TY - JOUR
T1 - Preoperative strength training for patients undergoing high tibial osteotomy
T2 - A prospective cohort study with historical controls
AU - Kean, Crystal O.
AU - Birmingham, Trevor B.
AU - Garland, S. Jayne
AU - Bryant, Dianne M.
AU - Giffin, J. Robert
PY - 2011/2
Y1 - 2011/2
N2 - STUDY DESIGN: Prospective cohort with historical controls. OBJECTIVE: To examine the effects of a 12-week preoperative high-intensity resistance training program on postoperative outcomes. BACKGROUND: The primary goals of high tibial osteotomy (HTO) are to decrease pain and improve overall function during activities of daily living and participation in sport and recreation in relatively young, active individuals with knee osteoarthritis. However, the postoperative recovery typically requires a considerable period of protected weight-bearing that can result in substantial deficits in muscular strength. METHODS: Fourteen patients (mean ± SD, 48.0 ± 7.8 years; 13 males, 1 females), scheduled for medial opening wedge HTO, completed a 12-week preoperative high-intensity isokinetic resistance training program focusing on quadriceps and hamstrings strength. These patients were matched to baseline clinical and demographic characteristics of 14 patients who previously received a medial opening wedge HTO without preoperative training. All outcomes were measured before and 6 months after surgery. The sport and recreation subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome of interest. Secondary outcomes included the other KOOS subscales, scores on the Lower Extremity Functional Scale, and selected kinematic and kinetic variables obtained from 3-dimensional gait analysis. RESULTS: The patients in the preoperative training group achieved significantly greater scores on the KOOS sport and recreation (mean ± SD, 58.6 ± 16.6 versus 42.1 ± 20.4; mean difference, 16.4; 95% CI: 2.0, 30.9) and activities of daily living (mean ± SD, 85.3 ± 9.3 versus 76.9 ± 12.0; mean difference, 8.4; 95% CI: 0.1, 16.8) subscales. There were no significant differences between groups on other outcomes. CONCLUSION: The present findings suggest preoperative high-intensity resistance training of the quadriceps and hamstrings before HTO improves postoperative functioning in sport, recreation, and activities of daily living.
AB - STUDY DESIGN: Prospective cohort with historical controls. OBJECTIVE: To examine the effects of a 12-week preoperative high-intensity resistance training program on postoperative outcomes. BACKGROUND: The primary goals of high tibial osteotomy (HTO) are to decrease pain and improve overall function during activities of daily living and participation in sport and recreation in relatively young, active individuals with knee osteoarthritis. However, the postoperative recovery typically requires a considerable period of protected weight-bearing that can result in substantial deficits in muscular strength. METHODS: Fourteen patients (mean ± SD, 48.0 ± 7.8 years; 13 males, 1 females), scheduled for medial opening wedge HTO, completed a 12-week preoperative high-intensity isokinetic resistance training program focusing on quadriceps and hamstrings strength. These patients were matched to baseline clinical and demographic characteristics of 14 patients who previously received a medial opening wedge HTO without preoperative training. All outcomes were measured before and 6 months after surgery. The sport and recreation subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome of interest. Secondary outcomes included the other KOOS subscales, scores on the Lower Extremity Functional Scale, and selected kinematic and kinetic variables obtained from 3-dimensional gait analysis. RESULTS: The patients in the preoperative training group achieved significantly greater scores on the KOOS sport and recreation (mean ± SD, 58.6 ± 16.6 versus 42.1 ± 20.4; mean difference, 16.4; 95% CI: 2.0, 30.9) and activities of daily living (mean ± SD, 85.3 ± 9.3 versus 76.9 ± 12.0; mean difference, 8.4; 95% CI: 0.1, 16.8) subscales. There were no significant differences between groups on other outcomes. CONCLUSION: The present findings suggest preoperative high-intensity resistance training of the quadriceps and hamstrings before HTO improves postoperative functioning in sport, recreation, and activities of daily living.
KW - Knee
KW - Muscular strength
KW - Osteoarthritis
KW - Prehabilitation
KW - Resistance training
UR - http://www.scopus.com/inward/record.url?scp=79751497039&partnerID=8YFLogxK
U2 - 10.2519/jospt.2011.3490
DO - 10.2519/jospt.2011.3490
M3 - Article
AN - SCOPUS:79751497039
SN - 0190-6011
VL - 41
SP - 52
EP - 59
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 2
ER -