Flexion Peak Torque Research Articles

Asymmetries In Quadriceps And Hamstring Strength And Fatigability In Patients 6-months After Acl Reconstruction

Muscle dysfunctions are common after anterior cruciate ligament reconstruction (ACL-R) and may contribute to functional limitations and return to play readiness; however, the severity of lingering muscle dysfunction following rehabilitation is not well understood. Bilateral comparisons of quadriceps and hamstring muscle function are common practice to evaluate rehabilitation progress. The role of muscle fatigue is not well understood in patients recovering from ACL-R. PURPOSE: To compare quadriceps and hamstring muscle strength and fatigability between ACL-R and contralateral limbs in patients 6-months after ACL-R. METHODS: Participants included thirty-five patients with a history of primary, unilateral ACL-R an average of 6.3 ± 1.1 months post-surgery (18.2 ± 2.8 years, 74.2 ± 18.2 kg, 1.72 ± 8.7 m, sex: 20 F/15 M) that had completed a post-surgical rehabilitation program. Strength was quantified using measures of normalized (mass) peak knee extension and flexion torques (Nm/kg) during maximal isometric contractions (90 degrees flexion). Fatigability was quantified using the percent (%) decline in torque during 30-second maximal isometric knee extension and flexion contractions (90 degrees flexion). All measures were performed bilaterally. Comparisons between ACL-R and contralateral limbs were made using paired t-tests. Limb symmetry index (LSI) was used to describe strength asymmetries (=ACL-R limb / contralateral limb × 100). RESULTS: Quadriceps strength was significantly lower (P< .001) in the ACL-R limb (1.5±0.5) compared to contralateral limb (2.3±0.5), with a strength LSI of 64.8±16.4%. There was no difference in hamstring strength (P=.17) between the ACL-R (0.8±0.3) and uninvolved (0.9±0.2) limbs, with a strength LSI of 94.7±2.6%. Quadriceps fatigability was significantly lower (P= .02) in the ACL-R limb (15.3±13.0) compared to the contralateral limb (22.3±9.1). There was no significant difference in hamstring fatigability (P=.59) between the ACL-R limb (23.0±10.6) and contralateral limb (23.9±8.7). CONCLUSION: Patients demonstrated large quadriceps strength asymmetries (65%) at an average of 6-months post-surgery. The ACL-R limb demonstrated less quadriceps fatigability compared to the contralateral limb. Hamstring strength and fatigability were symmetrical.

Comparison of the Effects between Isokinetic and Isotonic Strength Training in Subacute Stroke Patients

The goal of the study was to compare the effects of isokinetic and isotonic strengthening program on the changes of muscle strength, functional capacity, life quality, and inflammatory cytokines in hemiparetic patients within 6months of stroke attack. Thirty-one participants were randomly assigned into either isotonic training group or isokinetic training group. Both training programs were carried out 5 days a week for a total of 4 weeks. Outcome measures included the peak isometric torque of knees at 90° flexion, the peak torque of knees extension and flexion at angular velocities 60°/s and 120°/s, Short Form 36 (SF-36) Health Survey Questionnaire, Timed Up and Go test, and inflammatory cytokines including high sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-α. Seven patients were not able to complete the training program and were excluded from our study. The results from the remaining 24 patients showed that there were more peak torque, and SF-36 items significantly improved in the isokinetic training group compared with the isotonic group. The Timed Up and Go test and interleukin-6 were improved in both groups, but tumor necrosis factor-α was improved in only the isokinetic group. There were no significant differences between the improvements of the 2 groups except the isokinetic flexion torque at 60°/s and 120°/s. Early strengthening exercise is important for subacute stroke patients, and isokinetic program, if accessible, can bring more significant benefits forthem.

The effect of education for daily physical activity level recovery of osteoarthritis patients after total knee arthroplasty. A prospective randomized controlled clinical trial using accelerometry

The effect of education for daily physical activity level recovery of osteoarthritis patients after total knee arthroplasty. A prospective randomized controlled clinical trial using accelerometry

Acute effects of whole body vibration on functional capabilities of skeletal muscle (Los efectos agudos de la vibración corporal total sobre las capacidades funcionales del músculo esquelético)

