Isometric Power Research Articles

Investigation of the effects of tadalafil on the myocardium via electrical and isometric contractions and cardiac markers in Wistar rats

Purpose: Tadalafil, a long-acting phosphodiesterase-5 (PDE-5) inhibitor, is commonly used in the treatment of erectile dysfunction. This study investigates the contribution of tadalafil in cardiac function by measuring isometric and electrical contractions of myocardium in rats. Materials and Methods: Thirty rats were divided into five groups. Basal electrical contractions were recorded via electrocardiogram (ECG) for intervals PR (ms), QRS (ms), QT (ms), Tp (ms), Te (ms), pathological Q and heart beats/min. Then group 1 received saline for 7 days (control); group 2 received tadalafil 1 mg/kg; group 3 received tadalafil 10 mg/kg; group 4 received tadalafil 1 mg/kg for 7 days; group 5 received tadalafil 10 mg/kg for 7 days. After treatments, electrical contractions were re-performed to analyze the differences in ECG. For isometric contractions, hearts were connected to isometric power transducer to determine myocardial contractile forces (g), durations (ms) and frequencies (Hz). Serum samples were collected for cardiac creatine kinase (CK-MB) and cardiac troponin I via ELISA. Results: We found a significant decrease in CK-MB in Group 2 (395.56±124.38 pg/ml) and 3 (377.81±79.61 pg/ml), compared to Group 1 (575.32±83.54 pg/ml). The differences in cardiac contractile forces, contraction durations or frequencies were not statistically significant. Conclusion: Tadalafil did not exert obvious distruption on myocardial electrical or isometrical contractions. It is noteworthy that tadalafil 1 and 10 mg/kg reduced serum CK-MB. Shortening in QT and decrease in heart rate may have important implications on myocardial functions.

Spontaneous Deltoid Tear in Cuff Tear Arthropathy and Its Effect on the Outcome of Reverse Total Shoulder Arthroplasty: A Comparison Using Propensity Score Matching.

Deltoid function critically influences the results of reverse total shoulder arthroplasty (RTSA), and spontaneous deltoid attrition tears are frequently detected in cuff tear arthropathy (CTA) patients; however, the clinical impacts of these tears on RTSA outcomes are undetermined. Our aim was to determine the effect of spontaneous deltoid attrition tears on postoperative outcomes after RTSA without an additional deltoid procedure. Seventy-two patients who underwent RTSA for CTA with preoperative magnetic resonance imaging (MRI) and a minimum clinical follow-up of 1 year (mean, 32 months) were retrospectively reviewed in the study. Patients with a history of previous shoulder surgery or injury were excluded. The presence and location of deltoid attrition tears were determined in preoperative MRI. Propensity score matching (1:1) was performed to construct tear and no-tear groups. Finally, 21 patients, matched with respect to age, sex, hand dominance, symptom duration, medical comorbidity (obesity, diabetes mellitus, and coronary artery disease), Hamada grade, and implant type, were assigned to each group. Clinical outcomes (functional scores, isometric power, and range of motion) in the two groups were compared. Deltoid attrition tears were detected in 21 of the 72 enrolled cases (29.1%). Anterolateral deltoid was the most frequent location and no tear was detected in the posterior deltoid. The tear rate increased with disease severity (Hamada G2, 4.8%; G3, 23.8%; > G4, 71.4%). No pre- or postoperative clinical variables differed significantly between the tear and no tear groups. Deltoid attrition tears were detected in 29% of CTA patients who underwent RTSA. The most common site was the anterolateral region and tear prevalence tended to increase with CTA progression. However, RTSA was found to provide satisfactory outcomes regardless of the presence of a deltoid attrition tear.

FUNCTIONAL RESTORATION OF THE PARTIAL HAND AMPUTEE USING DIGITAL DISTRACTION LENGTHENING. A CASE SERIES STUDY.

FUNCTIONAL RESTORATION OF THE PARTIAL HAND AMPUTEE USING DIGITAL DISTRACTION LENGTHENING. A CASE SERIES STUDY.

