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

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.