Development and Evaluation of Progressive Lower-extremity Exercise Program for Patients with Total Knee Replacement Arthroplasty

Abstract

This study aimed to develop the progressive lower-extremity exercise program for patients with total knee replacement arthroplasty and to evaluate its effectiveness on knee functions. Methods: A non-equivalent quasi-experimental design with matching sample was used. The control group was recruited prior to the experimental group with the matched inclusion criteria for age, gender, and duration of osteoarthritis. The experimental group (n=34) participated in the 8-week progressive lower-extremity exercise program and completed both pretest and posttest with the dropout rates of 15%. The control group (n=35) received conventional exercise intervention during the study period with the dropout rates of 17.5%. Outcome measures were days to achieve possible range of motion, lower-extremity strength, and knee symptoms and function. Data were collected from April, 2019 to March, 2020 and analyzed with a x2 test, independent t-test, and repeated measures ANOVA using SPSS/WIN V. 23.0. Results: The progressive lower-extremity exercise program consisted of pre-op education, post-op progressive exercise provided 2~3 times/day with progressive intensity and duration, followed by pre-discharge education. The study participants were 71.7 years old in average, mostly women, and having osteoarthritis for 9.3 years. The experimental group reported significant improvement in lower-extremity strength and knee symptoms and function compared to their controls after 8 weeks based on interaction effects. No significant interaction effect was found in days to achieve possible range of motion. Conclusion: The progressive lower-extremity exercise program provided additional benefits over the conventional exercise to patients with total knee replacement arthroplasty. This program is easily applicable and useful as rehabilitation nursing strategies in this population.