Validity and reliability of isometric, isokinetic and isoinertial modalities for the assessment of quadriceps muscle strength in patients with total knee arthroplasty

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

doi:10.1016/j.jelekin.2013.09.004

Cited by 53 publications

(55 citation statements)

References 27 publications

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“…Validity and reliability are paramount in strength assessment [49, 50]. One of the biggest concerns in investigations that involve sensible strength variables such as RTD is to ensure proper placement and fixation of the subjects on the strength measuring device [29], as well as the maintenance of the exact same testing conditions.…”

Section: Discussionmentioning

confidence: 99%

Postactivation Potentiation Biases Maximal Isometric Strength Assessment

Lima

Oliveira

et al. 2014

BioMed Research International

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Postactivation potentiation (PAP) is known to enhance force production. Maximal isometric strength assessment protocols usually consist of two or more maximal voluntary isometric contractions (MVCs). The objective of this study was to determine if PAP would influence isometric strength assessment. Healthy male volunteers (n = 23) performed two five-second MVCs separated by a 180-seconds interval. Changes in isometric peak torque (IPT), time to achieve it (tPTI), contractile impulse (CI), root mean square of the electromyographic signal during PTI (RMS), and rate of torque development (RTD), in different intervals, were measured. Significant increases in IPT (240.6 ± 55.7 N·m versus 248.9 ± 55.1 N·m), RTD (746 ± 152 N·m·s−1 versus 727 ± 158 N·m·s−1), and RMS (59.1 ± 12.2% RMSMAX versus 54.8 ± 9.4% RMSMAX) were found on the second MVC. tPTI decreased significantly on the second MVC (2373 ± 1200 ms versus 2784 ± 1226 ms). We conclude that a first MVC leads to PAP that elicits significant enhancements in strength-related variables of a second MVC performed 180 seconds later. If disconsidered, this phenomenon might bias maximal isometric strength assessment, overestimating some of these variables.

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Section: Discussionmentioning

confidence: 99%

Postactivation Potentiation Biases Maximal Isometric Strength Assessment

Lima

Oliveira

et al. 2014

BioMed Research International

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“…The 1 load of the involved quadriceps was recorded in pounds (absolute quadriceps strength) and normalized as a percentage of body weight (BW; % pounds/BW) (normalized quadriceps strength). For the isoinertial quadriceps strength measures, one recent study in 29 patients with TKA has demonstrated excellent test-retest reliability (ICC 0.95; standard error of the measurement 6 pounds) and convergent validity with habitual gait speed (r 5 0.64) (21).…”

Section: Methodsmentioning

confidence: 99%

Sex Differences and Impact of Body Mass Index on the Time Course of Knee Range of Motion, Knee Strength, and Gait Speed After Total Knee Arthroplasty

Pua

Seah

Seet

et al. 2015

Arthritis Care & Research

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Objective. Quadriceps strength deficits and gait speed limitations remain significant issues after total knee arthroplasty (TKA), yet detailed longitudinal data characterizing these measures and their predictors are limited. This study aimed to describe the time course of knee range of motion, quadriceps strength, and gait speed post-TKA, and to assess whether sex and body mass index (BMI) influenced the time recovery of these measures. Methods. A total of 1,025 patients (mean 6 SD age 67 6 8 years) undergoing primary TKA participated. At 4-, 8-, 12-, and 16-weeks postsurgery, knee range of motion, quadriceps strength, and gait speed were quantified. The associations of the knee and gait measures profile over time with sex and BMI were assessed using generalized least squares modeling. Results. The various knee and gait measures improved nonlinearly over time, with substantial improvements observed in the first 8-10 weeks postsurgery. Sex and BMI influenced the time course of quadriceps strength (P < 0.001 for all interactions): improvements in quadriceps strength over time were slower in women and in patients with higher BMI. Post-TKA gait speed was consistently lower in women than in men, while BMI was negatively and nonlinearly related to gait speed. Conclusion. Although the various knee and gait measures improved over time, women and patients with higher BMI had poorer functional outcomes. The present study highlights the need for a mechanistic understanding of the results and targeted management of these patient subgroups.

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“…In addition, hamstring-quadriceps ratios were calculated from the isometric peak torques. Isometric muscle strength evaluation has been reported as a valid and reliable assessment in TKA patients (Lienhard et al 2013). …”

Section: Methodsmentioning

confidence: 99%

Moderate varus/valgus malalignment after total knee arthroplasty has little effect on knee function or muscle strength

Stučinskas¹,

Robertsson²,

Širka³

et al. 2015

Acta Orthopaedica

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Background and purpose — Postoperative muscle strength and component alignment are important factors affecting functional results after total knee arthroplasty (TKA). We are not aware of any studies that have investigated the relationship between them. We therefore investigated whether coronal malalignment of the mechanical axis and/or of individual implant components would affect knee muscle strength and function 1 year after TKA surgery.Patients and methods — We included 120 consecutive osteoarthritis (OA) patients admitted for TKA. Preoperative active range of motion (ROM) of the knee, patient age, sex, and BMI were recorded and the Knee Society score (KSS) and knee joint extensor/flexor muscle strength were assessed. At 1-year follow-up, the mechanical and coronal component alignment was measured from a postoperative long standing radiograph, and ROM, KSS, and muscle strength measurements were taken in 91 patients. Functional outcome and muscle strength measurements were compared between normally aligned and malaligned TKA groups.Results — 29 of 91 TKAs were malaligned, i.e. they deviated more than 3° from the neutral mechanical axis. 18 femoral components and 15 tibial components were malaligned. Before surgery, the malaligned and normally aligned groups were similar regarding sex distribution, BMI, ROM, KSS, and muscle strength. At the 1-year follow-up, the differences between the groups regarding knee joint function and muscle strength were small, not statistically significant, and barely clinically relevant.Interpretation — Moderate varus/valgus malalignment of the mechanical axis or of individual components has no relevant clinical effect on function or muscle strength 1 year after TKA surgery.

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Validity and reliability of isometric, isokinetic and isoinertial modalities for the assessment of quadriceps muscle strength in patients with total knee arthroplasty

Cited by 53 publications

References 27 publications

Postactivation Potentiation Biases Maximal Isometric Strength Assessment

Postactivation Potentiation Biases Maximal Isometric Strength Assessment

Sex Differences and Impact of Body Mass Index on the Time Course of Knee Range of Motion, Knee Strength, and Gait Speed After Total Knee Arthroplasty

Moderate varus/valgus malalignment after total knee arthroplasty has little effect on knee function or muscle strength

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