In the immediate postoperative period after total knee replacement, a pedaling-based protocol had superior functional and patient-reported outcomes compared with a standard multi-exercise-based protocol, according to recently published results.
“Our research showed a simple self-directed bike pedaling protocol after total knee replacement surgery was superior to standard physical therapy,” Larissa N. Sattler, MPhtySt, BSPE, told Healio.com/Orthopedics. “Patients who did the pedaling not only felt better but walked faster and further when compared to the standard group.”
Researchers performed a randomized controlled trial of 60 patients who underwent total knee replacement. Thirty patients were assigned to receive a three-exercise pedaling protocol and 30 patients were assigned to a 10-exercise, non-pedaling protocol. At 2 days, 2 weeks and 4 months, outcomes assessed included physical tests, patient-reported outcomes and perioperative measures.
Results showed patients who received the pedaling protocol had a significantly greater measured distance for the 6-minute walk test at 2 days postoperatively compared to those who received the multi-exercise, non-pedaling protocol. Patients who received the pedaling protocol had superior results in the 10-meter walk test, the timed-up-and-go test and the Oxford Knee Score compared with patients who received multi-exercise, non-pedaling protocol at 2 days. However, at 4 months, the mean Oxford Knee Score was not significantly different between the groups, with a score of 37.6 for the multi-exercise, non-pedaling group and 39.3 in the pedaling-based group. At 2 weeks, the Oxford Knee Score and the EQ-5D score were superior in patients who received the pedaling protocol. At all the time points, the visual analog scale score component of the EQ-5D was significantly higher in patients who received the pedaling protocol.
Patients who received pedaling protocol had a median length of stay of 2.5 days vs. 3 days for patients who received multi-exercise, non-pedaling protocol. The two groups had similar analgesic consumption, home-exercise program compliance, self-reported pain threshold and exercise satisfaction. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.