Search

Background and study aim: Isometric strength exercises engage the intricate knee joint, including the femur, tibia, and patella, along with multiple muscles and ligaments, aiding in the rehabilitation of knee injuries while supporting movement and injury prevention. The specific objective of this research is to investigate the effectiveness of isometric strength exercises in rehabilitating the knee injuries among football players, assessing their impact on recovery and performance. Material and methods: Thirty male ACL Knee injured football players were randomly assigned to isometric strength exercise group (ISEG) (N=15) (Age; 20±1.9, Height;171±4.5, Weight; 60±6.0) and control group (Age;21±1.3, Height;173±4.4, Weight; 63±8.2) and their age ranged between 18 and 23. Subjects were randomly selected from various football academies in Coimbatore, Tamil Nadu, India. Thirty subjects who will diagnosed by a physiotherapist and help of orthopaedician as having knee injuries in football players and who showed a typical restriction of Range of motion (ROM). Fifteen subjects underwent rehabilitation (Isometric Strength exercise Group) and the other 15 underwent cryotreatment (Control Group). Analysis was based on the active and passive flexion Range of motion (ROM) were measured by kinovea-0.9.5 software. Means and standard deviations (±) described all data, with Shapiro-Wilk tests checking for normality (p< 0.05). A dependent 't' test determined significant mean differences between experimental and control groups (p < 0.05). Results: The participants who underwent a regimen of Isometric strengthening exercises exhibited notable enhancements in their range of motion (ROM), highlighting the effectiveness of this comprehensive approach significantly improved in active and passive flexion Range of motion (p < 0.05). Conclusion: Isometric strength exercises demonstrate promise in enhancing knee rehabilitation outcomes among football players, warranting further exploration and implementation compared to control group. more...

Objective This study aimed to assess the effect of six weeks of patella taping on pain levels in women with knee osteoarthritis. Methods This research was an applied, semi-experimental study. The study population consisted of middle-aged women aged 30 to 50 years. Using convenience sampling, 30 women with knee osteoarthritis, referred to an orthopedic clinic in Tehran, were selected as the study sample. The participants were randomly assigned to either the experimental group (15 women) or the control group (15 women). Pain was measured using the Visual Analog Scale (VAS). The experimental group received patella taping for six weeks. Data analysis was performed using Paired-Sample T Test for intra-group comparisons and Analysis of Covariance (ANCOVA) for inter-group comparisons. All analyses were conducted using SPSS version 26, with a significance level set at 0.05. Results The experimental group showed a significant reduction in pain levels, with a mean difference of 2.91, a t-value of 2.67, and a significance level of p=0.04 between the pre-test and post-test. In contrast, the control group exhibited a mean difference of 0.11, a t-value of 0.74, and a significance level of p=0.32, indicating no significant effect. The ANCOVA results also revealed a significant difference between the two groups in the post-test (p=0.03). Conclusion The findings suggest that patella taping has a positive effect on reducing knee pain in women with osteoarthritis. Therefore, sports trainers and physiotherapists are encouraged to consider patella taping as a non-pharmacological intervention to alleviate pain in women with knee osteoarthritis. more...

ObjectiveIn order to address the issues of inconvenience, high medical costs, and lack of universality associated with traditional knee rehabilitation equipment, a portable intelligent wheelchair for knee rehabilitation was designed in this study. MethodsBased on the analysis of the knee joint’s structure and rehabilitation mechanisms, an electric pushrod-driven rehabilitation institution was developed. A multi-functional module was designed with a modular approach, and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer. A three-dimensional model was established using SolidWorks software. In conjunction with Adams and Ansys simulation software, kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components. A prototype was constructed to verify the equipment’s actual performance. ResultsAccording to the prototype testing, the actual range of motion for the knee joint swing rod is 15.1°~88.9°, the angular speed of the swing rod ranges from −7.9 to 8.1°/s, the angular acceleration of the swing rod varies from −4.2 to 1.6°/s², the thrust range of the electric pushrod is −82.6 to 153.1 N, and the maximum displacement of the load pedal is approximately 1.7 mm, with the leg support exhibiting a maximum deformation of about 1.5 mm. ConclusionThe intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria, thus validating the rationality and feasibility of the structural design. more...

