Rehabilitation Of Musculoskeletal Injuries Research Articles

Characterization of Motor Performance in 200 Normal Ankles Through Isokinetic Evaluation

Category: Ankle; Sports Introduction/Purpose: The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon’s injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients. Methods: We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30º / sec and 10 repetitions for power (W) at a speed of 120º / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter. Results: The mean age was 38.5 years and BMI 25.8 in 69 men and 31 women. In 78 participants, the dominant ankle was the right one. The non-dominant side was consistently stronger in all movements (p < 0.001). The mean values obtained for force in each movement were 29.9N/m for eversion, 34.8N/m for inversion, 48.6N/m for dorsiflexion and 140.2 N/m for plantar flexion. Such parameters for men and women were also obtained (p < 0.001) and there was no correlation between age or BMI with the maximum torque through Spearman's Correlation. The ratio of eversors/inverters was 88.8% and that of dorsiflexors/plantar flexors was 36.1%. The Muscle Deficiency Index showed a balance between the sides for each movement, with an average global difference of less than 10% between them. Conclusion: As far as we know, this is the largest isokinetic assessment of normal ankles ever performed. The sample, although not stratified, was considered homogeneous (coefficient of variation < 50%), which allows to propose several normative values for a non-athlete population in the isokinetic evaluation. It would be interesting to compare these data in the future with the functional results in patients after the treatment of certain injuries.

The Effect of Varying Eccentric Velocity on Muscle Hypertrophy

Resistance training is essential to muscle hypertrophy as it fatigues fibres through time-under-tension (TUT). As myocyte energy depletes, metabolites accrete, leading to inflammation to increase cell size, so it is adapted for future stimuli. TUT can be measured by varying eccentric velocities: i.e., the rate at which a muscle lengthens under load. A longer period of lengthening will lead to greater metabolite accretion and inflammation. However, it is unknown whether TUT is a threshold or if it can gradually increase and lead to more muscle growth. Through a literature review and experiment, this project investigates the effect of varying eccentric velocity on muscle hypertrophy. Previous research in the field of muscle physiology and metabolism were explored, with an emphasis on eccentric training. The supplementary experiment measured shoulder growth in response to the medial deltoid exercise called lateral raises, where different eccentric velocities were assigned to groups. Individualistic daily calorie and protein intake were controlled to ensure that sufficient nutrients were available for recovery and performance. Surprisingly, post-experimental research suggested that high-velocity eccentric training was best for hypertrophy due to greater levels of force production. This was consistent with the experiment, which found that the group with a fast-velocity eccentric, a lower TUT, experienced greater growth. They also exhibited greater strength gain due to neuromuscular junction adaptation. These findings related to TUT are significant for designing exercise regimens that are optimal for the prevention and rehabilitation of musculoskeletal injuries and disorders. The review’s findings suggest that fast-velocity eccentric contractions are ideal for increasing muscle size and strength.

Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review

It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.

The Effect of Combining Blood Flow Restriction and Plyometric Exercise on Quadriceps Muscle Strength, Functional Ability and Balance Capacity - A Pilot Study Amongst Amateur Soccer Players

Football is one of the most popular sports employing a plethora of people around the world. Plyometric exercise and Blood Flow Restriction (BFR) exercise are two different means used to enhance athletic performance in healthy athletes and also during the rehabilitation of musculoskeletal injuries. To our knowledge, the combination of plyometric exercise and BFR has not been studied so far. The aim of this study is to investigate the effect of BFR during plyometric lower limb exercise on quadriceps muscle strength, functional capacity and dynamic balance of the lower limb in amateur football players. This is a comparative study with a parallel 10-week, twice/week intervention in 2 different groups. Group A (N = 5) performed a plyometric exercise program and group B (N = 5) performed the same plyometric exercise program with the simultaneous application of BFR. Outcome measures were 1 Repetition Maximum of the squat exercise, Y Balance Test, Horizontal Countermovement Jump, Vertical Countermovement Jump, and single leg Triple Hop Test (THT). There was statistically significant improvement in both groups in all variable except THT on the non-dominant leg. There was no statistically significant difference between groups. Plyometric exercise, whether applied with or without blood flow restriction, improved strength, balance and functional capacity in male amateur football players

Effect of Manual Therapy on Musculoskeletal Injury Rehabilitation: Pain Modulation and Range of Motion Restoration

