Muscle Power In Patients Research Articles

Gender-Specific Differences in Spinal Alignment and Muscle Power in Patients with Parkinson's Disease.

Parkinson's disease (PD) is an advancing neurodegenerative disorder characterized by spinal anomalies and muscular weakness, which may restrict daily functional capacities. A gender-focused examination of these effects could provide valuable insights into customized rehabilitation strategies for both sexes. This study investigates the influence of spinal alignment on lower-limb function during the sit-to-stand (STS) movement in patients with Parkinson's disease compared to healthy individuals. A cross-sectional study was conducted with 43 consecutive patients with PD (25 males and 18 females; average age 73.7 ± 7.1 years) and 42 healthy controls (22 males and 20 females; average age 69.8 ± 6.0 years). Assessments included the International Physical Activity Questionnaire (IPAQ), Hoehn and Yahr staging, and measurements of vertical deviations from several spinal landmarks. Lower-limb muscle power during the STS task was evaluated using the Muscle Quality Index (MQI). Both absolute (Watts) and relative (Watts/Kg) muscle power in the lower limbs were notably decreased in the PD group compared to the control group. Within the PD cohort, muscle power showed a negative relationship with age and a positive association with the degree of lumbar lordosis (PL-L3). Importantly, gender-specific analysis revealed that male patients with PD had significantly higher lower-limb muscle power compared to female patients with PD, highlighting the need for gender-tailored therapeutic approaches. The findings suggest that preserving lumbar lordosis is crucial for maintaining effective lower-limb muscle biomechanics in individuals with Parkinson's disease.

Muscle Power in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis.

This study aimed to review the impact of training on muscle power in patients with chronic obstructive pulmonary disease (COPD). Randomized controlled trials evaluating the effects of exercise-based interventions on limbs muscle power and rate of force development in COPD patients were investigated. Five international databases were searched until October 2022. Meta-analyses were performed calculating the mean difference or standardized mean difference. Risk of bias in studies was assessed using Cochrane Risk of Bias tool 2.0. A total of nine studies were included in the analysis. There were concerns about risk of bias in seven out of nine studies. Comparison of exercising and non-exercising groups showed a significant effect of exercise in improving muscle power (P=0.0004) and rate of force development (P<0.001), in five and three trials, respectively. Four studies comparing different trainings showed no significant results on muscle power (P=0.45). Eight to 16 weeks of exercise-based intervention versus no intervention might be beneficial to enhance upper and lower limbs muscle power and rate of force development in people with COPD. In contrast, muscle power did not improve when different training modalities were compared. Future studies performing power training in COPD patients are encouraged.

The Effect of Shortwave Diathermy Treatment on Muscle Power in Patients with Chronic Low Back Pain

Objective: The goal of this study was to investigate the effects of shortwave diathermy therapy combined with exercise on lumbar muscle strength. Patients and methods: Our study was an interventional study involving 90 patients with chronic low back pain who were admitted to our clinic between 2007-2008. Patients were randomized into 3 groups (each group had 30 patients). The same exercise programs were given to all groups. Patients in the first group were applied placebo shortwave diathermy treatment, the second group was applied continuous shortwave diathermy and the third group received pulsed shortwave diathermy. Isokinetic muscle strength measurements of the patients were performed before and three months after the treatment. Results: In our study, the only significant difference observed between the groups was in isometric flexion strength and interestingly the first group had higher improvement compared to the other groups. In regard to within group comparisons, Group 1 was found to have significant improvements in strengths for:isometric flexion, isokinetic flexion (60°/sec and 120°/sec), isokinetic extension (60°/sec and 120°/sec). Group 2 had significant improvements in isokinetic flexion and extension (60°/sec) and also isokinetic extension (120°/sec). In Group 3, none of the improvements were found to be significant. Conclusion: Our findings indicate that there are no significant differences between exercise therapy alone and exercise therapy in combination with diathermy (either continuous or pulsed) in terms of their effects on lumbar muscle strength, even though marginal differences in some of the measurements were observed.

Size-adjusted muscle power and muscle metabolism in patients with cystic fibrosis are equal to healthy controls \u2013 a case control study

