Neuromuscular Adaptation to Early Post-Operative, High-Intensity, Short Resistance Training of Non-Operated Lower Extremity in Elderly Patients: A Randomized Controlled Trial

Author： Tal-Akabi Amir Steiger Ursula Villiger Peter M.

Publisher： Medical Journals Limited

ISSN： 1650-1977

Source： Journal of Rehabilitation Medicine, Vol.39, Iss.9, 2008-11, pp. : 724-729

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Abstract

Objective: To evaluate the short-term effects of high-intensity, task-specific vs regular rehabilitation programme on neuromuscular activity and functional changes in elderly inpatients. Design: Single-blind, randomized controlled trial.Patients: Sixty-two patients, aged 74.1 (standard deviation (SD) 6.9) years, 12.8 (SD 3.6) days after operation of one lower limb.Methods: Allocation to either high- or regular-intensity strength training of non-operated limb, of 3 weeks duration. Outcome measurements: ratio of integrated electromyography per weight lifted (mm vastus medialis and lateralis), isometric electromyography (EMG), maximal weight lifted expressed as 1 repetition maximum, torque in Nm and isometric maximal force of uninvolved leg, timed “up and go&rdquo test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire.Results: Both programmes resulted in significant improvements in: integrated EMG/weight lifted ratio, isometric EMG, 1 repetition maximum, torque and isometric force, TUG performance and WOMAC items (all p < 0.0001, Wilcoxon signed-rank test). Significant differences were found between the high- and regular-intensity groups for integrated EMG/weight lifted (p = 0.026), 1 repetition maximum and torque (p = 0.0014, Wilcoxon rank-sum test).Conclusion: High-intensity, short-period, early postoperative muscle training has a superior effect on maximal weight lifted by the knee extensors and integrated EMG/weight lifted compared with regular training. These findings are in accordance with more rapid neuronal adaptation by a high-intensity rehabilitation programme.