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Knee-extension exercise's lack of immediate effect on maximal voluntary quadriceps torque and activation in individuals with anterior knee pain |
Park J, Grindstaff TL, Hart JM, Hertel JN, Ingersoll CD |
Journal of Sport Rehabilitation 2012;21(2):119-126 |
clinical trial |
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
CONTEXT: Weight-bearing (WB) and non-weight-bearing (NWB) exercises are commonly used in rehabilitation programs for patients with anterior knee pain (AKP). OBJECTIVE: To determine the immediate effects of isolated WB or NWB knee-extension exercises on quadriceps torque output and activation in individuals with AKP. DESIGN: A single-blind randomized controlled trial. SETTING: Laboratory. PARTICIPANTS: 30 subjects with self-reported AKP. INTERVENTIONS: Subjects performed a maximal voluntary isometric contraction (MVIC) of the quadriceps (knee at 90 degrees). Maximal voluntary quadriceps activation was quantified using the central activation ratio (CAR): CAR = MVIC/(MVIC + superimposed burst torque). After baseline testing, subjects were randomized to 1 of 3 intervention groups: WB knee extension, NWB knee extension, or control. WB knee-extension exercise was performed as a sling-based exercise, and NWB knee-extension exercise was performed on the Biodex dynamometer. Exercises were performed in 3 sets of 5 repetitions at approximately 55% MVIC. Measurements were obtained at 4 times: baseline and immediately and 15 and 30 min postexercise. MAIN OUTCOME MEASURES: Quadriceps torque output (MVIC: Nm/Kg) and quadriceps activation (CAR). RESULTS: No significant differences in the maximal voluntary quadriceps torque output (F[2,27] = 0.592, p = 0.56) or activation (F[2,27] = 0.069, p = 0.93) were observed among the 3 treatment groups. CONCLUSIONS: WB and NWB knee-extension exercises did not acutely change quadriceps torque output or activation. It may be necessary to perform exercises over a number of sessions and incorporate other disinhibitory interventions (eg, cryotherapy) to observe acute changes in quadriceps torque and activation.
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