Lower Limb Muscle Strength Research Articles

Impact of a Tailored Self-Management Education Programme for Older Adults with Knee Osteoarthritis in a Multi-Ethnic Country

Self-management education program (SMEP) is essential in the knee osteoarthritis (OA) management. While the benefits of tailored SMEP have been highlighted in the literature, evidence on the effects of tailored knee OA SMEP for multi-ethnic populations, such as in Malaysia, remains limited. Therefore, the aim of this study was to conduct an intervention study on a tailored SMEP among Malaysian older adults with knee OA. Participants aged 60 years and over with a diagnosis of knee OA were recruited. The intervention comprised four weekly structured group SMEP which was developed specifically for the multicultural population in Malaysia. Symptom’s severity and functional performance were assessed at baseline and six-week follow-up using the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS), 30 seconds sit to stand (30sST), time up and go (TUG), chair sit and reach (CSR), back stretch (BS), handgrip strength (HGS) and two-minute walk (2MW) tests. Of the 32 individuals recruited, 30 participants, mean age of 66.77 (±6.42) years, completed the post-intervention assessment. Improvements in mean KOOS domains scores were observed by between 1.3% - 8.6% from baseline to follow-up. Significant differences between baseline and follow-up scores were identified for 30sST (p < 0.05), TUG ( p < 0.001) and 2MW (p < 0.001) tests. A 4-week tailored SMEP delivered face to face by a physiotherapist, improved lower limb muscle strength, mobility, balance and endurance. Larger randomized controlled trials regarding the long-term effects of SMEP for older adults with OA is warranted.

Lower limb muscle strength is associated with disability in non-specific chronic low back pain

Low back pain is one of the most common health problems that affects daily living activities of most people at some time in their lifetime. Non-specific chronic low back pain (NS-CLBP) can be seen in 85-95% of the population. Although it is known that disability and lower limb muscle strength are affected in patients with NS-CLBP, no study investigated the relationship between these variables. The aim of this study was to identify association between disability and lower limb muscle strength in these patients. 79 patients with NS-CLBP were enrolled. The strength of knee extensor and ankle dorsiflexor muscles were measured using a hand-held dynamometer. The disability was assessed using Oswestry Disability Index. Spearman correlation analysis revealed that there were negative significant correlations between Oswestry Disability Index score and right knee extensor muscle strength, left knee extensor muscle strength and left ankle dorsiflexor muscle strength (r=-0.290, p=0.009; r=-0.408, p

농촌지역 여성노인의 신체적 여가활동 참여가 신체적 기능과 삶의 질에 미치는 효과

Objective: This study aimed to assess the effects of a physical leisure activity program on the physical function and health-related quality of life of elderly women in rural areas. Methods: One hundred and thirteen elderly women living in rural communities participated using a one-group pre-post design. The physical leisure activity program was conducted for 16 group activities over 8 weeks. To determine changes in the physical function of the elderly after participation, muscle strength, flexibility, and balance ability were measured, and the 8 domain Short-Form Health Survey (SF-8) was used to examine changes in quality of life. Results: The physical function of the participants in the program was significantly increased in upper and lower limb muscle strength, balance, and flexibility (p < 0.05). The total score of QOL of elderly women who participated in the program also improved from 335.73 ± 52.93 points to 395.42 ± 28.79 points, and significantly changed in all sub-items (p < 0.05). Conclusion: Participation in leisure activities was confirmed effective not only in improving the physical health of the elderly women, but also in improving their quality of life. In the future, we look forward to the development and support of various participatory activity programs suitable for rural areas.

