Isokinetic Strength Measurements Research Articles

Isokinetic strength and experience: Analyzing key attributes in professional soccer players

Soccer is one of the sports where performance is shaped by the coming together of numerous variables. The importance of strength, a physical variable that determines performance, is thought to be as crucial as the experience levels of athletes, which are also considered important for performance. The present study aimed to compare the isokinetic strength characteristics and soccer experience of professional league (PRL) and amateur league (AML) soccer players. After recording variables such as total playing seasons and weekly training sessions, isokinetic strength measurements were conducted at angular velocities of 60°/sec and 180°/sec. The outcomes revealed that PRL players engaged in significantly more weekly training sessions and had accumulated a higher total number of playing seasons than their AML counterparts (p

Evaluation of the ankle function after Achilles tendon resection: a retrospective clinical study

IntroductionThe Achilles tendon is the strongest tendon in the human body and has the function of plantar ankle flexion. When the tendon is exposed, the peritendineum has been breached and the thick avascular tendon colonized with bacteria, a complete resection of the tendon may be indicated to achieve infection control and facilitate wound closure. The Achilles tendon reconstruction is not mandatory, as the plantar flexion of the ankle joint is assumed by the remaining flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles. Our study aimed to evaluate the impact of Achilles tendon resection without reconstruction on leg function and quality of life.Material and methodsWe retrospectively evaluated all patients who were treated with an Achilles tendon resection between January 2017 and June 2022 in our quaternary institution. After evaluating the data, the patients who survived and were not amputated were contacted for re-evaluation, which included isokinetic strength measurement of both ankle joints, evaluation of the ankle range of motion and collection of several functional scores.ResultsThirty patients were included in the retrospective study, with a mean age of 70.3 years, including 11 women and 19 men. The most frequent cause of the infection was leg ulcer (43.3%), followed by open tendon suture (23.3%). No tendon reconstruction was performed. Fifteen patients could be gained for reevaluation. The average difference in ankle flexion torque on the injured side compared to the healthy side at 30 degrees/second was 57.49% (p = 0.003) and at 120 degrees/second was 53.13% (p = 0.050) while the difference in power was 45.77% (p = 0.025) at 30 degrees/second and 38.08% (p = 0.423) at 120 degrees/second. The follow-up time was between 4 and 49 months and a positive correlation could be determined between the time elapsed from surgery and the ankle joint strength. There was a significant loss of range of motion on the operated side compared to the healthy side: 37.30% for plantar flexion, 24.56% for dorsal extension, 27.79% for pronation and 24.99% for supination. The average Lepillhati Score was 68.33, while the average American Orthopedic Foot and Ankle Score was 74.53.ConclusionThe complete Achilles tendon resection leaves the patient with satisfactory leg function and an almost normal gait. Especially in elderly, multimorbid patients, straightforward tendon resection and wound closure provide fast infection control with acceptable long-term results. Further prospective studies should compare the ankle function and gait in patients with and without Achilles tendon reconstruction after complete resection.

MYOGENIC CONTRIBUTORS TO PHYSICAL FUNCTION IN OLDER ADULTS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS

Abstract Knee osteoarthritis (OA) is a leading cause of mobility disability among middle-aged and older adults, and contributes to significant global disease burden. The impact of knee OA on physical function varies widely across individuals, and the factors contributing to this heterogeneity are poorly understood. Recent compelling research suggests that myogenic factors, including muscle quality (MQ), may underly symptoms in knee OA. While MQ is gaining attention in aging research, the role of MQ on functional outcomes in persons with knee OA remains unknown. This pilot study examined morphological and neuromuscular biomarkers of MQ among adults aged 50 years and older (N=44) who met clinical criteria for symptomatic knee OA. Physical performance was assessed using the Short Physical Performance Battery (SPPB). MQ was quantified using B-mode ultrasound (echo intensity) and isokinetic strength measures (force/body mass). Associations between MQ and physical performance were determined, with consideration for clinical pain, age, sex, and body mass index. Pearson correlation analysis indicated SPPB scores were associated with clinical pain, strength, and MQ (r values ranged -.42 – 0.60, p’s< 0.05). Multivariable backward stepwise linear regression analysis demonstrated that MQ biomarkers contributed 39% to variance for SPPB score independent of clinical pain and strength, after adjustment for age, sex, and BMI (b’s = -0.32 – 0.45; p’s < 0.05). MQ is an important consideration for physical function in older adults with chronic knee OA pain, regardless of pain severity, and represents a potentially potent treatment target for disability prevention.