Effect of Manual Therapy on Musculoskeletal Injury Rehabilitation: Pain Modulation and Range of Motion Restoration

Isokinetic Evaluation in a Large Cohort of Normal Ankles

Category: Ankle; Sports; Other Introduction/Purpose: The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon's injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients. Methods: We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30o / sec and 10 repetitions for power (W) at a speed of 120o / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter. Results: The mean age was 38.5 years and BMI 25.8 (CI 2.7 and 0.8 respectively) in 69 men and 31 women. In 78% of participants, the dominant ankle was the right one. The non-dominant side was consistently stronger (higher peak torque) in all movements (p<0.001 - Wilcoxon Test). The mean values obtained for force in each movement were 29.9N/m for eversion, 34.8N/m (CI 1.6) for inversion, 48.6N/m (2.0) for dorsiflexion and 140.2 N/m for plantar flexion. Such parameters for men and women were also obtained (p<0.001) and there was no correlation between age or BMI with the maximum torque (N/m) through Spearman's Correlation. The ratio of eversors / inverters was 88.8% (CI 3.1) and that of dorsiflexors / plantar flexors was 36.1% (1.3). Limb symmetry Index were >= 90% between sides in all four moviments (91,99% for eversion, 98,57% for inversion, 96,96% for dorsiflexion and 94,72% for plantarflexion). Conclusion: The non-dominant side was stronger in this evaluation of the two hundred healthy ankles. However, this difference was within the expected range for the limb symmetry index and for the MDI, showing that limb dominance is not relevant for the isokinetic assessment of the ankle. In the studied sample, the demographic variables (except gender) did not show any correlation with the evaluated parameters, especially with the maximum torque. Normative values of torque forces and agonist/antagonist balances were proposed. The results have implications for rehabilitation protocols and criteria for returning to sports.

Characterization of Motor Performance in 200 Normal Ankles Through Isokinetic Evaluation

Category:Ankle; SportsIntroduction/Purpose:The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon's injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients.Methods:We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30° / sec and 10 repetitions for power (W) at a speed of 120° / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter.Results:The mean age was 38.5 years and BMI 25.8 (CI 2.7 and 0.8 respectively). The non-dominant side was consistently stronger (higher peak torque) in all movements (p <0.001 -). The mean values obtained for force in each movement were 29.9N / m (CI 1.4) for eversion, 34.8N / m (CI 1.6) for inversion, 48.6N / m (2.0) for dorsiflexion and 140.2 N / m (CI 6.1) for plantar flexion. There was no correlation between age or BMI with the maximum torque (N / m). The ratio of eversors / inverters was 88.8% (CI 3.1) and that of dorsiflexors / plantar flexors was 36.1% (1.3). The Muscle Deficiency Index showed a balance between the sides for each movement (p 0.062), with an average global difference of less than 10% between them (eversion 8.66 [CI 3.17], inversion 4.2 [3, 48], dorsiflexion 3.41 [3.04] and plantar flexion 5.18 [2.51].Conclusion:As far as we know, this is the largest isokinetic assessment of normal ankles ever performed. The sample, although not stratified, was considered homogeneous (coefficient of variation <50%), which allows to propose several normative values for a non-athlete population in the isokinetic evaluation. It would be interesting to compare these data in the future with the functional results in patients after the treatment of certain injuries.

The Feasibility of Dynamic Musculoskeletal Function Analysis of the Vastus Lateralis in Endurance Runners Using Continuous, Hands-Free Ultrasound

Dynamic imaging of the skeletal muscles used to be strenuous and often impossible to perform manually. Accordingly, long-term dynamic musculoskeletal imaging has not been performed. The feasibility of long-term dynamic musculoskeletal functional analysis using hands-free ultrasound will be demonstrated in ten healthy endurance runners. After every kilometer, the vastus lateralis muscle was imaged whilst running using a fixated probe connected to a smart phone. The image quality was quantified by estimation of the probe-skin contact preservation and the field-of-view stability. Moreover, the pennation angles and muscle thicknesses were computed automatically. Long-term dynamic acquisition was successful in nine out of ten runners. Probe-skin contact loss ranged between 0 and 57% of the gait cycle. The biggest change in field-of-view occurred during the first kilometer with an average decline in complex-wavelet structural similarity index of 0.21, followed by an onward total decrease of 0.09, on average. The mean pennation angle and thickness were approximately constant, with the average fluctuation being 0.94 degrees and 0.11 cm, respectively. The feasibility of long-term musculoskeletal function analysis has been demonstrated, with probe-skin contact loss the main limiting factor. Dynamic, hands-free ultrasound might enable research for a more profound insight in the prevention and rehabilitation of musculoskeletal injuries.