Background/Objectives: Evaluations allowing patients to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) should be multimodal, including a psychological evaluation. The goal of this study was to determine if there is a correlation between the ACL–return to sport after injury (ACL-RSI) score at 6 months post-ACLR and mid-term functional results. Methods: A total of 498 patients were assessed 6 months after primary ACLR using a composite test including isokinetics, hops, and ACL-RSI. A minimum of 3 years of follow-up was necessary. At the last follow-up, each patient completed clinical and functional evaluations, including the subjective International Knee Documentation Committee (IKDC) score, Tegner Activity Scale, Self Knee Value (SKV), and ACL-RSI score. The results were compared overall and item by item. Results: At the last follow-up, the mean SKV, Tegner, IKDC, and ACL-RSI scores were 86.8 ± 14.3%, 6 ± 2.1, 77 ± 11.9%, and 68.8 ± 25.7%, respectively. A significant correlation existed between the 6-month ACL-RSI score and each functional test (respectively, ρ = 0.189 p < 0.001; ρ = 0.174 p < 0.001; ρ = 0.237 p < 0.001). The ACL-RSI score was significantly higher than at 6 months after surgery (p < 0.001). Over half (59.2%) of the cohort returned to an equal or greater level of activity, and there was a significant correlation between the 6-month ACL-RSI score and post-surgery level of activity. Conclusions: Patients with better ACL-RSI scores at 6 months post-ACLR have better functional results in the medium term and are more likely to RTS. Our results show a correlation between psychological factors at 6 months, measured through the ACL-RSI score, and activity level at mid-term follow-up. This study underlines the relationship between RTS and psychological effects, and the importance of ACLR rehabilitation to focus on decreasing apprehension and fear. [ABSTRACT FROM AUTHOR] more...

Knee osteoarthritis is among the most prevalent chronic diseases. Total knee arthroplasty is a common solution that effectively addresses the continued structural degeneration of the articular cartilage. However, effective physical therapy is critical for recovery. Despite participating in physical therapy, many patients fail to recover. This study investigated the potential efficacy of a behaviorally informed approach to surface electromyographic biofeedback following total knee arthroplasty relative to the clinical standard, neuromuscular electrical stimulation. The surface electromyographic biofeedback procedure incorporated improved techniques for establishing a baseline and individualized and adjusting criteria for feedback. The findings suggest some advantages for surface electromyographic biofeedback over neuromuscular electrical stimulation in quadriceps strength, range of motion, functional recovery, and quality of life. Behaviorally informed surface electromyographic biofeedback holds promise for total knee arthroplasty recovery and these data suggest considerable room for collaboration between behavior analysts and physical therapists. [ABSTRACT FROM AUTHOR] more...

Background and study aim. Isometric strength exercises engage the intricate knee joint, including the femur, tibia, and patella, along with multiple muscles and ligaments, aiding in the rehabilitation of knee injuries while supporting movement and injury prevention. The specific objective of this research is to investigate the effectiveness of isometric strength exercises in rehabilitating the knee injuries among football players, assessing their impact on recovery and performance. Material and methods. Thirty male ACL Knee injured football players were randomly assigned to isometric strength exercise group (ISEG) (N=15) (Age; 20±1.9, Height;171±4.5, Weight; 60±6.0) and control group (Age;21±1.3, Height;173±4.4, Weight; 63±8.2) and their age ranged between 18 and 23. Subjects were randomly selected from various football academies in Coimbatore, Tamil Nadu, India. Thirty subjects who will diagnosed by a physiotherapist and help of orthopaedician as having knee injuries in football players and who showed a typical restriction of Range of motion (ROM). Fifteen subjects underwent rehabilitation (Isometric Strength exercise Group) and the other 15 underwent cryotreatment (Control Group). Analysis was based on the active and passive flexion Range of motion (ROM) were measured by kinovea-0.9.5 software. Means and standard deviations (±) described all data, with Shapiro-Wilk tests checking for normality (p<0.05). A dependent 't' test determined significant mean differences between experimental and control groups (p<0.05). Results. The participants who underwent a regimen of Isometric strengthening exercises exhibited notable enhancements in their range of motion (ROM), highlighting the effectiveness of this comprehensive approach significantly improved in active and passive flexion Range of motion (p < 0.05). Conclusion. Isometric strength exercises demonstrate promise in enhancing knee rehabilitation outcomes among football players, warranting further exploration and implementation compared to control group. [ABSTRACT FROM AUTHOR] more...

