Hand-held Dynamometer Research Articles

Assessing quadriceps strength in patellofemoral pain patients: A study on the reliability and validity of a low-cost strain-gauge for clinical practice.

Patellofemoral pain (PFP) is a common knee complaint affecting diverse populations both acutely and chronically. Quadriceps muscle weakness is one possible aetiology, but current devices for measuring muscle strength (isokinetic dynamometer [ID] and hand-held dynamometers [HHD]) are frequently too expensive (e.g., ID) or lack reliability (e.g., HHD) for practitioners, especially in under-resourced settings. There is a need to evaluate a low-cost device to manage rehabilitation of people with PFP. Isometric quadriceps strength of participants aged 18-35 years (total [n = 33], control group [n = 17] and PFP group [n = 16]) were evaluated on an isokinetic dynamometer and a commercially available strain gauge at baseline and after an 8-week non-standardised intervention. The strain gauge showed high absolute and relative reliability (intraclass correlation coefficient = 0.89-0.99; typical error of measurement = 3.9-10.4%). Clinically meaningful difference scores (12.2-45 Nm) were greater than the typical error of measurement, implying sufficient sensitivity of the strain gauge to measure true changes in isometric quadricep strength. Strong to very strong correlations were evident between the strain gauge and isokinetic dynamometer torque measurements (r = 0.88-0.90, SEE = 0.05-0.07 Nm), but slope values (β = 0.65-0.77) indicated that torque from the strain gauge was lower than that obtained from the isokinetic dynamometer. An average systematic bias of 16.3-28.8 Nm was evident in favour of the isokinetic dynamometer, with no statistically significant between-group differences apparent between baseline and follow-up testing. The present commercially available strain gauge is reliable and sensitive enough to detect clinically meaningful differences in quadriceps strength of both healthy individuals and those with PFP. However, the strain gauge lacks validity and therefore cannot replace isokinetic dynamometry. Given the low cost and excellent reliability, the strain gauge can be a valuable tool to assess quadriceps muscle deficits and track rehabilitation progress in people with PFP.

#2072 Impact of the GoodRENal platform on lower-limbs muscle strength in a Spanish sample

Abstract Background and Aims People with chronic kidney disease on hemodialysis have low levels of physical activity and low lower-limbs muscle strength, partly due to the sedentary lifestyle, and a big number of hours sitting or in a recumbent position. The GoodRENal project aimed at creating an intradialysis health platform to improve health-related quality of life. The present study focused on the impact of the GoodRENal intradialysis platform on lower-limbs muscle strength. Method People in hemodialysis treatment from Spain were included. Participants were randomized into two groups, the GoodRENal or the usual care group. The participants used the GoodRENal platform for 12 weeks, 3 times a week. Games using non-immersive virtual reality were created aiming at educating on nutritional habits, increasing physical activity during the HD session, improving cognitive skills and increasing psychological well-being. All of them included dual tasks, so that the movement of the legs was used in every game. An Azure Kinect camera was used to capture the movement and all activities were dual, so that movement of lower limbs was promoted in every game. A handheld dynamometer was used to assess hip flexors and abductors muscle strength during the hemodialysis session. This procedure has proven to be reliable and save. An ANOVA mixed model (group and time factors) was used to analyze the results. Results 19 participants were included (Control n = 9; GoodRENal n = 10). Participants’ mean age was 73.4 years for the control and 68.3 years for the GoodRENal group, with a hemodialysis vintage, median 34 months (minimum 3- maximum 277) and 25 months (minimum 5- maximum 48) for the control and GoodRENal groups. Right hip flexor muscles changed in the control group over time: Baseline 124.7 (23.2) N; 4 weeks 121.3 (20.3) N; 12 weeks 119.0 (21.1) N. In the GoodRENal group, the data were: Baseline 116.7 (34.7) N; 4 weeks 124.7 (36.7) N; 12 weeks 142.7 (44.7) N. The ANOVA showed a significant time × group interaction (F = 11.347 p < 0.001) with a significant improvement in the GoodRENal group. Left hip abductor muscles changed in the control group over time: Baseline 124.5 (24.0) N; 4 weeks 123.0 (26.1) N; 12 weeks 122.0 (24.7) N. In the GoodRENal group, the data were: Baseline 111.1 (30.4) N; 4 weeks 119.2 (33.0) N; 12 weeks 138.5 (36.3) N. The ANOVA showed a significant time × group interaction (F = 15.218 p < 0.001) with a significant improvement in the GoodRENal group. Both left hip flexors (F = 19.055 p < 0.001) and abductors (F = 15.036 p < 0.001) showed a significant time per group interaction, with an improvement in the GoodRENal group. Conclusion The GoodRENal platform is a feasible strategy to increase the muscle strength of the hip flexors and abductors muscles. Future studies with bigger samples should confirm these results.

