before and after the intervention and surgery. To assess safety, we monitored D-dimer and high-sensitivity C-reactive protein levels pre- and post-intervention. Statistical analysis involved independent samples -tests and Mann-Whitney U tests for group comparisons of quadriceps strength changes. Additionally, a two-way repeated-measures analysis of variance was used to assess safety parameters. Results No significant differences were observed between the BFR and LST groups in terms of the rate of increase in quadriceps strength pre- and post-intervention (BFR: median 12.1%, interquartile range -0.8% to 19.5%; LST: median 6.2%, interquartile range 2.7% to 14.7%; p>0.99) or in the rate of reduction in quadriceps strength pre- and post-surgery (BFR: mean -72.4%, standard deviation ±11.2%; LST: mean -75.3%, standard deviation ±12.2%; p=0.57). Safety assessments showed no significant main effects of time, group, or interaction on the safety parameters (all p>0.05). Conclusions LLRT-BFR and LST demonstrated comparable effects on quadriceps strength before and after intervention and surgery in patients undergoing TKA. The lack of significant changes in the safety parameters supports the safety profile of both interventions, indicating their suitability for preoperative conditioning in patients scheduled for TKA.
背景/目的 增强术前股四头肌力量并减轻全膝关节置换术（TKA）导致的股四头肌力量损失对于TKA术后恢复至关重要。本研究比较了为期四周的术前低负荷抗阻训练联合血流限制（LLRT-BFR）方案与低强度抗阻训练联合缓慢动作和持续性发力（LST）方案对接受TKA患者术前和术后股四头肌力量的安全性和效果。方法 在这项随机对照试验中，22例患者被分配到LLRT-BFR组（n = 11）或LST组（n = 11）。主要结局包括干预和手术后股四头肌力量的变化。为评估安全性，我们在干预前后监测了D-二聚体和高敏C反应蛋白水平。统计分析采用独立样本t检验和Mann-Whitney U检验对股四头肌力量变化进行组间比较。此外，采用双向重复测量方差分析评估安全性参数。结果 在干预前后股四头肌力量增加率方面（BFR组：中位数12.1%，四分位间距-0.8%至19.5%；LST组：中位数6.2%，四分位间距2.7%至14.7%；p>0.99）或手术前后股四头肌力量降低率方面（BFR组：均值-72.4%，标准差±11.2%；LST组：均值-75.3%，标准差±12.2%；p = 0.57），BFR组和LST组之间均未观察到显著差异。安全性评估显示，时间、组间或交互作用对安全性参数均无显著主要影响（所有p>0.05）。结论 LLRT-BFR和LST在接受TKA的患者干预和手术后对股四头肌力量的影响相当。安全性参数缺乏显著变化支持了两种干预措施的安全性，表明它们适用于计划接受TKA患者的术前训练。