Copyright of International Journal of Engineering Transactions B: Applications is the property of International Journal of Engineering (IJE) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Contemporary total knee arthroplasty patients have increased expectations of returning to predisease function, including sexual activity (SA). The purpose of this study was to determine whether patients using a digital care management platform (DCMP) were more likely to have a higher rate and frequency of return to SA. We conducted an exploratory analysis of a prospective, multicenter, randomized controlled trial that enrolled patients undergoing total knee arthroplasty. A total of 304 patients were randomized to a DCMP (n = 119) providing preoperative and postoperative education regarding return to SA or standard postoperative care (control group; n = 185). Return to SA, assessed via questionnaire, patient-reported outcome measures, Timed Up and Go test, single leg stance, active range of motion and need for manipulation under anesthesia were assessed at 90 days postoperatively. More patients in the DCMP group returned to SA compared to control at 90 days (58.4 versus 39.6%, P =.018); however, the control group resumed SA sooner (33.1 versus 42.0 days, P =.023). Patients who returned to SA were younger (61.6 versus 65.9 year), more often men (56 versus 35%) (P <.001), higher performing on the Timed Up and Go and single leg stance tests (P <.001), and had greater active range of motion (P =.007). There were no differences in patient-reported outcome measures or need for manipulation under anesthesia between patients that returned to SA and those who did not. More patients using a DCMP resumed SA at 90 days; however, patients in the control group returned to SA sooner. Those who returned to SA were younger, possessed greater physical function, and were more often men. [ABSTRACT FROM AUTHOR] more...

The menisci increase the contact area of load bearing in the knee and thus disperse the mechanical stress via their circumferential tensile fibers. Traumatic meniscus injuries cause mechanical symptoms in the knee, and are more prevalent amongst younger, more active patients, compared to degenerative tears amongst the elderly population. Traumatic meniscus tears typically result from the load-and-shear mechanism in the knee joint. The treatment depends on the size, location, and pattern of the tear. For non-repairable tears, partial or total meniscal resection decreases its tensile stress and increases joint contact stress, thus potentiating the risk of arthritis. A longitudinal vertical tear pattern at the peripheral third red-red zone leads to higher healing potential after repair. The postoperative rehabilitation protocols after repair range from immediate weight-bearing with no range of motion restrictions to non-weight bearing and delayed mobilization for weeks. Pediatric and adolescent patients may require special considerations due to their activity levels, or distinct pathologies such as a discoid meniscus. Further biomechanical and biologic evidence is needed to guide surgical management, postoperative rehabilitation protocols, and future technology applications for traumatic meniscus injuries. more...

The article examines the results of MPFL reconstruction surgery in rural and urban patients, revealing that urban patients generally had better functional outcomes, particularly in knee extensor strength tests. Disparities in rehabilitation outcomes between rural and urban populations were noted even 12 months post-surgery, suggesting that access to rehabilitation facilities may impact results. The document also covers various studies on patellar instability and its treatment, including gait pattern recovery, muscle strength assessment, predictive factors for surgery failure, and patient-reported outcomes. Additionally, the importance of addressing the needs of disabled individuals in public health support systems is discussed. [Extracted from the article] more...

