Performance on a Clinical Quadriceps Activation Battery Is Related to a Laboratory Measure of Activation and Recovery After Total Knee Arthroplasty.

There was no untreated control group, so the study cannot say what recovery would look like without physical therapy. All patients received physical therapy as part of a clinical trial, including inpatient physical therapy twice daily before discharge and 26 outpatient visits over 11 weeks, so the findings may not apply to patients receiving less therapy. The analysis pooled the high-intensity and low-intensity groups because outcomes did not differ between them, so it cannot address whether a specific rehabilitation intensity changed the relationship. Patients had to be discharged to home and could not have severe contralateral knee OA, BMI greater than 40 kg/m 2, uncontrolled diabetes, current cancer treatment, current smoking, or neurological, vascular, or cardiac problems limiting function, so results may not apply to more medically complex or severely impaired patients. The battery was assessed by the treating physical therapist at the initial evaluation, while other outcomes were assessed by a blinded outcome assessor, so early battery grouping could be influenced by the treating therapist. The supplied text does not report the total number of patients analysed, so the precision of the group differences cannot be judged. This was a secondary analysis, not a direct test of whether electrical stimulation or other interventions improve recovery.

The authors reported no conflicts of interest. Funding was from NIH R01-HD065900, NIH/NCATS UL1-TR001082, NIH T32 AG00279, and the Foundation for Physical Therapy PODS I and II Scholarships.

Do not read this as proof that adding electrical stimulation or more therapy speeds recovery. All participants received physical therapy, there was no untreated control group, and the early differences between battery groups were gone by three months.