Background: The aim of the case report was to evaluate the effectiveness of ischemic exercise on atrophy and inhibition of the quadriceps femoris muscle in a patient after multiple surgical procedures of the knee joint. Methods: Patient was involved in an 8-week exercise program with ischemic exercise, resistance training, and plyometrics. We measured thigh circumference and skinfold, filled out knee questionnaires KOOS and Lysholm, assessed functional single leg hop test and Y balance test, tensiomyography (TMG) of quadriceps femoris muscle and isokinetic testing of knee flexors and extensors maximal torque at 60°/s and 240°/s angular velocity. Results: After the completed exercise program most of the measured parameters improved. The lean thigh circumference of the injured lower limb increased by 1.9 cm at the distal part and 1.1 cm at the proximal part. Results of TMG showed 17 % increase in the rectus femoris muscle symmetry between lower limbs. The maximal torque of knee extensor muscles of injured lower limb improved by 43 % at lower, and by 44 % at higher angular velocity. Conclusions: The results showed positive effects of ischemic exercise on performance, hypertrophy, and improved activation of the quadriceps femoris muscle. Because of the upper patella pain, it would be worthwhile to do more research on different approaches for reducing quadriceps femoris muscle inhibitory activity.
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