Avaliação isocinética da força de contração excêntrica dos músculos isquiotibiais no período pré-operatório de pacientes com lesão de ligamento cruzado anterior / Isokinetic assessment of eccentric hamstring strength in the preoperative period of patients with anterior cruciate ligament injury

Introdução: A força de contração excêntrica é uma moderna medida para definir diferentes parâmetros no estudo da Ortopedia moderna, sendo considerada uns dos recentes temas mais discutidos no quesito ganho de força muscular. O objetivo do trabalho foi analisar o estado da musculatura flexora da coxa (isquiotibiais), através da avaliação de sua força de contração excêntrica, por meio do dinamômetro isocinético no período pré-operatório nos pacientes com lesão de ligamento cruzado anterior. Métodos: Estudo retrospectivo observacional entre agosto e dezembro de 2018 de uma clínica especializada em atendimento em Criciúma/SC. Resultados: A média do pico de torque excêntrico da musculatura posterior da coxa em flexão do membro afetado foi de 27,60 ± 10,56 kg, e do membro contralateral atingiu 27,47 ± 6,91 kg. O déficit de força entre os membros teve uma mediana de 9,14 % (0,0 - 61,45), e o tempo médio entre a lesão e o exame isocinético foi de 10,0 (1,0 - 48,0) meses. Observou-se que os maiores déficits de força foram encontrados naqueles indivíduos que tinham maior intervalo de tempo entre a lesão e a realização da avaliação isocinética. Conclusão: Nos indivíduos submetidos ao teste de dinamometria isocinética após lesão do ligamento cruzado anterior, evidenciou-se um déficit na força de contração excêntrica da musculatura isquiotibial entre o membro afetado e contralateral, o que ratifica achados da literatura a respeito da biomecânica articular do joelho. Além disso, maiores déficits foram encontrados naqueles pacientes com maior intervalo de tempo para realização do exame isocinético.

Introduction: Eccentric strength is a modern measurement for defining different parameters in the study of modern orthopaedics, being considered one of the most widely discussed topics in recent times within the subject of muscle strength gain. The aim of this work was to analyze the state of flexor muscles in the thigh (hamstring muscles) by evaluating their eccentric strength with an isokinetic dynamometer during the preoperative period of patients with anterior cruciate ligament injury. Methods: This is a retrospective observational study performed between August and December 2018 at a specialized clinic in Criciúma/SC. Results: The mean eccentric peak torque of the hamstring muscles during flexion of the affected limb was 27.60 ± 10.56 kg and that for the contralateral limb was 27.47 ± 6.91 kg. The strength deficit between limbs had a median value of 9.14% (0.0­61.45) and the mean time between the injury and isokinetic testing was 10.0 (1.0­48.0) months. Higher strength deficits were observed in individuals who had longer periods between the injury and isokinetic testing. Conclusion: In individuals who underwent isokinetic testing after an anterior cruciate ligament injury, there was a deficit between the eccentric hamstring strength of the affected limb and that of the contralateral limb, which corroborates findings in the literature regarding the biomechanics of the knee joint. Moreover, larger deficits were found in patients with longer periods between the injury and isokinetic testing.

Advance in Ankle Isokinetic Test for Lower Limb Joint Injuries (review) / 中国康复理论与实践

This article reviewed the changes of ankle muscle strength after lower limb joint injuries and the isokinetic test mode which could reflect this characteristic better. The varus plantarflexion strength decreased significantly after plantarflexion injury of ankle joint. The dorsiflexor strength of ankle joint could not reach the level of the healthy side for a long time after anterior cruciate ligament rupture and Achilles tendon injury. Ankle isokinetic muscle test included testing direction, muscle contraction form and testing speed. It is meaningful to test varus/valgus and plantar/dorsal flexion in ankle joint sprain and functional ankle instability; however, the muscle contraction form and testing speed have little effect on the result.

Test-retest Reliability of Isokinetic Test for Hip Concentric Flexion and Extension / 中国康复理论与实践

@#Objective To investigate the reliability of isokinetic test for concentric flexion and extension of hip joint. Methods From September, 2014 to June, 2015, 30 healthy young people accepted isokinetic test for concentric flexion and extension of hip twice with the same procedure and method within a week. The intra-class correlation coefficient (ICC) of peak torque, peak torque to body weight, total work, total work to body weight and average power between the two tests was calculated. Results The ICCs were above 0.70 in all the parameters on both sides at 60°/s (P < 0.01). Meanwhile they were above 0.61 of right hip at 180°/s (P < 0.05), but below 0.55 on left (P > 0.05). Conclusion The isokinetic test for hip is reliable for clinical assessment.

Isokinetic Muscle Strength and Muscle Endurance by the Types and Size of Rotator Cuff Tear in Men

BACKGROUND: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. METHODS: Total of 81 male patients (mean age 57.8 +/- 7.4 years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system PRO(R) (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age 56.9 +/- 7.3 years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. RESULTS: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. CONCLUSIONS: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.