The menisci increase the contact area of load bearing in the knee and thus disperse the mechanical stress via their circumferential tensile fibers. Traumatic meniscus injuries cause mechanical symptoms in the knee, and are more prevalent amongst younger, more active patients, compared to degenerative tears amongst the elderly population. Traumatic meniscus tears typically result from the load-and-shear mechanism in the knee joint. The treatment depends on the size, location, and pattern of the tear. For non-repairable tears, partial or total meniscal resection decreases its tensile stress and increases joint contact stress, thus potentiating the risk of arthritis. A longitudinal vertical tear pattern at the peripheral third red-red zone leads to higher healing potential after repair. The postoperative rehabilitation protocols after repair range from immediate weight-bearing with no range of motion restrictions to non-weight bearing and delayed mobilization for weeks. Pediatric and adolescent patients may require special considerations due to their activity levels, or distinct pathologies such as a discoid meniscus. Further biomechanical and biologic evidence is needed to guide surgical management, postoperative rehabilitation protocols, and future technology applications for traumatic meniscus injuries. [ABSTRACT FROM AUTHOR] more...

Background: Knee pain is a prevalent issue affecting adolescents and adults, with various causes ranging from acute injuries to chronic conditions like osteoarthritis. The knee is particularly susceptible to injury, especially among athletes. Aquatic therapy has gained attention as a promising approach to knee rehabilitation because of its unique properties, including buoyancy, hydrostatic pressure, and viscosity, which can aid in reducing pain and enhancing recovery. This narrative review explores the effectiveness of aquatic therapy in knee rehabilitation across different knee conditions and presents findings from several studies conducted between 2006 and 2022. Methodology: A comprehensive search strategy was implemented using keywords in Google Scholar and PubMed. The search was limited to randomized controlled trials, systematic reviews, and pilot studies conducted between 2006 and 2022, published in English. Inclusion criteria encompassed original research with outcomes related to knee rehabilitation and aquatic therapy, while articles that did not focus on knee rehabilitation and aquatic therapy or were published prior to 2006 were excluded. Results: Several studies were reviewed to assess the effectiveness of aquatic therapy in knee rehabilitation for different conditions. A total of 7 articles were selected that said the effectiveness of aquatic therapy in knee rehabilitation. Conclusion: In this review, aquatic therapy is effective in all knee conditions. [ABSTRACT FROM AUTHOR] more...

Movement is an essential characteristic that has developed over the course of human evolution. With the inclusion of various populations in sports activities, sports have become an important part of people’s daily lives. Knee injuries are common among athletes, with knee joint being the most vulnerable to various injuries. Knee injuries require appropriate treatment to allow the athlete to return to their sports activities. Additionally, this study aimed to increase awareness of the importance of preventing knee injuries in sports and to highlight the potential impact of such injuries on an athlete’s ability to participate in their sport. A cross-sectional study was conducted to evaluate the functional outcomes of athletes with knee injuries. The study included 38 patients with knee injuries (ACL, meniscal injuries, collateral ligament injuries) out of which 21 were physically active athletes, 9 were not, but they were athletes who were not involved in sports at the time of the testing and 8 were recreational athletes. The majority of respondents (76%) reported that they sustained the injury during sports activities. Knee pain was reported as at least once a week by most respondents. The study highlights the importance of proper knee injury prevention measures during sports activities and the need for prompt and effective rehabilitation for those who do suffer injuries. Overall, these findings have important implications for the treatment and management of knee injuries among athletes and individuals seeking to maintain an active lifestyle. more...

