Biodex Multi-Joint System Research Articles

Test-retest reliability of isometric and isokinetic wrist strength

BackgroundThe isokinetic dynamometer has been considered the gold-standard measurement of muscle performance. However, the reliability for the isometric and isokinetic wrist flexor and extensor strength using the Biodex isokinetic dynamometer has not been reported to date. This study evaluated test-retest reliability of isometric and isokinetic wrist strength using the Biodex System 3 isokinetic dynamometer. MethodsThis is a test-retest reliability study. Peak concentric and isometric torque was determined of the dominant limb wrist flexor and extensor of healthy individuals using the Biodex Multi-Joint System 3 dynamometer. The participants were evaluated by the same examiner in two different sessions separated by an interval of two to seven days. Reliability was investigated using the intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM) and minimum detectable difference (MDD). ResultsTwenty healthy subjects participated in the study. The ICCs for concentric and isometric torque of the wrist flexor and extensor ranged from 0.79 to 0.91, revealing excellent intra-examiner test-retest reliability; SEM ranging from 0.4 to 1.5; and MDD ranged from 1.12 Nm to 4.17 Nm. ConclusionsExcellent intra-examiner test-retest reliability was found regarding peak concentric toque of the wrist flexor and extensor at an angular velocity of 45°/s as well as isometric torque of the wrist flexor and extensor in healthy individuals measured using the Biodex System 3 isokinetic dynamometer.

How Many Trials are Needed to Assess Ankle Joint Proprioception in Children with Chronic Ankle Instability?

The assessment of ankle joint repositioning is commonly used to detect joint impairment in people with chronic ankle instability (CAI). To decrease measurement fluctuation errors, it has been suggested that an average of 10 measurements be utilized. However, learning and tiredness difficulties, particularly in children, might make this difficult. Therefore, this study aimed to compare the repeatability of 3 and 10 measures of ankle joint repositioning using an isokinetic dynamometer (Biodex) in children with CAI. Ten children with CAI with an average age of 11.21 years were recruited in the study. The ankle inversion and eversion angles for 3 and 10 trials using active and passive reproduction protocols were recorded using Biodex Multi-Joint System 4TM. The error of reproduction angle was presented by the mean, correlation, and percentage changes for both active and passive reposition angles. The means of the error for ankle joint reproduction angles revealed no significant differences between 3 and 10 trials for both active and passive protocols (p > 0.05). The ICC(3,1) revealed high correlations between 3 and 10 trials of assessments (ICC(3,1) = 0.82 - 0.91). The percentage changes of means and standard deviations showed learning effect of ankle joint proprioception measurement after the 4th and the 5th trials for inversion and eversion, respectively. Therefore, to prevent learning and fatigue effects, a 3-trial protocol would be more appropriate than a 10-trial protocol. However, a 4-trial protocol and a 5-trial protocol were suggested for inversion and eversion, respectively. The suggested protocols are recommended to use for further reliability studies of the ankle joint proprioception in children with CAI. HIGHLIGHTS Ankle joint reproduction assessments using active and passive protocols are needed to identify the impairment of joint position sense in children with chronic ankle instability To prevent fatigue effect, 3 trials are sufficient for testing of ankle joint position sense in children with chronic ankle instability In research setting, a 4-trial protocol for ankle joint inversion and a 5-trial protocol for ankle joint eversion are more appropriate than a 10-trial protocol

Cryotherapy Reduces Muscle Spasticity But Does Not Affect Proprioception in Ischemic Stroke: A Randomized Sham-Controlled Crossover Study.

The aim of the study was to evaluate the immediate effects of cryotherapy (using an ice pack) on ankle joint position sense and the degree of spasticity after chronic hemiparetic stroke. We used a sham-controlled crossover design. Sixteen chronic hemiparetic patients were randomly assigned to two groups: (1) those who received cryotherapy followed by a control intervention 15 days later (cryotherapy group) and (2) those who received the control intervention followed by cryotherapy 15 days later (control intervention group). Ankle joint position sense was measured on the paretic side using a Biodex Multi-joint System 3 dynamometer before and after 20 mins of either application on the calf muscles. Lower absolute error scores were calculated for data analyses and were used to determine joint position sense. The degree of spasticity of the plantar flexor muscles was scored according to the Modified Ashworth Scale. Sixteen patients completed the crossover experiment; however, data analysis was successfully conducted in 15 participants. Cryotherapy reduced the degree of spasticity of the plantar flexor muscles without altering ankle joint position sense. Cryotherapy (using an ice pack) may reduce plantar flexor spasticity without influencing proprioception.