Quadriceps Muscle Fatigue Reduces Extension and Flexion Power During Maximal Cycling.

Purpose: To investigate how quadriceps muscle fatigue affects power production over the extension and flexion phases and muscle activation during maximal cycling.Methods: Ten participants performed 10-s maximal cycling efforts without fatigue and after 120 bilateral maximal concentric contractions of the quadriceps muscles. Extension power, flexion power and electromyographic (EMG) activity were compared between maximal cycling trials. We also investigated the associations between changes in quadriceps force during isometric maximal voluntary contractions (IMVC) and power output (flexion and extension) during maximal cycling, in addition to inter-individual variability in muscle activation and pedal force profiles.Results: Quadriceps IMVC (−52 ± 21%, P = 0.002), voluntary activation (−24 ± 14%, P < 0.001) and resting twitch amplitude (−45 ± 19%, P = 0.002) were reduced following the fatiguing task, whereas vastus lateralis (P = 0.58) and vastus medialis (P = 0.15) M-wave amplitudes were unchanged. The reductions in extension power (−15 ± 8%, P < 0.001) and flexion power (−24 ± 18%, P < 0.001) recorded during maximal cycling with fatigue of the quadriceps were dissociated from the decreases in quadriceps IMVC. Peak EMG decreased across all muscles while inter-individual variability in pedal force and EMG profiles increased during maximal cycling with quadriceps fatigue.Conclusion: Quadriceps fatigue induced by voluntary contractions led to reduced activation of all lower limb muscles, increased inter-individual variability and decreased power production during maximal cycling. Interestingly, power production was further reduced over the flexion phase (24%) than the extension phase (15%), likely due to larger levels of peripheral fatigue developed in RF muscle and/or a higher contribution of the quadriceps muscle to flexion power production compared to extension power during maximal cycling.

The effect of Omega-3 polyunsaturated fatty acid supplementation on exercise-induced muscle damage

BackgroundExercise-induced muscle damage (EIMD) results in transient muscle inflammation, strength loss, muscle soreness and may cause subsequent exercise avoidance. Omega-3 (n-3) supplementation may minimise EIMD via its anti-inflammatory properties, however, its efficacy remains unclear.MethodsHealthy males (n = 14, 25.07 ± 4.05 years) were randomised to 3 g/day n-3 supplementation (N-3, n = 7) or placebo (PLA, n = 7). Following 4 weeks supplementation, a downhill running protocol (60 min, 65% V̇O2max, − 10% gradient) was performed. Creatine kinase (CK), interleukin (IL)-6 and tumour necrosis factor (TNF)-α, perceived muscle soreness, maximal voluntary isometric contraction (MVIC) and peak power were quantified pre, post, and 24, 48 and 72 h post-EIMD.ResultsMuscle soreness was significantly lower in N-3 vs PLA group at 24 h post-EIMD (p = 0.034). IL-6 was increased in PLA (p = 0.009) but not in N-3 (p = 0.434) following EIMD, however, no significant differences were noted between groups. Peak power was significantly suppressed in PLA relative to pre-EIMD but not in N-3 group at 24 h post-EIMD. However, no significant difference in peak power output was observed between groups. MVIC, CK and TNF-α were altered by EIMD but did not differ between groups.ConclusionN-3 supplementation for 4 weeks may successfully attenuate minor aspects of EIMD. Whilst not improving performance, these findings may have relevance to soreness-associated exercise avoidance.

Intrarater reliability test of the ISOmetric power device—A new instrument for assessment of isometric force in six directions of wrist motion

