Early Activation of Quadriceps With Pressure Biofeedback for the Prevention of Arthrogenic Muscle Inhibition Following Lower Limb Orthopedic Surgeries: A Proof of Concept Clinical Trial

Abstract

Objective

The purpose of this study was to explore the possible role of pressure biofeedback in the early activation of quadriceps following lower limb orthopedic surgeries.

Methods

This was a proof of concept clinical trial. A single-blinded randomized controlled study was conducted on 24 patients who underwent lower limb surgeries. The experimental group received standardized physiotherapy treatment in addition to pressure biofeedback for quadriceps retraining. The control group received a standardized physiotherapy treatment developed for an inpatient orthopedic setting. The motor unit action potential (MUAP) duration and amplitude were measured using electromyography on the second and sixth postoperative days.

Results

Twenty-four participants, with a mean age for the control group of 58.67 ± 17.21 and the experimental group of 40.1 ± 6.96, were enrolled. No statistical significance in MUAP amplitude for within the groups (F[5,85] = 1.735, P = .135) was found. However, there was a statistical significance between the control and experimental groups in amplitude measured by electromyography (F[1,17] = 49.09, P < .01). There was no statistical significance in MUAP duration for within the groups (F[5,85] = 1.303, P = .270). However, there was a statistical significance in duration (F[1,17] = 71.84, P < .01).

Conclusion

Pressure biofeedback was more effective in the early activation of quadriceps muscle when coupled with conventional exercises compared with conventional exercises alone following lower limb orthopedic surgeries. Early activation of quadriceps could be a contributing factor to preventing arthrogenic muscle inhibition.