The Effects of Visual Biofeedback Information on Hyperextended Knee Control

Purpose: A hyperextended knee is described as knee pain associated with an impaired knee extensor mechanism. Additionally, a hyperextended knee may involve reduced position sense of the knee joint that decreases the individual's ability to control end-range knee extension movement. The purpose of this study was to investigate the effects of visual biofeedback information for plantar pressure distribution on knee joint angle and lower extremity muscle activities in participants with hyperextended knees. Methods: Twenty-three participants with hyperextended knees were recruited for the study. Surface electromyography signals were recorded for the biceps femoris, rectus femoris, gastrocnemius, and tibialis anterior muscle activities. The plantar pressure distribution was displayed and measured using a pressure distribution measuring plate. Knee joint angle kinematic parameters were recorded using a motion analysis system. The visual biofeedback condition was the point at which the difference between the forefoot and backfoot plantar foot pressure on the monitor was minimized. The Wilcoxon signed-rank test was used to determine the significance between the visual biofeedback condition and the preferred condition. Results: The knee joint angle was significantly decreased in the visual biofeedback condition compared to that in the preferred condition (p<0.05). The rectus femoris and gastrocnemius muscle activities were significantly different between the visual biofeedback and preferred conditions (p<0.05). Conclusion: The results of this study showed that visual biofeedback of information about plantar pressure distribution is effective for correcting hyperextended knees.