Effects of Lower Extremity Strength Training on Physical Recovery in Patients Underwent Total Knee Replacement

Friday, 28 July 2017

Yu-Hua Lin, PhD, RN1
Su-Ying Lee, MSN2
Chia-Chan Kao, PhD, RN1
(1)Department of Nursing, I-Shou University, Kaohsiung, Taiwan
(2)Nursing, Cheng Kung University hospital, Kaohsiung, Taiwan

Purpose:

 Patients with knee of osteoarthritis (OA) after surgery had experienced physical function decrease and impact their quality of life. However, they always lack a long-term, home-style, and continuous legs exercise training methods, and rare study to explore the effects on physical recovery and quality of life after exercise training. The purpose of this study was to examine the effects of lower extremity muscle strength training on patients’ physical recovery and quality of live underwent total knee replacement.

Methods:

 The quasi-experimental design was conducted, and using a simple randomize sampling (as patients admission priority order) to collect participants’ data. Eligible sample recruited from a hospital in Tainan. Inclusion criteria were above 20 old, and will be received total knee replacement (TKR). Outcome measurements included the Knee injury and osteoarthritis outcome score (KOOS, including pain, symptoms, active daily life [ADL], sport & recreation, and quality of life five subscales), disease related variables, and personal demographics. Participants were distributed into with a lower extremity muscle strength training and the training started before surgery (experimental group, n=100) or with usual care (control group, n=100). The lower extremity strength training was conducted by a nurse practitioner. We examined outcome indicators before surgery (T1) and follow up at two weeks (T2), one month (T3), two months (T4), and three months (T5) after TKR.

Results:

 The KOOS subscales scores showed that all the two groups’ patients experienced physical function (ADL and sport & recreation) and quality of life decreased at the two weeks after received TKR, but all the subscales scores gradually increased from one month to third months after TKR (p < .001). The generalized estimating equation (GEE) tests showed that both group and time were significantly different, indicated that both group patients experienced physical function and quality of life improvement, however, the exercise group physical function and quality of life was early recovery and better than no exercise group physical function and quality of life after TKR.

Conclusion:

The study confirmed that after lower extremity muscle strength training exercise helps to improve the quality of life and physical function recovery in patients who undergone TKR. This results recommend for the healthcare staff embed this training into pre-surgical nursing care and patients’ discharge plan in care of TKR patient as a continuous daily rehabilitation activity at home.