Isokinetic Muscle Strength and Muscle Endurance by the Types and Size of Rotator Cuff Tear in Men

BACKGROUND: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. METHODS: Total of 81 male patients (mean age 57.8 +/- 7.4 years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system PRO(R) (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age 56.9 +/- 7.3 years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. RESULTS: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. CONCLUSIONS: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.

Characteristics of Muscular Power Changes of Knee Joint and Static Balance in Elderly with Knee Osteoarthritis / 中国康复理论与实践

@# Objective To explore the characteristics of muscular power changes of knee joint and static balance in the elderly patients with knee osteoarthritis(KOA).Methods Isokinetic test and computerized static posturography were performed in 59 patients with KOA(KOA group) and 50 age-matched controlled subjects(conrtol group). The parameters were recorded.Results Peak torque, total work, average power and torque acceleration energy significantly decreased in KOA group compared with the control group at the low velocity of concentric pattern(P<0.05), while hamstring/quadriceps value increased statistically(P<0.05);The values of covered area, length of path, length/area statistically increased in KOA group compared with the control group only when eyes closed (P<0.01), and so did it in KOA group when eyes closed compared with eyes opened(P<0.05); There was significant relationship between length/area and hamstring/quadriceps value.Conclusion The ability of balance declined as knee muscular power decreased in the patients with KOA, especially the non-spontaneous decrease of extensor and flexor power of the knee joint.

Correlação entre a proporção de fibras rápidas do músculo bíceps braquial e o torque relativo da flexão do cotovelo em sujeitos com hipótese clínica de miopatia / Correlation between the proportion of fast fibers in the biceps brachii muscle and the relative torque during elbow flexion in subjects with clinical hypothesis of myopathy

A produção de força muscular pode estar comprometida em pacientes portadores de miopatias. Estas representam um grupo heterogêneo de doenças com distintas características clínicas e morfológicas. Supõe-se que achados de desempenho funcional estejam relacionados com o tipo predominante de fibra expresso no músculo em análise. OBJETIVO: Correlacionar a proporção das fibras tipo 2 (FT2) do músculo bíceps braquial de sujeitos com hipótese clínica de miopatia (HCM) com picos de torque isométrico e isocinético de flexão do cotovelo. MATERIAIS E MÉTODOS: Participaram deste estudo sete sujeitos com HCM: quatro do sexo feminino com média de idade de 37 anos (dp= 9), peso de 73kg (dp= 26) e altura de 155cm (dp= 6); e três do sexo masculino com média de idade de 39 anos (dp= 1), peso de 88kg (dp= 5) e altura de 172cm (dp= 4). Pela técnica histoquímica de mATPase, foi realizada análise de proporção das fibras musculares. Após um mês da realização das biópsias, os sujeitos realizaram teste de força isométrica e isocinética concêntrica de flexão e extensão do cotovelo em dinamômetro isocinético. Avaliou-se o pico de torque (PT) isométrico a 90ºs-Õ e 180ºs-Õ e calculou-se o torque relativo 90 (TR90) e 180 (TR180). Para análise estatística, utilizou-se correlação de Spearman (r). RESULTADOS: A proporção de FT2 se correlacionou positivamente com TR180 (r= 0,89, p= 0,01). Uma moderada correlação foi encontrada entre FT2 e TR90 (r= 0,75, p= 0,05). CONCLUSÕES: Os resultados sugerem que o comportamento contrátil das FT2 não foi modificado nestes sujeitos. O dinamômetro isocinético mostrou ser um instrumento que pode avaliar, de forma não invasiva, a predominância do tipo de fibra muscular.

Muscular strength production may be impaired in myopathic patients. Myopathies represent a heterogeneous group of diseases with distinct clinical and morphological characteristics. It has been hypothesized that functional performance findings may be related to the predominant fiber type expressed in the muscle analyzed. OBJECTIVE: To correlate the proportion of type 2 fibers in the biceps brachii muscles of subjects with a clinical hypothesis of myopathy with their peak isometric and isokinetic torque during elbow flexion. METHOD: Seven subjects with a clinical hypothesis of myopathy participated in this study: four females of mean age 37 years (sd = 9), weight 73kg (sd= 26) and height 155cm (sd= 6); and three males of mean age 39 years (sd= 1), weight 88kg (sd= 5) and height 172cm (sd= 4). The muscle fiber proportion was analyzed using the mATPase technique. One month after taking biopsies, the subjects performed concentric isometric and isokinetic strength tests for elbow flexion and extension using an isokinetic dynamometer. The isometric and isokinetic peak torques at 90ºs-Õ and 180ºs-Õ were evaluated and the relative 90º (RT90) and 180º (RT180) torques were calculated. Spearman's correlation (r) was used for statistical analyses. RESULTS: The proportion of type 2 fibers correlated positively with RT180 (r= 0.89, p= 0.01), and there was a moderate correlation with RT90 (r= 0.75, p= 0.05). CONCLUSIONS: The results suggest that the contractile behavior of type 2 fibers was not modified in these subjects. The isokinetic dynamometer was shown to be an instrument capable of noninvasively evaluating muscle fiber type predominance.