Association of Lower-Limb Muscle Strength Asymmetry and Functional Factors in Patients with Stroke

Association of Lower-Limb Muscle Strength Asymmetry and Functional Factors in Patients with Stroke

Transcranial Magnetic and Transcutaneous Spinal Cord Electrical Stimulation a Stroke-Patients Walking Correction: Blinded Clinical Randomised Study

INTRODUCTION. The impairment of motor system function due to stroke often leads to patients’ dependence on external assistance. The technique of rhythmic transcranial magnetic stimulation (rTMS) is now widely used in the restoration of impaired central nervous system (CNS) function. In recent years, there has been information about the use of transcutaneous electrical spinal cord stimulation (TSCS) in the correction of motor functions in CNS disorders of various genesis.
 AIM. To evaluate the possibilities of combined use of transcranial magnetic and transcutaneous electrical stimulation of the spinal cord in the correction of locomotor functions in patients after ischemic stroke.
 MATERIALS AND METHODS. The conducted blind clinical randomized study involved patients who had an ischemic stroke. Study participants were randomly divided into control (n = 12) and experimental (n = 9) groups. Patients in the control group received standardized neurorehabilitation techniques. The participants of the experimental group were offered standardized neurorehabilitation techniques combined with rTMS and TSCS. High-frequency rTMS was performed in the projection of the sensory-motor cortex on the side of the lesion, in the area of innervation of the lower limb. During TSCS, a stimulating electrode was placed between Th11–Th12, indifferent electrodes were placed in the region of the iliac crests, and the lumbar enlargement of the spinal cord was stimulated. The dynamics of neurological deficit was assessed using the rehabilitation routing scale, the Rivermead mobility index, the Berg balance scale, and a six-point scale for assessing muscle strength. The excitability of the neural networks of the spinal cord was determined using TSCS at the T11–T12 level, with electromyographic recording of the evoked motor responses of the muscles of the lower extremities.
 RESULTS AND DISCUSSION. The combined use of rTMS and TSCS in the rehabilitation of patients in the acute period after ischemic stroke leads to an increase in the excitability of neuronal networks of the lumbar thickening of the spinal cord, a decrease in the activation thresholds of the RF, BF, TA and GM muscles of the affected limb (by 7.7 ma, 18.3 ma, 24.8 ma and 14.2 ma, respectively). Inclusion of rTMS and TSCS in the rehabilitation course leads to a significant improvement in the rehabilitation routing scale (by 2 points), Rivermead mobility index (by 5.8 points), statokinetic control functions (balance-Berg by 12 points) and an increase in lower limb muscle strength (flexors by 5.1 points, extensors by 6.2 points).
 CONCLUSION. The use of rTMS and TSCS can be used as an additional effect within the framework of rehabilitation measures in the acute period after ischemic stroke.

Impact of Starting Knee Flexion Angle on Muscle Activity and Performance during Plyometrics without Jumping.

Most of the existing research has focused on jump plyometrics, where landing reaction forces must be dissipated among lower limb articulations. In contrast, the investigation of resisted plyometrics without jumping, devoid of such landing forces, remains relatively limited. This study aimed to (i) investigate the impact of resisted plyometrics without jumping at two knee flexion angles (60 and 90 degrees) on vastus muscle activity relative to limb dominance and (ii) assess strength, power, and work during the concentric-eccentric phases of these exercises. Thirty-one healthy participants underwent quantification of lower limb muscle amplitude, strength, power, and work during resisted plyometrics without jumping from both 60° and 90° knee flexion positions. After anthropometric evaluations, participants used a dynamometer with a load equal to 80% of body weight while wireless surface electromyography electrodes recorded data. Statistical analyses utilized paired t-tests or nonparametric equivalents and set significance at p ≤ 0.05. Results showed significantly higher muscle activity in the vastus medialis (VM) (dominant: 47.4%, p = 0.0008, rs = 0.90; nondominant: 54.8%, p = 0.047, rs = 0.88) and vastus lateralis (VL) (dominant: 46.9%, p = 0.0004, rs = 0.86; nondominant: 48.1%, p = 0.021, rs = 0.67) muscles when exercises started at 90° knee flexion, regardless of limb dominance. Substantial intermuscle differences occurred at both 60° (50.4%, p = 0.003, rs = 0.56) and 90° (54.8%, p = 0.005, rs = 0.62) knee flexion, favoring VM in the nondominant leg. Concentric and eccentric strength, power, and work metrics significantly increased when initiating exercises from a 90° position. In conclusion, commencing resisted plyometrics without jumping at a 90° knee flexion position increases VM and VL muscle activity, regardless of limb dominance. Furthermore, it enhances strength, power, and work, emphasizing the importance of knee flexion position customization for optimizing muscle engagement and functional performance.

