Recovery of Quadriceps Strength and Knee Function Using Adjuvant EMG-BF After Primary ACL Reconstruction

[摘要] Introduction: Immobility and limited usage of operated limbs lead to weakness and atrophy ofthe muscle after anterior cruciate ligament (ACL) reconstruction. However, training programsfor preventing biomechanical risk factors such as lower limb alignment and increased muscularcontraction are very limited. Thus, the current study was carried out to evaluate the recovery ofquadriceps muscle strength and the improvement of knee function using adjuvant electromyographicbiofeedback (EMG-BF) after ACL reconstruction.Methods: This prospective randomized controlled trial was conducted among 40 patients (20=EMGBF group, 20=Control group) with ACL reconstruction, who were referred to Akhtar Hospital from2021 to 2022. In the EMG-BF group, EMG BFB was added to the standard rehabilitation protocol,and in the control group, the standard rehabilitation protocol with full postoperative weightbearing, knee brace (zero degree of extension, 90 degrees of flexion), and electrical stimulationwith maximal voluntary isometric knee extension was performed. Each group was intervened for 4weeks and three sessions of 30 minutes per week. It should be noted that each patient participatedin 16 outpatient physiotherapy sessions after surgery. Nicholas Hand-Held Dynamometer (HHD)was used for measuring quadriceps strength, and Knee Outcome Survey-Activities of Daily Living(KOS-ADLs) and Knee Outcome Survey Sports Activities Scale (KOS-SAS) questionnaires were usedfor assessing the knee function.Results: Four weeks after the treatment, the EMG-BF group showed a significant increase inquadriceps strength (P=0.0001). Quadriceps strength had a significant difference before and after 4weeks of intervention (P=0.0001), but in the control group, no significant difference was observed(P=0.368). The EMG-BF group had a significant increase in KOS-ADLs and KOS-SAS scores after 4weeks of intervention (P=0.0001).Conclusion: In our study, isometric strengthening of quadriceps with adjuvant EMG-BF significantlyincreased the strength of quadriceps and knee function during 4 weeks. EMG-BF is a low risk,low cost, and less invasive intervention and has high safety and adjustment ability. It is a valuableadjuvant method for achieving better functional recovery in a shorter time.

[学科分类] 基础医学

[关键词] Electromyographic biofeedback;Adjuvant method;Quadriceps strength;Rehabilitation;Anterior cruciate ligament reconstruction.