Jesse C Christensen1, Christopher E Pelt2, K Bo Foreman3, Paul C LaStayo4, Andrew E Anderson5, Jeremy M Gililland6, Ryan L Mizner7. 1. University of Utah, Department of Physical Therapy & Athletic Training, 520 Wakara Way, Salt Lake City, UT 84108, United States; University of Utah, Department of Orthopaedics, 590 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: jesse.christensen@hsc.utah.edu. 2. University of Utah, Department of Orthopaedics, 590 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: chris.pelt@hsc.utah.edu. 3. University of Utah, Department of Physical Therapy & Athletic Training, 520 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: bo.foreman@hsc.utah.edu. 4. University of Utah, Department of Physical Therapy & Athletic Training, 520 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: paul.lastayo@hsc.utah.edu. 5. University of Utah, Department of Orthopaedics, 590 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: andrew.anderson@hsc.utah.edu. 6. University of Utah, Department of Orthopaedics, 590 Wakara Way, Salt Lake City, UT 84108, United States. Electronic address: jeremy.gililland@hsc.utah.edu. 7. University of Montana, School of Physical Therapy & Rehabilitation Science, Missoula, MT, United States. Electronic address: ryan.mizner@mso.umt.edu.
Abstract
BACKGROUND: This study aimed to evaluate clinical and biomechanical changes in self-report survey, quadriceps strength and gait analysis over 3- and 6-months post-total knee arthroplasty (TKA) and confirm the immediate effects of two forms of kinetic biofeedback on improving inter-limb biomechanics during a physically demanding decline walking task. METHODS: Thirty patients with unilateral TKA underwent testing at 3- and 6-months following surgery. All underwent self-report survey, quadriceps strength and gait analysis testing. Patients were assigned to one of two types of biofeedback [vertical ground reaction force (vGRF), knee extensor moment (KEM)]. RESULTS: No decrease in gait asymmetry was observed in non-biofeedback trials over time (p > 0.05), despite significant improvements in self-report physical function (p < 0.01, Cohen d = 0.44), pain interference (p = 0.01, Cohen d = 0.68), numeric knee pain (p = 0.01, Cohen d = 0.74) and quadriceps strength (p = 0.01, Cohen d = 0.49) outcomes. KEM biofeedback induced significant decrease in total support moment (p = 0.05, Cohen f2 = 0.14) and knee extensor moment (p = 0.05, Cohen f2 = 0.21) asymmetry compared to using vGRF biofeedback at 6-months. vGRF biofeedback demonstrated significant decrease in hip flexion kinematic asymmetry compared to KEM biofeedback (p = 0.05, Cohen f2 = 0.18) at 6-months. CONCLUSION: Gait compensation remained similar from 3- to 6-months during a task requiring greater knee demand compared to overground walking post-TKA, despite improvements in self-report survey and quadriceps strength. Single session gait symmetry training at 6-month supports findings at 3-month testing that motor learning is possible. KEM biofeedback is more effective at immediately improving joint kinetic loading compared to vGRF biofeedback post-TKA. Published by Elsevier B.V.
BACKGROUND: This study aimed to evaluate clinical and biomechanical changes in self-report survey, quadriceps strength and gait analysis over 3- and 6-months post-total knee arthroplasty (TKA) and confirm the immediate effects of two forms of kinetic biofeedback on improving inter-limb biomechanics during a physically demanding decline walking task. METHODS: Thirty patients with unilateral TKA underwent testing at 3- and 6-months following surgery. All underwent self-report survey, quadriceps strength and gait analysis testing. Patients were assigned to one of two types of biofeedback [vertical ground reaction force (vGRF), knee extensor moment (KEM)]. RESULTS: No decrease in gait asymmetry was observed in non-biofeedback trials over time (p > 0.05), despite significant improvements in self-report physical function (p < 0.01, Cohen d = 0.44), pain interference (p = 0.01, Cohen d = 0.68), numeric knee pain (p = 0.01, Cohen d = 0.74) and quadriceps strength (p = 0.01, Cohen d = 0.49) outcomes. KEM biofeedback induced significant decrease in total support moment (p = 0.05, Cohen f2 = 0.14) and knee extensor moment (p = 0.05, Cohen f2 = 0.21) asymmetry compared to using vGRF biofeedback at 6-months. vGRF biofeedback demonstrated significant decrease in hip flexion kinematic asymmetry compared to KEM biofeedback (p = 0.05, Cohen f2 = 0.18) at 6-months. CONCLUSION: Gait compensation remained similar from 3- to 6-months during a task requiring greater knee demand compared to overground walking post-TKA, despite improvements in self-report survey and quadriceps strength. Single session gait symmetry training at 6-month supports findings at 3-month testing that motor learning is possible. KEM biofeedback is more effective at immediately improving joint kinetic loading compared to vGRF biofeedback post-TKA. Published by Elsevier B.V.
Entities:
Keywords:
Biofeedback; Clinical, biomechanics; Gait analysis; Total knee arthroplasty
Authors: Jesse C Christensen; Jacob J Capin; Lauren A Hinrichs; Moiyad Aljehani; Jennifer E Stevens-Lapsley; Joseph A Zeni Journal: J Orthop Res Date: 2020-11-02 Impact factor: 3.102
Authors: Alberto César Pereira de Carvalho Froufe Andrade; Paolo Caserotti; Carlos Manuel Pereira de Carvalho; Eduardo André de Azevedo Abade; António Jaime da Eira Sampaio Journal: J Hum Kinet Date: 2013-07-05 Impact factor: 2.193