Total Knee Replacement Clinical Trial
Official title:
The Efficacy of Low-load Blood Flow Restricted Resistance Exercise in Patients With Knee Osteoarthritis Scheduled for Total Knee Arthroplasty: A Multicenter, Randomized Controlled Trial
The primary aim of this study is to investigate the efficacy of 8 weeks of Low-load blood flow restricted exercise (BFRE) compared to receiving standard care only (no preoperative training) before total knee replacement (TKR) on postoperative 30-seconds chair stand test (30s-CST). We hypothesize that 8 weeks of preoperative BFRE will increase chair stand performance 3 months postoperatively. Secondary aims are to investigate the efficacy of 8 weeks of preoperative BFRE compared to receiving standard care only on changes in muscle strength 3 months after TKR and investigate associations to functional capacity and quality of life. Furthermore, it will be investigated if 8 weeks of BFRE induces muscle hypertrophy and increases satellite cell and myonuclei content of the vastus lateralis muscle.
Status | Recruiting |
Enrollment | 86 |
Est. completion date | July 1, 2025 |
Est. primary completion date | June 10, 2023 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 50 Years and older |
Eligibility | Inclusion Criteria: - Patients = 50 years scheduled for TKA at Horsens- or Silkeborg Regional Hospital. Exclusion Criteria: - Severe cardiovascular diseases (New York Heart Association class III and IIII), previous stroke incident, thrombosis incident - Traumatic nerve injury in affected limb - Unregulated hypertension (Systolic =180 or diastolic =110 mmHg) - Spinal cord injury - Pregnancy - Planned other lower limb surgery within 12 months - Cancer diagnosis and currently undergoing chemo-, immuno-, or radiotherapy - Inadequacy in written and spoken Danish - an existing prosthesis in the index limb - living more than 45 minutes from either Horsens Regional Hospital or Silkeborg Regional Hospital. |
Country | Name | City | State |
---|---|---|---|
Denmark | Aarhus University Hosspital | Aarhus | Aarhus N |
Denmark | Horsens Regional Hospital | Horsens | |
Denmark | Silkeborg Regional Hospital | Silkeborg |
Lead Sponsor | Collaborator |
---|---|
University of Aarhus | Horsens Hospital, Regionshospitalet Silkeborg |
Denmark,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Blood pressure (used for eligibility) | Blood pressure will be measured with an electronic commercial blood pressure device | Baseline | |
Other | Exercise compliance and progression | project physiotherapists will register compliance with the BFRE sessions and progression during all 8 weeks for the patients in the BFRE Group. | The exercise period (8 weeks) | |
Other | Numeric Rating Scale Pain (NRS pain) | The NRS for pain is a segmented unidimensional 11-item measure of pain intensity in adults | Baseline, during each training session, in the week of surgery, 3 months after surgery, 12 months after surgery | |
Other | Declining to be operated | At 3 months follow up patients will be asked whether they decided to be operated or not | 3 months after surgery | |
Other | Postoperative supervised physiotherapy | Any participation in postoperative supervised training will be attained at all follow-up assessments by using patient-reported questionnaires (yes/no; type of exercise) in both the BFRE group and the CON group | 6 weeks after surgery, 3 months after surgery, 12 months after surgery | |
Other | Knee joint range of motion | Patients knee joint range of motion will be measured using a goniometer | baseline, in the week of surgery, 3 months after surgery, 12 months after surgery | |
Primary | 30-seconds chair stand test (30-sec CST) | The 30s-CST measures the number of sit-to-stand repetitions completed within 30 seconds. Patients will be instructed to perform a sit-to-stand movement starting from a seated position (seat height 43 cm without armrests) having the feet placed flat on the floor shoulder width apart, and arms crossed on chest to a standing position (hip and knee joints fully extended) repeated as many times as possible for 30 seconds. | change in 30-sec CST from baseline to 3 months after surgery | |
Secondary | Timed Up & Go | The TUG assesses the time required for patients to stand from a chair (seat height 46 cm) walk around a tape mark 3 meters away and sit into the chair at return. | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | 4x10 meter fast-paced walk test (40m-FWT) | The 40m fast-paced walk test (40m-FWT) measures the total time taken to walk 4 x 10 m excluding turns (meter/sec). | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | 1RM leg press strength | 1 Repetition maximum (RM) is the maximal load (kg) a patient is able to concentrically press in the leg press machine. The 1RM will be estimated from a 5-8RM leg press test. The 1RM will be calculated as [1RM = load (kg)/1.0278-0.0278·number of repetitions) | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | 1RM knee extension strength | 1 Repetition maximum (RM) is the maximal load (kg) a patient is able to concentrically lift in the knee extension machine. The 1RM will be estimated from a 5-8RM leg press test. The 1RM will be calculated as [1RM = load (kg)/1.0278-0.0278·number of repetitions) | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | Isometric knee extensor strength | Isometric knee extensor muscle strength will be assed with the participants seated on a examination table with knees and hip positioned at 90 degree flexion. Assessment of muscle strength will be performed with a hand-held dynamometer, fixed with an adjustable rigid belt to the examination table. | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | Isometric knee flexor strength | Isometric knee flexor muscle strength will be assed with the participants seated on a examination table with knees and hip positioned at 90 degree flexion. Assessment of muscle strength will be performed with a hand-held dynamometer, fixed with an adjustable rigid belt to the examination table. | Measured at baseline, in the week of surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | Muscle biopsy sampling and analysis - myofiber morphology (cross sectional area, fiber type composition, myonuclei number) and myogenic stemm cell (satellite cell) content | needle biopsies (100-150 mg) will be obtained from the vastus lateralis muscle of patients undergoing TKR at Horsens Regional Hospital | Measured at baseline, in the week of surgery, and 3 months after surgery | |
Secondary | Knee disability and Osteoarthritis Outcome Score (KOOS) | KOOS is a patient-administered knee specific questionnaire comprising five subscales Pain; Symptoms; Activities of daily living; Sport & Recreation; and Knee-Related Quality of Life. | Measured at baseline, in the week of surgery, 6 weeks after surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | EuroQol Group 5-dimension (EQ-5D-5L) | The EQ-5D-L5 is a self-completion questionnaire consisting of two parts; first part of the EQ-5D-5L comprises five dimensions involving mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. | Measured at baseline, in the week of surgery, 6 weeks after surgery, 3 months after surgery, and 12 months after surgery | |
Secondary | Adverse events | Adverse events will be defined as unpredicted or unintended events, signs, or disease occurring during the period from inclusion until the 3-month follow-up (primary end-point) resulting in contact with the healthcare system (hospital or general practitioner) independent of whether or not the event is related to the intervention or outcome assessments | 3 months after surgery |
Status | Clinical Trial | Phase | |
---|---|---|---|
Terminated |
NCT04040985 -
Legion Primary Safety and Efficacy
|
N/A | |
Recruiting |
NCT05279092 -
Yale Steroid Enhanced Versus Exparel Nerveblock TKA RCT Study
|
Phase 2 | |
Completed |
NCT03286543 -
Electrical Stimulation for the Treatment of Pain Following Total Knee Arthroplasty Using the SPRINT Beta System
|
N/A | |
Not yet recruiting |
NCT04594447 -
Physica System KR vs Physica System CR (K-20)
|
N/A | |
Completed |
NCT02413996 -
Effects of Virtual Reality Rehabilitation in Patients With Total Knee Arthroplasty
|
N/A | |
Completed |
NCT01500252 -
Patellar Resurfacing Versus Patellar Retention in Total Knee Arthroplasty - A Randomized Clinical Trial
|
Phase 4 | |
Active, not recruiting |
NCT03339557 -
Comparison of Three Knee Replacements
|
N/A | |
Enrolling by invitation |
NCT04513145 -
Adductor Canal Block
|
Phase 2/Phase 3 | |
Completed |
NCT06045078 -
Aromatherapy in Total Knee Replacement
|
N/A | |
Completed |
NCT02468934 -
Electrical Stimulation for the Treatment of Pain Following Total Knee Arthroplasty (TKA) Using the SPRINT System
|
N/A | |
Completed |
NCT02914210 -
Virtual vs. Traditional Physical Therapy Following Total Knee Replacement
|
N/A | |
Withdrawn |
NCT01523418 -
Study to Observe Safety of Xarelto in VTE Prophlylaxis After Elective TKR (Total Knee Replacement) or THR (Total Hip Replacement)
|
N/A | |
Completed |
NCT00795223 -
Comparative Pain Control Between 0.2 or 0.3 Spinal Morphine and 0.25 or 0.5 % Bupivacaine for FNB After TKA
|
Phase 4 | |
Completed |
NCT01307202 -
Morphine Consumption in Joint Replacement Patients, With or Without Gabapentin Treatment
|
N/A | |
Completed |
NCT01515449 -
Predictors of Poor Outcomes in 1038 Sigma Knees
|
N/A | |
Completed |
NCT01522781 -
10 Year Outcome of Total Knee Replacement (TKR) Using Sigma Prosthesis
|
N/A | |
Completed |
NCT04166539 -
Neurotoxicity and Cardiotoxicity in Total Joint Arthroplasty
|
||
Completed |
NCT03454256 -
Virtual Reality Rehabilitation in Patients With Total Knee Replacement
|
N/A | |
Enrolling by invitation |
NCT06118073 -
Effect of Mindfulness on Pain After Total Knee Arthroplasty
|
N/A | |
Completed |
NCT05597046 -
Qualitative Interviews With Healthcare Professionals
|