Taking A Look At Strength and Conditioning For Those Undergoing Or With A Knee Replacement

I was recently reading the article titled “An overview of total knee replacement and the role of the strength and conditioning professional article that was published in the strength and conditioning journal in 2011 and thought I would discuss some of the key take home messages.
As osteopaths we will have clients present to our clinic for advice on exercise rehabilitation and treatment following a knee replacement. It is important to remember that whilst many of us will provide hands on manual therapy, exercise intervention is very important for these individuals and we can also play an integral role in helping these people gain their mobility, strength and return them to a function that allows them to perform activities of daily living or work towards physical based goals.

Key messages from the article included:

  • Knee replacements are a suitable option for clients who have failed with conservative treatment and management options for their complaints such as osteoarthritis.
  • The article reports that some individuals who undergo knee replacement surgery will have difficulty with ADLs following the surgery.
  • The rehabilitation phase of a knee replacement is very important and will play a key role in reducing the burden on the healthcare system should it help individuals restore their function.
  • The total knee replacement is a common knee replacement and involves the replacement of the tibial, femoral and patellar components.
  • Knee replacements can be performed unilaterally or bilaterally if required.
  • There are several preoperative characteristics and traits that could influence ones functional outcomes following surgery. Being older, being a women, having a higher number of comorbidities and having a higher BMI may result in a poorer outcome. Other factors such as timing of the surgery i.e. how long one waits for surgery and the severity of preoperative symptoms may also impact the outcomes.
  • Unilateral knee surgery is more common than bilateral knee surgery.
  • Individuals who live alone had worse outcomes 1 year after a joint replacement.
  • Preoperative quads strength can be a good predictor for physical performance 12 months post operation.
  • Great loading of the uninvolved leg can will typically occur for up to 30 days post surgery, with this extending up to 1 year post op when changing from sit to stand functions.
  • The article highlights that individuals who undergo pre habilitation prior to surgery may have more positive physical performance outcomes post TKR surgery. Rehabilitation involving resistance based training has a positive effect on muscular strength of quadriceps.
  • Pool based water resistance training programs have also been shown to improve ones quadriceps strength.
  • Studies used a combination of exercises as part of their strength and conditioning program and exercise choices included leg press, leg extension, leg curl, call raise, step ups, wall squats, quads setting, Sit to stand transfers, active hip ROM, balance work. Some cycling, walking and stepping, stair climbing. Frequency of programs varied from 2 to 3 days per week. Program durations were 6 – 12 weeks.
  • Individuals ho undergo a total knee replacement will generally have less knee pain and a better quality of life compared to before the total knee replacement. However, many may not have the same function to those of adults the same age as them who do not have osteoarthritis in their knee or have had a total knee replacement.

This blog post was written by osteopath Heath Williams at Principle Four Osteopathy.  At Principle Four Osteopath we provide a range of services, including osteopathy manual therapy consultations, functional movement screening, exercise prescription, strength and conditioning and rehabilitation.

Principle Four Osteopathy is one of Melbourne City CBD and Docklands leading osteopathy clinics.  Both clinics are equipped with training equipment so that we are able to get you actively involved and moving towards a better moving you.

Principle Four Osteopathy CBD clinic is located at 29 Somerset Place, Melbourne 3000.

Principle Four Osteopathy Docklands clinic is located at 717 Bourke St, Docklands, 3008.

Book an appointment online at www.principlefourosteopathy.com or call 03 9670 9290.