The Effects of Exercise and Cycle Ergometry in Post-Operative Total Knee Patients-A Randomized Controlled Trial

Participants will be recruited from the current waiting list at either Thunder Bay Regional Health Sciences Centre or Big Thunder Orthopedics. The physician will be discussing the study and eligibility requirements with the potential participants. The research assistant at Big Thunder will then obtain signed consent from the potential participant during the pre-operative appointment. If the potential participant would like to discuss the study with the research team as well as the doctor before giving consent, the research team will be contacted. Adequate enrolment is expected as the amount of TKA performed in previous years has been above 300.

Eligibility screening will be performed by the physician in the surgeon's office prior to the potential participant giving informed consent. The physician will make the decision of whether or not someone is eligible based on examination of their medical history. If the potential participant is ineligible based on this information, they will not be involved in the study.

During a consultation, the physician will familiarize the potential participant with the study, the consent form, and any other relevant study material. The physician will answer any questions the potential participant has about the study and ask if they would rather speak with a member of the research team. The potential participant will be given the opportunity to discuss the study with an investigator and the Research Ethics Board prior to signing the consent form. If the participant wishes to consent to the study they will speak with the research assistant from Big Thunder at the pre-operative appointment who will obtain their signed consent form. The participant will be given a copy of the signed consent form and information letter for their records. The original form will be temporarily stored in a locked cabinet at Big Thunder, and picked up weekly to be retained by Dr. Paolo Sanzo in his locked office.

The two study groups will be the standard post-operative exercise protocol or the exercise protocol combined with the use of the Viscus V1.5 kinetic flywheel ergometer. The standard post-operative exercises are already currently recommended to patients. Briefly, they include deep breathing and coughing, ankle pumping, buttock contractions, and static quadriceps strengthening. The use of the kinetic flywheel ergometer will allow for pedal revolutions to be tracked as well as time of use. Participants randomized into the Viscus group will have access to a Viscus V1.5 24 hours per day in their recovery room to use at their leisure. All participants will track their own exercise in the exercise log which will be used to observe compliance. The participant's intensity of exercise will be rated on a 5-point Likert scale by the treating physiotherapist/nurse using the Sports Injury Rehabilitation Adherence Scale (SIRAS). The intensity of exercise will be rated from minimum effort to maximum effort; the frequency of exercise and the participants ability to follow instructions and advice will be rated from never to always; and the receptivity to changes in program will be rated from very unreceptive to very receptive.

Prior to surgery, demographic information such as height, weight, age and gender, as well as medical history and surgical history of the knee will be recorded.