Individuals with total knee arthroplasty demonstrate altered anticipatory postural adjustments compared with healthy control subjects

Dawn M. Venema, Gregory M Karst

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Persons with total knee arthroplasty (TKA) have many impairments that may compromise postural control. Most work examining postural control following TKA has focused on static and reactive postural control. Purpose: The purpose of this study was to (1) compare anticipatory postural adjustments (APAs) between individuals with TKA and healthy controls; and (2) identify possible pre- to postoperative changes in APAs in those undergoing TKA. Methods: Ten individuals planning TKA and 10 healthy age- and sex-matched controls were recruited. During a standing reaching task, lower extremity muscle activity was measured using electromyography (EMG) onsets and normalized EMG amplitudes, and center of pressure (COP) excursion was measured via a force platform. Other outcome measures included isometric strength of the knee flexors and extensors. Individuals in the TKA group were tested preoperatively, and at 3 and 6 months postoperatively. Controls were also measured 3 times over 6 months. Results: There were no pre- to postoperative differences in lower extremity EMG onsets, normalized EMG amplitudes, or COP excursion in those with TKA. When compared to controls, individuals with TKA demonstrated lower EMG amplitudes of the vastus lateralis and biceps femoris, whereas EMG onsets and COP excursion did not differ. Individuals with TKA demonstrated lower knee extension torque. Discussion and Conclusions: It seems that the surgery itself did not alter APAs among individuals with TKA. Potential contributors to the differences in EMG amplitudes in those with TKA compared to controls, such as impaired neural activation or efforts to reduce stress on the involved knee joint, need further investigation.

Original languageEnglish (US)
Pages (from-to)62-71
Number of pages10
JournalJournal of Geriatric Physical Therapy
Issue number2
StatePublished - Apr 2012


  • Anticipatory postural adjustments
  • Balance
  • Electromyography
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Rehabilitation
  • Geriatrics and Gerontology


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