Short-Term Effects of Isometric Quadriceps Muscle Exercise with Auditory and Visual Feedback on Pain, Physical Function, and Performance after Total Knee Arthroplasty: A Randomized Controlled Trial

Yasutaka Kondo; Yoshihiro Yoshida; Takashi Iioka; Hideki Kataoka; Junya Sakamoto; Tatsuya Hirase; Yuichiro Honda; Atsushi Nawata; Minoru Okita

doi:10.1055/s-0040-1721035

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2022; 35(08): 922-931
DOI: 10.1055/s-0040-1721035

Original Article

Short-Term Effects of Isometric Quadriceps Muscle Exercise with Auditory and Visual Feedback on Pain, Physical Function, and Performance after Total Knee Arthroplasty: A Randomized Controlled Trial

Authors

Yasutaka Kondo

¹Department of Rehabilitation, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Yoshihiro Yoshida

¹Department of Rehabilitation, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Takashi Iioka

³Department of Orthopedic Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Hideki Kataoka

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

⁴Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
Junya Sakamoto

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

⁵Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
Tatsuya Hirase

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

⁵Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
Yuichiro Honda

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

⁵Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
Atsushi Nawata

⁶Medical Engineering Laboratory, ALCARE Co, Ltd, Tokyo, Japan
Minoru Okita

²Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

⁵Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan

Abstract

Severe acute pain after total knee arthroplasty (TKA) may cause delay in muscle strength and functional recovery, and it is a risk factor for chronic postoperative pain. Although pharmacological approaches are the typical firstline to treat acute pain; recently, nonpharmacological approaches such as exercise have been increasingly applied. The purpose of this investigation was to evaluate the effects of a rehabilitation program involving isometric quadriceps exercise with auditory and visual feedback to improve the short-term outcome after TKA. Sixty-two patients, planning a primary unilateral TKA, were randomly assigned to either an intervention group (n = 31) involving isometric quadriceps exercise with auditory and visual feedback in usual rehabilitation after TKA or a control group (n = 31) involving a standardized program for TKA. Patients in the intervention group performed the isometric quadriceps muscle exercise using the Quadriceps Training Machine from 2 to 14 days after TKA instead of the traditional quadriceps sets. Pain intensity, isometric knee extension strength, range of motion, timed up and go test (TUG), 10-m gait speed, 6-minute walking distance, the Western Ontario and McMaster University Osteoarthritis index (WOMAC), the hospital anxiety and depression scale, and the pain catastrophizing scale were assessed before TKA (baseline) and 1 to 3 weeks after TKA. Pain intensity significantly decreased in the intervention group than in the control group at 1 (p = 0.005), 2 (p = 0.002), and 3 (p = 0.010) weeks after TKA. Greater improvements in TUG (p = 0.036), 10-m gait speed (p = 0.047), WOMAC total score (p = 0.017), pain (p = 0.010), and function (p = 0.028) 3 weeks after TKA were observed in the intervention group. These results suggest that isometric quadriceps exercises with auditory and visual feedback provided early knee pain relief, possibly leading to better improvements in physical performance, and patient's perception of physical function in the early stages of postoperative TKA. Further studies should investigate whether this short-term effect is sustainable.

Keywords

total knee arthroplasty - postoperative pain - auditory and visual feedback - task - attention

Full Text

References

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