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Experimental Methods to Study Human Postural Control
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Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial.

José Casaña1, Joaquín Calatayud2,3, Yasmín Ezzatvar1

  • 1Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, C/ Gasco Oliag 5, 46010, Valencia, Spain.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
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Summary

Preoperative high-intensity strength training significantly improves postural control in patients undergoing total knee arthroplasty (TKA). This approach enhances recovery of balance both before and shortly after surgery.

Keywords:
BalanceKneeOsteoarthritisPostural swayResistance trainingStrengthTotal knee arthroplasty

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Area of Science:

  • Orthopedics
  • Rehabilitation Medicine
  • Biomechanical Engineering

Background:

  • Postural control is crucial for functional recovery after total knee arthroplasty (TKA).
  • Osteoarthritis (OA) significantly impacts lower limb function and balance.
  • Prehabilitation strategies are increasingly explored to optimize surgical outcomes.

Purpose of the Study:

  • To evaluate the efficacy of preoperative high-intensity strength training on postural control post-TKA.
  • To assess the impact of focused lower limb strength and balance training prior to surgery.
  • To determine the duration of benefits on postural stability.

Main Methods:

  • A randomized controlled trial involving 44 patients (mean age 66.7 years) scheduled for unilateral TKA.
  • Intervention group: 8-week high-intensity strength and balance training program (3 days/week).
  • Control group: No intervention. Postural control assessed using Romberg tests (eyes open/closed) at baseline, post-training, 1 month, and 3 months post-TKA.

Main Results:

  • The intervention group demonstrated significantly lower Center of Pressure (COP) area at 8 weeks post-training, 1 month, and 3 months post-TKA.
  • Improvements in anteroposterior and medial-lateral COP measures were observed in the intervention group.
  • Specific benefits included reduced COP range (eyes open/closed) and standard deviation (eyes open/closed) at various time points.

Conclusions:

  • Preoperative high-intensity strength training effectively enhances postural control before and early after TKA.
  • Integrating strength training, not solely balance exercises, into prehabilitation can accelerate postural recovery.
  • This approach offers a valuable strategy for optimizing patient outcomes following TKA.