EFFECTS OF ADDING BIOFEEDBACK TRAINING TO ACTIVE EXERCISES AFTER TOTAL KNEE ARTHROPLASTY

2014 ◽  
Vol 17 (01) ◽  
pp. 1450001 ◽  
Author(s):  
Al-Sayed A. Shanb ◽  
Enas F. Youssef
Keyword(s):  
Total Knee Arthroplasty ◽  
Exercise Training ◽  
Training Program ◽  
Knee Arthroplasty ◽  
Functional Activity ◽  
Peak Torque ◽  
Biofeedback Training ◽  
Voluntary Activation ◽  
Exercise Training Program ◽  
Total Knee

The purpose of this study was to evaluate the effects of adding biofeedback training to active exercise training on quadriceps torque, voluntary activation and functional activity after total knee arthroplasty (TKA). A total of 45 patients with unilateral TKA participated in this study; their ages ranged from 58 to 67 years. They were assigned randomly to two groups. Group I comprised 21 patients who practiced an active exercise training program for 30 to 45 min/session, two sessions/week, for 4 months. Group II contained 24 patients who practiced biofeedback training in addition to the active exercise training program for 30 to 45 min/session, two sessions/week, for 4 months. Isometric peak torque of the quadriceps, voluntary activation and knee functional activity were measured. The results revealed significant improvements in quadriceps torque, voluntary activation and knee functional activity for both groups, with more improvement in knee functional activities in group II. There were nonsignificant differences between the two groups in both quadriceps peak torque and voluntary activation after training (p > 0.05). Conclusion: An active exercise program can enhance quadriceps peak torque, voluntary activation and knee functional activity after unilateral TKA. The addition of biofeedback training increases the benefits for the knee functional activity of a patient.

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

2020 ◽  
Author(s):  
Omer Ayik ◽  
Mehmet Demirel ◽  
Fevzi Birisik ◽  
Ali Ersen ◽  
Halil I. Balci ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Peak Torque ◽  
Thigh Muscle ◽  
Controlled Study ◽  
Total Work ◽  
Isokinetic Muscle Strength ◽  
Total Knee

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

Total Infrapatellar Fat Pad Excision Leads to Worse Isokinetic Performance in Total Knee Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Deniz Cankaya ◽  
Sefa Akti ◽  
Niyazi Erdem Yasar ◽  
Dilek Karakus ◽  
Kazim Onur Unal ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Peak Torque ◽  
Infrapatellar Fat Pad ◽  
Controlled Study ◽  
Fat Pad ◽  
Randomized Controlled ◽  
Total Knee ◽  
Isokinetic Performance ◽  
Partial Excision

AbstractThere are concerns that total infrapatellar fat pad (IPFP) excision in total knee arthroplasty (TKA) results in patellar tendon shortening due to ischemic contracture, but individual preference of the surgeon is still the main determinant between total or partial excision. The aim of this randomized controlled study was to compare isokinetic performance and clinical outcome of TKAs with total and partial excision of the IPFP. Seventy-two patients scheduled to undergo TKA for primary knee osteoarthritis by a single surgeon were randomly assigned to either total or partial excision group. Patients were evaluated preoperatively and at postoperative 1 year, with Knee Society Score (KSS) and isokinetic measurements. The physiatrist performing isokinetic tests and patients were blinded to the study. There were no significant differences between the groups in respect of age, body mass index, gender, and preoperative KSS and isokinetic performance. Postoperatively, both groups had improved KSS knee and KSS function scores, with no difference determined. Knee extension peak torque was significantly higher postoperatively in the partial excision group at postoperative 1 year (p = 0.036). However, there were no significant differences in knee flexion peak torque following TKA (p = 0.649). The results of this study demonstrated that total excision of the IPFP during TKA is associated with worse isokinetic performance, which is most likely due to changes in the knee biomechanics with the development of patella baja. Partial excision of the IPFP appears to be a valid alternative to overcome this potential detrimental effect without impeding exposure to the lateral compartment. This is a Level I, therapeutic study.

scholarly journals Voluntary Activation and Decreased Force Production of the Quadriceps Femoris Muscle After Total Knee Arthroplasty

2003 ◽  
Vol 83 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Ryan L Mizner ◽  
Jennifer E Stevens ◽  
Lynn Snyder-Mackler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Force Production ◽  
Knee Extension ◽  
Quadriceps Femoris ◽  
Voluntary Activation ◽  
Quadriceps Femoris Muscle ◽  
Extension Force ◽  
Total Knee ◽  
Femoris Muscle

