Hand-held Dynamometer Research Articles

Effect of arm ergometer versus stabilization exercises on trunk control and pper extremity functions in children with diplegia: a randomized controlled trial.

One of the most prevalent clinical subtypes of cerebral palsy (CP) is diplegia. Most children with diplegia have weakness in axial muscles and spasticity in extremities which have adverse impacts on trunk control and manual coordination of upper extremities. To examine and compare between the effects of arm ergometer and stabilization exercises applied for duration of 12 weeks on upper extremity functioning, trunk control, and hand grip strength (HGS) in children with spastic diplegia. Forty-two children with spastic diplegia aged from 6 to 10 years were randomly assigned to either group A or B, (n = 21 each). Children in group A received a designed arm ergometer exercises for 30min while those in group B received trunk stabilization exercises for 30min. As well, children in both groups received 30min of a designed physical training for 30min. Treatment was delivered three times a week for 12 weeks in succession. The quality of upper extremity skill test (QUEST), hand held dynamometer (HHD) and Trunk control measuring scale (TCMS) were used to assess upper extremity functions, HGS and trunk control respectively before and after suggested treatment duration. In terms of all indicators measured at baseline, study groups were comparable (P > 0.05). Significant improvements in all outcome indicators were recorded in within-group comparison (P < 0.05). Further, between groups comparison showed significant higher improvements in upper extremity functions and HGS in favor of group A while trunk control scores showed no significant difference between the two groups (P > 0.05). Arm ergometer exercises have the capability to enhance upper extremity functions, HGS and trunk control. It is therefore beneficial for physical rehabilitation specialists to incorporate the arm ergometer exercises into the intervention plans for children with spastic diplegia.

Dynamometry for the Assessment of Trunk Muscle Strength in Postpartum Women with Pregnancy-Related Posterior Pelvic Girdle Pain: A Reliability Study

ObjectivesTo investigate the inter and intra-rater reliability of maximum isometric trunk muscular strength in postpartum women with pregnancy-related posterior pelvic girdle pain using a handheld dynamometer. MethodsThirty women (30.13 ± 3.67 years) with pregnancy-related posterior pelvic girdle pain (PPGP) had their trunk muscular strength assessed using a handheld dynamometer. Inter-rater reliability was estimated for measurements of two separate raters on the first day of the investigation. The tests were repeated with the first rater seven days later to determine the intra-rater reliability. A digital handheld dynamometer was used for testing, and a metal bar was used to secure it to a table. Participants were instructed to use maximal force to push the dynamometer in various trunk flexion, extension, lateral flexion, and rotational orientations. Each trial was repeated three times and averaged to obtain the representative assessment data. Analysis of variance, interclass correlation, absolute agreement, and standard error of measurements were used to evaluate the repeatability of measurements. ResultsExcellent inter and intra-rater reliability were demonstrated. The inter-rater reliability, computed with intraclass correlation coefficient (ICC), ranged from 0.979 to 0.992, and intra-rater reliability (ICC) ranged from 0.966 to 0.987. The standard error of measurement ranged from 0.35% to 1.26% for the different tests. Additionally, the dynamometer values in women with PPGP might be reported using just one trial after an instruction. ConclusionThe maximum isometric trunk muscular strength is reliable, and a quantitative assessment of the trunk strength in women with postpartum pregnancy-related posterior pelvic girdle pain and could be used to monitor the changes in postural stability between sessions.

Lower urinary tract symptoms in children with Duchenne muscular dystrophy: An evaluation in terms of functional level, posture, and muscle strength.

