ABSTRACT
OBJECTIVE: To evaluate whether extended use of continuous passive motion (CPM) may allay the pain of walking, diminish disease effect, and increase the usual walking speed in patients with osteoarthritis (OA) of the hip. METHODS: This pilot study comprised 21 patients with Kellgren-Lawrence grade 2-4 OA of the hip who used CPM for periods of 1.2 to 7.6 h daily throughout a 12 week trial. RESULTS: Significant improvements were found in the patients' assessment of pain on visual analog scale, Sickness Impact Profile, self-selected walking speed, and the number of subjects who decreased their medication usage. None of these improvements was related to the radiographic grade of the patients' OA or the daily duration of CPM. CONCLUSION: Although regular exercise is now routinely recommended to patients with OA, there has been relatively little study of specific exercise programs. As such investigations are undertaken, we believe CPM should be included among the options that are studied.
Subject(s)
Motion Therapy, Continuous Passive/methods , Osteoarthritis, Hip/rehabilitation , Adult , Aged , Female , Hip Joint/physiopathology , Humans , Male , Middle Aged , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/physiopathology , Pain Measurement , Pain, Intractable/prevention & control , Patient Compliance , Patient Satisfaction , Pilot Projects , Range of Motion, Articular , Treatment OutcomeABSTRACT
To determine the effects of isokinetic resistance training of the quadriceps, 25 male volunteers were randomly assigned to five training groups: Concentric Slow (CS), Concentric Fast (CF), Concentric-Eccentric Slow (MS), Concentric-Eccentric Fast (MF), and Control (C). In training, subjects performed 20 contractions of each quadriceps using either 60 degrees/sec or 180 degrees/sec, for both sides, five days per week for 12 weeks. Testing consisted of measurement of peak torque, at intervals of 60 degrees/sec across a spectrum of velocities ranging from plus to minus 240 degrees/sec, at 0, 4, 8, and 12 weeks. Repeated MANOVA using planned comparisons showed that all trained subjects made significant peak torque gains (p < .05), but that the gains made by MS and MF were greater. These findings suggest that the addition of an eccentric training component to a concentric isokinetic training program may allow greater peak torque gains regardless of the velocity.
Subject(s)
Muscle Contraction , Physical Education and Training/methods , Adult , Humans , Male , Multivariate Analysis , ThighABSTRACT
Twenty men were randomized into three groups that performed maximal isokinetic knee extensions five days a week for 12 weeks; a fourth group was a control group. The training protocol was different for the opposite lower extremity of each subject, such that subjects in group I trained at 36 degrees/sec with 20 or 60 repetitions, group II did 20 repetitions at 36 degrees/sec with one limb and 60 repetitions at 108 degrees/sec contralaterally, and group III trained at 108 degrees/sec with 20 or 60 repetitions. Group IV did no training. Bilateral pretraining and posttraining vastus lateralis muscle biopsies were done, and maximal torque-velocity tests (0 degrees to 234 degrees/sec at 18 degrees/sec steps) were performed every two weeks. The muscle biopsies were examined for muscle-fiber area and enzyme activity. Statistical analysis of the torque-velocity curves showed that subjects who trained at 36 degrees/sec made significant overall gains in torque and significantly greater torque gains than those training at 108 degrees/sec. Torque gains were not made uniformly during the 12 weeks of training; they occurred primarily during the initial 4 to 8 weeks. There were no significant increases in muscle-fiber areas in response to training, but there were increases in glycolytic and mitochondrial enzyme activities. These findings suggest that the critical variable for developing strength (maximal torque), at least within the context of isokinetic training, is the amount of torque developed during training.
Subject(s)
Isometric Contraction/physiology , Physical Education and Training , Adenosine Triphosphatases/metabolism , Adult , Data Interpretation, Statistical , Humans , Malate Dehydrogenase/metabolism , Male , Muscles/anatomy & histology , Muscles/enzymology , NAD/metabolism , Reference Values , Succinate Dehydrogenase/metabolismABSTRACT
Heterotopic ossification can occur in neurologic disorders, burns, musculoskeletal trauma, and metabolic disorders. In addition to producing the complications of contracture, skin breakdown, and pain, it can cause peripheral nerve entrapment. Nerve entrapment due to heterotopic ossification may be misdiagnosed, and it is difficult to evaluate and treat without recurrence. Computed tomography is especially useful in localization before surgical release of the entrapped nerve. Resection of heterotopic ossification can be successful using disodium etidronate to decrease the risk of recurrence, and resection can improve range of motion and nerve function. Two case studies of nerve entrapment due to heterotopic ossification are presented with the results of computed tomography localization, successful resection, and long-term follow-up. Clinicians should be aware of this complication and the potential for rapid nerve injury. If heterotopic ossification is causing clinically significant peripheral nerve entrapment, early surgical treatment may be indicated, and may be successful.