The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient / 대한족부족관절학회지

PURPOSE: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. MATERIALS AND METHODS: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. RESULTS: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. CONCLUSION: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

Study of the reliability of the Cybex 6000 dynamometer measuring the shoulder extensor contracted concentrically and eccentrically / 中国康复理论与实践

@#ObjectiveTo evaluate the reliability of the Cybex 6000 isokinetic dynamometer in measuring the shoulder extensor contracted concentrically and eccentrically.Methods15 male subjects with no previous shoulder injuries were studied. The extensor muscles groups of asymmetrical shoulder were tested at 60°/s, 120°/s, and 180°/s respectively. Variables studied included peak torque (PT), average power (AP) and total work (TW). The interclass correlation coefficient (ICC) was used to determine the reliability.ResultsHigh test-retest reliability, ICC ranging from 0.86 to 0.97, was demonstrated for all tests.ConclusionThe Cybex 6000 isokinetic dynamometer shows a good reliability in measuring the shoulder extensor isokinetic contracted concentrically and eccentrically.

Correlation Analysis of KT 2000 arthrometer, Cybex Isokinetic Test and Lysholm Knee Score in ACL deficient knees

PURPOSE: The authors performed correlation analysis among the values of KT 2000 arthrometer, Cybex isokinetic test, and Lysholm knee score to reveal the clinical significance and their role in functional evaluation of ACL insufficiency. MATERIALS AND METHODS: Fifty-one patients with isolated ACL insufficiency were evaluated with KT 2000 arthrometer (15, 20, 30 lb, max.manual), Cybex isokinetic test (60 & 180 degrees/sec), and Lysholm knee score. Correlation analysis was performed between the values of the tests. RESULTS: The Lysholm knee scores had significant linear correlation with the values of KT 2000 of maximal manual difference (r=0.587, P<0.05). The Lysholm knee score had significant linear correlation with all the values of Cybex test of hamstring & quadriceps muscle weakness (r=0.585, 0.635, 0.656, 0.720, p<0.05). The degree of muscle weakness and maximum manual difference in KT 2000 did not show any linear correlation. The time lap between injury and evaluation did not show any correlation with any of the above parameters. CONCLUSION: Lysholm knee score appears to be mostly influenced by the degree of muscle weakness than anterior displacement. The values of KT 2000 of maximal manual difference revealed to be best correlated with Lysholm knee score. The time interval after injury cannot be clinically correlated with muscle weakness or Lysholm knee score.

The effects of kinesio taping on isokinetic muscle exertions of lower limb / 体力科学

This study aims to examine the effects of kinesio taping (KT) on explosive muscle and sustained maximal muscle exertions of lower limbs in pre- and post-strenuous exercises (SE) up to exhaustion. Twenty healthy college males (mean age 20.4 ± 1.08 yr) participated in the experiment for both the conditions of strapping KT (KT group) and no strapping KT (control group) . They all took pre- and post-SE isokinetic tests (IK test) .<BR>The KT was strapped around muscle groups related to flexion and extension motions of a knee joint before the experiment. The effects of KT were confirmed on the exertion of the explosive muscle strength in flexion motion of post-SE, and the sustained muscle strength in pre- and post-SEs. It was inferred that the effects of KT relate to the fatigue state of muscle groups related to motion and motion types, and interpretation of these effects differs by the load intensity and the variables used for evaluation.

The Study of Isokinetic Concentric Contraction of Low Limbs with Closed Chain / 中国康复理论与实践

@#normal males were tested by BIODEX isokinetic test and rehabilitation system and its closed chain attachment.The results show that Peak Torque,Peak Torque/Body Weight,Time to PT,Total Work,Total Work/Body Weight and Average Power were higher when extention than flexion.There were no significant influence on D1/D2 ratio.And the results with closed chain are the same with non closed chain test.

The Value of Trunk Retraining Hemiplegia / 中国康复理论与实践

@#The motor function of the trunk in 10 hemiplegic patlents was evaluated with Biodex Sys- tem Ⅱisokinetic testing aparatus. The result shows that the strength of flexors and extensors of the trunk,especially the flexors,becomes weaker(The ratio of flexors to extensors is less than 1).The patients weretreated with a series of the trunk retraining methods. The motor function of the trunk was improved aftertreatment(P<0.01 ).The total motor function(Fugl-Meyer Assessing Scale)also makes significant progress(P<0.01).The study proposes that the retraining and regaining of the trunk motor function in hemiplegiais quite important not only to the trunk but also to total motor function.