In this work, an IoT system with edge computing capability is proposed, facilitating the postoperative surveillance of patients who have undergone knee surgery. The main objective is to reliably identify whether a set of orthopedic rehabilitation exercises is executed correctly, which is critical since it is often necessary to supervise patients during the rehabilitation period so as to avoid injuries or long recovery periods. The proposed system leverages the Internet of Things (IoT) paradigm in combination with deep learning and edge computing to classify the extension–flexion movement of one's knee via embedded machine learning (ML) classification algorithms. The contribution of the proposed work is multilayered, as this paper proposes a system tackling the challenges at the embedded system level, algorithmic level, and user-friendliness level considering a performance evaluation, including the metrics at the power consumption level, delay level, and throughput requirement level, as well as its accuracy and reliability. Furthermore, as an outcome of this work, a dataset of labeled knee movements is freely available to the research community with no limitations. It also provides real-time movement detection with an accuracy reaching 100%, which is achieved with an ML model trained to fit a low-cost off-the-shelf Bluetooth Low Energy platform. The proposed edge computing approach allows predictions to be performed on device rather than solely relying on a Cloud service. This yields critical benefits in terms of wireless bandwidth and power conservation, drastically enhancing device autonomy while delivering reduced event detection latency. In particular, the "on device" implementation is able to yield a drastic 99.9% wireless data transfer reduction, a critical 39% prediction delay reduction, and a valuable 17% increase in the event prediction rate considering a reference period of 60 s. Finally, enhanced privacy comprises another significant benefit from the implemented edge computing ML model, as sensitive data can be processed on site and only events or predictions are shared with medical personnel. [ABSTRACT FROM AUTHOR] more...

Purpose: To investigate longitudinally the role of mental toughness (MT) in knee rehabilitation in terms of perceived pain and functionality in a sample of older adults with arthritis who adhered to their postsurgery clinic-based rehabilitation protocols and provide suggestions to rehabilitation psychologists. Design: To strengthen the internal validity of this study, we designed our methods and implementation in a way to minimize bias by utilizing the National Institute of Health Quality Assessment Tool for Before–After (Pre–Post) Studies With No Control Group. The data were collected from 92 older-adult patients, who had a diagnosis of osteoarthritis and underwent knee surgery. All patients were diagnosed, underwent surgery, and were evaluated by the same physician. We administered the Oxford Knee Score (OKS) to measure rehabilitation outcomes in terms of pain and functionality and the MT Index (MTI) to measure MT levels three times: 1 day before and 1 and 6 months after the surgery. We used a multilevel growth model to examine the change in the OKS across administrations using MTI scores as a time-varying covariate and sex, age at surgery, and knee as time-invariant covariates. Results: About 62% of the variability in OKS was due to between-patient differences. Of the variability that was attributable to differences within-patient across time, MT accounted for about 38% of the variability. Conclusions: MT could be another, positive psychology-based tool rehabilitation psychologists use to contribute to health promotion efforts to reduce the incidence of disability of older adults with osteoarthritis who undergo knee replacement surgery. Impact and Implications: Following control for in-clinic rehabilitation adherence of patients after total knee replacement surgery, this is the first study to investigate the proportion of variance in knee rehabilitation-related pain and function accounted for by mental toughness (MT) across time and the potential interaction of MT and time on the growth trajectory in knee rehabilitation-related pain and function. The study highlights the importance of considering individual levels of MT in knee rehabilitation outcomes and suggests that nearly 40% of the change across time is accounted for by an individual's MT levels. The findings indicate that healthcare providers, including surgeons and physical therapists, should focus on a multidisciplinary approach to managing the rehabilitation of total knee replacement and consider collaborating with rehabilitation psychologists to develop ways to increase MT levels before surgery. [ABSTRACT FROM AUTHOR] more...

Based on seminal research from the 1970s and 1980s, the myth that the knees should only move as far anterior during the barbell squat until they vertically align with the tips of the feet in the sagittal plane still exists today. However, the role of both the hip joint and the lumbar spine, which are exposed to high peak torques during this deliberate restriction in range of motion, has remained largely unnoticed in the traditional literature. More recent anthropometric and biomechanical studies have found disparate results regarding anterior knee displacement during barbell squatting. For a large number of athletes, it may be favorable or even necessary to allow a certain degree of anterior knee displacement in order to achieve optimal training outcomes and minimize the biomechanical stress imparted on the lumbar spine and hip. Overall, restricting this natural movement is likely not an effective strategy for healthy trained individuals. With the exception of knee rehabilitation patients, the contemporary literature suggests it should not be practiced on a general basis. [ABSTRACT FROM AUTHOR] more...

