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PubMed2002

Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis.

OBJECTIVE: To study the hip muscle strength and cross sectional area (CSA) in men with hip osteoarthritis (OA) compared to age and sex matched healthy controls. METHODS: Based on the American College of Rheumatology criteria regarding classification of hip OA, 27 men (aged 47-64 yrs) with unilateral or bilateral hip OA and 30 age matched randomly selected healthy male controls were studied. The maximal isometric hip abductor, adductor, flexor, and extensor strength (Nm) at 0 degree of hip flexion in the supine position was determined with a dynamometer. The isokinetic hip flexion and extension strength (peak torque, Nm) was determined using angular velocities of 60 degrees /s and 120 degrees /s. The subjective severity of hip pain was rated by visual analog scale prior to the muscle strength test. CSA of the pelvic and thigh muscles was measured from magnetic resonance images. RESULTS: The reliability of intraclass correlation coefficients for repeated measures of muscle strength varied from 0.70 to 0.94 in controls and from 0.84 to 0.98 in subjects with OA. Hip isometric adductor and abductor strength was 25% and 31% lower (p < 0.001) in OA subjects than in controls, respectively. The hip isometric and isokinetic flexion strength was 18-22% lower (p < 0.01) in OA subjects than in controls, but extension strength did not differ between groups. In OA subjects, the hip flexion and extension isometric and isokinetic strength values were 13-22% lower (p < 0.05) on the more deteriorated side compared to the better side. CSA of the pelvic and thigh muscles did not differ between the groups. However, in OA subjects, the CSA of the pelvic and thigh muscles was 6-13% less (p < 0.05 to < 0.001) on the more severely affected hip compared to the better hip. CONCLUSION: Men with hip OA have significantly lower abduction, adduction, and flexion muscle strength than controls. The decrease of muscle size and hip pain may contribute to the decrease of muscle strength in hip OA. Other possible underlying causes of the muscle weakness need to be studied.

Anatomy, Cross-Sectional↗
PubMedDate not supplied

[Arthroscopic joint debridement for gonarthrosis: influence of degree of chondral damage and muscle weakness on results].

AIM: Purpose of this study was to investigate the correlation between subjective patient discomfort, chondral damage and muscular weakness in cases of gonarthrosis (OA). METHODS: In 22 patients suffering from OA who underwent arthroscopy, the complaints were scored by the Lysholm score. Chondral damage was determined by a special "chondral score". The maximum peak torque was measured pre- and postoperatively (isokinetic test, Cybex 6000 dynamometer). RESULTS: Joint debridement and subsequent postoperative aggressive rehabilitation produced a significant increase in the Lysholm score (from 45.7 to 77.5 points). Subjective complaints correlated significantly with the degree of chondral damage. After treatment, the strength of the extensor muscles increased significantly. The strength of the flexor muscles strength also increased tendentially. However, there was a deficit in muscular strength in comparison to the contralateral leg in all cases. The subjective complaints correlated with the loss of muscle strength at slow angular velocities. CONCLUSIONS: The patients" evaluation with the Lysholm score in combination with an arthroscopic chondral score and the measurement of the isokinetic muscle strength is a suitable method to obtain information about the chances of success for arthroscopic joint debridement in patients suffering from OA. Arthroscopic treatment is an appropriate measure for a short-term reduction of subjective complaints in OA. But it is also useful to reduce muscular deficits.

Adult↗
PubMed1999

Muscle strength characteristics and central bone mineral density in women with recent onset rheumatoid arthritis compared with healthy controls.