Oral nanoliposome in postoperative home care of patients with myelitis.

Acute myelitis (AM) mainly presents with paralysis, and sensory and autonomic dysfunction, which affects the daily life and quality of life (QoL) of patients. Reasonable selection of treatment and nursing can promote the recovery of patients. It was to explore the effect of oral nanoliposomes combined with home care on the rehabilitation of patients. A total of 100 AM patients who received surgical treatment were enrolled. According to the treatment and nursing methods, they were grouped into a control (oral administration of nanoliposomes plus routine nursing, n=50) and an observation group (oral administration of nanoliposomes plus home care, n=50). Differences between patients' neurological recovery, lower limb muscle strength, activities of daily living, QoL, and satisfaction with quality of care were assessed. As against control, the time of muscle strength to level 2, urination recovery time, walking time, and sensory recovery time was shorter, and the degree of lower limb muscle strength recovery was higher, the Barthel and Newcastle Satisfaction with Nursing Scale (NSNS) scores of daily living ability increased, and the QoL EuroQol-5 dimensions (EQ-5D) score decreased in the observation group (P<0.05). Oral administration of nanoliposome plus home care can promote the recovery of lower limb muscle strength, improve daily living ability and QoL, and improve nursing satisfaction in patients with AM surgery.

Isometric and isokinetic strength of lower-limb muscles in female athletes during different phases of menstrual cycle: a causal-comparative study

BackgroundMuscle strength is affected by different stages of the menstrual cycle in women. Since the strength of the lower limb muscles plays a significant role in the occurrence of anterior cruciate ligament injury, it seems necessary to study the strength of the lower limb muscles at different stages of this cycle to take preventive measures. Therefore, this study aimed to compare the isometric and isokinetic strength of lower limb muscles in female athletes at different menstrual cycle stages.MethodsThe present study is of a causal-comparative type. Thirty-seven female athletes in anterior cruciate ligament injury high-risk disciplines participated in this study. Isometric and isokinetic knee extensors and flexors muscle strength status, including the traditional hamstrings/quadriceps (H/Q) ratios, were recorded at different stages of the menstrual cycle (follicular, ovulatory, luteal) by Biodex isokinetic dynamometry system 4. Then, the obtained results were analyzed by repeated measure analysis of variance.ResultsAnalysis of variance with repeated measures showed isokinetic and isometric strength in the knee flexor and extensor muscles at an angular velocity of 60˚/s in the ovulatory phase are higher than the follicular and luteal ones. The strength of the muscles declined during the follicular and luteal phases (p ≤ 0.05).ConclusionsDue to the negative effect of the follicular and luteal stages of the menstrual cycle on the strength of the flexor and extensor muscles of the knee, the risk of anterior cruciate ligament injury may increase during this period. Therefore, it is recommended that all female coaches and athletes take preventive measures during this period.

Effectiveness of functional electrical stimulation machine in managing neurological diseases - A retrospective study.