#3007 Association between sarcopenia and clinical outcomes in patients on maintenance hemodialysis

Abstract Background and Aims Sarcopenia is a generalized skeletal muscle disorder characterized by the progressive loss of skeletal muscle mass, strength, and function, resulting in worse quality of life and increased mortality. Chronic kidney disease and hemodialysis (HD) favor the development of sarcopenia; however, factors associated with sarcopenia in HD patients have not been well-studied. This study aimed to determine the prevalence and risk factors for sarcopenia in HD patients and to analyze the relationship between sarcopenia and overall morbidity and mortality. Method We conducted short-term follow-up prospective cohort study among maintenance HD patients. Hand Grip Strength was measured by a resisted hand-held dynamometer to identify muscle strength and Bioimpedance Spectroscopy to calculate appendicular skeletal muscle mass (ASM). Finally, appendicular skeletal muscle index (ASMI) was calculated as ASM (kg) divided by weight squared (m2). Patients were categorized as sarcopenic or non-sarcopenic using Revised European Working Group criteria (EWGSOP2). Low muscle mass was defined as an ASMI value of<7.00 kg/m2 for men and<5.40 kg/m2 for women; low muscle strength was defined as a hand grip strength of<28 kg for men and<18 kg for women. Results Our study enrolled 176 adult HD patients (60% male, 56.1 ± 14.8 years of age). Median follow-up was 15.9 (interquartile range [IQR] 8.6–21) months. Sarcopenia was present in 32.5 % of males and 28% of female patients and associated with older age (55.2 ± 13.4 vs. 64.0 ± 7.3, p<0.001), lower body mass index (25.3 ± 1.3 vs. 22.8 ± 3.1 kg/m2, p<0.05), longer dialysis vintage (9.2 ± 1.1 vs. 6.2 ± 1.9 years, p<0.001) lower Kt/V and lower serum phosphorus and albumin levels (p = 0.037, p = 0.042 and p = 0.048, respectively). In the multivariate analysis, the sarcopenic group had a significantly higher risk for all causes hospitalization than the non-sarcopenic group after adjusting for age and gender (OR 3.92, (95%CI 1.21–12.53, p = 0.031)). Sarcopenia was significantly associated with higher mortality risk (adjusted OR 1.76 (95% CI 1.32 to 2.67)), cardiovascular (adjusted OR 3.31 (95% CI 1.55 to 9.22)) and cerebrovascular events (adjusted OR 2.67 (95% CI 1.52 to 6.03)). Kaplan–Meier survival analysis showed a twelve-month survival rate of 82.1% in sarcopenic patients, which was significantly lower than the non-sarcopenic group (p = 0.034). Finally, both ASM and low muscle strength were independently related to increased mortality risk in dialysis patients (OR 1.86; 95% CI 1.31 to 2.62 and OR 2.31 95% CI 1.49 to 3.93, respectively). Conclusion Our study demonstrated that sarcopenia was highly prevalent among HD patients and was shown to be a significant predictor of poor patients outcomes. Future research should address whether the early diagnosis and treatment of sarcopenia improve outcomes.

#2786 Effect of intradialytic virtual reality exercise program on lower limb muscle strength in patients on hemodialysis

