Isotonic Group Research Articles

Comparative effects of isometric and isotonic global neck muscles strengthening exercise programme on pain, range of motion, strength, function and quality of life in patients with chronic mechanical neck pain.

The randomised clinical current study was planned to determine the comparative effects of isometric and isotonic global neck muscles strengthening exercises on pain, range of motion, strength, function and quality of life in patients with chronic mechanical neck pain. The study comprised 22 patients with chronic mechanical neck pain. The subjects were randomly divided into two interventional groups, with group A receiving isometric exercises and group B receiving isotonic exercises. Numeric Pain Rating Scale, Neck Disability Index, goniometer, dynamometer and Short Form-36 questionnaire were used for data collection. Isometric and isotonic exercise groups showed significant improvement (p<0.05) in terms of decreasing pain and functional disability, and increasing range of motion and strength. Intergroup comparison showed no significant differences (p>0.05), indicating similar efficacy of isometric and isotonic global neck muscles strengthening exercises. This study was registered at ClinicalTrials.gov ID: NCT05865951.

The efficacy and safety of isotonic and hypotonic fluids in intravenous maintenance fluid therapy in term newborns: national multicenter observational "neofluid" study.

The objective of this study was to evaluate the efficacy and safety of isotonic and hypotonic intravenous fluids in maintenance fluid therapy for term infants. This was a multi-centre, prospective, observational study conducted in 21 participating centres from December 30, 2020, to June 30, 2023. The study included term newborns requiring parenteral fluid therapy for maintenance (NCT04781361). The fluid treatment was divided into two groups based on the concentration of sodium in the parenteral fluid, designated as hypotonic (NaCl <130 mmol/L) and isotonic (NaCl = 130-154 mmol/L). The primary outcomes were the change in mean plasma sodium (pNa) levels per hour (∆pNa mmol/L/h), the incidence of hyponatremia (pNa <135 mmol/L) and hypernatremia (pNa >145 mmol/L), and the occurrence of clinically significant changes in sodium levels (∆pNa >0.5 mmol/L/h). A total of 420 patients from 21 centers were included. The ∆pNa was negative in the hypotonic fluid group and positive in the isotonic fluid group, with a significant difference between the groups [respectively -0.07 ± 0.03 (95% CI: -0.13 to -0.02); 0.04 ± 0.03 (95%CI: -0.02 to 0.09), p = 0.04]. There was no difference between the groups in terms of the development of hypernatremia or a clinically meaningful pNa increase. The hypotonic fluid group had a higher incidence of hyponatremia and a clinically meaningful sodium decrease compared to the isotonic fluid group [7.9% vs. 1.2% (OR:6.5, p:0.03)] and [12.2% vs.4.2% (OR:2.9, p = 0.03)]. Contrary to current understanding, this large-scale study is the first to demonstrate that the use of hypotonic fluids in maintenance fluid therapy for newborns poses a risk of hyponatremia development, whereas isotonic fluid therapy appears safe.

Comparison of the effect of isotonic and hypotonic saline solutions for children with mild dehydration at Lampang Hospital

Administering the appropriate type and rate of fluids is crucial for pediatric patients. Young patients should be given isotonic solutions, as they are safer than hypotonic solutions for fluid maintenance. However, limited studies exist on the efficacy and complications of isotonic solutions for treating acutely ill pediatric patients with mild dehydration. This study aimed to compare isotonic and hypotonic solutions in such cases. A stratified randomized controlled trial was conducted on patients aged 6 months to 15 years with acute illness and mild dehydration in two disease groups: acute gastroenteritis and other diseases. The trial involved administering intravenous fluids, either isotonic or hypotonic solution, for at least 24 hours. Pre and post-treatment serum sodium levels and treatment complications were assessed and compared between patients who received isotonic and hypotonic solutions. A total of 144 patients were randomly assigned to receive either isotonic solution or hypotonic solution. Of the 144 patients, 72 received isotonic and 72 received hypotonic solutions. The isotonic group comprised 51.4% males with a median age of 27.5 months. On the other hand, the hypotonic group comprised 56.9% males with a median age of 38 months. At baseline, both groups' sodium levels were similar at 136.2±2.5 and 136.8±2.5 mmol/L, respectively. After 24 hours, the isotonic group had a statistically significant increase in sodium levels (138.8±2.2 mmol/L; increased median 2.3) compared to the hypotonic group (138.1±2.0 mmol/L; increased median 1.5). In conclusion, no cases of hypernatremia, drowsiness, or seizures were observed, suggesting isotonic solutions can be safely used in these selected groups of acutely ill pediatric patients with mild dehydration.

