Pre-operative patient education reduces length of stay after knee joint arthroplasty

S. Jones, Mustafa Alnaib, Michail Kokkinakis, Mick Wilkinson, Alan St Clair Gibson, Deiary Kader

Research output: Contribution to journalArticlepeer-review

90 Citations (Scopus)


This study investigated the effect of dynamic exercise in a hot environment on muscle fibre conduction velocity (MFCV) of the knee extensors during a sustained isometric contraction. Seven trained male cyclists (mean [±SD], age, and were 35 ± 9.9 and 57.4 ± 6.6 ml kg−1 min−1) cycled for 50 min at 60% of peak power output in either: (1) 40 °C (HOT); or (2) 19 °C (NEUTRO); and (3) remained passive in 40 °C (PASS). Post-intervention a 100 s maximal sustained isometric contraction (SMC) of the knee extensors was performed. Rectal temperature increased (p <0.01) for both HOT and NEUTRO with PASS unchanged and with HOT rising higher (p <0.01) than NEUTRO (38.6 ± 0.4 vs. 37.6 ± 0.4 °C). Muscle temperature increased (p <0.01) for all three conditions with HOT rising the highest (p <0.01) (40.3 ± 0.5 vs. 38.3 ± 0.3 and 37.6 ± 1.3 °C for NEUTRO and PASS, respectively). Lactate showed higher accumulation (p <0.01) for HOT than NEUTRO (6.9 ± 2.3 vs. 4.2 ± 2.1 mmol l−1). During SMC the torque, electromyography root mean squared (RMS) and MFCV all significantly (p <0.01) declined. Only in HOT did MFCV decline significantly (p <0.01) less than torque and RMS (9.9 ± 6.2% vs. 37.5 ± 17.8% and 37.6 ± 21.4%, respectively). In conclusion, during exercise induced hyperthermia, reduced motor unit recruitment as opposed to slower conducting properties of the muscle fibre appears to be responsible for the greater reduction in torque output.
Original languageEnglish
Pages (from-to)71-75
JournalAnnals of the Royal College of Surgeons of England
Issue number1
Publication statusPublished - 2011


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