Effects of Closed Kinetic Chain Exercises in Chemotherapy-Induced Peripheral Neuropathy: A Case Report.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse reaction to many first- and second-line chemotherapy medications that can be debilitating, severe, and often dose-limiting. Treatment options for CIPN are limited. We report a case of a 52-year-old female patient with Stage II ovarian cancer who was hospitalised in the chemotherapy ward for a second round of chemotherapy. We describe the effectiveness of closed kinetic chain (CKC) exercises for the management of CIPN symptoms. The patient was advised to take neurophysiotherapy. The patient complained of pain, tingling in both feet, weakness in the lower limbs, and trouble keeping her balance while walking. Thus, three days after the start of the chemotherapy drugs, physical therapy rehabilitation was started. The patient stated total pain reduction and a noticeable improvement in tingling and numbness in both lower extremities following four weeks of physical therapy. Even though CIPN usually disappears gradually over time, it can persist for an extended period. It seems doubtful that this was a spontaneous resolve, given the regularity of her symptoms before starting physiotherapy sessions and their quick recovery with treatment. Further investigation is required to comprehend the role that physiotherapy and non-pharmacologic interventions play in ameliorating CIPN symptoms and to ascertain if improvements in CIPN symptoms are associated with an increase in blood flow directly or indirectly.

Effect of Various Movements on Shoulder External Rotators / 中国康复理论与实践

Objective To investigate the activities of infraspinatus (IS) and posterior deltoid (PD) under shoulder external rotation at open kinetic chain (OKC) and closed kinetic chain (CKC) exercise with shoulder abduction 0° and 90° to determine the optimal external rotation rehabilitation exercise.Methods From April to June, 2018, 19 healthy adults finished the movement of 0° OKC, 0° CKC, 90° OKC and 90°CKC. The root mean square (RMS) of IS and PD was recorded with surface electromyography (sEMG), then the standardized RMS (RMS％), ratio of IS/PD and onset time of activation were calculated.Results RMS％ of PD was the minimal at 90° CKC, and was less than that of 0° CKC (P ＜ 0.05). IS/PD was the most at90° CKC, and was more than that of 90° OKC (P ＜ 0.05). The onset time of IS was the earliest in 90° CKC, and earlier than that of 90° OKC (P ＜ 0.05) and 0°OKC (P ＜ 0.05). The onset time of PD was the latest in 0° CKC, and latter than that of 90° OKC (P ＜ 0.05).Conclusion 90°CKC activates IS mostly and earliest, which can be used in early rehabilitation for rotator cuff injury.

Lower limb muscle mechanics during isokinetic pedaling / 中华物理医学与康复杂志

Objective To document and analyze thepeak force and work during isokinetic pedaling at different linear speeds and the flexion-extension peak force ratio.Methods Thirty healthy adults were tested using the Legpress system of the IsoMED 2000 apparatus.Peak force,work and the flexion-extension peak force ratio were recorded and analyzed during isokinetic pedalingat 5 and 50 cm/s.Results The peak force applied and work done by the lower limbs were both significantly lowerwhen pedaling at 50 cm/s than at 5 cm/s.There was no significant difference in peak force or work between the left and right legs at 50 cm/s.The peak force ratio at 50 cm/s was significantly higher than at 5 cm/s.Conclusion The mechanical characteristics of the leg muscles during isokinetic pedaling vary greatly.It is advisable to choose different linear speeds or training modes accordingly.

Evaluation of open and closed kinetic chain exercises in rehabilitation following anterior cruciate ligament reconstruction.

[Purpose] To compare outcomes of anterior cruciate ligament (ACL) reconstruction after open kinetic chain (OKC) exercises and closed kinetic chain (CKC) exercises. [Subjects and Methods] The subjects comprised 11 female and 47 male patients who are randomly divided into two groups: which performed a CKC exercise program Group I and Group II which performed an OKC exercise program. Pain intensity was evaluated using visual analogue scale (VAS). Knee flexion was evaluated using a universal goniometer, and thigh circumference measurements were taken with a tape measure at baseline and at 3 months and 6 months after the treatment. Lysholm scores were used to assess knee function. [Results] There were no significant differences between the two groups at baseline. Within each group, VAS values and knee flexion were improved after the surgery. These improvements were significantly higher in the CKC group than in the OKC group. There were increases in thigh circumference difference at the 3 and 6 month assessments post-surgery. A greater improvement in the Lysholm score was observed in the CKC group at 6 months. [Conclusion] The CKC exercise program was more effective than OKC in improving the knee functions of patients with ACL reconstruction.

Electromyography of 3 scapular muscles: a comparative analysis of the cuff link device and a standard push-up.

CONTEXT: The Cuff Link is a closed kinetic chain rehabilitation apparatus for the upper extremity. Limited research has established its effectiveness to elicit muscle activation of the scapular muscles. OBJECTIVE: To determine if scapular muscle activation differs in response to 2 upper extremity closed kinetic chain exercises: Cuff Link and standard push-up. DESIGN: A single-group, repeated-measures design. SETTING: Controlled laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-eight healthy individuals (13 women: age = 19.69 +/- 1.55 years, height = 167.44 +/- 9.52 cm, mass = 61.00 +/- 8.79 kg; 15 men: age = 22.00 +/- 3.91 years, height = 181.44 +/- 6.60 cm, mass = 82.36 +/- 13.23 kg) with no history of shoulder or low back injury volunteered to participate in this study. INTERVENTION(S): Participants performed 10 trials of complete revolutions on the Cuff Link and 10 full-weight-bearing push-ups. We controlled trial velocity and randomized order. Trunk and shoulder positions were normalized to the participant's height. Using surface electromyography, we recorded muscle activity of the serratus anterior, middle trapezius, and lower trapezius. Rectified and smoothed electromyography data for the serratus anterior, middle trapezius, and lower trapezius were normalized as a percentage of the maximal voluntary isometric contractions (%MVIC). MAIN OUTCOME MEASURE(S): Mean muscle activity of the serratus anterior, middle trapezius, and lower trapezius. We used paired-samples t tests to analyze the mean data for each condition. The alpha level was adjusted to .016 to avoid a type I error. RESULTS: Middle trapezius %MVIC was greater during push-ups (27.01 +/- 20.40%) than during use of the Cuff Link (11.49 +/- 9.46%) (P = .001). Lower trapezius %MVIC was greater during push-ups (36.07 +/- 18.99%) than during use of the Cuff Link (16.29 +/- 8.64%) (P = .001). There was no difference in %MVIC for the serratus anterior between conditions. CONCLUSIONS: The push-up demonstrated greater middle trapezius and lower trapezius activation levels compared with the Cuff Link. However, the push-up had a high participant failure rate. Because serratus anterior activation levels were similar, the Cuff Link may be an appropriate alternative for individuals lacking the upper body strength to perform a push-up.