Seawater nasal wash to reduce symptom duration and viral load in COVID-19 and upper respiratory tract infections: a randomized controlled multicenter trial

PurposeThe objective was to assess the efficacy of seawater nasal wash on symptom duration, intranasal viral load, household transmission in COVID-19 and URTIs.MethodsThis prospective, randomized, controlled, multicentric, parallel study included 355 mild/moderate COVID-19 and URTI adults with rhinologic symptoms ≤ 48h. Active group performed 4-daily nasal washes with undiluted isotonic seawater versus control group (without nasal wash). Symptoms were self-assessed daily using the WURSS-21 questionnaire for 3 weeks. Viral load was measured by RT-PCR on nasopharyngeal swabs collected on Day 0, Day 5, Day 14 and Day 21. Digital droplet PCR was additionally performed for SARS-CoV-2.ResultsOverall COVID-19 subjects recovered earlier the ability to accomplish daily activities in the active group (– 1.6 day, p = 0.0487) with earlier improvement of taste (– 2 days, p = 0.0404). COVID-19 subjects with severe nasal symptoms at D0 showed the earliest resolution of anosmia (– 5.2 days, p = 0.0281), post-nasal drip (– 4.1 days, p = 0.0102), face pain/heaviness (– 4.5 days, p = 0.0078), headache (– 3.1 days, p = 0.0195), sore throat (– 3.3 days, p = 0.0319), dyspnea (– 3.1 days, p = 0.0195), chest congestion (– 2.8 days, p = 0.0386) and loss of appetite (– 4.5 days, p = 0.0186) with nasal wash. In URTIs subjects, an earlier resolution of rhinorrhea (– 3.5 days, p = 0.0370), post-nasal drip (– 3.7 days, p = 0.0378), and overall sickness (– 4.3 days, p = 0.0248) was reported with nasal wash.Evolution towards more severe COVID-19 was lower in active vs control, with earlier viral load reduction in youngest subjects (≥ 1.5log10 copies/10000 cells at Day 5: 88.9% vs 62.5%, p = 0.0456). In the active group, a lower percentage of SARS-CoV-2 positive household contacts (0–10.7%) was reported vs controls (3.2–16.1%) among subjects with Delta variant (p = 0.0413).ConclusionThis trial showed the efficacy and safety of seawater nasal wash in COVID-19 and URTIs.Trial registrationTrial registry ClinicalTrials.gov: NCT04916639. Registration date: 04.06.2021.

COMPARISON OF SODIUM ABNORMALITIES ASSOCIATED WITH HYPOTONIC VERSUS ISOTONIC MAINTENANCE INFUSIONS IN HOSPITALIZED CHILDREN

OBJECTIVE: To compare Sodium abnormalities associated with Maintenance Infusions, Hypotonic versus isotonic in hospitalized children: A Randomized Controlled Trial MATERIAL AND METHODS: This study was a randomized control trial conducted in the Department of Pediatrics A Hayat Abad Medical Complex Peshawar from 28 October 2020 to 28 April 2021. All the admitted patients aged 1 year to 12 years requiring maintenance infusion and were nothing by mouth (NBM) for at least 48 hours and serum sodium between 135-145 mmol/l were included in the study. Patients with renal disease and on drugs affecting sodium level were excluded from the study. Two hundred and four patients who fulfilled the inclusion criteria, were randomly classified into two groups A and B 102 each. Group A was given Isotonic fluids (0.9% Sodium Chloride and 5% Dextrose water with Potassium 20 mmol/L) and Group B was given hypotonic fluids (0.45% Sodium Chloride and 5% Dextrose water with Potassium 20 mmol/L). The baseline tests and targeted tests, such as CBC, Blood sugar, urea, creatinine, electrolytes (sodium, potassium, and chloride), osmolality, and arterial blood gases, were performed. Data was analyzed using SPSS version 21.0. The post-stratification chi-square test was utilized to examine potential effect modifiers, and results were presented in tables. RESULTS: For a total of 204, there were 43 (42.3%) female patients and 59 (57.8%) male patients in Group A. Eighty (78.4%) male patients and twenty-two (21.6%) female patients were documented in Group B. In Group A, 61 (59.8%) patients had ages of 1-6 years while 41 patients (40.2%) were 7-12 years old. Eighteen patients in this group developed hyponatremia after receiving isotonic fluids. Fifty-two (51.0%) patients in Group B were 1-6-year-old and 50 (49.0%) patients were 7-12 years old. while 49 patients in this group developed, hyponatremia receiving hypotonic fluids. Patients given isotonic fluids didn’t develop any complications (Hypernatremia and hyperchloremic metabolic acidosis). CONCLUSION: On the basis of the results of this study, Isotonic intravenous maintenance fluids are a safe option in the pediatric population. KEYWORDS: Children, Intravenous fluids, Hypotonic, Isotonic Maintenance Infusions

Effects of Salinity Stress on Histological Changes, Glucose Metabolism Index and Transcriptomic Profile in Freshwater Shrimp, Macrobrachium nipponense.

