Highlights
- •The quadriceps activation battery (QAB) is the first clinical battery of tests shown to be related to recovery of activation, strength, and function after total knee arthroplasty (TKA).
- •Timing of assessment of the QAB is critical because patient performance on the QAB was most informative in the initial postoperative period (4d after surgery).
- •The QAB could be used to identify individuals who may need specific interventions such as neuromuscular electrical stimulation to target activation deficits or prolonged physical therapy intervention to achieve optimal results after TKA.
Abstract
Objective
Design
Setting
Participants
Main Outcome Measures
Results
Conclusions
Keywords
List of abbreviations:
6MWT (6-minute walk test), MVIC (maximum voluntary isometric contraction), NMES (neuromuscular electrical stimulation), OA (osteoarthritis), SCT (stair climbing test), TKA (total knee arthroplasty), TUG (Timed Up and Go)Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationReferences
- Most frequent operating room procedures performed in U.S. hospitals, 2003-2012.(Available at:)https://www.hcup-us.ahrq.gov/reports/statbriefs/sb186-Operating-Room-Procedures-United-States-2012.jspDate accessed: July 8, 2016
- Outcomes before and after total knee arthroplasty compared to healthy adults.J Orthop Sports Phys Ther. 2010; 40: 559-567
- Outcomes after hip or knee replacement surgery for osteoarthritis.Med J Aust. 1999; 171: 235-238
- Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects.Phys Ther. 1998; 78: 248-258
- Does total knee replacement restore normal knee function?.Clin Orthop. 2005; : 157-165
- Early quadriceps strength loss after total knee arthroplasty.J Bone Joint Surg. 2005; 87: 1047-1053
- Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis.J Orthop Res. 2003; 21: 775-779
- Quadriceps strength and the time course of functional recovery after total knee arthroplasty.J Orthop Sports Phys Ther. 2005; 35: 424-436
- Examing outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time.Clin Biomech. 2008; 23: 320-328
- Associations between knee extensor power and functional performance in patients after total knee arthroplasty and normal controls without knee pain.Int J Sports Phys Ther. 2014; 9: 168-178
- Pain and effusion and quadriceps activation and strength.J Athl Train. 2013; 48: 186-191
- Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries.Clin Sci. 1994; 86: 305-310
- Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives.Semin Arthritis Rheum. 2010; 40: 250-266
- Early progressive strength training to enhance recovery after fast-track total knee arthroplasty: a randomized controlled trial.Arthritis Care Res. 2014; 66: 1856-1866
- Early high-intensity versus low-intensity rehabilitation after total knee arthroplasty: a randomized controlled trial.Arthritis Care Res. 2017; 69: 1360-1368
- A case highlighting the influence of knee joint effusion on muscle inhibition and size.Nat Clin Pract Rheumatol. 2008; 4: 153-158
- Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial.Phys Ther. 2012; 92: 210-226
- Quadriceps activation failure after anterior cruciate ligament rupture is not mediated by knee joint effusion.J Orthop Sports Phys Ther. 2012; 42: 502-510
- Electromyography of the quadriceps femoris muscles in subjects with normal knees and acutely effused knees.Phys Ther. 1982; 62: 279-283
- Electromyographic analysis of knee exercises in healthy subjects and in patients with knee pathologies.Phys Ther. 1987; 67: 1691-1696
- Neural control of lengthening contractions.J Exp Biol. 2016; 219: 197-204
- Muscle inactivation: assessment of interpolated twitch technique.J Appl Physiol (1985). 1996; 81: 2267-2273
- Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty.BMC Musculoskelet Disord. 2005; 6: 3
- Computing contrasts, effect sizes, and counternulls on other people's published data: general procedures for research consumers.Psychol Methods. 1996; 1: 331
- Statistical power analysis for the behavioral sciences.2nd ed. Lawrence Eearlbaum Associates, Hillsdale1988
- Pre-synaptic modulation of quadriceps arthrogenic muscle inhibition.Knee Surg Sports Traumatol Arthrosc. 2005; 13: 370-376
- Arthrogenic muscle inhibition is not present in the limb contralateral to a simulated knee joint effusion.Am J Phys Med Rehabil. 2003; 82: 910-916
- Quadriceps inhibition induced by an experimental knee joint effusion affects knee joint mechanics during a single-legged drop landing.Am J Sports Med. 2007; 35: 1269-1275
- Does electric stimulation of the vastus medialis muscle influence rehabilitation after total knee replacement?.Orthopedics. 2011; 34: 175
- Effects of transcutaneous electrical nerve stimulation and therapeutic exercise on quadriceps activation in people with tibiofemoral osteoarthritis.J Orthop Sports Phys Ther. 2011; 41: 4-12
- Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation.Med Sci Sports Exerc. 2009; 41: 1175-1181
- The time course of knee swelling post total knee arthroplasty and its associations with quadriceps strength and gait speed.J Arthroplasty. 2015; 30: 1215-1219
Article info
Publication history
Footnotes
Supported by the National Institutes of Health (grant no. R01-HD065900), National Institutes of Health/National Center for Advancing Translational Sciences (grant nos. UL1-TR001082 and NIH T32 AG00279), and the Foundation for Physical Therapy Promotion of Doctoral Studies I and II Scholarships.
Clinical Trial Registration No.: NCT01537328.
Disclosures: none.