[Reference values in isometric strength diagnostics : Measurement of core strength values in patients with back pain]. / Referenzwerte in der isometrischen Kraftdiagnostik : Messung von Rumpfkraftwerten bei Patienten mit Rückenschmerzen.

OBJECTIVE: Isometric strength testing is known as a valid and reliable tool in the context of functional diagnostics and quality control for chronic low back pain rehabilitation, but reference values differ markedly between varied assessment devices, depending on their biomechanical lever arm framework. This study aimed to evaluate sex and age-specific isometric peak force reference values of trunk muscle functions in all dimensions using the Myoline® test device (Diers, Schlangenbad, Germany). MATERIAL AND METHODS: In a retrospective cross-sectional study, data of 678 (541 females, 137 males) age-clustered (18-35, 36-50, 51-65 years) low back pain patients (ICD-10: M54) were analyzed referring to their absolute (N) and body weight related (N/kg) isometric maximum peak forces in all spatial dimensions (flexion, extension, rotation, lateral flexion) and the corresponding ratios (M ± SD, 95% CI), accompanied by sex and age-related effect analyses (two-way ANOVA). RESULTS: Male and younger patients were significantly stronger than females and older patients (p < 0.05), but none of the ratios differed significantly between any sex or age cluster (p > 0.05). The flexion/extension ratio showed a 1:2 relation, and the rotation and lateral flexion ratios demonstrated a 1:1 relation, but all ratios varied markedly (30-50%). CONCLUSIONS: The demonstrated data represented a special norm for sex and age clustered low back pain patients assessed with the recent Myoline® test device. The markedly varying peak forces and their ratios underlined the individual diversity and heterogeneous state of functional capacities within low back pain patients.

Agreements and disagreements in exercise therapy prescriptions after hip replacement among rehabilitation professionals: a multicenter survey.

BACKGROUND: Exercise therapy following total hip replacement (THR) is considered to be important during the initial postoperative care, but till date only a few evidence-based recommendations exist. The aim of this survey was to identify prescription standards among different rehabilitation professionals, for the exercise therapy management after THR in Germany. METHODS: The study was a cross-sectional survey. Standardized questionnaires were sent to 38 eligible rehabilitation facilities in Germany. Participating surgeons, orthopaedic physicians, physiotherapists and exercise therapists rated the optimal early weight-bearing, resistance training, key components and dose of exercise therapy, and the hip loading during exercising. The returned questionnaires were then analyzed for level of agreement (≥80%) among respondents. RESULTS: 313 rehabilitation professionals from 28 clinics returned completed questionnaires and were considered eligible for analysis. Out of total respondents, 53.9% (cemented THR) and 18.2% (uncemented THR) recommended full weight-bearing within five days after surgery. Commencement of resistance training later than three weeks after surgery is recommended by 20.6% (36%) for cemented (uncemented) prosthesis. Feedback varied significantly amongst the professions. Regarding the overall objectives of rehabilitation after hip replacement, respondents agree in six out of eight requested items. Agreement concerning priorities of specific exercises was achieved in three out of twelve items. The recommended exercise therapy dose varied significantly with working experience (p = 0.02). CONCLUSION: Rehabilitation professionals mainly disagreed with the exercise therapy prescriptions following the total hip replacement during the initial postoperative care in Germany.