A pedalling-based protocol was superior to standard physiotherapy for post-operative rehabilitation after total knee replacement in a randomised controlled trial

Larissa Nicole Sattler, Wayne A Hing, Christopher Vertullo

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Aim: To determine if a self-directed pedalling protocol following total knee replacement surgery was superior to standard multi-exercise non-pedalling physiotherapy. Design: Randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Method: Sixty TKR patients were randomized to receive postoperative physiotherapy involving either a 3- exercise pedalling-based (3-Ex-Pedal-Group) or a standard 10-exercise, non-pedalling protocol (10-Ex- NonPedal-Group). Outcomes were assessed at 2 days, 2 weeks, and 4 months, and included tests of function, patient-reported outcomes, and other perioperative measures. Results: For the primary outcome, the 6-minute walk test, distance walked was further in the 3-Ex-Pedal- Group at 2 days (p = 0.001). The 10-m walk (10MWT) and the Timed Up & Go (TUG) tests, were faster for the 3-Ex-Pedal-Group at 2 days (p = 0.016, p = 0.020). Oxford Knee Scores were better in the 3-Ex-Pedal- Group at 2 days (p = 0.034) and at 2 weeks (p = 0.007), as was the EQ-5D score at 2 weeks (p = 0.037). The EQ-5D-VAS was better for the 3-Ex-Pedal-Group at all three time points (p = 0.031, p = 0.050, and p = 0.044). Length of stay was shorter, by a half-day, for the 3-Ex-Pedal-Group (p = 0.024). The 10-Ex-Nonpedal-Group was not superior for any outcome at any time point. Conclusion: A pedalling-based protocol after TKR was superior to a standard multi-exercise physiotherapy protocol with these benefits decreasing over time. Key Practice Points: • An inexpensive and self-directed pedalling protocol is superior for patients than standard multiexercise physiotherapy following total knee replacement surgery. Proposed impact, if any, on the health outcomes of Aboriginal and Torres Strait Islander people: As pedalling on a simple set of floor pedals is relatively inexpensive and can be done as a self-directed home program it would be an easily adopted protocol for those living in regional or remote areas.
Original languageEnglish
Number of pages1
Publication statusPublished - 17 Oct 2019
EventTRANSFORM 2019 Physiotherapy Conference - Adelaide Convention Centre, Adelaide, Australia
Duration: 17 Oct 201919 Oct 2019


ConferenceTRANSFORM 2019 Physiotherapy Conference
Abbreviated titleAPA
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