Cerebrovascular Accident (CVA) or stroke, Spinal Cord injury can lead to neurological diseases resulting in major loss in motor function causing hemiplegia or tetraplegia. In 2019, according to The Global Burden of Diseases (GBD) CVA/Stroke is the second leading cause of death and the third leading cause of death and disability combined, globally. Its prevalence vary drastically among South Asian countries. The objective of this study was to determine the effectiveness of Functional Electrical Stimulation (FES) machine on neurologically impaired patients at the Physical Therapy department at IHHN, Karachi, Pakistan. In this retrospective study data was extracted from August 2016 to February 2022 on patients with neurological symptoms i.e. hemiplegia or paraplegia with muscle power of two or less on Manual Muscle Testing (MMT). The parameters for evaluating patients progress pre and post treatment were MMT results and their mobility status. The number of sessions ranged between 40 to 100 sessions of Functional Electrical Stimulation (FES) provided on alternate days according to the patient's need. Data of 51 patients who had completed their treatment were extracted and analyzed. The mean age of patients who completed treatment was 49.62 ± 17.26 years. Out of 51(100%), 30 (58.8%) were male and 21 (41.2%) were female. Pre- and post-treatment median (IQR) showed remarkable improvement in MMT of upper limb muscle (from 1.0 to 4.0) and lower limb muscle (from 2.0 to 4.0). FES cycling is an effective treatment for patients with neurological impairments, as it resulted in improvement in both upper and lower limb muscle strength, along with mobility status.

Physical training and activity in people with diabetic peripheral neuropathy: A case report

Background: Diabetes mellitus (DM) is the most common endocrine disorder affecting more than 100 million people worldwide, around 6% of the population. This matter characterized by hyperglycemia (high glucose levels in blood) caused by a lack or ineffective production of insulin by the pancreas which results in an increase or decrease in the concentration of glucose in the blood. Diabetic peripheral neuropathy (DPN) or what is called diabetic peripheral neuropathy is the most common complication in cases of diabetes mellitus. DPN is a disease of loss of motor, sensory and autonomic nerve function, which can affect the peripheral nervous system. Sensorimotor training is considered a technique that can improve balance. This emphasizes the function of the sensorimotor system as a unit that works to increase sensory input and motor recruitment patterns in maintaining joint stability and regulating movement through the central nervous system (CNS). Aerobic exercise is a type of physical activity that can prevent and reduce DPN. Aerobic exercise such as treadmill can train balance. Balance training shows a high positive effect on improving motor and sensory symptoms in peripheral neuropathyPurpose: To examine the effects of sensorimotor training and lower limb muscle activity in DPN patients using treadmill.Method: The research uses a case study design, namely a research method that uses various data sources that can be used as research material, describing and explaining comprehensively various aspects of an individual, group, program, organization or event systematically. Participants in this study were patients aged 64 years, female, diagnosed diabetes mellitus type 2 (T2DM) for 10 years by a doctor. This research uses an aspect identification questionnaire instrument. DPN is screened using Michigan Neuropathy Screening Instrument (MNSI). Static balance is determined by romberg test and for dynamic balance it is measured by timed up and go test. Functional lower limb muscle strength is checked using tests Five Time Sit to Stand (5xSST).Results: The data for the respondent is a housewife aged 64 years, last education is junior high school with status as a housewife. The patient suffered from T2DM for 10 years with a hemoglobin 1AC level of 6.8 mg/dl, was overweight as indicated by the patient's BMI of 26 kg/m2. Often feels pain in both legs, when the patient walks and does strenuous activities with a score of 9, and the pain decreases when resting with a score of 3. Apart from that, the patient also has vision problems with a score of 20/40, meaning the patient can only see letters. at a distance of 20 feet. Even though normally letters can be seen clearly, namely 40 feet, this visual disturbance can cause the patient's balance to be disturbed. Providing treatment for 6 weeks can significantly improve the patient's quality of life as seen from the initial WHO QoL score of 58 to 86.Conclusion: Providing treadmill training for 6 weeks carried out 3 times a week showed significant results in reducing hemoglobin levels and DPN scores in T2DM patients.