To examine factors associated with lower urinary tract symptoms (LUTS) and lower urinary tract dysfunction (LUTD) in children with Duchenne muscular dystrophy (DMD). This cross-sectional study included 45 individuals diagnosed with DMD between the ages of 5 and 18 years. LUTS were evaluated with the Dysfunctional Voiding and Incontinence Scoring System, functional levels with the Brooke Upper Extremity Functional Classification and the Vignos Scale, lumbar lordosis angle with a bubble inclinometer, pelvic inclination angles with a digital inclinometer, and muscle strength with a hand-held dynamometer. The mean age of the children was calculated as 9.00 ± 3.32 years, body weight as 31.10 ± 12.59 kg, and height as 125.87 ± 18.46 cm. LUTD was detected in 20 children (44.44%). There was an association between high LUTD severity and low strength of the following muscles: bilateral hip flexor (Dominant: r = -0.338, p = 0.023; nondominant: r = -0.411, p = 0.005), quadriceps femoris (Dominant: r = -0.445, p = 0.002; nondominant: r = -0.504, p < 0.001), elbow flexor (Dominant: r = -0.461, p = 0.001; nondominant: r = -0.455, p = 0.002), and elbow extensor (Dominant: r = -0.442, p = 0.002; nondominant: r = -0.450, p = 0.002). Upper extremity functionality level was significantly higher in the LUTD-negative group (p = 0.004). There was no relationship between lumbar lordosis and pelvic inclination angles and LUTS symptoms (p > 0.05). To provide the adequate care for bladder health in children with DMD, it is essential to focus on parameters that will increase functionality and independence in this population.

Functional outcome of mirror therapy versus task oriented training on hand function in children with unilateral cerebral palsy

Background. Unilateral cerebral palsy (UCP) is a kind of spastic cerebral palsy which is characterized by atypical posture of upper limb, poor eye-hand coordination, and reduced hand skills. These symptoms can restrict a child’s ability to engage in life activities. Purpose. To compare the effectiveness of mirror therapy as well as task-oriented training on hand functions improvement among UCP children. Methods. Sixty children suffering from UCP were randomly allocated into three equal groups. A schemed physical therapy protocol was utilized to the control, mirror therapy (MT), and task-oriented training (TOT) groups. The protocols of mirror therapy and task-oriented training were administered to MT and TOT groups respectively. Assessments of upper extremity skills, hand dexterity, wrist extension range of motion, along with overall grip strength were conducted at baseline and after intervention using the Quality of Upper Extremity Skills Test (QUEST), Box and Block Test (BBT), universal goniometer, as well as pneumatic squeeze handheld dynamometer respectively. Throughout a total of twelve consecutive weeks, the intervention session was held three days a week. Results. The change amount in all measured hand outcomes were significantly improved following the intervention in all three groups, with the TOT group showing a larger significant effect. Conclusion. Task-oriented training had superior impact than mirror therapy in enhancing hand functions among children having UCP.

Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial.

Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum's role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

Relationship Between Pain, Muscle Strength, Function, and Quality of Life in Overhead Players With Chronic Internal Shoulder Impingement

Background and Objectives: This study aims to determine the relationship between pain, muscle strength, function, and quality of life (QoL) in overhead players with chronic shoulder internal impingement syndrome. Methods: Forty-seven overhead players consisting of 15 men, 32 and women (mean age 32.45±7.2) with chronic shoulder internal impingement were enrolled. The pain was measured by a visual analogue scale (VAS). Disabilities of the arm, shoulder, and hand (DASH) and shoulder pain and disability index (SPADI) questionnaires were used to measure pain and function, and a short form (SF)-36 questionnaire to measure QoL. Muscle strengths were evaluated in both hands with a hand-held dynamometer and players were asked to hold the maximal voluntary isometric contraction (MVIC) in the middle range for 3 s and rest for 30 s between each test and each contraction was repeated three times on both affected and healthy side and the average of contractions was considered for each side. Results: The study showed a significant relationship between pain, the strength of shoulder muscle groups (-0.354), function (-0.935), and QoL (-0.861) in overhead throwers with chronic shoulder internal impingement syndrome and the strength of internal rotators of the affected shoulder decreased more than others. (P&lt;0.05) Conclusions: This correlational study showed a significant relationship between pain and strength of shoulder muscles and function and QoL in overhead throwers with this syndrome.

