Disclosures: HIROO MATSUSE: No financial relationships or conflicts of interest
Objective: To assess the efficacy of knee bending exercise with a hybrid training system (HTS) that stimulates the antagonist muscle along with a conventional rehabilitation program on bone metabolism following total knee arthroplasty (TKA) in patients with knee osteoarthritis. HTS has been developed as a resistance exercise method combining electrical stimulation with voluntary exercise using electrically stimulated eccentric antagonist muscle contractions.
Design: Randomized, single-blind, controlled trial. Setting : Clinical rehabilitation center. Participants : Patients with knee osteoarthritis (n=23), female, age 73.6 ± 7.5 years
Interventions: Participants were randomized to 12 weeks of triweekly knee bending exercise with HTS alongside a conventional rehabilitation program (HTS group, n = 12) or a conventional rehabilitation program alone (control group, n = 11).
Main Outcome Measures: Serum levels of bone turnover markers: bone specific alkaline phosphatase (BAP), total osteocalcin (tOC), undercaroxylated osteocalcin (ucOC) , tartrate-Resistant ACid Phosphatase-5b (TRACP-5b), total parathyroid hormone (PTH and corrected serum calcium (Ca).
Results: 2 patients in the control group dropped out for personal reasons. PTH significantly decreased after 6 weeks (p < .05), and TRACP-5b increased after 6 weeks and 12 weeks following TKA in both groups, however these changes did not differ statistically between groups. On the other hand, In the HTS group, tOC increased by 1.18 ± 1.34 ng/ml (p < .05) after 6 weeks and 1.73 ± 2.25 ng/ml (p < .05) after 12 weeks respectively, which was higher than the control group. However, ucOC/tOC, BAP and Ca did not significantly change in either group. Conclusions: These results suggest that bone turnover would change, and bone resorption would be enhanced following TKA with or without HTS. However, HTS may affect the response of OC following TKA, separately from bone metabolism.
Level of Evidence: Level I
To cite this abstract in AMA style:
MATSUSE H. The Effects of Knee Bending Exercise Combined with Electrically Stimulated Contractions on Serum Levels of Bone Turnover Markers Following Total Knee Arthroplasty: A Randomized Controlled Trial [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-effects-of-knee-bending-exercise-combined-with-electrically-stimulated-contractions-on-serum-levels-of-bone-turnover-markers-following-total-knee-arthroplasty-a-randomized-controlled-trial/. Accessed May 8, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-effects-of-knee-bending-exercise-combined-with-electrically-stimulated-contractions-on-serum-levels-of-bone-turnover-markers-following-total-knee-arthroplasty-a-randomized-controlled-trial/