Short-term effect of cryotherapy on knee joint proprioception and quadriceps isometric strength in healthy young females

Background Cryotherapy is one of the essential modality in physical therapy being used since the time of the ancient Greeks. Objective The objective of this study was to investigate the short-term effect of cryotherapy on knee proprioception and isometric strength of quadriceps muscle. Participants and methods A total of 54 normal healthy female participants participated in this study, with an age between 19 and 28 years. They were divided into two equal groups, control and study, consisting of 27 participants in each group. The active knee joint position sense and isometric strength of quadriceps were tested by Biodex Multi-joint System 4 Pro Isokinetic Dynamometer. These measurements were taken before and after 20 min of resting period for the control group, whereas cryotherapy was applied for the study group instead of resting. Results After 20 min of cryotherapy application, the study group showed significant reduction in the proprioceptive error of the knee joint (P≤0.05) and no significant difference in isometric strength of quadriceps (P=0.686). For the control group, there were no significant differences for both proprioceptive accuracy of the knee joint (P=0.469) and isometric strength of quadriceps (P=0.121). In addition, there were no significant differences between the two groups for both proprioceptive accuracy of the knee joint and isometric strength of quadriceps (P>0.05). Conclusion The findings of the study show that cryotherapy does not impair the proprioceptive accuracy of the knee joint or isometric strength of quadriceps muscle, so cryotherapy can be used safely during physical activities and training programs.

An electromyographic analysis of selected asana in experienced yogic practitioners

The purpose of this study was to assess electromyographic (EMG) output of the anterior tibialis (TA), medial head of the gastrocnemius (GA), rectus femoris (RF), bicep femoris (BF), and gluteus medius (GM) in experienced yogic practitioners during selected yoga asana. A secondary purpose was to examine the differences in EMG output in unilateral V. bilateral standing yoga asana. The study was a single occasion descriptive design. Thirteen healthy yoga practitioners (1 male, 12 females, average age of 37.5) with more than five years of experience were recruited. EMG activity was recorded during maximum voluntary isometric contractions (MVIC) of the TA, GA, RF, and BF using the Biodex Multijoint System®, and GM using manual muscle testing position. Subjects then performed the following yoga asana while EMG activity was recorded: downward facing dog, half-moon, tree, chair, and warrior three pose. Each asana was held for fifteen seconds and performed three times. EMG data were band pass filtered and the root mean square was obtained. Asana data were then amplitude normalized with the subjects’ MVIC data. Integrated EMG was calculated for TA, GA, RF, BF and GM, in each asana. A multilevel regression analysis was performed, and peak EMG data was compared. Analysis between muscles showed that during CH and DD EMG activity was greatest in the TA muscle compared to the other muscles, while during HM and WR the GA muscle showed the greatest activity. Analysis within muscles showed low GA, BF, and GM activity during chair pose and downward facing dog compared to half moon, tree, and warrior three, and high RF activity during chair compared to the other poses. In conclusion, there were differences in frontal and sagittal plane muscle activation between single limb and double limb poses in experienced yogic practitioners.