Investigating the relationship between pain level and grip and wrist muscles strength in individuals with lateral epicondylitis: is pain a barrier to strength assessment?

This study was carried out to examine the relationship between rest, activity, and nighttime pain and grip and isokinetic muscle strength of the wrist muscles in individuals with lateral epicondylitis. Fifty-six sedentary individuals aged between 18 and 65years diagnosed with unilateral lateral epicondylitis volunteered to participate in the study. The level of rest, activity, and nighttime pain was evaluated with visual analog scale (VAS). The grip strengths of both arms were evaluated by averaging a maximum of three grip strength measurements using a hand dynamometer. The strength of both wrist flexor and extensor muscles were evaluated with isokinetic dynamometer at angular velocities of 60 and 180°/s with five and 15 concentric repetitions respectively. There was no significant relationship found between the affected side's grip strength and isokinetic muscle strength with rest, activity and nighttime pain (all P > 0.05). However, there was a difference observed between the affected and unaffected side in grip strength and isokinetic strength measurements of all wrist muscles (all P < 0.05); the unaffected side values were found to be higher. The result of this study found no correlation between the stated level of pain and the true muscle strength in the affected hand. In line with these findings, we think that assessments involving strength can be made in other musculoskeletal problems where pain is present. However, the findings may not reflect the true muscle strength which will tend to be underrated.

The effects of modified hardinge approach on hip muscle strength in patients with primary hip arthroplasty: a patient evaluation with isokinetic strength test and gait analyses.

Numerous factors affect abductor strength after Total hip arthroplasty (THA), including surgical technique, prosthesis type, postoperative rehabilitation program, and preoperative patient condition. We prospectively investigated the effects of the modified Hardinge approach on hip muscle strength, which was evaluated using the isokinetic test, functional results, and gait function of patients who underwent primary THA. The hip muscles strength were measured using an isokinetic dynamometer. The primary outcomes of the present study were measurement of isokinetic strength of hip abductor muscle strengths using an isokinetic evaluator and gait analyses preoperatively and at 6months postoperatively in 27 patients. Isokinetic muscle strength test, abductor and other hip circumference groups achieved the preoperative muscle strength at 3months postoperatively, and the postoperative sixth month values showed a statistically significant improvement compared with the preoperative and third month values. In gait analyze, our temporospatial data showed a slight regression at postoperative 3months but reached the same values at 6months postoperatively. Kinematic data showed a significant regression, but the data were not compared with those in the preoperative period. Adequate muscle strength and physiological gait pattern, similar to the preoperative status, can be achieved at 6months postoperatively. Level III.

Relationship between the Nordic hamstring strength test and isokinetic hamstring strength test at different eccentric contraction velocities

ABSTRACT The main purpose of the study was to analyse the relationship between the Nordic hamstring (NH) and the gold standard isokinetic eccentric strength measurements at three different eccentric velocities (30°, 60°, and 90°/s). Twenty-seven (15 male, 12 female) physical education students, experienced in strength training, performed isokinetic and NH tests. The results of the isokinetic hamstring strength test were statistically significantly higher compared to the results of the NH test, regardless of the velocity of the isokinetic test. The correlations observed ranged from moderate to large (0.419 ≤ r ≤ 0.582) and were statistically significant for the left leg, right leg, and the average results between the legs. However, no statistically significant correlations were found between the measures for inter-leg symmetry variables. We observed excellent intra-session reliability of the NH test results (ICC2.1 = 0.891–920), but only good reliability (ICC2.1 = 0.601) for the intra-leg symmetry variable. Although NH strength measurements were found to be highly reliable, sports practitioners should be aware of the discrepancy between the measures and interpret the results carefully. Eccentric hamstring strength and inter-leg symmetry cannot be evaluated interchangeably with the NH test and gold standard isokinetic test performed in the 90° hip flexion position.