Abstract Background and Aims In patients on hemodialysis, muscle weakness is highly prevalent and may lead to frailty, limitation of mobility and functional impairment. Moreover, low muscle strength was associated with an increase in mortality risk in these patients. Despite the fact that some studies showed that resistance training improves muscle strength in patients on hemodialysis, the effects of virtual reality (VR) exercise should be confirmed. Therefore, the aim of this study was to evaluate the effects of an intradialytic non-immersive VR exercise program, performed at different times during the hemodialysis session, on lower limb muscle strength in patients on hemodialysis. Method A randomized clinical trial was conducted with patients aged ≥18 years who were undergoing hemodialysis treatment for at least 3 months. Patients were randomized into 2 protocols of exercise at different times during the hemodialysis session (first 2 hours and last two hours) for 3 months. The intradialytic exercise program in both groups consisted of a non-immersive VR game (Treasure Hunting) in which the patients try to catch treasures and avoid bombs by moving their lower limbs (hip flexion, abduction and adduction, and knee flexion and extension), with a progressive duration of 6 to 36 minutes. The difficulty level of the game was graduated according to the characteristics of each patient. The muscle strength of the hip flexion (HF), hip abduction (HA) and ankle extension (AE) was evaluated using a portable handheld dynamometer during hemodialysis session. Patients were advised to perform a 5 s maximum isometric contraction, and the peak values were recorded for 3 repetitions in both lower limbs. The mean muscle strength of 3 trials was recorded. Data were expressed as the median (interquartile range). The Mann‒Whitney U test was used for between-group comparisons. The Friedman test was conducted to evaluate the differences in medians among the muscle strength data at baseline, after 1, 2 and 3 months of exercise program. Results This study included 11 patients in the exercise within the first 2 hours group [50 (55-75) years, 55% male] and 11 patients in the exercise within the last 2 hours group [64 (58-72) years, 64% male]. Table 1 shows that muscle strength of the HA and AE increased significantly in the exercise within the first 2 hours group. Muscle strength of HF, HA and AE improved significantly in the exercise within the last 2 hours group. There were no significant differences between two groups. Conclusion This study suggests that an intradialytic non-immersive VR exercise program can improve lower limb muscle strength in patients on hemodialysis.

Test-retest reliability and concurrent validity of knee extensor strength measured by a novel device incorporated into a weight stack machine vs. handheld and isokinetic dynamometry.

The current clinical gold standard for assessing isometric quadriceps muscle strength is an isokinetic dynamometer (IKD). However, in clinics without an IKD, clinicians default to using handheld dynamometers (HHD), which are less reliable and accurate than the IKD, particularly for large muscle groups. A novel device (ND) was developed that locks the weight stack of weight machines, and measures forces applied to the machine, turning this equipment into an isometric dynamometer. The objectives of this study were to characterize the test-retest reliability of the ND, determine the within-day and between-days inter-rater reliability and concurrent validity compared with that of the HHD, in healthy volunteers (HV) and individuals with knee osteoarthritis (OA) for measuring knee extensors isometric muscle force. 29 healthy (age = 28.4 ± 7.4 years) and 15 knee OA (age = 37.6 ± 13.4 years) participants completed three maximum force isometric strength testing trials on dominant side knee extensor muscles on three devices (ND, HHD, and IKD) in two separate sessions by two raters. The maximum force (Fmax) produced, and the force-time series were recorded. Reliability and validity were assessed using Intraclass Correlation Coefficient (ICC), Bland-Altman Plots, Pearson's r, and cross-correlations. The ND demonstrated excellent test-retest reliability (ICC2,3 = 0.97). The within-day (ICC2,3 = 0.88) and between-day inter-rater reliability (ICC2,3 = 0.87) was good for HHD. The ND showed excellent within-day (ICC2,3 = 0.93) and good between-day (ICC2,3 = 0.89) inter-rater reliability. The Bland-Altman analysis revealed HHD systematic bias and underestimation of force particularly with quadriceps force values exceeding 450 N. Mean differences were found in maximum force between HHD vs. IKD (MDabs = 58 N, p < .001) but not the HHD vs. ND (MDabs = 24 N, p = .267) or ND vs. IKD (MDabs = 34 N, p = .051). The concurrent validity of Fmax (r = 0.81) and force-time curve correlation (0.96 ± 0.05) were the highest between the ND and IKD. The ND's test-retest reliability and concurrent validity make it a potential strength assessment tool with utility in physical therapy and fitness settings for large muscle groups such as the knee extensors.

Pole Dancing-Specific Muscle Strength: Development and Reliability of a Novel Assessment Protocol.

Pole dancing is a physically demanding sport that combines dance and acrobatic movements on a vertical pole. Despite its highly growing popularity, there is currently limited research in the field. The aim of this study was to create and evaluate a strength assessment protocol for athletes in pole dancing, with a specific focus on functional positions on the pole. Thirty-two female pole dancing athletes participated in this study. Maximal voluntary isometric contractions (MVIC) were measured at three different sport-specific positions on the pole (shoulder abduction and adduction, and hip adduction), on two separate days (test and re-test) with a five to seven day interval between them. A hand-held dynamometer (Activ5- Activbody) stabilized on the pole was used for this study. The intra-session reliability was good to excellent for all sports-specific positions and for both sides of the body, across all different movements (ICC = 0.837-0.960, SEM = 5.02Kg-2.24Kg, and SDD = 27.46%-14.92%). Slightly better results were found regarding inter-session reliability (ICC = 0.927-0.970, SEM = 3.72Kg-1.97Kg, and SDD = 22.86%-15.19%). There was not a statistically significant difference between the MVICs between the left and right or dominant and non-dominant side in shoulder abduction (p = 0.105) and hip adduction (p = 0.282), in contrast to shoulder adduction (p = 0.00). The strength assessment protocol developed in the current study has proven to be a reliable and functional tool, with the potential for utilization in clinical practice as part of objective strength testing. Further studies are needed in order to expand the protocol to other muscle groups and positions and to generalize the results in all pole dancing populations such as male athletes.

Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia

ObjectivesThis research was aimed at comparing the effects of neuromuscular electrical stimulation (NMES) combined with interrupted serial casting (SC) versus SC alone on various aspects of lower limb function in children with diplegic cerebral palsy. SC is a clinical technique used to increase passive range of motion (ROM), decrease hypertonicity, and improve walking in children with cerebral palsy (CP). MethodsThis randomized comparative trial involved 33 children with diplegic CP, who were randomly assigned to group A or group B at recruitment. Group A received SC along with a customized physical therapy program, whereas group B received the same interventions as group A along with NMES applied through cast windows during casting. Evaluations were based on ROM, the Modified Tardieu Scale, handheld dynamometer measurements, and the Observational Gait Scale. Assessments were conducted before and after 8 weeks of intervention. ResultsBoth groups exhibited significant improvements in dorsiflexion ROM, popliteal angle, gastrocnemius dynamic spasticity, and hamstring dynamic spasticity after the intervention (P = 0.0001 for all). However, significant differences (P < 0.05) in dorsiflexor strength, knee extensor strength, and observational gait scale score were observed between groups after the intervention, favoring group B. ConclusionsThe use of NMES during SC may help overcome the substantial decrease in strength resulting from casting, thus achieving less reduction of tone, improving ROM without significantly decreasing strength, and attaining greater improvements in gait function.

Single-Joint Type Hybrid Assistive Limb for Knee Training in the Acute Postoperative Phase After Opening Wedge High Tibial Osteotomy: A Feasibility and Safety Trial.

Opening wedge high tibial osteotomy (OWHTO) influences the knee extensor mechanism, the range of passive motion of knee extension and persistent quadriceps, and anterior knee pain and weakness. Rehabilitation should focus on quadriceps strength and improving joint mobility. The single-joint hybrid assistive limb device (HAL-SJ) is a wearable exoskeleton cyborg. In this study, we investigated the feasibility and safety of HAL-SJ training after the early postoperative period following OWHTO and whether the use of this device can improve functional outcomes, including knee muscle extensor strength and knee extension range of motion without knee pain. Patients who had been diagnosed with knee osteoarthritis and had undergone OWHTO were assessed for eligibility in this prospective trial conducted at our institution between June 2015 and November 2020. The participants were split into two groups, i.e., 10 patients in the hybrid assistive limb (HAL) group and eight patients in the control group. We initiated HAL-SJ therapy on postoperative day 8 and continued it until the patient's discharge. During the hospitalization period, patients engaged in HAL-SJ-assisted knee extension exercises. This exercise routine encompassed five sets, each comprising 10 repetitions, and was conducted twice a week. We conducted assessments aimed at detecting any potential adverse events that could be linked to HAL training. Assessment of the knee extension angle via the visual analog scale (VAS) and strength assessments using a hand-held dynamometer (HHD) were conducted. To compare clinical outcomes before and after OWHTO, knee extension angle, the VAS, HHD, Japanese Orthopaedics Association (JOA) score, and the Japanese Knee Osteoarthritis Measure (JKOM) were assessed at four distinct time points. No adverse events were observed during the study. The assessment of clinical outcomes before and after OWHTO demonstrated a gradual improvement in outcomes. The single-joint hybrid assistive limb device in patients who underwent OWHTO appears to be potentially safe. It contributed to enhanced muscle activity efficiency by reducing knee pain and improving knee extension angles in the early postoperative phase.

