Isokinetic Evaluation of the Shoulder After Bristow/Latarjet Surgical Procedure in Athletes / Avaliação isocinética do ombro após procedimento cirúrgico de Bristow/Latarjet em atletas

Abstract Objectives To evaluate the muscular strength of the internal (IR) and external (ER) rotators of the shoulder after Bristow/Latarjet surgery. Methods Cross-sectional study with 18 patients (36 shoulders). The isokinetic evaluation was performed using the Biodex 3 System Pro dynamometer (Biodex Medical System, Inc., Shirley, NY, USA). The athletic shoulder outcome rating scale (ASORS) and the visual analogue scale (VAS) were applied. Results The values of peak torque and maximum work in concentric and eccentric mode on the non-operated shoulder were higher than on the operated side for both the IR and ER (p< 0.01). The conventional and functional balance between the ER and IR showed no differences between the operated and the non-operated side. When comparing patients with postoperative time < 1 year or 1 year, no differences were observed in peak torque values at 60°/s and 240°/s and maximum work at 60°/s and 240°/s of the IR to the operated shoulder. However, the peak torque values of 60°/s and 240°/s and maximum work at 60°/s and 240°/s of the ER were higher in subjects with postoperative time ≥ 1 year in all variables (p< 0.05). Conclusions There was a decrease in the strength of the IR and ER in the operated shoulder compared with the healthy shoulder. However, the conventional and functional balance was maintained.

Resumo Objetivos Avaliar a força muscular dos rotadores medial (RM) e lateral (RL) do ombro após cirurgia de Bristow/Latarjet. Métodos Estudo transversal com 18 pacientes (36 ombros). A avaliação isocinética foi realizada por meio do dinamômetro Biodex 3 System Pro (Biodex Medical System, Inc., Shirley, NY, EUA). A escala de avaliação dos resultados do ombro do esportista (EROE) e a escala visual analógica (EVA) da dor foram aplicadas. Resultados Os valores do pico de torque e o trabalho máximo no modo concêntrico e excêntrico no ombro não-operado foram maiores que no lado operado, tanto para o RM e como para o RL (p< 0,01). O equilíbrio convencional e funcional entre o RL e o RM não apresentou diferenças entre o lado operado e o não operado. Na comparação entre pacientes com o tempo pós-operatório < 1 ano ou ≥ 1 ano, não se observou diferenças nos valores do pico de torque em 60°/s e 240°/s e do trabalho máximo em 60°/s e 240°/s do RM para o ombro operado. No entanto, os valores de do pico de torque em 60°/s e 240°/s e do trabalho máximo em 60°/s e 240°/s do RL foram superiores em indivíduos com tempo pós-cirúrgico ≥ 1 ano em todas as variáveis (p< 0,05). Conclusões Houve diminuição da força do RM e do RL no ombro operado em relação ao ombro saudável; porém, o equilíbrio convencional e funcional foi mantido.

Is 12 months enough to reach function after athletes' ACL reconstruction: a prospective longitudinal study

Abstract Context: Anterior Cruciate Ligament (ACL) injury is disabling in several sports because it causes knee instability and functional deficit. Usually, surgical treatments produce the best functional outcomes, however, sometimes they are not always able to fully restore stability and function. Objective: The objective of this study was to evaluate postural balance, muscle strength, and functional performance of young athletes with an ACL injury before and after ACL reconstruction. Design: This was a longitudinal observational prospective study. Method: 74 athletes, 60 men, and 14 women, aged between 16 and 45, divided into two groups: the Group-Lesion of ACL with 34 athletes (24.1 years) and the Group-Control with 40 athletes without ACL lesion (27.7 years old). All volunteers performed posturography, isokinetic dynamometry, and the Hop-Test. The ACL-Group was evaluated before and 12 months after the reconstruction and the control group was evaluated once. Results: The Postoperative ACL Group presented greater limb symmetry, 0.96 (± 0.12), than the preoperative ACL Group, 0.87 (± 0.17), p < 0.01 in the Hop-Test. In the posturography, the displacement area was smaller in the postoperative ACL Group, 19.85 (± 5.74), compared to the preoperative ACL Group, 24.20 (± 8.97), p < 0.01. In isokinetic dynamometry the torque peak was greater in the postoperative ACL Group, 0.91 (± 0.14), than in the preoperative ACL Group, 0.74 (± 0.15), p < 0.01. Conclusion: The functional outcomes increased in ACL reconstruction athletes after 12 months, but not at the same level as in the Control Group. The result indicates an incomplete functional recovery, adaptive changes in postural control after injury, reconstruction, and return to sport.

