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首页> 外文期刊>Trials >Efficacy of pre-operative quadriceps strength training on knee-extensor strength before and shortly following total knee arthroplasty: protocol for a randomized, dose-response trial (The QUADX-1 trial)
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Efficacy of pre-operative quadriceps strength training on knee-extensor strength before and shortly following total knee arthroplasty: protocol for a randomized, dose-response trial (The QUADX-1 trial)

机译：术前股四头肌力量训练对全膝关节置换术之前和之后不久的膝-伸肌力量的功效：一项随机的剂量反应试验方案（QUADX-1试验）

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Patients with knee osteoarthritis (OA) report knee pain, limitation in physical activities and low quality of life. The two primary treatments for knee OA are non-surgical treatment (e.g., exercise) and surgery (total knee arthroplasty (TKA)); however, national guidelines recommend non-surgical treatment to be tried prior to surgical procedures. Patients with knee OA are characterized by decreased muscle strength, particularly in the knee-extensor muscles. Correspondingly, decreased knee-extensor strength is found to be associated with an increased risk of development, progression and severity of knee OA symptoms. Recent trials suggest a positive effect of pre-operative exercise on pre- and post-operative outcome; however, the most effective pre-operative knee-extensor strength exercise dosage is not known. The purpose of the present trial is to investigate the efficacy of three different exercise dosages of pre-operative, home-based, knee-extensor strength exercise on knee-extensor strength before and shortly after surgery in patients eligible for TKA due to end-stage knee OA. In this randomized dose-response trial with a three-arm parallel design, 140 patients with end-stage knee OA (candidates for TKA) are randomized to one of three exercise dosages (two, four or six session/week) of knee-extensor strength exercise (three sets, 12 repetitions at 12 RM, per exercise session) for 12?weeks. The knee-extensor strength exercise is home-based (unsupervised) and performed with an elastic exercise band following an initial exercise instruction. Adherence is objectively quantified using a sensor attached to the exercise band. The primary outcome will be the change in knee-extensor strength. Following the 12-week exercise period, the need for TKA surgery is re-assessed by an orthopedic surgeon. Decreased knee-extensor strength is a major challenge in patients with knee OA. Exercise programs focusing on knee-extensor strength are found to be more effective in relieving knee OA pain and symptoms compared to more general exercise programs. However, the optimal exercise dosage for knee-extensor strength deficits in patients with knee OA is inconclusive. Knowledge on the dose-response relationship for knee-extensor strength exercise in patients with knee OA will help guide future non-surgical treatment in this patient population. ClinicalTrials.gov, ID: NCT02931058 . Pre-registered on 10 October 2016.
机译：膝骨关节炎（OA）患者报告膝关节疼痛，身体活动受限和生活质量低下。膝盖OA的两种主要治疗方法是非手术治疗（例如运动）和手术（全膝关节置换术（TKA））;但是，国家指南建议在手术之前尝试非手术治疗。膝骨关节炎患者的特点是肌肉力量下降，特别是在膝伸肌中。相应地，发现膝伸肌力量下降与膝骨关节炎症状的发展，进展和严重程度增加有关。最近的试验表明，术前运动对术前和术后结局有积极作用。但是，尚无最有效的术前膝-伸肌力量锻炼剂量。本试验的目的是研究三种不同运动剂量的术前，家庭式，膝伸肌力量锻炼对因终末期可行TKA的患者术前和术后不久对膝伸肌力量的疗效膝骨关节炎。在这项采用三臂并联设计的随机剂量反应试验中，将140例晚期膝OA（TKA的候选人）患者随机分配到三种运动剂量（每周两次，两次，四个或六个疗程）中的一种力量运动（3套，每次练习12次，每次RM 12）12周。膝伸肌力量训练是家庭式的（无人指导），并在遵循最初的运动指导后使用弹性运动带进行。使用附着在运动带上的传感器可以客观地量化粘附性。主要结果将是膝伸肌力量的变化。经过12周的运动后，骨科医生重新评估了TKA手术的必要性。膝伸肌强度下降是膝骨关节炎患者的主要挑战。与更一般的锻炼计划相比，以膝盖伸肌力量为重点的锻炼计划被发现在缓解膝盖OA疼痛和症状方面更为有效。但是，对于膝骨关节炎患者，膝部伸肌力量不足的最佳运动剂量尚无定论。有关膝骨关节炎患者膝-伸肌力量锻炼的剂量反应关系的知识将有助于指导该患者人群未来的非手术治疗。 ClinicalTrials.gov，ID：NCT02931058。预注册于2016年10月10日。

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