PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Early Body-weight Supported Treadmill Training on Strength, Pain, and Arthrogenic Muscle Inhibition after Knee Surgery

무릎 수술 후 조기 체중 지지 트레드밀 훈련이 근력, 통증, 관절기원성 근억제에 미치는 영향

  • Jin-Ee Kim (Physical Therapy and Rehabilitation Center, Eulji University Medical Center ) ;
  • Min-Seo Gu (Department of Orthopaedic Surgery, Eulji University Medical Center, Eulji University College of Medicine ) ;
  • Jeong-Hoon Lee (Physical Therapy and Rehabilitation Center, Eulji University Medical Center) ;
  • Min-Hee Kim (Department of Physical Therapy, College of Health Science, Eulji University) ;
  • Hyo-Yeol Lee (Department of Orthopaedic Surgery, Eulji University Medical Center, Eulji University College of Medicine )
  • 김진이 (대전을지대학교병원 재활치료실) ;
  • 구민서 (대전을지대학교병원 정형외과) ;
  • 이정훈 (대전을지대학교병원 재활치료실) ;
  • 김민희 (을지대학교 보건과학대학 물리치료학과) ;
  • 이효열 (대전을지대학교병원 정형외과)
  • Received : 2024.06.10
  • Accepted : 2024.06.17
  • Published : 2024.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to evaluate the effects of early body-weight-supported treadmill training on quadriceps strength, knee pain, and arthrogenic muscle inhibition (AMI) after knee surgery. Methods: Sixteen adults were selected. Seven patients in the experimental group performed body-weight-supported treadmill training, and nine patients in the control group performed general therapeutic exercise programs. Both groups received 20 minutes of neuromuscular electrical stimulation and 20 minutes of exercise therapy for two weeks. We measured quadriceps strength, visual analogue scale, and modified AMI classification grade before and after the intervention. Data were analyzed using the Mann-Whitney U test and Wilcoxon signed-rank test. Results: Within the experimental group, significant differences were observed in quadriceps strength, visual analogue scale, and modified AMI classification grade. Significant differences were observed between the before- and after-intervention groups in quadriceps strength and visual analogue scale. However, no significant differences were found in the modified AMI classification. Conclusion: The results of this study indicate that early body-weight-supported treadmill training may be an effective intervention for improving strength, reducing pain, and addressing arthrogenic muscle inhibition following knee surgery.

Keywords

Acknowledgement

이 논문은 2023학년도 을지대학교 학술연구비 지원에 의하여 이루어진 것임(EJRG-23-19).

