Knee Muscle Strength Research Articles

Relationship between muscular strength, gait and postural parameters in multiple sclerosis

Objective To evaluate muscle strength, balance control and gait capacity in patients with multiple sclerosis (MS) and to study the correlations between these parameters. Patients and methods Twenty MS patients were evaluated in terms of knee muscle strength, gait and balance parameters. These evaluations were performed using an isokinetic dynamometer (the Cybex II ®), a Bessou gait analyzer and a Satel ® force platform, respectively. The patients’ results were compared with those of a healthy control group. Results Hamstring and quadriceps peak torque values were lower in the MS group than in the control group. The sway area was greater in the MS group under eyes-open and eyes-closed conditions. The MS patients displayed lower gait speed, cadence and stride length. Hamstring and quadriceps strength values were significantly correlated with posture and gait parameters. Conclusion The present study revealed the value of an overall evaluation of knee muscle strength, gait and posture in MS patients.

Isokinetic trunk and knee muscle strengths and gait performance in walking patients with T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP).

The aim of this study was to investigate the isokinetic trunk and knee muscle strengths, and examine the clinical relevance of dynamic muscle strengths and gait performance in walking patients with human T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP). Thirteen patients with HAM/TSP (8 females and 5 males, aged 38-76) and 13 sex- and age-matched healthy control subjects participated in the study. We assessed gait speed, stride length, cadence; and maximal isokinetic torque of trunk and knee extensors and flexors at 30°/s, 60°/s and 90°/s using a Biodex System 3 dynamometer. Furthermore, we calculated the isokinetic trunk extensor/flexor (E/F) and hamstrings/quadriceps (H/Q) strength ratios (parameter of the muscle strength balance about the trunk and knee joint). Compared with the age-matched controls, the patients with HAM/TSP had significantly reduced gait speed, stride length and cadence (P < 0.05). Peak torque values related to body weight (PTBW) were significantly reduced, especially for the knee flexors (P < 0.05). For the knee extensors, the PTBW values were significantly reduced at an increased angular velocity (P < 0.05). The PTBW of knee flexors was positively correlated with gait speed and cadence in the patients with HAM/TSP. The H/Q ratio but not E/F ratio was significantly decreased compared with the control. Our results indicated that the isokinetic trunk and knee muscle performance had reduced from the ambulatory stage, and suggested the deterioration in knee muscle performance to be associated with gait disturbance in walking HAM/TSP patients.

Relation Between Cycling Exercise Capacity, Fiber-Type Composition, and Lower Extremity Muscle Strength and Muscle Endurance

The aim of the study was to determine the relation between peak oxygen uptake V(O2)peak), peak work rate (WRpeak), fiber-type composition, and lower extremity strength and endurance during a maximal incremental cycle test. Thirty-nine healthy sedentary men, aged 30-46, participated in the study. Subjects performed a maximal incremental cycle test and isokinetic knee extension (KE) and flexion (KF) strength and endurance tests at velocities of 60 and 180° · s(-1). Muscle biopsies were taken from m. vastus lateralis and analyzed for fiber-type composition. A significant correlation existed between KE strength and V(O2)peak and WRpeak. Also, KF endurance correlated significantly to V(O2)peak and WRpeak. The KE endurance correlated significantly to WRpeak (rp = 0.32, p < 0.05) and almost significantly to V(O2)peak (rp = 0.28, p = 0.06). Stepwise multiple regression analyses showed that KE strength, KF endurance, and the percentage of type I fibers could explain up to 40% of the variation in V(O2) and WRpeak. The performance of sedentary subjects in a maximal incremental cycle test is highly affected by knee muscle strength and endurance. Fiber-type composition also contributes but to a smaller extent.

트레드밀 경사도에 따른 발목 중량부하 걷기 후 신체 기능에 미치는 영향

Purpose : The purpose of this study was to investigate knee muscle strength, balance, and proprioception by walking while giving weight to the ankle joint at a load of 0%, 10%, and 15% gradient on a treadmill. Methods : Twenty-four subjects were divided into three groups. Group A walked on a 0% gradient while giving weight to the ankle joint as a load. Group B walked on a 10% gradient while giving weight to the ankle joint as a load. Group C walked on a 15% gradient while giving weight to the ankle joint as a load. This was performed three times per week for four weeks. The walking speed was set at 4km/hour and the walking time was set at 20 minutes. Measurements were performed before and after the experiment. Biodex medical system and Balance system SD were used as measuring instruments. Results : There was no significant difference between the gradients in muscle strength, balance and proprioception. However, there were differences in pretest and posttest measurements for muscle strength, balance and proprioception in each gradient. In particular, the gradient of 10% showed a significant difference. Conclusion : According to the results of this study, to use a 10% gradient is effective when walking while giving weight to the ankle joint as a load.