Dynamic loads have short and long-term effects in the rehabilitation of lower limb joints. However, an effective exercise program for lower limb rehabilitation has been debated for a long time. Cycling ergometers were instrumented and used as a tool to mechanically load the lower limbs and track the joint mechano-physiological response in rehabilitation programs. Current cycling ergometers apply symmetrical loading to the limbs, which may not reflect the actual load-bearing capacity of each limb, as in Parkinson's and Multiple Sclerosis diseases. Therefore, the present study aimed to develop a new cycling ergometer capable of applying asymmetric loads to the limbs and validate its function using human tests. The instrumented force sensor and crank position sensing system recorded the kinetics and kinematics of pedaling. This information was used to apply an asymmetric assistive torque only to the target leg using an electric motor. The performance of the proposed cycling ergometer was studied during a cycling task at three different intensities. It was shown that the proposed device reduced the pedaling force of the target leg by 19% to 40%, depending on the exercise intensity. This reduction in pedal force caused a significant reduction in the muscle activity of the target leg (p < 0.001), without affecting the muscle activity of the non-target leg. These results demonstrated that the proposed cycling ergometer device is capable of applying asymmetric loading to lower limbs, and thus has the potential to improve the outcome of exercise interventions in patients with asymmetric function in lower limbs. [ABSTRACT FROM AUTHOR] more...

Background: The goal of this study was to assess the reliability of electromyography and range of motion measurements obtained using a knee exercise monitoring system. This device was developed to collect data on knee exercise activities. Methods: Twenty healthy individuals performed isotonic quadriceps exercises in this study. The vastus medialis surface electromyography (sEMG) and range of motion (ROM) of the knee were recorded during the exercise using the isotonic knee exercise monitoring device, the Mobi6-6b, and a video camera system. Each subject underwent a second measuring session at least 24 h after the first session. To determine reliability, the intraclass correlation coefficients (ICCs) and standard error of measurement (SEM) at the 95% confidence interval were calculated, and a Bland-Altman analysis was performed. Results: For inter-rater reliability, the ICCs of the mean absolute value (MAV) and root mean square (RMS) of sEMG were 0.73 (0.49, 0.86) and 0.79 (0.61, 0.89), respectively. ROM had an ICC of 0.93 (0.02, 0.98). The intra-rater reliability of the MAV of the sEMG was 0.89 (0.71, 0.96) and the intra-rater reliability of RMS of the sEMG was 0.88 (0.70, 0.95). The ROM between days had an intra-rater reliability of 0.82 (0.54, 0.93). The Bland-Altman analysis demonstrated no systematic bias in the MAV and RMS of sEMG, but revealed a small, systematic bias in ROM (-0.8311 degrees). Conclusion: For sEMG and range of motion measures, the isotonic knee exercise monitoring equipment revealed moderate to excellent inter- and intra-rater agreement. However, the confidence interval of ROM inter-rater reliability was quite large, indicating a small agreement bias; hence, the isotonic knee exercise monitor may not be suitable for measuring ROM. This isotonic knee exercise monitor could detect and collect information on a patient's exercise activity for the benefit of healthcare providers. [ABSTRACT FROM AUTHOR] more...

This investigation carries out the biomechanical modeling of the knee with the purpose of contributing to rehabilitation therapies for patients who come to the Patronato of Latacunga, through a mathematical model that serves as initial support for the design and the construction of physiotherapy equipment, guaranteeing functionality, safety, and ergonomics to the patients. With the data from the anthropometric study of the population under study, the mathematical variables have been introduced to create a mathematical model with the help of MATLAB/Simulink tool with a focus on the modeling of physical systems, by taking the mechanical system as a biomechanical research because it acts on the bodies in a way that gives them movement, analyzing their laws, variables and elements. A bibliographic method has been used to collect the data, the analytical method to analyze data and variables and the experimental method through the simulation of the model, the developed model is perfectly adaptable to any person, by only changing the variables of the matrix. [ABSTRACT FROM AUTHOR] more...

