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Table 1 Rehabilitation protocol

From: Targeted rehabilitation to improve outcome after total knee replacement (TRIO): study protocol for a randomised controlled trial

Category Description Expected achievements
Range of motion • Prone knee flexion AROM • AROM of 100
  • Heel props for extension PROM • Less than 1cm effusion after exercises
  • Stationary bicycle/rowing machine for ROM stimulus and endurance • Able to attain full extension
  • Hamstring, quadriceps & gastrocnemius /soleus stretching  
  • Total end range time (TERT) of 30 minutes a day until ROM guideline attained (Aim 100°)  
Strengthening • Isometric quads • Able to achieve voluntary quadriceps control, demonstrated by SLR without lag
  • Straight leg raise (if not able) • Able to perform semi squat equal weight bearing between limbs
  • Partial squats to 90°  
  • Supine sub-maximal leg press or equivalent (emphasis on pain free motion and neuromuscular control vs. pure strengthening)  
  • Front and lateral step ups progressing from 10cm  
  • Resistive exercises against Theraband 90°-30° in sitting – progress to 90°-0°  
Proprioception • Balance exercises in single leg stance • Able to perform sit-to-stand unsupported
  • Sit to stand • Able to perform single leg stance activities
  • Balance ball  
  • BalanceMaster / low wobbleboard if BalanceMaster not available  
  • Perturbation from soft unstable surface  
Balance/Gait • Braiding – alternate front and back crossover steps whilst moving laterally – progress by increasing speed • Able to complete multiple changes of direction walking without support
  • Tandem Walk forward and backwards  
  • Walk multiple change in direction on command  
  • Shuttle walking to increase stamina