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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↗
PubMed1997

Relationship between isokinetic concentric and eccentric contraction modes in the knee flexor and extensor muscle groups.

We investigated whether in normal subjects isokinetic concentric and eccentric strength variables were related in order to have a better picture in relation to rehabilitation and possible injury prevention. We studied the relationship between isokinetic concentric and eccentric peak torque, total work, and average power of knee extension and knee flexion at 60 degrees/sec and 120 degrees/sec in 42 young Chinese adults (22 males, age = 27 +/- 6.9 years; 20 females, age = 24.9 +/- 5.05 years) using the Cybex 6000 isokinetic dynamometer. Repeated analysis of covariance was used to compare the means between concentric and eccentric variables adjusted by limb dominance, speed of testing, and the muscle groups tested. A highly significant correlation was found between all concentric and eccentric variables, with correlation coefficients (r) ranging from 0.67 to 0.93. All but two of the eccentric variables were significantly greater than the concentric variables. Concentric and eccentric knee flexion to knee extension (H:Q) ratios were poorly correlated, with r ranging from 0.359 to 0.645. Although there is an acceptably high correlation between isokinetic concentric and eccentric strength variables of knee flexion and extension in young healthy individuals, we recommend measuring concentric and eccentric strength to plan a proper rehabilitation program and to assess muscle groups in a given contraction mode.

Adult↗
PubMed1993

The function of the quadriceps muscle after a fracture of the femur in patients who are less than seventeen years old.

Thirty-three patients who had been managed for an isolated, closed fracture of the femoral shaft when they were less than seventeen years old were examined at an average of thirty-three months (range, eighteen to fifty-six months) after the injury. Thirteen patients (39 per cent) had a persistent deficit in the strength of the quadriceps of the fractured limb, as identified on testing with a Cybex-II isokinetic dynamometer. Six patients (18 per cent) had a deficit according to the one-leg-hop for distance test, fourteen (42 per cent) had an average loss of ten millimeters in the circumference of the thigh, and sixteen (48 per cent) had an average loss of 10 degrees of flexion of the knee. The etiological factors that were thought to possibly be responsible for the weakness of the quadriceps were evaluated. The amount of maximum displacement of the fracture, as seen on the initial radiographs, was the only factor that was significant for the prediction of weakness of the quadriceps (p = 0.006) at both test speeds of the Cybex dynamometer and in all statistical analyses. Despite the persistent weakness of the quadriceps, none of the patients had a clinical problem at the latest follow-up examination. A subclinical deficit in the strength of the quadriceps may be related to damage sustained by the muscle at the time of the fracture. On the basis of the results of this study, we do not recommend a change from the traditional methods of treatment, which involve early application of a spica cast or use of traction followed by application of a spica cast.

Adolescent↗
PubMed1990

Isokinetic muscle strength predicts maximum exercise tolerance in renal patients on chronic hemodialysis.

Patients with end-stage renal disease receiving chronic hemodialysis have impaired exercise tolerance. To distinguish between a central cardiorespiratory and a peripheral skeletal muscular origin for this fatigue, we measured exercise performance and peak oxygen consumption during a maximum exercise test in 10 patients receiving chronic hemodialysis. Skeletal muscle function was measured with an isokinetic cycle ergometer and a Cybex II isokinetic dynamometer. Peak rates of oxygen consumption (17.7 +/- 3.6 [mean +/- SD] mL O2/kg/min), blood lactate concentrations (3.4 +/- 0.9 mmol/L), peak heart rates (168 +/- 12 beats/min), and rates of ventilation (37.3 +/- 14.6 L/min) were low, but respiratory exchange ratios (1.1 +/- 0.1) were compatible with maximal effort. There was a significant correlation between isokinetic muscle strength and VO2 peak, exercise duration, peak ventilation, and peak blood lactate concentrations (P less than 0.05 to less than 0.001), but not between hemoglobin concentration, total blood hemoglobin content, or hematocrit and these variables. Therefore, in renal dialysis patients, isokinetic muscle strength is a better predictor of exercise capacity than are variables determining blood oxygen carrying capacity. This suggests that altered skeletal muscle function explains the impaired exercise tolerance of anemic patients with end-stage renal disease receiving chronic hemodialysis.