Salinity is an important factor in the aquatic environment and affects the ion homeostasis and physiological activities of crustaceans. Macrobrachium nipponense is a shrimp that mainly lives in fresh and low-salt waters and plays a huge economic role in China's shrimp market. Currently, there are only a few studies on the effects of salinity on M. nipponense. Therefore, it is of particular importance to study the molecular responses of M. nipponense to salinity fluctuations. In this study, M. nipponense was set at salinities of 0, 8, 14 and 22‱ for 6 weeks. The gills from the control (0‱) and isotonic groups (14‱) were used for RNA extraction and transcriptome analysis. In total, 593 differentially expressed genes (DEGs) were identified, of which 282 were up-regulated and 311 were down-regulated. The most abundant gill transcripts responding to different salinity levels based on GO classification were organelle membrane (cellular component), creatine transmembrane transporter activity (molecular function) and creatine transmembrane transport (biological function). KEGG analysis showed that the most enriched and significantly affected pathways included AMPK signaling, lysosome and cytochrome P450. In addition, 15 DEGs were selected for qRT-PCR verification, which were mainly related to ion homeostasis, glucose metabolism and lipid metabolism. The results showed that the expression patterns of these genes were similar to the high-throughput data. Compared with the control group, high salinity caused obvious injury to gill tissue, mainly manifested as contraction and relaxation of gill filament, cavity vacuolation and severe epithelial disintegration. Glucose-metabolism-related enzyme activities (e.g., pyruvate kinase, hexokinase, 6-phosphate fructose kinase) and related-gene expression (e.g., hexokinase, pyruvate kinase, 6-phosphate fructose kinase) in the gills were significantly higher at a salinity of 14‱. This study showed that salinity stress activated ion transport channels and promoted an up-regulated level of glucose metabolism. High salinity levels caused damage to the gill tissue of M. nipponense. Overall, these results improved our understanding of the salt tolerance mechanism of M. nipponense.

Investigating phase separation properties of chromatin-associated proteins using gradient elution of 1,6-hexanediol

BackgroundChromatin-associated phase separation proteins establish various biomolecular condensates via liquid–liquid phase separation (LLPS), which regulates vital biological processes spatially and temporally. However, the widely used methods to characterize phase separation proteins are still based on low-throughput experiments, which consume time and could not be used to explore protein LLPS properties in bulk.ResultsBy combining gradient 1,6-hexanediol (1,6-HD) elution and quantitative proteomics, we developed chromatin enriching hexanediol separation coupled with liquid chromatography-mass spectrometry (CHS-MS) to explore the LLPS properties of different chromatin-associated proteins (CAPs). First, we found that CAPs were enriched more effectively in the 1,6-HD treatment group than in the isotonic solution treatment group. Further analysis showed that the 1,6-HD treatment group could effectively enrich CAPs prone to LLPS. Finally, we compared the representative proteins eluted by different gradients of 1,6-HD and found that the representative proteins of the 2% 1,6-HD treatment group had the highest percentage of IDRs and LCDs, whereas the 10% 1,6-HD treatment group had the opposite trend.ConclusionThis study provides a convenient high-throughput experimental method called CHS-MS. This method can efficiently enrich proteins prone to LLPS and can be extended to explore LLPS properties of CAPs in different biological systems.

SHORT TERM EFFECT OF INTRAVENOUS FLUID THERAPY IN PAEDIATRIC INTENSIVE CARE UNIT ON SERUM ELECTROLYTES AND RENAL FUNCTION TESTS OF CHILDREN

