Quality of knee strengthening exercises performed at home deteriorates after one week

BACKGROUND: To compare the performance (as determined by lower extremity kinematics) of knee exercises in healthy middle-aged and older individuals immediately after instruction and one week later. METHODS: This is a cross-sectional study in a laboratory setting. Nineteen healthy volunteers (age [y] 63.1 ± 8.6, mass [kg] 76.3 ± 14.7, height [m] 1.7 ± 0.1) participated in this study. High speed video and reflective markers were used to track motion during four exercises. The exercises were knee flexion, straight leg raise, and “V “in supine position, and hip abduction in side lying position. All participants received verbal and tactile cues during the training phase and the therapist observed and, if necessary, corrected the exercises. Upon return a week later the participants performed the same exercises without any further instructions. Knee and hip sagittal and rotational angles were extracted from the motion capture. A repeated measures t-test was used to compare the motions between two visits. RESULTS: Participants demonstrated more knee flexion during straight leg raise and “V in” exercises at the 2nd visit compared to the 1st visit (both p < 0.05). During the “V out” exercise, they performed more external rotation (p < 0.05) while they showed more internal rotation during the “V in” exercise at the 2nd visit compared to the 1st visit. CONCLUSIONS: Exercise performance declined significantly in healthy middle-aged and older individuals one week after instruction. This decline occurred despite an instructional exercise sheet being given to every participant. Other approaches designed to help individuals retain the ability to perform rehabilitative exercises correctly need to be explored.