Assessment of quadriceps muscle weakness in patients after total knee arthroplasty and total hip arthroplasty: Methodological issues

Lauermann, S.P.; Lienhard, Karin; Item-Glatthorn, Julia F.; Casartelli, Nicola C.; Maffiuletti, Nicola A.

doi:10.1016/j.jelekin.2013.10.018

Cited by 17 publications

(18 citation statements)

References 30 publications

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“…Four months after the surgery, isokinetic torque and isometric strength measurements were performed using a Cybex 350 isokinetic dynamometer. The bilateral quadriceps and hamstring muscle strengths were measured at 4 months after surgery; our time frame was similar to Lauermann et al 14 ) . Patients were seated on the dynamometer chair (Cybex 350) with a trunk-thigh angle of 90°.…”

Section: Methodsmentioning

confidence: 95%

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Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty

2015

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[Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term.

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Section: Methodsmentioning

confidence: 95%

“…Lauermann et al asserted that open chain mono-articular testing may not reflect functional activities of living 14 ) . In agreement with this, the results of the present study demonstrate increased ROM and accelerated functional recovery without change in peak isokinetic torque.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty

2015

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“…As a classification for asymmetry deficits in TKA patients, a threshold between 10% and 20% was determined for abnormal/pathological muscle weakness, provided the NOP leg is asymptomatic and not affected by osteoarthritis (Lauermann et al., ). In the present study, at baseline, the highest AI was found during isokinetic and isometric knee extension strength tests in the IG with a higher force or torque in the NOP leg by 13% and 14%, respectively, compared with the OP leg.…”

Section: Discussionmentioning

confidence: 99%

Alpine Skiing With total knee ArthroPlasty (ASWAP): effects on strength and cardiorespiratory fitness

Pötzelsberger

Stöggl

Lindinger

et al. 2015

Scandinavian Med Sci Sports

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This study investigated the effect of a 12-week recreational skiing intervention on lower limb muscle strength and cardiorespiratory fitness in participants with unilateral total knee arthroplasty (TKA). Twenty-seven older adults (70 ± 5 years) were assigned to the intervention (n = 13) or control group (n = 14) after surgery (2.5 ± 1 years). Leg muscle strength was measured using an IsoMed 2000 dynamometer and cardiorespiratory fitness was determined by cycle ergometry before and after the intervention as well as after an 8-week retention period. The skiing intervention led to increased muscle strength in the operated leg during unilateral single joint isometric extension (maximal force: 11%; P < 0.05; rate of torque development: 24%; P < 0.05) and during the unilateral multi-joint isokinetic single leg strength test (8%; P < 0.05). This resulted in a decreased asymmetry index in the isokinetic test (13% to 5%; P < 0.05). These adaptations remained unchanged toward the retention test. No effect was observed for cardiorespiratory fitness. The results demonstrate that muscle contraction forces required during recreational skiing in individuals with TKA seem adequate and effective to increase quadriceps and hamstrings muscle strength in the initially weaker operated leg and to reduce an augmented post-operative asymmetry index.

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“…Isokinetic dynamometry is widely considered the standard for assessing muscle mechanical parameters [4][5][6][7][8]21]. To the best of our knowledge, only a few studies have been published on isokinetic dynamometry in patients undergoing total knee arthroplasty [4][5][6][7][8][9][10]. According to Berman et al [8], pioneers of TKR isokinetic studies in this particular field, quadriceps deficit persists 2 years after TKR, while flexion deficit subsides after one year.…”

Section: Discussionmentioning

confidence: 99%

“…Following TKR, function is mainly affected by quadriceps weakness, which is usually not resolved even years after surgery, so characterization of post surgical quadriceps weakness is of paramount importance in orthopaedic and rehabilitation practice. Isokinetic dynamometry is an effective method for documenting post-TKR strength with objective, quantitative parameters in an accurate reliable and reproducible way [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The association of WOMAC, HSS and isokinetic strength and fatigue of knee muscles in people with osteoarthritis following total knee replacement

Tutté

Avellanet

Valero

et al. 2015

IES

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BACKGROUND: Osteoarthritis (OA) is the most prevalent joint pathology and an important cause of disability among people over 65 years of age. Following total knee replacement (TKR), which may be the only curative intervention, function is mainly affected by quadriceps weakness whose extent can accurately be assessed using isokinetic dynamometry. AIM: To evaluate the association between the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Hospital for Special Surgery Score (HSS) scores and knee muscle isokinetic strength and fatigue findings in TKR patients 2-5 years postoperatively as well as assess the reproducibility and validity of the isokinetic test findings in this cohort. DESIGN: Twenty-four women who underwent TKR filled in the WOMAC and HSS questionnaires. The isokinetic test was carried out at 120 and 180 • /s in concentric flexion/extension. The maximal isokinetic strength was evaluated as the peak torque (PT). Isokinetic fatigue was measured using the fatigue index and calculated based on 40 repetitions at 120 • /s. The same protocol was performed 7 days apart. Test-retest reproducibility was analyzed using intraclass correlation coefficient (ICC), the standard error of measurement (SEM) and Bland Altman plots. HSS and WOMAC internal consistency was tested with Cronbach's alpha; questionnaire validity and correlations were obtained using Spearman's rho. RESULTS: The HSS Function sub-score was significantly correlated with quadriceps PT but not with fatigue isokinetic scores. Excellent reproducibility was indicated for all outcome measures, with the exception of the HSS Knee subscore and the fatigue index. CONCLUSIONS: Isokinetic dynamometry of the quadriceps can provide objective and useful information regarding the functional status of patients following TKR due to OA of the knee.

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Assessment of quadriceps muscle weakness in patients after total knee arthroplasty and total hip arthroplasty: Methodological issues

Cited by 17 publications

References 30 publications

Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty

Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty

Alpine Skiing With total knee ArthroPlasty (ASWAP): effects on strength and cardiorespiratory fitness

The association of WOMAC, HSS and isokinetic strength and fatigue of knee muscles in people with osteoarthritis following total knee replacement

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