Association between isometric muscle strength and gait joint kinetics in adolescents and young adults with cerebral palsy

The purpose of this study was to determine the association between isometric muscle strength of the lower limbs and gait joint kinetics in adolescents and young adults with cerebral palsy (CP). Twenty-five participants (11 males) with bilateral spastic CP, aged 14–22 years (mean: 18.9, sd: 2.0 yr) and Gross Motor Function Classification System (GMFCS) level II ( n = 19) and III ( n = 6) were tested. Hand held dynamometry was used to measure isometric strength (expressed in N m/kg) of the hip, knee, and ankle muscles using standardized testing positions and procedures. 3D gait analysis was performed with a VICON system to calculate joint kinetics in the hip, knee and ankle during gait. Ankle peak moments exceeded by far the levels of isometric strength of the plantar flexors, while the knee and hip peak moments were just at or below maximal isometric strength of knee and hip muscles. Isometric muscle strength showed weak to moderate correlations with peak ankle and hip extension moment and power during walking. Despite considerable muscle weakness, joint moment curves were similar to norm values. Results suggest that passive stretch of the muscle–tendon complex of the triceps surae contributes to the ankle moment during walking and that muscle strength assessment may provide additional information to gait kinetics.

Experimental Knee Pain Reduces Muscle Strength

Pain is the principal symptom in knee pathologies and reduced muscle strength is a common observation among knee patients. However, the relationship between knee joint pain and muscle strength remains to be clarified. This study aimed at investigating the changes in knee muscle strength following experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0, 60, 120, and 180 degrees/second, before, during, and after experimental pain induced by injections of hypertonic saline into the infrapatellar fat pad. On a separate day, isotonic saline injections were used as control condition. The pain intensity was assessed on a 0- to 100-mm visual analogue scale. Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P < .001) in both knee extension and flexion at all angular velocities. The reduction in muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension and flexion muscle strength indicating a generalized muscle inhibition augmented by higher pain intensities. This study showed that knee joint pain has a significant impact on muscle function. The findings provide evidence of a direct inhibition of muscle function by joint pain, implying that rehabilitative strengthening exercises may be antagonized by joint pain.

Concurrent Measurement of Isokinetic Muscle Strength of the Trunk, Knees, and Ankles in Patients With Lumbar Disc Herniation With Sciatica

A cross-sectional study comparing normal subjects and patients with lumbar disc herniation (LDH) with sciatica. To simultaneously measure the isokinetic muscle strength of the trunk, knees, and ankles in both groups. Coordination between the trunk and lower extremity muscles is important for normal physical activity. Reduced trunk and knee muscle strength have been reported in patients with lower level LDH; however, ankle performance in these patients is still unknown. We recruited 43 normal subjects as controls and 33 patients with lower level LDH with sciatica. The isokinetic strength of the trunk, knees, and ankles was measured at 2 velocities in random order: 60°/s and 120°/s, and 60°/s and 180°/s for trunk and ankle strength and for knee strength, respectively. The isokinetic trunk strength was significantly lower in the LDH group irrespective of test modes or velocity. Despite unilateral sciatica or test modes and velocity, the unilateral knee strength was significantly lower in the LDH group than that in the control group. Knee extension torque was also found to be significantly lower in the limbs with sciatica than in those without sciatica at the testing velocity of 180°/s (80.25 ± 24.88 vs. 95.42 ± 26.29 Nm, P < 0.05). Irrespective of unilateral sciatica or test velocity, ankle plantar flexion torque revealed to be significantly lower in the LDH group than the control group; however, dorsiflexion torque was not different. Significant correlations were demonstrated among the total muscle strength of the trunk, knees, and ankles in both groups. Besides the lower trunk strength, concurrent lower unilateral knee and ankle plantar flexion but not dorsiflexion strength was demonstrated in the LDH subjects with unilateral sciatica, regardless of its location. As compared to the limbs without sciatica, an additional 14% reduction of knee extension torque at 180°/s was found in the limbs with sciatica in the LDH patients.