Hand grip strength in older and very old people: Results of the study Gesundheit 65+

Abstract Background Functional capacity decreases with increasing age. Hand grip strength (HGS) is considered as an objective general measure of health and a parameter of muscle strength, a component of functional capacity and is part of the evaluation of frailty. HGS is important for many everyday functions, such as holding heavy objects or supporting oneself to prevent a fall. Low HGS is associated with a higher mortality risk. In our study we describe HGS in people aged 66 to 101 years in Germany and identify groups with low HGS. Methods Gesundheit 65+ is a longitudinal epidemiologic study of the health status of persons 65 years and older in Germany by the Robert Koch Institute. In 2022/23, one year after baseline, isometric HGS was measured during the examination part of the study using a hand-held dynamometer (Smedley, Scandidact, Denmark, 100 kg). Two values were recorded for each hand. Maximum HGS from all attempts was used for analyses. Weighted prevalence estimates and 95% confidence interval (CI) for grip strength are reported by sex, age-group, height, self-rated health, chronic conditions, and difficulties in activities of daily living (ADL). Results HGS was measured in 1,457 persons aged 66 to 101 (48% women). Mean maximum HGS was 28.8 kg (CI 28.4-29.3). HGS was significantly related to sex (men: 35.4 kg, CI 34.8-36.0, women 21.8 kg, CI 21.4-22.2) and age (66-79: 31.0 kg, CI 30.1-31.9, 80+: 23.9 kg, CI 23.0-24.7). In both sexes, shorter persons and persons with bad self-rated health, chronic conditions or difficulties in ADL showed lower HGS than their reference group. Conclusions HGS was reduced in very old people, people with support needs, and people with poor health or chronic diseases, identifying these people as important risk groups for preventive measures. These should aim to improve not only endurance but also strength in older and very old people. In the long term, this could also maintain independence and reduce serious injuries from falls. Key messages • We found sex and age-related differences in hand grip strength in older people in Germany. • Based on the results, planning of prevention and intervention could be enhanced.

Strength effects of the Copenhagen adduction exercise vs an adductor squeeze exercise in male football players - A randomized controlled trial.

To examine the effect of assigning male football players to an 8-week Copenhagen Adduction (CA) and Adductor Squeeze (SQ) Pragmatic randomized controlled trial, 57 participants (16.7 ± 0.9 years, 175.9 ± 7.3height and 66 ± 8.4 weight) were individually randomized to an 8-week progressive dynamic training protocol with the CA or an isometric training protocol with the SQ twice per week. Maximal eccentric (EHAD) and isometric (IHAD) hip adductor torque was tested with a handheld dynamometer. Perceived exertion and delayed onset muscle soreness (DOMS) were recorded throughout the intervention period. In the intention-to-treat analysis, no significant between-group difference was observed for EHAD (p = 0.478-0.833) nor IHAD (p = 0.084-0.118). There was a significant difference in DOMS between groups in the third to sixteenth exercise session, with the CA group reporting higher values (median varying between 0-3 vs 0-1, p = 0.000-0.009). Perceived exertion was greater for the CA group only in the fifteenth exercise session of the protocol (median of 4 vs 3, p = 0.031). No other significant differences between the groups were observed for DOMS nor perceived exertion. An 8-week adductor training program with either the Copenhagen Adduction or Adductor Squeeze exercise performed with two sets twice a week and adjusted for total volume did not result in significant differences in eccentric nor isometric adduction torque between the groups.

Effect of cervical traction on cervicogenic headache in patients with cervical radiculopathy: a preliminary randomized controlled trial