Study DesignDescriptive reliability study. IntroductionA well-functioning wrist requires sufficient range of motion accompanied by adequate strength in every movement and direction—factors that are not regularly measured simultaneously in patients with wrist problems today. The ISOmetric Power device (ISOP) is a new instrument that measures isometric wrist force in all six directions of motion, but its intrarater reliability in a healthy population has not yet been evaluated. Purpose of the StudyThe purpose of this study was to perform an intrarater reliability test of the ISOP in healthy participants. MethodsThirty-two healthy study participants (16 women/16 men; mean age 38.3 years; SD 6.5) were included. With a standardized testing protocol, the three planes of wrist motion— wrist flexion/extension, radial/ulnar deviation, pro/supination—were measured at one time interval (T1) and repeated after one week (T2). The results were analyzed using the intraclass correlation coefficient (ICC). A paired-samples t-test was also performed to determine if a statistically significant difference (P < .05) existed between the first and the second test values. Measurements with Jamar Dynamometer were performed at both time intervals, for internal control of measurement intrarater reliability. ResultsExcellent correlations (ICC: 0.90-0.99) were found for all test-retests performed. The lowest value (ICC: 0.90) was seen for supination and the highest value (ICC: 0.99) for flexion of the left hand. No statistically significant differences were found in any of the pairs (P > .05) in terms of test-re-test, which additionally strengthen the correlation between the first and second test values. DiscussionContrary to the Jamar Dynamometer, the ISOP is not designed for measuring grip strength, but for assessing the isometric muscle force in flexion, extension, pronation, supination, and radial and ulnar deviation. A systematic review has reported a moderate to strong correlation between isometric strength and dynamic performances. Thus, the ISOP is a more complete and applicable instrument for evaluating the functional strength in different directions in the upper extremity. ConclusionsThe ISOmetric Power device shows excellent intrarater reliability and is proposed to be a possible valuable wrist strength assessment tool to aid in both diagnostics and outcome measures of wrist and upper extremity disorders.

Comparison of Muscle Recovery Following Bi-cruciate Substituting versus Posterior Stabilized Total Knee Arthroplasty in the Asian Population

The purpose of this study was to compare muscle recovery in the lower extremities following the newly developed bi-cruciate substituting (BCS) to posterior stabilized (PS) total knee arthroplasty (TKA) in the Asian population. Forty-one knees in 41 patients undergoing BCS-TKA (41 female, average age: 71 ± 8.8) and 34 knees in 34 patients undergoing PS-TKA (33 female, average age: 73 ± 7.2) were included in this study. The maximum isometric power of the quadriceps and hamstring muscles was measured preoperatively, and at 1, 3, 6, and 12 months after surgery using a handheld dynamometer. Postoperative muscle recovery was calculated regarding preoperative muscle power as 100%. Pre- and postoperative range of knee motion, femorotibial angle, and clinical scores (Knee Society score and function score) were also compared. No significant difference in sex, age, preoperative quadriceps, or preoperative hamstring power was observed between the BCS and PS-TKA groups. When regarding the preoperative muscle power as 100%, quadriceps power at 1, 3, 6, and 12 months following BCS-TKA was 61.2 ± 22%, 86.3 ± 28.3%, 97 ± 27.4%, and 112.4 ± 30.8%, respectively. Quadriceps power at 1, 3, 6, and 12 months following PS-TKA was 72.4 ± 20.8%, 84 ± 16.9%, 95 ± 20.7%, and 110.8 ± 27%, respectively. Hamstring power at 1, 3, 6, and 12 months following BCS-TKA was 96.3 ± 30%, 111.4 ± 35%, 120 ± 37%, and 125 ± 31%, respectively. Hamstring power at 1, 3, 6, and 12 months following PS-TKA was 95 ± 25%, 112.4 ± 27%, 117 ± 38.5%, and 120.4 ± 18.5%, respectively. No significant difference in muscle power recovery was observed at 3 (p = 0.995), 6 (p = 0.944), and 12 (p = 0.917) months after surgery between the two groups. No significant difference of the clinical score was observed between the groups (Knee Society score: p = 0.479, function score: p = 0.342). No significant difference in muscle recovery and clinical score were observed between the BCS and PS-TKA groups. Longer follow-up is needed for the evaluation of efficacy of BCS-TKA in the Asian populations.

