Kenneth McLeod, Sara Morley, Andrew Matsushima
J. Biomedical Science and Engineering, 2012, 5, 194-201 JBiSE
doi:10.4236/jbise.2012.54025 Published Online April 2012 (http://www.SciRP.org/journal/jbise/)
Muscle imbalances are a well accepted cause of mus-culo-skeletal pain, yet clinicians lack a simple, non- invasive, and reproducible means to assess muscle effort during activities of daily living. To address this issue, we have been developing vibromyography (VMG) as a means to quantitatively assess muscle mechanical effort such that accurate muscle effort ratios can be determined in the clinic. In this study, VMG was used to characterize muscle imbalances in older adults with low-level knee pain while they per-formed step-up and step-down activities. In addition to determining whether VMG can identify the im-balances previously reported in individuals with knee pain, we address the question of whether these knee muscle imbalances were a likely cause of knee pain, or whether the imbalances represented a coping re-sponse for pre-existing knee pain. A population (N = 30) of 35 - 85 year old men and women with a total of 42 painful knees were assessed. Robust multiple step- wise regression analysis identified weak hip abductor muscle effort relative to hamstring muscle effort as the best predictor of knee pain (p = 0.00006), with weak vastus lateralis effort in eccentric contraction, relative to concentric contraction, being the second best predictor (p = 0.0003). Muscle imbalances were able to account for 40% of the variation in reported pain, and the observed pattern of increasing knee pain with increasing quadriceps strength during con-centric contraction leads us to infer that the observed muscle imbalances are not the result of a protective action by the individual, but rather are a principle cause of the knee pain.
Keywords: Vibromyography; Knee Pain; Muscle Balance; Osteoarthritis
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Mark J McElroy, Aaron J Johnson, Michael G Zywiel and Michael A Mont
Expert Rev. Med. Devices 8(1), 57–65 (2011)
Persistent pain and dysfunction following total knee arthroplasty require treatment beyond standard rehabilitation. This article discusses devices used to prevent and treat decreased range of motion. If deficits remain after initial standard therapy, multiple devices exist that can be used for nonoperative treatment. Load-control devices apply a constant force, producing variable soft-tissue displacement as tissues stretch. Static progressive stretch devices use the principle of stress relaxation by applying progressively increasing constant displacements. Both types of devices are reported to be effective in treating persistent knee stiffness. The authors feel that future developments will occur in improving treatment protocols for these devices.
..."Using CPM led to shorter hospital stays by a difference of approximately 1 day (95% CI: 0.03–1.35 days, based on 382 patients), improved active knee flexion at 2-week follow-up by a mean of 4.3° (95% CI: 2.0–6.6°, based on 286 patients) and lowered the incidence of postoperative manipulation by a relative risk of 0.12 (95% CI: 0.03–0.53, based on three trials). "...
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