Isokinetic Muscle Strength Measurements Research Articles

A comparison between hypertonic dextrose prolotherapy and conventional physiotherapy in patients with knee osteoarthritis.

The aim of the present study was to compare the efficacy of hypertonic dextrose prolotherapy (HDP) with conventional physiotherapy (CPT) in improving symptoms in females with knee osteoarthritis (OA). The present study included 60 patients with a diagnosis of knee OA. The patients were randomly assigned to the HDP (n=30) and CPT (n=30) groups. The patients in the HDP group were treated with a dextrose injection into the knee joint (25% dextrose) and around the knee (15% dextrose) in two sessions for 1 month, while those in the CPT group received a hot pack, transcutaneous electrical nerve stimulation and therapeutic ultrasound in five sessions a week for 4 weeks. Prior to commencing the treatment, and at 1 and 3 months post-treatment, all the patients were evaluated using the visual analog scale (VAS), Western Ontario and McMaster Osteoarthritis Index (WOMAC), the goniometric measurement of active knee range of motion (ROM), a 50-m walking test and isokinetic knee muscle strength measurements. There were no statistically significant differences between the two groups as regards the demographic characteristics at pre-treatment (P>0.05). However, at 1 and 3 months post-treatment, the scores of all the outcome parameters were significantly improved in the HDP group compared with the CPT group (P<0.05 for all). In both groups, a significant improvement was observed in the VAS scores, WOMAC total values and ROM following the treatments, with the greatest improvement observed in the HDP group (P<0.001). The isokinetic quadriceps peak torque measurements were increased in both groups following treatment. All the scores exhibited a statistically significant improvement in the HDP group at both 1 and 3 months post-treatment. On the whole, the results of the present study demonstrate that both HDP and CPT are effective treatment modalities to relieve pain, and increase functionality and strength in patients with knee OA. However, greater improvements in pain and functionality can be achieved with prolotherapy.

DİZ OSTEOARTRİTİ OLAN HASTALARDA BALNEOTERAPİNİN ERKEN DÖNEM ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

OBJECTIVE: Balneotherapy is a non-pharmacological method recommended and used in knee osteoarthritis. The aim of this study is to evaluate the early-term effectiveness of the physical therapy program applied together with balneotherapy in patients with knee osteoarthritis. MATERIAL AND METHODS: Sixty patients diagnosed with primary knee osteoarthritis were included in the study. Randomization was carried out as a balneotherapy group (n=30) and a control group (n =30) by simple randomization method. In Both groups, all of the patients were treated with a fifteen sessions physical therapy program consisting of a hot pack, transcutaneous electrical stimulation, and ultrasound (1 MHz, 1,5 Watt/cm2). Patients in the balneotherapy group were also treated for fifteen sessions balneotherapy program lasting 20 min/day in addition to the physical therapy program. Patients were assessed by Visual Analogue Scale (VAS), WOMAC, and isokinetic muscle testing at the beginning and end of the therapies. RESULTS: A statistically significant improvement was observed in the mean scores of VAS, all WOMAC scores, and isokinetic test measurements after treatment in both groups (p&amp;lt;0.001). Comparison of the groups by percent changes showed that; VAS (p=0.047), WOMAC pain (p=0.002), WOMAC stiffness (p=0.004), WOMAC function (p=0.001), WOMAC total (p=0.001) differed significantly in favor of balneotherapy group, no significant difference was found in isokinetic muscle strength measurements (p&amp;gt;0.05). CONCLUSIONS: Balneotherapy combined with a physical therapy program in patients with knee osteoarthritis is effective in reducing pain and increasing physical function in the early period.

Low thigh muscle strength in relation to myosteatosis in patients with type 2 diabetes mellitus

