Quantification of full-range-of-motion unilateral and bilateral knee flexion and extension torque ratios.

OBJECTIVES: To evaluate the reliability and variability of repeated measurements of isometric knee flexion and extension strength, to quantify the extent of measurement error that may occur due to gravity, and to quantify isometric knee flexion/extension torque ratios at multiple angles through a full range of motion. DESIGN: Reliability assessment. SETTING: A university exercise center. PARTICIPANTS: Seventy-seven healthy men and women recruited from a university and surrounding community. INTERVENTION: Isometric knee flexion and extension strength tests. MAIN OUTCOME MEASURES: Knee flexion/extension strength was measured at 6 degrees, 24 degrees, 42 degrees, 60 degrees, 78 degrees, 96 degrees, and 108 of knee flexion. Before each contraction, subjects were instructed to completely relax the limbs to measure the mass of the lower leg. Torque values obtained during relaxation at each angle were added to or subtracted from "Total Torque" (TTQ) at peak exertion. The adjusted value was recorded as "Net Muscular Torque" (NMT). RESULTS: Reliability for the unilateral and bilateral tests was high (r =.88 to r=.98) and measurement variability low (SEM%=5.1% to 12.6%). There was a statistically significant difference at each angle of measurement between the TTQ and NMT values for both knee flexion and extension. Knee flexion/extension ratios were highly dependent on the angle tested, ranging from 1.30 (at 60) to .31 (at 1080). CONCLUSIONS: Isometric testing, using standardized angles, can reliably quantify knee flexion/extension strength. Furthermore, these findings emphasize the importance of correcting for the mass of the lower leg when assessing muscle function. Angle-specific knee flexion/extension torque ratios should provide clinicians with a more precise method of evaluating muscular balance (imbalance) throughout the range of motion.

Limited range-of-motion lumbar extension strength training.

The purpose of this study was to evaluate the effect of limited range-of-motion (ROM) resistance training on the development of lumbar extension strength through a 72 degrees ROM. Thirty-three men and 25 women (age = 30 +/- 11 yr) were randomly assigned to one of three training groups or a control group (C; n = 10) that did not train. Training was conducted once per week for 12 wk and consisted of one set of 8-12 repetitions of variable resistance lumbar extensions until volitional fatigue. Group A (n = 18) trained from 72 degrees to 36 degrees of lumbar flexion; group B (n = 14) from 36 degrees to 0 degree of lumbar flexion; and group AB (n = 16) from 72 degrees to 0 degree of lumbar flexion. Prior to and after training, isometric lumbar extension torque was assessed at 72 degrees, 60 degrees, 48 degrees, 36 degrees, 24 degrees, 12 degrees, and 0 degree of lumbar flexion. Analysis of covariance showed that groups A, B, and AB increased lumbar extension torque (P less than or equal to 0.05) at all angles measured when compared with C. The greatest gains in torque were noted for groups A and B in their respective ranges of training but A and B did not differ from AB (P greater than 0.05) at any angle. These data indicate that limited ROM lumbar extension training through a 36 degrees ROM is effective for developing strength through 72 degrees of lumbar extension.

Effect of 12 and 20 weeks of resistance training on lumbar extension torque production.

This study compared the effect of varied training frequencies on the development of isometric lumbar extension torque (strength) over 12- and 20-week training periods. Fifty-six subjects were randomly assigned to training once every other week (training group 1, n = 10), once per week (training group 2, n = 12), twice per week (training group 3, n = 12), or three times per week (training group 4, n = 7) or to a nontraining control group (n = 15). Training consisted of one set of 8 to 12 variable-resistance lumbar extensions to volitional muscular fatigue. Prior to and following 12 and 20 weeks of training, subjects were given a test that evaluated isolated isometric lumbar extension torque in a seated position at seven positions (angles) through a 72-degree range of motion. The control group showed no change in isometric torque. All training groups showed significant increases in lumbar extension torque at 12 and 20 weeks of training, whereas no significant differences were found among the groups with respect to the magnitude of torque gained. Pooled training showed a significant time x angle interaction at 12 weeks and a continuing trend at 20 weeks, indicating that the shape of the isometric torque-angle curve changed as a result of training. This effect was due to greater increases in isometric torque at the fully extended position than at the fully flexed position at 12 weeks (92% versus 16%, respectively) and at 20 weeks (123% versus 17%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Back pain and the exercise prescription.

Rationale for the use of exercise in the treatment and prevention of LBP and injury has been discussed. Current knowledge supports the use of individualized exercise programs that emphasize the restoration and maintenance of adequate lumbar-spinal function. When indicated, aerobic exercises to develop overall fitness and prevent deconditioning should be included in the exercise prescription. Several commonly used exercises for strengthening the lumbar extensor muscles have been reviewed. Lumbar extension exercises that stabilize the pelvis, provide a means for progressively increasing the resistance, and allow the exerciser to move through a full range of lumbar movement appear to offer the greatest benefit to the patient with LBP.

Cortical desmoid-like lesion of the proximal humerus and its occurrence in gymnasts (ringman's shoulder lesion).

Eighteen gymnasts were interviewed and examined radiographically for a cortical irregularity of the proximal humerus simulating malignancy. Fifty percent of the gymnasts had the lesion which is considered to be a benign reactive lesion secondary to excessive forces at the pectoralis major insertion to the proximal humerus. All patients were asymptomatic. The lesion is probably unique to gymnasts, particularly those involved with strength moves.