Background: Studies have shown that using hypotonic fluids may result in hyponatremia and the use of isotonic fluids is associated with lower incidence of electrolyte disturbances. Renal functions usually based on measurements of serum urea and creatinine are dependent on the maintenance of appropriate intravascular volume in order to maintain adequate organ perfusion and functioning. Aims and Objectives: To analyze the short term effect of IV Fluids in PICU on serum electrolytes and renal function tests. Methods: This observational descriptive study was conducted in 125 children admitted PICU from April 2022 to September 2022 receiving IV fluids and kept nil by mouth. The levels of serum sodium, potassium, urea and creatinine done at day1 of admission were compared to the investigations done after 72hrs.The data was categorized based on the type of fluid received by the child. Hypotonic fluids (0.45% DNS, D10) and isotonic fluids (0.9% DNS). Results: Out of 125 children, 61(48.8%) received hypotonic fluids whereas 64(51.2%) received isotonic fluids. The average volume of hypotonic fluid given was 3.2±1.7 ml/kg/hr whereas of isotonic fluid given was 2.7±1.3 ml/kg/hr (p=0.11). Hyponatremia developed in 16 out of 42 baseline normal sodium patients in hypotonic group and 6 out of 46 in isotonic group(p=0.03). Serum creatinine was raised in 6(12%) patients out of 50 baseline normal patients in hypotonic group. Serum urea from baseline normal was raised in 7(21.9%) in hypotonic and in 5(17.9%) in isotonic group (p=0.4). Mortality was significantly higher in hypotonic group (13.1%) compared to isotonic group (3.1%) (p=0.04). Conclusions:For preventing positive fluid balance and also development of hyponatremia, isotonic fluids should be considered as routine maintenance fluids.

COMPARISON BETWEEN SPORTS DRINK AND COCONUT WATER ON CARDIOVASCULAR ENDURANCE PERFORMANCE AMONG FOOTBALL PLAYERS

A sports drink is a drink containing electrolytes and glucose, meanwhile coconut drink is known as a natural source of sports drink. Both drinks have the benefit of restoring energy and electrolyte, especially when ingested during strenuous physical activity that requires maximum endurance performance. The purpose of this study was to compare the effects of sports drinks and coconut drinks in enhancing cardiovascular endurance performance among UiTM football players. A total of 24 male participants representing Universiti Teknologi MARA Football Club (UiTM FC) were recruited. Participants were randomly assigned into three groups that are isotonic drink group (IDG) (n=8), the coconut drink group (CDG) (n=8), and the control group (n=8). Cardiovascular endurance performance was determined based on bleep test results at the pre-test and post-test. The intervention was conducted by giving a different type of drink according to the assigned group. IDG received 100 plus isotonic drink, CDG received a Vita Coco drink and CG were only given plain water. After the end of the pre-test session, the participants were given 2-hour to rest, and drinks were given according to their group. After 2-hour of rest, the participants continue with the post-test. The level of VO2 max was measured by an equation based on the bleep test results. The result shows there was a significant increment in pre-post-test VO2 max level within all groups, showing improvement in the mean level of VO2 max at post-test. The mean of pre-post-test VO2 max for the three respective groups was IDG 47.53 ± 6.32 to 49.46 ± 5.88 ml/kg/min, CDG 47.01 ± 3.45 to 48.81 ± 3.29 ml/kg/min and CG 47.06 ± 3.11 to 47.91 ± 3.43 ml/kg/min. However, there was no significant difference (p=0.276) between groups and pre-post-test VO2 max level. Looking at between groups effect, there was no significant effect (p=0.900) between these three groups and their VO2 max level. In conclusion, there was a significant positive change in the participant's pre-post-test VO2 max level for all three groups across two different periods at the pre-test and post-test. This suggests ingesting drinks between exercises substantially improved football players' cardiovascular endurance performance. However, there was no significant difference in the participants' cardiovascular endurance performance between the three groups. This indicates the type of drink does not influence the cardiovascular endurance performance among these football players.

KONDROMALAZİ PATELLA TANILI OLGULARDA KUADRİSEPS GÜÇLENDİRİCİ İZOMETRİK VE İZOTONİK EGZERSİZLERİN AĞRI, YAŞAM KALİTESİ VE FONKSİYONEL KAPASİTE ÜZERİNE ÜSTÜNLÜKLERİNİN KARŞILAŞTIRILMASI

Purpose: This study aims to investigate the superiority of different exercise modalities, including isotonic and isometric strengthening for quadriceps, over each other and their effect on pain, quality of life and functional capacity in patients diagnosed with chondromalacia patellae (CMP). &#x0D; Methods: This study was designed as a prospective study in 30 patients(15 patients in isometric, 15 patients in isotonic group) and 15 healthy volunteers aged 20–50 years who were diagnosed with CMP based on physical examination and magnetic resonance imaging and had pain complaints. Pain level was evaluated with Visual Analogue Scala (VAS), functional capacity with Lysholm scale, and quality of life with Short Form-36(SF-36). Q-angle, and thigh circumference were evaluated before and after exercise in all patients. &#x0D; Results: In patients with CMP, there were significant differences in Q-angle, pain, functional capacity, and some subcomponents of the SF-36 quality of life after performing isometric or isotonic exercises compared with the control group (p0,05). In the evaluation of the isotonic and isometric exercise groups, there were no significant difference in the assessment of Q-angle, thigh circumference, pain, functional capacity, and quality of life of patients with CMP (p&gt;0,05).&#x0D; Conclusion: Isometric and isotonic quadriceps strengthening exercises are not superior to each other in terms of pain, functional capacity, and quality of life in CMP treatment.

