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Session: Rehabilitation
Session starts: Friday 27 January, 14:00
Presentation starts: 14:00
Room: Room 530

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Roos GA Duijn (University of Groningen, University Medical Center Groningen)
Daniëlle Meijering (University of Groningen, University Medical Center Groningen)
Riemer JK Vegter (University of Groningen, University Medical Center Groningen)
Friederike Albers ()
Alexander L Boerboom (University of Groningen, University Medical Center Groningen)
Denise Eygendaal (Erasmus University Medical Center)
Sjoerd K Bulstra (University of Groningen, University Medical Center Groningen)
Michel PJ Bekerom (OLVG)
Claudine CJ Lamouth (University of Groningen, University Medical Center Groningen)
Martin Stevens (University of Groningen, University Medical Center Groningen)
Reslin Schelhaas (University of Groningen, University Medical Center Groningen)
Alessio Murgia (University of Groningen, University Medical Center Groningen)

Abstract:
Background: Survival rates of elbow prostheses following total elbow arthroplasty (TEA) are low compared to hip and knee prostheses. Overloading of the elbow joint is hypothesized to be one of the failure mechanisms following total elbow arthroplasty. However, it is unclear whether the current post-operative loading instruction of “not lifting more than 1kg” would lead to lower elbow loads. The aim of this study is to investigate the elbow joint loads, expressed as joint moments, in three directions (flexion-extension (FE), pronation-supination (PS), varus-valgus (VV)) during eight simulated activities of daily living (ADLs). In addition, the effect of the current post-operative instruction is examined. Our hypothesis is that instruction will not lead to a significant decrease in elbow joint load. Methods: Nine healthy participants (49.8±14.7years) performed eight ADL tasks in an uninstructed and an instructed condition. Elbow joint angles and elbow joint moments were calculated using inverse dynamical and musculoskeletal modeling software (OpenSim, Stanford University, CA). Wilcoxon signed-rank test was used to investigate the influence of the instruction on peak joint moment during the eight ADL tasks. Results: The results show no significant effect of the instruction on elbow joint moment in FE-direction and PS-direction (all p>0.05). The most demanding ADLs were rising from a chair (-14±6.7Nm FE, -3.7±1.7Nm PS), followed by opening a door (7.7±1.9Nm FE, 2.9±1.9Nm PS). The slide task shows the lowest elbow moments (4.1±0.8Nm FE, 0.6±1.3Nm PS). Conclusion: The results of this study show that the current post-operative instruction is not sufficient to decrease the elbow joint loading, i.e., joint moments, in the selected ADLs. This finding raises the question whether people can accurately predict which changes in movement will lead to lower moments in the elbow. The outcomes provide a first step in formulating a more evidence-based and specific post-operative instruction for patients following TEA. However, to formulate evidence-based recommendations, joint contact forces, in both healthy adults and patients following TEA need to be investigated in future research.