Muscle strength and bone mineral density (BMD) at the lumbar spine (BMDspine) and femoral neck (BMDfem) were determined in 20 healthy women and in 20 women with recent onset rheumatoid arthritis (RA). The mean duration of articular symptoms of the patients was eleven months and none of them had used glucocorticoids or disease modifying antirheumatic drugs. BMDs were measured by dual x-ray absorptiometry (DXA). Knee extension, trunk extension, and flexion as well as grip strength were measured with David 200 and Digitest dynamometers. BMDspine (1.17 g/cm2 and 1.20 g/cm2) and BMDfem (0.98 g/cm2 and 0.96 g/cm2) between the women with early RA and healthy women did not differ. However, knee extension strength was 46%, grip strength 31%, trunk extension strength 14% and overall muscle strength index 29% lower in RA women (p < 0.020-0.001) than in healthy subjects. Femoral neck BMD correlated statistically significantly with knee extension strength and muscle strength index in both groups and with trunk extension and flexion strength as well as rapid force development in RA women. The data indicates that the loss of muscle strength is clearly visible during the first months of disease but the significant bone loss at central bone regions develops later.

Adult↗
PubMed2000

Isometric progressive resistive exercise for osteoporosis.

OBJECTIVE: To assess the effect of site-specific resistive isometric exercises on muscle strengthening of 10 muscle groups over 2 months. A second study measured bone alkaline phosphatase (ALP) as a marker of bone formation and bone resorption [urine deoxypyridinoline (D-Pyr) crosslinks] in a similar cohort. METHODS: Twenty postmenopausal Caucasian women aged 56 to 69 yrs (mean 61) on a stable or no medication regimen for the previous 6 months participated in the initial exercise cohort. Twenty-one women ages 52-69 (mean 62) participated in the second cohort. All women had osteopenia (DXA T less than -1.0) or osteoporosis (DXA T less than -2.5). An inflatable ball with attached nonelastic straps provided progressive resistance. Exercises consisted of a 5 s maximum contraction against progressively increasing resistance of the ball or nonelastic straps. Muscle strengthening was measured by a hand held dynamometer at 0, 4, and 8 weeks. Twenty women completed 8 weeks of the initial study and 21 women completed the second study. RESULTS: Muscles showing increased strength in the first cohort were neck extensors (p < 0.04), hand grips (p < 0.02), elbow flexors (p < 0.05), quadriceps (p < 0.04), trunk extensors (p > 0.05, not significant = NS). Elbow extensors were purposely not exercised (as a control) and showed no significant strength increase. In the second cohort, increased muscle strength was measured in the neck extensors (p < 0.001), trunk extensors (p < 0.001), and left quadriceps (p < 0.024); and bone ALP increased (p < 0.05), with no change detected in bone resorption (urine D-Pyr). CONCLUSION: Brief progressively resisted isometric exercises for 10 min daily are an adequate stimulus for muscle strengthening of the neck, back, upper and lower extremities, and are capable of enhancing bone formation measured by bone ALP.

Alkaline Phosphatase↗
PubMed2003

Sex-Related and Age-Related Differences in Knee Strength of Basketball Players Ages 11-17 Years.

OBJECTIVE: To assess hamstrings and quadriceps strength of basketball players ages 11-13 and 15-17 years. DESIGN AND SETTING: This cross-sectional study occurred during the 2000 American Youth Basketball Tour National Tournament. We investigated whether sex- or age-related strength differences existed among study participants. SUBJECTS: Forty-one tournament participants (22 girls, 19 boys; 11-13 or 15-17 years old) who reported no history of knee sprain or surgery were recruited. MEASUREMENTS: We used a Cybex II dynamometer to obtain isokinetic concentric peak torques relative to body mass (Nm/kg) at 60 degrees /s for hamstrings and quadriceps bilaterally. From average peak torques, we determined ipsilateral hamstrings:quadriceps and homologous muscle-group ratios. RESULTS: Correlations between hamstrings and quadriceps strength measures ranged from 0.78 to 0.97. Players 15-17 years old had greater relative hamstrings and quadriceps strength than 11- to 13-year-old athletes. Age and sex interacted significantly for quadriceps strength. The quadriceps strength of 15- to 17-year-old girls did not differ from that of 11- to 13-year-old girls, whereas 15- to 17-year-old boys had stronger quadriceps than 11- to 13-year-old boys. Boys 15-17 years old had greater quadriceps strength than girls 15-17 years old. CONCLUSIONS: This study is unique in providing normative data for the hamstrings and quadriceps strength of basketball players 11-13 and 15-17 years old. Age-related strength differences did not occur consistently between the sexes, as girls 11-13 and 15-17 years old had similar relative quadriceps strength.

