A randomized trial to compare exercise treatment methods for patients after total knee replacement: protocol paper

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Geriatric Medicine

Background:

• Total knee replacement (TKR) often fails to fully restore physical function and activity levels.
• Persistent limitations after TKR necessitate interventions beyond surgery, particularly exercise.
• Evidence on the effectiveness of later-stage post-TKR exercise is limited.

Purpose of the Study:

• To compare the effectiveness of clinic-based rehabilitative exercise versus community-based group exercise for improving physical function and activity in patients post-TKR.
• To identify predictors of functional recovery in patients undergoing exercise interventions after TKR.
• To evaluate the impact of exercise on physical function and activity in the later stages following TKR.

Main Methods:

• A 3-group, single-blind randomized clinical trial involving 240 older adults at least 2 months post-TKR.
• Intervention groups: 12 weeks of clinic-based individual exercise, 12 weeks of community-based group exercise, and a wait-listed control group.
• Primary outcome: physical function (WOMAC-PF); secondary outcomes: performance-based tests and physical activity (surveys, accelerometry).

Main Results:

• Data collection at baseline, 3 months, and 6 months, with a 9-month follow-up for the control group.
• Analysis will use linear mixed models for outcome comparisons and logistic regression for predictor identification.
• Exploratory outcomes include adherence, co-interventions, attrition, and adverse events.

Conclusions:

• Findings will inform evidence-based recommendations for exercise programs to enhance physical function and activity post-TKR.
• Results will aid in tailoring exercise interventions based on individual patient characteristics.
• This study addresses a critical gap in understanding the benefits of exercise in the later stages of TKR recovery.