Ultrasonic therapy modulates the expression of genes related to neovascularization and inflammation in fibroblasts

Abstract Introduction: In the rehabilitation of musculoskeletal injuries, ultrasound is widely used in clinical practice. Objective: To evaluate the effects of pulsed ultrasonic therapy on the viability and modulation of genes involved in inflammation (IL-6) and neovascularization (VEGF) processes of L929 fibroblast cells. Methods: For irradiation with ultrasound the cells were subdivided into groups: G1 (without irradiation), G2 (0.3 W/cm2-20%) and G3 (0.6 W/cm2-20%), with periods of treatment at 24, 48 and 72 hours. The cell viability assay was analyzed by the MTT method and gene modulation was analyzed by RT-qPCR method. Results: After the comparative analysis between groups, only G2 and G3 (48-hour) presented statistically significant differences in relation to the control. In relation to the gene expression, the selection of the groups analyzed was delimited according to the comparative analysis of the values obtained by the MTT test. After the achievement of RT-qPCR, it could be observed that in G2 the amount of VEGF gene transcripts increased by 1.125-fold compared to endogenous controls, and increased 1.388-fold in G3. The IL-6 gene, on the other hand, had its transcripts reduced in both G2 (5.64x10-9) and G3 (1.91x10-6). Conclusion: Pulsed ultrasound in L929 fibroblasts showed a significant biostimulatory effect in the 48-hour period, with increased cell viability, and the same effect in the modulation of gene expression related the neovascularization and inflammation, mediating the acceleration of the tissue repair cascade.

Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization.

Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization.

The Role of Blood Flow Restriction Therapy Following Knee Surgery: Expert Opinion

Blood flow restriction (BFR) therapy is becoming increasingly popular in musculoskeletal injury rehabilitation. In particular, this form of therapy is being utilized more often in the postoperative setting following knee surgery, including anterior cruciate ligament reconstruction. BFR therapy provides patients and clinicians an alternative treatment option to standard muscle strengthening and hypertrophy guidelines in the setting of postoperative pain, weakness, and postoperative activity restrictions that contribute to muscle atrophy. The ability to complete exercise in a low load environment and achieve similar physiological adaptations as high-intensity strength training makes this modality appealing. With poor patient-related outcomes associated with continued muscle atrophy, pain, and muscle weakness, some researchers have investigated BFR training postoperatively following arthroscopic knee surgery with promising results. However, owing to the current paucity of research studies, inconsistency among reported protocols, and mixed results, it may be some time before a mass adoption of BFR therapy is made into the world of orthopaedic rehabilitation. Although the current data is inconclusive, we choose to utilize BFR in postoperative knee patients, regardless of weight-bearing status, for whom maintenance of existing muscle mass or improvement of decreased postoperative strength levels is important. Therefore, the purpose of this expert opinion is to review the background of BFR, describe the clinical evidence of BFR following knee surgery, and report the authors' current recommendations for application of BFR postoperatively.

The potential psychological benefits of active video games in the rehabilitation of musculoskeletal injuries and deficiencies

Background:Recent literature suggests that active video games (AVGs) may offer potential psychological benefits during the rehabilitation of musculoskeletal injuries and their corresponding deficiencies.Objectives:To review existing literature regarding the potential psychological benefits of AVGs within the context of rehabilitation from musculoskeletal injury or debilitation.Method:A narrative review of the literature that used the Population, Intervention, Comparison, and Outcome (PICO) method was conducted. The literature review included studies that discussed and/or investigated potential psychological benefits of AVGs during musculoskeletal rehabilitation. Of the total 163 papers that were identified, 30 met the inclusion criteria.Results:The Nintendo® Wii™ (Nintendo Co., Ltd, Kyoto, Japan) was the most commonly used games console that was employed in AVG interventions (15 out of 21), and these studies that investigated potential psychological benefits were typically conducted with elderly populations. These studies reported that using AVGs in musculoskeletal rehabilitation resulted in a number of positive psychological effects (e.g. enjoyment, effects on self). However, most studies lacked a clear theoretical framework, and varied greatly in their designs and methodologies.Conclusion:Despite encouraging findings of AVGs use, insufficient evidence exists to reliably verify or refute the potential psychological benefits of AVGs in musculoskeletal rehabilitation. It is recommended that future studies in this area contain a theoretical framework to ensure greater consistency in the methodology used and the execution of the intervention. The potential findings of such investigations may result in the development of optimal, client-tailored rehabilitation programmes.

