Five studies (1-5) examined the effectiveness of supervised strength-based training in patients awaiting total knee replacement.
The interventions commenced between eight and three weeks prior to the date of surgery and consisted of between 12 and 30 supervised exercise sessions. In one study (moderate quality) (4), patients were supervised via video-call. In one study (strong quality)(3) exercise sessions took place in the hospital. The remainder of the studies did not report the intervention setting. In one study (moderate quality) (2) patients also received postoperative rehabilitation as part of the intervention.
Control group comparisons consisted of usual care (3, 4), no intervention (5), postoperative rehabilitation only (2) and receiving print material, alongside one meeting with a physiotherapist (1). Four of the five studies (1, 3-5) were three-armed RCTs, which also included other intervention groups. Only outcomes for the supervised exercise group, compared to a control group have been reported in this summary.
Function:
Inconsistent (5 studies; 3 [1 strong(3), 1 moderate quality(4), 1 weak quality(5)] showing an
improvement in the intervention group compared to control. 2 moderate quality studies(1, 2)
showing no improvement in the intervention group compared to control).
Quality of life:
Inconsistent (3 studies; 2 strong(3), 1 moderate(2), 1 weak quality(5). Inconsistent effects
across studies).
Mobility:
Inconsistent (3 studies; 2 strong(3), 1 moderate(2), 1 weak quality(5). Inconsistent effects
across studies).
Strength:
Inconsistent (3 studies; 1 weak(5), 2 moderate quality(2, 4). Inconsistent effects across
studies)
Range of motion:
Inconsistent (2 moderate quality studies(2, 4). Inconsistent effects across studies).
Health status:
Might be effective (1 moderate quality study showing a significant improvement for intervention compared to control (4).
Stiffness:
Might be effective (1 moderate quality study showing a significant improvement for intervention compared to control) (4).
Pain pressure threshold:
Might not be effective (1 moderate quality study showing no effect for the intervention compared to the control) (4).
Delay/cancellation of surgery:
In one strong quality study (3), 1 participant in the intervention group chose not to undergo surgery, compared to 2 in the control group.
Safety/feasibility:
One moderate quality study (2) reported no adverse events related to the intervention.