Unilateral Strength Training after Total Knee Arthroplasty Leads to Similar or Better Effects on Strength and Flexibility than Bilateral Strength Training - A Randomized Controlled Pilot Study.
Markus Tilp, Sebastian Ringler, Herwig Mariacher and 1 others
PMID 37073719WHAT IT FOUND
Unilateral strength training after knee replacement worked as well as bilateral training for the operated leg, but improved flexibility more and strength in the healthy leg.
Both groups gained function. The study was small, so treat this as a promising option rather than proof.
Key findings
01Strength in the operated leg improved similarly in both groups, but the unilateral group gained significantly more strength in the healthy leg.
02Knee flexibility increased significantly more in the unilateral group than in the bilateral group.
03Both groups improved equally in functional tasks like standing from a chair and walking distance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (11 per group), which limits the statistical power and generalizability of the findings. The study was open-label, meaning participants and therapists knew which training method was being used, which could introduce bias. The rehabilitation period was short (3 weeks), so long-term effects and durability of gains were not assessed. The study was conducted in a specific inpatient setting in Austria, which may not reflect outpatient or community-based rehabilitation contexts. No follow-up measurements were taken to assess retention of strength or flexibility gains after the programme ended.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume unilateral training is superior for the operated leg. Strength gains in the affected knee were similar between groups; the advantage was seen in flexibility and the healthy leg, and the study was too small to confirm these differences are clinically robust.