Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement.

Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement. Objective To evaluate the maintenance of observed aquatic training-induced benefits at 12-month follow-up. Design Twelve-month follow-up of a randomized controlled study. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample of 55 to 75-year-old women and men 4 to 18 months (on average 10mo) after unilateral knee replacement. Fifty people were willing to participate in the exercise trial and 42 people in the follow-up study. Intervention Twelve-month follow-…

Neuromuscular function during therapeutic knee exercise under water and on dry land

Abstract Poyhonen T, Keskinen KL, Kyrolainen H, Hautala A, Savolainen J, Malkia E. Neuromuscular function during therapeutic knee exercise under water and on dry land. Arch Phys Med Rehabil 2001;82:1446-52. Objectives: To compare muscle activity and resistive drag force during knee extension-flexion exercises while barefoot and while wearing a Hydro Boot (increased frontal area) both under water and on dry land. Design: Participants performed the exercises while seated on an elevator chair under water. Setting: A hydrotherapy pool. Participants: Eighteen healthy persons (10 women, 8 men). Interventions: Not applicable. Main Outcome Measures: Isokinetic and isometric forces were measured wit…

Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods A minimum of 80 volunteers who meet the inclusion criteria will b…

Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation.

BackgroundKnee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength (“force-generating capacity”) of the involved leg and difficulties with walking and other physical activities.Objective and DesignThe aim of this cross-sectional study was to determine the extent of deficits in knee extensor and flexor muscle torque and power (ability to perform work over time) and in the extensor muscle cross-sectional area (CSA) after knee joint replacement. In addition, the association of lower-leg muscle deficits with mobility limitations was investigated.Methods…

Effects of an eccentric training programme on hamstring strain injuries in women football players

Summary Study aim: to test the hypothesis that an eccentric training programme applied on women football players would reduce the hamstring injury rate by improving thigh muscle balance and, particularly, hamstring strength. Material and methods: three football teams were recruited for this randomised controlled trial. They played in the first and second divisions in Spain. Players were randomised within clubs either to the intervention (eccentric exercises, n = 22) or control (control exercises, n = 21) groups, and randomisation was stratified according to previous history of thigh strains. The eccentric programme was divided into 3 phases, and each phase was composed of 7 weeks. Complianc…

Human isometric force production and electromyogram activity of knee extensor muscles in water and on dry land.

This study was designed to determine trial-to-trial and day-to-day reproducibility of isometric force and electromyogram activity (EMG) of the knee extensor muscles in water and on dry land as well as to make comparisons between the two training conditions in muscle activity and force production. A group of 20 healthy subjects (12 women and 8 men) were tested three times over 2 weeks. A measurement session consisted of recordings of maximal and submaximal isometric knee extension force with simultaneous recording of surface EMG from the vastus medialis, vastus lateralis and biceps femoris muscles. To ensure identical measurement conditions the same patient elevator chair was used in both th…

Knee extensor and flexor muscle power explains stair ascension time in patients with unilateral late-stage knee osteoarthritis: a cross-sectional study.

To determine the extent of asymmetrical deficits in knee extensor and flexor muscles, and to examine whether asymmetrical muscle deficits are associated with mobility limitations in persons with late-stage knee osteoarthritis (OA).Cross-sectional.Research laboratory.A clinical sample (N=56; age range, 50-75y) of eligible persons with late-stage knee OA awaiting knee replacement.Not applicable.Knee extensor and flexor power and torque assessed isokinetically; thigh muscle cross-sectional area (CSA) assessed by computed tomography; mobility limitation assessed by walking speed and stair ascension time; and pain assessed with the Western Ontario and McMaster Universities Osteoarthritis Index q…

Neuromuscular function during knee exercises in water : with special reference to hydrodynamics and therapy

The present series of studies examined neuromuscular function during knee exercise in water and training responses of an aquatic exercise program. Emphasis was placed on the quantification of water resistance, the drag. Subjects who participated in this series of studies were 25-35-year-old healthy women and men. Neuromuscular function was examined using electromyography (EMG), force and reflex sensitivity measurements in the isometric condition on land and in water. EMG and angular velocity were measured during dynamic knee extension-flexion in still and flowing water. The drag forces acting on the leg and foot model were measured in the barefoot condition and with a large resistance boot.

Effects of a progressive aquatic resistance exercise program on the biomechanical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background. Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods. A minimum of 80 volunteers who meet the inclusion criteria will…

Effects of preoperative group-based aquatic training on health related quality of life in persons with late stage knee osteoarthritis

drainage is better than resistance training alone as far as improvement in lymphedema is concerned. Implications: Lymphedema has a substantial effect on the upper limb functioning, independence as well as quality of life post mastectomy. Manual lymphatic drainage can help these patients to achieve functional independence and thereby increase their life quality in a simple, cost effective and efficient way.

Effects of preoperative aquatic resistance training on knee pain, mobility limitation and muscle impairments in people with late-stage knee osteoarthritis

Electromyographic and kinematic analysis of therapeutic knee exercises under water.

Abstract Objective. This study aimed to evaluate muscle function and kinematics during commonly used knee rehabilitation exercises performed in water. Design. Maximal effort single extension and flexion trials in still water and repeated extension–flexion trials in flowing water in barefoot condition were analysed from 18 healthy participants (8 men, 10 women). Background. Despite the fact that water exercises are widely used, there are only few studies involving biomechanical and hydrodynamical analysis of aquatic exercises in rehabilitation. Methods. Electromyography of the quadriceps (vastus medialis, vastus lateralis) and hamstring muscles (biceps femoris, semitendinosus) and angular ve…

Determination of hydrodynamic drag forces and drag coefficients on human leg/foot model during knee exercise.

Objective. The purpose of this laboratory experiment was to measure hydrodynamic drag forces in barefoot/hydro-boot conditions and accordingly, to determine the coefficients of drag on human leg/foot model during simulated knee extension–flexion exercise. Design. The prosthesis of the human lower leg was set in a water tank and connected into an isokinetic force dynamometer to measure resistive forces during knee motion. Background. Quantifying resistance for aquatic exercises has been a challenge in hydrotherapy. The use of models of foot/leg provides a practical method to calculate coefficients of drag and to estimate resistance for rehabilitation purposes in musculoskeletal and amputee p…

Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients.

It is currently unknown whether knee replacement-associated bone loss is modified by rehabilitation programs. Thus, a sample of 45 (18 men and 25 women) persons with unilateral knee replacement were recruited; age 66 years (sd 6), height 169 cm (sd 8), body mass 83 kg (sd 15), time since operation 10 months (sd 4) to explore the associations between maximal torque/power in knee extension/flexion and femoral mid-shaft bone traits (Cortical cross-sectional area (CoA, mm(2)), cortical volumetric bone mineral density (CoD, mg/mm(3)) and bone bending strength index (SSI, mm(3))). Bone traits were calculated from a single computed tomography slice from the femoral mid-shaft. Pain in the operated …

Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.

Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement. Objective To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. Design Randomized controlled trial. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial. Interventions Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24). Main Out…