Assessment of the quality of life, muscle strength, and dynamic balance of elderly Kendo players

OBJECTIVE:To compare Kendo players with active elderly adults in terms of quality of life, functional aspects (muscle strength, postural balance) and body composition.METHODS:This was a controlled cross-sectional study. Twenty elderly individuals were divided into two groups: the Kendo group, with an average age of 71.8 (5.4) years, and the Control group, with an average age of 73.1 (4.8) years. Quality of life was evaluated using a questionnaire (WHOQOL-bref and WHOQOL-old); body composition was evaluated with a bioimpedance scale (InBody230); hand-grip strength was assessed with a portable manual dynamometer (Jamar SH 5001); flexor and extensor muscle strength of the knees was evaluated with an isokinetic device (Biodex® System 3 model Biodex Multi Joint System, BIODEX); and dynamic balance was assessed using a force platform (Balance Master System, Neurocom International, Inc.,® Clackamas County, Oregon, USA).RESULTS:The groups were statistically homogeneous in terms of socio-demographic characterization, body composition, muscle strength, and dynamic balance, but the Control group was faster in the sit-to-stand test (p=0.03). The Kendo group had a statistically significantly better quality of life; in the WHOQOL-bref, these differences were present in the physical (p≤0.001) and environment (p=0.004) domains, and in the WHOQOL-old, these differences were present in social participation (p=0.001) and in past, present, and future activities (p=0.019).CONCLUSION:The results suggest that Kendo is a health-promoting activity that improves the quality of life, functional aspects (muscle strength and postural balance) and body composition of players.

Proprioception of Knee Joint in Athletes and Non-Athletes Obese

<p><strong>BACKGROUND</strong><strong>: </strong>Proprioception plays an integral role in the neuromotor control of the knee joint. The objective of this study was to evaluate the relationship of knee joint proprioception deficit and regular exercise activities with obesity.</p><p><strong>MATERIAL/METHOD</strong><strong>: </strong>In this case control study, we had 60 participants, aged 18 to 35 in four groups (15 athletes obese; 15 athletes with normal weight; 15 non-athletes obese; 15 non-athletes with normal weight). The average Body Mass Index for the obese groups was 33.50±(3.10) kg/m<sup>2</sup> and for the normal weight groups was 23.77±(2.94) kg/m<sup>2</sup>. We used a Biodex Multi-Joint System 4 Isokinetic Dynamometer to examine proprioception acuity as the amount of a subject's error when trying to reproduce a test knee extension angle (a measure of the joint position sense). We tested proprioception actively (active reproduction test; AAR) and passively (passive reproduction test; PAR) in the right leg.</p><p><strong>RESULTS: </strong>The non-athlete obese group had significantly poorer proprioception acuity in the knee extension movement compared to the normal weight groups and also compared to the athlete obese group. For knee active angle reproduction test AAR, a significant difference was found (p=0.011). The results for passive angle reproduction test PAR, revealed no significant differences between the four groups (p=0.596).</p><p><strong>CONCLUSIONS:</strong> The obese groups showed a deficit in the proprioception function in knee extension movement. Furthermore, the findings suggest that doing regular weight bearing training is associated with better proprioceptive function, even in obese groups. It could manifest that the deleterious effect of obesity on the knee joint proprioception might be stronger than the beneficial influence of exercise training.</p>

Effect of Chinese massage (Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis

ObjectiveChinese massage (Tui Na) is one of the most popular Traditional Chinese Medicine remedies for knee osteoarthritis (OA). Several studies have subjectively evaluated the effect of Chinese massage on knee OA through self-assessment questionnaires; however, very few studies have objectively assessed the effect by measuring knee muscle strength. The purpose of this study was to assess the efficacy of Chinese massage in improving knee extensor and flexor muscle strength in patients with knee OA. MethodsThirty patients with knee OA received Chinese massage therapy three times per week for 2 weeks. Patients completed pre- and post-treatment Visual Analogue Scale (VAS) pain questionnaires, and pre- and post-treatment knee muscle strength was evaluated using the Biodex Multi-Joint System 3. Isokinetic muscle strength measurements were performed at 60 degrees/s and 180 degrees/s. The peak torque (PT), peak torque/body weight (PT/BW), total work (TW), average power (AP), hamstring/quadriceps (H/Q), and range of motion (ROM) values were recorded separately for flexors and extensors. ResultsChinese massage therapy significantly improved knee pain as assessed by the VAS in patients with knee OA (P < 0.05). Post-treatment values were significantly greater than pre-treatment values in the extensor muscles for PT (right P = 0.013, left P = 0.001), PT/BW (right P = 0.008, left P = 0.001) and TW (right P = 0.036, left P = 0.004) at 60 degrees/s. The AP increased significantly after treatment in the flexor muscles in the right knee (P = 0.009) and the extensor muscles in the left knee (P = 0.001). There were no significant differences in pre- and post-treatment ROM and H/Q at 60 degrees/s and 180 degrees/s. ConclusionChinese massage therapy decreased pain and may improve extensor muscle strength in patients with knee OA, but does not appear to improve ROM.