Jerry can carriage is an effective predictor of stretcher carry performance

Carrying a casualty on a stretcher is a critical task conducted in a range of occupations. To ensure that personnel have the requisite physical capacity to conduct this task, two bilateral jerry can carries were used to predict individual performance in a four-person stretcher carry. Results demonstrated a bilateral 22-kg jerry can carry (R2 = 0.59) had superior predictive ability of stretcher carry performance than a bilateral 15-kg jerry can carry (R2 = 0.46). Pre- to post-carry changes in grip endurance (p > 0.05), back–leg isometric strength (p > 0.05) and leg power (p > 0.05) were not significantly different between carry tasks. There was no significant difference in heart rate (p > 0.05) and oxygen consumption (p > 0.05) between the stretcher carry and either jerry can carry. Thus, on the basis of performance correlations and physiological measures, the 22-kg jerry can carry is an appropriate predictive assessment of four-person stretcher carriage.Practitioner Summary: This study investigated the ability of a jerry can carry to predict individual performance on a four-person stretcher carry. Performance correlations were substantiated with physiological measures to demonstrate similar physical requirements between task and test. These results can be used to set physical employment standards to assess stretcher carriage.

Reliability Testing of ISOP, a Wrist Isometric Power Device for Evaluation of Wrist Function

Reliability Testing of ISOP, a Wrist Isometric Power Device for Evaluation of Wrist Function

Clinical results of a surgical technique using endobuttons for complete tendon tear of pectoralis major muscle: report of five cases

BackgroundWe herein describe a surgical technique for the repair of complete tear of the pectoralis major (PM) tendon using endobuttons to strengthen initial fixation.MethodsFive male patients (3 judo players, 1 martial arts player, and 1 body builder) were treated within 2 weeks of sustaining complete tear of the PM tendon. Average age at surgery and follow-up period were 28.4 years (range, 23-33) and 28.8 months (range, 24-36). A rectangular bone trough (about 1 × 4 cm) was created on the humerus at the insertion of the distal PM tendon. The tendon stump was introduced into this trough, and fixed to the reverse side of the humeral cortex using endobuttons and non-absorbable suture. Clinical assessment of re-tear was examined by MRI. Shoulder range of motion (ROM), outcome of treatment, and isometric power were measured at final follow-up.ResultsThere were no clinical re-tears, and MRI findings also showed continuity of the PM tendon in all cases at final follow-up. Average ROM did not differ significantly between the affected and unaffected shoulders. The clinical outcomes at final follow-up were excellent (4/5 cases) or good (1/5). In addition, postoperative isometric power in horizontal flexion of the affected shoulder showed complete recovery when compared with the unaffected side.ConclusionsSatisfactory outcomes could be obtained when surgery using the endobutton technique was performed within 2 weeks after complete tear of the PM tendon. Therefore, our new technique appears promising as a useful method to treat complete tear of the PM tendon.

Chronic rupture of Achilles tendon: is the percutaneous suture technique effective?

We report the long-term results of the surgical treatment of chronic rupture of the Achilles tendon using percutaneous suturing under local anesthesia. We operated on 22 patients with median age of 50 years (29-72) with chronic rupture of Achilles tendon between 1991 and 2005. The median time from injury to surgery was 7.1 weeks (4-40). We used percutaneous surgical technique similar to a technique described by Ma and Griffith (1977, Clin Orthop Relat Res 128:247-255) and Kosanović (1994, Arch Orthop Trauma Surgery 113:177-179). Eighteen (82%) patients attended the clinical review at a mean of 67 months (14-176). During follow up, patients were asked about pain, stiffness, weakness of the calf, footwear restrictions, occupation and level of activity before and after injury (Tegner score), influence of injury on ADL activities and satisfaction with treatment. The passive and active range of movement of the ankle and the power of isometric plantar flexion were measured, and the endurance test was performed. Functional assessment was performed using a Leppilahti clinical scoring scale and a modified Merkel score Complete healing of the tendon was achieved in 21 patients (95%). In 17 patients (77%) the postoperative course was complications free. There were no reruptures during the observation period. All were able to stand on the tiptoe of the injured leg. The operated leg had a mean of 87.5% of the isometric power compared with the uninjured leg (p = NS). On an average they could stand on toes and raise the heel 13 times on side with the ruptured tendon. The Leppilahti scoring scale revealed a result that was excellent for 11 patients (62%), good for 2 (11%), fair for 5 (28%) and no one had poor result. The average score was 83.3 (60-100). Eighty-three percent of patients stated that the result of surgery was very good and 11% rated it as good. Fourteen patients (78%) returned to same level of activity at median 7 months after surgery. Our series is one of the largest to be reported for the treatment of chronic rupture. Our technique offers a considerable advantage; it is minimal invasive, easy to perform with no associated harvesting morbidity and increased patient acceptance. We recommend this technique for the treatment of chronic rupture of Achilles tendon.