Journal Article↗
PubMed1995

Isokinetic strength testing for evaluating the efficacy of intravenous immune globulin therapy for inclusion body myositis.

Inclusion body myositis is a disease of striated skeletal muscle of unclear etiopathogenesis. Its diagnosis is difficult. Corticosteroids and immunosuppressants are of limited efficacy. Positive responses to intravenous immune globulins have recently been reported in a few patients. We used a CYBEX 6000 isokinetic dynamometer to evaluate the efficacy of intravenous immune globulin therapy in a patient with inclusion body myositis. Measurements were done at the flexors and extensors of the knee, at baseline and four and eight months after treatment initiation. A course of intravenous immune globulins (2 g per course) was given every month for five months then every two months. Isokinetic muscle strength measured at an angular speed of 180 degrees/second increased by more than 41% at both knees. As compared with muscle imaging studies (computed tomography, X-ray absorptiometry, ultrasonography, magnetic resonance imaging), isokinetic strength testing has the advantage of providing data on functional improvements under treatment.

Humans↗
PubMed1998

Alternatives for measuring knee extension strength of the elderly at home.

OBJECTIVE: To examine the construct validity of three measures of knee extension strength obtained from elderly individuals. DESIGN: Retrospective and cross-sectional. SETTING: Home care. SUBJECTS: Forty-one consecutively treated patients (mean age 79.2 years). MEASURES: Knee extension strength was measured using manual muscle testing, hand-held dynamometry, and the sit-to-stand test. RESULTS: Convergent construct validity was supported by the significant correlations between the measures (rs = 0.578-0.702). Discriminant construct validity was confirmed by the finding of significant differences in the manual muscle test scores and in the hand-held dynamometer measures of patients who were unable versus able to stand from a chair without the upper extremities or help. The sensitivity of the two measures for discriminating between patients able versus unable to stand from a chair was 90.9% for manual testing and 68.2% for dynamometry. The specificity was 78.9% for manual testing and 94.7% for dynamometry. CONCLUSION: The results of this study show that the three measures employed to characterize knee extension strength are valid when employed with elderly patients in a home care setting.

Aged↗
PubMed1983

Quantitative electromyography: response of the neck muscles to conventional helmet loading.

Experiments were conducted to quantify the fatigue of neck muscles which occurs during loading of these muscles by: the head itself (CON), the conventional SPH-4 helmet (HEL), and a combination of the SPH-4 helmet with Night Vision Goggles (H/NVG). Two exercise periods of 5 min and 35 min duration, respectively, were performed by the 5 subjects, during which a subject would rotate the head laterally (from side-to-side) in the CON, HEL, or H/NVG configuration. Immediately thereafter, the subject would position his head in an isometric head dynamometer and exert a sustained right lateral (LAT) neck contraction, or forward (FOR) neck contraction at 70% of his maximum strength, during which his endurance time to fatigue was recorded, and the EMG over the right sternocleidomastoid (SCM) muscle, and over the posterior trapezius/splenius muscles was continuously recorded. The root-mean-squared (RMS) amplitude of the electromyogram (EMG) continuously increased during the fatiguing contraction, being 78% greater (on the average) by the time of fatigue, and the center frequency of the EMG power spectrum continuously decreased, being 27% less (on the average) at the fatigue end-point. Some variability with head loading configuration and contraction mode was observed. These results are significant since they demonstrate that the EMG of neck muscles can be used as a noninvasive, objective and quantitative index of the neck muscle fatigue.

Adult↗
PubMed1994

Isokinetic Muscle Testing: Is It Clinically Useful?