We report the case of a 78-year-old woman who presented with a 14-month history of progressive bilateral knee spasms and pain and reduced quality of life. The patient had undergone bilateral total knee arthroplasty after a diagnosis of osteoarthritis and failure of conservative treatment. Symptoms reappeared 8 months postoperatively, and the patient was diagnosed with cervical spondylotic myelopathy. Consequently, she was successfully treated with chiropractic rehabilitation which involved scraping therapy, spinal manipulation, and intermittent motorized traction to relieve cervical nerve pressure. Thus, cervical spondylotic myelopathy should be considered in the differential diagnosis of cases of persistent knee pain. [ABSTRACT FROM AUTHOR] more...

Background: Almost all patients experience neuromuscular disorders of the quadriceps after knee trauma or surgery such as anterior cruciate ligament (ACL) reconstruction. This phenomenon is described in literature as arthrogenic muscle inhibition (AMI). It can be detrimental to patients and cause complications. However, few studies have evaluated the long-term persistence of deficits arising from this, following ACL reconstruction., Purpose: By comparing neuromuscular activation in the lower limb after ACL reconstruction with the unaffected lower limb, after more than 3-years of follow-up, this study aimed to evaluate the possible persistence of long-term deficits after surgery., Methods: Fifty-one patients who underwent ACL reconstruction in 2018 were included in the study, with a minimum follow-up of 3 years. The neuromuscular activation deficit was assessed using the Biarritz Activation Score-Knee (BAS-K), whose intra- and inter-observer reproducibility was also evaluated. The ACL-RSI, KOOS, SANE Leg, Tegner and IKDC scores were also evaluated., Results: The mean BAS-K score of the knee that underwent surgery was 21.8/50 versus 37.9/50 in the healthy knee (p < 0.05). The SANE leg score was 76.8/100 versus 97.6/100 (p < 0.05). The mean IKDC was 84.17 (±12.7). The mean KOOS was 86.2 (±9.2). The mean ACL-RSI was 70 (±7.9) and the Tegner score was 6.3 (±1.2). Intra- and inter-observer reproducibility was satisfactory for the BAS-K score., Conclusion: We found that the neuromuscular activation deficit was high (roughly 42%) at more than 3-years of follow-up after ACL reconstruction. The deficit is not limited to the quadriceps and affects the whole limb. Our findings highlight the need for appropriate rehabilitation after ACL surgery, targeting the corticospinal level in particular., Level of Evidence Iii: prognostic retrospective case-control study., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.) more...

Purpose: Commercially available smartphone apps and wearable devices have proven valuable in a variety of clinical settings, yet their utility in measuring physical activity and monitoring patient status following total knee arthroplasty (TKA) remains unclear., Methods: A systematic review was performed to assess the evidence supporting the use of smartphone apps and wearable devices to assist rehabilitation interventions following TKA. A search was conducted in the PubMed, Cochrane, Medline, and Web of Science databases in September 2021., Results: One hundred and seventy-six studies were retrieved, of which 15 met inclusion criteria, including 6 randomized control trials. Four of these studies utilized smartphone apps, seven utilized wearable devices, and four utilized a combination of both. A total of 1607 TKA patients participated in the included studies. For primary outcomes, three reported on device accuracy, three on recovery prediction, two on functional recovery, two on physical activity promotion, two on patient compliance, two on pain control, and one on healthcare utilization., Conclusion: Commercially available smartphone apps and wearable devices were shown to capably monitor physical activity and improve patient engagement following TKA, making them potentially viable adjuncts or replacements to traditional rehabilitation programs. Components of interventions such as step goals, app-based patient engagement platforms, and patient-specific benchmarks for recovery may improve effectiveness. However, future research should focus on the economics of implementation, long-term outcomes, and optimization of compliance and accuracy when using these devices. more...