A profile of Biokinetics service provided by the University of Kwa-Zulu Natal, 2005-2009

Biokinetics can be viewed as an emerging member of the South African health professions in comparison to the longstanding professions of physiotherapy, chiropractics and occupational therapy which were established in 1924, 1939 and 1945, respectively. The aim of this investigation was to determine the profile of the biokinetics services provided by the University of Kwa-Zulu Natal, South Africa. All the patient records of the University of Kwa-Zulu Natal’s biokinetics practice were categorized as follows: nature of biokinetics service provided and year of service rendered for the period of January, 2005-December, 2009. Descriptive statistics comprising mode, mean, frequency and percentages were calculated. The results indicated a 103.71% growth trend in the number of patient consultations from 2005 (n=889) to 2009 (n=1811). The primary services rendered by this biokinetics practice in order of prevalence were: health and wellness (68.07%), pre-participation assessments (17.84%), rehabilitation of musculoskeletal injuries (7.46%), sports evaluation of highly trained and/or elite athletes (2.70%), rehabilitation of hypokinetic disease conditions (2.38%), and rehabilitation of cardiac diseases (1.54%). There has been evidence of cross referrals for patients with cardiac and musculoskeletal dysfunction from cardiologists and orthopaedic surgeons, respectively.Key words: Biokinetics, rehabilitation, injury.

A Pivoting Elliptical Training System for Improving Pivoting Neuromuscular Control and Rehabilitating Musculoskeletal Injuries

Knee injuries often occur in pivoting activities but most existing training and rehabilitation devices mainly involve sagittal movements. A pivoting elliptical training system (PETS) was developed to train and evaluate neuromuscular control in pivoting for the purposes of prevention and rehabilitation of musculoskeletal injuries. The PETS have capabilities of controlling two footplates individually or simultaneously through servomotor control so that the footplates behave like two torsional springs with adjustable offset and stiffness, slippery surface, or under external perturbations. Feasibility of the PETS in improving pivoting neuromuscular control and pivoting neuromechanical properties was demonstrated through experiments on healthy subjects, with reduced pivoting instability and reaction time, and improved proprioceptive acuity following training. The PETS can potentially be used as a therapeutic and research tool to investigate mechanisms underlying pivoting-related injuries and train human subjects for improving neuromuscular control during risky pivoting activities.

Prevention and Rehabilitation of Musculoskeletal Injuries During Military Operations and Training

Zambraski, EJ and Yancosek, KE. Prevention and rehabilitation of musculoskeletal injuries during military operations and training. J Strength Cond Res 26(7): S101–S106, 2012—Injuries are a major impacting factor for a military organization. Injuries may be the result of direct combat, or noncombat, and may be incurred during deployment, other military operations and training. The impact of injuries is the loss of manpower (e.g., lost duty days), medical costs for treatment, and the influence that an injury may have on an individual's quality of life. To address this issue, it is essential to understand the types of injuries that are occurring, and the mechanisms responsible for those injuries, to develop strategies to reduce injury incidence and to allocate the resources required for rehabilitation to return the individual to duty. This article will review the most common medical injury being incurred by our present warfighter; namely, musculoskeletal injuries (MSIs). The number, types, and causal mechanisms of MSIs will be reviewed. Risk factors for MSIs will be identified and the various interventions being used to prevent or mitigate the severity of MSIs will be discussed. Lastly, the programs that have been developed within the U.S. Department of Defense and the U.S. Army for the assessment, care, and rehabilitation of the most severe MSIs incurred while deployed will be described.

Prevention and rehabilitation of musculoskeletal injuries during military operations and training.

