Efficacy of Sling Exercise Training Compared to Standard Physiotherapy to Improve Muscle Strength, Joint Range of Motion and Functional Outcomes Following Total Knee Arthroplasty: A Pilot Randomized Controlled Trial

Abstract

Background Recovery following total knee arthroplasty (TKA) is frequently incomplete, highlighting the need for more effective rehabilitation approaches.Methods This single-blind pilot randomized controlled trial allocated 40 women undergoing unilateral total knee arthroplasty (TKA) to either Sling Training (ST) or Standard Physiotherapy Training (SPT) (1:1). Both groups completed supervised outpatient rehabilitation three times weekly for 8 weeks, beginning 1-week post-surgery. Outcomes included quadriceps and hamstring isometric strength, knee range of motion, and WOMAC total score, assessed at baseline and week 8 by a blinded assessor.Results Both groups improved significantly; however, ST produced larger gains in quadriceps strength (+60 vs. +30), hamstring strength, knee flexion ROM (+19.2 degrees vs. +12.2 degrees), and WOMAC reduction (-41.9 vs. -35.7; p = 0.003). Approximately 90 of ST participants versus 75 of SPT participants exceeded the >= 12-point MCID threshold.Conclusion Sling-based exercise training may offer superior early functional and strength recovery compared with standard physiotherapy after TKA, supporting its potential role as an adjunct to early rehabilitation. Larger, multi-centre trials are needed to confirm effectiveness and generalizability.Trial Registration IRCT20221226056934N1