Effect Of Isokinetic And Isometric Emg Biofeedback Aided Training On Proprioception, Muscle Strength And Selected Gait Characteristics In Knee Osteoarthritis Patients
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Date
2017-01
Authors
Raj, Naresh Bhaskar
Journal Title
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Volume Title
Publisher
Universiti Sains Malaysia
Abstract
The aim of the present study was to investigate the role of Isokinetic Training and Isometric (Electromyography) EMG aided training in improving proprioception in participants with Osteoarthritis of knee. Seventy two participants (male and female) in the age range of 50-63 years with knee Osteoarthritis of Grade II & III (Kellgren-Lawrence criteria) severity were recruited from the Department of Orthopedics, Hospital Universiti Sains Malaysia. The selected participants were taken to the Exercise and Sports science laboratory and the laboratory of School of Medical Sciences, Universiti Sains Malaysia for baseline assessment. Extent of proprioception was assessed employing the isokinetic device BIODEX 4 System Pro, and specific muscle potentiality, maximum voluntary contraction and fatigability was evaluated incorporating the Mega ME 6000 Biomonitor. Analysis of gait and force distribution across the knee joint was done using Qualisys 3D motion analyser and Bertec force distribution analyser respectively. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate the subjective indices of pain, stiffness and physical dysfunction. On completion of the baseline assessment the participants were randomly categorized into four groups (Gr.) (Viz. Gr. A, Gr. B, Gr. C and Gr. D) and thus each group consisted of 18 participants.Gr.A participants received Conventional Physiotherapy consisting of strengthening exercises; stretching exercises and range of motion exercises. Gr. B received Isokinetic Training at velocities of 90° and 150°/second. Gr. C participants received Isometric EMG aided training. Participants in Gr. D underwent combined
intervention. Participants in Gr. D were again categorized into two sub-groups – D1 and D2. Group D1 received Isometric EMG aided training prior to Isokinetic Training and Group D2 received Isokinetic Training prior to Isometric EMG aided training. All the interventions were imparted for 25 - 30 minutes per session; 2 sessions per week for10 weeks (20 sessions). Mid intervention assessment was done after 5th week followed by the post intervention assessment after 10th week following baseline assessment protocol. After the post intervention assessment, the participants were instructed not to attend the training session for the next 8 weeks and not to get engaged in any sort of physical training, exercise or sport programme. The issue of sustainability was also verified by the post-follow-up assessments of the all of the variables following identical assessment protocols after 14th and 18th week of completion. Two-way repeated measure of ANCOVA revealed that, Isokinetic Training was beneficial in enhancing muscle-strength, improving proprioception, gait and functional activities in participants, while Isometric EMG aided training was observed as better than Conventional Physiotherapy in enhancing proprioception, muscle strength, gait and functional activities in participants with Osteoarthritis of knee joint. Combined intervention of Isokinetic Training and Isometric EMG aided training was also beneficial. Isokinetic training was observed to sensitise the sensory receptors of the muscle and the tendon thereby causing enhancement in proprioception of knee joint, strength of the muscle, gait and functional activities in participants suffering from Osteoarthritis of knee.
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Keywords
The role of Isokinetic Training , participants with Osteoarthritis of knee.