BackgroundCervical radiculopathy (CR) is a common condition, often associated with cervicogenic headache (CGH), a secondary headache arising from cervical spine disorders. Mechanical intermittent cervical traction (MICT) is frequently prescribed to treat CR symptoms. The purpose of the study was to make a preliminary estimate of efficacy of adding MICT to conventional rehabilitation on CGH in patients with cervical radiculopathy.MethodsA total of 36 CR patients with CGH were randomly allocated to 3 equally sized groups (A, B and C). The treatment consisted of twelve sessions of conventional rehabilitation (4 weeks) combined with MICT (2 kg for group A, 8 kg for group B and 12 kg for group C). Primary outcomes were CGH intensity (visual analog scale) and frequency (days per week). Secondary outcomes were radicular pain intensity (visual analog scale), cervical range of motion (cervical range of motion instrument), proprioception (cervical range of motion instrument) and muscle strength (MicroFET2 dynamometer), handgrip strength (handheld dynamometer), function (Neck Disability Index), kinesiophobia (Tampa Scale for KInesiophobia), anxiety and depression (Hospital Anxiety and Depresion questionnaire), and quality of life (World Health Organization Quality of Life). Patients were assessed at baseline, one, three and six months after the beginning of treatment. The post hoc Dunn testing was used to determine which traction load had the better effect on CGH symptoms.ResultsAt one, three and six months follow-ups, Group C exhibited the highest improvement in CGH intensity and frequency compared to the other groups (p = 0.021 and p = 0.023; p = 0.012 and p = 0.01; p = 0.005 and p = 0.005). Both groups C and B showed a significant improvement in radicular pain compared to group A at one month follow-up (p = 0.05).The improvement in group C was significantly better in terms of function (p = 0.049) and anxiety (p = 0.011) at three months and quality of life at six months (Psychological p = 0.046 and Environment p = 0.006).ConclusionsThe blend of conventional rehabilitation alongside 12 kg MICT seems to be efficacious in diminishing both the intensity and frequency of CGH in patients with CR. These advantages appear to last for up to six months following the treatment period, potentially leading to decreased CGH severity and occurrence rates, heightened functionality, reduced anxiety levels, and an overall enhancement in quality of life. These findings are preliminary and require confirmation in larger trials.Trial registrationThe study protocol was retrospectively registered at the Pan African Clinical Trial Registry (PACTR202401838955948). Date of registration is 16/01/2024.

The effectiveness of vitamin D supplementation in patients with end-stage knee osteoarthritis: Study protocol for a double-blinded, randomized controlled trial.

Osteoarthritis (OA) knee is one of the most common chronic degenerative conditions that imposes clinical and economic burdens on individuals and societies worldwide. Previous studies showed vitamin D levels correlated positively with lean muscle mass and grip strength, implying that vitamin D supplementation may improve muscle health in knee OA subjects. This randomized controlled trial (RCT) aims to compare the effects of vitamin D supplementation on knee muscle strength, physical function, pain, and sarcopenia status in patients with end-stage knee OA. Patients and outcome assessors will be blinded to group allocation. Fifty-six end-stage knee OA patients with vitamin D insufficiency fulfilling our inclusion criteria will be invited to participate in this study. Patients will be randomly assigned to take vitamin D supplementation (4,000 IU capsule daily) or placebo for six months. Measurements will be taken at baseline, three and six-month after the commencement of the vitamin D supplement, and 6-month after the interventional period. The primary outcome includes the isometric quadriceps and hamstring muscle strength measured by a hand-held dynamometer. Secondary outcomes include pain, performance-based and self-reported physical function and sarcopenia status. The success of this study will provide scientific evidence of whether the relatively cheap and well-tolerated vitamin D supplement can improve quadriceps muscle strength, physical function, pain symptoms, and sarcopenia status of this increasingly large population for end-stage knee OA patients. The study has great clinical significance given Hong Kong's lengthy and growing waiting list for complete knee replacement procedures. Trial registration: The trial was registered on clinicaltrials.gov (NCT05981534) on 31st July 2023.

Comparison of quadriceps and hamstring muscle strength ratios between dominant and non-dominant legs in Saudi under-17 and under-19 premier league football players: A cross-sectional study

Football’s global popularity is often overshadowed by frequent lower limb injuries, particularly hamstring strains, which are linked to imbalances in the strength ratio of hamstring-to-quadriceps (H/Q). Research on these factors among Saudi Premier League players, specifically in Madinah City, is limited. Our study is a cross-sectional study that assessed 42 male professional football players from Ohoud Football Club, divided into Underage 17 (UD- 17) and Under age 19 (UD-19) of age groups. The Strength of muscle for hamstrings and quadriceps, as well as the H/Q ratio, was measured using handheld dynamometers (HDD), and demographic data were analyzed using SPSSv26. Results showed that UD-19 players had significantly greater quadriceps strength on both dominants (dominant and non-dominant) sides compared to UD-17 players, with no significant differences in strength of hamstring. The ratio of hamstring to quadriceps was significantly higher in UD-17 players on the dominant side compared to UD-19 players, but statistically significant differences were not found on the non-dominant side. These results suggest that quadriceps strength develops with age and training, potentially reducing injury risk, while the strength of hamstring stabilizes earlier. Tailored training programs focusing on quadriceps strength and balanced hamstring development are recommended for improving injury prevention and performance. Future research involving larger and more diverse samples could further validate these findings and provide a deeper understanding of muscle dynamics in young football players.