Exercise-Induced Hypoalgesia Following Proprioceptive Neuromuscular Facilitation and Resistance Training Among Individuals With Shoulder Myofascial Pain: Randomized Controlled Trial.

Various exercises can attenuate pain perception in healthy individuals and may interact with the descending pain modulation in the central nervous system. However, the analgesic effects of exercise in patients with myofascial pain can be disrupted by the pathological changes during chronic pain conditions. Thus, the exercises targeted on the facilitation of the sensory-motor interaction may have a positive impact on the restoration of the descending pain modulation and the analgesia effects. This paper estimates the effect of proprioceptive neuromuscular facilitation (PNF) and resistance training on exercise-induced hypoalgesia (EIH) and conditioned pain modulation (CPM) among patients with myofascial pain syndrome. A total of 76 female patients with myofascial pain syndrome (aged 18-30 years), with the pain in the upper trapezius and a visual analog scale score of greater than 30/100 mm, were enrolled in the study. Participants were randomly assigned into 3 intervention groups, including isometric (n=18, 24%), isotonic (n=19, 25%), and PNF (n=20, 26%) exercises, as well as 1 control group (n=19, 25%) with no intervention. Pressure pain threshold and the CPM responses at the myofascial trigger point, arm, and leg sites were assessed before and after the exercise session. The effective EIH response was reflected in the improvement of pressure pain thresholds. There was an increase in pressure pain thresholds and CPM responses at trigger point (P<.001 and P<.001), arm (P<.001 and P<.001), and leg sites (P<.001 and P=.03) in participants who performed PNF and isotonic exercise, while the isometric exercise only increased pressure pain thresholds at leg sites (P=.03). Compared with the control group, both the isotonic (P=.02) and PNF (P<.001) groups showed greater EIH responses at the trigger points. In comparison to the control group, only the PNF exercise (P=.01) significantly improved pressure pain thresholds and CPM responses at arm and leg sites compared to the control group. PNF, isotonic, and isometric exercises could lead to local and global EIH effects. The improvement in CPM response following PNF and isotonic exercises suggested that the EIH mechanisms of different resistance exercises may be attributed to the enhancement of the endogenous pain modulation via the motor-sensory interaction from the additional eccentric and dynamic muscle contraction. Chinese Clinical Trial Registry ChiCtr202111090819166165; https://tinyurl.com/2ab93p7n.

Ratiometric ECL sensor based on Apt-AuNS@Lu nanoprobe for analyzing cell swelling-induced ATP release.

A novel ratiometric electrochemiluminescence (ECL) system based on gold nanostars (AuNSs) support was constructed for the determination of hypotonicity-induced ATP release from HepG2 cells. AuNS@Lu nanoprobe was used as anodic luminophore and K2S2O8 as cathodic luminophore as well as anodic co-reactant. AuNS with the large specific surface was adopted to adsorb plentiful luminol to form solid-state probe and as affinity support to immobilize ATP aptamer (Apt). The obtained nanocomposite (Apt-AuNS@Lu) generated astrong ECL signal at + 0.4V (vs. Ag/AgCl) with co-reactant K2S2O8, because of excellent conductivity and catalytic activity of AuNS. Furthermore, graphene oxide was reduced onto indium tin oxide (ITO) electrodes to facilitate the electron transfer. Following, polydopamine (PDA) film was formed via self-polymerization, improving stability and adhesion of the electrode surface. To immobilize ATP capture aptamer (AptC), abounding AuNSs were attached to RGO/PDA surface. When the sensor was incubated in the mixture solution of Apt-AuNS@Lu and target ATP, the ECL signal of Apt-AuNS@Lu increased with the increase of ATP concentration, meanwhile, the signal of K2S2O8 declined. The ratio of the two luminophores was used for the quantitative determination of ATP. The linear range was 5 to 250nM, and the limit of detection was 1.4nM at (3σ)/S. The method was successfully applied to analyze ATP release from HepG2 cells stimulated by 0.45% NaCl hypotonic solution. The results showed that the release kinetics profile of ATP had a sigmoidal shape with rapid release within 10min and then slowed. Compared to the isotonic groups, the intracellular ATP concentration was 3.7 ± 0.3µM (n = 3) decreasing by 40.3% and the extracellular was 23.4 ± 1.2nM (n = 3) increasing by 9.2 times in the hypotonicity for 10min, which showed ATP release from cells and good agreement with commercial ELISA test. The proposed strategy would be beneficial to broadening application of ECL technology in studying cell biological functions.

