Exploratory insights into novel prehabilitative neuromuscular exercise-conditioning in total knee arthroplasty

Autor: Anna Maria Risso, Marietta L. van der Linden, Andrea Bailey, Peter Gallacher, Nigel Gleeson
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 23, Iss 1, Pp 1-11 (2022)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-022-05444-0
Popis: Abstract Background Contemporary strategies for prehabilitation and rehabilitation associated with total knee arthroplasty (TKA) surgery have focused on improving joint range-of-motion and function with less emphasis on neuromuscular performance beneficially affecting joint stability. Furthermore, prehabilitation protocols have been found to be too long and generic-in-effect to be considered suitable for routine clinical practice. Methods A pragmatic exploratory controlled trial was designed to investigate the efficacy of a novel, acute prehabilitative neuromuscular exercise-conditioning (APNEC) in patients electing TKA. Adults electing unilateral TKA were assessed and randomly allocated to exercise-conditioning (APNEC, n = 15) and usual care (Control, n = 14) from a specialised orthopaedic hospital, in the United Kingdom. APNEC prescribed nine stressful exercise-conditioning sessions for the knee extensors of the surgery leg, accrued over one week (3 sessions·week−1; 36 exercise repetitions in total; machine, gravity-loaded) and directly compared with usual care (no exercise). Prescribed exercise stress ranged between 60%—100% of participant’s daily voluntary strength capacity, encompassing purposefully brief muscular activations (≤ 1.5 s). Baseline and follow-up indices of neuromuscular performance focusing on muscle activation capacity (electromechanical delay [EMD], rate of force development [RFD] and peak force [PF]) were measured ipsilaterally using dynamometry and concomitant surface electromyography (m. rectus femoris[RF] and m. vastus lateralis[VL]). Results Group mean ipsilateral knee extensor muscular activation capacity (EMDRF [F(3,57) = 53.5; p
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