Anaerobic capacity, isometric endurance, and Laser sailing performance

Laser sailors have to tolerate fatiguing contractions of the lower-body muscles for prolonged periods. The aims of the present study were (1) to evaluate the difference between top-ranked and club sailors, in their capacity to resist fatigue during sustained isometric and maximal power exercise, and (2) to examine the relationships between the above parameters and performance on a Laser simulator and competitive racing performance according to the national ranking list. Eight Greek nationally ranked Laser sailors were compared with eight club sailors. Each sailor performed: (a) an effort to the limit of tolerance on the Laser simulator, (b) an effort to the limit of tolerance of isometric endurance for the right leg on an isokinetic dynamometer, and (c) a Wingate test of maximal lower-body anaerobic power on a cycle ergometer. In the nationally ranked sailors, isometric endurance time (mean 160 s, s = 50) and endurance time on the Laser simulator (1381 s, s = 1354) were significantly (P < 0.05) longer than in the club sailors (101 s, s = 29 and 565 s, s = 367, respectively), whereas the final minute heart rate (in both groups: 149 beats · min−1, s = 22) and the mean arterial pressure (nationally ranked sailors: 129 mmHg, s = 16; club sailors: 120 mmHg, s = 21) on the Laser simulator were not different between groups. During the Wingate test, the nationally ranked sailors had a significantly lower index of fatigue (42%, s = 5) than the club sailors (49%, s = 6). Isometric endurance time was significantly correlated with the Wingate index of fatigue (r = −0.73; P < 0.001). The nationally ranked sailors' mean and maximal anaerobic powers were significantly correlated with their national ranking positions (r = −0.83 and −0.71, respectively). It is suggested that isometric endurance and anaerobic power are well-developed in Laser class sailors and may influence their sailing performance. Furthermore, compared with club sailors, the nationally ranked sailors are able to sustain the same intensity of lower-limb isometric contractions for much longer with similar cardiovascular responses.

Isometric measurement of wrist-extensor power following surgical treatment of displaced lateral condylar fracture of the humerus in children

Muscle disability is a common sequel after fracture management. Previous research has shown divergent results concerning muscle-power recovery after bone healing. This study has investigated the muscle function of wrist extensors after lateral condylar fracture in children, as evaluated by a hand-held dynamometer and compared with sex- and age-matched children. From 1999 to 2004, 20 patients (13 boys and seven girls; mean age: 9 years and 4 months) with displaced lateral condylar fracture of the humerus were treated by open reduction and internal fixation with Kirschner wires (K-wire). The duration of K-wire fixation was 35 days and the mean follow-up time was 50 months. A total of 180 healthy age-, sex- and weight-matched children were used as control groups. A paired Student's test was applied for the analysis of statistical significance. The range of motion of the elbow and radiographic findings were not significantly different between the injured limb and normal control groups. The maximum isometric power of wrist-extensor muscles after surgical treatment of lateral condylar fracture of the humerus in final follow-up was not statistically different from that in the normal control children. Muscle power therefore recovers to its normal status after the healing of lateral condylar fracture of the humerus in children.

