Land-Based Versus Pool-Based Exercise for People Awaiting Joint Replacement Surgery of the Hip or Knee: Results of a Randomized Controlled Trial

Gill, Stephen D.; McBurney, Helen; Schulz, Debra L.

doi:10.1016/j.apmr.2008.09.561

Cited by 59 publications

(78 citation statements)

References 24 publications

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“…However, the available systems are not optimal since harness systems may not be used over prolonged periods of time due to discomfort and impeded circulation. Movements in deep water may help to maintain the aerobic fitness, but the neuromuscular training and the movement pattern are very different from normal movements, as the forces applied to the body in water differ significantly from the forces during overground movements (eg, [20][21][22] ). Ambulation in a LBPP chamber may be beneficial not only for early mobilization after injury and surgery, 23 but also as a motor evaluation and learning tool for neuromuscular patients, as motor control can be challenged systematically.…”

Section: Discussionmentioning

confidence: 99%

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Jensen

Hovgaard-Hansen²,

Cappelen³

2016

Journal of Applied Biomechanics

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Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMG peak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle). It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force. Keywords: rehabilitation, body weight support, EMG, estimated joint load, runningEarly mobilization after injury and surgery on the lower extremities is essential to reduce adverse effects of immobilization and to facilitate rehabilitation. Walking or running with weight support on a lower-body positive-pressure (LBPP) treadmill is a new training and rehabilitation modality. 1,2 A recent study indicated strong correlation between tibiofemoral force and treadmill ground reaction force in a small group of elderly patients during slow walking. 3 Another study showed that runners can reduce peak vertical ground reaction forces while maintaining the aerobic stimulus when running on a LBPP treadmill. 4 Even training at high speeds and high aerobic stimuli with the benefit of low vertical ground reaction force and near-normal movement pattern can be performed on the LBPP treadmill. 5 Furthermore, no adverse impact on systemic and head cardiovascular parameters has been found. 6 However, the effect of different levels of LBPP weight support during running on neuromuscular adaptations and their possible associations to joint forces have not been studied systematically.During level running, leg muscles support body weight (BW) against gravity and accelerate/decelerate the body mass in a forward direction. BW, as measured in Newton, is directly related to gravity, while body mass (kg) is independent of gravity. Therefore, by unweighting in a LBPP chamber, it is possible to create a new biomechanical environment where the vertical forces are reduced while forces associated with horizontal acceleration/deceleration of the body remain unchanged. This allows systematic study of individual leg muscle contribution to body support against grav...

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Section: Discussionmentioning

confidence: 99%

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Jensen

Hovgaard-Hansen²,

Cappelen³

2016

Journal of Applied Biomechanics

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“…The problems connected with hydrotherapy are cost and organisation. Hydrotherapy seems to be a better treatment than land-kinesis, because pain, stiffness and function impairment emerged as significantly lower and it had a positive influence on social behaviour and mood [40][41][42][43][44].…”

Section: Hydrotherapymentioning

confidence: 99%

“…A randomized single blind controlled trial, conducted in 2009, compared land-based versus pool-based exercise in people awaiting joint replacement surgery (land-based group, 40 patients: 23 total knee and 17 total hip arthroplasty; pool-based group 42 patients: 24 total knee and 18 total hip arthroplasty) [41]. One group underwent a sixweek program comprising education, twice-weekly land-based exercise classes; the other group were given pool-based exercises and an occupational therapy home assessment.…”