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.

Test−Retest Reliability of Isokinetic Ankle, Knee and Hip Strength in Physically Active Adults Using Biodex System 4 Pro

The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. To examine the test-retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CVTE) values were 6.6-19.5%. Change in the mean expressed as a percent varied from -3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs. Test-retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings.

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.

Association between isokinetic strength measures and functional performance in community-dwelling older adults

RESUMO Estudos anteriores já demonstraram a associação entre força muscular de membros inferiores e desempenho funcional, mas a contribuição dos principais músculos dos membros inferiores para o desempenho de pessoas idosas nas atividades cotidianas não foi bem estabelecida. O objetivo deste estudo foi investigar a associação entre a força muscular isocinética dos oito principais grupos musculares dos membros inferiores e o desempenho funcional em pessoas idosas da comunidade. A força muscular dos plantiflexores e dorsiflexores do tornozelo, flexores e extensores do joelho e flexores, extensores, adutores e abdutores do quadril foi avaliada utilizando um dinamômetro isocinético Biodex System 4 Pro®. O desempenho funcional de 109 participantes foi avaliado usando o teste de sentar e levantar cinco vezes (TSL) e de velocidade de marcha habitual de 4 metros (VMH). As análises de regressão linear múltipla mostraram que a força dos abdutores do quadril previu 31,3% da variabilidade para a VMH (p=0,011), e a força dos extensores do joelho (p=0,015) 31,6% da variabilidade para o TSL. Concluímos que os abdutores do quadril e os extensores do joelho podem ser os principais grupos musculares envolvidos no desempenho de pessoas idosas para sentar-levantar e caminhar.

The bone mineral density and isokinetic knee strength in amputee soccer players.

The aim of this study was to examine the isokinetic knee strength, H/Q ratio (%), and bone mineral density values between amputees (n=14; amputee soccer players) and healthy football players (n=14; non-amputee soccer players). A total of 28 amputee soccer players and non-amputee soccer players participated in the study. An isokinetic dynamometer was used to determine the knee flexion/extension forces of the dominant legs of the athletes at 60, 180, and 240°/s. Bone mineral density scans were performed using dual-energy X-ray absorptiometry. H/Q ratio and 60º/s flexion and 180 and 240º/s flexion/extension strength (p<0.05) were found to be high (180º/s, p=0.03; 240º/s, p=0.048) in the non-amputee soccer player group. Accordingly, the bone mineral density values of the lumbar vertebra, femoral neck, proximal metaphysis of the femur (p<0.01), tibia/fibula proximal metaphysis, and tibia/fibula distal metaphysis (p<0.05) were found to be high. A correlation was observed between the 60º/s knee extension strength and tibia/fibula diaphyseal bone mineral density (p=0.025; r=0.594) and tibia/fibula distal metaphysis bone mineral density (p=0.017; r=0.623) values in the amputee soccer players group. The Z-scores of the amputee soccer players and non-amputee soccer players were in the expected range according to age (>-2). The bone mineral density, H/Q ratio, and all measured angular velocities of isokinetic strength were high in non-amputee soccer players. This finding made us think that lower extremity amputation may also be associated with losing strength. However, it was observed that the relationship between strength and bone mineral density in amputee athletes might vary according to different angular velocities. It is recommended that isokinetic strength measurement can be evaluated together with bone mineral density in athletes.

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.