Design and validation of a wearable dynamometry system for knee extension-flexion torque measurement

Muscle strength assessments are vital in rehabilitation, orthopedics, and sports medicine. However, current methods used in clinical settings, such as manual muscle testing and hand-held dynamometers, often lack reliability, and isokinetic dynamometers (IKD), while reliable, are not easily portable. The aim of this study was to design and validate a wearable dynamometry system with high accessibility, accuracy, and reliability, and to validate the device. Therefore, we designed a wearable dynamometry system (WDS) equipped with knee joint torque sensors. To validate this WDS, we measured knee extension and flexion strength in 39 healthy adults using both the IKD and WDS. Comparing maximal isometric torque measurements, WDS and IKD showed strong correlation and good reliability for extension (Pearson’s r: 0.900; intraclass correlation coefficient [ICC]: 0.893; standard error of measurement [SEM]: 9.85%; minimal detectable change [MDC]: 27.31%) and flexion (Pearson’s r: 0.870; ICC: 0.857; SEM: 11.93%; MDC: 33.07%). WDS demonstrated excellent inter-rater (Pearson’s r: 0.990; ICC: 0.993; SEM: 4.05%) and test–retest (Pearson’s r: 0.970; ICC: 0.984; SEM: 6.15%) reliability during extension/flexion. User feedback from 35 participants, including healthcare professionals, underscores WDS's positive user experience and clinical potential. The proposed WDS is a suitable alternative to IKD, providing high accuracy, reliability, and potentially greater accessibility.

Effects on the Physical Functioning of Two Exercise Interventions in Patients with Multiple Myeloma: A Pilot Feasibility Study.

Because of the high prevalence of bone destruction in patients with multiple myeloma (MM), physical exercise is oftentimes discouraged by healthcare providers. The goal of this prospective trial was to investigate the feasibility of two six-month exercise interventions in patients with MM (N = 42): a remotely prompted home-based walking intervention or a supervised strength training intervention. Physical function and pain were assessed with the Activity Measure for Post-Acute Care (AM-PAC) Basic Mobility Short Form raw score, a six-minute walk test (6 MWT), a 30-second sit-to-stand test (30 SST), a timed up-and-go (TUG) test, a visual analog scale (VAS) for pain, handheld dynamometer tests, heart rate at rest, blood oxygen saturation at rest, and body mass index. No intervention-related serious adverse events were observed. Adverse events mostly affected the musculoskeletal system. In the resistance training group (n = 24), patients showed significant improvements in AM-PAC, TUG, 6 MWT, and 30 SST, with all effects but the 6 MWT sustained six months after the intervention. The walking group (n = 18) saw improvements in the AM-PAC, TUG, 6 MWT, and 30 SST, with a sustained change in the AM-PAC and TUG. This trial shows the feasibility of both exercise interventions with a sustained beneficial effect on the physical functioning of a six-month strength training intervention and, to a lesser extent, a six-month unsupervised walking intervention. A larger study building on these findings is currently underway.

Progress Monitoring Tool for Patient Suffering From OA Knee: Fitknees- Wearbale Sensor and Fitmust (Hand-Held Dynamometer): A Case Study

Background-OA risk rises significantly with age and is incredibly uncommon in anyone under the age of 30. Female sex, obesity, past joint damage (such as an ankle fracture or knee ligament rupture), atypical joint anatomy, and having family members with OA all raise the risk of getting the condition. It has now become necessary to monitor the progress of the individual with the treatment given. Aim- To track the progression of the ailment using unique fitness and Fit must devices. Objective - To find out the percentage of progress the participant did in each of the parameters, to find any co-relation within the parameters. Results-Wearables and a handheld dynamometer were used to calculate and significant findings were seen over the course of four months in addition to physiotherapy activities. Conclusion- Wearables and artificial intelligence have made it simple for patients and therapists to monitor progress and recovery.

Validity and Reliability of Handheld Dynamometry to Assess Isometric Hamstrings and Quadriceps Strength at Varying Muscle Lengths.

The hamstrings are the most commonly injured muscle in sports and are especially injury prone in lengthened positions. Measuring knee muscle strength in such positions could be relevant to establish injury risk. Handheld dynamometry has been shown to be a valid, reliable, and practical tool to measure isometric muscle strength clinically. The aim of this study was to assess the validity and reliability of the assessment of isometric knee muscle strength with a handheld dynamometer (HHD) at various muscle lengths, by modifying the hip and knee angles during testing. Concurrent validity and test-retest reliability. Thirty young healthy participants were recruited. Hamstring and quadriceps isometric strength was measured with a HHD and with an isokinetic dynamometer, over 2 testing sessions, in a randomized order. Isometric strength was measured on the right lower limb in 6 different positions, with the hip at either 0° or 80° of flexion and the knee at either 30°, 60°, or 90° of flexion. Pearson and Spearman correlations were used to assess the validity, and intraclass correlation coefficients were calculated to establish the test-retest reliability of the HHD. Good to excellent reliability and moderate to high validity were found in all the tested muscle length positions, except for the hamstrings in a seated position with the knee extended at 30°. The use of a HHD is supported in the clinical setting to measure knee muscle strength at varying muscle lengths in healthy adults, but not for the hamstrings in a lengthened position (hip flexed and knee extended). These results will have to be confirmed in sport-specific populations.