Reliability of isokinetic evaluation in passive mode for knee flexors and extensors in healthy children

BACKGROUND: The isokinetic dynamometer has been considered the gold-standard measurement of muscle performance. However, the reliability for the passive mode in children has not been reported to date. OBJECTIVES: The purpose was to evaluate the reliability of the isokinetic dynamometer in passive mode in children. METHOD: Twenty-one healthy children (ten girls, eleven boys), aged 5 to 12 years (age: 8.5±2.2 years), were evaluated using an isokinetic dynamometer. Each participant was tested twice with a one-week interval and performed five consecutive cycles of knee extension and flexion. The test was performed at 60º/s in the concentric passive mode and the children performed maximal contractions. The measured variables were peak torque, average peak torque, total work, and average power, time to peak torque and angle of peak torque for dominant and non-dominant lower limbs. Reliabilities were determined using intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM and SEM%), and coefficient of variation (CV). RESULTS: We found good reliability in both lower limbs for peak torque, average peak torque, total work and average power of knee flexors and extensors, with ICC3,1 values greater than 0.80; SEM ranging from 6.7 to 79.2; SEM% ranging from 10.4% to 16.8%; CV lower than 15%. Bland-Altman analysis showed that the bias was low than 10% and limits of agreement (LOAs) ranging from 33.9% to 59.2%, and -28.8% and -52.8%, showing that measures tended to disagree. However, time to peak torque (ICC3,1<0.68; SEM > 0.34; SEM%>37.4%; CV>41.7%; bias >24.0%; LOA>101.0%) and angle of peak torque (ICC3,1<0.76; SEM>9.3; SEM%>27.6%; CV>15.3%; bias>11.0%; LOA>61.0%) were not reliable. CONCLUSIONS: The findings indicate that isokinetic evaluation in passive mode for knee extensors ...

Variação do equilíbrio muscular durante uma temporada em jogadores de futebol categoria sub-20 / Variation of the muscular balance during a season in under-20 soccer players

O objetivo deste estudo foi analisar o equilíbrio muscular dos flexores e extensores (RFE) de joelho ao longo de uma temporada de treinamento em jogadores de futebol categoria sub-20. Fizeram parte da amostra 15 sujeitos pertencentes à equipe sub-20 da Associação Atlética Ponte Preta de Campinas. Os atletas participaram de um macrociclo de preparação (MP) de 29 semanas, composto por período preparatório e competitivo que foram divididos em quatro mesociclos: etapa geral (M1), etapa especial (M2), etapa pré-competitiva (M3) e etapa competitiva (M4). A RFE de ambos os membros foi determinada em dinamômetro isocinético utilizando o pico de torque (PT) obtido em três séries consecutivas de cinco repetições com velocidade de 60º/s. Avaliação isocinética foi realizada em quatro momentos ao longo do MP, sempre ao final de cada mesociclo (M1, M2, M3 e M4). Para análise estatística, foi empregado teste Friedman de medidas repetidas, seguida do teste de Wilcoxon e teste U de Mann-Whitney, com nível de significância de p<0,05. O PT nos músculos flexores de joelho, em ambos os membros, no M2 e M3 foram superiores aos observados em M1 e M4. O PT dos extensores de joelho em M1 foi significantemente inferior aos demais momentos do estudo (M2, M3 e M4), em ambos os membros. A RFE, em ambos os membros, foi inferior em M1 quando comparado a M2 e M3. A comparação da RFE entre os membros não revelou diferenças significantes em nenhum dos momentos do estudo (M1, M2, M3 e M4). Os resultados encontrados na presente investigação indicaram existência de alterações na magnitude da RFE, porém dentro da normalidade, e, manutenção da proporcionalidade entre os membros ao longo do MP. Esses resultados sugerem que não existem períodos sensíveis para a ocorrência de lesões em virtude de desequilíbrios musculares ao longo do MP em jogadores de futebol da categoria sub-20.

The objective of the present study was to evaluate the muscular balance of knee flexors and extensors (RFE) in under-20 soccer players during a training season. 15 under-20 subjects from the Ponte Preta Athletic Association of Campinas participated in a 29 week macrocycle preparation (MP), composed of preparatory and competitive periods which were divided into four mesocycles: general stage (M1), special stage (M2), pre-competitive stage (M3) and competitive stage (M4). RFE of both members was determined with the torque peak (TP) obtained in isokinetic dynamometer in three consecutive sets of five repetitions of 60 degrees/s. Isokinetic evaluation was accomplished in four stages along the MP at the end of each mesocycle (M1, M2, M3, and M4). Statistic analysis was performed using the Friedman test with repeated measures, followed by Wilcoxon test and Mann-Whitney U test, with significance level of p<0.05. TP of knee flexors muscles in both members were greater in M2 and M3 than in M1 and M4. TP of knee extensors in M1 was significantly inferior than the other stages of the study (M2, M3, and M4), in both members. RFE, in both members, was inferior in M1 when compared to M2 and M3. RFE comparison among members did not reveal significant differences in any moment of the study (M1, M2, M3, and M4). The results indicated the existence of alterations in the size of RFE; within normality though, and maintenance of the proportionality among members along the MP. These results suggest that there are not sensitive periods to the occurrence of injuries due to muscular imbalances along MP in under-20 soccer players.

