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What is the effect of biofeedback on quadriceps and gluteal strength when used as an adjunct to short arc quad and seated clam exercises?
Author(s):
Bright P. (United Kingdom)
,
Bright P. (United Kingdom)
Affiliations:
Hambly Karen
Hambly Karen
Affiliations:
ESSKA Academy. Bright P. May 9, 2018; 209542; P09-695 Topic: Sports Related Injuries
Dr. Philip Bright
Dr. Philip Bright
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Abstract
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Objectives: Knee pain is reported as inevitable with ageing, contributing to the comorbidity of chronic musculoskeletal pain in the global population. Knee conditions such as osteoarthritis and patellofemoral pain syndrome benefit directly from exercise interventions with clinically important pain reduction. There is growing use of biofeedback within exercise and rehabilitation with suggestion of increased post-operative function and muscle strength. This study looked to explore differences in gluteal and quadriceps strength subsequent to a home exercise programme for the knee with or without the augmentation of biofeedback.

Methods: In this single-blinded study, asymptomatic, moderately active participants were randomised into two groups undertaking modified clamshell and short-arc quadriceps extension exercises. One group included the addition of biofeedback (facilitated by a bathroom scale strength outcome measure) as part of the exercise. The study was run over 6-weeks in a domiciliary setting; staged progression was orchestrated by text message reminders and instructions. Pre- and post-intervention normalised quadriceps and gluteal strength, dynamometry and volumetric measures were tested for mean or median differences, dependent on parametric test assumptions (student's t-test or Wilcoxon Mann Whitney U). An intention to treat approach with imputation was adopted; effect sizes and post-hoc power were calculated in relation to mean differences.

Results: Thirty-six participants completed the study from 42 initial recruits; biofeedback group (n=19, 47% female) and control group (n=17, 64% female) were comparable at baseline. A statistically significant shift in mean strength was apparent for the short-arc quadriceps control (61% increase, student t-test: P=.01). The effect size in this instance was large (0.87) with achieved power of 72%. All other outcomes demonstrated non-significant increases in terms of strength, dynamometry and volume. There were no exercise-attributable adverse events reported during the study that contributed to the withdrawal of participants.

Conclusions: This study aimed to investigate if the inclusion of a biofeedback mechanism alongside domiciliary exercises for the quadriceps and gluteal muscles resulted in a difference in hip abductor and knee extension strength. Main findings suggest that no difference is apparent in strength or circumferential measurements of the implicated musculature. There is scope that the use of bathroom scales may facilitate compliance and autonomy in the area of knee pain management. Extended research into the use of home-based and eHealth technology as a means to provide suitable biofeedback for exercise efficacy is warranted with a view to increasing exercise motivation and adherence in symptomatic populations.

Keywords:
Knee, rehabilitation, biofeedback, exercise
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