The focus of this research was to evaluate the effect whole body vibration (WBV) on measures of muscular contractile function. In addition, this research was conducted to compare the effects of WBV on athletes versus non-athletes. Nineteen male, non-athlete college students, as well as eighteen male Division I collegiate athletes participated in this research. All participants completed 2 conditions, vibration and no vibration, in a randomized order. Participants were exposed to either a 2-minute bout of vibration or a 2-minute no vibration condition. Immediately following both conditions, participants were tested for peak vertical jump height, isokinetic peak torque and average power of knee extensors and flexors, and anaerobic power during a 30-second maximal effort cycle task. Results showed a significant improvement in knee flexion peak torque at 6.28 rad·sec-1 in the athlete group following the vibration condition. Results also showed a trend toward a significant improvement in knee extensor and knee flexor average power at 6.28 radΧsec-1 in the athlete group following the vibration condition. There were no significant changes in any isokinetic measure for the non-athlete group. There were no significant changes in vertical jump or anaerobic power for either group. This may be due in part to the complexity of the dose-response relationship, which is largely dictated by the parameters of vibration frequency, amplitude, and duration. However, previous studies have found positive results using similar protocols as the present study. Practically speaking, the use of WBV prior to exercise may result in facilitated contractile and athletic performance. Consequently, this study sought to describe the impact of using WBV prior to exercise on muscle function.Key Words. Performance enhancement; Athletes; Power; Muscle Performance.Resumen. El objetivo de esta investigaciσn fue evaluar el efecto de la vibraciσn de cuerpo entero (WBV) sobre parαmetros de la funciσn contrαctil muscular. Ademαs, esta investigaciσn se realizσ para comparar los efectos de la WBV en atletas en comparaciσn con no atletas. Diecinueve hombres, estudiantes universitarios no deportistas, asν como 18 hombres, atletas de Divisiσn I universitaria participaron en esta investigaciσn. Todos los participantes completaron dos condiciones en orden aleatorio: la vibraciσn y la ausencia de vibraciσn. Los participantes fueron expuestos a 2 min de vibraciσn o una condiciσn de no vibraciσn por dos minutos. Inmediatamente despuιs de ambas condiciones, a los participantes se les midiσ la altura pico de salto vertical, el torque pico isocinιtico, la potencia media de extensores y flexores de la rodilla y la potencia anaerσbica durante una tarea de ciclo de esfuerzo mαximo 30 s. Los resultados muestran una mejorνa significativa en el torque pico de la rodilla a 6.28 rad·sec-1 en el grupo de deportistas luego de la condiciσn de vibraciσn. Los resultados tambiιn muestran una tendencia hacia un aumento significativo en la potencia promedio de los flexores y extensores de la rodilla a 6.28 rad·sec-1 en el grupo de deportistas luego de la condiciσn de vibraciσn. No hubo cambios significativos en las variables isocinιticas en el grupo de no atletas. Tampoco hubo cambios significativos en el salto vertical ni en la potencia anaerσbica en ambos grupos. Esto puede explicarse en parte a la complejidad de la relaciσn de dosis-respuesta, la cual estα ampliamente determinada por los parαmetros de frecuencia, amplitud y duraciσn de la vibraciσn. Sin embargo, estudios previos han encontrado resultados positivos utilizando protocolos similares a los del presente estudio. En tιrminos prαcticos, el uso de WBV antes del ejercicio puede resultar en una mejor contractilidad y rendimiento deportivo. En consecuencia, este estudio tratσ de describir el impacto del uso de WBV antes del ejercicio en la funciσn muscular.Palabras claves. mejora del rendimiento, atletas, potencia, rendimiento muscular

Isolated Gastrocnemius Recession for Achilles Tendinopathy: Strength and Functional Outcomes