Abstract Background and Purpose. Quadriceps femoris muscle weakness as manifested by a decrease in force-generating capability is a persistent problem after total knee arthroplasty (TKA). The authors hypothesized that (1) patients with a TKA would have decreased quadriceps femoris muscle performance (weakness) and impaired volitional activation when compared with a group of older adults without knee pathology, (2) pain and age would account for a large portion of the variability in volitional activation after surgery, and (3) volitional activation in the TKA group would account for a large portion of the variability in force production. Subjects. Comparison subjects were 52 volunteers (mean age=72.2 years, SD=5.34, range=64–85). The TKA group comprised 52 patients (mean age=64.9 years, SD=7.72, range=49–78) with a diagnosis of osteoarthritis who had undergone a tricompartmental, cemented TKA. Methods. Knee extension force was measured using a burst superimposition technique, where a supramaximal burst of electrical stimulation was superimposed on a maximal voluntary isometric contraction (MVIC). The amount of failure of volitional activation is determined by the amount of electrical augmentation of force beyond a person's MVIC at the instant of the application of the electrical burst. Results. The average normalized knee extension force of the TKA group was 64% lower than that of the comparison group. The average volitional activation deficit in the TKA group (26%) was 4 times as great as the comparison group's deficit (6%). Age did not correlate with quadriceps femoris muscle activation, and knee pain explained only a small portion of the variance in knee extension force (r2=.17). Volitional activation was highly correlated with knee extension force production (r2=.65). Discussion and Conclusion. Considerable quadriceps femoris muscle inhibition after surgery has several implications for recovery. Rehabilitation programs that focus on volitional exercise alone are unlikely to overcome this pronounced failure of activation. Early interventions focused at improving quadriceps femoris muscle voluntary activation may improve efforts to restore muscle force.

scholarly journals Effects of Preoperative Telerehabilitation on Muscle Strength, Range of Motion, and Functional Outcomes in Candidates for Total Knee Arthroplasty: A Single-Blind Randomized Controlled Trial

2021 ◽  
Vol 18 (11) ◽  
pp. 6071
Author(s):  
Jung-Ae An ◽  
Ho-Kwang Ryu ◽  
Suk-Joo Lyu ◽  
Hyuk-Jong Yi ◽  
Byoung-Hee Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Peak Torque ◽  
Test Time ◽  
Control Group ◽  
Womac Pain ◽  
Total Knee

This study aims to investigate the effect of a preoperative telerehabilitation (PT) program on muscle strength, knee range of motion (ROM), and functional outcomes in candidates for total knee arthroplasty (TKA). Sixty patients (all women, mean age 70.53 ± 2.7 years) scheduled for bilateral TKA participated in this study. The PT and preoperative patient education (PE) groups participated in a 3-week intensive exercise program (30 min/session, 2 times/day, 5 days/week), whereas the control group received the usual care before TKA. Quadriceps muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), ROM of knee flexion, pain, and time up-and-go (TUG) test time were evaluated at 4 weeks preoperatively, post-interventionally, and 6 weeks after TKA. Significant differences were found in the time-by-group interaction for 60°/s extension peak torque [F(4, 100) = 2.499, p < 0.047, η2p = 0.91], 180°/s extension peak torque [F(4, 100) = 3.583, p < 0.009, η2p = 0.125], ROM [F(4, 100) = 4.689, p < 0.002, η2p = 0.158], TUG time [F(4, 100) = 7.252, p < 0.001, η2p = 0.225], WOMAC pain [F(4, 100) = 9.113, p < 0.001, η2p = 0.267], WOMAC functional outcome [F(4, 100) = 6.579, p < 0.001, η2p = 0.208], and WOMAC total score [F(4, 100) = 10.410, p < 0.001, η2p = 0.294]. The results of this study demonstrate the early benefits of a PT program in elderly female patients with end-stage osteoarthritis. The PT program improved muscle strength, ROM, and functional outcomes before TKA, which contributed to better functional recovery after TKA.

scholarly journals Intraoperative Midflexion Medial Laxity Affects Patient Expectations Following Total Knee Arthroplasty

2021 ◽  
Author(s):  
Masahiro Hasegawa ◽  
Shine Tone ◽  
Yohei Naito ◽  
Akihiro Sudo
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Functional Activity ◽  
Outcome Measure ◽  
Patient Expectations ◽  
Affected Patient ◽  
Posterior Stabilized ◽  
Total Knee ◽  
The Mean

Abstract Background: Patient satisfaction and expectations are now recognized as an outcome measure for successful total knee arthroplasty (TKA). The purpose of this study was to determine which factors including soft tissue balance during surgery affect patient satisfaction and expectations after TKA.Methods: A total of 135 patients (157 knees) with knee osteoarthritis who underwent primary TKA with a posterior stabilized design were studied. After implantation of all components, varus/valgus laxity of the knee was measured intraoperatively with the knee at 0°, 30°, 60°, 90°, and 120° guided by an image-free navigation system. Factors that affected patient satisfaction and expectations, including lateral and medial laxities, were evaluated using the 2011 Knee Society score.Results: The mean intraoperative lateral laxity was 1.1°, 1.6°, 0.9°, 1.3°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. The mean intraoperative medial laxity was 1.1°, 1.4°, 1.1°, 1.1°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. Patient satisfaction after TKA correlated positively with symptom (R = 0.61, P < 0.01) and functional activity (R = 0.47, P < 0.01) scores. Patient expectations after TKA correlated positively with symptom (R = 0.29, P < 0.01) and functional activity (R = 0.20, P = 0.01) scores, and negatively with medial laxity at 30° (R = -0.21, P < 0.01).Conclusion: Midflexion medial laxity was associated with worse patient expectations after TKA. Avoiding medial laxity could be one of the important techniques during TKA.

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