Effects of preoperative telerehabilitation on muscle strength, range of motion, and functional outcomes in candidates for total knee arthroplasty: A single-blind randomized controlled trial

Abstract

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60◦ /s extension peak torque [F(4, 100) = 2.499, p < 0.047, η2 p = 0.91], 180◦ /s extension peak torque [F(4, 100) = 3.583, p < 0.009, η2 p = 0.125], ROM [F(4, 100) = 4.689, p < 0.002, η2 p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2 p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2 p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2 p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2 p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.