Methods for Improving Quadriceps Femoris Strength after Total Knee Arthroplasty

Abstract

Research background. The recovery of quadriceps femoris muscle strength after total knee arthroplasty is suboptimal. Quadriceps weakness is associated with decreased gait speed, balance, stair–climbing and chair rise ability, as well as increased risk for falls. Scientifc data about the impact of physiotherapy methods for quadriceps strength is ambiguous. The goal of research was to review and analyse studies evaluating effectiveness of physiotherapy for quadriceps femoris strength after total knee arthroplasty. Methods. Fourteen full articles in English, published in 2006–2016, were selected and analysed; the articles met the following criteria: randomised controlled trials were reviewed if they assessed quadriceps strength, and compared two or more physiotherapy methods after primary total knee arthroplasty for osteoarthritis. Results. In total 1011 people after total knee arthroplasty participated in the analysed studies. The impact of progressive strength training, aquatic physical therapy, and resistance exercises using vibration plate, neuromuscular electrical stimulation, preoperative physiotherapy, traditional physiotherapy and telerehabilitation were assessed. It has been specifed that quadriceps strength significantly increases and functional status improves using various physiotherapy methods, but the most effcient methods are unclear, the data of the studies are ambiguous. Conclusions. Various physiotherapy methods are used for the improvement of the quadriceps muscle strength after total knee arthroplasty: preoperative physiotherapy, resistance exercises, aquatic physiotherapy, whole body vibration, neuromuscular electrical stimulation. Telerehabilitation is as effective as traditional rehabilitation in patients after total knee arthroplasty. There is a lack of scientific research that would deny or confrm the advantages of less frequently used physiotherapy methods against traditional physiotherapy, as well as the recommendations of their use after total knee arthroplasty.

Keywords: total knee arthroplasty, physiotherapy, quadriceps femoris, muscle strength.