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Comparison of functional training and strength training in improving knee extension lag after first four weeks of total knee replacement

The weakness of quadriceps and reduced activation has been identified as a major cause of activity limitations post Total knee replacement (TKR). There is a need to evaluate various available techniques in their effectiveness in improving quadriceps strength and minimizing functional limitations after total knee replacement. Objective of this study was to determine the effectiveness of strength training as compared to functional training in improving knee extension lag after first four weeks of Total Knee Replacement. This Randomized control trial was conducted at Ghurki trust teaching hospital, from June to December 2015.Patients with total knee replacement were selected consecutively and then randomly assigned to control group (n=33) and treatment group (n=31). Primary and secondary outcome measures were goniometry and Visual Analogue Scale (VAS) respectively. There was no significant difference found in knee extension Lag between the two groups (p-value>0.05). The mean Value for pain on visual analogue scale was 1.78 (SD=3.03) for control group and 1.33 (SD=3.32) for treatment group. The difference in mean scores for pain was significantly different for both groups (pvalue< 0.05). Both strength training and functional training were found equally effective in improving quadriceps lag, however, functional training exercises resulted in significant reduction in post-operative knee pain compare to resistance training. It is recommended to make functional exercises an essential part of physical rehabilitation post total knee replacement.

Author(s): Maryam Shabbir, Bilal Umar, Sarah Ehsan, Sunaina Munir, Umoal Bunin, Khurram Sarfraz