Using Inspiratory Muscle Training to Improve Respiratory Strength, Functional Capacity, Fatigue, and Stress in Breast Cancer Patients Undergoing Surgery.

The main aim of the trial was to assess the effectiveness of inspiratory muscle training on respiratory muscle strength, functional capacity, fatigue, and stress in post-surgical breast cancer survivors. Forty-seven females who had undergone unilateral post-mastectomy were randomly assigned to an intervention group (IG; n = 24) and a control group (CG; n = 23). Both groups received aerobic exercise training. In addition, the intervention group received inspiratory muscle training 3 days a week for 8 weeks. Maximum inspiratory and expiratory pressure (Pimax) (Pemex), 6-minute walk test, Handgrip strength by hand-held dynamometer, Fatigue Assessment Scale (FAS), and Perceived Stress Scale pss 10 values were measured before the training and then at the eighth week for both groups. No differences were detected between the groups in terms of sample and clinical characteristics 8 weeks post-intervention. In favor of the intervention group, a significant difference with medium to high effect size was found in terms of Pimax, Pemax, FAS, PS, and 6MWT (p < 0.05). However, there was no difference in terms of handgrip strength (p-value: 0.072), with a medium effect size (0.070). Regarding within-group comparisons, IG exhibited substantial differences in all outcome measures (p < 0.05) compared to CG, with the exception of PImax and 6MWT. In post-operative breast cancer survivors, respiratory muscle training combined with aerobic training increases respiratory muscle strength and functional ability while lowering stress and tiredness.

Effect of Arthroscopic Acromioplasty on the Isometric Abduction Strength.

Introduction Acromioplasty is a widely performed procedure for various rotator cuff pathologies with good outcomes and high patient satisfaction. However, few studies have focused on its potential complications. Previous cadaveric studies have demonstrated that a considerable portion of the deltoid muscle is detached from its acromial origin following arthroscopic acromioplasty, but the clinical relevance of this muscle detachment has not been investigated. The goal of our research was to examine the influence of arthroscopic acromioplasty on abduction strength and to assess whether acromial anatomy plays a role in any potential effect. Methods From a preliminary sample of 87 individuals who were diagnosed with isolated impingement syndrome and underwent arthroscopic acromioplasty, 74 patients who met the inclusion criteria were ultimately included in the study. The patients were divided into two groups according to their acromion morphology: Bigliani type 2 (33 patients) and type 3 (41 patients). The isometric abduction strength of the two groups was measured by a handheld dynamometer (Isobex®; Cursor AG, Berne, Switzerland) at different abduction angles preoperatively and at the first, third, and sixth months following surgery and was statistically compared. Results Both groups showed reduced abduction strength postoperatively; however, the strength of abduction in the Bigliani type 3 group returned to near preoperative values in the third month. Although increased mean abduction strength was recorded at 30° abduction in the sixth month, this difference was not statistically significant (p=0.78). In the Bigliani type 2 group, compared with those in the sixth-month group, the preoperative abduction strength decreased from 8.32 kg to 6.0 kg (p = 0.047), 6.57 kg to 5.15 (p = 0.025), and 6.1 kg to 4.56 kg (p = 0.006) at 30, 60, and 90° abduction, respectively. Conclusions Arthroscopic acromioplasty decreased isometric abduction strength in patients with a Bigliani type 2 acromion. Patients should be counseled about this loss, which might be especially important for professional athletes and heavy manual workers.

Effect of hypertension on muscle strength, balance, and mobility in older adults

Purpose: Hypertension (HT) can exacerbate impaired blood pressure regulation and thus increase the risk of falls. The higher incidence of HT and impaired balance in older adults may lead to the hypothesis of an association between HT and physical function in older individuals. The purpose of this study was to investigate the effects of HT on muscle strength, balance, and mobility in older adults and the relationship between them. Methods: Sixty-one older adults were included in the study and individuals with systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg formed the Hypertensive group (n=31), while the others formed the Normotensive group (n=30). Quadriceps Femoris (QF) muscle strength was evaluated with a hand-held dynamometer, mobility was evaluated with the Timed Up and Go Test (TUG), balance performance was evaluated with the Nintendo Wii Fit Balance Board (NWBB), and physiological age was evaluated with Wii Fit Age (WFA). The systolic and diastolic blood pressure were measured before the balance test. Results: TUG and NWBB scores between groups were significantly better in the Normotensive group (p&amp;lt;0.05). In both Hypertensive and Normotensive groups, there was a negative correlation between QF muscle strength and TUG score, and a positive correlation between QF muscle strength and NWBB score (p&amp;lt;0.05). Conclusion: HT may worsen mobility and balance in older adults. Further studies are required to better understand HT and establish better appropriate interventions for older hypertensive adults.

