Sackiriyas Steni, Heinert Becky, Rutherford Drew, Fritz Gwen M, Kernozek Thomas W
Health Professions University of Wisconsin-La Crosse.
Gundersen Health System.
Int J Sports Phys Ther. 2023 Aug 1;18(4):856-863. doi: 10.26603/001c.84312. eCollection 2023.
Load asymmetry can be present before and after total knee arthroplasty (TKA), which may affect progress during knee rehabilitation in an outpatient sports medicine setting. Current rehabilitation primarily focuses on strength, pain, and range of motion deficits; however, recent evidence suggests the use of movement retraining strategies such as load feedback to address load asymmetry. Therefore, the purpose of this study was to examine how a single session of concurrent force feedback influences load symmetry during the leg-press and body-weight squat exercises in individuals following TKA. Additionally, a secondary purpose was to examine the retention of any changes over the course of a week.
Case-series study.
This observational, repeated-measures study design examined the effect of concurrent force feedback training on the mean and standard deviation of load symmetry index during the leg press and squat exercises in 26 patients with TKA in an outpatient sports medicine clinic.The load asymmetry was measured with loadpad sensors placed underneath the each extremity during leg press and squat (baseline), after one training session consisting of concurrent force feedback during these exercises within a single physical therapy session (post feedback), and after seven to ten days of a washout period (post retention). Separate 2 x 3 repeated measures analysis of variance was used to compare the mean and standard deviation of load symmetry across exercise (leg press and squat) and across time (baseline, post feedback and post retention).
There was a time effect for the mean load symmetry index (p=0.027) but not for the standard deviation (p=0.441) during these exercises. The leg press showed a greater mean symmetry index compared to the squat regardless of time (p=0.001).
A reduction in the mean load symmetry index following concurrent feedback training suggests improved use of the surgical limb during both leg press and squat exercises during the same therapy session but the more symmetric loading pattern was not retained one week later. Overall, the leg press showed greater mean asymmetry than the squat. Standard deviation in the load symmetry index did not change across time or by exercise.
3©The Author(s).
全膝关节置换术（TKA）前后可能存在负荷不对称，这可能会影响门诊运动医学环境下膝关节康复的进程。目前的康复主要集中在力量、疼痛和活动范围的缺陷上；然而，最近的证据表明，使用诸如负荷反馈等运动再训练策略来解决负荷不对称问题。因此，本研究的目的是探讨单次同步力反馈如何影响TKA术后患者在腿举和体重深蹲练习中的负荷对称性。此外，第二个目的是研究在一周的时间内这些变化的持续性。
病例系列研究。
本观察性重复测量研究设计，在门诊运动医学诊所中，对26例TKA患者在腿举和深蹲练习期间，同步力反馈训练对负荷对称指数的均值和标准差的影响进行了研究。在腿举和深蹲时（基线）、在一次物理治疗 session 内进行包括同步力反馈的一次训练 session 后（反馈后）以及在洗脱期7至10天后（保留后），使用放置在每个肢体下方的负荷垫传感器测量负荷不对称。使用单独的2×3重复测量方差分析来比较运动（腿举和深蹲）和时间（基线、反馈后和保留后）之间负荷对称的均值和标准差。
在这些练习中，平均负荷对称指数存在时间效应（p = 0.027），但标准差不存在时间效应（p = 0.441）。无论时间如何，腿举的平均对称指数均高于深蹲（p = 0.001）。
同步反馈训练后平均负荷对称指数降低，表明在同一治疗 session 期间，腿举和深蹲练习中患侧肢体的使用得到改善，但一周后更对称的负荷模式未得到保持。总体而言，腿举的平均不对称性高于深蹲。负荷对称指数的标准差在时间上或运动之间没有变化。
3©作者。