Movement pattern training improves function in people with intra-articular, pre-arthritic hip disease: Preliminary data

Movement pattern training improves function in people with intra-articular, pre-arthritic hip disease: Preliminary data

Isokinetic Muscle Strength and Muscle Endurance by the Types and Size of Rotator Cuff Tear in Men

Background: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. Methods: Total of 81 male patients (mean age 57.8 ± 7.4 years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system PRO ® (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age 56.9 ± 7.3 years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. Results: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. Conclusions: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.

Bilateral Effect of Unilateral Isokinetic Concentric Training and Russian Current Stimulation on Quadriceps Strength

Isokinetic training and Russian current stimulation have been advertised to increase muscle strength. So, the purpose of this study was to compare between unilateral isokinetic concentric training and Russian current stimulation on the quadriceps strength of ipsilateral and contralateral limbs. Sixty healthy male subjects were randomly assigned into 3 equal groups; Isokinetic group; received isokinetic concentric training. Russian group; received Russian current stimulation, and control group: did not receive any training program. Isokinetic and Russian groups trained for 4 weeks, 3 session/week on the dominant quadriceps femoris muscle. Biodex Multi-joint System 3, Biodex, Shirley, NY, used to measure the isokinetic concentric peak torque/body weight before and after 4 weeks training for all groups at angular velocity 30°/s. For contralateral and ipsilateral quadriceps strength there was significant increase in the quadriceps strength of isokinetic and Russain group (p= 0.000). However, there was no significant increase in the quadriceps strength of control group (p= 0.214, 0.061) respectively. There was no significant difference between isokinetic and Russian group for the value of increasing of the quadriceps strength (p= 0.391, 0.579) respectively. The percent of improvement of ipsilateral side was significantly higher than the improvement of contralateral side for isokinetic and Russian group (p= 0.004, 0.006) respectively. So, Isokinetic training and Russian current stimulation have equal level of effectiveness in improving the concentric strength of the contralateral and ipsilateral quadriceps muscle. In spite of, the improvement of ipsilateral side was higher than that of the contralateral side.

Impact of Reactive Neuromuscular Training on Falling in Parkinson's Disease

Purpose: The purpose of the study was to examine the influence of reactive neuromuscular training (RNT) on falling in patients with Parkinson's disease (PD). Subjects: Thirty male and female patients were selected, their ages ranged from 50-60 years. They were randomly divided into two equal groups: Control and study. Methods: Balance was evaluated by Biodex balance system (BBS), falling was assessed by the Unified Parkinson Rating Scale (UPDRS), step length, velocity, and cadence were also assessed by motion analysis system and finally, muscle EMG activity for rectus abdominus and erector spinae were recorded before and after the study period. Both groups received conventional physical therapy program. In addition, the study group received RNT and balance training by Biodex multi-joint system (BMJS) and BBS respectively. Results: There was significant improvement in the test parameters in the study group after treatment compared to that of the control group (p<0.01). Conclusion: Reactive neuromuscular training is considered a new useful and effective modality in preventing falling in patients with Parkinson's disease.