Reliability of a new stabilization device for measurement of muscle strength using a hand-held dynamometer.

The hand-held dynamometer (HHD) is a reliable and portable tool for quantitatively assessing muscle strength. However, a number of variables, including the strength of the tester, the adequacy of stabilization, and the selected testing position, can affect the reliability of the device. The objective of the present study was to examine the reproducibility and inter-rater reliability of strength assessments using HHD with and without a stabilization device. Strength assessments were conducted with and without the stabilization device by two independent raters. Healthy volunteers with no history of musculoskeletal disorders were included in the study. The strength of the shoulder flexion, scapula elevation, knee extension, and hip abduction muscle groups was evaluated using HHD. The reliability of the measurements was evaluated using intra-class correlation (ICC), standard error of measurement, and minimal detectable change. Fifty-two healthy volunteers (age 21.51 ± 2.02 years) participated in the study. The reproducibility was found to be excellent (ICC = 0.89-0.99). While reliability between the assessors was good to excellent (ICC = 0.85-0.93), reliability between assessors and device was found moderate to good (ICC = 0.48-0.78). The strength values obtained for all directions of movement with the stabilization device were found to be significantly higher than those obtained without fixation of the HHD. It can be concluded that the data obtained from the assessors and HHD with stabilization device are not comparable. Moreover, the utilization of a stabilization device may serve to enhance the reliability of the measurements by eliminating the rater effect.

12521 Electrical Impedance Myography And Muscle Health In Older Adults With Type 1 Diabetes

Abstract Disclosure: A. Fremaint: None. G. Jung: None. E. Yu: None. M. Bouxsein: None. Introduction: Recent studies indicate that individuals with Type 1 diabetes mellitus (T1D) develop skeletal muscle health impairments which might contribute to falls and explain their high fracture risk. A novel handheld Electrical Impedance Myography (EIM) device (mScan model 1301, Myolex) has been developed to assess muscle quality by calculating tissue impedance. We hypothesized that mScan could identify individuals with worse strength and body composition outcomes among older adults with and without T1D. Methods: We studied participants of the T1D Bone Health Connection (BEACON) Study who were aged 50+ and who had undergone EIM testing (n=63 T1D, n=50 non-diabetic controls). We analyzed EIM-derived phase angle [Phase = arctan(reactance/resistance)] at 100 kHz in 3 upper extremity muscles (biceps brachii, lateral deltoid, and wrist extensors), where lower phase values indicate poorer muscle quality. Correlations of EIM data were performed with grip strength measured by a handheld dynamometer and appendicular lean mass/height2 (ALM/ht2) and visceral adipose tissue (VAT) from whole-body DXA scans. Pearson’s correlations were used for all statistical analyses. Results: Mean age (63±7 years), sex (54% female), and BMI (26.5 kg/m2) were similar between T1D and control groups. Adults with T1D had a nonsignificant trend towards lower muscle quality at the biceps brachii than controls (8.9±5.4 vs 10.9 ±6.0 degrees, p=0.078). There were no differences between groups in phase angle for lateral deltoid nor wrist extensors. Higher muscle quality at the biceps brachii was associated with higher grip strength (r=0.28, p=0.005) in the full cohort as well as in the T1D group (r=0.40, p &amp;lt;0.001). In the full cohort, greater VAT was associated with lower muscle health at the biceps brachii (r = -0.34, p=0.003) and lateral deltoid (r = -0.23, p&amp;lt;0.014), with similar patterns in both T1D and controls. There were no correlations of muscle quality with ALM/ht2. Conclusion: Our data suggest that mScan holds promise for detection of skeletal muscle health impairments in older adults, including those with T1D, potentially aiding in the diagnosis and prevention of related falls and fractures. Further research is required to investigate the association between VAT and muscle health and to validate the effectiveness of mScan in T1D and other populations. Presentation: 6/3/2024