Gastrocnemius recession has emerged as a viable intervention for patients with recalcitrant foot and ankle disorders associated with isolated gastrocnemius contracture. The purpose of this case-control study was to investigate the effects of an isolated gastrocnemius recession on pain, patient-reported function, and strength in patients with chronic Achilles tendinopathy and an isolated gastrocnemius contracture. Thirteen patients with unilateral Achilles tendinopathy (mean age [and standard deviation], fifty-two ± 7.7 years) who received a gastrocnemius recession and ten matched-control subjects participated. A visual analog scale was used to assess pain, and the Foot and Ankle Ability Measure was used to evaluate patient-reported function in activities of daily living and sports. Patients were asked about their satisfaction with the results of the gastrocnemius recession. Ankle plantar flexion peak torque was assessed at 60°/sec and 120°/sec. Appropriate t tests were used to assess limb symmetry and strength differences between the groups. The mean duration of follow-up was eighteen months (range, twelve to twenty-eight months). Gastrocnemius recession provided significant pain relief (mean preoperative visual analog scale score [and standard deviation], 6.8 ± 1.8; mean follow-up visual analog scale score, 1.4 ± 2.7; p < 0.05). Foot and Ankle Ability Measure outcomes showed between-group differences in activities of daily living (Achilles tendinopathy group, 89.7; control group, 98.5; p = 0.05) and sports subscales (Achilles tendinopathy group, 71.9; control group, 95.1; p = 0.05). The activities reported to be the most challenging included going up hills, climbing stairs, running, and jumping. Eleven of the thirteen patients in the Achilles tendon group were satisfied with treatment. Side-to-side strength comparisons showed no differences at 60°/sec. Significant differences were observed at 120°/sec (Achilles tendinopathy group, 21%; control group, 3%; p < 0.05); however, the involved limb reached a peak torque similar to that in the control limb. Isolated gastrocnemius recession provides significant and sustained pain relief for chronic Achilles tendinopathy. Good function can be expected for activities of daily living, but power and endurance activities were more problematic for the Achilles tendinopathy group. Isokinetic strength assessment may not effectively capture patient-reported functional deficits. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Analysis of isokinetic muscle strength for sports physiotherapy research in Korean ssireum athletes.

[Purpose] The purpose of the present study was to elucidate the muscle conditions such as the isokinetic muscle of Korean ssireum athletes. [Subjects and Methods] This study enrolled 25 elite ssireum athletes. We measured body composition and peak torque at an angular speed at 60°/s using an isokinetic muscle strength dynamometer. [Results] The lean body mass of the left upper limb was significantly higher than that of the right upper limb. However, the lean body mass of the left lower limb was significantly lower than that of the right lower limb. The peak torque for left elbow flexion was significantly higher than that for right elbow flexion. Conversely, the peak torque for left elbow extension was significantly lower than that for right elbow extension. Furthermore, the peak torque for the left knee was significantly lower than that for the right knee for both flexion and extension. [Conclusion] The data from this study elucidate in part the muscle conditions of Korean ssireum athletes, which can be used to establish a reference for the scientific study of sports physiotherapy.

Functional, Clinical and Biomechanical Comparison of Anterior Cruciate Ligament Reconstruction with Anatomical Placement of Transtibial Tunnel Placement

Objectives:Functional, clinical and biomechanical comparison of Anterior Cruciate Ligament reconstruction with anatomical placement of transtibial tunnel placement.Methods:55 patients who can be adequately followed-up being divided into transtibial and anatomic groups. Lachman and Pivot-shift tests were performed to all patients. Laxity was measured by performing KT-1000 arthrometer test with 15,20 and 30 pounds power. Muscle strength were evaluated with Cybex II at 60 ° / sec, 240 ° / sec frequencies with flexion and extension peak torque. The maximum force values of untouched knee and the knee with surgery have been compared. Groups were evaluated by using IKDC knee ligament healing standard form, IKDC activity scale, modified Lysholm and Cincinnati evaluation forms. Return to work and return to fitness times of patients were compared. NCSS 2007 & PASS 2008 Statistical Software was used for statistical analysis.Results:Statistically, there was not any observed significant difference between Lachman and Pivot-shift levels. Positive value of Pivot-shift test and incidence of anterior translation in Lachman test were higher in the cases which were subjected to transtibial technique . There was not any statistically significant difference between Lysholm activity levels of cases. Lysholm activity levels of patients who underwent anatomic techniques significantly higher than transtibial technique. There was not any statistically significant difference between Modified Cincinnati activity levels. Modified Cincinnati activity levels of patients who were subjected anatomical techniques, are significantly higher than transtibial technique. There was not any statistically significant difference between post treatment IKDC activity levels. Intense activity after treatment rate of patient who were subjected to anatomic techniques was significantly higher than transtibial technique. There was a statistically significant differences between Cybex extension-flexion 60 measurements and Extension 240 measurements. Results of KT-1000 arthrometer testing anatomical technique was found to be stable than transtibial technique in antero-posterior translation of the knee kinematics at 20 and 30 pounds of forces. Return to sport times of patients who underwent transtibial technique, significantly higher than anatomic technique. There was not any statistically significant difference between return to work times of patients.Conclusion:Previously published studies we observed that anatomic single band ACL reconstruction is better than transtibial ACL reconstruction by providing rotational and anterior translational stability control, in reducing the complications and it is more effective in returning normal functions after operation. As an important implication, a single-band anatomic ACL reconstruction’s clinical, functional and laboratory results are found to be better than the transtibial technique.