The use of computer-driven muscle-testing devices has become increasingly popular during the past two decades. This expensive equipment allows evaluation of muscles and muscle groups in an isokinetic manner. Isokinetic muscle testing is performed with a constant speed of angular motion but variable resistance. Isokinetic dynamometers have been shown to produce relatively reliable data when testing simple, uniaxial joints, such as the knee, as well as when testing the spine in flexion and extension. Isokinetic strength data are generally not helpful in the diagnosis of orthopaedic abnormalities. Isokinetic testing can be helpful during the rehabilitation of orthopaedic patients, since it allows easy monitoring of progress. It also enables the patient to work on muscle rehabilitation in a controlled manner at higher speeds than are possible with more conventional exercise equipment. An isokinetic rehabilitation program can be easily tailored with concentric and eccentric components that closely resemble muscle actions during occupational and sports activities.

Journal Article↗
PubMed2006

Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test.

BACKGROUND: Physical examination of patients with shoulder injury not involving actual rotator cuff tears frequently demonstrates decreased rotator cuff strength on manual muscle testing. This decrease has been attributed to supraspinatus muscle weakness, but it may be owing to alterations in scapular position. HYPOTHESIS: The position of stabilized scapular retraction, by minimizing proximal kinetic chain factors and providing a stable base of muscle origin, positively influences demonstrated supraspinatus strength. STUDY DESIGN: Controlled laboratory study. METHODS: Supraspinatus strength was tested in 20 injured patients and 10 healthy controls in both the empty-can arm position and a position of scapular retraction using a handheld dynamometer. Pain in both maneuvers was measured by use of a visual analog scale. RESULTS: Paired t tests indicated the scapular retraction position resulted in statistically significantly (P = .001) higher supraspinatus strength values within both groups. There was no significant difference between the 2 positions in visual analog scale scores. CONCLUSION: This study shows that demonstrated apparent supraspinatus weakness on clinical examination in symptomatic patients may be dependent on scapular position. The weakness may be owing to other factors besides supraspinatus muscle weakness, such as a lack of a stable base in the kinetic chain or scapula. CLINICAL RELEVANCE: The clinical examination that addresses scapular posture and includes scapular retraction will allow more accurate determination of absolute supraspinatus muscle strength and allow efficacious rehabilitation protocols to address the source of the demonstrated weakness.

Adult↗
PubMed2005

Parallel comparison of grip strength measures obtained with a MicroFET 4 and a Jamar dynamometer.

Repeated measures of grip strength obtained bilaterally with a Jamar and a MicroFET 4 dynamometer were compared. Measurements obtained with the MicroFET 4 tended to be slightly (2.2-3.1 lb.) higher but were highly correlated (r > or = .96) with those obtained with the Jamar. Parallel reliability for the two devices was excellent (intraclass correlation coefficient > or = .96). Although clinicians should be cautious about using the devices interchangeably, the MicroFET 4 appears to be a legitimate alternative to the Jamar dynamometer.

Adult↗
PubMed1987

Strength evaluation in neuromuscular disease.

Strength evaluation in neuromuscle disease is necessary to track the natural history of the disease, to understand its pathophysiology, to determine the efficacy of treatment, and, most importantly, to evaluate an experimental treatment regimen. This article describes the physiology of muscle activity, discusses fatigue, examines various testing methods, and suggests appropriate measurements to assess the neuromuscular patient's strength and endurance in a variety of clinical settings. The minimal amount of equipment necessary to follow patients with NMD is a stop watch, a goniometer, a hand-held dynamometer, a hand-grasp dynamometer, and a creative mind.

Biomechanical Phenomena↗
PubMed2005

Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke.