Effect of 12 Weeks of Accelerated Rehabilitation Exercise on Muscle Function of Patients with ACL Reconstruction of the Knee Joint

[Purpose] To examine changes in the knee joint’s isokinetic muscle functions following systematic and gradual rehabilitation exercises lasting for 12 weeks for male and female patients who underwent anterior cruciate ligament (ACL) reconstruction. Differences in muscle functions between the uninvolved side (US) and the involved side (IS) before surgery, differences in muscle functions between US and IS after rehabilitation exercises lasting for 12 weeks, and changes in muscle functions on US and IS between before and after surgery were analyzed to examine the effects of accelerated rehabilitation exercises after ACL reconstruction. [Subjects] The study subjects were 10 patients, five females and five males, who underwent ACL reconstruction performed by the same surgeon. [Methods] As a measuring tool, a Biodex Multi-joint system 3pro (USA), which is an isokinetic measuring device, was used to examine the flexion and extension forces of the knee joint. During isokinetic muscle strength evaluation, the ROM of US was set to be the same as that of IS for consistency of measurement. [Results] At 60°/s, the isokinetic muscle functions of the females did not show any significant change between before and after surgery in any of the variables on both US and IS. At 60°/s, the isokinetic muscle functions of the males did not show any significant change between before and after surgery in the peak torque, average power, and entire work done on US. In extension, peak torque on IS did not show any significant change.

Differences between genders in eccentric hip adduction to abduction, hip medial to lateral rotation and knee flexion to extension peak torques ratios

Muscle imbalances appear to contribute to lower limb injuries and the incidence rate of some knee injuries has been reported to be greater in females than in males. The purposes of this study were to compare the differences between genders in eccentric hip and knee peak torques normalized according to body mass as well as in eccentric hip adduction to abduction (HAD/HAB), hip medial to lateral rotation (HMR/HLR) and knee flexion to extension (KF/KE) peak torques ratios. Seventee n males and twenty-two females participated in this study. Eccentric hip and knee peak torque for each movement were measured using an isokinetic dynamometer (Biodex Multi-Joint System 2). The Student t test for independent samples and the Mann- Whitney U test were used for all comparisons between genders (� = 0.05). The results showed that females had significantly lower eccentric hip adduction, abduction, medial rotation and lateral rotation as well as lower knee flexion and extensi on peak torques. Females also showed greater eccentric HAD/HAB and HMR/HLR as well as lower KF/KE peak torques ratios when compared to males. The differences verified between genders help to explain the greater rate of knee disorders observed i n females.

Resistance Training for Medial Compartment Knee Osteoarthritis and Malalignment

1) To evaluate the effects of a 12-wk high-intensity knee extensor and flexor resistance training program on strength, pain, and adherence in patients with advanced knee osteoarthritis and varus malalignment and 2) to generate pilot data for change in dynamic knee joint load, patent-reported outcomes, and self-efficacy after training. Fourteen patients (48.35 +/- 6.51 yr) with radiographically confirmed medial compartment knee osteoarthritis and varus malalignment of the lower limb were recruited from a surgical waiting list for high tibial osteotomy. Participants completed a high-intensity isokinetic resistance training program three times per week for 12 wk. Knee extensor and flexor strength were assessed every third week, whereas pain and adherence were recorded at every training session. The external knee adduction moment during the gait, the 6-min-walk test, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Arthritis Self-Efficacy Scale (ASES) were also evaluated before and after training. Significant improvements in knee extensor and flexor strength were observed without increases in pain during or after training. Adherence to the high-intensity program was high. No significant changes were observed for dynamic knee joint load or the KOOS. There was a significant increase in the function subscale of the ASES only. These findings suggest that patients with advanced knee osteoarthritis and malalignment can experience substantial gains in strength after a high-intensity resistance training program without concomitant increases in pain, adverse events, or compromised adherence. These findings provide support for future clinical trials with longer-term outcomes.

The Effect of Electro-Acupuncture on Spasticity of the Wrist Joint in Chronic Stroke Survivors