Muscle activation and knee biomechanics during squatting and lunging after lower extremity fatigue in healthy young women

Muscle activations and knee joint loads were compared during squatting and lunging before and after lower extremity neuromuscular fatigue. Electromyographic activations of the rectus femoris, vastus lateralis and biceps femoris, and the external knee adduction and flexion moments were collected on 25 healthy women (mean age 23.5years, BMI of 23.7kg/m2) during squatting and lunging. Participants were fatigued through sets of 50 isotonic knee extensions and flexions, with resistance set at 50% of the peak torque achieved during a maximum voluntary isometric contraction. Fatigue was defined as a decrease in peak isometric knee extension or flexion torque ⩾25% from baseline. Co-activation indices were calculated between rectus femoris and biceps femoris; and between vastus lateralis and biceps femoris. Fatigue decreased peak isometric extension and flexion torques (p<0.05), mean vastus lateralis activation during squatting and lunging (p<0.05), and knee adduction and flexion moments during lunging (p<0.05). Quadriceps activations were greater during lunging than squatting (p<0.05). Thus, fatigue altered the recruitment strategy of the quadriceps during squatting and lunging. Lunging challenges quadriceps activation more than squatting in healthy, young women.

Isokinetic strength test and functional outcomes in proximal humeral fractures treated with a locking plate

Background Despite the use of many shoulder outcome scales in subjects with rotator cuff pathology or instability symptoms, it can be problematic to select an instrumental evaluation in the shoulder trauma population. In this study we evaluated patients with proximal humeral fractures treated with internal fixation with a locking plate, analyzing the recovery of strength with an isokinetic test and its correlation with clinical and functional outcomes.Methods We enrolled 46 individuals (17 men, 29 women). The evaluation included a structured interview, measurement of ROM, isokinetic strength test and Constant-Murley and QuickDASH scores. The isokinetic test was performed in flexion/extension and external/internal rotation of the operated shoulder in comparison with the contralateral side and concentric contractions in all movements. The parameter tested was peak torque.Results In the operated shoulder values we noticed a statistically significant correlation between the QuickDASH and Constant-Murley score. QuickDASH showed a significant correlation with flexion isokinetic strength, partial correlation with extension isokinetic values and no correlation with external/internal rotation values. In addition, we found a correlation between the Constant-Murley score and all the isokinetic strength parameters. Comparing the operated shoulder and the contralateral, in Neer type 2 fractures there was no significant difference in all the isokinetic peak torque values; in Neer type 3 and type 4, there was a significant statistical difference in both flexion peak torque values and no significant difference in the other movements.Conclusions The isokinetic test can give objective data on strength recovery and could help the surgeonʼs clinical evaluation to assess the functional recovery of the operated shoulder over time. We believe that the isokinetic test and Constant-Murley score could act as a reference in the evaluation of post-surgical outcome of proximal humeral fractures. Furthermore, the type of fracture could be a post-surgical limb recovery predictor and the shoulder flexion force could be the best functionality recovery indicator.

Isokinetic leg strength and power in elite handball players.

Isokinetic strength evaluation of the knee flexion and extension in concentric mode of contraction is an important part of the comprehensive evaluation of athletes. The aims of this study were to evaluate the isokinetic knee peak torque in both the extension and flexion movement in the dominant and non-dominant leg, and the relationship with jumping performance. Twelve elite male handball players from the top Spanish handball division voluntary participated in the study (age 27.68 ± 4.12 years; body mass 92.89 ± 12.34 kg; body height 1.90 ± 0.05 m). The knee extensor and flexor muscle peak torque of each leg were concentrically measured at 60º/s and 180º/s with an isokinetic dynamometer. The Squat Jump and Countermovement Jump were performed on a force platform to determine power and vertical jump height. Non-significant differences were observed between legs in the isokinetic knee extension (dominant= 2.91 ± 0.53 Nm/kg vs non-dominant = 2.70 ± 0.47 Nm/kg at 60º/s; dominant = 1.90 ± 0.31 Nm/kg vs non-dominant = 1.83 ± 0.29 Nm/kg at 180º/s) and flexion peak torques (dominant = 1.76 ± 0.29 Nm/kg vs non-dominant = 1.72 ± 0.39 Nm/kg at 60º/s; dominant = 1.30 ± 0.23 Nm/kg vs non-dominant = 1.27 ± 0.35 Nm/kg at 180º/s). Low and non-significant correlation coefficients were found between the isokinetic peak torques and vertical jumping performance (SJ = 31.21 ± 4.32 cm; CMJ = 35.89 ± 4.20 cm). Similar isokinetic strength was observed between the legs; therefore, no relationship was found between the isokinetic knee flexion and extension peak torques as well as vertical jumping performance in elite handball players.

