title: Evaluation of the acceptability of a sphygmomanometer device in knee extension training following surgical procedures of the knee.
abstract: BACKGROUND
  The postoperative treatment after a standard surgical intervention such as knee arthroplasty, proximal tibial osteotomy or supracondylar osteotomy, can have an important impact on the overall treatment outcome. In most cases, outcomes are positively effected by patients receiving physiotherapy and occupational therapy. Basic movements and range of motion need to be learnt. Self-responsible behaviour, which is similar to exercise programs in sports, needs to be supported. However, in most cases the transfer of training techniques into successful and desired postoperative care is not simple. A training technique needs to be developed which is self-explanatory, effective, encouraging for and accessible to the patient.
  
  
  OBJECTIVE
  The purpose of this study was to describe and evaluate an easy and effective technique to support regular physiotherapy in early postoperative rehabilitation using a sphygmomanometer device. Measurements were undertaken relating to handling, training results and motivation.
  
  
  METHODS
  This was a descriptive study.
  
  
  METHODS
  Forty one patients were instructed to undertake extension exercises of the knee in the early postoperative phase. A sphygmomanometer cuff was rolled out and placed just below the popliteal fossa, and inflated to 20 mmHg. In this position the patients were prompted to push the knee down with the maximum available power. The quadriceps muscle of the leg is activated when patients extend the knee using two thirds of their maximum power, and then followed by one third of their maximum power. This exercise sequence was carried out three times for 5 seconds. The results were documented by using a patient questionnaire.
  
  
  RESULTS
  Thirteen patients indicated that they felt highly motivated while undertaking the training program. One patient reported poor motivation due to inconvenient handling (preparing the cuff by closing the valve screw or calculating the target value) and six patients reported that the method of handwritten recording of training sessions needed to be improved. There were no technical problems. The training results were rated as being predominantly good. Due to the variation in individual ability in extending the knee, comparison of the overall values obtained could not be done.
  
  
  CONCLUSIONS
  The use of a sphygmomanometer device is cheap and feasible technique in postoperative independent knee extension training.
authors.affiliation: Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: horstmann.hauke@mh-hannover.de.
authors.forename: Hauke
authors.initials: H
authors.lastname: Horstmann
authors.affiliation: Trauma Department, Evangelisches Krankenhaus Bielefeld, Burgsteig 13, 33617 Bielefeld, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Colcuc
authors.affiliation: Gelenkchirurgie Orthopädie Hannover, Uhlemeyerstraße 16, 30175 Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Lobenhoffer
authors.affiliation: Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.affiliation: Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors.forename: Thomas Sanjay
authors.initials: TS
authors.lastname: Weber-Spickschen
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000451:nursing / Q000534:rehabilitation* / Q000601:surgery; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D019722:Sphygmomanometers
keywords: Fast track; Knee extension; Rehabilitation