Mukherjee M, McPeak LK, Redford JB, Sun C, Liu W. The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors. Objective To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after electro-acupuncture treatment. Design Crossover design. Setting University medical center research laboratory. Participants Seven chronic stroke subjects (age, 63.14±7.01y). Intervention Participants received two 6-week treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only. Muscle strength and spasticity of the wrist joint were quantified by using the Biodex multijoint System 3 Pro. Electro-acupuncture was given through a commercial electro-acupuncture device. Main Outcome Measures Velocity sensitivity of averaged speed-dependent reflex torque (VASRT); segmented averaged speed-dependent reflex torque (SASRT); Modified Ashworth Scale (MAS) scores; and integrated electromyographic activity of the affected wrist flexors during passive stretch of the affected wrist joint. Results VASRT was reduced significantly in the combined treatment group ( P=.02) after the 6-week period, but not in the strengthening-only group ( P=.23); however, no significant immediate effect of electro-acupuncture was observed ( P>.05). MAS scores also showed a significant reduction ( P<.01). SASRT did not differ significantly across different positions of the joint or across velocity; however, significant differences were present between the 2 treatment groups ( P<.05) for each position and at all the velocities except at 20°/s. Integrated electromyographic activity showed a trend for reduction after the combined treatment. Conclusions A combination of electro-acupuncture and muscle strengthening exercise for 6 weeks significantly reduced spasticity. The effect of spasticity reduction was consistent across different joint positions and different velocities of passive stretch.

Joint Laxity and Isokinetic Thigh Muscle Strength Characteristics After Anterior Cruciate Ligament Reconstruction

To analyze ligamentous stability and isokinetic strength of knee extensor and flexor muscles after anterior cruciate ligament reconstruction using 2 different autografts with identical fixation. This study implements a comparative case series design. Schulthess Clinic, Switzerland. A total of 153 consecutive patients (n = 87 bone-patellar tendon-bone [BPTB]/66 quadruple semitendinosus/gracilis tendons [QSGT] patients) who underwent BPTB and QSGT surgery were functionally assessed. All patients were functionally assessed (knee extension/flexion isokinetic strength and knee joint laxity) at a mean follow-up time of 11 months. Laxity was measured utilizing the Kneelax arthrometer, whereas isokinetic strength of the knee extensor/flexor muscle groups was measured using the Biodex Multi Joint System 2 (180 degrees/s and 300 degrees/s). The QSGT group had significantly greater knee joint laxity when compared with the BPTB group (P < 0.001). Furthermore, females in the QSGT group demonstrated the greatest knee joint laxity overall (P < 0.001). Additionally, a significant flexor torque deficiency was demonstrated in the QSGT group (P < 0.001); however, no differences in extensor torque were observed. The use of a BPTB autograft achieved better knee joint stability as well as greater knee flexor torque than the QSGT autograft. Both grafts exhibited a similar knee extensor torque deficit, indicating that only quadriceps strength is not graft-dependent.

Collagen Hydrolysate Supplementation Improve Symptoms In Patients With Severe Osteoarthritis

PURPOSE Knee pain is a common complaint associated with aging and for those over 40 years of age, this is often the first sign of osteoarthritis (OA). New nutritional supplements have peaked interest over the last 20 years to both relieve symptoms and potentially create structural changes to slow the process of osteoarthritis. Insoluble collagen makes up a majority of articular cartilage. It has been theorized that new treatments for OA should focus on improving the health of this existing joint collagen. For this reason, collagen hydrolysate, a natural component of gelatine, has been suggested as a mode of treatment and thus far has shown minimal side effects. Therefore, the purpose of this study was to evaluate the effectiveness of a collagen hydrosylatebased nutritional supplement on muscle function in individuals with OA of the knee. METHODS One-hundred two individual with severe symptoms of OA of the knee based on criteria from the American College of Rheumatology (ACR) were randomly assigned to either a treatment group (CH group; n=50) consisting of collagen hydrolysate (10 grams), calcium (300 milligrams), and vitamin C (60 milligrams) or a placebo group (n=52). Subjects for this study were sequestered from a larger study involving patients with mild to severe cases of osteoarthritis, to examine the effects of the intervention (CH) in the most severe cases confirmed either by medical record or X-ray. Subjects were assessed at baseline and after 14 weeks using the Biodex Multi-Joint System B2000 (isometric and isokinetic) to assess joint strength and work performance. RESULTS Significant improvements occurred in the CH group for 8 isokinetic leg strength measures and 2 isometric leg strength measures from baseline to week 14 (p<0.05) in this group of subjects with most significant symptoms or x-ray evidence of OA. CONCLUSIONS These data show that CH supplementation can be a useful tool for those with more severe cases of OA by improving functional strength and range of motion. Thus, daily activities, which are most challenging for patients with more severe symptoms of OA, may become more manageable following supplementation with CH. Work Supported by: Gelita Health Initiative