Section: Hydrotherapymentioning

confidence: 99%

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

Aless¹,

Bistolfi²,

Federico³

et al. 2016

Int J Phys Med Rehabil

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This review focuses on the validity and the effectiveness of rehabilitation techniques and physical therapies before and after total knee arthroplasty (TKA). The intent is to drive surgeons and rehabilitation specialists in the choice of the strategies for the treatment after TKA. The Data sources were MEDLINE, PubMed, CINAHL, EMBASE, and PsychINFO databases using the selected key words. Three authors independently selected studies for review using as criteria English, adults, any clinical population, and intervention for. Among several published studies of rehabilitation after TKA, only a few were based on scientific evidence. Moreover, many studies were heterogeneous and included different outcomes and evaluations. There is consensus that a complete and specific rehabilitation post-operative programme is effective in reducing the length of hospitalisation and the incidence of early complications. However, it is not clear what "complete and specific rehabilitation" may mean: the real efficacy of every specific treatment (continuous passive motion, cryotherapy, magneto therapy, neuro muscular electrical stimulation, whole body vibration, hydrotherapy, pre-operative physiotherapy) is still questionable, and often related to the experience of the authors. In conclusion, patients undergoing physiotherapy obtain a better and faster outcome achievement than non-treated patients; however, evidence-based treatments, protocols and clinical trials are recommended.

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“…[19] Aquatic exercises were not deemed to be superior when compared with other types of exercises, but they might be preferred due to less pain occurring after exercise. [20] According to the results of an RCT which compared the effects of loading and non-loading exercises, simple flexionextension exercises for an eight-week period provided significant functional improvement for patients using either type of exercises; however, the beneficial effect in position sensation was shown only in the group doing the loading exercises (LOE Ib). [21] In another RCT, simple strengthening exercises designed as a home program provided significant pain relief and functional improvement in long-term follow-up.…”

Section: Non-pharmacologic Treatmentmentioning

confidence: 99%

Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism

et al. 2012

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Amaç: Diz osteoartriti (OA) sık görülen ve neden olduğu ağrı ve sakatlık sonucunda sosyoekonomik yük bindiren bir hastalıktır. Türkiye Romatizma Araştırma ve Savaş Derneği (TRASD) OA tedavisi ile uğraşan hekimlere günlük klinik uygulamalarında yardımcı olmak amacıyla, uzman görüşleri ile desteklenmiş, ulusal "diz osteoartrit tedavisinde kanıta dayalı önerileri" hazırlamak için bir proje başlatmıştır. Objectives: Knee osteoarthritis (OA) is a common disease which causes pain, disability and great socioeconomic burden as a result. Turkish League Against Rheumatism (TLAR) initiated a project to prepare national, "evidence-based recommendations for the management of knee osteoarthritis" supported by expertopinion in order to assist the physicians who are interested in knee OA in their daily clinical practice. Gereç ve yöntemler: Materials and methods:The expert committee was composed of 25 academicians, 23 of whom were physical medicine and rehabilitation (PM&R) specialists (three also had rheumatology subspeciality) and two were orthopedic surgeons. At the first meeting, the previous guidelines were discussed, and 2008 Osteoarthritis Research Society International (OARSI) recommendations were decided to be taken as the fundamental template for national recommendations. Databases of the Pubmed, Embase, Cochrane, and Turkish Medical Index were used to search the literature, and this was carried out for the period between 2009-2010 for international publications since studies up to 2009 were present in the 2010 OARSI update. No limit was applied for searching of national publications. The selected relevant publications were graded according to evidence level and quality, and were sent to the members who were then asked to suggest propositions according to their experiences, knowledge, and review of the literature. After amalgamation and editing of new proposals, Delphi rounds were started. After five Delphi rounds, the propositions on which the members were in consensus, were discussed with regard to evidence and the "strength of recommendation" was determined by measuring on visual analog scale (VAS) for each proposal at the final meeting.Results: Nineteen propositions (one for general principles, nine for nonpharmacologic treatments, seven for pharmacologic treatments, and two for surgical treatments) were accepted as the "TLAR Evidence-Based Recommendations for the Management of Knee OA" in consensus as a result of Delphi rounds. Conclusion:Evidence-based recommendations for the management of knee OA were developed by TLAR for the first time in our country. The recommendations should be updated regularly according to new evidence and insights. It is expected that physicians who are interested in knee OA will benefit greatly from this report in their daily clinical practice.

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Land-Based Versus Pool-Based Exercise for People Awaiting Joint Replacement Surgery of the Hip or Knee: Results of a Randomized Controlled Trial

Cited by 59 publications

References 24 publications

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Rehabilitation and Physical Therapy before and after Total Knee Arthroplasty: A Literature Review and Unanswered Questions

Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism

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