Reliability of isokinetic hip abductor and adductor strength measurements: A systematic review and meta-analysis

The aims of this study were to: (I) examine the reliability of the abduction and adduction isokinetic strength measurements in healthy subjects and athletes; (II) determine which position is the most valid and reliable for strength measurement; and (III) determine the most reliable velocity to assess hip abductor and adductor strength. The databases used were Web of Science, SCOPUS, MedLine and PubMed. The metafor package of R software was used to conduct meta-analysis. A total of 767 studies were identified through a search of electronic databases, of which 10 were included in this meta-analysis. The main finding of the study revealed; (I) the reliability of isokinetic force measurement is good in abduction (ICC = 0.83) and adduction (ICC = 0.81); (II) standing position presents good reliability in abduction (ICC = 0.83) and adduction (ICC = 0.79); (III) the lateral position presents good reliability in abduction (ICC = 0.83) and adduction (ICC = 0.82); (IV) the velocity of 60°/s (ICC = 0.84), 90°/s (ICC = 0.84) and 120°/s (ICC = 0.86) show good reliability for abduction, and; (V) the velocity of 30°/s (ICC = 0.76), 60°/s (ICC = 0.83), and 120°/s (ICC = 0.89) show good reliability for adduction. Many factors influence the reliability of isokinetic assessments of the hip abductors and adductors, the best known of which are body position, isokinetic velocity, and type of muscle contraction. And although most of the researchers opt for the evaluation in lateral position, and at low velocities, our results conclude that the standing position, at a velocity of 120°/s is a better alternative to evaluate these movements (ABD-ADD), and not only because of its good reliability, but also because of the similarity of the evaluation with the gestures developed within the sport.

How limb dominance influences limb symmetry in ACL patients: effects on functional performance

BackgroundTiming for return to sport (RTS) after anterior cruciate ligament (ACL) injury is paramount for the avoidance of a secondary injury. A common criterion in RTS decision-making is the limb symmetry index (LSI) which quantifies (a)symmetries between the affected and unaffected limb. Limb dominance is one of many factors that may contribute to the recovery of the LSI after ACL reconstruction. The purpose of this study was to examine how limb dominance affects the LSI of functional performance tasks nine months following ACL reconstruction (time of RTS).MethodsAt time of return to sport, n = 100 patients (n = 48 injured the dominant limb, n = 52 injured the non-dominant limb, n = 34 female, n = 66 male) with ACL reconstruction surgery performed isokinetic strength measurements of the knee extensors and flexors, and drop jumps (DJ), single leg hop for distance (SHD) and 6 m timed hop (6MTH) testings.ResultsThe findings indicated that injury of the dominant leg led to significantly higher LSI values in maximal isokinetic knee extensor strength (p = 0.030). No significant differences were observed for maximal isokinetic knee flexor strength, DJ, SHD or 6MTH performance. Stratifying for sex revealed no significant differences. Simple regression analyses demonstrated that LSI in maximal knee extensor strength significantly predicted LSIs in DJ and SHD while explaining 14% and 18% of the respective variance.ConclusionsGiven that limb dominance affects the LSI of muscle strength suggests that a differentiated interpretation of the LSI with respect to limb dominance should be considered for a safe return to sport. Monoarticular knee extensor strength and multiarticular hop test performance are interrelated and thus can show asymmetries which are not maladaptive but established during years of habituation or training.

Quadriceps Strength and Knee Function After Anterior Cruciate Ligament Reconstruction with Quadriceps Tendon Bone Autograft: A Preliminary Report.

