Effects of isometric exercise using biofeedback on maximum voluntary isometric contraction, pain, and muscle thickness in patients with knee osteoarthritis

Yun Lak Choi, Bo Kyung Kim, Yong Pil Hwang, Ok Kon Moon, Wan Suk Choi, Yun Lak Choi, Bo Kyung Kim, Yong Pil Hwang, Ok Kon Moon, Wan Suk Choi

Abstract

[Purpose] The purpose of our study was to investigate the effects of isometric exercises using electromyographic biofeedback (EMGBF) and ultrasound biofeedback (USBF) on maximum voluntary isometric contraction (MVIC), pain assessed by the Visual Analogue Scale (VAS), and vastus medialis oblique (VMO) thickness in patients with knee osteoarthritis (OA). [Subjects and Methods] Thirty females over 65 years of age who had been diagnosed with knee osteoarthritis were recruited and randomly assigned to three groups, each comprising of 10 subjects. The Subjects in the EMGBF training and USBF training groups were trained with the corresponding physical training exercise program targeting the vastus medialis oblique, whereas the subjects in the control group were treated with conventional physical therapies, such as a hot pack, ultrasound, and transcutaneous electrical nerve stimulation. Subjects in each group were trained or treated for 20 min, 3 times a week for 8 weeks. [Results] The MVIC in the EMGBF and USBF training groups was significantly increased compared with that in the control group, and the VAS score (for measurement of pain) in the EMGBF and USBF training groups was significantly decreased compared with that in the control group. Only the EMGBF training group showed a significantly increased VMO thickness compared with before training. [Conclusion] These results suggest that USBF training is similar to EMGBF training in terms of its effectiveness and is helpful for treating patients with knee OA.

Keywords: Conventional physical therapy; Electromyographic biofeedback; Ultrasound biofeedback.