Injuries are a major impacting factor for a military organization. Injuries may be the result of direct combat, or noncombat, and may be incurred during deployment, other military operations and training. The impact of injuries is the loss of manpower (e.g., lost duty days), medical costs for treatment, and the influence that an injury may have on an individual's quality of life. To address this issue, it is essential to understand the types of injuries that are occurring, and the mechanisms responsible for those injuries, to develop strategies to reduce injury incidence and to allocate the resources required for rehabilitation to return the individual to duty. This article will review the most common medical injury being incurred by our present warfighter; namely, musculoskeletal injuries (MSIs). The number, types, and causal mechanisms of MSIs will be reviewed. Risk factors for MSIs will be identified and the various interventions being used to prevent or mitigate the severity of MSIs will be discussed. Lastly, the programs that have been developed within the U.S. Department of Defense and the U.S. Army for the assessment, care, and rehabilitation of the most severe MSIs incurred while deployed will be described.

Prevention and Rehabilitation of Musculoskeletal Injuries During Military Operations and Training

Prevention and Rehabilitation of Musculoskeletal Injuries During Military Operations and Training

Soothing suffering swimmers: a systematic review of the epidemiology, diagnosis, treatment and rehabilitation of musculoskeletal injuries in competitive swimmers

This review details the examination, diagnosis, treatment and management of injuries encountered by competitive swimmers. Primarily, these involve the shoulder, however, the spine, knee and hip can be involved. Using the Coleman methodology score, we show that the methods used in obtaining and reporting clinical findings and intervention results could be improved. Where possible, we suggest improvements. A literature review was conducted in English, Italian, French and German using PubMed, Google Scholar and Ovid search engines with strict inclusion/exclusion criteria. Poor technique, and high training intensity and distance are the most common cause of missed swim practice and competition through injury. Few articles agree on a single method of each of clinical examination, diagnosis, treatment and rehabilitation. Articles are consistently retrospective with few investigating spine, hip and knee injuries. Clinical findings and rehabilitation methods should be reported using a more structured method possibly based on the Coleman methodological scoring system.

Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

BackgroundAnkle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI.MethodsThe athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: [1] Cumberland Ankle Instability Tool (CAIT) scores, [2] Star Excursion Balance Test (SEBT) reach distances, [3] ankle joint plantar flexion during drop landing and drop vertical jumping, and [4] ground reaction forces (GRFs) during walking.ResultsCAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention.ConclusionsThe 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

Muscle Activation and Perceived Loading During Rehabilitation Exercises: Comparison of Dumbbells and Elastic Resistance

High-intensity resistance training plays an essential role in the prevention and rehabilitation of musculoskeletal injuries and disorders. Although resistance exercises with heavy weights yield high levels of muscle activation, the efficacy of more user-friendly forms of exercise needs to be examined. The aim of this study was to investigate muscle activation and perceived loading during upper-extremity resistance exercises with dumbbells compared with elastic tubing. A single-group, repeated-measures study design was used. Exercise evaluation was conducted in a laboratory setting. Sixteen female workers (aged 26-55 years) without serious musculoskeletal diseases and with a mean neck and shoulder pain intensity of 7.8 on a 100-mm visual analog scale participated in the study. Electromyographic (EMG) activity was measured in 5 selected muscles during the exercises of lateral raise, wrist extension, and shoulder external rotation during graded loadings with dumbbells (2-7.5 kg) and elastic tubing (Thera-Band, red to silver resistance). The order of exercises and loadings was randomized for each individual. Electromyographic amplitude was normalized to the absolute maximum EMG amplitude obtained during maximal voluntary isometric contraction and exercise testing. Immediately after each set of exercise, the Borg CR10 scale was used to rate perceived loading during the exercise. Resistance exercise with dumbbells as well as elastic tubing showed increasing EMG amplitude and perceived loading with increasing resistance. At the individually maximal level of resistance for each exercise-defined as the 3 repetitions maximum-normalized EMG activity of the prime muscles was not significantly different between dumbbells (59%-87%) and elastic tubing (64%-86%). Perceived loading was moderately to very strongly related to normalized EMG activity (r=.59-.92). Limitations The results of this study apply only for exercises performed in a controlled manner (ie, without sudden jerks or high acceleration). Comparably high levels of muscle activation were obtained during resistance exercises with dumbbells and elastic tubing, indicating that therapists can choose either type in clinical practice. The Borg CR10 can be a useful aid in estimating intensity of individual rehabilitation protocols.