Determining the respiratory functions and isometric strength differences among recreational athletes and non-athletes: a cross-sectional analysis

Understanding the differences in respiratory functions and isometric strength between recreational athletes and non-athletes has a significant importance in the fields of Sports science, exercise physiology, and performance enhancement. The purpose of this study was to determine the respiratory functions and isometric strength differences among recreational athletes and non-athletes. A cross-sectional design was selected for this research with 16 recreational athletes and 16 non-athletes. Respiratory functions were assessed using spirometry tests, measuring parameters such as forced vital capacity (FVC), peak expiratory flow rate (PEFR), and forced expiratory volume in one second (FEV1). Isometric strength was measured by a handheld dynamometer for dominant and non-dominant hands. The results of the study showed a significant difference between recreational athletes and non-athletes for respiratory function parameters (FVC = t-3.00, p-.006 &amp; FEV1= t-2.221, p-.011), whereas PEFR is insignificant (t-218, p-.219). The isometric strength is also significant between recreational athletes and non-athletes (Dominant arm = t—3.039, p-.005 &amp; non-dominant arm= t-.255, p-.001). The study findings revealed significant differences in respiratory functions and isometric strength between recreational athletes and non-athletes, and there was a significant relationship between parameters. Athletes typically exhibit remarkable isometric strength due to their consistent engagement in activities designed to enhance muscle function. Future research should give priority to conducting long term studies that directly compare the effects of different sports disciplines on respiratory functions and isometric strength. Keywords: Isometric Strength, Pulmonary Functions, Forced Vital Capacity, Peak Expiratory Flow Rate, FEV1, Recreational Athletes.

How effective is proprioception exercise on pain, grip force, dexterity and proprioception of elbow joint in patients with tennis elbow? A randomized controlled trial

BackgroundPatients with tennis elbow (TE) disorder suffer from proprioception deficits alongside other symptoms, which usually is neglected to be targeted in different physiotherapy protocols. This study aimed to investigate the effects of proprioception exercises on treatment outcomes. MethodsIn this RCT, 14 males and 30 females TE volunteered patients were randomly divided into two intervention (IG) and control (CG) groups, in which CG received routine physiotherapy, while IG underwent further proprioception exercises for 18 sessions within six weeks. Pain, function, grip force, dexterity, and proprioception of elbow joint were evaluated using Patient-Rated Elbow Evaluation (PREE) questionnaire, handheld dynamometer, Purdue Pegboard, and isokinetic dynamometer, respectively. ResultsA significant within group improvement was observed in terms of pain (IG: 49.93%, CG: 42.75%), function (IG: 61.9%, CG: 48.95%), grip force (IG: 22.1% CG: 16.9%), dexterity (IG: 18.96% CG: 11.82%), active joint position error (IG: 32.99, CG: 7.33 %), and the threshold to detection of passive motion (TTDPM) for both groups (IG: 24.35, CG: 24.86%) in both groups after treatment as compared to before treatment (p < .0001), with no statistically significant differences between the groups for these variables except for active joint position error, which showed a significant reduction in the IG (p < .02). ConclusionIt could be concluded that proprioception exercises has a limited added value on routine physiotherapy it terms of pain, function, grip force, and dexterity. However, adding proprioception exercises found to be beneficial for improving variables determining joint position sense.

Proximal Hamstring Avulsions: Surgical Versus Conservative Treatment Using a Shared Decision-Making Strategy

