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 Publisher Pubmed



Rajaeian N ; Rajaeian B ; Ghasemi GA ; Kahrizsangi NG
Source: Musculoskeletal Care Published:2026

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° vs. +12.2°), 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. © 2026 John Wiley & Sons Ltd.