AB1165-HPR Relationship between Anterior Knee Pain Severity, Functional Capacity, Frontal Plane Projection Angle, Trunk and Hip Strength in Patellofemoral Pain

BackgroundPatellofemoral Pain Syndrome (PFPS) is characterized by anterior knee pain most commonly on the patella lateral facet. Although the increased Frontal Plane Projection Angle (FPPA), core deficit and hip strength...

Association of the Single-Limb Hop Test With Isokinetic, Kinematic, and Kinetic Asymmetries in Patients After Anterior Cruciate Ligament Reconstruction.

Background:Asymmetries persist after anterior cruciate ligament reconstruction (ACLR). Physical performance tests such as the single-limb hop test have been used extensively to assess return-to-sport criteria, as they reproduce dynamic athletic maneuvers.Hypothesis:The single-limb hop is associated with muscle strength and kinematic and kinetic asymmetries in ACLR patients 6 to 9 months after surgery.Study Design:Controlled laboratory study.Methods:Twenty-two men with ACLR (mean age, 28.8 ± 11.2 years) at 6 to 9 months (mean, 7.01 ± 0.93 months) after surgery completed isokinetic testing in 3 velocities (120, 180, and 300 deg/s) and a kinetic, kinematic, and functional evaluation of the single-limb hop test. Pearson correlation coefficients were used to assess the relationship between the Limb Symmetry Index (LSI) of the single-limb hop distance and each of the outcome variables.Results:There were significant positive correlations between the LSI of the single-limb hop distance and the LSI of the peak extension torque at 120 deg/s (P = 0.044, r = 0.37) and the peak extension torque at 180 deg/s (P = 0.042, r = 0.38) as well as a negative correlation with the peak flexion torque at 180 deg/s (P = 0.043, r = −0.38). The LSI of the single-limb hop test was not correlated with any kinetic or kinematic variable (P > 0.05).Conclusion:The findings of the present study demonstrate that distance LSI of the single-limb hop test correlates with isokinetic extension peak torque LSI but not kinetic and kinematic asymmetry.Clinical Relevance:The single-limb hop test can be used as an additional tool for the recognition of muscle strength asymmetries but not for kinetic or kinematic asymmetries 6 to 9 months after ACLR.

Anterior cruciate ligament injury after more than 20 years. II. Concentric and eccentric knee muscle strength

The long-term consequences on knee muscle strength some decades after rupture of the anterior cruciate ligament (ACL) are not established. The aims of our study were to examine peak torque more than 20 years after ACL injury and to compare their knee muscle strength to that of healthy controls. We tested 70 individuals with unilateral ACL injury 23 ± 2 years after injury, whereof 33 (21 men) were treated with physiotherapy in combination with ACL reconstruction (ACLR ) and 37 (23 men) with physiotherapy alone (ACLPT ). These were compared with 33 age- and gender-matched controls (21 men). A Kin-Com(®) dynamometer (90°/s) was used to measure peak torque in knee flexion and extension in both concentric and eccentric contractions. Knee extension peak torque, concentric and eccentric, was ∼10% lower for the injured leg compared with the non-injured leg for both ACLR (P < 0.001; P < 0.001) and ACLPT (P = 0.007; P = 0.002). The ACLPT group also showed reduced eccentric knee flexion torque of the injured leg (P = 0.008). The strength of the non-injured leg in both ACL groups was equal to that of controls. No difference was seen for those with no-or-low degree of knee osteoarthritis compared to those with moderate-to-high degree of osteoarthritis. ACL injury may lead to a persistent reduction of peak torque in the injured leg, which needs to be considered across the lifespan.