Comprehensive fine mapping of chr12q12-14 and follow-up replication identify activin receptor 1B (ACVR1B) as a muscle strength gene

Muscle strength is important in functional activities of daily living and the prevention of common pathologies. We describe the two-staged fine mapping of a previously identified linkage peak for knee strength on chr12q12-14. First, 209 tagSNPs in/around 74 prioritized genes were genotyped in 500 Caucasian brothers from the Leuven Genes for Muscular Strength study (LGfMS). Combined linkage and family-based association analyses identified activin receptor 1B (ACVR1B) and inhibin β C (INHBC), part of the transforming growth factor β pathway regulating myostatin - a negative regulator of muscle mass - signaling, for follow-up. Second, 33 SNPs, selected in these genes based on their likelihood to functionally affect gene expression/function, were genotyped in an extended sample of 536 LGfMS siblings. Strong associations between ACVR1B genotypes and knee muscle strength (P-values up to 0.00002) were present. Of particular interest was the association with rs2854464, located in a putative miR-24-binding site, as miR-24 was implicated in the inhibition of skeletal muscle differentiation. Rs2854464 AA individuals were ∼2% stronger than G-allele carriers. The strength increasing effect of the A-allele was also observed in an independent replication sample (n=266) selected from the Baltimore Longitudinal Study of Aging and a Flemish Policy Research Centre Sport, Physical Activity and Health study. However, no genotype-related difference in ACVR1B mRNA expression in quadriceps muscle was observed. In conclusion, we applied a two-stage fine mapping approach, and are the first to identify and partially replicate genetic variants in the ACVR1B gene that account for genetic variation in human muscle strength.

Multivariate Analyses of Anterior Laxity of the Knee and Quadriceps Muscle Strength after Anterior Cruciate Ligament Reconstruction

Multivariate Analyses of Anterior Laxity of the Knee and Quadriceps Muscle Strength after Anterior Cruciate Ligament Reconstruction

Downhill Walking Training in Individuals with Parkinson's Disease

The purpose of this study was to examine the effects of downhill walking training on gait and thoracic kyphosis in patients with Parkinson's disease. Thirty-three patients with Parkinson's disease were randomized into an experimental group (n = 16) or a control group (n = 17). Subjects in the experimental group underwent 4-wks of downhill walking training, whereas subjects in the control group received conventional therapy for 4 wks. Gait parameters, thoracic kyphosis, and muscle strength of knee were measured at pretraining, posttraining, and at 1-mo follow-up. There were significant interaction effects between group and time of evaluation on gait parameters and thoracic kyphotic curve. There was also a significant group effect for muscle strength of knee extensors. Our results suggest that downhill walking training is beneficial for improving gait performance in patients with Parkinson's disease and may contribute to maintenance of thoracic posture in these subjects.

No Effects of Whole-Body Vibration Training on Muscle Strength and Gait Performance in Persons With Late Effects of Polio: A Pilot Study

Brogårdh C, Flansbjer U-B, Lexell J. No effects of whole-body vibration training on muscle strength and gait performance in people with late effects of polio: a pilot study. Objective To evaluate the feasibility and possible effects of whole-body vibration (WBV) training on muscle strength and gait performance in people with late effects of polio. Design A case-controlled pilot study with assessments before and after training. Setting A university hospital rehabilitation department. Participants People (N=5; 3 men, 2 women; mean age, 64±6.7y; range, 55−71y) with clinically and electrophysiologically verified late effects of polio. Interventions All participants underwent 10 sessions of supervised WBV training (standing with knees flexed 40°−55° up to 60 seconds per repetition and 10 repetitions per session twice weekly for 5 weeks). Main Outcome Measures Isokinetic and isometric knee muscle strength (dynamometer), and gait performance (Timed Up & Go, Comfortable Gait Speed, Fast Gait Speed, and six-minute walk tests). Results All participants completed the 5 weeks of WBV training, with no discernible discomfort. No significant changes in knee muscle strength or gait performance were found after the WBV training period. Conclusions This pilot study did not show any significant improvements in knee muscle strength and gait performance following a standard protocol of WBV training. Thus, the results do not lend support to WBV training for people with late effects of polio.