The purpose of this study was to evaluate quadriceps strength and knee function after anterior cruciate ligament (ACL) reconstruction using a quadriceps tendon bone (QTB) autograft. Preliminary data were extracted from an ongoing prospective cohort study in which the operative extremity was compared to non-operative extremity. Patients from 14 to 40 years of age who had an ACL reconstruction with QTB autograft volunteered to have knee assessment including quadriceps isokinetic strength measures and functional knee testing at 6 and 12 months post-operatively. Paired t-tests were conducted to compare post-operative strength and function scores on participants who had minimum one-year post-surgical follow-up. Patients had a significant recovery of quadriceps strength as determined by isokinetic testing and single leg hop test. For 31 participants, quadriceps strength of the operative leg measured at 60 deg/sec was 63% of the non-operative leg at six months, increasing to 79% at one year (p < 0.001); when measured at 180 deg/sec, these values were 68% at six months, increasing to 82% at one year (p < 0.001). For 30 participants, single leg hop functional scores of the operative leg were 80% of the non-operative leg at six months, increasing to 91% at one year (p < 0.001). After QTB autograft for ACL reconstruction, there were significant gains in quadriceps strength and knee function from six months to one year post-operative. These findings indicated the QTB is an acceptable ACL reconstruction option.

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.

Inter-limb asymmetries and kicking limb preference in English premier league soccer players.

The aims of this study were: (1) to quantify interlimb asymmetries in EPL soccer players in the context of kicking limb preference and (2) to establish the relationship between interlimb asymmetries and measures of physical performance. Twenty-two players (age: 21.8 ± 4.4 years) from an EPL club performed a running gait assessment (20 km/h) and unilateral countermovement jumps, a CoD assessment (modified 505 test), and an isokinetic knee extension/flexion protocol using each leg. Asymmetries were quantified using the percentage difference method and Pearson's correlations were used to quantify the association between variables. Players displayed the greatest level of asymmetry in isokinetic strength measures (5.9–12.7%) and lower levels of asymmetry in gait (1.6–7.7%), jump (0.9–7.0%) and CoD (1.9–3.5%) assessments. The influence of the preferred kicking limb was most evident in the isokinetic assessment with the players showing dominance in the preferred limb for knee flexor strength and in the non-preferred limb for knee extensor strength. These manifested in the asymmetry values calculated for the hamstring:quadricep (H:Q) ratios at 60°/s (8.80 ± 7.82%) and 240°/s (11.22 ± 7.04%) and in the functional H:Q ratio (12.67 ± 8.25%). The asymmetry values for peak extensor moment at 240°/s showed a significant correlation (ρ = −0.55, p = 0.034) with 10 m time in the CoD assessment. These findings provide benchmark asymmetry data for soccer practitioners and reveal that kicking limb preferences may bring about interlimb differences in the H:Q ratio which raises important considerations in the design of testing batteries and injury reduction interventions.

Does Blood Flow Restriction Therapy Improve Leg Strength in Patients With a Painful Total Knee Arthroplasty?

Blood flow restriction (BFR) therapy has been proposed to help patients build strength with fewer repetitions than standard physical therapy (PT). We sought to determine if BFR would improve quadriceps and hamstring strength in patients with instability and perceived weakness >1 year after primary total knee arthroplasty (TKA). We retrospectively reviewed 48 patients with painful TKAs and flexion instability as well as quadriceps and hamstring weakness who performed a 6-week PT program and received isokinetic strength measurements (ISMs). Thirty-six patients completed a standard PT program (non-BFR) and 12 patients completed a BFR regimen. ISMs were taken before and after PT to quantify quadriceps and hamstring power, torque, and work compared to the contralateral leg. Statistical analysis was conducted on pre-PT and post-PT ISMs and decisions for revision surgery. There were no differences in ISMs after PT between the BFR and non-BFR groups. The non-BFR group showed statistically significant strength improvements in flexion but not extension (+28.7%-32.8%, P= .0145-.255). Although no significant difference was found in the BFR group, they saw improvements in all extension strength metrics (19.4%-23.4%, P= .3315-.3901) and flexion (25.7%-29.9%, P= .1994-.2392). No difference was observed between the groups in the rates of subsequent revision TKA (8.3% vs 16.7%, P= .3362). BFR did not improve quadriceps and hamstring strength compared to PT alone in patients with instability and weakness after TKA. Over 80% of total patients chose to avoid revision TKA after completion of focused PT with or without BFR.