Effects of nurse-led lower extremity strength training on knee function recovery in patients who underwent total knee replacement

Aims and objectivesTo examine the effects of lower extremity muscle strength training on knee function recovery and quality of life in patients who underwent total knee replacement. BackgroundPatients with knee osteoarthritis after surgery experience decreased knee function that impacts their quality of life. However, patients typically lack a long-term, home-based and continuous leg exercise training method and rarely have studies explored the effects of exercise training on knee function recovery and quality of life. DesignA experimental and longitudinal study design. MethodsThe simple randomised sampling (based on patients' admission priority order) was used to collect participant data. Outcome measurements included the Knee Injury and Osteoarthritis Outcome Score. Participants were randomised to receive and starting lower extremity muscle strength training before surgery (training group, n=100) or to receive usual care (nontraining group, n=100). Data were collected and followed up with the patients before surgery (T1) and at 2weeks (T2), 1month (T3), 2months (T4) and 3months (T5) after discharge. ResultsThe Knee Injury and Osteoarthritis Outcome Score subscale scores showed that both groups of patients experienced knee function and quality of life decreases 2weeks after total knee replacement, but all subscale scores gradually increased from the first month to the third month after total knee replacement. Both groups and times were significantly different, but the training group's knee function and quality of life recovered earlier and better than the nontraining group does. ConclusionsThis study confirmed that lower extremity muscle strength training helps to improve quality of life and knee function in patients who undergo total knee replacement. Healthcare staff should include this training in presurgical nursing care and in patients' discharge plans as a continuous, daily rehabilitation activity at home. Relevance to clinical practiceWhen patients are diagnosed with knee osteoarthritis and undergo surgery, a presurgical exercise education and discussion of knee function rehabilitation should be part of standard care.