Background: Surgical treatment of patients with proximal hamstring avulsions provides good results; however, less is known about the outcome in patients who are offered conservative treatment. Purpose: To investigate the effect of surgical or conservative treatment (decided by a shared decision strategy) of proximal hamstring avulsions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 24 patients with magnetic resonance imaging–verified proximal hamstring avulsion were included and had either surgical treatment (11 patients, 45% women; mean age, 50 ± 16 years) or conservative treatment (13 patients, 46% women; mean age, 50 ± 17 years). At baseline, 6 months and 12 months, all patients answered the Perth Hamstring Assessment Tool (PHAT) (0-100 scale) and Hip Sports Activity Scale (0-8 scale). Patients had their maximal hip extension strength and maximal strength at 30° and 90° of knee flexion measured in newton meters per kilogram using a handheld dynamometer. A minimal important change in PHAT was considered &gt;7 points and a minimal important change in strength was considered &gt;0.15 N·m/kg, respectively. Results: The surgical group had a shorter time from injury to initiation of treatment compared with the conservative group (median: 15 vs 64 days; P = .02). The surgical group had a greater amount of retraction of the tendons compared with the conservative group (3 vs 2 cm; P = .04). From baseline to 12-month follow-up, the surgical and conservative groups improved their mean PHAT scores (35 points [95 CI, 24-45 points] and 20 points [95% CI, 9-31 points], respectively) reaching a median of 79 points (interquartile range [IQR], 66-95 points) in the surgical group and 75 points (IQR, 66-85 points) in the conservative group at the 12-month follow-up. Their Hip Sports Activity Scale levels at 12 months were 3 points (95% CI, 1-4 points) and 1 point (95% CI, 0-3 points) (not significant). Furthermore, the surgical and conservative groups improved their maximal hip extension strength by 0.61 N·m/kg (IQR, 0.42-0.80 N·m/kg) and 0.62 N·m/kg (IQR, 0.13-1.10 N·m/kg), respectively. Their maximal knee flexion strength at 30° improved by 0.52 N·m/kg (IQR, 0.29-0.74 N·m/kg) and 0.32 N·m/kg (IQR, 0.12-0.52 N·m/kg) and their maximal knee flexion strength at 90° improved by 0.28 N·m/kg (IQR, 0.19-0.37 N·m/kg) and 0.22 N·m/kg (IQR, 0.02-0.41 N·m/kg). At the 12-month follow-up, the side-to-side difference in maximal muscle strength was 6% and 7%, respectively, during hip extension and 19% to 25% and 16% to 17%, respectively, during knee flexion. Conclusion: Twelve months after treatment of proximal hamstring avulsion, good clinical outcomes were seen when using a shared decision strategy regardless of whether the strategy led to surgical or conservative treatment.

Knee proprioception, muscle strength, and stability in Type 2 Diabetes Mellitus- A cross-sectional study

BackgroundThe burgeoning prevalence of Type 2 Diabetes Mellitus (T2DM) has been linked to a spectrum of health complications, including those affecting the musculoskeletal system. Knee proprioception, muscle strength, and stability are essential for maintaining functional mobility and preventing falls, yet their relationship with T2DM is not fully elucidated. ObjectivesThis study aimed to compare knee proprioception, muscle strength, and limits of stability (LOS) between individuals with T2DM and asymptomatic controls and to examine the moderating role of physical activity on these relationships. MethodsIn a cross-sectional design, 192 participants (96 with T2DM and 96 asymptomatic) underwent assessments for knee proprioception using a digital inclinometer, muscle strength via a handheld dynamometer, and LOS through dynamic posturography, graded as a percentage of maximum lean without losing balance. ResultsOur analysis revealed that individuals with T2DM demonstrated reduced knee muscle strength, with mean differences of 12.90 Nm (right) and 18.80 Nm (left) in 25° of flexion, and 25.78 Nm (right) and 26.36 Nm (left) in 40° of flexion, compared to asymptomatic controls. Proprioception errors were greater in the T2DM group (p < 0.001), with significant deficits noted in both knee 25° of flexion and 40° of flexion. Stability limits were also compromised, with the T2DM group displaying a decreased ability to maintain balance across all tested directions (p < 0.001). Physical activity emerged as a positive moderator, with higher activity levels correlating with improved muscle strength and stability. ConclusionT2DM significantly impairs musculoskeletal function, highlighting the need for integrated management strategies. The study underscores the importance of physical activity in mitigating T2DM-related musculoskeletal deterioration, suggesting that therapeutic interventions should include a focus on enhancing muscle strength and stability to improve the quality of life in this population.