Addition of an Anabolic Steroid to Strength Training Promotes Muscle Strength in the Nonparetic Lower Limb of Poststroke Hemiplegia Patients

ABSTRACTIn this prospective observer-blinded open-label nonrandomized controlled trial, 25 inpatients with hemiplegia 1–8 months after stroke were assigned to an anabolic androgenic steroid (AAS; n = 14) or a control (n = 11) group: The former received 100 mg metenolone enanthate by intramuscular injection once a week for 6 weeks along with rehabilitation therapy including muscle strength training of the nonparetic lower limb, which consisted of 100 repetitions of isokinetic reciprocal knee extension/flexion (60°/s) on a dynamometer once a day for 5 days a week over 6 weeks, and the latter received rehabilitation therapy alone. The maximal peak torque of the nonparetic lower limb, including the isokinetic (60°/s, 120°/s, and 180°/s), isotonic, and isometric muscle strength of knee extension/flexion, measured every 2 weeks, was compared with the baseline values. Significant increases in peak torque were seen at 2 weeks in 9 of the 10 conditions and at 6 weeks in 8 of the 10 conditions tested for the AAS group but in only 1 and 5 conditions for the control group, respectively. While no contraindications for AAS were encountered, the combination of AAS and muscle strength training tended to have a positive effect on muscle strength after stroke.

Posture and gait abilities in patients with myotonic dystrophy (Steinert disease). Evaluation on the short-term of a rehabilitation program

ObjectivesTo evaluate the effects of a rehabilitation program in terms of balance, gait and muscle strength in a population of patients with myotonic dystrophy. PatientsTwenty patients benefited, as outpatients in a hospital setting, from a rehabilitation program with clinical and instrumental evaluations. The evaluation focused on quantitative balance measurement by clinical and stabilometer tests, gait assessed by Locometre® and extensors and flexors knee muscle strength measured in isokinetic concentric mode at 60°/s. ResultsAfter the rehabilitation program, we observed a significant improvement in the patients’ balance capacities measured with the Berg Balance Scale (BBS), fast gait speed and muscle strength. However, the instrumental evaluation did not report any gains for static balance and spontaneous gait speed after the training program. No correlation was found between the various improvements. ConclusionA rehabilitation program focused on strength, gait and balance allowed for significant improvements in some parameters of myotonic dystrophy. These results attest to the relevance of a short-term rehabilitation protocol for these patients in the framework of a multidisciplinary therapeutic care. The disparity observed in the results measured for these patients suggest the contribution of cognitive involvement in the limitations felt by patients with myotonic dystrophy in the areas of gait and balance.

스위스 볼운동이 슬관절 내측 측부인대와 전방십자인대 동반 손상 환자의 자세균형 및 슬관절 기능점수에 미치는 영향

The purpose of this study was to investigate the effects of swiss ball exercise program on postural control and Lymsholm score after ACL reconstruction with MCL injury. Nineteen subjects was composed to necessary patients proprioception promotion and muscle strength of knee join. Among them, ten patients(experiment group) were managed by swiss ball exercise another nine patients(control group) were treated by modality method for 5 times a week, total 8 weeks. Measurement instruments evaluated was functional reach test(FRT), one leg standing(OLS), tandem walk(TW), Lymsholm score. As the results are as follows; First, Compared pre-test with post-test in both group by postural control, Experiment group and control group was significants differences in both groups(p＜.001). However experiment group was significants differences more than control group. Secondly, Compared pre-test with post-test between both group by postural control, Both groups was not significants differences in pre-test(p>.05). However OLS, TW was significants differences(p＜.001), FRT was not significants differences in post-test(p>.05). Third, Compared pre-test with post-test in both group by Lymsholm score, Experiment group and control group were significants differences in both groups(p＜.001). However experiment group was significants differences more than control group. Fourth, Compared pre-test with post-test between both group by Lymsholm score, Both groups was not significants differences in pre-test(p>.05). However there were significants differences in post-test(p＜.001). In conclusion, experiment group were improved in postural control and Lymsholm score more than control group. These results suggested that swiss ball exercise shall be used to clinical method for postural control and function recovery of injured knee joint.

Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA

Background Patients with hip osteoarthritis (OA) have muscular weakness, impaired balance, and limp. Deficits in the different limb muscles and their recovery courses are largely unknown, however. We hypothesized that there is persisting muscular weakness in lower limb muscles and an impaired balance and gait 2 years after THA.Patients and methods 20 elderly patients with unilateral OA were assessed before, and 6 and 24 months after surgery for maximal voluntary isometric strength of hip and knee muscles and by gait analysis, postural stability, and clinical scores (HHS, SF-36, EuroQoL).Results Hip muscles showed a remaining 6% weakness compared to the contralateral healthy limb 2 years after THA. Preoperatively and 6 months postoperatively, that deficit was 18% and 12%, respectively. Knee extensors fully recovered a preoperative 27% deficit after 2 years. Gait analysis demonstrated a shorter single stance phase for the OA limb compared to healthy limb preoperatively, that had already recovered at the 6-month follow-up. Balance of two-foot standing showed improvement in both sagittal and lateral sway after operation. All clinical scores improved.Interpretation Muscle strength data demonstrated a slow but full recovery of muscles acting about the knee, but there was still a deficit in hip muscle strength 2 years after THA. Gait and balance recovered after the operation. To accelerate improvement in muscular strength after THA, postoperative training should probably be more intense and target hip abductors.

A study of isokinetic trunk and knee muscle strength in patients with chronic sciatica

Objective To evaluate trunk and knee muscle strength in patients with chronic sciatica. Patients and method Twenty-eight patients with right-side chronic sciatica (group 1, G1) and 40 healthy controls (group 2, G2) were evaluated using an isokinetic dynamometer (Cybex Norm II). Quadriceps and hamstring muscle strength were evaluated at concentric velocities of 60 and 120°/s and the trunk muscles were evaluated at concentric velocities of 60 and 90°/s. Results G1 comprised 15 women and 13 men (mean ± SD age: 34.787 ± 6.06; weight: 65.85 ± 5.33 kg; height: 165 ± 6.92 cm). G2 comprised 20 women and 20 men (mean ± SD age: 35.92 ± 6.66; weight: 67.07 ± 6.12 kg; height: 165.82 ± 7.65 cm. There were no significant inter-group differences concerning these parameters. In G1, the peak torque values for the trunk extensors were 123.71 ± 32.45 and 108.85 ± 32.07 Newton metres (Nm) at angular velocities of 60 and 90°/s, respectively. In G2, the values were 192.73 ± 64.24 and 168.65 ± 53.96 Nm, respectively. In G1, the peak torque values for the trunk flexors were 134.32 ± 30.77 and 124.39 ± 32.59 Nm at angular velocities of 60 and 90°/s, respectively. In G2, they were 177.44 ± 44.1 and 157.81 ± 39.01 Nm, respectively. The difference between G1 and G2 was statistically significant. The peak torque for the right quadriceps in G1 was 100.03 ± 24.45 and 78.71 ± 22.92 Nm at angular velocities of 60 and 120°/s, respectively. In G2, these values were 160.5 ± 36.34 and 131.05 ± 33.42 Nm. The peak torque for the hamstrings in G1 was 56.42 ± 13.02 and 50 ± 13.55 Nm at angular velocities of 60 and 120°/s, respectively. In G2, these values were 97.77 ± 33.32 and 84.72 ± 31.41 Nm. Again the difference between G1 and G2 was statistically significant. We also noted a statistically significant difference between G1 and G2 in terms of the peak quadriceps and hamstring torque values on the left side. In G1, the quadriceps and hamstrings were significantly weaker on the sciatica side than on the unaffected side. Conclusion The present study demonstrated trunk and knee muscle weakness in patients with chronic sciatica, when compared with healthy subjects. This weakness was predominant on the sciatica side. Consequently, the management of these patients should include a knee muscle reinforcement programme.

A Randomized Study of the Effects ofT'ai Chion Muscle Strength, Bone Mineral Density, and Fear of Falling in Women with Osteoarthritis

Individuals with osteoarthritis can experience difficulty walking and poor strength, possibly leading to falls and fractures. Exercise has been found to increase strength and bone mineral density. The purpose of this study was to determine the effects of 6 months of t'ai chi on knee muscle strength, bone mineral density, and fear of falling in older women with osteoarthritis. Eighty-two (82) women with osteoarthritis, recruited from outpatient clinics and community health centers, were randomly assigned to either a t'ai chi group and took part in a t'ai chi program, or a control group. Of these, 30 subjects (mean age = 63 years) in the t'ai chi group and 35 (mean age = 61 years) in the control group completed post-test measures at 6 months. After the 6-month study period, subjects in the t'ai chi program had significantly greater knee extensor endurance (pre- to post-test mean increase = 36.4 W/kg, versus 1.1 W/kg for the controls), and significantly greater bone mineral density in the neck of the proximal femur (mean change = 0.09, versus -0.10 for the controls), Ward's triangle (mean change = 0.04, versus -0.04 for the controls), and trochanter (mean change = 0.07, versus -0.05 for the controls) than the controls. However, knee extensor and flexor strength did not differ significantly between the groups. The fear of falling during daily activities reduced significantly more in the t'ai chi group (mean change = -2.40, versus 0.66 for the controls). T'ai chi increased knee extensor muscle endurance and bone mineral density in older women with osteoarthritis, and decreased their fear of falling during daily activities. Further study with long-term follow-up is needed to substantiate the role of t'ai chi exercise in the prevention of fall and its related fracture.

