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http://dx.doi.org/10.14474/ptrs.2022.11.1.16

The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement  

Kim, San-Han (Department of Physical Therapy Graduate School Sahmyook University)
Park, Hye-Kang (Rehabilitation Center, Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital)
Lee, Wan-Hee (Department of Physical Therapy, Sahmyook University, College of Health Science)
Publication Information
Physical Therapy Rehabilitation Science / v.11, no.1, 2022 , pp. 16-23 More about this Journal
Abstract
Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.
Keywords
hip joint; gait; knee joint; osteoarthritis; total knee replacement;
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1 Han, A. S. Y., et al Early rehabilitation after total knee replacement surgery: a multicenter, noninferiority, randomized clinical trial comparing a home exercise program with usual outpatient care. Arthritis Care Res. 2015;67(2):196-202.   DOI
2 Alnahdi, A. H., Zeni, J. A., & Snyder-Mackler, L. Hip abductor strength reliability and association with physical function after unilateral total knee arthroplasty: a cross-sectional study. Phys Ther. 2014;94(8):1154-1162.   DOI
3 Mizner, R. L., Petterson, S. C., & Snyder-Mackler, L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35(7):424-436.   DOI
4 Mundermann, A., Dyrby, C. O., & Andriacchi, T. P. Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum. 2005;52(9):2835-2844.   DOI
5 Silva, M., Shepherd, E. F., Jackson, W. O., Pratt, J. A., McClung, C. D., & Schmalzried, T. P. Knee strength after total knee arthroplasty. J Arthroplasty. 2003;18(5):605-611.   DOI
6 Westby, M. D., & Backman, C. L. Patient and health professional views on rehabilitation practices and outcomes following total hip and knee arthroplasty for osteoarthritis: a focus group study. BMC Health Serv Res. 2010;10(1):119.   DOI
7 Neumann, D. A. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010;40(2):82-94.   DOI
8 Heiderscheit, B. C. Lower extremity injuries: is it just about hip strength? J Orthop Sports Phys Ther. 2010;40(2):39-41.   DOI
9 Piva, S. R., Teixeira, P. E., Almeida, G. J., Gil, A. B., DiGioia, A. M., Levison, T. J., & Fitzgerald, G. K. Contribution of hip abductor strength to physical function in patients with total knee arthroplasty. Phys Ther. 2011;91(2):225-233.   DOI
10 Mizner, R. L., Petterson, S. C., Stevens, J. E., Vandenborne, K., & Snyder-Mackler, L. Early quadriceps strength loss after total knee arthroplasty. The contributions of muscle atrophy and failure of voluntary muscle activation. J Bone Joint Surg Am. 2005;87(5):1047-1053.   DOI
11 Berman, A. T., Bosacco, S. J., & Israelite, C. Evaluation of total knee arthroplasty using isokinetic testing. Clin Orthop Relat Res. 1991;271(271):106-113.
12 Schache, M. B., McClelland, J. A., & Webster, K. E. Does the addition of hip strengthening exercises improve outcomes following total knee arthroplasty? A study protocol for a randomized trial. BMC Musculoskelet Disord. 2016;17(1):259.   DOI
13 Iijima, H., Yorozu, A., Suzuki, Y., Eguchi, R., Aoyama, T., & Takahashi, M. Specific contribution of hip abductor muscle strength to turning movement in individuals with knee osteoarthritis. Osteoarthr Cartil. 2018;26:S388.
14 Irrgang, J. J., Snyder-Mackler, L., Wainner, R. S., Fu, F. H., & Harner, C. D. Development of a patient-reported measure of function of the knee. J Bone Joint Surg Am. 1998;80(8):1132-1145.   DOI
15 Berger, M. J., McKenzie, C. A., Chess, D. G., Goela, A., & Doherty, T. J. Quadriceps neuromuscular function and self-reported functional ability in knee osteoarthritis. J Appl Physiol (1985). 2012;113(2):255-262.   DOI
16 Chang, T. F., Liou, T. H., Chen, C. H., Huang, Y. C., & Chang, K. H. Effects of elastic-band exercise on lower-extremity function among female patients with osteoarthritis of the knee. Disabil Rehabil. 2012;34(20):1727-1735.   DOI
17 Ferber, R., Kendall, K. D., & Farr, L. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome. J Athl Train. 2011;46(2):142-149.   DOI
18 Antich, T. J., & Brewster, C. E. Modification of quadriceps femoris muscle exercises during knee rehabilitation. Phys Ther. 1986;66(8):1246-1251.   DOI
19 Cram, P., Lu, X., Kates, S. L., Singh, J. A., Li, Y., & Wolf, B. R. Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010. JAMA 2012;308(12):1227-1236.   DOI
20 Kennedy, D. M., Stratford, P. W., Wessel, J., Gollish, J. D., & Penney, D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. BMC Musculoskelet Disord, 2005;6(1):3.   DOI
21 Costa, R. A., Oliveira, L. M. d., Watanabe, S. H., Jones, A., & Natour, J. Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee. Clinics (Sao Paulo). 2010;65(12):1253-1259.   DOI
22 Hinman, R. S., Hunt, M. A., Creaby, M. W., Wrigley, T. V., McManus, F. J., & Bennell, K. L. Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010;62(8):1190-1193.   DOI
23 Hess, R. J., Brach, J. S., Piva, S. R., & VanSwearingen, J. M. Walking skill can be assessed in older adults: validity of the Figure-of-8 Walk Test. Phys Ther. 2010;90(1):89-99.   DOI
24 Sled, E. A., Khoja, L., Deluzio, K. J., Olney, S. J., & Culham, E. G. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial. Phys Ther. 2010;90(6):895-904.   DOI
25 Harikesavan, K., Chakravarty, R. D., Maiya, A. G., Hegde, S. P., & Y Shivanna, S. Y. Hip abductor strengthening improves physical function following total knee replacement: one-year follow-up of a randomized pilot study. Open Rheumatol J. 2017;11:30-42.   DOI
26 Benedetti, M. G., Catani, F., Bilotta, T. W., Marcacci, M., Mariani, E., & Giannini, S. Muscle activation pattern and gait biomechanics after total knee replacement. Clin Biomech (Bristol Avon). 2003;18(9):871-876.   DOI
27 Aagaard, P., Simonsen, E. B., Magnusson, S. P., Larsson, B., & Dyhre-Poulsen, P. A new concept for isokinetic hamstring: quadriceps muscle strength ratio. Am J Sports Med. 1998;26(2):231-237.   DOI
28 Bade, M. J., & Stevens-Lapsley, J. E. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther. 2011;41(12):932-941.   DOI
29 Stevens-Lapsley, J. E., Balter, J. E., Kohrt, W. M., & Eckhoff, D. G. Quadriceps and hamstrings muscle dysfunction after total knee arthroplasty. Clin Orthop Relat Res. 2010;468(9):2460-2468.   DOI
30 Selistre, L. F. A., Goncalves, G. H., Nakagawa, T. H., Petrella, M., Jones, R. K., & Mattiello, S. M. The role of hip abductor strength on the frontal plane of gait in subjects with medial knee osteoarthritis. Physiother Res Int. 2019;24(4):e1779.