Angst und Depression bei chronischen Rückenschmerzpatienten: Beziehungen zu individuellen Kontrollüberzeugungen und zur muskulären Leistungsfähigkeit

Chronic back pain patients often show a fear- and depression-related behavior with social retreat and less physical activity. Increasing pain is associated by decreasing muscular capacity of the spine stabilizing muscular system. The aim of the present study was to analyse the level of anxiety and depression (HADS-D) among chronic low back pain patients (n = 685) in ambulatory treatment in comparison with standardised values of a representative German adult population sample (n = 1943). Furthermore, the association between conspicuous values of anxiety or depression and beliefs of control (KU-WS) and muscular capacity (isometric power of lumbal extensor and flexor) were analysed. Back pain patients showed significantly higher mean scores in anxiety and depression without a significantly correlation to the age. Female subjects were more anxious than males. 14.9 % showed conspicuous values of anxiety, 16.1 % of depression. Patients with conspicuous values of anxiety and depression respectively showed lower levels of internal beliefs of control and muscular capacity. The present study confirms the importance of early anxiety and depression screening in patients with low back pain in ambulatory treatment to figure out risks of chronicity and to derive optimal treatment.

Rectus femoris muscle flap donor-site morbidity

Donor-site morbidity in four patients after reconstruction with free neurovascular rectus femoris muscle was examined through a series of strength tests in which the leg with rectus femoris muscle harvested was compared with the contralateral leg with an intact rectus femoris muscle. The tests were conducted with three testing devices: (1) the 'Con-Trex Leg-press' in which the force and power of right and left leg extensions at 0.2 and 0.4 m/s in a knee angle from 50 to 90 degrees were tested separately; (2) the isometric power tester, which enabled the unilateral evaluation of the isometric leg extension at three knee angles: 50, 70 and 90 degrees ; and (3) at the 'SP-Force Platforms' in which the patients performed a counter-movement jump where the amplitude of the ground reaction force, the parameters maximum force, and the jump height were calculated in order to compare the right and left leg during a single dynamic movement. Our results showed that the patients (with one exception) demonstrated a balanced relationship between the donor leg and the intact contralateral leg. The patient that primarily demonstrated a large strength deficit was retested 3 months later and showed, after an extensive rehabilitation and training program, an impressive increase in strength. The authors concluded that there is no significant limitation in the strength of the donor leg after removal of the rectus femoris muscle and consequently no significant functional donor-site morbidity. We believe that for the realisation of such results that the intraoperative linking of the vastus lateralis muscle with the vastus medialis muscle, especially in their lower third, and an extensive postoperative rehabilitation and training program are essential.

Relative optimum grip span as a function of hand anthropometry

This study investigates the optimum grip span relative to an individual's hand anthropometry (ROGS) for an isometric power grip exertion. Maximum voluntary isometric grip force (MVGF), muscular activity (EMG) and subjective rating (SR) were used as criteria. Two complementary experiments were conducted. In both experiments, nine different widths of span, separated with 0.5 cm intervals, were tested across 12 subjects. The span size was a function of one's modified thumb crotch length (TCL m). In the first experiment, the grip spans were tested as a function of MVGF and SR. The results of this experiment indicate TCL m-2 as the ROGS. The SR was also supportive of this result. In the second experiment, EMG at a constant force (30% MVGF) was evaluated as a function of the grip span. The EMG based efficiency coefficients indicate TCL m-2.5 as the optimum span, resulting in the least muscular activity. Based on the analysis of MVGF, EMG and SR, the ROGS is in the interval, TCL m-2.5⩽ROGS⩽TCL m-2, indicating a precise location of optimum grip span as a function of one's TCL m. This result suggests that hand-powered tools with two-handles should be designed for adjustability as a function of TCL m. Relevance to industry Excessive grip force exertion is one of the most important factors contributing to the occurrence of upper extremity cumulative trauma disorders, in addition to reducing workers’ productivity. This study suggests a new tool design criterion for minimizing unnecessary effort and increasing productivity.

Myo1c is designed for the adaptation response in the inner ear.

The molecular motor, Myo1c, a member of the myosin family, is widely expressed in vertebrate tissues. Its presence at strategic places in the stereocilia of the hair cells in the inner ear and studies using transgenic mice expressing a mutant Myo1c that can be selectively inhibited implicate it as the mediator of slow adaptation of mechanoelectrical transduction, which is required for balance. Here, we have studied the structural, mechanical and biochemical properties of Myo1c to gain an insight into how this molecular motor works. Our results support a model in which Myo1c possesses a strain-sensing ADP-release mechanism, which allows it to adapt to mechanical load.

