Angry and Weak - Perception of Recovery Relates to Strength: A Case Series

Research Objectives: To investigate if patients perception of recovery is associated with strength and range of motion following a total knee arthroplasty.

Design: A case series of 10 consecutive patients status post total knee arthroplasty completed their rehabilitation without complications between the months of August 2023 to July 2023. At discharge, total arc of knee motion and maximum volitional isometric contraction knee extension strength symmetry was gathered in addition to subjective information regarding perceived recovery.

A Spearman Correlation Coefficient was utilized to determine the relationship between the patients’ perceived recovery and their respective isometric strength index.

Setting: Hospital based outpatient physical therapy clinic at the Hospital for Special Surgery - Westchester NY.

Participants: A sample of convenience was utilized, comprised of 10 individuals who had undergone an uncomplicated total knee arthroplasty at the Hospital for Special Surgery between the months of August 2023 and July 2024. The sample included 4 males and 6 females with an average mean age of 66 at the time of their discharge.

Interventions: Interventions provided included standard rehabilitation procedures and interventions to include strengthening, stretching, balance, range of motion, and functional integration of the surgical limb.

Main Outcome Measures: Maximum volitional isometric strength testing at 60 degrees knee flexion was performed at discharge utilizing a Biodex Systems 4. After a bike warm-up and 3 practice trials consisting of 50%, 75%, and 100% max effort contractions on the Biodex, testing was then performed on the uninvolved limb followed by the surgical limb. The best of 3 trials was utilized in the calculation of the patient’s strength index.

Functional outcomes measurements included the Lower Extremity Functional Scale which is a 20 item questionnaire designed to capture patient perceived function. Additional questioning was performed at discharge, with the treating authors asking, “From 0% to 100%, how recovered do you feel, with 0% being nothing and 100% representing full recovery”?

Results: Strong correlation of rs =0.70; p< 0.05 between perceived recovery and quadriceps strength limb symmetry index. However, there is not a correlation between perceived recovery and total arc of motion, p=0.81 (>0.05).

Conclusions: This study aimed to analyze the relationship between patient perception of recovery and quadricep strength index following a TKA. Our current findings suggest there is a positive correlation between limb symmetry index and patient’s perceived recovery.

Author(s) Disclosures: no disclosures