Adult↗
PubMed2003

Lower-extremity muscle forces measured by a hand-held dynamometer and the risk of falls among day-care users in Japan: using multinomial logistic regression analysis.

PURPOSE: To assess the relationship between the lower extremity muscle forces and risk of falls among the elderly who were using day-care services in the long-term care insurance system. METHOD: The study population comprised 96 women aged 69 - 91 years. At baseline, we assessed ADL, functional capacity, isometric muscle forces of knee extension and ankle dorsiflexion obtained with a hand-held dynamometer. After 1 year, we asked subjects about falls during the follow up period. RESULTS: In univariate analysis, only the knee extensor strength (p = 0.003) and ankle dorsiflexor strength (p = 0.02) differed significantly according to the fall status. After adjustment for age using multinomial logistic regression analysis, the weak quadriceps group was 7.50 times more likely than the strong group to fall once (p = 0.02), and 5.00 times more likely to fall twice or more (p = 0.02). The weakest ankle dorsiflexor group was 5.09 times more likely than the strongest group to fall twice or more (p = 0.05). CONCLUSIONS: Our results indicated that the forces of knee extensor and ankle dorsiflexor were strongly associated with falls among day-care users. Physiotherapy should focus on the lower-extremity muscle strength to prevent falls and deterioration of physical ability among elderly persons who are partially dependent and need support.

Accidental Falls↗
PubMed2006

Difference in isokinetic strength of the muscles around dominant and nondominant shoulders.

BACKGROUND: Muscle training usually plays an important role in the treatment of shoulder disorders. Clinicians traditionally predict the pre-injury strength of an injured shoulder by using the contralateral uninjured side as the baseline data. OBJECTIVE: The primary purpose of the present study was to determine the difference in isokinetic peak torque of dominant and nondominant shoulders. MATERIAL AND METHOD: Both shoulders of 39 healthy subjects (24 men, 15 women) were tested isokinetically by using the CON-TREX MJ dynamometer at two angular velocities (60 and 180 degrees/sec) during abduction, adduction, flexion, extension, internal rotation and external rotation. RESULT: There were statistical differences of contralateral peak torque in almost all directions of shoulder muscle contractions except in shoulder flexion at both speeds. Peak torque of shoulder adduction, extension, and internal rotation were greater in the dominant side. Shoulder abduction and external rotation peak torque were greater in the nondominant side. CONCLUSION: Therefore, clinicians should not directly use the isokinetic strength of the contralateral shoulder as normal baseline data for an injured side without consideration.

Adult↗
PubMed1997

Body composition and muscle strength in women scheduled for a knee or hip replacement. A comparative study of two groups of osteoarthritic women.

It is unclear whether patients with knee osteoarthritis (OA) and hip OA differ regarding soft tissue composition and bone mineral density (BMD). A total of 42 women waiting for a replacement of the hip (n = 20) or the knee (n = 22) due to OA were examined. Fat mass (FM), percent body fat (%fat), lean mass (LM) and BMD were measured by dual energy X-ray absorptiometry (DEXA). Knee extensor and flexor strength was measured by an isokinetic dynamometer. No significant differences in age, height, disease duration, Lequesne score or pain scores were found between the groups. Comparing the radiographic changes of the knees with those of the hips, changes were most severe in the joints which were to be replaced. Body weight, body mass index, total and regional FM, and %fat were more than 15% higher in patients waiting for a knee replacement (p < 0.001). Also lean mass tended to be higher in the knee patients. Differences in BMD did not remain statistically significant after correction for body weight. Muscle strength was similar in the two groups but was reduced by 20% in the legs in which the joint was to be replaced compared to the contralateral legs. However, the mean difference in lean mass between the two legs was only 3% (p < 0.05). The scores for pain felt during strength testing were significantly higher for the involved legs than for the contralateral legs. In conclusion, fat mass values were considerably higher in patients scheduled for a knee replacement. Impaired strength performance in OA may be more strongly associated with pain than with reduced muscle mass.

Aged↗
PubMed1999

Isokinetic knee muscle strength of individuals with mental retardation, a comparative study.