References

  1. Bae CH, Lee JH, Kim JC, et al. Effects of resistance exercise using vibration stimulation on knee muscle strength and balance after anterior cruciate ligament reconstruction. The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2017;23(2):17-25.
  2. Baltaci G. Knee surgery in athletes: The importance of post-operative rehabilitation guidelines. Physical Therapy Reviews. 2000;5(4):195-205. https://doi.org/10.1179/108331900786166623
  3. Bodkin SG, Norte GE, Hart JM. Corticospinal excitability can discriminate quadriceps strength indicative of knee function after ACL-reconstruction. Scandinavian Journal of Medicine & Science Sports. 2019;29(5):716-724. https://doi.org/10.1111/sms.13394
  4. Brodie DJ, Burnett JF, Walker JM. Evaluation of low back pain by patient questionnaires and therapist assessment. Journal of Orthopaedic & Sports Physical Therapy. 1990;11(11):519-529. https://doi.org/10.2519/jospt.1990.11.11.519
  5. Bugbee WD, Pulido PA, Goldberg T, et al. Use of an anti-gravity treadmill for early postoperative rehabilitation after total knee replacement: a pilot study to determine safety and feasibility. American Journal of Orthopedics. 2016;45(4):E167-173.
  6. Ciccotti MG, Kerlan RK, Perry J, et al. An electromyographic analysis of the knee during functional activities. The American Journal of Sports Medicine. 1994;22(5):645-649. https://doi.org/10.1177/036354659402200512
  7. Criss CR, Onate JA, Grooms DR. Neural activity for hip-knee control in those with anterior cruciate ligament reconstruction: a task-based functional connectivity analysis. Neuroscience Letters. 2020;730:134985.
  8. Florez Fonnegra JP, Pino Prestan AC, Lopez LL, et al. Rehabilitation of patients with arthrogenic muscular inhibition in pathologies of knee using virtual reality. Sensors. 2023;23(22):9114.
  9. Guerra-Pinto F, Thaunat M, Daggett M, et al. Hamstring contracture after ACL reconstruction is associated with an increased risk of cyclops syndrome. Orthopaedic Journal of Sports Medicine. 2017;5(1):2325967116684121.
  10. Hesse S, Werner C, Seibel H, et al. Treadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial. Archives Physical Medicine and Rehabilitation. 2003;84(12):1767-1773. https://doi.org/10.1016/S0003-9993(03)00434-9
  11. Henriksson M, Rockborn P, Good L. Range of motion training in brace vs. plaster immobilization after anterior cruciate ligament reconstruction: A prospective randomized comparison with a 2-year follow up. Scandinavian Journal of Medicine & Science in Sports. 2002;12(2):72-80. https://doi.org/10.1034/j.1600-0838.2002.120203.x
  12. Kim TK, Park KK, Kim SJ, et al. Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty. Knee Surgery, Sports Traumatology Arthroscopy. 2009;17:1152-1158. https://doi.org/10.1007/s00167-009-0731-2
  13. Kim SY, Muscle Strength Ratio and Q-angle in Patients With Osteoarthritis of The Knee: A Comparative Study With Healthy Persons. Physical Therapy Korea. 2005;12(1):45-54.
  14. Lepley LK, Wojtys EM, Palmieri-Smith RM. Combination of eccentric exercise and neuromuscular electrical stimulation to improve quadriceps function post-ACL reconstruction. Knee. 2015;22(3):270-277. https://doi.org/10.1016/j.knee.2014.11.013
  15. Lepley LK, Grooms DR, Burland JP, et al. Eccentric cross-exercise after anterior cruciate ligament reconstruction: novel case series to enhance neuroplasticity. Physical Therapy in Sport. 2018;34: 55-65. https://doi.org/10.1016/j.ptsp.2018.08.010
  16. Mcpherson AL, Schilaty ND, Anderson, et al. Arthrogenic muscle inhibition after anterior cruciate ligament injury: Injured and uninjured limb recovery over time. Frontiers in Sports and Active Living. 2023;5:1143376.
  17. Norte G, Rush J, Sherman D. Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation. Journal of Sport Rehabilitation. 2021;31(6):717-735.
  18. Peeler J, Christian M, Cooper J, et al. Managing knee osteoarthritis: the effects of body weight supported physical activity on joint pain, function, and thigh muscle strength. Clinical Journal of Sport Medicine. 2015;25(6):518-523. https://doi.org/10.1097/JSM.0000000000000173
  19. Rice DA, McNair PJ. Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Seminars in Arthritis Rheumatism. 2010;40(3):250-266. https://doi.org/10.1016/j.semarthrit.2009.10.001
  20. Sonnery-Cottet B, Hopper GP, Gousopulos L. Arthrogenic muscle inhibition following knee injury or surgery: pathophysiology, classification, and treatment. Video Journal of Sports Medicine. 2022;2(3).
  21. Stevens SL, Caputo JL, Fuller DK, et al. Effects of underwater treadmill training on leg strength, balance, and walking performance in adults with incomplete spinal cord injury. The Journal of Spinal Cord Medicine. 2015;38(1):91-101. https://doi.org/10.1179/2045772314Y.0000000217
  22. Sherrington C, Lord SR, Herbert RD. A randomized controlled trial of weight-bearing versus non-weight-bearing exercise for improving physical ability after usual care for hip fracture. Archives of Physical Medicine and Rehabilitation. 2004;85(5):710-716. https://doi.org/10.1016/S0003-9993(03)00620-8
  23. Sueyoshi T, Emoto G. The effect of anti-gravity treadmill on balance in acute phase of post-operative knee rehabilitation. Asian Journal of Sports Medicine. 2018;9(4).
  24. Thompson SG, Phillip RD, Roberts A. How do orthopaedic surgeons and rehabilitation professionals interpret and assess 'toe touch' weight bearing and 'partial' weight bearing status in the rehabilitation setting? BMJ Open Sport & Exercise Medicine. 2018;4(1):e000326.
  25. Visintin M, Barbeau H, Korner-Bitensky N, et al. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke. 1998;29(6):1122-1128. https://doi.org/10.1161/01.STR.29.6.1122
  26. Yoon TJ. Clinical research of quadriceps muscle atrophy in mobility impaired patients. Ewha woman University. Dissertations of master's degree. 1989.