Knee-Extension Exercise’s Lack of Immediate Effect on Maximal Voluntary Quadriceps Torque and Activation in Individuals With Anterior Knee Pain

Abstract

Context:Weight-bearing (WB) and non-weight-bearing (NWB) exercises are commonly used in rehabilitation programs for patients with anterior knee pain (AKP).Objective:To determine the immediate effects of isolated WB or NWB knee-extension exercises on quadriceps torque output and activation in individuals with AKP.Design:A single-blind randomized controlled trial.Setting:Laboratory.Participants:30 subjects with self-reported AKP.Interventions:Subjects performed a maximal voluntary isometric contraction (MVIC) of the quadriceps (knee at 90°). Maximal voluntary quadriceps activation was quantified using the central activation ratio (CAR): CAR = MVIC/(MVIC + superimposed burst torque). After baseline testing, subjects were randomized to 1 of 3 intervention groups: WB knee extension, NWB knee extension, or control. WB knee-extension exercise was performed as a sling-based exercise, and NWB knee-extension exercise was performed on the Biodex dynamometer. Exercises were performed in 3 sets of 5 repetitions at approximately 55% MVIC. Measurements were obtained at 4 times: baseline and immediately and 15 and 30 min postexercise.Main Outcome Measures:Quadriceps torque output (MVIC: N·m/Kg) and quadriceps activation (CAR).Results:No significant differences in the maximal voluntary quadriceps torque output (F2,27 = 0.592, P = .56) or activation (F2,27 = 0.069, P = .93) were observed among the 3 treatment groups.Conclusions:WB and NWB knee-extension exercises did not acutely change quadriceps torque output or activation. It may be necessary to perform exercises over a number of sessions and incorporate other disinhibitory interventions (eg, cryotherapy) to observe acute changes in quadriceps torque and activation.