Muscle quality improvement in subacute post-stroke patients after rehabilitation: Usefulness of segmental phase angle from bioelectrical impedance analysis

During stroke rehabilitation, the whole-body Phase Angle (PhA) from Bioelectrical Impedance Analysis (BIA) is measured to assess whole-body muscle quality, which reflects cellular integrity and function. The segmental BIA is a valuable method for assessing the body composition of specific body segments, such as the arms, legs, and hemisoma. After a stroke insult, patients frequently experience hemiparesis, and segmental PhA from segmental BIA appears to be an appropriate parameter for examining the muscle quality of affected and unaffected limbs separately. This study aims to investigate whether segmental PhA is more informative than whole-body PhA in (a) assessing the deterioration of muscle quality in post-stroke patients and (b) monitoring its recovery following rehabilitative treatment. This longitudinal study recruited subacute post-stroke patients who were admitted to our rehabilitation center. At admission, demographic, anamnestic, and clinical information, such as the presence of comorbidities, were recorded. BIA was used to evaluate the whole-body PhA and segmental PhA of the affected and unaffected hemisoma, arms, and legs at admission (T0) and after a six-week rehabilitation program (T1). The modified Barthel Index (mBI), Fugl-Meyer Assessment for the Upper Extremity (FMA-UE), and Motricity Index of the Upper (MI-UE) and Lower (MI-LE) Extremities were evaluated at T0 and T1 to determine the patient's Activity of Daily Living (ADL) performance, upper limb motor performance, and upper and lower limb muscle strength, respectively. We evaluated segmental and whole-body BIA in 70 subacute post-stroke patients (women n=34, ischemic n=56, mean age 70±11) at T0 and T1. Whole-body PhA values of the patients were below the normal range. Considering segmental data, the affected hemisoma, arm, and leg had considerably lower PhA values as compared to the unaffected body segments. Furthermore, at T1, the PhA values of all affected body segments improved, while those of the unaffected ones and whole-body PhA did not. At both T0 and T1, the segmental PhA values of the affected body segments showed to be related with all clinical outcome measures, while whole-body PhA correlated only with mBI. This study emphasizes the significance of measuring segmental PhA in hemiparetic subacute stroke patients undergoing rehabilitation treatment. Segmental PhA is a more accurate parameter to evaluate rehabilitation treatment in patients with hemiparesis because it can distinguish affected from unaffected body segments, hence facilitating accurate monitoring of muscle quality improvements resulting from a rehabilitation program.

Evaluation of Balance and Muscle Strength of Upper and Lower Limbs in Rock Climbers

Abstract Introduction. The purpose of this study was to evaluate the effects of bouldering on upper and lower limb muscle strength and body balance. Material and Methods. The study group consisted of 22 climbers (aged 27.23 ± 4.81) with at least 2 years of bouldering experience, while the control group consisted of 20 men (aged 23.10 ± 5.28) not practicing rock climbing. The study received approval from the local bioethical commission in Poland. Static and dynamic stabilographic parameters were measured with eyes open (EO) and closed (EC) on the Biodex Balance System SD USA (BBS) platform. Subsequently, the maximum muscle torques of the elbow, hip, knee and ankle joints were measured in isometric conditions. Hand-grip strength (HGS) with and without the thumb was assessed using a handheld dynamometer. Results. Climbers achieved significantly higher values of HGS with the thumb of both hands (p &lt; 0.005), foot extensors strength (FES) in both limbs (p &lt; 0.05) and left hip extensors (HES L) (p &lt; 0.05). They also achieved significantly lower values of all stabilographic parameters, indicating better balance compared to the control group (p &lt; 0.05). An interaction of HES x SIDE across the groups was observed (F(1,40) = 13.588, p &lt; 0.001 η2 = 0.254). Moreover, there was a statistically significant negative correlation of ankle extensors strength with medial-lateral stability index (MLSI EC) (right: r = -0.418; left: r = -0.331) and fall risk index (FRI6-2) (right: r = -0.520; left: r = -0.435). Conclusions. Regular climbing training develops muscle strength, especially FES, HES, HGS, and improves balance. Climbing can be used for prevention of muscle weakness and equilibrium disorders.