Assessment of Hip and Knee Muscle Function in Orthopaedic Practice and Research

Isometric evaluation of hip and knee muscle strength can be a useful objective assessment tool in the clinic and may be preferred over other forms of dynamic muscle testing, such as isokinetic assessment or variable-resistance weight-lifting. Assessment of isometric strength with use of a handheld dynamometer requires little skill and is easily administered, relatively inexpensive, valid, reliable, and functional; thus, it could be easily integrated into routine clinical examinations. Surface electrical stimulation, electromyography, and ultrasonography can be used in conjunction with isometric muscle testing for the identification of neuromuscular factors influencing muscle force generation. Further research is warranted to investigate the neural and/or muscular impairments associated with hip and knee muscle weakness in orthopaedic populations, with the ultimate goal of improving rehabilitation strategies.

Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: A double-blind randomized exploratory trial

BackgroundPrinciples of brain plasticity is used in the treatment of patients with functional limitations to improve sensorimotor function. Training is included in the treatment of knee injury to improve both patient-reported function and sensorimotor function. However, impairment in sensorimotor function often persists despite training. Therefore, it was suggested that training programs need to be more effective to improve sensorimotor function after knee injury. The aim of the current study was to investigate if principles of brain plasticity that have been successfully used on the hand and foot to improve sensorimotor function can be applied on the knee. We hypothesized that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg.MethodsIn this first double-blind exploratory study, 28 uninjured subjects (mean age 26 years, range 19–34, 50% women) were randomized to temporary local cutaneous application of anesthetic (EMLA®) (n = 14) or placebo cream (n = 14). Fifty grams of EMLA, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia) and motor function (knee muscle strength, hop test) were assessed before and after 90 minutes of treatment with EMLA or placebo. The paired t-test was used for comparisons within groups and the independent t-test for comparisons between groups. The number of subjects needed was determined by an a priori sample size calculation.ResultsNo statistically significant or clinically relevant differences were seen over time (before vs. after) in the measures of sensory or motor functions in the EMLA group or in the placebo group. There were no differences between the groups due to treatment effect (EMLA vs. placebo).ConclusionWe found no effect of temporary cutaneous anesthesia on sensorimotor function of the ipsilateral knee and leg in uninjured subjects. The principles used in this study remain to be tested in subjects with knee injury.

The effect of an intensive exercise programme on leg function in chronic stroke patients: a pilot study with one-year follow-up

Objective: To investigate the effect of two weeks of intensive exercise on leg function in chronic stroke patients and to evaluate the feasibility of an intensive exercise programme in a group setting. Design: Pilot study with one-group pre-test post-test design with two pre-tests and one-year follow-up. Setting: Inpatient rehabilitation hospital. Subjects: Twelve hemiparetic patients completed the intervention. Ten patients participated at one-year follow-up. Intervention: Six hours of daily intensive exercise for two weeks with focus on weight-shifting towards the affected side and increased use of the affected extremity during functional activities. An insole with nubs in the shoe of the non-paretic limb was used to reinforce weight-shift toward the affected side. Main measures: Timed Up and Go, Four Square Step Test, gait velocity, gait symmetry and muscle strength in knee and ankle muscles. Results: Maximal gait velocity (P = 0.002) and performance time (seconds) on Timed Up and Go (mean, SD; 12.2, 3.8 vs. 9.4, 3.2) and Four Square Step Test improved from pre- to post-test (P = 0.005). Improvements remained significant at follow-up. Preferred gait velocity and gait symmetry remained unchanged. Knee extensor (P<50.009) and flexor (P<50.001) strength increased bilaterally from pre- to post-test but only knee flexor strength remained significant at follow-up. Ankle dorsi flexor (P = 0.02) and plantar flexor (P<0.001) strength increased on paretic side only (not tested at follow-up). Conclusion: Intensive exercise for lower extremity is feasible in a group setting and was effective in improving ambulatory function, maximal gait velocity and muscle strength in chronic stroke patients. Most improvements persisted at the one-year follow-up.