An interventional study of Foam rolling after total knee arthroplasty and Standard home exercise program after total knee arthroplasty in Total Knee Arthroplasty Recovery, Total Knee Arthroplasty Postoperative Pain and Total Knee ArthroplastyKnee Pain, Functionality, sponsored by Dokuz Eylul University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.
Sponsored by Dokuz Eylul University · Not applicable, Interventional, and Treatment
The aim of this study is to investigate the effects of foam rolling in patients who have undergone total knee arthroplasty on pain, knee mobility, leg muscle strength, the ability to sense joint position, fear of movement, walking, balance, and the ability to perform daily activities.
A total of 26 patients, with 13 patients in each group, will be included in the study. Participants will be randomly assigned to two groups. One group will receive the routine rehabilitation program, while the other group will receive foam rolling in addition to the routine rehabilitation program.
Foam rolling and rehabilitation exercises will be taught at the Dokuz Eylül University Orthopedics and Traumatology Outpatient Clinic, and you will be asked to perform these exercises at home. The foam rolling group will perform foam rolling 6 days per week, 2 sets per day, with 3 repetitions of 60 seconds each. The control group will not perform foam rolling and will follow the routine rehabilitation program.
The standard rehabilitation program will consist of strengthening exercises in different directions for the entire leg, range-of-motion exercises, stretching exercises, and walking exercises. You will be asked to perform the exercises for 3 sets of 10 repetitions per day.
The assessments in the study will be performed at the second postoperative week (test 1), sixth postoperative week (test 2), and fourteenth postoperative week (test 3). These time points are also times when you would normally visit your doctor for routine follow-up; therefore, you will not be expected to make any additional hospital visits for the study.
The study will continue for 1 year, and each patient will be followed for 14 weeks.
Pain will be assessed using a single-question questionnaire. Walking, functional level, and leg muscle strength will be assessed using short performance tests involving sitting-to-standing and walking activities, as well as a questionnaire. Knee joint range of motion and proprioception will be assessed by measuring the angles of your knee using a ruler-like plastic device. Fear of movement will be assessed using a short questionnaire.
All assessments will take no more than 20 minutes. The results will be determined by examining whether there are differences in these measurements between the different assessment time points.
The aim of this study is to investigate the effects of foam rolling after total knee arthroplasty on pain, range of motion, muscle strength, proprioception, kinesiophobia, gait, balance, and functional level.
All patients will receive education regarding postoperative pain management, exercises, foam rolling, and the rehabilitation program to be implemented. Both the rehabilitation exercises and foam rolling will be taught to the patients by physiotherapists in the outpatient clinic and performed by the patients at home as part of their home program. The foam rolling intervention group will perform foam rolling for 4 weeks starting from the second postoperative week, 3 days per week, 1 set per day, with 3 repetitions of 60 seconds each. The control group will not perform foam rolling and will follow the standard home exercise program.
The standard home exercise program will consist of lower-extremity range-of-motion exercises, isometric exercises, stretching exercises for the knee joint, and straight leg raise exercises in different directions. Patients will be instructed to perform these exercises for 3 sets of 10 repetitions per day. In addition, patients will be encouraged to mobilize both indoors and outdoors.
Outcome assessments will be performed at the second postoperative week (test 1), sixth postoperative week (test 2), and fourteenth postoperative week (test 3).
Demographic and clinical characteristics, including age, gender, height, body weight, and body mass index, will be recorded on the data collection form. Clinical assessments will include pain level, range of motion, muscle strength, proprioception, kinesiophobia, gait, balance, and functional level. Maximum isometric muscle strength will be assessed only at the fourteenth postoperative week (test 3).
Pain will be assessed using the Visual Analog Scale (VAS). The maximum isometric muscle strength of the quadriceps femoris and hamstring muscles will be assessed using manual muscle testing and a hand-held dynamometer. Range of motion will be assessed using a plastic manual goniometer. Knee joint proprioception will be assessed using the active joint repositioning test at target angles of 30° and 60° of knee flexion. The Hospital for Special Surgery (HSS) Knee Score will be used to evaluate knee arthroplasty outcomes. Kinesiophobia will be assessed using the self-reported Tampa Scale for Kinesiophobia. The Timed Up and Go Test and the Five-Times Sit-to-Stand Test will be used to assess lower-extremity function, functional mobility, gait, and balance.
Exclusion Criteria:
The foam rolling intervention group will perform foam rolling for 4 weeks starting from the second postoperative week, 3 days per week, 1 set per day, with 3 repetitions of 60 seconds each.
Other: Foam rolling after total knee arthroplasty
The control group will not perform foam rolling and will follow the standard home exercise program. The standard home exercise program will consist of lower-extremity range-of-motion exercises, isometric exercises, stretching exercises for the knee joint, and straight leg raise exercises in different directions. Participants will be instructed to perform the exercises for 3 sets of 10 repetitions per day.
Other: Standard home exercise program after total knee arthroplasty
The foam rolling intervention will be performed for 4 weeks starting from the second postoperative week, 3 days per week, 1 set per day, with 3 repetitions of 60 seconds each.
The control group will not perform foam rolling and will follow the standard home exercise program. The standard home exercise program will consist of lower-extremity range-of-motion exercises, isometric exercises, stretching exercises for the knee joint, and straight leg raise exercises in different directions. Participants will be instructed to perform the exercises for 3 sets of 10 repetitions per day.
Change from baseline at week 14 in knee pain
Pain will be assessed using the 10-cm Visual Analog Scale (VAS), scored from 0 (no pain) to 10 (unbearable pain).
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in knee range of motion
Knee range of motion will be measured using a 30-cm transparent plastic manual goniometer.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in muscle strength
Maximum isometric strength of the quadriceps femoris and hamstring muscles will be measured using a hand-held dynamometer and muscle strength will also be assessed using manual muscle testing.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in knee joint proprioception
Knee proprioception will be assessed using the active joint repositioning test at 30° and 60° knee flexion, with the absolute difference between the target and reproduced angles recorded.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in kinesiophobia
Kinesiophobia will be assessed using the 17-item Turkish version of the Tampa Scale for Kinesiophobia. Each item will be scored using a 4-point Likert scale ranging from 1 to 4.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in Timed Up and Go Test performance
Gait, balance, and functional mobility will be assessed using the Timed Up and Go Test. The patient will be asked to stand up from a chair, walk 3 meters, turn around, and sit back down. The completion time will be recorded in seconds.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in Five Times Sit-to-Stand Test performance
Lower-extremity strength, balance, and functional level will be assessed using the Five Times Sit-to-Stand Test. The patient will be asked to stand up and sit down five times as quickly and safely as possible, and the completion time will be recorded in seconds.
Time frame: From enrollment to the end of the 14-week period
Change from baseline at week 14 in Hospital for Special Surgery Knee Score
Knee function will be assessed using the Hospital for Special Surgery Knee Score. The Hospital for Special Surgery (HSS) Knee Score will be rated on a 0-100-point scale, with scores of ≥85 indicating excellent, 70-84 good, 60-69 moderate, and ≤59 poor knee function.
Time frame: From enrollment to the end of the 14-week period
Plan to share: No — Individual participant data will not be shared because the study does not plan to make individual-level participant data available to other researchers.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Dokuz Eylul University