Comparison of the Supervised and Home-Based Progressive Resistant Training in Female Total Knee Arthroplasty Patients

The muscle strength was assessed with a hand-held dynamometer. For the quadriceps muscle test, the patient was seated on the edge of a hard bed. The dynamometer was placed on the midline of the tibia 5 cm proximal to the lateral malleolus. The patient was asked to force his leg into extension by overcoming the resistance of the dynamometer. For measurement of hip abductors muscle strength, the patient was placed supine and the dynamometer was placed on the lateral side of the leg, 5 cm proximal to the lateral malleolus. The patient was asked to force his leg into extension by overcoming the resistance of the dynamometer. The quadriceps and hip abductor muscles' strength were assessed at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

The total number of sit-to-stand repetitions completed in 30 seconds was recorded. 30s sit-to-stand test is a measurement of lower limb strength and endurance. 30s sit-to-stand test was assessed at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

The 40m fast-paced walking test measures short-distance walking activities. 40m fast-paced walk test was assessed at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

Functional limitations specific to ascending stairs were assessed with timed stair climbing and descending using a standard 9 steps (16-20 cm). Participants were instructed to climb stairs safely as soon as possible. Stair climbing test was assessed at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

The universal goniometer was used to measure active knee flexion and extension while the participants were sitting with their knees hanging down on the edge of a firm bed. Knee ROM was assessed at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

Knee pain intensity during rest and activity (walking, sitting-to-standing, climbing stairs) were measured using separate 10 cm pain rating scale, with zero representing no pain at all and 10 representing worst imaginable pain. Knee pain was evaluated at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

WOMAC was used to assess knee functions. WOMAC is a patient-reported, lower extremity-specific questionnaire and includes 24 questions: 17 on physical function, 5 on pain, and 2 on stiffness. WOMAC was evaluated at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

Artificial joint awareness was evaluated with FJS-12. The FJS-12 is a patient-reported outcome scale designed to assess joint awareness in the hips and knees. A five-point Likert response format consisting of a total of 12 questions, with a raw score converted from zero to 100 points, is used. FJS-12 was evaluated at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).

Quality of life was evaluated with the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). The WHOQOL-BREF questionnaire is a test used to evaluate the quality of life of healthy individuals and patients and consists of four subscales: physical health, psychological health, social relations and environmental areas. WHOQOL-BREF was evaluated at baseline (third month postoperatively) and after an 8-week intervention (fifth month postoperatively).