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A 67-year-old male underwent bilateral total knee replacement surgery and was subsequently placed on a bilateral isokinetic knee rehabilitation program. Isokinetic knee testing was performed on unilateral dominant (UD; right) and nondominant (UND; left) limbs as well as bilateral limbs (BLs) before and after a three-times-per-week, 8-week protocol during which the patient followed a bilateral isokinetic velocity spectrum (60 to 300°/s) rehabilitation program. The protocol was made possible by the introduction of a new bilateral isokinetic knee attachment developed by the authors. The BL extension and flexion peak torque increased 41% and 51% at 60°/s, respectively. The UD and UND extension peak torque increased 22% and 37%, respectively, while flexion peak torque increased 68% and 52%, respectively. The bilateral deficit decreased with increasing velocity for both extension and flexion. These results demonstrate that a bilateral isokinetic approach to rehabilitation may be a legitimate technique to increase knee extension and flexion peak torque both unilaterally and bilaterally following bilateral total knee replacement surgery.

During knee rehabilitation, squats are a commonly used closed kinetic chain exercise. We have been unable to locate data reporting electromyographic (EMG) activity of lower extremity musculature during maximal effort squats and the contribution of gastrocnemius and gluteus maximus muscles. Therefore, the purposes of this study were (a) to quantify EMG activity of selected lower extremity muscles during a maximal isometric squat and during a maximal voluntary isometric contraction (MVIC), and (b) to determine ratios between the vastus medialis oblique (VMO) and vastus lateralis (VL) during maximal isometric squat and MVIC testing. Twenty-three subjects participated in a single testing session. Results are as follows: intraclass correlations for MVIC testing and squat testing ranged from .60 to .80 and .70 to .90, respectively. Percentage MVIC during the squat was as follows: rectus femoris 40 ± 30%, VMO 90 ± 70%, VL 70 ±40%, hamstrings 10 ± 10%, gluteus maximus 20 ± 10%, and gastrocnemius 30 ± 20%. No statistical difference existed in VMO:VL ratios during MVIC or squat testing. We conclude that large variations in muscle recruitment patterns occur between individuals during isometric squats.

Context: Protonics^™ knee brace has been suggested as an intervention for patients with patellofemoral pain syndrome. However, the effectiveness of this knee brace compared with traditional conservative methods knee rehabilitation is lacking. Objective: To compare the effect of Protonics^™ knee brace versus sport cord on knee pain and function in patients with patellofemoral pain syndrome. Design: Randomized controlled trial. Setting: Loma Linda University. Participants: There were 41 subjects with patellofemoral pain with a mean age of 28.8 (5.0) years and body mass index of 25.6 (4.7) kg/m² participated in the study. Intervention: Subjects were randomized to 1 of 2 treatment groups, the Protonics^™ knee brace (n = 21) or the sport cord (n = 20) to complete a series of resistance exercises over the course of 4 weeks. Main Outcome Measures: Both groups were evaluated according to the following clinical outcomes: anterior pelvic tilt, hip internal/external rotation, and iliotibial band flexibility. The following functional outcomes were also assessed: Global Rating of Change Scale, the Kujala score, the Numeric Pain Rating Scale, and the lateral step-down test. Results: Both groups showed significant improvement in the outcome measures. However, the Protonics^™ knee brace was more effective than the sport cord for the Global Rating of Change Scale over time (immediate 1.0 [2.1] vs post 2 wk 3.0 [2.2] vs 4 wk 4.6 [2.3] in the Protonics^™ brace compared with 0.0 [2.1] vs 1.3 [2.2] vs 3.0 [2.3] in the sport cord, P < .01), suggesting greater satisfaction. Conclusions: Both study groups had significant improvements in the clinical and functional symptoms of patellofemoral pain. The Protonics^™ knee brace group was significantly more satisfied with their outcome. However, the sport cord may be a more feasible and cost-effective method that yields similar results in patients with patellofemoral pain syndrome.