Multi-modal physiotherapy and high tibial osteotomy can mitigate risk factors for disease progression in patients with varus gonarthrosis

Multi-modal physiotherapy and high tibial osteotomy can mitigate risk factors for disease progression in patients with varus gonarthrosis

The acute effect of the tongue position in the mouth on knee isokinetic test performance: a highly surprising pilot study.

The tongue involvement within the isokinetic knee extension/flexion exercises has been investigated. Eighteen participants randomly underwent isokinetic testing at 90 and 180°/s with three different tongue positions: middle position (MID, thrusting on the lingual surface of incisive teeth), lying on the lower arch of the mouth (LOW) and extended up to the palatine spot (UP). Statistical analysis of the data revealed an about 30% significant increase of knee flexion peak torque in UP with respect to MID at both angular speeds. Such a difference could have had a confounding effect on results from numerous past studies using isokinetic knee flexion testing. This study alerts future researchers about standardization of tongue position and warrants further investigations on the explicative processes of this phenomenon.

Differences in body fat mass, muscular endurance, coordination and proprioception in woman with and without knee pain: a cross-sectional study

The aim of this study was to compare body fat mass, muscular endurance, multi-joint coordination and proprioception between sedentary adult women with and without knee pain. This cross-sectional study included 149 women. All participants were evaluated using the Visual Analog Scale to determine knee pain during specific functions and divided into 2 groups accordingly. The knee pain group (n=52; mean age: 42.6±4.1 years; mean height: 1.56±5.11 m; mean weight: 75.2±14.1 kg) included patients with mild to moderate knee pain scores. The without knee pain group (n=97; mean age: 41.7±4.2 years; mean height: 1.58±5.06 m; mean weight: 73.4±10.6 kg) included cases who reported no pain. Body composition was assessed using the TANITA Body Composition Analyzer. Concentric maximal torque of the knee flexor and extensor muscles was recorded using an Isomed 2000 isokinetic dynamometer at 180 deg/s. Coordination and proprioception were assessed using the Functional Squat System. There was no significant difference in terms of physical characteristics, body composition parameters and coordination results between groups (p>0.05). Peak torque of flexion (0.65±0.21 N/kg) and extension (0.88±0.23 N/kg) of the affected side in the knee pain group were significantly lower than the without knee pain group dominant side flexion (0.74±0.19 N/kg) and extension (0.98±0.19 N/kg) (p<0.05). A significant difference in knee extension was observed between the affected (0.88±0.23 N/kg) and non-affected sides (0.93±0.21 N/kg) of the knee pain group (p<0.05). There were no significant differences for both legs between groups in terms of coordinative concentric side-to-side deficits and eccentric deficits (p>0.05). The deviation on visible movement for proprioception was significantly higher in the knee pain group (3.23±1.01 cm) than in the without knee pain group (2.78±1.03 cm) (p=0.012). Knee pain impairs flexor and extensor peak torques of knee endurance and multi-joint proprioceptive accuracy in sedentary woman. No differences were observed in terms of body composition and joint coordination of the groups with or without knee pain.

Is Walking Capacity in Subjects with Multiple Sclerosis Primarily Related to Muscle Oxidative Capacity or Maximal Muscle Strength? A Pilot Study

Background and Purpose. Walking capacity is reduced in subjects with multiple sclerosis (MS). To develop effective exercise interventions to enhance walking capacity, it is important to determine the impact of factors, modifiable by exercise intervention (maximal muscle strength versus muscle oxidative capacity), on walking capacity. The purpose of this pilot study is to discriminate between the impact of maximal muscle strength versus muscle oxidative capacity on walking capacity in subjects with MS. Methods. From 24 patients with MS, muscle oxidative capacity was determined by calculation of exercise-onset oxygen uptake kinetics (mean response time) during submaximal exercise bouts. Maximal muscle strength (isometric knee extension and flexion peak torque) was assessed on dynamometer. All subjects completed a 6-minute walking test. Relationships between walking capacity (as a percentage of normal value) and muscle strength (of knee flexors and extensors) versus muscle oxidative capacity were assessed in multivariate regression analyses. Results. The expanded disability status score (EDSS) showed a significant univariate correlation (r = −0.70, P < 0.004) with walking capacity. In multivariate regression analyses, EDSS and mean response time, but not muscle strength, were independently related to walking capacity (P < 0.05). Conclusions. Walking distance is, next to disability level and not taking neurologic symptoms/deficits into account, primarily related to muscle oxidative capacity in subjects with MS. Additional study is needed to further examine/verify these findings.