Grasping rehabilitation using motor imagery with or without neurofeedback after tetraplegia: a study protocol for a bicentric randomised controlled trial

IntroductionTetraplegia causes extensive sensorimotor deficits affecting activity, participation and quality of life. People with C6-C7 tetraplegia can learn to grasp objects by performing wrist extension movement (ie, tenodesis grasp), and...

Existing and Emerging Measures of Muscle Strength and Mass in the Assessment of Sarcopenia

Abstract Background Sarcopenia, an accelerated loss of muscle strength and mass is a major driver of adverse health outcomes in older people. The European Working Group on Sarcopenia recommends muscle strength assessment with handgrip strength (HGS) or five chair stands test (5CST) and muscle mass assessment with dual energy X-ray absorptiometry or bioelectrical impedance analysis (BIA). However, these methods can be contraindicated, unavailable or patients can be unable to perform them. We sought to compare the existing measures HGS, 5CST and BIA to emerging measures: quadriceps muscle strength (QMS) and muscle ultrasound. Methods Thirty-one participants from a local healthy ageing group (mean age 71±5 years, 80% female) were recruited to the FRAILMatics Physiological Cohort. Max HGS was assessed using the Jamar Plus+ dynamometer and 5CST timed from a standard height chair. Max QMS was measured with the Actiforce hand-held dynamometer. BIA was performed with the TANITA DC-430 MAP and the Sergi equation used to estimate appendicular skeletal muscle mass (ASMM). Rectus femoris muscle thickness (RFMT), vastus lateralis muscle thickness (VLMT) and anterior thigh muscle thickness (ATMT) measurements were taken using the linear array transducer on the GE Vscan Air point of care ultrasound system. Pearson correlation was used to examine the relationship between measures. Results Strong correlation was seen between max QMS and max HGS (r = 0.73, P &amp;lt;0.001); moderate correlation between RFMT, VLMT, ATMT and ASMM (r = 0.51, P &amp;lt;0.01; r = 0.56, P&amp;lt;0.01; r = 0.40, P &amp;lt;0.05). 5CST was not correlated with any of the measures (P &amp;gt;0.05). Conclusion In the assessment of sarcopenia, QMS and muscle ultrasound could be alternatives to HGS and BIA respectively, especially in cases where the latter are not available or contraindicated. 5CST appears less useful in the assessment of sarcopenia and may be more appropriate as a test of physical performance.

Effectiveness of Mulligan Mobilization Technique and Core Stabilization Exercises in Female Patients With Knee Osteoarthritis: A Randomized Controlled Single-Blind Study

ObjectivesThe aim of this study was to compare the effectiveness of the Mulligan mobilization (MM) technique and Core stabilization (CS) exercises added to the conventional physiotherapy (CP) program in female patients with knee osteoarthritis (KOA). MethodsThe study included 42 female patients diagnosed with bilateral KOA. Participants were randomly divided into 3 groups as CP group (mean age: 57.79 ± 7.43 years), MM group (mean age: 56.14 ± 6.95 years), and CS group (mean age: 54.36 ± 6.56 years). They were divided into 3 groups and treated 3 sessions per week for 4 weeks. Pain intensity, range of motion (ROM), and muscle strength were evaluated with visual analog scale, universal goniometer, and handheld dynamometer, respectively. Balance, aerobic capacity, and functional level were assessed with 30-second sit-to-stand test, 6-minute walk test, and Western Ontario and McMaster Universities Osteoarthritis Index. The quality of life of the participants was evaluated with the Nottingham Health Profile. ResultsAfter treatment, significant improvement was achieved in the all parameters evaluated in the groups (P < .05). CS was found to be more effective in reducing resting pain intensity than the other two treatment approaches (P = .001). It was observed that MM technique increased knee flexion ROM more (P = .001). There was no superiority of MM group and CS group over each other in balance, functional level, aerobic capacity, and quality of life assessments (P > .05). ConclusionOur study showed that CP, MM technique, and CS exercises were effective treatment approaches in the management of KOA in female patients. Results revealed that the MM technique was more effective in increasing knee flexion ROM, and the CS exercise was more effective in reducing resting pain intensity in female patients with KOA.