Efficacy of neuromuscular electrical stimulation for thoracic and abdominal surgery: A systematic review and meta-analysis.

This systematic review and meta-analysis examined the efficacy of neuromuscular electrical stimulation (NMES) on lower limb muscle strength and health-related quality of life (HR-QOL) after thoracic and abdominal surgery. We searched the Cochrane Central Register of Controlled Trials, MEDLINE via PubMed, Excerpta Medica Database via Elsevier, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, World Health Organization International Clinical Trials Registry Platform via their dedicated search portal, and ClinicalTrials.gov on November 2021 and updated in April 2023 to identify randomized controlled trials that examined the effects of NMES after thoracic and abdominal surgery. The primary outcomes were lower limb muscle strength, HR-QOL, and adverse events. We used the Cochrane Risk of Bias Tool and the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess the certainty of evidence. A total of 18 randomized control trials involving 915 participants, including 10 on cardiovascular surgery, two on pulmonary surgery, five on digestive system surgery, and one on other surgery, were included. NMES slightly increased lower limb muscle strength and adverse events in cardiovascular surgery. Adverse events (hypotension, pain, and muscle discomfort) occurred in seven patients. HR-QOL was measured in two studies on cardiovascular surgery, but these were not pooled due to concept heterogeneity. Overall, NMES slightly increases lower limb muscle strength after cardiovascular surgery without serious adverse events. However, higher-quality randomized control trials in thoracic and abdominal surgeries are needed.

Prediction of ACL-tear by lower limbs muscle strength and flexibility: a prospective cohort study in 95 female soccer players

ABSTRACT The aims of the study were to build models using logistic regression analysis of flexibility and strength tests to prospectively predict risk factors for anterior cruciate ligament tear (ACL-tear) in female soccer (FS) players, and to determine training cut-off for risk factors of the predictive model built. A prospective cohort study of 95 female players (aged 14–33 years) was conducted. Age, anthropometric data, soccer history, lower limb range of motion (ROM) and hip maximal isometric strength (MIS) were measured. At the prospective follow-up after 12 months, 7.4% of the players had developed an ACL-tear. The model showed a significant relationship (χ2(93) = 30.531, p < 0.001) between the ACL-tear and the predictor variables (leg length, HAD-NH [hip adduction] MIS, asymmetric ROM [ankle dorsiflexion with knee extended (AD-KE) and with knee flexed (AD-KF), and HE (hip extension)], hip ROM [HIR (internal rotation) and HAB (abduction)]). The Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC) for model fit were 30.24 and 51.79, respectively. The value R2 showed good model fit, 76.5% for Nagelkerke´s R2, 71.4% for McFadden´s R2 and 67.5% for Tjur´s R2. For the screening test, cut-off for leg length of ≥0.40 m, for HIR ROM of ≤44º and for asymmetry of HE ROM of ≥5° were set, which have an acceptable (AUC ≥ 0.755) discriminatory ability for the development of ACL-tear.

Influence of lower limb muscle isometric strength and cardiovascular parameters on locomotor capacity in children and adolescents.

Although measures of exercise performance and physical activity are known to be related to 6-minute walk test (6mWT), the role of the strength of each muscle group of the lower limb in the locomotor capacity during the development period is unknown. To identify the role of the isometric strength of lower limb muscles and cardiovascular parameters on the locomotor capacity in children and adolescents, controlling for participants sex, age, and height. Participants (7 to 15 years old; female, n= 113; male, n= 128) were assessed for isometric strength (seven lower limb muscles), cardiovascular parameters (diastolic pressure, oxygen saturation, resting heart rate, respiratory rate), and 6mWT. Participants were split into nine age groups and separated by 1-year intervals. Hip flexors-controlled for sex, age, and height-explained a meaningful percentage of the variance (R=2 0.45; p< 0.001) for 6mWT distance, and the resting heart rate explained a change in R2 of only 2% (p= 0.008). Isometric strength of hip flexors explained ∼ 50% of the 6mWT distance, suggesting the importance of strength from an early age. Other factors, such as cardiovascular parameters, while relevant, may exert a secondary role on youth's capacity.

