REHABILITATION MEDICINE IN RHEUMATIC DISEASES: Edited by Kenneth O’RourkeRestoration of physical function in patients following total knee arthroplasty an update on rehabilitation practicesBade, Michael J.; Stevens-Lapsley, Jennifer E.Author Information School of Medicine, University of Colorado, Aurora, Colorado, USA Correspondence to Dr Jennifer E. Stevens-Lapsley, UC Physical Therapy Program, Mail Stop C244, 13121 East 17th Avenue, Room 3116, Aurora, CO 80045, USA. Tel: +1 303 724 9170; e-mail: [email protected] Current Opinion in Rheumatology: March 2012 - Volume 24 - Issue 2 - p 208-214 doi: 10.1097/BOR.0b013e32834ff26d Buy Metrics Abstract Purpose of review Previous studies on rehabilitation following total knee arthroplasty (TKA) demonstrated limited efficacy in increasing long-term outcomes. More recently, several rehabilitation approaches have demonstrated greater efficacy for increasing long-term strength and functional performance outcomes following TKA. Recent findings Neuromuscular electrical stimulation (NMES), applied to the surgical limb's quadriceps muscle for the first 6 weeks following surgery, has been shown to improve the speed of recovery from TKA and leads to long-term increases in strength and functional performance. Rehabilitation programs that incorporate higher intensity, progressive resistive exercises that target all major muscle groups of the lower extremity have demonstrated superior long-term strength and functional gains compared with lower intensity programs. Finally, although the greatest strength and functional losses occur immediately after surgery, there is emerging evidence that strength and functional gains can be made after the acute postoperative recovery period with programs focusing on the use of progressive aquatic exercise or eccentric exercise. Summary Functional recovery following TKA can be enhanced by the use of NMES and utilization of a comprehensive, higher intensity strength training program in conjunction with traditional rehabilitation approaches. © 2012 Lippincott Williams & Wilkins, Inc.