BackgroundSkeletal muscle function dysfunction has been reported in patients with cystic fibrosis (CF). Studies so far showed inconclusive data whether reduced exercise capacity is related to intrinsic muscle dysfunction in CF.MethodsTwenty patients with CF and 23 age-matched controls completed an incremental cardiopulmonary cycling test. Further, a Wingate anaerobic test to assess muscle power was performed. In addition, all participants completed an incremental knee-extension test with 31P magnetic resonance spectroscopy to assess muscle metabolism (inorganic phosphate (Pi) and phosphocreatinine (PCr) as well as intracellular pH). In the MRI, muscle cross-sectional area of the M. quadriceps (qCSA) was also measured. A subgroup of 15 participants (5 CF, 10 control) additionally completed a continuous high-intensity, high-frequency knee-extension exercise task during 31P magnetic resonance spectroscopy to assess muscle metabolism.ResultsPatients with CF showed a reduced exercise capacity in the incremental cardiopulmonary cycling test (VO2peak: CF 77.8 ± 16.2%predicted (36.5 ± 7.4 ml/qCSA/min), control 100.6 ± 18.8%predicted (49.1 ± 11.4 ml/qCSA/min); p < 0.001), and deficits in anaerobic capacity reflected by the Wingate test (peak power: CF 537 ± 180 W, control 727 ± 186 W; mean power: CF 378 ± 127 W, control 486 ± 126 W; power drop CF 12 ± 5 W, control 8 ± 4 W. all: p < 0.001). In the knee-extension task, patients with CF achieved a significantly lower workload (p < 0.05). However, in a linear model analysing maximal work load of the incremental knee-extension task and results of the Wingate test, respectively, only muscle size and height, but not disease status (CF or not) contributed to explaining variance. In line with this finding, no differences were found in muscle metabolism reflected by intracellular pH and the ratio of Pi/PCr at submaximal stages and peak exercise measured through MRI spectroscopy.ConclusionsThe lower absolute muscle power in patients with CF compared to controls is exclusively explained by the reduced muscle size in this study. No evidence was found for an intrinsic skeletal muscle dysfunction due to primary alterations of muscle metabolism.

The Inorganic NItrate For eXercise In Heart Failure (INIX-HF) Trial: Rationale, Design, And Preliminary Data

Peak oxygen uptake (VO2peak) and muscle contractile function are both impaired in patients with heart failure with reduced ejection fraction (HFrEF), with these deficits significantly contributing to the diminished quality of life and possibly even early mortality of such individuals. In previous pilot studies, however, we have reported that these deleterious changes can be ameliorated by acute ingestion of nitrate (NO3-), which in vivo can be converted to nitric oxide (NO) via the enterosalivary NO3- → nitrite (NO2-) → NO pathway. PURPOSE Based on these studies, the INIX-HF trial is a proposed multi-center (i.e., 8 site), randomized control trial of the effects of acute (i.e., single dose) and chronic (i.e., 2 wk) dietary NO3- supplementation (in the form of KNO3) on VO2peak and muscle contractility in patients with HFrEF. We are presently performing the work that is necessary and sufficient to set up this trial, including determining the optimal dose of KNO3 to utilize. METHODS Using a double-blind, crossover design, six patients with HFrEF (5 men, 1 woman; age = 49±4 y; EF = 32±3%) were studied 2-3 h after acute ingestion of either 10 or 20 mmol KNO3. On each occasion, VO2peak was measured during an incremental treadmill exercise test (modified Naughton protocol) and muscle function was determined using isokinetic dynamometry. RESULTS The increase in plasma NO3- was greater following ingestion of 20 vs. 10 mmol KNO3 (Δ = 430±51 vs. 218±19 μmol/L; P=0.002). However, plasma NO2- increased to a similar degree in both trials (Δ = 0.219±0.078 vs. 0.169±0.044 μmol/L; P=0.67). Presumably as a result, VO2peak did not differ between treatments (i.e., 18.0±1.5 vs. 17.7±1.3 mL.min-1.kg-1; P=0.74). There was also no difference in maximal knee extensor power (4.52±0.56 vs. 4.25±0.59 W/kg; P=0.69) across trials. 27% of subjects experienced moderate-to-severe nausea and/or vomited after ingesting the higher dose KNO3, vs. only 9% after the lower dose. CONCLUSION There was no difference in the efficacy of 10 vs. 20 mmol KNO3 in influencing VO2peak or muscle power in patients with HFrEF. The higher dose, however, was associated with a greater frequency of gastrointestinal distress. Based on these preliminary data, it appears that 10 mmol KNO3 is the preferred dose for a larger, multicenter trial. Supported by award R34HL138253 from the NHLBI

Acute Dietary Nitrate Intake Improves Muscle Contractile Function in Patients With Heart Failure: A Double-Blind, Placebo-Controlled, Randomized Trial.

Skeletal muscle strength, velocity, and power are markedly reduced in patients with heart failure, which contributes to their impaired exercise capacity and lower quality of life. This muscle dysfunction may be partially because of decreased nitric oxide (NO) bioavailability. We therefore sought to determine whether ingestion of inorganic nitrate (NO3 (-)) would increase NO production and improve muscle function in patients with heart failure because of systolic dysfunction. Using a double-blind, placebo-controlled, randomized crossover design, we determined the effects of dietary NO3 (-) in 9 patients with heart failure. After fasting overnight, subjects drank beetroot juice containing or devoid of 11.2 mmol of NO3 (-). Two hours later, muscle function was assessed using isokinetic dynamometry. Dietary NO3 (-) increased (P<0.05-0.001) breath NO by 35% to 50%. This was accompanied by 9% (P=0.07) and 11% (P<0.05) increases in peak knee extensor power at the 2 highest movement velocities tested (ie, 4.71 and 6.28 rad/s). Maximal power (calculated by fitting peak power data with a parabola) was therefore greater (ie, 4.74±0.41 versus 4.20±0.33 W/kg; P<0.05) after dietary NO3 (-) intake. Calculated maximal velocity of knee extension was also higher after NO3 (-) ingestion (ie, 12.48±0.95 versus 11.11±0.53 rad/s; P<0.05). Blood pressure was unchanged, and no adverse clinical events occurred. In this pilot study, acute dietary NO3 (-) intake was well tolerated and enhanced NO bioavailability and muscle power in patients with systolic heart failure. Larger-scale studies should be conducted to determine whether the latter translates into an improved quality of life in this population. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01682356.