External rotator sparing with posterior acetabular fracture surgery: does it change outcome?

This study analyses the results of the treatment with external rotator sparing approach in acetabular fractures to determine whether muscle sparing has a positive impact on functional outcome. 20 patients with a mean age of 45.9 years (range: 26–64) that had been treated for displaced acetabular fractures were included in this series. Short Musculoskeletal Function Assessment (SMFA) questionnaire and hip muscle strength measurement were done at the 24-month of follow-up period. The radiographic results at the final followup were excellent in 9 hips (45%), good in 6 hips (30%), fair in 4 hips (20%), and poor in one hip (5%) according to the criteria developed by Matta. The average SMFA score for all of the patients was 18.3 (range: 0–55.4). The mean dysfunctional and bother indexes were 17.2 and 20.6, respectively. The overall muscle strength deficit was 11.8%. The greatest loss of strength was in internal rotation. In patients with better postoperative reduction quality of acetabular fracture, peak torque, and maximum work of hip flexion, extension and also internal rotation maximum work deficit were significantly lower (P < 0.05). Accurate initial reduction and longer postoperative muscle strengthening exercise programs seem critical to decrease postoperative hip muscle weakness after acetabular fractures.

Effect of Togu-exercise on Lumbar Back Strength of Women with Chronic Low Back Pain.

[Purpose] The present study analyzed the effect of the Togu exercise program on the lumbar back strength of middle-aged women who did not perform regular exercise, and presents an effective exercise method for middle-aged women with chronic low back pain symptom. [Subjects] The subjects were 16 women with chronic low back pain attending N University, Chungcheong-do, Korea. [Methods] Height, weight, body fat, and body mass index (BMI) were measured using a body composition analyzer (Inbody 720, Biospace, Korea), which utilizes bioelectrical impedance analysis. Using isokinetic lumbar muscle strength measurement equipment [Isomed 2000, Back system, (Germany)], peak torque/body weight, total work and average power of flexion and extension of the lumbar region were measured. For lumbar stabilization exercises, an air cushion (Germany), jumper (Germany), and aero step (Germany) were employed. First, warm-up exercise was conducted for 10 minutes, followed by 10 sets of the 3 main exercises using the above tools with 10-second rest intervals. The main exercise was done for 40 minutes in total. [Results] The paired sample t-test showed significant in the Togu exercise group peak torque of flexion, peak torque of extension, total work of flexion, total work of extension, average power of flexion, average power of extension, after the exercise showed a significant difference in the Togu exercise group. [Conclusion] The trunk muscle actiation program for middle-aged women had a significant effect on muscle strength and low back pain. Therefore the trunk muscle activation program is effective at increasing muscular strength of middle-aged women, and the results suggest improve muscle strength is effectively stabilizaties the lumbar region.

Long-term functional results and isokinetic strength evaluation after arthroscopic tenotomy of the long head of biceps tendon.

Introduction:The objective of this study is to evaluate the biomechanical function of the upper arm after arthroscopic long head of biceps (LHB) tenotomy at long-term follow-up.Materials and Methods:Twenty-five male subjects ranging from 30 to 63 years old were evaluated at a mean follow-up of 7.0 years after tenotomy. Bilateral isokinetic testing was performed to obtain peak torque values, as well as total work done throughout the full range of elbow flexion and supination.Results:Magnetic resonance imaging scans revealed nine unrecognized LHB ruptures in the contralateral arm, leaving 16 subjects to complete the testing protocol. The mean quickDASH score was 8.1 (standard error [SE] 2.5). The mean oxford elbow score was 97.9 (SE 1.6). The tenotomy arm recorded a decrease in peak flexion torque of 7.0% (confidence interval [CI] 1.2-12.8), and a decrease in the peak supination torque of 9.1% (CI 1.8-16.4) relative to the contralateral arm. The total work carried out through the full range of joint motion was reduced in elbow flexion by 5.1% (CI −1.3-11.4) and in forearm supination by 5.7% (CI-2.4-13.9).Discussion:Maximum strength in elbow flexion and forearm supination is significantly reduced compared with the contralateral arm. However, this impairment is partially compensated for by relatively greater strength sustained through the latter stages of joint motion. This results in comparable total work measurements between the tenotomised and contralateral side, potentially accounting for ongoing high levels of patient satisfaction and clinical function in the long term after LHB tenotomy.Level of Evidence IV:Case series without comparison group.