Collagen Hydrolysate Supplementation Improve Symptoms In Patients With Severe Osteoarthritis

PURPOSE Knee pain is a common complaint associated with aging and for those over 40 years of age, this is often the first sign of osteoarthritis (OA). New nutritional supplements have peaked interest over the last 20 years to both relieve symptoms and potentially create structural changes to slow the process of osteoarthritis. Insoluble collagen makes up a majority of articular cartilage. It has been theorized that new treatments for OA should focus on improving the health of this existing joint collagen. For this reason, collagen hydrolysate, a natural component of gelatine, has been suggested as a mode of treatment and thus far has shown minimal side effects. Therefore, the purpose of this study was to evaluate the effectiveness of a collagen hydrosylatebased nutritional supplement on muscle function in individuals with OA of the knee. METHODS One-hundred two individual with severe symptoms of OA of the knee based on criteria from the American College of Rheumatology (ACR) were randomly assigned to either a treatment group (CH group; n=50) consisting of collagen hydrolysate (10 grams), calcium (300 milligrams), and vitamin C (60 milligrams) or a placebo group (n=52). Subjects for this study were sequestered from a larger study involving patients with mild to severe cases of osteoarthritis, to examine the effects of the intervention (CH) in the most severe cases confirmed either by medical record or X-ray. Subjects were assessed at baseline and after 14 weeks using the Biodex Multi-Joint System B2000 (isometric and isokinetic) to assess joint strength and work performance. RESULTS Significant improvements occurred in the CH group for 8 isokinetic leg strength measures and 2 isometric leg strength measures from baseline to week 14 (p<0.05) in this group of subjects with most significant symptoms or x-ray evidence of OA. CONCLUSIONS These data show that CH supplementation can be a useful tool for those with more severe cases of OA by improving functional strength and range of motion. Thus, daily activities, which are most challenging for patients with more severe symptoms of OA, may become more manageable following supplementation with CH. Work Supported by: Gelita Health Initiative

The Role of Dynamometry in Assessing Patients With Mild Osteoarthritis of the Knee

1072 PURPOSE: To determine the efficacy of symptom, mobility and strength tests in evaluating intervention-induced improvements in knee function in patients with symptoms of mild osteoarthiritis (OA) of the knee. METHODS: One hundred ninety individuals (mean age 57 y; 103 M, 87 F) with symptoms of mild OA of the knee based on criteria from the American College of Rheumatology (ACR) were randomly assigned to either a treatment group consisting of collagen hydrolysate or a placebo group in a randomized double blind trial. Subjects were assessed at baseline and weeks 8 and 14 for joint pain, stiffness, mobility, flexibility, and strength. Pain and stiffness symptoms were scored using the WOMAC Index, Knee Pain Scale, and Lequesne Index. Mobility was assessed using the 50-Foot Walk Time and 6-Minute Walk Test. Range of motion of the knee (extension and flexion) was measured using a goniometer. Isokinetic and isometric leg strength tests were performed using the Biodex Multi-Joint System B2000 to assess joint strength and work performance. RESULTS: Statistically significant improvement (p<0.05) occurred in all pain, stiffness, and mobility measures across testing sessions for all subjects in both groups. The collagen hydrolysate group, however, showed statistically significant improvement compared to placebo for certain strength and work performance tests, particularly those that presented the greatest challenge to the joint structure (p<0.05). A sub-group analysis of participants with more severe symptoms showed greater increases (p<0.05) in the collagen hydrolysate group for a greater number of isokinetic and isometric variables when compared with placebo. CONCLUSIONS: These data suggest that measures of isokinetic and isometric leg strength may have the potential to discriminate early improved knee functional mobility more accurately than symptoms or walk test in patients with symptoms of mild OA of the knee. Support: Gelita Health Initiative