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A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry
Includes bibliographical references
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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MRC/UCT RU for Exercise and Sport Medicine
2016
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| _version_ | 1867613271782064128 |
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| access_status_str | Open Access |
| author | Bakkum, Amanda |
| author2 | Posthumus, Michael |
| author_browse | Bakkum, Amanda Posthumus, Michael |
| author_facet | Posthumus, Michael Bakkum, Amanda |
| author_sort | Bakkum, Amanda |
| collection | Thesis |
| description | Includes bibliographical references |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/16477 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:28.738Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | MRC/UCT RU for Exercise and Sport Medicine |
| publisherStr | MRC/UCT RU for Exercise and Sport Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/16477 A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry Bakkum, Amanda Posthumus, Michael Albertus, Yumna Collins, Malcolm Exercise Science Includes bibliographical references Purpose: The predominant impairment to function following a total knee arthroplasty (TKA) is a distinctive reduction in quadriceps muscle strength. It has been suggested that eccentric rehabilitation may be more beneficial than traditional concentric only rehabilitation at improving muscle strength, physical functioning and quality of life in this population. The aim of this study was therefore to determine if an eccentric cycling ergometry rehabilitation intervention (a) was feasible in participant's early after TKA surgery (Study 1), (b) resulted in greater improvements in muscle strength and endurance, as well as muscle activity and muscle volume (Study 2) and, (c)resulted in greater knee functional ability, health related quality of life and physical activity levels (Study 3), when compared to an concentric cycling ergometry rehabilitation intervention. Finally, knee and hip kinematics, ground reaction force and muscle activity was described during the sit-to-stand transfer within this population (Study 4). Methods: Eighteen age- and sex-matched participants', three to nine month's post-TKA were recruited and randomly divided into either an eccentric or concentric cycling rehabilitation intervention. The participants were required to perform three exercise sessions a week, over a period of eight weeks. Isokinetic strength and muscle activity of the quadriceps and hamstring muscles, sit-to-stand motion capture analysis and knee functional ability and health related quality of life questionnaires (Knee Injury and Osteoarthritis Outcome Score, SF-36Health Survey and Tegner Activity Scale) were assessed pre and post- rehabilitation intervention. Data Analysis: Two-way repeated-measures analysis of variance were used to analyse the effects of time and the ECC and CON intervention groups and the group/time interaction for each of the dependent variables. Results: The eccentric rehabilitation intervention was well tolerated with regards to pain levels in participants' as early as three months post-TKA, the peak level of pain perceived per session, never exceeding a "mild" classification. The eccentric intervention resulted in greater power (P= 0.029) and work output (P ≤ 0.001) with a reduced overall heart rate (P= 0.014) ; moderate decreases in biceps femoris (BF) muscle activity (-3.2%) and increases in the lean thigh volume (+807.32) of the uninvolved limb; as well as improvements in the physical fun ctioning (+12.2%) and physical role functioning SF-36 scores (+22.2%) and the level of physical activity (+0.9) (Tegner activity scale). The concentric intervention resulted in decreases in vastus lateralis (VL) muscle activity (-8.17%) and work fatigue (-7.34%) and increases in the lean thigh volume (+677.49) and the hip abduction angle (+ 2.67°) (sit-to-stand) of the involved limb. Conclusion: The eccentric rehabilitation intervention is well tolerated with regards to pain and is characterised by significantly greater power output produced and work performed at significantly lower heart rates. Eccentric cycling ergometry matched in perceived exertion and duration, is associated with greater improvements in physical functioning outcome scores, physical activity level and knee flexion muscle efficiency during concentric contractions, when compared with concentric cycling ergometry. However, knee extensor muscle endurance and efficiency during concentric contractions, as well as muscle volume of the involved limb increased more significantly after concentric training in comparison to eccentric training, Further research is required to establish which training modality is the most feasible and effective in restoring knee function in participant's three months post-TKA. 2016-01-21T11:06:31Z 2016-01-21T11:06:31Z 2015 Master Thesis Masters MSc (Med) http://hdl.handle.net/11427/16477 eng application/pdf MRC/UCT RU for Exercise and Sport Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Exercise Science Bakkum, Amanda A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| thesis_degree_str | Master's |
| title | A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| title_full | A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| title_fullStr | A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| title_full_unstemmed | A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| title_short | A randomised control trial for the restoration of functional ability in patients post total knee arthroplasty: a comparison of eccentric versus concentric cycling ergometry |
| title_sort | randomised control trial for the restoration of functional ability in patients post total knee arthroplasty a comparison of eccentric versus concentric cycling ergometry |
| topic | Exercise Science |
| url | http://hdl.handle.net/11427/16477 |
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