The purpose of this study was to assess differences in isokinetic muscle torque in the knee among mentally retarded individuals with Down syndrome, mentally retarded individuals without Down syndrome, and sedentary subjects without mental retardation (ns of 7, 8, and 12, respectively). Subjects performed strength tests to knee extension and flexion on a Cybex II isokinetic dynamometer. The measure was peak torque at angular velocities of 60, 120, and 300 degrees/sec. For the Mentally Retarded subjects with and without Down syndrome, the test was performed on two separate days 24 hr. apart. For Sedentary subjects, testing was performed on one day. Their scores indicated significantly higher values of torque than the two other groups. Also, subjects with Down syndrome had inferior muscle torque of lower extremities than peers in the Mentally Retarded Group.

Adult↗
PubMed1990

[Studies of the neuromuscular system of the knee joint].

The paper analysis the therapeutic effects of isometric training and electromechanic therapy (EMT) of the quadriceps muscles on subjects. The effects of the training practised with the knee joint bent was to be compared with previous results of training with the knee joint stretched. 36 subjects were trained and the increase in strength was measured with the help of a strain gauge dynamometer. Again a marked superiority of the EMT over sole isometric training could be demonstrated. More over, the results showed that the increase of the isometric maximal strength following an EMT is not influenced by the position of the angle of the joint.

Adolescent↗
PubMed1997

Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years.

OBJECTIVE AND DESIGN: Only a few studies have provided reference values for muscle strength obtained by hand-held dynamometry. Such values are essential for establishing the degree to which an individual's strength is impaired. This descriptive study was conducted to provide reference values for the strength of 10 extremity muscle actions. SUBJECTS AND INSTRUMENTATION: A convenience sample of 106 men and 125 women volunteers was tested twice with an Ametek digital hand-held dynamometer. RESULTS: The measurements were found to be reliable. Predictive equations are provided for the measurements. Reference values generated are expressed in Newtons and as a percentage of body weight and are organized by gender, decade of age, and side. CONCLUSIONS: The values can be employed in a clinical setting to document whether an individual is impaired relative to healthy subjects of the same gender and age.

Adult↗
PubMed1993

The serratus anterior free-muscle transplant for reconstruction of the injured hand: an analysis of the donor and recipient sites.

The present study evaluated donor-site function in eight patients for whom serratus anterior free-muscle transplantation was performed to treat a traumatic defect of the palm. The lowest two or three slips of the muscle were transferred from the uninjured side and covered with split-thickness skin grafts. After an average follow-up period of 50 months (range 13 to 84 months), function and appearance of the flaps were assessed, and shoulder strength on the donor side was objectively tested in six patients by using an isokinetic computerized robotic dynamometer. No patient noticed any change in upper extremity function following the procedure. Each of the three patients in whom three slips had been taken displayed mild scapular winging, but none complained of any related symptoms. Neither push strength nor abduction strength on the donor side was significantly different compared with that on the recipient side. The transplanted muscle provided excellent contour and durable cover in all eight hands with limited donor-site morbidity. For this reason, the serratus anterior transplant is our flap of choice for the treatment of large palmar defects.

Adult↗
PubMed1997

Hormone replacement therapy does not augment gains in muscle strength or fat-free mass in response to weight-bearing exercise.

Lower extremity strength and fat-free mass were examined in 58 postmenopausal women aged 60-72 yr. Subjects were studied before and after an 11-mo control period (n = 16) or before and after an 11-mo weight-bearing exercise training program designed to generate relatively high ground reaction forces (n = 42). Twenty-two of the exercisers initiated hormone replacement therapy (HRT) at the outset of exercise and continued HRT for 11 mo. Hip extension and abduction strength were assessed using a hand-held dynamometer. Force production during knee extension and flexion was evaluated on an isokinetic dynamometer at 60, 90, and 180 degrees/s. Simultaneous knee and hip extension strength was also assessed on a leg press machine. Total body and lower extremity fat-free mass were determined using dual-energy x-ray absorptiometry. There were no significant changes in muscle strength or body composition in control subjects. Both exercise groups had significant increases in fat-free mass and in all strength measures. Fat-free mass increased from 38.8 +/- 4.3 to 39.7 +/- 4.3 kg in the exercise group and from 37.7 +/- 3.9 to 38.9 +/- 4.6 kg in the exercise-plus-HRT group. The average relative increase in strength was 16.2 +/- 11.0% in the exercise group and 17.0 +/- 13.0% in the exercise-plus-HRT group. Women receiving HRT did not have a gain in fat-free mass or in strength over and above that demonstrated by the women not on HRT. Our results provide evidence that HRT does not augment the increases in muscle mass or strength that occur in response to weight-bearing exercise in older women.