Comparison and evaluation of two different crystalloids - Normal saline and plasmalyte in patients of traumatic brain injury undergoing craniotomy.

Fluid therapy is one of the most important components of the management of patients with traumatic brain injury (TBI). The present study was planned to compare plasmalyte and normal saline (NS) in patients who underwent craniotomies for TBI in terms of their effects on acid-base equilibrium, renal functions, and coagulation profile. Fifty patients of age 18-45 years of either sex, who underwent emergency craniotomy for TBI, were included in the study. The patients were randomized into two groups. Group P (n = 25) received isotonic balanced crystalloid (plasmalyte) and Group N (n = 25) received NS intraoperatively and postoperatively till 24 h after surgery. The pH was lower in Group N (P < 0.05) at different time points after surgery. Similarly, more patients in Group N had pH <7.3 (P < 0.05); while the rest of the metabolic parameters were comparable in the two groups. Blood urea and serum creatinine were higher in Group N. Coagulation profile was comparable in the two groups. Acid-base, electrolyte balance, and renal profile were better in patients receiving plasmalyte as compared to NS. Hence, it can be a wiser choice for fluid management in patients of TBI undergoing craniotomy.

Effects of Isometric and Isotonic Training on Health-Related Fitness Components in Young Adults

Isometric and isotonic exercises are important modes of resistance training for enhancement of athletic performance. However, less is known about their effects on fitness and health in recreationally physically active individuals. This study evaluates the effect of isometric and isotonic training protocols on health-related fitness components in young university students. A group of one hundred males (18–24 years) underwent a 12-week isotonic and isometric training program (two days per week, 45 min per session). They were randomized into two groups, group A (n = 50) and group B (n = 50). While group A underwent the isotonic resistance training, the group B completed isometric resistance training. Prior to and after training programs, body mass index (BMI) was measured and the bench press 1RM test, sit-ups test, sit and reach test, and 12 min run/walk test were performed. Results showed significant improvements in BMI, bench press 1RM test, sit-ups test, sit and reach test, and 12 min run/walk test after both isotonic and isometric training protocols. The isotonic training group increased in BMI by 2.70%, bench press 1RM by 34.45%, number of sit-ups by 24.13%, sit and reach distance by 29.12%, and 12 min run/walk distance by 19.82%. Isometric training group increased in BMI by 1.96%, bench press 1RM by 14.23%, number of sit-ups by 7.80%, sit and reach distance by 6.92%, and 12 min run/walk distance by 6.99%. A comparison of these training protocols revealed that the isotonic group improved significantly more than the isometric group in the bench press 1RM (20.22%), number of sit-ups (16.33%), and sit and reach distance (22.2%) but not in the 12 min run/walk distance (12.83%) and BMI (0.74%). These findings indicate that both isotonic and isometric resistance training protocols improve health-related fitness components in young adults; however isotonic training is more efficient than isometric training in increasing their muscle strength, muscular endurance, and flexibility.

Comparison of the Effects of Isokinetic, Isometric, and Isotonic Exercises on Knee Osteoarthritis Using Ultrasound.

Introduction: This study aims to investigate the effects of different types of exercise on pain, functional capacity, muscle strength measured by an isokinetic dynamometer, and femoral cartilage (FC) thickness measured using ultrasound in patients with knee osteoarthritis (KOA).Methods: Sixty patients were randomized to isokinetic, isometric, and isotonic exercise groups, and exercise programs were completed five days a week over three weeks. The FC thickness for each knee was evaluated in medial, intercondylar, and lateral areas using ultrasound, and muscle strength was assessed by an isokinetic dynamometer. Activity levels were also measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). At three weeks from baseline, follow-up clinical measurements of knee muscle strength and FC thickness were performed.Results: A significant decrease was observed in all three groups in post-treatment visual analog scale (VAS) pain scores. In terms of evaluation of WOMAC scores, no significant difference was observed between the groups. In the isokinetic group, a significant increase was detected in extensor and flexor muscle strength measurements at the angular velocities of 60º/s and 180º/s. In the isotonic group, a statistically significant increase was detected in peak torque values of extensor and flexor muscles at 60º/s in the left knee only. Regarding FC thickness, a significant increase was found in the intercondylar area and the lateral condyle measurements of the left knee in the isokinetic group and the intercondylar area measurements of the right knee in the isometric group. In the isokinetic group, a statistically significant decrease was detected in the medial condyle of the right knee. It was observed that isokinetic exercise ended up with a significant increase in FC thickness in the intercondylar area and the lateral condyle of the left knee and a significant decrease in the medial condyle of the right knee.Conclusion: Isokinetic exercise is functionally superior to isometric and isotonic exercise, providing more significant improvements in muscle strength measurements and FC thickness. Further research is needed to determine the interactions among therapeutic exercises in patients with KOA that impact knee cartilage quantities.

