Cycle Sprint Test for the Evaluation of Lower Limb Muscle Power After Total Knee Arthroplasty: A Proof-of-Concept Study

Mark Hurworth, Jade M Evans, Rebekah Gibbons, Katherine E Mackie, Stephen J Edmondston, Mark Hurworth, Jade M Evans, Rebekah Gibbons, Katherine E Mackie, Stephen J Edmondston

Abstract

Background: Lower limb muscle power is emerging as an important determinant of patient function after knee injury or surgery. This study tested proof of concept of a cycle sprint test for the evaluation of lower limb muscle power, as an outcome measure for patients having total knee arthroplasty (TKA).

Methods: Thirty-two patients were enrolled, of which 16 completed all follow-ups (3, 6, and 12 months). All patients completed the Oxford Knee Score and Knee Injury and Osteoarthritis Outcome Score questionnaires, a 10-m walk test, and 30-second sit-stand test. A trainer-mounted road cycle fitted with an instrumented crank was used for the cycle sprint test. Maximum muscle power was measured from 3, 10-second maximal efforts.

Results: Significant improvements in Oxford Knee Score and Knee Injury and Osteoarthritis Outcome scores relative to baseline were achieved at each follow-up (P < .001), and functional test performance improved significantly at 6 and 12 months (P < .001). Compared with the baseline of 268W, muscle power was significantly lower at 3 months (239W, -13%, P < .05) and significantly higher at 12 months (308W, +12%, P < .05).

Conclusion: The concept of muscle power measurement using a cycle sprint test before and after TKA has been demonstrated in this study. Identification of individuals with lower limb muscle power deficits after TKA may inform rehabilitation programs and enhance long-term outcomes.

Keywords: Cycle sprint test; Muscle power; Total knee arthroplasty; Treatment outcome.

© 2021 The Authors.

Figures

Figure 1
Figure 1
Cycle sprint test setup.

References

    1. Ackerman I.N., Bohensky M.A., Zormer E. The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030. BMC Musculoskelet Disord. 2019;20(1):90.
    1. Kahn T.L., Soheili A., Schwarzkopf R. Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative. Geriatr Orthop Surg Rehabil. 2013;4(4):117.
    1. Mizner R.L., Petterson S.C., Clements K.E. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty. 2011;26:728.
    1. Hossain F.S., Konan S., Patel S., Rpdroguez-Merchan E.C., Haddad F.S. The assessment of outcome after total knee arthroplasty: are we there yet? Bone Joint J. 2015;97-B(1):3.
    1. Mizner R.L., Petterson S.C., Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005;35(7):424.
    1. Husby V.S., Foss O.A., Husby O.S., Winther S.B. Randomized controlled trial of maximal strength training vs. standard rehabilitation following total knee arthroplasty. Eur J Phys Rehabil Med. 2018;54(3):371.
    1. Meier W., Mizner R.L., Marcus R.L., Dibble L.E., Peters C., Lastayo P.C. Total knee arthroplasty: muscle impairments, functional limitations, and recommended rehabilitation approaches. J Orthop Sports Phys Ther. 2008;38(5):246.
    1. Petterson S.C., Mizner R.L., Stevens J.E. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009;61(2):174.
    1. Reid K.F., Fielding R.A. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev. 2012;40(1):4.
    1. Aalund P.K., Larsen K., Hansen T.B., Bandholm T. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty: which measure is most closely associated with performance-based and self-reported function? Arch Phys Med Rehabil. 2013;94(2):384.
    1. Sattler L.N., Hing W.A., Vertullo C.J. Pedaling-based protocol superior to a 10-exercise, non-pedaling protocol for postoperative rehabilitation after total knee replacement: a randomized controlled trial. J Bone Joint Surg Am. 2019;101(8):688.
    1. Asplund C. St Pierre, P., Knee pain and bicycling: fitting concepts for clinicians. Phys Sportsmed. 2004;32(4):23.
    1. Unver B., Baris R.H., Yuksel E., Cekmece S., Kalkan S., Karatosun V. Reliability of 4-meter and 10-meter walk tests after lower extremity surgery. Disabil Rehabil. 2017;39(25):2572.
    1. Unver B., Kalkan S., Yuksel E., Kahraman T., Karatosun V. Reliability of the 50-foot walk test and 30-sec chair stand test in total knee arthroplasty. Acta Ortop Bras. 2015;23(4):184.
    1. Collins N.J., Misra D., Felson D.T., Crossley K.M., Roos E.M. Measures of knee function: international knee documentation committee (IKDC) subjective knee evaluation form, knee injury and osteoarthritis outcome score (KOOS), knee injury and osteoarthritis outcome score physical function short form (KOOS-PS), knee outcome survey activities of daily living Scale (KOS-ADL), Lysholm knee scoring Scale, Oxford knee score (OKS), Western Ontario and McMaster universities osteoarthritis index (WOMAC), activity rating Scale (ARS), and Tegner activity score (TAS) Arthritis Care Res (Hoboken) 2011;63(Suppl 11):S208.
    1. Roos E.M., Roos H.P., Lohmander L.S., Ekdahl C., Beynnon B.D. Knee injury and osteoarthritis outcome score (KOOS) - development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88.
    1. Davila Castrodad I.M., Recai T.M., Abraham M.M. Rehabilitation protocols following total knee arthroplasty: a review of study designs and outcome measures. Ann Transl Med. 2019;7(Suppl 7):S255.
    1. Silva M., Shepherd E.F., Jackson W.O., Pratt J.A., McClung C.D., Schmalzried T.P. Knee strength after total knee arthroplasty. J Arthroplasty. 2003;18(5):605.
    1. Ishii Y., Noguchi H., Sato J., Sakurai T., Toyabe S.I. Quadriceps strength impairment in the mid- to long-term follow-up period after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25(11):3372.
    1. Hamai S., Miura H., Higaki H. Three-dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty. J Orthop Res. 2008;26(12):1556.

Source: PubMed

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