| Description |
Individuals recovering from total knee arthroplasty (TKA) perform compensatory strategies defined as interlimb asymmetries, resulting in lower functional performance and accelerated arthritic changes in other joints. This body of work focuses on factors related to the performance of the surgical limb by: 1) investigating how the demand of the mobility task influences compensation, 2) comparing the effectiveness of two biofeedback modes in correcting compensation, 3) evaluating if biofeedback can normalize compensation to similar levels as healthy matched pers (HMP), and 4) studying the relationship of modifiable risk factors to the compensations following TKA. A total of 46 patients with TKA and 15 HMP were assessed in three separate clinical studies. In Study #1, compensation was compared between low- (level) and high- (decline) demand walking tasks in patients with TKA and HMP. In Study #2, we compared the efficacy of two modes of biofeedback on improving compensation and compared between groups. In Study #3, we tested whether risk factors considered modifiable (i.e., lower limb strength, power, residual knee pain, and/or balance confidence) help explain the level of compensation following TKA. Study #1 showed greater total support moment (MS), knee extensor moment (MK), and vertical ground reaction force (vGRF) differences during decline walking compared to level walking in patients with TKA. Greater MS, MK, vGRF, and knee joint angle differences were present in patients with TKA compared to HMP during decline walking. Study #2 showed patients with TKA exposed to internal knee extensor moment (IKEM) biofeedback demonstrated improvement in MS and MK symmetry compared to vGRF biofeedback. Additionally, IKEM biofeedback could normalize the level of compensation similar to HMP during decline walking. Study #3 concluded that knee extensor strength asymmetry showed a strong relationship on both MS and MK asymmetry following surgery. Lower limb power, residual knee pain, and balance confidence had no relationship on compensation. These results suggest that compensation is amplified during more physically demanding mobility and can be normalized using knee kinetic biofeedback. Further, it seems intuitive to continue to focus on knee extensor strength and integrate into functional movement retraining with knee kinetic biofeedback to effectively correct compensatory movement strategies during rehabilitation. |