Lower limb muscle strength of the affected side in stroke patients is an accurate predictor of the need for a KAFO.

Accurate prediction of recovery is essential to determine whether a knee-ankle-foot orthosis (KAFO) is required in the subacute phase of stroke. However, there are currently no reliable methods to predict such recovery. This study aimed to determine whether muscle strength of the affected lower limb (affected side LL strength) in stroke patients in the subacute phase who cannot walk without a KAFO can be used to predict the continuous need for a KAFO, using a hand-held dynamometer. We enrolled patients with severe hemiplegia (n = 51) who were unable to walk without a KAFO for 10 days after stroke onset. They were divided into two groups depending on the continuous need for a KAFO at 1 month after onset; the KAFO and non-KAFO groups. Logistic regression analysis was used to investigate whether the affected side LL strength was a predictor of the continuous need for a KAFO at 1 month after onset. In addition, significant predictors were analyzed using receiver operating characteristic (ROC) curves. The KAFO and non-KAFO groups included 23 (45.10%) and 28 (54.90%) patients, respectively. The affected side LL strength and pusher syndrome severity were identified as predictors of the continuous need for a KAFO. The predictor with the highest predictive ability was the affected side LL strength, with an area under the ROC curve of 0.80 (95% CI, 0.68-0.93). Affected side LL strength may be a highly accurate predictor of the need for a KAFO in the subacute phase of stroke.

Effects of proprioceptive training on gait and plantar pressure after anterior cruciate ligament reconstruction: study protocol for a randomized controlled trial

BackgroundPeople who have undergone anterior cruciate ligament reconstruction have an increased risk of osteoarthritis. Abnormality of lower limb kinematics will occur after the operation. This may be related to lower limb muscle strength, the co-excitation of hamstrings and quadriceps femoris, and the weakness of proprioception. Proprioceptive training can improve the proprioception of lower limbs and promote the recovery of lower limb kinematics. Our research objective is to observe whether proprioceptive training can improve the proprioception of lower limbs within 3 months after surgery and whether the recovery of proprioception can correct the abnormal lower limb kinematics. The secondary objective is to explore the underlying mechanism of postoperative lower limb gait abnormalities.Methods/designThis study is a prospective single-center randomized clinical trial to be conducted in the Sports Medicine and Orthopedics of Zhongda Hospital Southeast University. Forty participants aged 18–50, preparing to undergo anterior cruciate ligament reconstruction, and initial anterior cruciate ligament reconstruction using hamstring tendons as grafts will be randomly assigned to the intervention or comparator group. People in the intervention group will add proprioceptive training three times a week, 20 min each time. The intervention will be conducted on the first day after surgery. The researcher mainly collects the data of joint of sense, gait, and plantar pressure. The assessment will be divided into three stages: after signing the informed consent form (within 2 weeks before surgery), 6 weeks after surgery, and 12 weeks after surgery.DiscussionThe main purpose of our study is to explore whether the proprioception of patients after anterior cruciate ligament reconstruction is weakened, whether the lower limb kinematics is abnormal and whether the lower limb kinematics can be corrected through proprioceptive training.Trial registrationChinese Clinical Trial Registry ChiCTR2200065808. Registered on 15 November 2022; Version 1.

