Performance on a Clinical Quadriceps Activation Battery Is Related to a Laboratory Measure of Activation and Recovery After Total Knee Arthroplasty

Bade, Michael; Struessel, Tamara; Paxton, Roger; Winters, Joshua D.; Baym, Carol; Stevens-Lapsley, Jennifer E.

doi:10.1016/j.apmr.2017.07.013

Cited by 8 publications

(7 citation statements)

References 30 publications

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“…However, one month post-surgery, the relative contribution of VA was nearly twice as large compared to the relative contribution of muscle atrophy to the observed MVS decrease ( 48 ). Similar trends were also observed in two more recent studies ( 91 , 92 ), suggesting that an early rehabilitation program should particularly focus on the recovery of VA deficit to attenuate the detrimental loss of muscle strength ( 93 , 94 ).…”

Section: Discussionsupporting

confidence: 80%

The Time Course of Quadriceps Strength Recovery After Total Knee Arthroplasty Is Influenced by Body Mass Index, Sex, and Age of Patients: Systematic Review and Meta-Analysis

2022

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IntroductionFor patients with osteoarthritis who have undergone total knee arthroplasty (TKA), quadriceps strength is a major determinant of general physical function regardless of the parameters adopted for functional assessment. Understanding the time course of quadriceps strength recovery and effectiveness of different rehabilitation protocols is a must. Therefore, the aim of this study was to: (i) determine the magnitude of maximal voluntary strength (MVS) loss and the time course of recovery of the quadriceps muscle following TKA, (ii) identify potential moderators of strength outcomes, and (iii) investigate whether different rehabilitation practices can moderate the strength outcomes following TKA, respectively.DesignGeneral scientific databases and relevant journals in the field of orthopedics were searched, identifying prospective studies that investigated quadriceps’ MVS pre-to post-surgery.ResultsSeventeen studies with a total of 832 patients (39% males) were included. Results showed that in the early post-operative days, the involved quadriceps’ MVS markedly declined, after which it slowly recovered over time in a linear fashion. Thus, the greatest decline of the MVS was observed 3 days after TKA. When compared to pre-operative values, the MVS was still significantly lower 3 months after TKA and did not fully recover up to 6 months following TKA. Furthermore, a meta-regression analysis identified that the variables, time point of evaluation, patient age, sex, and BMI, significantly moderate the MVS of the quadriceps muscle.ConclusionThe analyzed literature data showed that the decrease in strength of the involved quadriceps muscles following TKA is considerable and lasts for several months post-surgery. Therefore, we recommend to specifically target the strengthening of knee extensor muscles, preserve motor control, and apply appropriate nutrition to ensure a holistic quadriceps muscle recovery. Since age, sex, and BMI were found to be moderating factors in patients’ recovery, further research should include specific analyses considering these moderators.

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Section: Discussionsupporting

confidence: 80%

The Time Course of Quadriceps Strength Recovery After Total Knee Arthroplasty Is Influenced by Body Mass Index, Sex, and Age of Patients: Systematic Review and Meta-Analysis

2022

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“…Independence level in these functional activities representing the success of TKA is accepted as milestones of the clinical evaluation to determine overall independence. 35,36 Adequate quadriceps strength is needed to perform these functional tasks. However, immediately after TKA, quadriceps strength loss is greatest (by 60%) and strongly related to decreased functional performance.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies underlined the importance of assessing functional tasks such as ambulation, rise from a chair, or stair climbing for patients with TKA. Independence level in these functional activities representing the success of TKA is accepted as milestones of the clinical evaluation to determine overall independence 35,36 . Adequate quadriceps strength is needed to perform these functional tasks.…”

Section: Discussionmentioning

confidence: 99%

Hand-Held Dynamometry in the Inpatient Care Setting After Total Knee Arthroplasty

Eymir

Yüksel

Ünver

et al. 2021

Am J Phys Med Rehabil

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Objective The aim of the study was to determine intrarater and interrater reliabilities for static strength assessment of knee flexors and knee extensors in patients with total knee arthroplasty, during the acute postoperative rehabilitation. Design Forty-five total knee arthroplasty patients were included in the study. Two physical therapists performed strength assessments by using hand-held dynamometry. Patients performed three trials and a 30-sec rest was provided between each trial. After this, a 5-min rest was provided, and then, a second investigator performed the same procedure for interrater reliability. Assessments for intrarater reliability were performed 1 hr later. Results The intrarater reliability of knee extensors and knee flexors strength measurements were 0.96 and 0.94, respectively. The standard error of measurement and minimal detectable change 95% confidence level were 6.17 and 17.01 Nm for knee extensors and were 8.89 and 24.51 Nm for knee flexors, respectively. The interrater reliability of knee flexors and knee extensors strength measurement was 0.96 for both. The standard error of measurement and minimal detectable change values at 95% confidence level were 6.00 and 16.54 Nm for knee extensors and were 6.32 and 17.42 Nm for knee flexors, respectively. Conclusions Hand-held dynamometry is a reliable method to assess static knee strength. Hand-held dynamometry assessment can be implemented during acute postoperative rehabilitation. Our results may assist the clinicians in determining an accurate postoperative rehabilitation program after total knee arthroplasty surgery.

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“…Direct measures of AMI that are commonly used in research settings include the interpolated twitch technique, or burst superimposition [ 6 ]. Indirect measures of AMI include measuring voluntary force output of the quadriceps via dynamometry or a clinical battery of quadriceps activation [ 17 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The past and future of peri-operative interventions to reduce arthrogenic quadriceps muscle inhibition after total knee arthroplasty: A narrative review

Churchill,

John Bade,

Koonce

et al. 2024

Osteoarthritis and Cartilage Open

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Performance on a Clinical Quadriceps Activation Battery Is Related to a Laboratory Measure of Activation and Recovery After Total Knee Arthroplasty

Cited by 8 publications

References 30 publications

The Time Course of Quadriceps Strength Recovery After Total Knee Arthroplasty Is Influenced by Body Mass Index, Sex, and Age of Patients: Systematic Review and Meta-Analysis

The Time Course of Quadriceps Strength Recovery After Total Knee Arthroplasty Is Influenced by Body Mass Index, Sex, and Age of Patients: Systematic Review and Meta-Analysis

Hand-Held Dynamometry in the Inpatient Care Setting After Total Knee Arthroplasty

The past and future of peri-operative interventions to reduce arthrogenic quadriceps muscle inhibition after total knee arthroplasty: A narrative review

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