OBJECTIVE To evaluate the efficacy and safety of progressive resistance exercise (PRE) for patients with total knee arthroplasty (TKA) in a meta-analysis. DATA SOURCES PubMed, MEDLINE, Cochrane's Library, and EMBASE databases. STUDY SELECTION Randomized controlled trials evaluating the effect of PRE on mobility and function in TKA patients. DATA EXTRACTION A random-effect model was applied if significant heterogeneity was detected; otherwise, a fixed-effect model was applied. DATA SYNTHESIS Seven RCTs. Compared to a rehabilitation program without PRE, physiotherapy including PRE was associated with improvements in the 6-minute walking test (weighed mean difference [WMD]: 19.22 m, p = 0.04) with a wide confidence interval (CI: 0.48∼37.95). However, sensitivity analysis by omitting one study with preoperative rehabilitation revealed non-significant results (WMD: 15.15m, p = 0.16). Moreover, PRE did not significantly improve the maximal walking speed (WMD: 0.05 m/s, 95% CI: 0.00∼0.11, p = 0.05). However, PRE was associated with improved knee strength of extension (standard mean difference [SMD]: 0.72, 95% CI: 0.47∼0.96, p < 0.001) and flexion (SMD: 0.47, 95% CI: 0.19∼0.74, p < 0.001), but not self-reported physical function (SMD: -0.17, 95% CI: -0.37∼0.03, p = 0.10) or changes in pain score (SMD: 0.11, 95% CI: -0.15∼0.37, p = 0.40). PRE did not increase the risk of adverse events (risk ratio = 1.19, 95% CI: 0.52∼2.71, p = 0.68). CONCLUSIONS PRE may lead to improvements in physical function among patients receiving a TKA. PRE leads to higher ultimate strength in the surgical knee and is safe to perform.

中文翻译：

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下肢渐进式抗阻运动对全膝关节置换术患者的疗效和安全性：随机对照试验的荟萃分析

目的在荟萃分析中评估渐进式抗阻运动（PRE）对全膝关节置换术（TKA）患者的疗效和安全性。数据源 PubMed、MEDLINE、Cochrane 图书馆和 EMBASE 数据库。研究选择 评估 PRE 对 TKA 患者活动能力和功能影响的随机对照试验。数据提取 如果检测到显着异质性，则应用随机效应模型；否则，采用固定效应模型。数据综合 七项随机对照试验。与没有 PRE 的康复计划相比，包括 PRE 的理疗与 6 分钟步行测试（加权平均差 [WMD]：19.22 m，p = 0.04）的改善相关，置信区间较宽（CI：0.48∼37.95）。然而，通过省略一项术前康复研究进行的敏感性分析显示结果不显着（WMD：15.15m，p = 0.16）。此外，PRE 没有显着提高最大步行速度（WMD：0.05 m/s，95% CI：0.00∼0.11，p = 0.05）。然而，PRE 与膝关节伸展强度（标准平均差 [S​​MD]：0.72，95% CI：0.47∼0.96，p < 0.001）和屈曲强度（SMD：0.47，95% CI：0.19∼0.74，p < 0.001），但不是自我报告的身体功能（SMD：-0.17，95% CI：-0.37∼0.03，p = 0.10）或疼痛评分的变化（SMD：0.11，95% CI：-0.15∼0.37，p = 0.40）。PRE 并未增加不良事件的风险（风险比 = 1.19，95% CI：0.52∼2.71，p = 0.68）。结论 PRE 可能会改善接受 TKA 的患者的身体功能。