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BACKGROUND: Compensating unstable situations is an important functional capability to maintain joint stability, to compensate perturbations and to prevent (re-)injury. Therefore, reduced maximum strength and altered neuromuscular activity are expected by inducing instability to load test situations. Possible effects are not clear for induced instability during maximum legpress tests in healthy individuals. OBJECTIVE: To compare isokinetic legpress (LP) strength and lower-leg muscle activity using stable (S) and unstable (UN) footplates. METHODS: 16 males (28 +/- 4 yrs, 179 +/- 7 cm, 75 +/- 8 kg) performed five maximum LP in concentric (CON) and eccentric (ECC) mode. The maximum force (Fmax) and muscle activity were measured under conditions of S and UN footplates. The tested muscles comprised of the tibialis anterior (TA), peroneus longus (PL) and soleus (SOL) and their activity were quantified against the MVIC of each muscle respectively. RESULTS: The main finding revealed a significant reduction in Fmax under UN condition: 11.9 +/- 11.3% in CON and 23.5 +/- 47.8% in ECC (P < 0.05). Significant findings were also noted regarding the RMS derived values of the EMG of PL and TA. CONCLUSION: Unstable LP reduced force generation and increased the activity of PL and TA muscles which confirmed greater neuromuscular effort to compensate instability. This may have some implications for resistance testing and training coupled with an unstable base in the prevention and rehabilitation of injury to the neuromusculoskeletal system.
Research question: The purpose of this study was to evaluate the test-retest reliability of lower extremity kinematics during squat, hip abduction and lunge exercises captured by the Kinect and to evaluate the agreement to a reference 3D camera-based motion system. Methods: Twenty-one healthy individuals performed five repetitions of each lower limb exercise on two different days. Movements were simultaneously assessed by the Kinect and the reference 3D motion system. Joint angles and positions of the lower limb were calculated for sagittal and frontal plane. For the inter-session reliability and the agreement between the two systems standard error of measurement (SEM), bias with limits of agreement (LoA) and Pearson Correlation Coefficient (r) were calculated. Results: Parameters indicated varying reliability for the assessed joint angles and positions and decreasing reliability with increasing task complexity. Across all exercises, measurement deviations were shown especially for small movement amplitudes. Variability was acceptable for joint angles and positions during the squat, partially acceptable during the hip abduction and predominately inacceptable during the lunge. The agreement between systems was characterized by systematic errors. Overestimations by the Kinect were apparent for hip flexion during the squat and hip abduction/adduction during the hip abduction exercise as well as for the knee positions during the lunge. Knee and hip flexion during hip abduction and lunge were underestimated by the Kinect. Significance: The Kinect system can reliably assess lower limb joint angles and positions during simple exercises. The validity of the system is however restricted. An application in the field of early orthopedic rehabilitation without further development of post-processing techniques seems so far limited.
Background: Telerehabilitation can contribute to the maintenance of successful rehabilitation regardless of location and time. The aim of this study was to investigate a specific three-month interactive telerehabilitation routine regarding its effectiveness in assisting patients with physical functionality and with returning to work compared to typical aftercare.
Objective: The aim of the study was to investigate a specific three-month interactive telerehabilitation with regard to effectiveness in functioning and return to work compared to usual aftercare.
Methods: From August 2016 to December 2017, 111 patients (mean 54.9 years old; SD 6.8; 54.3% female) with hip or knee replacement were enrolled in the randomized controlled trial. At discharge from inpatient rehabilitation and after three months, their distance in the 6-minute walk test was assessed as the primary endpoint. Other functional parameters, including health related quality of life, pain, and time to return to work, were secondary endpoints.
Results: Patients in the intervention group performed telerehabilitation for an average of 55.0 minutes (SD 9.2) per week. Adherence was high, at over 75%, until the 7th week of the three-month intervention phase. Almost all the patients and therapists used the communication options. Both the intervention group (average difference 88.3 m; SD 57.7; P=.95) and the control group (average difference 79.6 m; SD 48.7; P=.95) increased their distance in the 6-minute-walk-test. Improvements in other functional parameters, as well as in quality of life and pain, were achieved in both groups. The higher proportion of working patients in the intervention group (64.6%; P=.01) versus the control group (46.2%) is of note.
Conclusions: The effect of the investigated telerehabilitation therapy in patients following knee or hip replacement was equivalent to the usual aftercare in terms of functional testing, quality of life, and pain. Since a significantly higher return-to-work rate could be achieved, this therapy might be a promising supplement to established aftercare.