The effectiveness of relaxation exercise on pain, functional outcomes and muscle strength in patients with total knee arthroplasty

This study aimed to compare progressive muscle relaxation (PMR) therapy, which was added to standard physiotherapy (PT), to standard PT during inpatient rehabilitation of total knee arthroplasty (TKA) patients in terms of pain, functional outcomes, muscle strength and other postoperative outcomes. One-hundred six patients with TKA were included in this study. Patients were randomly allocated into PMR and control groups. Both groups received standard PT along their hospital stay. PMR group received PMR exercise in addition to the standard rehabilitation program during inpatient period. The control group received a standard rehabilitation program. Patients were evaluated at preoperative, discharge and postoperative third month regarding pain intensity, functional outcomes, muscle strength, range of motion, knee edema, anxiety and depression level, fear of movement and quality of life. The groups were similar at baseline in term of demographic and clinical outcomes (p>0,05). During inpatient period, PMR group had better results in terms of pain relief (p<0.05), quadriceps strength (p<0,05), fear of movement level (p<0,05) compared to control group. Nonetheless, PMR+standard PT program provided a significant group-by-time effect on reducing pain level and improving muscle strength compared to standard PT (p<0.05). No difference was detected between groups regarding other evaluation parameters (p>0.05). Our findings support PMR exercise, which was added to the standard PT during inpatient period following TKA, is an effective approach in terms of alleviating pain, and improving quadriceps muscle strength.