This study aimed to investigate the association of thigh muscle fat infiltration by quantitative MRI with muscle strength in patients with type 2 diabetes mellitus (T2DM). Seventy T2DM patients and sixty control subjects (71 males; age: 52 ± 8 years) underwent 3.0T MRI and isokinetic muscle strength measurements to obtain the skeletal muscle index (SMI), intermuscular adipose tissue (IMAT) proton density fat fraction (PDFF), intramuscular fat (IMF) PDFF, peak torque (PT) and total work (TW) of knee extensors and flexors. The differences of measurements between T2DM patients and asymptomatic volunteers were compared. Multivariate regression analysis was used to determine significant predictors of thigh extension and flexion strength. The SMI, IMAT and IMF PDFF of thigh muscles in T2DM patients were higher than that in the control group (p < 0.001), while PT and TW were lower than those in the control subjects (p < 0.05). Both IMF and IMAT PDFF were negatively correlated with PT, TW in participants with T2DM (extensors: r = − 0.72, − 0.70, p < 0.001; r = − 0.62, − 0.56, p < 0.05. flexors: r = − 0.37, − 0.43, p < 0.05; r = − 0.39, − 0.46, p < 0.05). Moderate and strong correlations between HOMA-IR and muscle strength measurements, muscle PDFFs were observed in extensors and flexors. IMF PDFF and age were the statistically significant predictor of PT and TW of extensors of thigh in multivariate regression analysis. Therefore, the thigh muscle PDFF increased was associated with muscle strength decreased in T2DM patients beyond SMI. Age are also important factors influencing thigh muscle PDFF and strength in T2DM patients.

Isokinetic knee muscle strength comparison after enhanced recovery after surgery (ERAS) versus conventional setup in total knee arthroplasty (TKA): a single blinded prospective randomized study

PurposeTotal knee arthroplasty (TKA) combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate isokinetic knee muscle strength after cemented TKA in combination with an enhanced recovery after surgery (ERAS) compared to a conventional setup.MethodsIn the single blinded prospective randomized study, 52 patients underwent navigated primary cemented TKA within an ERAS (n = 30) or a conventional setup (n = 22). Preoperatively, five days and four weeks after surgery isokinetic knee muscle strength with BIODEX-type measuring device (peak torque in Nm, work in Joules and power in Watt) and subjective patient-related outcome measures (PROMs) were investigated.ResultsThe ERAS group showed significantly better outcomes in knee flexion at 180°/s (peak torque (Nm) p = 0.047, work (J) p = 0.040 and power (W) p = 0.016) 5 days postoperatively. The isokinetic measuring at knee extension 60°/s and 180°/s demonstrated no significant difference. The PROMs showed that patients were satisfied with the postoperative results in both groups. After 4 weeks, there was no longer a significant difference in isokinetic measuring at knee extension and flexion between the ERAS and conventional group.ConclusionsTKA with the concept of ERAS improves excellent isokinetic outcome and patient satisfaction. The isokinetic muscle strength measurement can help patients and surgeons to modify expectations and improve patient satisfaction.

Examination and reliability of measuring muscle strength of ankle plantar flexion with knee extended.

[Purpose] A hand-held dynamometer (HHD) is less expensive than the isokinetic muscle strength measurement device, and research using HHD is gradually increasing. However, measurement is performed only at a low muscle strength level at which the heel does not take off or heel detachment occurs; therefore, fixation of the foot becomes a problem. This study aimed to determine the validation of measuring ankle plantar flexion strength (with the knee extended) using HHD. [Participants and Methods] Twenty healthy adults (14 males and 6 females) participated in this study. The chair used in this study was for swallowing videofluorography, which was fixed to a wall bar by the belt. The sensor was located at the third metatarsal head. After warming up, the participants sat in a long sitting position on the chair. We conducted the test two times. We used intraclass correlation coefficient (ICC) and Bland-Altman analysis to assess reliability. [Results] The ICC(1, 1) and ICC(2, 1) results were all greater than 0.9. No fixed and proportional errors were present. [Conclusion] The measurement method of this study was both intra- and inter-examiner reliabilities, which were high, and we suggest that sufficient clinical application is possible.

Muscle architecture in patients with primary Sjögren syndrome.

This study aims to investigate skeletal muscle architecture and strength in patients with primary Sjögren syndrome (pSS). Between July 01, 2017 and November 30, 2017, 19 pSS patients (19 females; mean age: 54.1±6.6 years; range, 42 to 62 years) and 19 age-, body mass index-, and sex-matched healthy controls (19 females; mean age: 53.2±6.7 years; range 42 to 61 years) were included. Sjögren symptoms were assessed with the European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI). Muscle thickness, pennation angle, and fascicle length were measured at quadriceps femoralis, gastrocnemius and soleus muscles. Isokinetic muscle strength tests were performed at 60 and 180°/sec for knee and at 30 and 120°/sec for ankle. Anxiety and depression evaluated with the Hospital Anxiety and Depression Scale (HADS), fatigue with Multidimensional Assessment of Fatigue scale (MAF), and functionality with Health Assessment Questionnaire (HAQ). In the pSS group, the mean ESSPRI was 7.70±1.17. The mean scores of depression (10.05±3.09 vs. 4.47±2.29; p<0.0001), anxiety (8.26±4.28 vs. 3.79±2.42; p<0.0001), functionality (0.94±0.78 vs. 0.22±0.26; p<0.0001), and fatigue (37.69±5.47 vs. 17.69±5.26; p<0.0001) were significantly higher in patients with pSS. Only, the pennation angle of vastus medialis in dominant leg was significantly greater in healthy controls (p=0.049). Peak torques/body weight of knee and ankle muscles were found to be similar. Excluding a minor decrease of the pennation angle at vastus medialis, muscle structure of lower extremity of pSS patients were similar to healthy controls. In addition, isokinetic muscle strength did not significantly differ in patients with pSS compared to healthy controls. In patients with pSS, disease activity and fatigue level were negatively correlated with isokinetic muscle strength measurements.

Effect of Lower Extremity Muscle Strength on Aerobic Capacity in Adults with Cerebral Palsy

The purpose of this study is to analyze the effect of lower extremity muscle strength of HIP joint and KNEE joint on the aerobic capacity to provide the basic data for developing an exercise program that can effectively improve the aerobic capacity of adults with cerebral palsy (CP) by identifying the part of the lower extremity muscle. A total of 18 ambulant adults with CP were recruited for this study. Seven ambulant adults with CP were excluded because they did not achieve the criteria of maximal exercise. The data from 11 subjects (11 men) with CP were used for the analysis. The mean (±SD) age, height, weight, and BMI of the subjects were 37.00 ± 12.72 years, 170.45 ± 6.37 cm, 67.02 ± 8.62 kg, and 23.09 ± 2.78 kg/m2, respectively. To measure the muscle strength of HIP joint and KNEE joint in lower extremities, the variables of the isokinetic muscle strength and the muscular endurance were performed using the isokinetic equipment (Biodex Co., Shirley, NY, USA). For the isokinetic muscle strength measurement of HIP joint, the 45°/sprotocol indicating the muscle power and the 300°/s protocol indicating the muscle endurance were used. Additionally, the measurement of KNEE joint was performed once on the left and right side, using the protocol of 60°/s indicating the muscle power and 300°/s indicating the muscular endurance. Progressive exercise tests were conducted on the treadmill (Quinton model—4500) using previously developed protocols targeting CP. The initial protocol speeds were 5 km/h−1 and 2 km/h−1 for the subjects who have been classified as Gross Motor Function Classification System (GMFCS) level I and II, respectively. Using a portable cardiopulmonary indirect breath-by-breath calorimetry system (MetaMax 3B; Cortex Biophysik, Leipzig, Germany), pulmonary ventilation (VE), respiratory exchange ratio (RER), and oxygen uptake (VO2) have been persistently measured. HR monitor (Polar Electro, Kempele, Finland polar Co. RS-800) was used to measure heart rate (HR). A correlation analysis was conducted to find out how the lower extremity muscle strength and aerobic capacity with cerebral palsy are related. Therefore, as a result, VO2peak among aerobic capacity displayed a significant positive correlation in 45° and 300°/s peak torque/BW of HIP joint, and with 60° and 300°/s peak torque/BW of KNEE joint. It was the same with 60°/s Agon/Antag ratio of KNEE Joint (p &lt; 0.05). VEpeak showed a significant positive correlation with 45° and 300°/s peak torque/BW of HIP joint, as well as correlation with 60° and 300°/s peak torque/BW and 60°/s Agon/Antag ratio of KNEE joint (p &lt; 0.05). However, HRpeak showed a significant positive correlation only in 45°/s peak torque/BW of HIP joint (p &lt; 0.05). The result of step-wise analysis was to find out which muscle strength significantly affects VO2peak and HRpeak among aerobic abilities in the lower extremity muscles of those disabled with cerebral palsy. Among the muscle functions of lower extremity muscle strength, 300°/s peak torque/BW of KNEE Joint was found to have the greatest effect on VO2peak (p &lt; 0.001). As a result, 300°/s peak torque/BW of KNEE Joint was found to be the predictable factor that could explain the VO2peak in the disabled people with cerebral palsy at 67% (R2 = 0.661). In particular, among the muscle functions of lower extremity muscle strength at 45°/s peak, torque/BW of HIP Joint was found to have the greatest effect on HRpeak (p &lt; 0.001). As a result, this factor was found to be the predictable factor that could explain the HRpeak in disabled people with cerebral palsy at 39% (R2 = 0.392). In this study, the muscle strength of the lower extremity of CP was closely related to the aerobic capacity, and the muscle endurance of KNEE Joint and the muscle power of HIP Joint were found to be important factors to predict the aerobic capacity of CP.

The Evaluation of Surgery Applied In Acute Achilles Tendon Rupture with Subjective and Objectıve Data In Accordance with Isokinetic Muscle Strength Measurement

The Evaluation of Surgery Applied In Acute Achilles Tendon Rupture with Subjective and Objectıve Data In Accordance with Isokinetic Muscle Strength Measurement

Isometric and isokinetic muscle strength measurements of the lumbar flexors and extensors with BioniX Sim3 Pro in patients with chronic low back pain: A pilot study.

The World Health Organization states that low back pain is the leading cause for disability worldwide. Patients with chronic low back pain (CLBP) show important decreases in lumbar strength and can now be assessed by using the new isokinetic dynamometer BioniX Sim3 Pro which offers very detailed measurements. To compare lumbar flexion and extension strength values, as well as extension-flexion ratio (EFR) based on isokinetic velocity and gender, for patients with CLBP on the BioniX Sim3 Pro. A retrospective analysis was performed on data from 20 men and 22 women with CLBP. Maximum torque in flexion and extension was measured isometrically and isokinetically. Statistical analysis was performed on these parameters. EFR shows a downward trend with increasing speed of measurement (isometric to isokinetic 30∘/s and isokinetic 30∘/s to isokinetic 90∘/s, respectively): in men from 1.21 to 1.04 (p< 0.001) and from 1.04 to 0.93 (p= 0.207). In women, EFR decreased from 1.41 to 1.13 (p< 0.001) and from 1.13 to 1.00 (p= 0.144). Patients with CLBP have a decreased strength in lumbar extension and flexion compared to the age-corrected normal values of Bionix Sim3 Pro. With increasing speed of testing protocol, a decrease in EFR is observed in this population.

The Effect of Shortwave Diathermy Treatment on Muscle Power in Patients with Chronic Low Back Pain

Objective: The goal of this study was to investigate the effects of shortwave diathermy therapy combined with exercise on lumbar muscle strength. Patients and methods: Our study was an interventional study involving 90 patients with chronic low back pain who were admitted to our clinic between 2007-2008. Patients were randomized into 3 groups (each group had 30 patients). The same exercise programs were given to all groups. Patients in the first group were applied placebo shortwave diathermy treatment, the second group was applied continuous shortwave diathermy and the third group received pulsed shortwave diathermy. Isokinetic muscle strength measurements of the patients were performed before and three months after the treatment. Results: In our study, the only significant difference observed between the groups was in isometric flexion strength and interestingly the first group had higher improvement compared to the other groups. In regard to within group comparisons, Group 1 was found to have significant improvements in strengths for:isometric flexion, isokinetic flexion (60°/sec and 120°/sec), isokinetic extension (60°/sec and 120°/sec). Group 2 had significant improvements in isokinetic flexion and extension (60°/sec) and also isokinetic extension (120°/sec). In Group 3, none of the improvements were found to be significant. Conclusion: Our findings indicate that there are no significant differences between exercise therapy alone and exercise therapy in combination with diathermy (either continuous or pulsed) in terms of their effects on lumbar muscle strength, even though marginal differences in some of the measurements were observed.

Effect Of Whole-body Vibration Training On Muscle Strength In Individuals With Knee Osteoarthritis

Knee osteoarthritis (KOA) is one of the most common osteoarthritis diseases which affects physical function. As a new modality in strength training, whole-body vibration (WBV) training is considered as an efficient treatment for KOA. However, the inconsistent results of previous studies dampened enthusiasm for clinical application. PURPOSE: To investigate the effect of WBV on physical function and muscle strength of KOA. METHODS: After diagnosed by orthopedic surgeon, eligible participants were randomly allocated to WBV and control groups. The supervised 8-week intervention was performed three times per week with the intensity and duration increased gradually. The participants performed static squat training on the vibration platform under the frequency of 20 Hz and amplitude of 2 mm. The participants in the control group were asked to maintain their previous lifestyle and to avoid participating in any other regular rehabilitation programs. The isokinetic muscle strength measurements were performed at baseline and post-intervention at angular velocity of 90°/s and 180°/s. Two-way repeated measures ANOVA was used to determine the difference in outcomes between the two groups. RESULTS: 40 participants completed the intervention and measurements (Control; n=20, age=62.80±4.43 years; WBV; n=20, age=64.10±4.95 years). At an angular velocity of 90°/s, only significance was found at interaction in the peak power of flexors (p = 0.025). However, the peak torque (PT) of the flexors at 180°/s increased significantly in WBV group compared with control group (p = 0.023, partial eta-square = 0.132). Additionally, the significances were found at the interaction in the peak torque and peak power of extensors as well as the peak power of flexors at 180°/s. CONCLUSIONS: This study found that WBV training offered positive effects on muscle strength gain in patients with KOA.

Reproducibility of isokinetic muscle strength measurements in normal and arthritic individuals

The serial reproducibility of an individual's isokinetic torque was assessed in order to establish a reliable baseline value for future comparison. Thirty-two controls and twenty arthritic patients were tested for their peak isokinetic torque on knee flexion and extension and hip flexion at three velocities on five occasions, at fortnightly intervals. The first test was found to provide a reliable baseline for controls and subjects who could generate a peak torque of 54 Newton meters (Nm) or more. The second test was found to be more representative of the series for groups containing weaker subjects. Variation related to torque: for subjects who generate a peak torque of 54 Nm or more, a range of +/- 20% accommodates the variability of 95% of tests. We conclude that a +/- 20% range applied to either the first or second test, depending on the nature of the group to be studied, serves as a representative baseline value.

Medial tibial stres sendromlu sporcularda ayak bileği izokinetik kas kuvveti ve naviküler çökme miktarı

Purpose: The purpose of this study is to compare some anatomical features and ankle isokinetic muscle strength of adolescent athletes with medial tibial stress syndrome (MTSS) and healthy control group and to examine the adequacy of ‘tibial facial traction theory in the development of MTSS.Materials and Methods: Adolescent athletes who had been diagnosed with MTSS during the season and healthy control group participants were included in the study. Demographic data and training details of the athletes were recorded. The MTSS score was used to determine the severity of the injury. The navicular drop test, lower extremity length measurement, and isokinetic muscle strength measurement were performed. Results: The complaint duration of the patients with MTSS (n:21) was 1.8 ± 1.8 months and the MTSS score was 3.9 ± 2.2. The control group (n:12) and the athletes diagnosed with MTSS had similar demographic characteristics and training details. There was no difference between the groups in terms of navicular drop and lower extremity length. There was no ‘lower extremity difference’ for right and left extremities. According to the results of the isokinetic muscle strength test in plantarflexion and dorsiflexion direction, there was no difference between the groups in terms of muscle strength at both low and high angular speeds. Conclusion: ‘The tibial traction theory’ does not sufficiently explain the pathogenesis of MTSS. Studies which evaluate isokinetic muscle strength and perform real-time dynamic analysis on the track are required to make recommendations for ideal protection and rehabilitation in cases of MTSS.

Relationship Between Isokinetic Muscle Strength and Functional Tests in Chronic Ankle Instability

Isokinetic muscle strength measurements and functional tests are usually performed to evaluate ankle condition in chronic ankle instability (CAI), yet there is no clear demonstration of the relationship between isokinetic muscle strength and functional tests. The objective of this study was to evaluate the relationship between isokinetic muscle strength and functional tests in CAI. Between April 2014 and August 2016, 103 patients with unilateral CAI were studied. Single-leg balance, single-heel raise, and single-leg squat tests were performed for static balancing assessment. Single-leg hop, double-leg jump, and sidestep tests were performed for dynamic balancing assessment. The isokinetic muscle strength of both ankles was measured using a dynamometer. The involved ankle showed lower muscle strength in inversion than the uninvolved ankle, while eversion, dorsiflexion, and plantarflexion muscle strength had no significant differences between ankles. There were significant correlations between the isokinetic muscle strength of inversion and the single-leg balance test, single-heel raise test, and sidestep test (Pearson's r; 0.246, 0.514, and 0.229 at 30°/second; 0.288, 0.473, and 0.239 at 180°/second, respectively). The single leg balance, single heel raise, and sidestep tests are useful to assess not only ankle functional performance but also isokinetic muscle strength. Among these tests, the single heel raise test was the most reliable test to reflect muscle strength deficiency in CAI.

Evaluation of the Isokinetic Calf Muscle Strength and the Range of Motion of Joint in C3 Chronic Venous Insufficiency.

PurposeThe present study aimed to compare the isokinetic muscle strength and range of motion (ROM) values of the ankle between patients diagnosed with C3 chronic venous insufficiency (group 1, n=57) and healthy individuals (group 2, n=30).Materials and MethodsAfter identifying the venous refilling time (VRT) of all participants, the active ROM of the ankle joint and plantar flexion (PF) and dorsi-flexion (DF) muscle strength in the concentric/concentric mode at angular velocities of 60°/sec and 120°/sec were measured.ResultsNo statistically significant differences were found between the demographic data of groups 1 and 2 (P>0.05). In total, 102 lower extremities were included in group 1 and 60 lower extremities in group 2. The VRT of the patients in group 1 was 15.5±5.6 seconds, the PF ROM of the ankle joint was 39.3°±9.5°, and the DF ROM of the ankle joint was 27°±8°; in group 2, the VRT, PF ROM, and DF ROM were 36±8.1 seconds, 41°±6.2°, and 27.2°±7.5°, respectively. Statistically significant differences were found between the two groups in terms of VRT (P<0.05); however, no statistically significant difference was observed in terms of ankle ROM (P>0.05). Statistically significant difference was found in terms of all parameters of isokinetic muscle strength measurements, such as peak torque, peak torque/body weight, total work done, and ratio (DF/PF) in group 1 (P=0.001).ConclusionThe lower extremity muscle strength of patients with chronic venous insufficiency was low, and this weakness was prominent particularly in the direction of PF.

Posturography table is a good test to evaluate the anterior cruciate Ligament reconstruction?

Introduction: The success of anterior cruciate ligament reconstruction (ACLR) is assessed using subjective and functional scores, as well as measurements of knee laxity. The latter is often quantified using instrumented laximetry devices, which measure ‘static’ anterior tibial translation, though recent studies suggested more comprehensive “dynamic” analyses such as jump tests. To facilitate and improve dynamic stability analyses, a proprioception table was adapted to evaluate knees before and after ACLR, though the accuracy and pertinence of its measurement have not yet been demonstrated. Objectives: To determine whether proprioceptive analysis following ACLR provides meaningful and helpful information to guide surgeons and physiotherapists with postoperative rehabilitation and return to sports. Methods: We conducted a prospective study, on a population of 50 amateur or professional sports patients, who received ACLR by the one surgeon (FW). Preoperative and 6-months assessments included GnRB laxity analysis and proprioceptive dynamic stability analysis, with evaluation of the bearing area under 6 different conditions: open eyes (C1), closed eyes (C2), vision distorted by virtual reality headset (C3), open eyes on unstable support (C4), closed eyes on unstable support (C5) and distorted vison on unstable support (C6); a calculation of the C4/C1 ratio enabled appreciation of visual compensations in the proprioceptive capacity, and dependence on visual inference (low ratios indicate greater recourse to visual afference). A complementary analysis of muscular strength by isokinetic assessment was also performed at 6 months followup. Results: There was a significant improvement in proprioception table stability at 6 months compared to the preoperative condition at the C4 (470 vs 440 mm2), C5 (1710 vs 1315 mm2) and C6 (1330 vs 1210 mm2) assessments. For 32 patients evaluated by GnRB, differential laxity at 6 months was less than 5 mm at 200 N, and isokinetic muscle strength measurement was less than 20% different between the knee healthy and the operated knee, or between quadriceps and hamstrings. Proprioceptive quality was variable, with significant visual offsets in some cases (C4/C1 ratio, 0.5 to 16.2). Conclusion: Patients, who have good results in laximeter tests and isokinetic muscle strength measurement, may have a poor proporioception quality with significant visual offsets. The proprioception analysis at 6 months following ACLR could therefore be important to consider rehabilitation and sports recovery.

Aquatic Exercise Program for Individuals With Osteoarthritis: Pain, Stiffness, Physical Function, Self-Efficacy.

This research was conducted to determine the effects of an aquatic exercise program on pain, stiffness, physical function, and self-efficacy in individuals with osteoarthritis. A randomized controlled trial. Participants in the experimental group participated in the aquatic exercise program three times a week for 8 weeks; participants in the control group did not. The mean scores of the experimental group on the pain, stiffness, and difficulty in carrying out physical functions subscales of the Western Ontario and McMaster Universities Osteoarthritis Index decreased significantly, whereas those of the control group decreased very little. The mean scores of the experimental group on the Arthritis Self-Efficacy Scale and the isokinetic muscle strength measurements increased, but those of the control group did not change in the final measurements. The difference between the groups was statistically significant. Through the study, it was determined that the aquatic exercise program decreased pain, stiffness, and difficulty in carrying out physical functions and increased self-efficacy and muscle strength of individuals with osteoarthritis. The aquatic exercise program can be used by nurses as a reference in the management of osteoarthritic patients' health status.

Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis?

The aim of this study was to examine the relationship of psychosocial factors, namely, pain catastrophizing, kinesiophobia, and maladaptive coping strategies, with muscle strength, pain, and physical performance in patients with knee osteoarthritis (OA)-related symptoms. A total of 109 women (64 with knee OA-related symptoms) with a mean age of 65.4 years (49-81 years) were recruited for this study. Psychosocial factors were quantified by the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Coping Inventory. Clinical features were assessed using isometric and isokinetic knee muscle strength measurements, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and functional tests. Associations were examined using correlation and regression analysis. In knee OA patients, pain catastrophizing, kinesiophobia, and coping strategy explained a significant proportion of the variability in isometric knee extension and flexion strength (6.3%-9.2%), accounting for more overall variability than some demographic and medical status variables combined. Psychosocial factors were not significant independent predictors of isokinetic strength, knee pain, or physical performance. In understanding clinical features related to knee OA, such as muscle weakness, pain catastrophizing, kinesiophobia, and coping strategy might offer something additional beyond what might be explained by traditional factors, underscoring the importance of a biopsychosocial approach in knee OA management. Further research on individual patient characteristics that mediate the effects of psychosocial factors is, however, required in order to create opportunities for more targeted, personalized treatment for knee OA.

Effects of isokinetic, isometric, and aerobic exercises on clinical variables and knee cartilage volume using magnetic resonance imaging in patients with osteoarthritis.

This study aims to evaluate the effect of isokinetic, isometric, and aerobic exercise protocols on pain, disability, physical function, and articular cartilage in osteoarthritis. A total of 45 women (mean age 52.1 years; range 45 to 65 years) who were admitted to the Physical Medicine and Rehabilitation outpatient clinic and were diagnosed with primary bilateral knee osteoarthritis between May 2008 and January 2010 were included. The patients were randomly divided into three groups as isokinetic (n=15), aerobic (n=15), and isometric exercise groups (n=15). Exercise protocols were applied five days a week for four weeks. Pain was evaluated using a 10 cm Visual Analog Scale for Pain (VAS-pain), pain, joint stiffness and physical function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and disability was assessed using the Lequesne Index before and after the interventions. Isokinetic knee muscle strength measurements were also obtained. Patellar and femoral cartilage volumes were analyzed using magnetic resonance imaging. The VAS-pain, WOMAC, and Lequesne scores and peak torque values of knee extension improved in all groups with the highest improvement in the isokinetic group. For the knee flexion peak torque values, improvements were significant only in the isokinetic group at both velocities. There was no significant change in the femoral cartilage volume in any group after the interventions. However, patellar cartilage volume significantly increased in the isometric group (p=0.036). A four-week isokinetic, aerobic, and isometric exercise programs improved pain and functional capacity in patients with knee osteoarthritis. Isokinetic exercise also increased the muscle strength with improved maintenance of the quadriceps/hamstring ratio. Only isometric exercise increased the patellar cartilage volume.

Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency.

Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly ( p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.