Trial reportMedicine and science in sports and exercise2026
High-Intensity Resistance Training Enhances Strength, But Not Muscle Mass and Physical Functioning Gains during Total Knee Arthroplasty Rehabilitation.
Trial report in Medicine and science in sports and exercise, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
purposeTo determine whether high-intensity resistance exercise training with nutritional support (RET) during recovery from total knee arthroplasty induces greater improvements in muscle-related outcomes compared with standard rehabilitation (SR) alone.
methodsThirty-three patients (70 ± 6 yr; 28.7 ± 3.1 kg⋅m -2 ) were randomized to receive RET (intervention + regular rehabilitation, n = 18) or SR (regular rehabilitation only, n = 15) for 12 wk, starting 8 wk post-TKA. RET involved supervised, bilateral, high-intensity resistance exercise, 3×/wk, daily supplementation (45 g protein, 5.5 g Vivinal GOS, 800 IU vitamin D, 366 mg calcium), and dietary counseling. Outcomes included bilateral and unilateral leg press one-repetition maximum, DXA-derived appendicular lean mass, computed tomography-derived quadriceps cross-sectional area, 6-min walking test, and 5-times chair-stand test (5CST). Data are mean ± SD, analyzed with two-way repeated-measures ANOVAs, or median [IQR], analyzed with Wilcoxon Signed-Rank test.
resultsBilateral leg press one-repetition maximum improved to a greater extent following RET (131 ± 38 to 174 ± 56 kg; P < 0.001) versus SR (124 ± 36 to 143 ± 49 kg, P = 0.018, P value of interaction [ Pint ] = 0.026). Strength in the nonoperated leg increased in the RET group only (RET: 22% ± 17%, P < 0.001, SR: 6% ± 11%, P = 0.175, Pint = 0.002). Operated leg strength increased similarly between groups (RET: 51% ± 33%, SR: 40% ± 30%, P value of main time effect [ Ptime ] < 0.001, Pint = 0.338), as did appendicular lean mass (RET: 0.5 ± 0.8 kg, SR: 0.3 ± 0.8 kg, Ptime = 0.009, Pint = 0.390), and quadriceps cross-sectional area (operated: RET: 7.8% ± 7.5%, SR: 9.2% ± 5.9%, nonoperated: RET: 4.8% ± 4.5%, SR: 3.8% ± 3.7%, Ptime < 0.001, Pint ≥ 0.557). Six-minute walking test improved more in the SR (428 ± 94 to 513 ± 75 m, P < 0.001) versus RET group (417 ± 69 to 460 ± 72 m, P = 0.002, Pint = 0.034). 5CST only improved significantly following RET (RET: 15.3 [4.2] to 13.2 [3.9] s, P = 0.039, SR: 14.4 [4.0] to 14.4 [5.1] s, P = 0.064).
conclusionsCompared with standard total knee arthroplasty rehabilitation, high-intensity resistance training with nutritional support induces greater gains in bilateral strength but not muscle mass or physical functioning.
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