Featured Articles #006: Total knee arthroplasty, Stroke and ACL
Previously featured articles #006: February 15, 2022 – March 31,2022
Does preoperative physiotherapy improve outcomes in patients undergoing total knee arthroplasty? A systematic review
Abstract
Objective:
To systematically review the scientific literature and to investigate the effectiveness of preoperative rehabilitation on subjective and objective outcomes after total knee arthroplasty (TKA) when compared with patients in a control group.
Methods
Sources: A search was conducted in PubMed, PubMed Central, Embase, Cochrane Library and Physiotherapy Evidence Database databases in May 2021. Study selection: randomized controlled trials (RCTs) were reviewed if they compared a preoperative physiotherapy exercise intervention with no intervention group for patients undergoing TKA for severe Osteoarthritis (OA). A total of 24 RCTs were included at the end of the evaluation process. By the end of the evaluation process, a total of 24 RCTs were included. Data extraction: Two authors independently screened the literature, extracted data, and assessed the quality of included studies. The outcomes were knee extension, knee flexion, pain Visual Analogue Scale (VAS), overall Western Ontario and McMaster Universities OA Index, 6 min walking test, and Timed Up and Go test.
Results
The majority of the studies included in this systemic review demonstrated a comparable trend of long-term postoperative improvement of knee extension strength, VAS, range of movement and functional scores, and those of quality of life between two groups. Many studies showed a significant improvement in terms of preoperative pain, length of hospital stay and functional performance shortly after the operation, but all studies failed to show a prolonged effect on knee motion or patient function between 3 and 12 months..
Conclusion
Low to moderate evidence from mostly small RCTs demonstrated that preoperative physiotherapy interventions reduce pain and improve functional performance for patients with knee OA prior shortly after the TKA.
Degree and pattern of dual-task interference during walking vary with component tasks in people after stroke: a systematic review
Abstract
Questions
What are the degree and pattern of dual-task interference during walking in people after stroke? How do these vary with disease chronicity and different component tasks in people after stroke? How does dual-task interference differ between people after stroke and people without stroke?
Methods
Design: Systematic review with meta-analysis of studies reporting gait-related dual-task interference. Participants: People after stroke and people without stroke. Outcome measures: Measures of walking and secondary (cognitive or manual) task performance under dual-task conditions relative to those under single-task conditions
Results
Seventy-six studies (2,425 people after stroke and 492 people without stroke) were included. Manual and mental tracking tasks imposed the greatest dual-task interference on gait speed, although there was substantial uncertainty in these estimates. Among mental tracking tasks, the apparently least-complex task (serial 1 subtractions) induced the greatest dual-task interference (−0.17 m/s, 95% CI −0.24 to −0.10) on gait speed, although there was substantial uncertainty in these estimates. Mutual interference (decrement in both walking and secondary component task performances during dual-tasking) was the most common dual-task interference pattern. The results of the sensitivity analyses for studies involving people with chronic stroke were similar to the results of the primary analyses. The amount of dual-task interference from a mental tracking or manual task during walking was similar between people with or without stroke.
Conclusion
The degree and pattern of dual-task interference vary with the choice of component tasks. When evaluating limitations to functional mobility during dual-tasking conditions and in planning interventions accordingly, clinicians should select dual-task assessments that correspond to the daily habits and physical demands of people after stroke.
Quadriceps and Hamstrings Strength Reference Values for Athletes With and Without Anterior Cruciate Ligament Reconstruction Who Play Popular Pivoting Sports, Including Soccer, Basketball, and Handball: A Scoping Review
Abstract
Summary
To synthesize and present reference values for quadriceps and hamstring strength tests in healthy athletes who play pivoting sports and athletes with anterior cruciate ligament reconstruction (ACLR) who play pivoting sports.
Methods
Design: Scoping review. Literature Search: We searched PubMed, the Cochrane Library, MEDLINE, Embase and Web of Science until January 26, 2021. Study Selection Criteria: We included reference values in two different categories: I) quadriceps and hamstring strength test outcomes from healthy pivoting sport athletes and II) quadriceps and hamstring strength test outcomes from pivoting sport athletes with ACLR at a specific time point during rehabilitation. Data Synthesis: We performed a qualitative synthesis for reference values from isokinetic (at 60, 180 and 300°/sec) and isometric quadriceps and hamstring strength tests. We summarized the data for type of sport, sex, sport participation level and age group.
Results
Of the 42 included studies, 26 reported reference values from healthy soccer players, 4 from healthy basketball players, 4 from healthy handball players and 11 from other healthy pivoting sport athletes. LSI dominant/non-dominant (LSI-D/ND) ranged from 98% to 114% for healthy athletes. Six studies reported reference values from pivoting sport athletes with ACLR at a specific time point during rehabilitation. After 7 months and beyond, strength values for athletes with ACLR are comparable to those of healthy pivoting sport athletes.
Conclusion
This scoping review summarizes quadriceps and hamstrings strength reference values for athletes who play the most common pivoting sports, including soccer, basketball and handball.
Differences in the muscle activities of the quadriceps femoris and hamstrings while performing various squat exercises.
Abstract
Background
Knee injuries in the lower limbs frequently occur, and lower limb muscles need to be strengthened to reduce injuries. Activating muscles can help strengthen muscles.. This study aimed to determine the squat exercises [general squat (GS), wall squat (WS), and Spanish squat (SS)] that effectively increased muscle activity using electromyography (EMG).
Methods
In this cross-sectional study, 22 participants performed three different squat exercises with EMG attached to the rectus femoris (RF), vastus lateralis (VL), vastus medialis, biceps femoris, semitendinosus, and semimembranosus. The Kruskal–Wallis H test was used to compare thigh muscle activities among the various squat exercises.
Results
During SS, RF showed greater muscle activation compared to WS and GS (RF: χ2 = 21.523, p = 0.000, η2 = 0.333). VL also showed greater muscle activation during SS compared to WS (VL: χ2 = 7.101, p = 0.029, η2 = 0.109).
Conclusion
The results from this study indicate that SS shows more activation in the RF and VL muscles compared to GS and WS. These findings suggest that SS can provide more muscle activation for the RF and VL muscles and will greatly help those who lack muscle activation in these muscles.