Effects of cardiopulmonary and metabolic rehabilitation in post-COVID-19 patients: Clinical trial

Objective: To evaluate the effects of cardiopulmonary rehabilitation on the functional capacity of post-COVID-19 individuals. Methods: Clinical trial, 7 patients participated in the study who tested positive for COVID-19. Participants underwent a 30-session rehabilitation program. They were evaluated using: Post COVID-19 Functional Scale (PCFS), inspiratory and expiratory muscle strength, 6-minute walk test (6MWT), 30-second sit-to-stand test (SE30’), hand grip (HG), VO2max, maximum HR, resting and reserve. Functional variables were analyzed using ANOVA for repeated measures and the Bonferroni multiple comparison test, considering a significance level of 5%. Results: The participants showed improvement in their functional status, with a decrease in the PCFS score (p=0.006), improvement in MIP (p=0.013), distance covered in the 6MWT (p=0.022), HGSR (p=0.005) and HGSL (p=0.009). In SE30’, they showed improvement in the intermediate (p=0.002) and final (p=0.046) assessments. Conclusions: The individuals demonstrated a decrease in functional limitations, improvement in functional capacity, inspiratory and lower limb muscle strength, handgrip strength after the 7th week of rehabilitation, with maintenance of the functional status being promoted until the end of the program. Implying the reestablishment of the global functional state of the pa-tients.

Effect of TRX Suspension Training on Balance, Mobility, Lower Limb Muscle Strength, and Fear of Falling in Older Men

Background and Aims Decreased muscle strength due to aging can lead to neuromuscular disorders, increased risk of falling, decreased function in daily activities, and reduced independence in the elderly. The present study aims to investigate the effect of eight weeks of TRX suspension training on lower limb muscle strength, balance, mobility, and fear of falling in older men. Methods This is a quasi-experimental. Participants were 30 elderly men with a mean age of 67.9±4.3 years who were assigned into two groups of TRX (n=16) and control (n=14). In the pre-test phase, lower limb strength was measured by the 30-second chair stand test, functional balance by the Berg balance scale, functional mobility by the timed up &amp; go test, and fear of falling by the falls efficacy scale -international. Then, the TRX group performed the functional training for eight weeks, three sessions per week, each for about one hour. After performing the exercises, post-test assessments were performed in two groups. To compare the groups, the analysis of covariance and Bonferroni post hoc test were used in SPSS software, version 19. The significance level was set at 0.05. Results The TRX functional training significantly improved lower limb strength, balance, and functional mobility of the elderly (P≤0.001); however, it had no significant effect on their fear of falling (P&gt;0.05). Conclusion Given the positive effects of TRX functional training on lower limb strength, functional balance, and mobility of elderly men, it seems that this suspension training can be used to improve lower limb muscle strength, functional balance, and mobility of older men.

PERBEDAAN PENGARUH LATIHAN LUNGES DAN LATIHAN RESISTANCE BAND LEG PRESS TERHADAP KEKUATAN OTOT TUNGKAI PADA ANGGOTA SILAT DI SMPN 4 BEKASI

Background: The strength of the limb muscles is one of the factors that determine the quality of the technique in the pencak silat, such as punching, blowing, kicking. The lunges exercise and the resistance band leg press exercise are exercises to increase the strength of the lower limb muscles. Objective:Is there a difference in influence between lunges exercise and resistancebandlegpressexercisetoimprovingthelowerlimbmusclesstrengthonthemember of the pencak silat in the 4 Junior High School of Bekasi. Method: This research is quasi- experimental with the design of research two groups pre-test and post-test. The samples were selected using a purposive sampling technique of 14 people divided into two groups with a total sample of 28 people. Group 1 lunges exercise, in group 2 resistance band leg press exercise, each of the exercise given for 6 weeks with a frequency of 3 times a week, measurement using leg dynamometer. Results: The results of the paired samples t testshowed thatlungesexerciseandresistancebandlegpressexercisecanaffectthestrengthofthelower limb muscles. There is no difference between the effects of the lunges exercise and resistance band leg press exercise of the lower limb muscles strength. Conclusion: Based on the differencevalues,theresistancebandlegpressexercisegrouphadabettereffectonthelower limb muscles strength than lungesexercise.&#x0D; Keywords:Lower Limb Muscle Strength, Lunges Exercise, Resistance Band Leg Press Exercise, Leg Dynamometer