The patient is a 62 year old man 12 months status post left TKA whose goal is to return to competitive cycling. He reports that he is currently pain-free with all activities. By his orthopod's orders he was not allowed to do ANY quadriceps strength training for the first 3 months post surgery. At nine months he began high intensity quadriceps strength training (inlcuding bilateral leg press, bilateral calf raises, and bilateral and unilateral knee extensions). The patient reports that he is unable to exercise his quadriceps to the point of a "deep, achy fatigue." Which of the following interventions would you choose to treat the persistent quadriceps weakness in this patient? Choose all that apply:
A.NMES in 75 degrees of knee flexion, 50 pps, 400 microsecs, 10/50 on/off time (sec), 10 contractions, at 50% of involved MVIC force
B.NMES in 20 degrees of knee flexion, 15 pps, 200 microsecs, 10/20 on/off time (sec), 10 contractions, at 10% of involved MVIC force
C.Training in functional weight bearing activities (such as walking and stair climbing) with emphasis on equal weight bearing
D.Unilateral strength training including step downs, squats, knee extensions and leg press with emphasis on the eccentric control phase of each exercise