J Orthop Sports Phys Ther. 2019 Feb;49(2):105-111. doi: 10.2519/jospt.2019.7800. Epub 2018 Aug 20.
Individuals with total knee arthroplasty (TKA) display interlimb knee extensor moment (KEM) asymmetry during level walking that is exacerbated as task demands are increased. Studies using biofeedback to correct interlimb KEM asymmetry following TKA have reported mixed results.
To compare the immediate effect of 2 forms of real-time kinetic biofeedback-vertical ground reaction force (vGRF) or KEM-on improving interlimb peak KEM symmetry during the weight-acceptance phase of decline walking in persons who have undergone TKA.
In this cross-sectional, controlled laboratory study, 30 participants (17 men; mean ± SD age, 61.9 ± 8.5 years; body mass index, 28.4 ± 3.7 kg/m) were allocated to either a vGRF or KEM real-time biofeedback group. Peak KEM interlimb asymmetry was obtained during both nonbiofeedback and biofeedback decline walking trials 3 months following TKA.
Significant interlimb asymmetry in peak KEM was observed in both groups during the nonbiofeedback condition (KEM, P = .02; vGRF, P<.01). The KEM biofeedback group demonstrated an immediate improvement in peak KEM asymmetry (P = .42). No change in peak KEM asymmetry was observed in the vGRF biofeedback group (P = .01).
Knee extensor moment biofeedback has an immediate effect on improving peak KEM asymmetry 3 months post TKA. J Orthop Sports Phys Ther 2019;49(2):105-111. Epub 20 Aug 2018. doi:10.2519/jospt.2019.7800.
全膝关节置换术（TKA）患者在平地行走时表现出双侧膝关节伸肌力矩（KEM）不对称，随着任务需求的增加，这种不对称性会加剧。使用生物反馈来纠正 TKA 后双侧 KEM 不对称的研究报告结果喜忧参半。
比较 2 种实时动力学生物反馈-垂直地面反力（vGRF）或 KEM 在改善 TKA 后人员在下降行走的负重接受阶段的双侧峰值 KEM 对称性方面的即时效果。
在这项横断面、对照实验室研究中，30 名参与者（17 名男性；平均年龄±标准差，61.9±8.5 岁；体重指数，28.4±3.7kg/m 2 ）被分配到 vGRF 或 KEM 实时生物反馈组。TKA 后 3 个月，在非生物反馈和生物反馈下降行走试验中均获得双侧峰值 KEM 不对称。
在非生物反馈条件下，两组的双侧峰值 KEM 均存在明显的不对称（KEM，P=0.02；vGRF，P<.01）。KEM 生物反馈组的峰值 KEM 不对称性立即改善（P=0.42）。vGRF 生物反馈组的峰值 KEM 不对称性没有变化（P=0.01）。
TKA 后 3 个月，膝关节伸肌力矩生物反馈可立即改善峰值 KEM 不对称。
生物反馈；膝关节置换；膝关节；下肢；运动疗法；步态