Effectiveness of thera-band exercise program and electro- physiotherapy on abductor strength of the iliotibial band in athletes with iliotibial band syndrome

Objectives: The iliotibial band (ITB) is a thick fascial band formed near the hip by merging the fascia of the gluteus maximus, gluteus medius, and tensor fasciae latae muscles. Iliotibial band syndrome (ITBS) is a common overuse injury, manifests as pain on the outer side of the knee and hip due to ITB friction with the femur. Athletes may experience reduced hip and knee mobility, potentially impacting performance. This study aims to compare the efficacy of two ITBS treatments: Thera-Band Exercise Program (TBEP) as the experimental group and Electro-Physiotherapy (EPT) as the control group.Methods: A randomized controlled trial carried out at the Teaching Hospital Karapitiya, with thirty athletes in each group. The control group received EPT, and medications, for two weeks, the experimental group received TBEP and medications for the same duration. Abductor Muscle strength assessment was conducted on Day 01 and Day 28 using handheld dynamometer (HHD)Results: The mean ages in the control and experimental groups were 24.33±6.40 years and 24.97±6.87 years, respectively. Muscle strength (N) for the control group on Day 1 and Day 28 were 99.77± 24.81 and 108.83±22.36, respectively. In the experimental group, the corresponding values were 102.50±26.71 and 147.00±29.92, respectively. The mean differences for muscle strength of two groups in D1 and D28 were 2.733(P&gt;0.683) and 38.167(P&lt;0.001) (RM-ANOVA). TBEP had a statistically significant effect (p=0.000), and it explained 16.8% of the variance in muscle strength. The Partial Eta Squared was 0.168.Conclusions: The Thera band program works better in improving abductor muscle strength of the athletes with ITBS compared to electro- physiotherapy.

The effect of proprioceptive neuromuscular facilitation on functional skills, muscle strength, and trunk control in children with cerebral palsy: A randomized controlled trial

BackgroundProprioceptive neuromuscular facilitation (PNF) is generally used for the lower limbs in children with Cerebral Palsy (CP). This study aimed to determine the effect of PNF and Neurodevelopmental Therapy (NDT) on functional abilities, muscle strength, and trunk control in children with CP. MethodsThirty spastic CP children classified as either level I–II in the Gross Motor Function Classification System (GMFCS) or level I–II in the Manual Ability Classification System (MACS) were included. The PNF (n = 15) and the NDT group (n = 15) had physiotherapy for six weeks. The ABILHAND-Kids scale, the Purdue Pegboard Test (PBPT), the Nine-Hole Peg Test (9-HPT), and the Jebson-Taylor Hand Function Test (JTHFT) were employed. Pinch meters, Jamar handheld dynamometers, and digital muscular strength assessments were used. ResultsThe PNF group increased shoulder flexion (p < 0.05), adduction (p < 0.05), elevation (p < 0.05), scapular abduction (p < 0.05), elbow extension (right) (p < 0.05), grip (p < 0.05), and pinch strengths (left p < 0.05, right p < 0.05). The PNF group had significantly lower 9-HPT (p < 0.05), JTHFT (card turning), JTHFT (simulated feeding), JTHFT (lifting light cans), and JTHFT (lifting weight cans) durations (p < 0.05), and significantly higher PBPT (right-left) PBPT (bimanual), PBPT (assembly).(p < 0.05), ABILHAND (p < 0.05), and TCMS total scores (p < 0.001). While JTHFT (simulated feeding-left), JTHFT (stacking checkers-left), JTHFT (lifting light cans-left), and JTHFT (lifting weight cans-right/left) (p < 0.05) durations decreased in the NDT group, PBPT (right) (p < 0.05) had an increase in duration. ConclusionPNF improves trunk control, upper extremity functional skills, selective proximal muscle strength, and distal upper extremity muscle and grip strength.

