Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Effect of Ankle Position on Isometric Quadriceps Strengthening in Osteoarthritis of Knee Joint


Affiliations
1 Central Research Institute for Ayurveda, New Delhi, India
2 Hamdard University, New Delhi, India
3 Jamia Milia Islamia University, New Delhi, India
     

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Objective The one exercise commonly used to strengthen the anterior thigh musculature is quadriceps setting exercise. But despite being the most frequently performed exercise, there still remains lack of agreement as to the most satisfactory way of performing this exercise. There is a lot of discrepancy with regard to the effects of ankle position while performing this exercise. The purpose of this study was to examine if ankle position influences the isometric quadriceps strength and to further find the most effective position of the ankle while performing the exercise. Methods 45 subjects were included for a 3 weeks protocol and randomly assigned to three groups (dorsiflexion, natural resting and plantar flexion position of ankle). Isometric strength, Reduced Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score and Visual Analog Score (VAS), were measured. Oneway ANOVA was applied for the analysis of isometric strength between the group and for Reduced WOMAC and VAS scores Kruskal Wallis test was used for analysis between the groups. Results At the end of the protocol, there was a statistically significant difference in terms of isometric strength between the three groups. The dorsiflexion group showed better increase in the strength as compared to the natural resting and plantar flexion groups. However the values of isometric strength in both natural resting position and plantar flexion position were statistically insignificant with respect to each other. On comparing the final Reduced WOMAC and VAS score, there was no statistically significant difference between the dorsiflexion, natural resting and plantar flexion position. Conclusion The results of the study suggest that active dorsiflexion position of ankle, while performing quadriceps setting exercise is best suited in an attempt to facilitate quadriceps strength in patients with OA knee. The ankle position while performing setting exercise for quadriceps; however has no influence on the functional score and pain intensity.

Keywords

Quadriceps, Osteoarthritis, Ankle Position, Isometric Strength
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  • Elizabeth M, Badley, Iris Rasooly, Gregory K. Webster. Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: Findings from the 1990 Ontario Health Survey. J Rheumatol. 1994; 21:505–14.

  • Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001; 60:91–7.

  • Gerberding L, Popovic T, Stephens J, Solomon S, Bernhardt M, Aguilar R. Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis attributable activity limitation-United States, 2003-2005.Morb. Mortal Wkly Rep. 2006; 55:1089-1092.

  • Bashaw RT, Tingstad EM.Rehabilitation of osteoarthritic patient: focus on the knee. Clin Sports Med.2005; 24:101-131.

  • Gough JV, Geoffery L. An investigation into the effectivness of various forms of quadriceps exercise. Physiotherapy. 1971; 356-361.

  • Soderberg GL, Cook. An EMG analysis of quadriceps femoris during muscle setting and SLR. Phys Ther. 1983; 63:1434-1438.

  • Zakaria D, Harburn KL, Kramer JF. Preferential activation of vastus medialis oblique, vastus lateralis and hip adductors muscles during isometric exercise in females. J Orthop Sports Phys Ther.1997; 26: 23-28.

  • Tepperman PS, Mazliah J, Naumann S, Delmore T. Effect of ankle position on isometric quadriceps strengthening. Am J Phys Med 1986; 65(2): 69-74.

  • Khalil W, Jerome W, Earl C, Gordon M. Objective recording of muscle strength. Arch Phys Med and Rehab1950; Feb: 90-100.

  • William Kennedy. The development and comparison of an electrical strain gage dynamometer and a cable tensiometer for objective muscle testing. Arch Phys Med and Rehab 1965; Dec: 793-803.

  • Whitehouse S.L., Lingard E.A., Katz J.N, Learmonth I.D. Development and testing of a reduced WOMAC function scale. J Bone Joint Surg (Br) 2003; 85-B: 706- 711.

  • Bijur P.E., Silver W, Gallagher J. Reliability of the VAS for measurement of acute pain. Academic Emergency Medicine 2001; 8:1153-1157.

  • Donald D, McGarth P, Rafii A, Buckingham B. The validation of visual analog scale for chronic and experimental pain. Pain 1983; 17:45-56.

