Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection

Journal of Experimental Orthopaedics

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[1] 0000 0000 9531 3915, grid.418079.3, National Research Centre for the Working Environment, Copenhagen, Denmark;0000 0000 9531 3915, grid.418079.3, National Research Centre for the Working Environment, Copenhagen, Denmark;0000 0001 0742 471X, grid.5117.2, Sport Sciences, Department of Health Science and Technology, Aalborg University, Copenhagen, Denmark;0000 0004 0646 7373, grid.4973.9, Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen University Hospital, Hvidovre, Denmark;0000 0001 0674 042X, grid.5254.6, Section for Surgical Pathophysiology 7621, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;0000 0004 0646 7373, grid.4973.9, Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen University Hospital, Hvidovre, Denmark;0000 0004 0646 7373, grid.4973.9, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark;0000 0004 0646 7373, grid.4973.9, Physical Medicine & Rehabilitation Research – Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark;0000 0004 0646 7373, grid.4973.9, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark;Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark;0000 0004 0646 7373, grid.4973.9, Physical Medicine & Rehabilitation Research – Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark;0000 0004 0646 7373, grid.4973.9, Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen University Hospital, Hvidovre, Denmark;Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark;Section for Orthopaedic and Sports Rehabilitation (SOS-R), Health Centre Nørrebro, City of Copenhagen, Copenhagen, Denmark;

关键词: Total knee arthroplasty;    Strength training;    Electromyography;    Rehabilitation;    Exercise;   

DOI  :  10.1186/s40634-019-0193-5

来源: publisher

【 摘 要 】

BackgroundIn the early phase after a total knee arthroplasty (TKA), patients experience multi-level weakness in the operated leg, which is caused primarily by reduced central nervous system (CNS) activation failure of the muscles - especially the knee extensors (quadriceps muscle). Whether similar levels of neuromuscular activity of the muscles in the operated leg, elicited during strength training exercises in machines, can be reached during strength training exercises in more simple forms is unknown. Many clinicians are faced with the problem of not having strength training equipment at their institution or having to prescribe simple strength training exercises for home-based training. Therefore, the purpose of this study was to determine which strength training exercises that activated the muscles in the operated leg the most after TKA. The hypothesis was that strength training exercises performed in machines would elicit higher levels of voluntary peak quadriceps and hamstring muscle activity than strength training exercises performed in more simple forms, using elastic bands or the patients’ own body weight.MethodsA cross-sectional electromyographic study investigated voluntary peak muscle activity in the operated leg during 6 different strength training exercises. Twenty-four patients, who received a TKA 4 to 8 weeks earlier, performed the exercises in a randomized order, using a pre-determined loading of 10 RM (repetition maximum). Voluntary peak muscle activity (%EMGmax) was calculated for the quadriceps and hamstring muscles for each exercise.ResultsKnee extensions with elastic band showed significantly higher voluntary peak quadriceps muscle activity than knee extensions in machine (93.3 vs. 74.9; mean difference, 18.3 %EMGmax [95% confidence interval (CI), 11.7 to 24.9]; P < 0.0001). Similarly, one-legged squat (and sit to stand) elicited higher voluntary peak quadriceps muscle activity than leg press in machine (86.7 vs. 66.8; mean difference, 19.9 %EMGmax [95% CI, 14.8 to 25.0]; P < 0.0001).ConclusionsStrength training exercises in more simple forms elicited higher voluntary peak quadriceps muscle activity than strength training exercises in machines early after TKA. Consequently, simple home-based strength training exercises using e.g. elastic bands or the patients’ own bodyweight should be considered to alleviate muscle strength losses early after TKA.Trial registrationClinicalTrials.gov identifier: NCT01708980.

【 授权许可】

CC BY