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Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection
BACKGROUND: In the early phase after a total knee arthroplasty (TKA), patients experience multi-level weakness in the operated leg, which is caused primarily by reduced central nervous system (CNS) activation failure of the muscles - especially the knee extensors (quadriceps muscle). Whether similar...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606685/ https://www.ncbi.nlm.nih.gov/pubmed/31267365 http://dx.doi.org/10.1186/s40634-019-0193-5 |
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author | Jakobsen, Thomas Linding Jakobsen, Markus Due Andersen, Lars Louis Husted, Henrik Kehlet, Henrik Bandholm, Thomas |
author_facet | Jakobsen, Thomas Linding Jakobsen, Markus Due Andersen, Lars Louis Husted, Henrik Kehlet, Henrik Bandholm, Thomas |
author_sort | Jakobsen, Thomas Linding |
collection | PubMed |
description | BACKGROUND: In the early phase after a total knee arthroplasty (TKA), patients experience multi-level weakness in the operated leg, which is caused primarily by reduced central nervous system (CNS) activation failure of the muscles - especially the knee extensors (quadriceps muscle). Whether similar levels of neuromuscular activity of the muscles in the operated leg, elicited during strength training exercises in machines, can be reached during strength training exercises in more simple forms is unknown. Many clinicians are faced with the problem of not having strength training equipment at their institution or having to prescribe simple strength training exercises for home-based training. Therefore, the purpose of this study was to determine which strength training exercises that activated the muscles in the operated leg the most after TKA. The hypothesis was that strength training exercises performed in machines would elicit higher levels of voluntary peak quadriceps and hamstring muscle activity than strength training exercises performed in more simple forms, using elastic bands or the patients’ own body weight. METHODS: A cross-sectional electromyographic study investigated voluntary peak muscle activity in the operated leg during 6 different strength training exercises. Twenty-four patients, who received a TKA 4 to 8 weeks earlier, performed the exercises in a randomized order, using a pre-determined loading of 10 RM (repetition maximum). Voluntary peak muscle activity (%EMGmax) was calculated for the quadriceps and hamstring muscles for each exercise. RESULTS: Knee extensions with elastic band showed significantly higher voluntary peak quadriceps muscle activity than knee extensions in machine (93.3 vs. 74.9; mean difference, 18.3 %EMGmax [95% confidence interval (CI), 11.7 to 24.9]; P < 0.0001). Similarly, one-legged squat (and sit to stand) elicited higher voluntary peak quadriceps muscle activity than leg press in machine (86.7 vs. 66.8; mean difference, 19.9 %EMGmax [95% CI, 14.8 to 25.0]; P < 0.0001). CONCLUSIONS: Strength training exercises in more simple forms elicited higher voluntary peak quadriceps muscle activity than strength training exercises in machines early after TKA. Consequently, simple home-based strength training exercises using e.g. elastic bands or the patients’ own bodyweight should be considered to alleviate muscle strength losses early after TKA. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01708980. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40634-019-0193-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6606685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-66066852019-07-18 Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection Jakobsen, Thomas Linding Jakobsen, Markus Due Andersen, Lars Louis Husted, Henrik Kehlet, Henrik Bandholm, Thomas J Exp Orthop Research BACKGROUND: In the early phase after a total knee arthroplasty (TKA), patients experience multi-level weakness in the operated leg, which is caused primarily by reduced central nervous system (CNS) activation failure of the muscles - especially the knee extensors (quadriceps muscle). Whether similar levels of neuromuscular activity of the muscles in the operated leg, elicited during strength training exercises in machines, can be reached during strength training exercises in more simple forms is unknown. Many clinicians are faced with the problem of not having strength training equipment at their institution or having to prescribe simple strength training exercises for home-based training. Therefore, the purpose of this study was to determine which strength training exercises that activated the muscles in the operated leg the most after TKA. The hypothesis was that strength training exercises performed in machines would elicit higher levels of voluntary peak quadriceps and hamstring muscle activity than strength training exercises performed in more simple forms, using elastic bands or the patients’ own body weight. METHODS: A cross-sectional electromyographic study investigated voluntary peak muscle activity in the operated leg during 6 different strength training exercises. Twenty-four patients, who received a TKA 4 to 8 weeks earlier, performed the exercises in a randomized order, using a pre-determined loading of 10 RM (repetition maximum). Voluntary peak muscle activity (%EMGmax) was calculated for the quadriceps and hamstring muscles for each exercise. RESULTS: Knee extensions with elastic band showed significantly higher voluntary peak quadriceps muscle activity than knee extensions in machine (93.3 vs. 74.9; mean difference, 18.3 %EMGmax [95% confidence interval (CI), 11.7 to 24.9]; P < 0.0001). Similarly, one-legged squat (and sit to stand) elicited higher voluntary peak quadriceps muscle activity than leg press in machine (86.7 vs. 66.8; mean difference, 19.9 %EMGmax [95% CI, 14.8 to 25.0]; P < 0.0001). CONCLUSIONS: Strength training exercises in more simple forms elicited higher voluntary peak quadriceps muscle activity than strength training exercises in machines early after TKA. Consequently, simple home-based strength training exercises using e.g. elastic bands or the patients’ own bodyweight should be considered to alleviate muscle strength losses early after TKA. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01708980. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40634-019-0193-5) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2019-07-02 /pmc/articles/PMC6606685/ /pubmed/31267365 http://dx.doi.org/10.1186/s40634-019-0193-5 Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Jakobsen, Thomas Linding Jakobsen, Markus Due Andersen, Lars Louis Husted, Henrik Kehlet, Henrik Bandholm, Thomas Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title | Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title_full | Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title_fullStr | Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title_full_unstemmed | Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title_short | Quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
title_sort | quadriceps muscle activity during commonly used strength training exercises shortly after total knee arthroplasty: implications for home-based exercise-selection |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606685/ https://www.ncbi.nlm.nih.gov/pubmed/31267365 http://dx.doi.org/10.1186/s40634-019-0193-5 |
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