Caracterização da performance muscular em atletas profissionais de futebol / Characterization of professional soccer players' muscle performance

INTRODUÇÃO E OBJETIVOS: Estudos que relacionam parâmetros de performance muscular com risco de lesão e desempenho em diferentes esportes têm sido freqüentemente reportados na literatura. Entretanto, há carência de dados que caracterizem a performance muscular em atletas profissionais do futebol brasileiro. Portanto, o objetivo deste estudo foi realizar uma análise descritiva dos parâmetros relacionados à performance muscular dessa população. MÉTODOS: A amostra consistiu de 117 atletas pertencentes a clubes de elite do futebol mineiro. Para avaliação da performance muscular foi utilizado um dinamômetro isocinético e os testes consistiram de contrações concêntricas máximas das musculaturas avaliadas. No quadril, as musculaturas adutora e abdutora foram avaliadas nas velocidades 30º/s, 60º/s e 120º/s. No joelho, foram avaliados os músculos flexores e extensores a 60º/s, 180º/s e 300º/s. No tornozelo, os músculos dorsoflexores, flexores plantares, inversores e eversores foram avaliados nas velocidades 30º/s, 60º/s e 180º/s. Para análise dos dados foram utilizados estatística descritiva e testes t pareados para avaliar diferenças entre pernas. RESULTADOS: Os resultados deste estudo caracterizam o perfil de atletas profissionais do futebol relativo à capacidade de produção de torque, trabalho máximo e potência média. Além disso, foram observadas diferenças significativas entre pernas em algumas variáveis. CONCLUSÃO: Os dados normativos estabelecidos podem ser utilizados como valores de referência na prevenção, treinamento e reabilitação dos atletas, além de servirem de referência para futuros estudos que tenham como objetivo relacionar os parâmetros de performance muscular à incidência de lesões no futebol.

INTRODUCTION AND OBJECTIVE: The association of muscular performance with risk of injury and functional performance in different sports has been reported in numerous studies in the literature. However, there is a paucity of data that characterizes the muscular performance in Brazilian professional soccer athletes. Therefore, the objective of this study was to make a descriptive analysis of parameters related to the muscular performance of this population. METHODS: The sample of this study was composed of 117 athletes belonging to professional soccer clubs in Minas Gerais State. In order to evaluate the muscular performance of the athletes, an isokinetic dynamometer was used and the tests involved maximum voluntary contractions of the selected muscles. Hip abductors and adductors were assessed at the speeds of 30º/s, 60º/s and 120º/s; knee flexors and extensors at 60º/s, 180º/s and 300º/s; and ankle dorsiflexors, plantarflexors, invertors and evertors at 30º/s, 60º/s and 180º/s. Descriptive statistics were used to present the normative data and paired t-tests were used to identify significant differences between legs considering the parameters evaluated in this study. RESULTS: This study generated normative data to characterize the profile of Brazilian professional soccer players relative to their capacity of producing torque, muscle work and power. Significant differences were observed between legs considering some of the study's variables. CONCLUSION: The established normative data can be used as reference values in the prevention, training and rehabilitation of the athletes. In addition, these data may be used as reference for future studies with the objective of testing the association between muscular performance and incidence of injury in soccer practice.

Isokinetic Evaluation of the Knee in Patients with Osteoarthritis of Knees and Its Relationship with Walking Time

Muscle functions are limited in patients with osteoarthritis of knees. In patients with osteoarthritis, isokinetic testing of knee musculature reveals decreased peak torque and increased walking time(50-ft). The purpose of this study was to demonstrate deficiency in muscular performance of knee, and the relationship between walking time and isokinetic parameters of muscular strength, endurance and pain of knee in patients with osteoarthritis of knees. The subjects were divided into a control group and the study group. The control group consisted of 40 persons without a knee pain, and the study group consisted of 30 patients with osteoarthritis of knees. The peak torque of patients in the study group was decreased by 16-21%, compared to that the control group. There was a negative relationship between the walking time and the endurance of knee extensors(r=?0.7195). These findings suggest that exercises to increase the strength and endurance of extensors and flexors of knees should be emphasized in the rehabilitation program for the osteoarthritis of knees.