Effects of Resistance Training on Pain, Muscle Strength, and Function in Patients Undergoing Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

TL;DR

Resistance training helps reduce pain, improve muscle strength, and enhance function in patients who have undergone knee replacement surgery.

Contribution

This study provides a meta-analysis showing the effectiveness of resistance training in TKA patients, highlighting optimal intervention design.

Findings

Resistance training significantly improves pain, muscle strength, and function in TKA patients.

Standalone resistance training or interventions under 12 weeks show the best results.

Subgroup analyses reveal differences in effectiveness based on intervention type and duration.

Abstract

Background/Objectives: The importance of resistance training for functional recovery in Total Knee Arthroplasty (TKA) patients has been emphasized. Therefore, this systematic review and meta-analysis was conducted to analyze its effects on pain, muscle strength, and function in patients with TKA. Methods: The following databases were used: PubMed, Web of Science, the Cochrane Library, and Embase. Randomized controlled trials that administered resistance training to patients undergoing TKA and measured pain, strength, and function were included. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes were calculated using Hedges’ g and are presented as Standardized Mean Differences (SMDs) with 95% Confidence Intervals (CIs). Subgroup analyses were conducted to determine the effect size based on the type and duration of the intervention. Results: The study selection process resulted in the inclusion of seven studies comprising a total of 439 participants. The bias assessment found that three studies had a low risk of bias and four had some concerns. Resistance training was effective in improving pain (SMD: 0.84, 95% CI: 0.11; 1.57, I2: 89.6%), muscle strength (SMD: 1.03, 95% CI: 0.29; 1.77, I2: 83.1%), self-reported function (SMD: 1.58, 95% CI: 0.15; 3.01, I2: 93.1%), and performance-based function (SMD: 0.74, 95% CI: 0.38; 1.11, I2: 68.9%). Subgroup analysis revealed significant differences in pain, strength, and performance-based function by comparison group, performance-based function by intervention duration, and self-reported function by intervention type. Conclusions: Resistance training improves pain, muscle strength, and function in TKA patients. Additionally, resistance training appears particularly effective when implemented as a standalone intervention or for durations under 12 weeks. These findings suggest that the design of resistance training protocols should be considered in clinical practice.

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