  • Jan MH, Chai HM, Wang CL, Lin FY, Tsai LY. Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study. Phys Ther 2006; 86:236-244.

  • Hwang IS, Abraham LD, Chou SW. The effect of ankle joint position and effort on quadriceps reflex sensitivity. Clin Neurophysiol.2000; 111:1175-1183.

  • Guyton AC, Hall JE. Textbook of Medical Physiology. 10th ed. Philadelphia: W.B.Saunders 2001.

  • Chaix Y, Marque P, Meunier S, Deseilligny E, Simonetta M. Further evidence for non- monosynaptic group I excitation of motoneurones in the human lower limb. Exp Brain Res.1997; 115:35-46.

  • Marchand V, Nielsen JB. Modulation of non monosynaptic excitation from ankle dorsiflexor afferents to quadriceps motoneurones during walking. J Physiol.2002; 538(2): 647-657.

  • Staron RS, Karapondo DL, Kraemer WJ, Fry AC, Gordon SE, Falkel JE, et al. Skeletal muscle adaptations during early phase of heavy resistance training in men and women. J Appl Physiol.1994;76(3): 1247-1255

  • Moritani T, De Vries. Neural factors versus hypertrophy in the time course of muscle strength gain. Am J Phys Med.1979; 58(3):115-130.

  • Duchateau J, Semmler J, Enoka RM. Training adaptations in the behavior of human motor units. J Appl Physiol.2006; 101:1766-1775.

  • Pucci AR, Griffin L, Cafarelli E. Maximal motor unit firing rates during isometric resistance training in men. Exp Physiol.2006; 91:171-178.

  • Adegoke B, Gbeminiyi. Efficacy of ice and shortwave diathermy in the management of OA of knee. Afr J Biomed Res.2004; 7:107-111.

  • Jan MW, Lai JS. The effects of physiotherapy on osteoarthritic knee of females.J Formos Med Assoc. 1991; 90:1008-1013.

  • Miyaguchi M, Kobayashi A, Kadoya Y, Ohashi H, Yamano Y, Takaoka K. Biochemical changes in joint fluid after isometric quadriceps exercise for patients with osteoarthritis of knee joint. Osteoarthritis Cartilage. 2003; 11:252-259.


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  • Effect of Ankle Position on Isometric Quadriceps Strengthening in Osteoarthritis of Knee Joint

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Authors

Katyal Shveta
Central Research Institute for Ayurveda, New Delhi, India
Nishat Quddas
Hamdard University, New Delhi, India
Zubia Vequar
Jamia Milia Islamia University, New Delhi, India

Abstract


Objective The one exercise commonly used to strengthen the anterior thigh musculature is quadriceps setting exercise. But despite being the most frequently performed exercise, there still remains lack of agreement as to the most satisfactory way of performing this exercise. There is a lot of discrepancy with regard to the effects of ankle position while performing this exercise. The purpose of this study was to examine if ankle position influences the isometric quadriceps strength and to further find the most effective position of the ankle while performing the exercise. Methods 45 subjects were included for a 3 weeks protocol and randomly assigned to three groups (dorsiflexion, natural resting and plantar flexion position of ankle). Isometric strength, Reduced Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score and Visual Analog Score (VAS), were measured. Oneway ANOVA was applied for the analysis of isometric strength between the group and for Reduced WOMAC and VAS scores Kruskal Wallis test was used for analysis between the groups. Results At the end of the protocol, there was a statistically significant difference in terms of isometric strength between the three groups. The dorsiflexion group showed better increase in the strength as compared to the natural resting and plantar flexion groups. However the values of isometric strength in both natural resting position and plantar flexion position were statistically insignificant with respect to each other. On comparing the final Reduced WOMAC and VAS score, there was no statistically significant difference between the dorsiflexion, natural resting and plantar flexion position. Conclusion The results of the study suggest that active dorsiflexion position of ankle, while performing quadriceps setting exercise is best suited in an attempt to facilitate quadriceps strength in patients with OA knee. The ankle position while performing setting exercise for quadriceps; however has no influence on the functional score and pain intensity.

Keywords


Quadriceps, Osteoarthritis, Ankle Position, Isometric Strength

References