Vol. 40 No. 2, March/April 2003
Pages 95 — 108
Phase I design and evaluation of an isometric muscle reeducation device for knee osteoarthritis rehabilitationRobert J. Goldman, MD; Kirk A. Reinbold, PhD; Z. Annette Iglarsh, PhD, PT; Lawrence M. Neustadter, DO; Carol A. Oatis, PT, PhD; H. Ralph Schumacher, MDSensorPad Systems, Inc., Norristown, PA; University of the Sciences in Philadelphia, Philadelphia, PA; Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; Arcadia University, Glenside, PA
Abstract: — Our long-term goal is to improve adherence to a home-based isometric program for rehabilitation of knee osteoarthritis (OA) using a force-biofeedback device (Isopad™). Our goal for Phase I was to design and evaluate an Isopad-based program in a supervised clinical setting. Our subjects were five patients with knee OA of Kellgren stage II or greater. A capacitive force sensor was tested for accuracy, repeatability, and durability. An Arthritis Foundation home-based isometric program inspired the Isopad design. The Isopad provided visual and auditory feedback instantaneously and continuously about force generated between the ankles. The five subjects completed a supervised 8-week progressive isometric program using the Isopad. Absolute isolated quadriceps and hamstring torques were quantified with a dynamometer, and patients completed a self-assessment of symptoms (Western Ontario and McMaster Universities Osteoarthritis Index). The capacitive sensor accuracy error averaged 10% and repeatability 4%. Cognitively intact subjects used the Isopad successfully for isometric progressive resistance training. Quadriceps and hamstrings absolute torques increased an average of 30%. Patients reported decreased functional complaints (Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index). All changes were trends. The Isopad helped subjects with knee OA adhere to a supervised isometric program and meet progressive strength targets. The next-generation Isopad will be employed in a home-based program.
Key words: biofeedback device, isometric exercise, muscle reeducation, osteoarthritis of the knee, patient compliance.