Comparison of the Therapeutic Effects Between Isokinetic and Isotonic Strength Training in Patients After Total Knee Replacement: A Prospective, Randomized Controlled Trial.

Background:Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery stage after TKR.Purpose:To compare the therapeutic effects between isokinetic and isotonic strengthening in patients after TKR.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:From April 2018 to August 2020, 37 patients met the inclusion criteria and were randomly assigned to perform either 4-week isokinetic or isotonic strength training programs. Other components of the rehabilitation program were kept the same between the 2 groups. All cases were evaluated by the Timed Up and Go (TUG) test, peak torque of knee extension and flexion (60 and 120 deg/s), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).Results:After undergoing a 4-week strength training regimen, significant improvements in the TUG test were noted in both groups; however, the time improvement in the isotonic group did not reach the minimal detectable change. All peak torque measurements improved in the isokinetic group but not in the isotonic group for knee flexion at 60 deg/s. The pain subdomain, physical domain, mental domain, total SF-36 score, and WOMAC index all improved significantly in both groups after training. Both training groups improved significantly in peak torque of knee strength, TUG test, and functional scores, but the differences between isokinetic and isotonic training were not statistically significant.Conclusion:The study findings showed that a 4-week strengthening exercise program in the early postoperative stage, involving either isokinetic or isotonic training, resulted in significant improvements in patients undergoing TKR.Registration:NCT02938416 (ClinicalTrials.gov identifier).

Comparison of combined isotonic and deep friction soft tissue techniques on pain and function in patients with chronic lateral epicondylitis

To determine the effects of combined isotonic and deep friction soft tissue techniques on pain and function in patient with chronic lateral epicondylitis. Study Design: Quasi Experimental study. Place and Duration of study: Data was collected from Mednic clinic and services hospital Lahore, for 6 months of duration after the approval of synopsis. Method: Quasi Experimental study was conducted on twenty-two patients of chronic lateral epicondylitis. Participants were allocated to either combined isotonic technique group and deep friction soft tissue technique group, both groups were treated for 12 sessions in 4 weeks. NPRS and PRTEE scale were used to measure the treatment effect before and after treatment of 3 session per week, total 12 sessions in 4 weeks to each participant. Data was analyzed by SPSS 21. Results: Total participants 22 were classified into two groups, Group A (combined isotonic technique) and Group B (deep friction soft tissue technique group). Minimum age was 30, maximum age was 46, mean age 37 and standard deviation was ±4.93. The significance was greater than 0.05 which mean the data is normally distributed as the value of Shapiro wilk test for NPRS .88 and for PTREE was .208, therefore parametric test (paired and independent T test) was applied. The significance values for all statistical tests were set to 0.05. Paired sample T test for NPRS mean difference reading for group A was 2.63 ±.9244 and group B was 1.09 ±.3015 and for PRTEE mean difference for group A was 14.09 ±7.8288 and group B was 5.81 ±3.945 showed that although in both group changes were significant but difference of mean was greater in Combined isotonic technique group. Independent T test comparison of mean score of NPRS and PRTEE between Group A and Group B showed that there was significant difference in value, pretreatment NPRS mean difference was .011 and post treatment NPRS score was 1.54. pretreatment PRTEE mean difference was 1.90 and post treatment NPRS score was 6.36 so combined isotonic technique showed greater mean difference after treatment. Conclusion: The study concluded that combined isotonic exercises group showed better results than deep friction soft tissue technique group for improvement of pain and functional disability in lateral epicondylitis patients

Comparison of combined isotonic and deep friction soft tissue techniques on pain and function in patients with chronic lateral epicondylitis

