SWELLING OF THE KNEE-JOINT - EFFECTS OF EXERCISE ON QUADRICEPS MUSCLESTRENGTH

Objective: To investigate the effects of excessive fluid in the knee j oint on the performance of the quadriceps muscles and to determine whe ther quadriceps muscle performance can be altered by exercising the sw ollen joint. Design and Setting: a before-after trial design was used, and the procedures were performed in a laboratory setting. Subjects: A random sample of 27 adult men with no musculoskeletal problems was d ivided into intervention and control groups. Intervention: First, in a ll groups, torque generated by the quadriceps muscle was examined by i sokinetic muscle testing undertaken at a joint angular velocity of 120 degrees/sec over a range of motion from 5 degrees to 80 degrees flexi on. After this initial test, in group 1, 60mL saline and dextrose was injected into the knee joint and subjects repeated the maximal effort procedure. Subjects then performed submaximal exercise for 3 to 3 minu tes, after which maximal effort testing was undertaken again. In group 2, subjects received no injection of fluid, undertook 2 maximum effor t tests, then performed submaximal exercise for 3 to 3 minutes, after which maximum effort testing was undertaken again. In group 3 (control group), subjects undertook three maximum effort tests over a time per iod similar to that for the other groups. Main Outcome Measure: Quadri ceps muscle torque generated at 60 degrees from full knee extension. R esults: Torque decreased (p < .05) 30% immediately after the injection of fluid. However, torque returned to preinjection levels after subma ximal exercise (p > .05). These findings were related to joint capsule compliance and fluid movement. No significant changes (p > .05) in to rque were observed for the other two groups. Conclusion: Submaximal ex ercise of swollen knee joints can decrease artificially induced quadri ceps muscle inhibition. These findings may have implications for patie nts with perennial effusions who at times undertake gait activities. ( C) 1996 by the American Congress of Rehabilitation Medicine and rite A merican Academy of Physical Medicine and Rehabilitation