Absorptiometry, Photon↗
PubMed1985

Steroid myopathy: incidence and detection in a population with asthma.

Sixty steroid-treated patients with asthma were evaluated for the presence of muscle weakness by use of both manual muscle testing and the Cybex II isokinetic dynamometer. The patients were compared to age and sex-matched sedentary control subjects. Forty-eight percent of the patients (12/25) taking greater than or equal to 40 mg per day of prednisone had hip flexor strength greater than or equal to 2 SD below the mean of age and sex-matched control subjects by Cybex testing (CT). Sixty-four percent of the patients (16/25) taking greater than or equal to 40 mg per day of prednisone were found on manual muscle testing to have hip flexor weakness. Only one patient taking less than 30 mg per day of prednisone was found to have muscle weakness. Biochemical parameters, including CPK, aldolase, SGOT, LDH, and LDH isoenzymes were measured to assess the degree of steroid-induced muscle damage. They neither correlated with the degree of hip flexor weakness as measured by CT, nor did they discriminate between patients receiving small doses and large doses of steroids. Changes in urinary excretion of creatine did not help to confirm the diagnosis of steroid myopathy. Although CT provides an objective means of assessing muscle strength in these patients, at this time no definitive chemical test is available for the diagnosis of steroid myopathy.

Adult↗
PubMed2000

Relationships between plantar flexor muscle stiffness, strength, and range of motion in subjects with diabetes-peripheral neuropathy compared to age-matched controls.

STUDY DESIGN: Descriptive study to compare relationships between muscle performance measures in 2 subject groups. OBJECTIVES: To determine the relationships between plantar flexor (PF) muscle stiffness, strength (concentric peak torque), and dorsiflexion (DF) range of motion (ROM) in subjects with diabetes who have peripheral neuropathy (n = 17, 10 men, 7 women; age = 58 +/- 11 years) and age-matched controls (n = 17, 10 men, 7 women; age = 62 +/- 6 years). BACKGROUND: The relationships between muscle stiffness, strength, and joint ROM have not been clearly established. Furthermore, the effect of neuromuscular pathology on these relationships is unknown. METHODS AND MEASURES: PF stiffness and strength measurements were obtained with an isokinetic dynamometer. DF ROM was measured with a goniometer. A Pearson correlation matrix was constructed for each subject group using stiffness, strength, and ROM variables. The percent contribution of passive torque to total torque was computed at 2 joint angles. RESULTS: In subjects with diabetes and peripheral neuropathy (DM-PN) peak concentric PF torque was positively correlated with passive torque at 5 degrees DF (r = 0.77), Stiffness #1 (r = 0.58), and Stiffness #2 (r = 0.50). The percentage of passive PF torque at 5 degrees DF was greater in subjects with DM-PN, compared to control subjects (29.3 +/- 9.4% versus 12.6 +/- 5.9%). CONCLUSIONS: The positive correlation between PF stiffness and strength, and the greater percentage of passive PF torque in subjects with DM-PN suggest that patients with decreased strength may use passive torque to maximize total torque. Therefore, treatment methods designed to decrease stiffness should be used cautiously.

Aged↗
PubMed2002

Pfannenstiel versus Maylard incision for cesarean delivery: A randomized controlled trial.

OBJECTIVE: To compare the Pfannenstiel incision with transverse muscle-cutting Maylard incision in women who had cesarean delivery. METHODS: Patients were assigned randomly to a Pfannenstiel or Maylard incision. Postoperative treatment was similar for each group. Surgical characteristics, complications, postoperative pain (visual analog scale, analgesic use), and related quality of life (1- and 3-month self-administered questionnaires) were analyzed. Abdominal wall muscle recovery was compared objectively by dynamometer. RESULTS: Fifty-four women had a Pfannenstiel incision and 43 had the Maylard incision. There were no differences in intraoperative characteristics, postoperative morbidity, or pain. Women's responses to the Nottingham Health Profile questionnaire at 1 and 3 months postoperatively and clinical and isokinetic testing for abdominal wall strength were similar between the two groups. CONCLUSION: Transecting the rectus muscle was no more deleterious than the Pfannenstiel incision. There was no difference in objectively measured abdominal wall strength.

Abdominal Muscles↗