To determine the effects of combined isotonic and deep friction soft tissue techniques on pain and function in patient with chronic lateral epicondylitis. Study Design: Quasi Experimental study. Place and Duration of study: Data was collected from Mednic clinic and services hospital Lahore, for 6 months of duration after the approval of synopsis. Method: Quasi Experimental study was conducted on twenty-two patients of chronic lateral epicondylitis. Participants were allocated to either combined isotonic technique group and deep friction soft tissue technique group, both groups were treated for 12 sessions in 4 weeks. NPRS and PRTEE scale were used to measure the treatment effect before and after treatment of 3 session per week, total 12 sessions in 4 weeks to each participant. Data was analyzed by SPSS 21. Results: Total participants 22 were classified into two groups, Group A (combined isotonic technique) and Group B (deep friction soft tissue technique group). Minimum age was 30, maximum age was 46, mean age 37 and standard deviation was ±4.93. The significance was greater than 0.05 which mean the data is normally distributed as the value of Shapiro wilk test for NPRS .88 and for PTREE was .208, therefore parametric test (paired and independent T test) was applied. The significance values for all statistical tests were set to 0.05. Paired sample T test for NPRS mean difference reading for group A was 2.63 ±.9244 and group B was 1.09 ±.3015 and for PRTEE mean difference for group A was 14.09 ±7.8288 and group B was 5.81 ±3.945 showed that although in both group changes were significant but difference of mean was greater in Combined isotonic technique group. Independent T test comparison of mean score of NPRS and PRTEE between Group A and Group B showed that there was significant difference in value, pretreatment NPRS mean difference was .011 and post treatment NPRS score was 1.54. pretreatment PRTEE mean difference was 1.90 and post treatment NPRS score was 6.36 so combined isotonic technique showed greater mean difference after treatment. Conclusion: The study concluded that combined isotonic exercises group showed better results than deep friction soft tissue technique group for improvement of pain and functional disability in lateral epicondylitis patients

A randomized controlled trial of the effect of postoperative hand exercise training on arteriovenous fistula maturation in patients with chronic kidney disease

Immature arteriovenous fistula (AVF) is a critical problem in patients with chronic kidney disease (CKD) after creation. Exercise with 30% maximum voluntary contraction (MVC) encourages vascular functions in other populations. It is unknown which exercise type is superior on maturation in the CKD population. We compare effects of isometric (ISM) and isotonic (IST) hand exercise training, both at 30% MVC, on AVF maturation and grip strength in patients with CKD. Fifty patients with CKD were randomized into the ISM program or IST program (25 per group). Each group performed exercise program at intensity of 30% MVC every day for 10 weeks. Cephalic vein (CV) and brachial artery diameters, brachial blood flows, and grip strength were measured at weeks 0, 2, 6, and 10 of the program. The number of patients meeting clinical and ultrasound maturation were evaluated at weeks 2, 6, and 10. At weeks 6 and 10 of the programs, the ISM group had greater CV diameters (week 6, 7.1 ± 1.2 vs 6.2 ± 1.0 mm; week 10, 7.1 ± 1.0 vs 6.2 ± 1.1 mm) than the IST group. Compared with the IST group, the ISM group had a higher number of patients meeting ultrasound maturation at weeks 2 (IST/ISM, 8/2), 6 (IST/ISM, 16/8), and 10 (IST/ISM, 21/12), and clinical maturation at week 10 (IST/ISM, 25/18). No adverse events were observed throughout the study. At 30% MVC, ISM is more effective at promoting increases in CV diameter and maturation than IST. Both exercise types are feasible and safe for patients with CKD after AVF creation.

Comparison of different neuromuscular facilitation techniques and conventional physiotherapy in knee osteoarthritis

This study was conducted to compare the effects of conventional physiotherapy and two different ‘proprioceptive neuromuscular facilitation’ (PNF) techniques on knee muscle strength, knee muscular endurance, and proprioception in knee osteoarthritis (KOA). The study included 35 patients between the ages of 47 and 62 who were diagnosed with stage 1-2 KOA. The patients were divided into three groups with block randomization method as Repeated Stretching Group (N = 12) With Repeated Stretching Technique, Combined Isotonic Contraction Group (N = 11) With Combined Isotonic Contractions (CIC) Technique, And Conventional Physiotherapy Group (n = 12). PNF was applied to all patterns of the lower extremity in full pattern and patients in all groups were treated for 6 weeks, 3 days a week. Muscle strength, muscle endurance, and proprioception were evaluated with Biodex System Pro3 (Biodex Corp. Shirley NY, USA). Knee extensor muscle strength showed more improvement at CIC group than the other groups, and CIC group showed more improvement compared to the conventional physiotherapy in terms of knee joint position sensation evaluated at 60° (p < 0.05). All methods were effective in patients with early-stage knee osteoarthritis; however, the most effective results were obtained by PNF using CIC technique.