Effects of Transcutaneous Electrical Nerve Stimulation with Taping on Wrist Spasticity, Strength, and Upper Extremity Function in Patients with Stroke: A Randomized Control Trial.

Objective: Six months after the onset of stroke, over 60% of patients experience upper limb dysfunction, with spasticity being a major contributor alongside muscle weakness. This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) with taping on wrist spasticity, strength, and upper extremity function in patients with stroke. Methods: In total, 40 patients with stroke were included and randomly divided into two groups: the TENS + taping (n = 20, age 52.4 ± 9.3 (range: 39 to 70)) and TENS (n = 20, age 53.5 ± 10.8 (range: 39 to 74)) groups. All subjects performed 30 sessions of task-related training, which included 10 min of postural control training and 20 min of task performance. Additionally, all subjects received TENS on the spastic muscle belly for 30 min before task-related training. In the TENS + taping group, taping was additionally applied to the forearm and wrist but not in the TENS group. The Modified Ashworth Scale was used to measure spasticity, and a handheld dynamometer was used to measure muscle strength. The Fugl-Meyer Assessment of Upper Extremity was used to evaluate the functional ability of the upper extremity. Results: In the TENS + taping group, spasticity and upper extremity function were significantly improved as compared to those in the TENS group (p < 0.05). However, no significant difference in muscle strength was observed between the two groups (p > 0.05). Conclusions: This study demonstrated that the combination of TENS and taping for spasticity and function of the upper extremity was more effective in relieving the spasticity than TENS alone. Therefore, we suggest this combination as an additional treatment for spasticity and function of the upper extremity.

IJCM_218A: Association between school bag weight and trunk strength among children in Mangalore

Background: School bags serve as a practical means for students to transport essential academic materials and personal items, including food. The significance of school bag weight has garnered increased attention in recent years due to its potential impact on the musculoskeletal health of school children. Excessive school bag weight has been identified as a significant contributor to various health issues, ranging from neck pain and shoulder discomfort to headaches, general fatigue, decreased muscle strength, and, notably, back injuries among children. Methods: The study involved 178 school children in Mangalore, ranging from 10-15 years, for a period of 23 days. School bag weights were measured using calibrated scales, and trunk strength was assessed using a hand held dynamometer. Statistical analysis, including Chi-square test, student’s ‘t’ test and Karl Pearson correlation test were employed to identify any significant relationships between these variables. Results: Preliminary findings revealed a positive correlation between school bag weight and trunk strength among the participants. Results indicated that a considerable proportion (83.1%) of students were burdened with an excessive load of bags. The evaluated muscular strength was discovered to be diminished in these individuals, and they experienced symptoms that were interconnected, highlighting the potential impact of school bag weight on the musculoskeletal health of children in Mangalore. Conclusion: These findings advocate measures to alleviate the burden on children’s musculoskeletal health. Further research and interventions are warranted to promote a balanced and healthy school environment for the well-being of the younger generation.

Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain syndrome: a randomized controlled trial

BackgroundPatellofemoral pain syndrome is considered a common cause of anterior knee pain that could disturb function and limit daily activities. The purpose of the study was to investigate the effect of adding short foot exercise on pain, function, balance, and hip abductors, and quadriceps muscles strength in the treatment of patients with patellofemoral pain syndrome.MethodsTwenty-eight male and female patients with patellofemoral pain syndrome with age ranged from 18 to 35 years old participated in this study. They were equally and randomly assigned into two groups; the study group which received short foot exercise in addition to hip and knee exercises (n = 14) and thecontrol group which received hip and knee exercises only (n = 14). Participants received their interventions during 6 consecutive weeks (12 sessions). Pain intensity, function, abductors quadriceps muscle strength, and balance were assessed using the Visual Analog Scale, anterior knee pain scale (AKPS), hand-held dynamometer, and the Biodex Balance System respectively. All measurements were taken before and after 6 weeks of intervention in both groups. Multivariate analysis of variance was performed to compare the within and between groups effects for measured variables.ResultsThe within-group comparison showed significant improvement in pain severity, function, balance, and hip abductors, and quadriceps muscles strength in both groups post-treatment compared with pre-treatment. Between groups analysis, however, showed no significant statistical difference between both groups in all variables, except in pain, function, and mediolateral stability which showed better improvement compared to the control group.ConclusionsAdding short foot exercise to hip and knee exercises improved pain, function, and mediolateral stability in patients with patellofemoral pain syndrome.Trial registrationclinicaltrials.gov. NO: NCT05383781. Date 19/ 5/2022.