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Intense Exercise Gets New Knees Moving

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May 22, 2009 2:48 pm US/Mountain

Intense Exercise Gets New Knees Moving

Written for the Web by CBS4 Special Projects Producer Libby Smith

Reporting
Dr. Dave Hnida
AURORA, Colo. (CBS4) ― Nearly half-a-million total knee replacements are done in the United States each year. Doctors are doing the surgery on patients who are younger and younger. Now a study shows intense physical therapy is the key to recovery.

"Between obesity, aging, and active lifestyles, we're seeing more and more osteoarthritis in patient's knees," said CBS4 Medical Editor Dr. Dave Hnida.

As the number of knee replacements goes up, researchers are finding that pushing those people to rehab earlier and harder is helping them get their full strength back. That is a switch from the cautious approach doctors have taken in the past.

"We see a 60 percent loss in muscle strength one month after surgery," said Jennifer Stevens-Lapsley, assistant professor in the University of Colorado Denver Physical Therapy program and co-author of the newest study.

The study, published in February's issue of Arthritis Care & Research, shows that patients who did progressive strength training two or three times a week made significant gains in quadriceps strength and muscle activation, as well as, functional performance.

"Progressing people causes no injury to the knee, does not hamper their range of motion, doesn't increase their swelling or pain levels. Previously it's been thought that we should be careful and cautious," said Stevens-Lapsley.

Stevens-Lapsley is working on several new studies at the University of Colorado Denver. In one, researchers are starting patients on intense physical therapy just days after their knee replacement surgery. She's also looking at how using neuromuscular electrical stimulation (NMES) early in rehabilitation helps strengthen the quadriceps muscle. The electrical stimulation helps the muscle work even when it doesn't want to.

"The electrical impulses are designed to try to override the activation deficit we see in the muscle. The muscle, for whatever reason, shuts down after surgery, there's pain and swelling in the knee that makes it difficult for the muscle to contract," explained Stevens-Lapsley.

Early results from the study indicate that early rehab with progressive strength training and electrical stimulation improves outcomes:
-- 53% faster in stair climbing time.
-- 32% more distance walked in 6 minutes.
-- 70% increase in quadriceps strength.

Researchers are currently looking for more patients to enroll in this study, for more information you can call 303-724-9590.

(© MMIX CBS Television Stations, Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

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