Effects of creatine supplementation on exercise performance and muscular strength in amyotrophic lateral sclerosis: preliminary results

Creatine supplementation in humans has been reported to enhance power and strength both in normal subjects and in patients with various neuromuscular diseases. The purpose of this study was to examine the effects of supplementation on exercise performance and maximal voluntary isometric muscular contraction (MVIC) in Amyotrophic Lateral Sclerosis (ALS) patients. We report the results obtained in 28 patients with probable/definite ALS. In each patient we acquired the dynamometric measurement of MVIC in 10 muscle groups of upper and lower limbs and a measure of fatigue by means of an high-intensity intermittent protocol in elbow flexors and knee extensors muscles. All patients completed the protocols at the baseline and after supplementation of 20 g per day for 7 days and after supplementation of 3 g per day for 3 and 6 months. MVIC increased after 7 days of supplementation in 20 patients (70%) in knee extensors and in 15 (53%) of them also in elbow flexors. A statistically significant difference between pre and post-treatment mean values of MVIC was found both in elbow flexors ( P<0.05) and knee extensors ( p<0.04). The analysis of the slopes of fatigue test showed a statistically significant improvement after 7 days of supplementation in 11 patients (39%) in elbow flexors and in 9 patients (32%) also in knee extensors muscles. During the 6-month follow-up period all the examined parameters showed a linear progressive decline. In conclusion, our preliminary results have demonstrated that supplementation temporary increases maximal isometric power in ALS patients so it may be of potential benefit in situations such as high intensity activity and it can be proposed as a symptomatic treatment.

Free anterolateral thigh flap for extremity reconstruction: clinical experience and functional assessment of donor site.

From August of 1995 through July of 1998, 38 free anterolateral thigh flaps were transferred to reconstruct soft-tissue defects. The overall success rate was 97 percent. Among 38 anterolateral thigh flaps, four were elevated as cutaneous flaps based on the septocutaneous perforators. The other 34 were harvested as myocutaneous flaps including a cuff of vastus lateralis muscle (15 to 40 cm3), either because of bulk requirements (33 cases) or because of the absence of a septocutaneous perforator (one case). However, vastus lateralis muscle is the largest compartment of the quadriceps, which is the prime extensor of the knee. Losing a portion of the vastus lateralis muscle may affect knee stability. Objective functional assessments of the donor sites were performed at least 6 months postoperatively in 20 patients who had a cuff of vastus lateralis muscle incorporated as part of the myocutaneous flap; assessments were made using a kinetic communicator machine. The isometric power test of the ratios of quadriceps muscle at 30 and 60 degrees of flexion between donor and normal thighs revealed no significant difference (p > 0.05). The isokinetic peak torque ratio of the quadriceps and hamstring muscles, including concentric and eccentric contraction tests, showed no significant difference (p > 0.05), except the concentric contraction test of the quadriceps muscle, which revealed mild weakness of the donor thigh (p < 0.05). In summary, the functional impairment of the donor thighs was minimal after free anterolateral thigh myocutaneous flap transfer.

Resistance training and elite athletes: adaptations and program considerations.

The skepticism surrounding the potential benefits of resistance exercise training prevalent just decades ago has evolved over the years to an understanding of the integral nature muscular overload plays in the training programs for athletes. The science of training elite athletes is progressing rapidly, as insights into the physiological adaptations resulting from varying program configurations become available. Resistance training impacts several body systems, including muscular, endocrine, skeletal, metabolic, immune, neural, and respiratory. An understanding and appreciation of basic scientific principles related to resistance training is necessary in order to optimize training responses. Careful selection of the acute program variables in a workout to simulate sports-specific movements is required for optimal transfer of gains made in training to competition. Thus, whether athletes require predominantly eccentric, isometric, slow-velocity, or high-velocity strength or power in their athletic event will dictate the time commitment to each component and form the basis for designing individual workouts. Program variation over a training period is essential to maximize gains and prevent overtraining.