References

    1. Guccione AA, Felson DT, Anderson JJ, et al. : The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health, 1994, 84: 351–358.
    1. Cho HJ, Chang CB, Jung JW, et al. : Prevalence of radiographic knee osteoarthritis in elderly koreans. J Korean Knee Soc, 2009, 21: 223–231.
    1. Sharma MK, Swami HM, Bhatia V, et al. : An epidemiological study of correlates osteoarthritis in geriatric population of UT Chandigarh. Indian J Community Med, 2007, 32: 77–78.
    1. Andersson G, Bouchard J, Bozic K, et al. : The burden of musculoskeletal diseases in the United States. Rosemont: American Academy of Orthopaedic Surgeons, 2008.
    1. Sharma L, Dunlop DD, Cahue S, et al. : Quadriceps strength and osteoarthritis progression in malaligned and lax knees. Ann Intern Med, 2003, 138: 613–619.
    1. Demura T, Demura S, Uchiyama M, et al. : Examination of factors affecting gait properties in healthy older adults: focusing on knee extension strength, visual acuity, and knee joint pain. J Geriatr Phys Ther, 2014, 37: 52–57.
    1. Ettinger WH, Jr, Afable RF: Physical disability from knee osteoarthritis: the role of exercise as an intervention. Med Sci Sports Exerc, 1994, 26: 1435–1440.
    1. van Baar ME, Dekker J, Lemmens JA, et al. : Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics. J Rheumatol, 1998, 25: 125–133.
    1. Longino D, Frank C, Herzog W: Acute botulinum toxin-induced muscle weakness in the anterior cruciate ligament-deficient rabbit. J Orthop Res, 2005, 23: 1404–1410.
    1. Meier WA, Marcus RL, Dibble LE, et al. : The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatr Phys Ther, 2009, 32: 79–82.
    1. Wang Y, Wluka AE, Berry PA, et al. : Increase in vastus medialis cross-sectional area is associated with reduced pain, cartilage loss, and joint replacement risk in knee osteoarthritis. Arthritis Rheum, 2012, 64: 3917–3925.
    1. Ling SM, Conwit RA, Talbot L, et al. : Electromyographic patterns suggest changes in motor unit physiology associated with early osteoarthritis of the knee. Osteoarthritis Cartilage, 2007, 15: 1134–1140.
    1. Pietrosimone BG, Saliba SA: Changes in voluntary quadriceps activation predict changes in quadriceps strength after therapeutic exercise in patients with knee osteoarthritis. Knee, 2012, 19: 939–943.
    1. Kim HH, Chang HS: Comparison of the VMO/VL EMG ratio and onset timing of VMO relative to VL in subjects with and without patellofemoral pain syndrome. J Phys Ther Sci, 2012, 24: 1315–1317.
    1. Marks R: The effects of 16 months of angle-specific isometric strengthening exercises in midrange on torque of the knee extensor muscles in osteoarthritis of the knee: a case study. J Orthop Sports Phys Ther, 1994, 20: 103–109.
    1. Fisher NM, Pendergast DR: Effects of a muscle exercise program on exercise capacity in subjects with osteoarthritis. Arch Phys Med Rehabil, 1994, 75: 792–797.
    1. Anwer S, Alghadir A: Effect of isometric quadriceps exercise on muscle strength, pain, and function in patients with knee osteoarthritis: a randomized controlled study. J Phys Ther Sci, 2014, 26: 745–748.
    1. Levitt R, Deisinger JA, Remondet Wall J, et al. : EMG feedback-assisted postoperative rehabilitation of minor arthroscopic knee surgeries. J Sports Med Phys Fitness, 1995, 35: 218–223.
    1. Ahamed NU, Sundaraj K, Ahmad RB, et al. : Recent survey of automated rehabilitation systems using EMG biosensors. J Phys Ther Sci, 2011, 23: 945–948.
    1. Qi Z, Ng GYF: EMG analysis of vastus medialis obliquus/ vastus lateralis activities in subjects with patellofemoral pain syndrome before and after a home exercise program. J Phys Ther Sci, 2007, 19: 131–137.
    1. McConnell J: The physical therapist’s approach to patellofemoral disorders. Clin Sports Med, 2002, 21: 363–387.
    1. Kermode F: Benefits of utilising real-time ultrasound imaging in the rehabilitation of the lumbar spine stabilising muscles following low back injury in the elite athlete-a single case study. Phys Ther Sport, 2004, 5: 13–16.
    1. Bunce SM, Hough AD, Moore AP: Measurement of abdominal muscle thickness using M-mode ultrasound imaging during functional activities. Man Ther, 2004, 9: 41–44.
    1. Hodges PW, Pengel LH, Herbert RD, et al. : Measurement of muscle contraction with ultrasound imaging. Muscle Nerve, 2003, 27: 682–692.
    1. Critchley DJ, Coutts FJ: Abdominal muscle function in chronic low back pain patients: measurement with real-time ultrasound scanning. Physiotherapy, 2002, 88: 322–332.
    1. Ferreira PH, Ferreira ML, Maher CG, et al. : Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. Br J Sports Med, 2010, 44: 1166–1172.
    1. Park DJ, Lee HO: The use of rehabilitative ultrasound imaging for feedback from the abdominal muscles during abdominal hollowing in different positions. J Phys Ther Sci, 2011, 23: 895–898.
    1. Callaghan MJ, Oldham JA: Quadriceps atrophy: to what extent does it exist in patellofemoral pain syndrome? Br J Sports Med, 2004, 38: 295–299.
    1. Rodríguez-Merchán EC, Gómez-Cardero P: The outerbridge classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res, 2010, 468: 1254–1257.
    1. .
    1. Anwer S, Equebal A, Nezamuddin M, et al. : Effect of gender on strength gains after isometric exercise coupled with electromyographic biofeedback in knee osteoarthritis: a preliminary study. Ann Phys Rehabil Med, 2013, 56: 434–442.
    1. Bø Kari, Kvarstein Bernt, Rolf R, et al.: Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurourol Urodyn, 1990, 9: 479–487.
    1. McLean L, Varette K, Gentilcore-Saulnier E, et al. : Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing. Neurourol Urodyn, 2013, 32: 1096–1102.
    1. Wang SY, Olson-Kellogg B, Shamliyan TA, et al. : Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review. Ann Intern Med, 2012, 157: 632–644.
    1. Mascarin NC, Vancini RL, Andrade ML, et al. : Effects of kinesiotherapy, ultrasound and electrotherapy in management of bilateral knee osteoarthritis: prospective clinical trial. BMC Musculoskelet Disord, 2012, 13: 182.
    1. Cetin N, Aytar A, Atalay A, et al. : Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil, 2008, 87: 443–451.
    1. Wasielewski NJ, Parker TM, Kotsko KM: Evaluation of electromyographic biofeedback for the quadriceps femoris: a systematic review. J Athl Train, 2011, 46: 543–554.
    1. Lepley AS, Gribble PA, Pietrosimone BG: Effects of electromyographic biofeedback on quadriceps strength: a systematic review. J Strength Cond Res, 2012, 26: 873–882.
    1. Akkaya N, Ardic F, Ozgen M, et al. : Efficacy of electromyographic biofeedback and electrical stimulation following arthroscopic partial meniscectomy: a randomized controlled trial. Clin Rehabil, 2012, 26: 224–236.
    1. Kim HJ, Kramer JF: Effectiveness of visual feedback during isokinetic exercise. J Orthop Sports Phys Ther, 1997, 26: 318–323.
    1. Liu IS, Chai HM, Yang JL, et al. : Inter-session reliability of the measurement of the deep and superficial layer of lumbar multifidus in young asymptomatic people and patients with low back pain using ultrasonography. Man Ther, 2013, 18: 481–486.
    1. Bemben DA, Fetters NL, Bemben MG, et al. : Musculoskeletal responses to high- and low-intensity resistance training in early postmenopausal women. Med Sci Sports Exerc, 2000, 32: 1949–1957.
    1. Sipilä S, Suominen H: Quantitative ultrasonography of muscle: detection of adaptations to training in elderly women. Arch Phys Med Rehabil, 1996, 77: 1173–1178.
    1. Hurley MV, Scott DL, Rees J, et al. : Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis, 1997, 56: 641–648.
    1. Fitzgerald GK: Therapeutic exercise for knee osteoarthritis: considering factors that may influence outcome. Eura Medicophys, 2005, 41: 163–171.
    1. Machado A, García-López D, González-Gallego J, et al. : Whole-body vibration training increases muscle strength and mass in older women: a randomized-controlled trial. Scand J Med Sci Sports, 2010, 20: 200–207.
    1. Andersen LL, Magnusson SP, Nielsen M, et al. : Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: implications for rehabilitation. Phys Ther, 2006, 86: 683–697.
    1. Lucca JA, Recchiuti SJ: Effect of electromyographic biofeedback on an isometric strengthening program. Phys Ther, 1983, 63: 200–203.
    1. Segal NA, Findlay C, Wang K, et al. : The longitudinal relationship between thigh muscle mass and the development of knee osteoarthritis. Osteoarthritis Cartilage, 2012, 20: 1534–1540.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere