Isokinetic Rehabilitation Research Articles

Research on design and control methods of a lightweight upper limb joint isokinetic rehabilitation training equipment.

Isokinetic exercise can improve joint muscle strength and stability, making it suitable for early rehabilitation of stroke patients. However, traditional isokinetic equipment is bulky and costly, and cannot effectively avoid external environmental interference. This paper designed a lightweight upper limb joint isokinetic rehabilitation training equipment, with a control system that includes a speed planning strategy and speed control with disturbance rejection. Based on the established human-machine kinematic closed-loop model between the equipment and the user, a dynamic evaluation method of torque at the joint level was proposed. To validate the effectiveness of the equipment, experiments were conducted by manually applying random disturbances to the equipment operated at an isokinetic speed. The results showed that the root mean square error between the observed torque curve of the second-order linear extended state observer used in this paper and the actual disturbance curve was 0.52, and the maximum speed tracking error of the speed control algorithm was 1.27%. In fast and slow sinusoidal speed curve tracking experiments, the root mean square errors of the speed tracking results for this algorithm were 9.65 and 5.27, respectively, while the tracking errors for the PID speed control algorithm under the same environment were 19.94 and 12.11. The research results indicate that compared with traditional PID control method, the proposed control strategy demonstrates superior performance in achieving isokinetic control and suppressing external disturbances, thereby exhibiting significant potential in promoting upper limb rehabilitation among patients.

Evaluation de la force musculaire chez le lombalgique chronique: Comparaison entre reeducation isocinetique et reeducation classique

Chronic low back pain is a public health problem in view of its functional repercussions and the functional rehabilitation is an integral part of its management. To compare the evolution of muscle strentgh of spinal extensors and flexors in chronic low back pain patients after an isokinetic rehabilitation protocol and a conventional rehabilitation one. This was a prospective and comparative study carried out in the Physical Medicine Department of the Tunis Military Hospital over a period of 7 months. Fifty patients were included, randomly divided into two groups of 25. The first group (G1) benefited from an isokinetic rehabilitation protocol and the second one (G2) from a classic active physiotherapy. We performed a clinical (Sorensen test and Shirado test) and isokinetic evaluation of the trunk muscles before and after rehabilitation. The mean age of the general population was 42±8.6 years old. Clinical evaluation showed a deficit in the extensor and flexor muscles of the spine, more important in the extensors in both groups. After rehabilitation, there was a significant improvement in clinical tests of muscular endurance in G1 and G2. Isokinetic assessment showed a greater muscle deficit in the extensors in both groups. After isokinetic rehabilitation, peak torque for flexors and extensors increased by 21% and 23% respectively, power was 34% and 37% higher, and total work increased by 26% and 47%. On the other hand, the (F/E) ratios were unchanged for all three speeds. In Group 2, peak torque values for flexors and extensors increased by 22 and 15% respectively, power was higher by 31 and 23% and total work was also up by 29 and 17%, while F/E ratios were also unchanged. Group 1 showed the greatest improvement in extensor strength at 60°/s, and in power at 90°/s for the various muscles. In our study, we concluded that endurance and muscular strength improved the most after isokinetic rehabilitation.

Disturbance Rejection Speed Control Based on Linear Extended State Observer for Isokinetic Muscle Strength Training System

Isokinetic muscle strength training is a type of rehabilitation therapy that can effectively improve the motor dysfunction of limbs and enhance joint muscle strength. In active isokinetic training, how to plan the speed reasonably and improve the performance of speed control to fit individualized needs is the core problem of isokinetic muscle strength training equipment control. In this study, a control strategy for isokinetic muscle strength training equipment is proposed, which identifies the user&#x2019;s motion intention and performs speed planning according to the user&#x2019;s motion participation so that the equipment produces a dynamic damping effect. This ensures active interaction between the user and the equipment and meets the force-speed requirements of elbow joint muscle training. To handle the uncertain disturbance in the training process, a linear extended state observer is used to estimate the disturbance term, and a tracking differentiator and nonlinear error feedback control are used to improve the speed tracking performance. The experimental results show that the proposed control scheme realizes effective speed control in isokinetic muscle strength training. <i>Note to Practitioners</i>&#x2014;The bottleneck of isokinetic muscle strength training equipment control system lies in how to plan the speed according to the patient&#x2019;s movement intention reasonably, and how to improve the performance of speed control in the process of rehabilitation training. This paper designs a speed auto disturbance rejection control strategy for isokinetic muscle strength training system with external interference and model uncertainty in practical application. The experimental results show that the performance of the controller is better than the traditional PI controller, and it can realize isokinetic muscle training. This study provides a method for practitioners interested in developing control systems for isokinetic rehabilitation training equipment.

Development of a Control Strategy in an Isokinetic Device for Physical Rehabilitation.

Robotic-assisted rehabilitation is currently being applied to improve the effectiveness of human gait rehabilitation and recover the mobility and strength after a stroke or spinal cord injury; a robotic assistant can allow the active participation of the patient and the supervision of the collected data and decrease the labor required from therapists during the patient's training exercises. The goal of gait rehabilitation with robotic-based assistance is to restore motor function by using diverse control strategies, taking account of the physical interaction with the lower limbs of the patient. Over the last few years, researchers have extracted useful information from the patient's biological signals that can effectively reflect movement intention and muscle activation. One way to evaluate progress in rehabilitation is through isokinetic prototype tests that describe the dynamic characteristics of an isokinetic leg extension device for rehabilitation and control action. These tests use an isokinetic system to assess muscle strength and performance in a patient during isometric or isokinetic contraction. An experimental prototype shown in the following work allows the device's performance to be evaluated in a controlled environment before the patient's use. New features provide a control system that can be teleoperated for distributed structures, enabling the remote operation and management of the device. In order to achieve physical recovery from musculoskeletal injuries in the lower limbs and the reintegration of the affected subject into society as an independent and autonomous individual in their daily activities, a control model that introduces a medical isokinetic rehabilitation protocol is presented, in which the element that carries out such protocol consists of a magnetic particle brake whose control action is strongly influenced by the dynamics of the system when in contact with the end user-specifically, the patient's legs in the stretch from the knee to the ankle. The results of these tests are valuable for health professionals seeking to measure their patient's progress during the rehabilitation process and determine when it is safe and appropriate to advance in their treatment.

Isokinetic Rehabilitation Trajectory Planning of an Upper Extremity Exoskeleton Rehabilitation Robot Based on a Multistrategy Improved Whale Optimization Algorithm

Upper extremity exoskeleton rehabilitation robots have become a significant piece of rehabilitation equipment, and planning their motion trajectories is essential in patient rehabilitation. In this paper, a multistrategy improved whale optimization algorithm (MWOA) is proposed for trajectory planning of upper extremity exoskeleton rehabilitation robots with emphasis on isokinetic rehabilitation. First, a piecewise polynomial was used to construct a rough trajectory. To make the trajectory conform to human-like movement, a whale optimization algorithm (WOA) was employed to generate a bounded jerk trajectory with the minimum running time as the objective. The search performance of the WOA under complex constraints, including the search capability of trajectory planning symmetry, was improved by the following strategies: a dual-population search, including a new communication mechanism to prevent falling into the local optimum; a mutation centroid opposition-based learning, to improve the diversity of the population; and an adaptive inertia weight, to balance exploration and exploitation. Simulation analysis showed that the MWOA generated a trajectory with a shorter run-time and better symmetry and robustness than the WOA. Finally, a pilot rehabilitation session on a healthy volunteer using an upper extremity exoskeleton rehabilitation robot was completed safely and smoothly along the trajectory planned by the MWOA. The proposed algorithm thus provides a feasible scheme for isokinetic rehabilitation trajectory planning of upper extremity exoskeleton rehabilitation robots.

Knee Joint Isokinetic Rehabilitation Exercise Equipment Usability Evaluation

Knee Joint Isokinetic Rehabilitation Exercise Equipment Usability Evaluation

Awakening the control of the ankle dorsiflexors in the post-stroke hemiplegic subject to improve walking activity and social participation: the WAKE (Walking Ankle isoKinetic Exercise) randomised, controlled trial

BackgroundStroke is the leading cause of acquired disability in France. While 90% of patients recover the ability to walk, it is often limited with a steady speed of approximately 0.7 m/s. This limitation of walking activity is partly related to a decrease in strength associated with more or less significant spasticity. In particular, it seems that the strength of the dorsiflexor muscles is directly related to walking speed. We hypothesise that a protocol based on gestural repetition targeted at the ankle during the subacute phase potentiates the recovery of motor control, improving walking activity, and participates in recovering better social participation.MethodsAn estimated total of 60 patients with subacute stroke will be recruited to participate in this multicentre, interventional, prospective, randomised controlled trial.All participants will benefit from conventional rehabilitation. In addition, the experimental group will take part in an ankle isokinetic rehabilitation programme for 6 weeks (at least 25 sessions). The control group will receive the same duration of conventional rehabilitation.The primary outcome measure will be a 10-m walking speed at post-intervention. Secondary outcomes will include social participation, walking spatio-temporal parameters, and dorsiflexor strength. Outcome measurements will be taken at baseline, immediately after treatment (6 weeks), then at 6 months and 1 year of follow-up.DiscussionThis study aims to provide scientific evidence that a protocol based on an early over-solicitation of the ankle dorsiflexor muscles to promote their “awakening” can serve to achieve a more effective walking activity, which in turn encourages social participation following discharge from the hospital.This protocol should also help optimise physical medicine and rehabilitation practices: the more systematic use of the isokinetic dynamometer as a technique associated with, and integrated into the conventional rehabilitation protocol would allow an objective evaluation of the rehabilitation benefits and should increase the rehabilitation gain in central nervous system disorders.Trial registrationLimoges University Hospital is the sponsor of this research (Unique Protocol ID: 87RI18_0010)This research is supported by the French Ministry of Health (PHRC 2020-A03328-31) and is conducted with the support of DGOS (PHRC interregional – GIRCI SOHO).The study protocol was approved by the French Human Subjects Protection Review Board (Comité de Protection des Personnes Nord-Ouest III) on February 23, 2021.The trial was registered in the ClinicalTrials.gov registry (NCT04800601) on March 16, 2021.

Analyses of Isokinetic Thigh Muscle Strength: Camera-Based Assessment Alters the Magnitude, but Not the Message

ABSTRACT Background: Thigh muscle strength capacities are major modifiable risk factors for knee and thigh muscle injuries. Therefore, their valid assessment is essential. Most isokinetic knee tests are conducted in a seated position and rely on dynamometer-based data. However, their accuracy is doubtful because axis alignment is erroneous. Purpose: This study investigated if hip angle (flexed vs. extended) and assessment method (dynamometer-based vs. camera-based) affect isokinetic outcome parameters. Methods: Sixteen healthy male participants (27 years, 184 cm, 80 kg) performed discrete isokinetic tests of the knee flexors and extensors (60°/s) while their kinematics were captured (100 fps). Results: Both assessment methods revealed very strong linear relationships (94% ≤ R 2 ≤ 98%) although peak moments (d ≤ 0.87), contractional work (d ≤ 1.26), and functional knee flexor:extensor ratios (d ≤ 0.81) significantly differed. Seated knee flexor tests demonstrated the largest knee trajectory center’s misalignment (x = 4.0 cm, z = −2.5 cm; 1.37 ≤ d ≤ 4.74). Conclusion: Hip-angle induced kinematic changes did not affect the relation between the lever arms, thus causing highly proportional deviations of kinetic parameters. The assessment method altered the magnitude, but not the message of isokinetic knee tests, which should be preferentially performed with extended hip joint to improve axis alignment. Knowledge of these kinetic and kinematic interactions assists practitioners and scientists with isokinetic tests and/or rehabilitation training to ensure reasonable interpretations of gathered isokinetic outcomes.

Implementation and experimental tests of an impedance control of pneumatic artificial muscles for isokinetic rehabilitation

Implementation and experimental tests of an impedance control of pneumatic artificial muscles for isokinetic rehabilitation

Isokinetic Force and Work Capacity After Long-Duration Space Station Mir and Short-Term International Space Station Missions.

INTRODUCTION: The effects of long-duration (213.0 ± 30.5 d) stays aboard the orbital station Mir and short-term (∼10 d) spaceflights aboard the International Space Station (ISS) on the joint torques of various muscles and work capacity of knee extensors were studied in male cosmonauts.METHODS: Joint torque and muscle endurance testing was performed 30 d before and 3-5 d after a spaceflight, using a LIDO® Multi-Joint Isokinetic Rehabilitation System (USA).RESULTS: Greater postflight changes in maximal joint torque were observed for back, knee, and ankle extensors compared with flexors, and the difference was especially clearly seen after long-term spaceflights. The decrease in maximal joint torque of hip extensors substantially varied, being the greatest in voluntary concentric movements in a low-velocity high-force mode at angular velocities of 30 and 60° · s-1 (by 16 and 13%, respectively) and the lowest in high-velocity modes at velocities of 120 and 180° · s-1 (by 9 and 11%, respectively). Muscle work capacity was inferred from the gradient of declining muscle force produced in a series of rhythmic voluntary concentric movements and was found to decrease after both short- and long-term spaceflights. The area under the muscle contraction curve decreased to a greater extent and in all regions of the curve after long-term spaceflights. The fatigue index averaged 0.90 ± 0.03 at baseline and remained much the same, 0.90 ± 0.04, after a short-term spaceflight. However, after a long-duration spaceflight, the fatigue index increased 14.1%.DISCUSSION: The finding that the contractile functions and work capacity of muscles decrease more after long-term than after short-term spaceflights in spite of the physical training program of a certain type gave grounds to assume that physical training employed in long-term spaceflights were insufficient to simulate the daily mechanical load that the cosmonauts had before a spaceflight.Koryak YA. Isokinetic force and work capacity after long-duration Space Station Mir and short-term International Space Station missions. Aerosp Med Hum Perform. 2020; 91(5):422-431.

Effect of isokinetic training of thigh muscle group on graft remodeling after anterior cruciate ligament reconstruction

To investigate the effect of isokinetic training of thigh muscle group on graft remodeling after anterior cruciate ligament (ACL) reconstruction, and summarize the relevant rules to guide the clinic. Between August 2016 and December 2016, forty patients underwent arthroscopic ACL reconstruction using hamstring tendon were randomly divided into isokinetic group and control group ( n=20). The two groups of patients underwent staged rehabilitation treatment. The isokinetic group replaced the traditional intervention with the corresponding isokinetic strength training from 3 to 6 months after operation, and the traditional rehabilitation intervention was used in the control group. Finally, 12 cases of isokinetic group and 12 cases of control group with complete follow-up were enrolled in study. There was no significant difference in gender, age, body mass index, side of injury, the interval between injury and operation, and preoperative International Knee Documentation Committee (IKDC) score between the two groups ( P>0.05). The peak torque (PT) of knee extension and flexion and hamstring quadriceps ratio (H/Q) were measured at 3 months, 6 months, 12 months, and the second-look arthroscopy. The MRI examination was performed at the same time to evaluate graft remodeling. The shape, tension, and degree of vascularization of grafts were observed under arthroscopy. The grafts were harvested and observed by HE staining. The invertal between ACL reconstruction and the second-look arthroscopy was (23.57±3.23) months in isokinetic group and (23.22±3.56) months in control group, showing no significant difference between the two groups ( P>0.05). At the second-look arthroscopy, the IKDC score was 90.45±4.73 in isokinetic group and 89.32±4.54 in control group, showing significant differences when compared with preoperative scores in the two groups ( P<0.05). But there was no significant difference between the two groups ( t=0.868， P=0.404). At 3 months after operation, there was no significant difference in the PT of knee extension and flexion between the two groups ( P>0.05). At 6 months, 12 months, and the second-look arthroscopy, the PT of knee extension and flexion in isokinetic group were higher than those in control group ( P<0.05). The H/Q at 6 months and 12 months were higher in isokinetic group than in control group, and the differences were significant ( P<0.05). There was no significant difference in MRI score between the two groups at 3 months, 6 months, and the second-look arthroscopy ( P>0.05). The MRI score at 12 months was significantly higher in isokinetic group than in control group ( P<0.05). At the second-look arthroscopy, there was no significant difference in the arthroscopic score between the two groups ( P>0.05), and the histological score of the isokinetic group was superior to the control group ( P<0.05). On the basis of regular rehabilitation training, using the isokinetic training system to develop a suitable post-surgical isokinetic rehabilitation training program is helpful in early muscle strength recovery, early graft remodeling, and even long-term histological results after ACL reconstruction.

English

Introduction: A 29-year old male athlete (body mass: 64 kg; height: 172 cm)sustained complete ACL rupture of the right knee. He was a martial-arts player and the injurywas repetitive, overuse in nature due to cyclic unilateral loading and unloading of the rightknee during training sessions. Rupture was diagnosed through detailed patient history, clinicalphysical examination and was confirmed through magnetic resonance imaging (MRI) of theright knee. Surgical reconstruction of the ACL was planned and a patellar tendon graft wasused. His baseline isokinetic data was recorded 4 months after the surgery. Objective: Thiscase study describes the effects of isokinetic strength training on knee biomechanics andphysical function of an ACL-reconstructed martial-arts athlete. Setting: Pakistan Sports BoardIslamabad. Study period: 40 days. Materials and Methods: Biodex System 3 Pro was used totrain the athlete for 15 sessions on alternate day basis. Average peak torque, average power,total work and peak torque to body weight ratio were recorded for hamstring and quadricepsbefore and after isokinetic rehabilitation. The athlete was positioned in the dynamometer withupright back while hip and knee were flexed to 90 degrees. Unilateral isokinetic contractionswere performed according to a premeditated exercise protocol. Both hamstring and quadricepswere tested isokinetically at five different movement speeds (30deg/sec, 90deg/sec, 150deg/sec, 210deg/sec, and 270deg/sec). Five contractions were performed at each speed duringboth knee flexion and extension. At baseline, average peak torque was higher at lower speedsfor both hamstring and quadriceps. Results: As a result of rehabilitation, average peak torquefor hamstring and quadriceps significantly improved at speeds of 150deg/sec and 90deg/secrespectively. Average power, peak torque to body weight ratio, total work was also improved forboth hamstring and quadriceps. Two physical performance tests - agility run test and verticaljump test - were used to assess the effects of training and both performance tests improved 51%and 100% respectively. Conclusion: Isokinetic training improved the strength of quadricepsand hamstring after ACL reconstruction. Hamstring muscle demonstrated greater traininginducedincrements in torque production compared to quadriceps at all contraction velocities.

KNEE BIOMECHANICS AND PHYSICAL PERFORMANCE;

Introduction: A 29-year old male athlete (body mass: 64 kg; height: 172 cm)sustained complete ACL rupture of the right knee. He was a martial-arts player and the injurywas repetitive, overuse in nature due to cyclic unilateral loading and unloading of the rightknee during training sessions. Rupture was diagnosed through detailed patient history, clinicalphysical examination and was confirmed through magnetic resonance imaging (MRI) of theright knee. Surgical reconstruction of the ACL was planned and a patellar tendon graft wasused. His baseline isokinetic data was recorded 4 months after the surgery. Objective: Thiscase study describes the effects of isokinetic strength training on knee biomechanics andphysical function of an ACL-reconstructed martial-arts athlete. Setting: Pakistan Sports BoardIslamabad. Study period: 40 days. Materials and Methods: Biodex System 3 Pro was used totrain the athlete for 15 sessions on alternate day basis. Average peak torque, average power,total work and peak torque to body weight ratio were recorded for hamstring and quadricepsbefore and after isokinetic rehabilitation. The athlete was positioned in the dynamometer withupright back while hip and knee were flexed to 90 degrees. Unilateral isokinetic contractionswere performed according to a premeditated exercise protocol. Both hamstring and quadricepswere tested isokinetically at five different movement speeds (30deg/sec, 90deg/sec, 150deg/sec, 210deg/sec, and 270deg/sec). Five contractions were performed at each speed duringboth knee flexion and extension. At baseline, average peak torque was higher at lower speedsfor both hamstring and quadriceps. Results: As a result of rehabilitation, average peak torquefor hamstring and quadriceps significantly improved at speeds of 150deg/sec and 90deg/secrespectively. Average power, peak torque to body weight ratio, total work was also improved forboth hamstring and quadriceps. Two physical performance tests - agility run test and verticaljump test - were used to assess the effects of training and both performance tests improved 51%and 100% respectively. Conclusion: Isokinetic training improved the strength of quadricepsand hamstring after ACL reconstruction. Hamstring muscle demonstrated greater traininginducedincrements in torque production compared to quadriceps at all contraction velocities.

Isokinetic rehabilitation in the chronic former instability of the shoulder: For individualized rehabilitative care

The isokinetic exploration of the shoulder seems little standardized, particularly at the time of the choice of the studied muscular groups, of the installation of the subject as well as positioning of the articulation itself. Rehabilitation treatment of a 17 year old patient, hyperlaxe, swimmer, in the context of a painful chronic former instability of the shoulder without osseous, muscular lesion or labrale. An isokinetic work of reinforcement of the internal rotators is carried out, into concentric of 60°/s to 240°/s, position known as of Davies modified then in decubitus dorsal of 45° to 90° of abduction. At the end of the rehabilitation a work of reinforcement of the external rotators out of eccentric is associated with 60°/s in decubitus dorsal with 90° of abduction. The parameters of follow-up were the maximum moment of force, its bilateral comparison between homologous muscles, the quality of relative force and the shape of the curves of contraction. At 6 months, the evolution is favorable, with a complete disappearance of the painful phenomena and of instability, allowing even a resumption of swimming in competition. The isokinetic rehabilitation of the shoulder offers a rehabilitation treatment personalized interesting as regards chronic former instability of the shoulder, which corresponds to a muscular weakness of the RI and RE without imbalance determining of ratio RE/RI.

The isokinetic evaluation of the knee joint function following the autoplastic correction of its anterior cross-shaped ligament

The flexors/extensors imbalance can be a cause knee instability and therefore lead to progression of osteoarthritis. The isokinetic evaluation of the strength of flexors after the autoplastic reconstruction the anterior cross-shaped (cruciate) ligament (ACL) is of primary importance bearing in mind that certain authors have reported a persistent deficiency in flexor strength after surgery. The purpose of the present study was to objectively evaluate the isokinetic function of the knee during each treatment stage and estimate the influence of harvesting semitendinosus/gracilis tendon (SGT) on the knee flexion. During the period from 2012 to 2014, a total of 44 patients (20 women and 24 men) presenting with ACL rupture were available for the examination. All the patients underwent the isokinetic evaluation of the knee function before operation, 6-8 weeks and 3-4 months after the arthroscopic ACL reconstruction with the use of the SGT graft. The patients were divided into two groups. The first group was comprised of 22 subjects who were treated in accordance with the standard protocol of therapeutic physical exercises starting from week 6 after the initiation of the physiotherapeutic rehabilitative measures. The second group consisted of 22 patients who had to perform the isokinetic training within 6-8 weeks after surgery. The results of the study indicate that all the patients suffering injuries to the anterior cross-shaped ligaments had well apparent flexor/extensor imbalance. In those of the first group, the flexor imbalance amounted to 25-35% while the extensor imbalance was 10-15% within 3-4 months after the surgery. The second group showed a 10-15% flexor imbalance and 2-5% extensor imbalance after 3-4 months. The isokinetic testing provides a tool for the objective evaluation of the knee function. It helps to reveal the high effectiveness of isokinetic rehabilitation protocol leading to the recovery of the patients within 3-4 months after the surgery. It can be assumed based on the results of the present study that harvesting of the semitendinosus/gracilis tendon does not exert any negative influence on the knee flexion strength given the rehabilitation program includes the isotonic training protocol.

Isokinetic rehabilitation: Experience of physical medicine and rehabilitation university hospital Casablanca

Isokinetic rehabilitation: Experience of physical medicine and rehabilitation university hospital Casablanca

Interest of an intensive isokinetic rehabilitation treatment in the case of a persistent functional deficit 4 years after a shoulder stabilization surgery

Interest of an intensive isokinetic rehabilitation treatment in the case of a persistent functional deficit 4 years after a shoulder stabilization surgery

Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol

Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports. Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student's t-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test. Functional outcomes and pain are significantly improved (p<0.0001). The average IKDC score improved with 28 points and the pain improved with 3.2 points on the visual analog scale (VAS). The results are correlated with the follow-up time (p=0.008) but not correlated with the delay between the surgery and the beginning of the isokinetic protocol. Isokinetic rehabilitation provides a significant improvement in the knee function as measured by the IKDC score and by the VAS, regardless of the painful period preceding the program. The function improvement continues after the end of the protocol, but the pain may not completely disappear. The isokinetic rehabilitation program may resume functional AKP related to muscular deficit and may be used as the starter of other physical therapy protocols. IV.

Validity of isokinetic trunk measurements with respect to healthy adults, athletes and low back pain patients

Background: Isokinetic measurements are widely used to assess strength capacity in a clinical or research context. Nevertheless, the validity of isokinetic measures for identifying strength deficits and the evaluation of therapeutic process regard- ing different pathologies is yet to be established. Therefore, the purpose of this review is to evaluate the validity of isokinetic measures in a specific case: that of muscular capacity in low back pain (LBP). Methods: A literature search (PubMed; ISI Web of Knowledge; The Cochrane Library) covering the last 10 years was performed. Relevant papers regarding isokinetic trunk strength measures in healthy and patients with low back pain (PLBP) were searched. Peak torque values (Nm) and peak torque normalized to body weight (Nm/kg BW) were extracted for healthy and PLBP. Ranked mean values across studies were calculated for the concentric peak torque at 60 ◦ /s as well as the flexion/extension (F/E) ratio. Results: 34 publications (31 flexion/extension; 3 rotation) were suitable for reporting detailed isokinetic strength measures in healthy or LBP (untrained adults, adolescents, athletes). Adolescents and athletes were different compared to normal adults in terms of absolute trunk strength values and the F/E ratio. Furthermore, isokinetic measures evaluating therapeutic process and isokinetic rehabilitation training were infrequent in literature (8 studies). Conclusion: Isokinetic measurements are valid for measuring trunk flexion/extension strength and F/E ratio in athletes, adoles- cents and (untrained) adults with/without LBP. The validity of trunk rotation is questionable due to a very small number of pub- lications whereas no reliable source regarding lateral flexion could be traced. Therefore, isokinetic dynamometry may be utilized for identifying trunk strength deficits in healthy adults and PLBP.

Isokinetic muscle strengthening after acquired cerebral damage: A literature review

ObjectiveIsokinetic strengthening is a rehabilitation technique rarely used in stroke patients. However, the potential benefits of force and endurance training in this population are strongly suspected. MethodThis literature review synthesizes the results of clinical trials on this topic. The research was conducted on PubMed, using “Stroke”, “rehabilitation”, “isokinetic”, “upper limb” and “training” as keywords. ResultsSeventeen studies focusing on the use of isokinetics in assessment or rehabilitation (six studies) following stroke were reviewed. For the lower limb, muscle strength and walking ability improved after isokinetic rehabilitation programs. For the upper limb, the only two studies found in the literature suggest improvement in the strength of the trained muscles, of grip force, of the Fugl-Meyer motor score and of global functional capacities. This review does not reveal any consensus on the protocols to be implemented: type of muscle contraction, velocities…. ConclusionWhile isokinetic strengthening has not proven its efficiency in rehabilitation of the upper limb following stroke, its interest with regard to rehabilitation of the lower limbs has been recognized. Randomized controlled trials in this field are necessary to confirm its efficiency, especially concerning upper arm rehabilitation.