This study investigated the relationship of lower extremity joint torques and weight-bearing symmetry to sit-to-stand (STS) performance in individuals with chronic stroke. A motion analysis system and two force plates measured STS duration and weight-bearing symmetry (determined by ground reaction forces) during three self-paced and three fast-paced conditions. An isokinetic dynamometer measured maximum concentric joint torques of the paretic and non-paretic ankle, knee, and hip, which were normalized by body mass. Pearson correlations indicated that (a) paretic ankle dorsiflexion and knee extension torques related to the duration of the self-paced STS condition (r = -0.450, -0.716, respectively), (b) paretic ankle dorsiflexion, plantar flexion, and knee extension torques related to the duration of the fast-paced STS condition (r = -0.466, -0.616, -0.736, respectively), and (c) greater weight-bearing symmetry related to faster STS performance for both self-paced and fast-paced STS conditions (r = -0.565, -0.564, respectively) (P < 0.05). This evidence suggests that paretic muscle strength and the ability to load the paretic limb are important factors underlying the ability to rise from a chair in individuals with chronic stroke.

Aged↗
PubMedDate not supplied

An eccentric- and concentric-strength profile of shoulder external and internal rotator muscles in professional baseball pitchers.

The purpose of this study was to establish a data base on the isokinetic eccentric muscular performance characteristics of external and internal rotator muscles in the shoulders of professional baseball pitchers. Concentric data are also included and compared with previously published concentric studies. Twenty-five professional baseball pitchers were evaluated with a Kin-Com isokinetic dynamometer. The subjects tested had a mean age of 23.5 years and a mean body weight of 199 pounds. Eccentric and concentric isokinetic tests were performed at 60 and 120 deg/sec. The testing protocol was standardized for each subject. Test results indicated no statistically significant difference in mean torque between throwing and nonthrowing shoulders for either external or internal rotator muscle groups. Eccentric strength was significantly greater than concentric strength for all muscle groups tested. The external-to-internal rotator muscle strength ratios were well above those previously published for high school through professional pitchers. Mean torque-to-lean body weight ratios were also included to establish a data base. This study establishes one of the first data bases for eccentric isokinetic muscle strength of shoulder rotator muscles in professional baseball pitchers. The data may help clinicians prevent and rehabilitate shoulder injuries in professional throwing athletes.

Adult↗
PubMed2004

A home-based two-year strength training period in early rheumatoid arthritis led to good long-term compliance: a five-year followup.

OBJECTIVE: To evaluate the impact of a 2-year home-based strength-training program on physical function in patients with early rheumatoid arthritis (RA) after a subsequent 3-year followup. METHODS: Seventy patients with early RA were randomized to perform either strength training (experimental group [EG]) or range-of-motion exercises (control group [CG]). Maximal strength values were recorded by dynamometers. The Modified Disease Activity Score (DAS28), pain, Health Assessment Questionnaire (HAQ), walking speed, and stair-climbing speed were also measured. RESULTS: The maximum strength of assessed muscle groups increased by 19-59% in the EG during the training period and remained at the reached level throughout the subsequent 3 years. Muscle strength improved in the CG by 1-31%, but less compared with the EG. During the 2-year training period, DAS28 decreased by 50% and 45% and pain by 67% and 39% in the EG and CG, respectively. The differences in muscle strength, DAS28, and HAQ were significantly in favor of the EG both at the 2-year and 5-year followup assessments. CONCLUSIONS: The improvements achieved during the 2-year strength-training period were sustained for 3 years in patients with early RA.

Arthritis, Rheumatoid↗
PubMed2005

Recovery of knee function following fracture of the tibial plateau.

We assessed the functional outcome following fracture of the tibial plateau in 63 consecutive patients. Fifty-one patients were treated by internal fixation, five by combined internal and external fixation and seven non-operatively. Measurements of joint movement and muscle function were made using a muscle dynamometer at three, six and 12 months following injury. Thirteen patients (21%) had a residual flexion contracture at one year. Only nine (14%) patients achieved normal quadriceps muscle strength at 12 months, while 19 (30%) achieved normal hamstring muscle strength. Recovery was significantly slower in patients older than 40 years of age. We conclude that there is significant impairment of movement and muscle function after fracture of the tibial plateau and that the majority of patients have not fully recovered one year after injury.

Adolescent↗