Agreement and Reliability of Functional Performance and Muscle Power in Patients with Advanced Osteoarthritis of the Hip or Knee

The purpose of this study was to test the reproducibility and clinical feasibility of three functional performance measures and five single-joint or multijoint muscle power measures. Twenty patients with a mean age of 68.7 ± 7.2 yrs with severe hip or knee osteoarthritis were assessed for test-retest reliability and agreement on two occasions 1 wk apart. The outcomes were maximal single-joint muscle power (hip extension/abduction and knee extension/flexion), maximal muscle power during multijoint leg extension press, and functional performance measures (20-m walk, five-time repeated chair stands, and repeated unilateral knee bending). For single-joint and multijoint maximal peak power and functional performance measures, we demonstrated poor (CV(ws), approximately 25%, single-joint hip extension) and moderate (CV(ws), approximately 15%, multijoint leg extension press, single-joint knee extension, chair stands, and knee bending) to good (CV(ws), <10%, single-joint knee flexion, single-joint hip abduction, and 20-m walk) agreement and good (intraclass correlation coefficient, 0.61-0.80, single-joint hip extension, multijoint leg extension press, and knee bending) to excellent (intraclass correlation coefficient, >0.81, single-joint knee extension, knee flexion, hip abduction, 20-m walk, and chair stands) reliability. Isolated muscle power over the hip and knee can safely be evaluated with poor to good agreement and good to excellent reliability in patients with advanced hip or knee osteoarthritis. Functional performance and muscle power may be assessed concurrently.

Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery

Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that may have a negative effect on dynamic knee-joint stabilization.

Postrehabilitation Outcomes of Muscle Power (Torque-Acceleration Energy) in Patients with Selected Shoulder Dysfunctions

Context:Most patients on an index concentric isokinetic test of the shoulder internal and external rotators have significant torque-acceleration-energy (TAE) deficits.Objective:To assess the effectiveness of rehabilitation on muscle power in patients with shoulder dysfunctions.Design:Prospective, pretest–posttest.Setting:Physical therapy clinic.Participants:67, mean age 28.7 ± 12.89 years.Main Outcome Measures:Concentric shoulder internal and external rotators measured with arm at 90° of abduction, 90° of elbow flexion. Isokinetic velocities tested: 60°, 180°, and 300°/s.Results:A paired t test (P &lt; .05) compared the differences from index to discharge test for involved and uninvolved internal and external shoulder rotators. Percentages of TAE deficits involved vs uninvolved on discharge and change in TAE from index to discharge were also analyzed. Significant improvement of the involved shoulder for all velocities for both internal and external rotators was seen. The uninvolved extremity saw statistically significant improvements at all velocities for external rotators yet only at 300°/s for internal rotators. Involved-extremity TAE deficits returned to within 10% on discharge.Conclusions:The study demonstrated improved muscle power as measured by TAE in shoulder internal and external rotators in a sample of patients treated in an outpatient clinic.

Systematic muscle building exercises in the rehabilitation of stroke patients

The effects of targeted strength training in patients with muscle weakness of central origin following cerebrovascular accidents has hardly been investigated to date. This prospective non-randomized study of 56 patients was designed to shed light on the effects of strength building exercises on muscle tone and on the gain in muscle strength achieved with them. All patients underwent a full residential neurologic rehabilitation program for 4 weeks, which included an exercise program for restoring the extensor strength of the legs and the supporting strength of the arms by leg and arm presses. Throughout the rehabilitation program muscle spasticity was evaluated clinically and maximal muscle strength on completion of the exercise program was compared to baseline. The extensor strength of the legs increased by 31.0 (+/- 26.7)% by 40.2 (+/- 15)%. significant for both variables. The extent of strength gain was positively correlated with the intensity and the number of exercising units. Muscle tone, which was abnormally high at baseline, did not further increase in any one case. The results of this study showed that targeted strength training significantly increased muscle power in patients with muscle weakness of central origin without any negative effects on spasticity.

Neurological long-term sequelae after spinal anaesthesia in a tropical setting: a case control study.

Spinal anaesthesia (SA) is an important form of anaesthesia in tropical countries. It is considered to have few long-term complications or sequelae, although this hypothesis has not been proven in a rural tropical setting. In a case control study we found SA to he a significant risk factor for lower back pain, reflex abnormalities and muscular atrophy and mild impairment of muscle power in patients examined between 3 months and 4 years after SA. These long-term sequelae need to be confirmed in a larger prospective study employing all possible neurophysiological and neuroimaging techniques.