Comparison of High Intensity Strength Training and Muscle Energy Techniques in TKR Patients

July 3, 2025 updated by: Riphah International University

Comparison of Effects of High Intensity Strength Training and Muscle Energy Technique on Pain, ROM and Functional Status in Patients With Total Knee Replacement

Globally, the prevalence of total joint replacement (TKR) procedures has been rising, providing patients with better joint function, decreased pain, and enhanced quality of life. A thorough and successful postoperative rehabilitation program, which attempts to restore optimal function and lower the risk of problems related to the treatment, is necessary for the success of total knee replacement (TKR) procedures. After total knee replacement, postoperative rehabilitation is a crucial stage in the patient's healing process. Normal knee function is frequently hampered by issues like pain management, muscular weakness, joint stiffness, and proprioceptive deficiencies. Therefore, choosing a suitable rehabilitation regimen is crucial.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The main objective of this study is to compare two different rehabilitation strategies: Muscle Energy Techniques with Balance Exercises and High Intensity Strength Training with Balance Exercises. The research aims to maximize postoperative results for patients who have undergone total knee replacement surgery.

The focus on resistance exercises intended to improve muscle strength and power is what defines high intensity strength training, or HIST. Research has indicated that HIST is beneficial in enhancing joint stability, muscle function, and overall functional outcomes across a range of orthopedic groups. Its precise use and effect on patients recovering from TKR surgery, however, need further investigation. In order to increase joint mobility, lessen pain, and improve neuromuscular control, patients who get Muscle Energy Techniques (MET) actively participate in targeted muscle contractions. MET has demonstrated potential in treating muscular imbalances.

Study Type

Interventional

Enrollment (Actual)

36

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 05450
        • Horizon Hospital Lahore

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Individuals between the ages of 45 and 75
  • Patients should be within a certain timeframe following surgery (e.g., post op day 0-day) to ensure homogeneity throughout the rehabilitation phase.
  • Patients who have had primary total knee replacement
  • To take part in the RCT, participants must give informed consent
  • they must be able and willing to follow the study protocol's instructions for post-rehabilitation care.

Exclusion Criteria:

  • Comorbidities: Individuals with significant comorbidities affecting rehabilitation, such as severe cardiovascular disease or neuromuscular disorders, may be excluded.
  • Allergies/Contraindications: Patients with allergies or contraindications to specific exercises or techniques used in the study.
  • Inadequate Cognitive Function: Participants with cognitive impairments that prevent them from comprehending and adhering to the rehabilitation protocols.
  • Other Knee Surgeries: Patients who have had other knee surgeries or have had bilateral knee replacements may be excluded due to variations in recovery and rehabilitation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: High Intensity Strength Training
Group of TKR patients are given high intensity strength training.
Other: High Intensity Strength Training
  • High-intensity workouts to strengthen the quadriceps and enhance knee function;
  • Knee flexion and extension 10 lbs.
  • 10RM of hip flexion and extension
  • 10RM hip adduction and abduction
  • Standing with feet aligned for one minute*2, standing on one leg's forefoot and the other leg's heel for two minutes*2, standing on one foot for three seconds*15, and walking ten meters in a straight line for four minutes
  • 4-week program; 3 days/week; Conventional Treatment: Exercises for range of motion, mobility and weight bearing, muscle stretching, static quadriceps exercise, quadriceps exercise, and straight leg raising
Active Comparator: Muscle Energy Technique Exercises
patients are given muscle energy technique exercise.
Other: Muscle Energy Technique

The Muscle Energy Technique (MET) to strengthen and flex your quadriceps and hamstrings.

  • After maintaining an isometric contraction for ten seconds, a little stretch was maintained for thirty seconds.
  • Four contractions every treatment, separated by three seconds of rest. Standing with feet parallel for one minute*2, standing on one leg's forefoot and the other leg's heel for two seconds*2, standing on the forefoot for three seconds*15
  • Move in a 10 m by 4 straight line.
  • 4-week program; 3 days/week Conventional Treatment: Exercises for range of motion, mobility and weight bearing, muscle stretching, static quadriceps exercise, quadriceps exercise, and straight leg raising

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
ROM
Time Frame: 4th week

An instrument called a goniometer will be used to measure angles or rotate objects into desired positions. In orthopedics, it is primarily used to quantify joint angles.

Changes from the baseline was taken.
4th week
Functional Status: Knee Injury and Osteoarthritis outcome score
Time Frame: 4th week
The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a questionnaire designed to assess short and long-term patient-relevant outcomes following knee injury. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as common in orthopedic scales, and generic measures. Scores between 0 and 100 represent the percentage of the total possible score achieved.
4th week
Pain : Numeric Pain Rating Scale
Time Frame: 4th week

A simple tool for measuring pain intensity is the Numeric Pain Rating Scale. This grading system has eleven points: zero represents no pain, and ten represents the "worst pain imaginable or highest level of discomfort.

Changes from the baseline was taken.
4th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Hafiza Amna Tariq, DPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 30, 2025

Primary Completion (Actual)

May 15, 2025

Study Completion (Actual)

June 12, 2025

Study Registration Dates

First Submitted

May 6, 2024

First Submitted That Met QC Criteria

May 8, 2024

First Posted (Actual)

May 9, 2024

Study Record Updates

Last Update Posted (Actual)

July 4, 2025

Last Update Submitted That Met QC Criteria

July 3, 2025

Last Verified

July 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/23/01104

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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