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At least 163 records · Page 9Linked to original sources

Gait, lower extremity strength, and self-assessed mobility after hip arthroplasty.

BACKGROUND: Rehabilitation services after hip arthroplasty (HA) usually occur in the first 6 months following surgery. Reports in the literature suggest that 9 months to several years after HA surgery, patients are generally satisfied with pain relief. However, many express dissatisfaction with their ability to perform domestic and social activities. Reduced walking ability and long-term lower extremity (LE) muscle weakness may contribute to decreased mobility. The purpose of this study was to compare the within-group LE muscle strength, gait, and self-assessed functional mobility in adults 9 months to 6 years after HA surgery to age- and gender-matched controls. METHODS: Thirty subjects (15 HA and 15 control) were studied. LE muscle strength was assessed using the Spark handheld dynamometer. Gait parameters were measured using the GAITMAT II, and self-assessed mobility was evaluated using the hip-rating questionnaire. RESULTS: The HA group walked significantly more slowly than the control group at maximum walking speed. The operative LE of the HA group had less muscle strength than the nonoperative LE, and the hip abductors were the most affected muscle group in that LE. The HA group scored lower in the domains of impact, pain, and function on the hip-rating questionnaire. CONCLUSION: Because of long-term residual impairments and disabilities noted after HA surgery, intervention beyond the initial post-surgical rehabilitation is needed.

Adult↗

1,25-Dihydroxyvitamin D3 and muscle strength in the elderly: a randomized controlled trial.

An unexplained loss of muscle strength occurs with aging. Vitamin D deficiency can cause myopathy and administration of 1,25-dihydroxyvitamin D3 [1,25-(OH2)D3] to persons with low serum concentrations can improve strength. To test the hypothesis that the weakness associated with aging is in part due to inadequate serum concentrations of [1,25-(OH2)D3], we conducted a randomized, controlled, double blinded trial in 98 men and women volunteers over 69 yr old. Treatment consisted of 0.25 micrograms 1,25-(OH)2D3, orally, twice per day or identical placebo for 6 months. Leg muscle strength of the quadriceps was measured with an isokinetic dynamometer. There was no difference between the two groups at 1 week, 1 month, or 6 months of treatment in any of the measures of muscle strength. We conclude that oral administration of 0.5 micrograms 1,25-(OH)2D3/day does not improve muscle strength in older persons. Further research is needed to determine the etiology of the decline in muscle strength associated with aging.

Aged↗

Muscle strength during bedrest with and without muscle exercise as a countermeasure.

Bedrest is known to be a useful experimental model for simulating weightlessness and studying its effects on human skeletal muscle activity. We therefore conducted a study in which 12 healthy male subjects underwent 28 days of continuous exposure to 6 degrees head-down bedrest. Our main objective was to test a set of preventive countermeasures for maintaining the stability of the human body. Of the subjects 6 performed deadlifts in the supine position for 30 to 45 min each day. The isometric actions were performed for 5-30 s at 90, 120 and 150 degrees knee angles and isokinetic training at speeds of 30 and 180 degrees.s-1. In vivo quadriceps muscle strength was measured under controlled experimental conditions with a commercial dynamometer. The hypothesis that intense daily isometric and isokinetic leg exercise and lower body negative pressure (LBNP) might serve to maintain muscle strength under conditions of weightlessness was tested. Of the subjects 6, who did not perform any exercise, served as the control population under conditions of simulated weightlessness. The results showed that a significant reduction (P < or = 0.0001) in the muscle force [-10.3 (SD 6.7%)] occurred in the control group whereas no significant changes were observed in the trained group [+3.9 (6.8%)]. From these studies we conclude that intense muscle training and LBNP constitute efficient countermeasures to compensate for the biomechanical effects of weightlessness on human lower limbs and to limit other factors such as cardiovascular deconditioning.

Adult↗

Anterior cruciate ligament reconstruction using the semitendinosus and gracilis tendons augmented by the losee iliotibial band tenodesis. A long-term study.

Seventy patients were evaluated after combined intra- and extraarticular reconstruction of the anterior cruciate ligament. Semitendinosus and gracilis tendons were used for the intraarticular reconstruction and Losee iliotibial band tenodesis for the extraarticular procedure. Minimum followup was 5 years (average, 7). Clinical examination and instrumented ligament examination with the KT-1000 arthrometer and the Cybex II dynamometer were used to evaluate results. Subjectively, patients had no complaints of instability with daily activities; 93% had no complaints of instability with athletic participation. Clinical examination demonstrated that 81% had less than a 1 + Lachman test; 98% had a negative pivot shift. Instrumented examination of the anteroposterior limits of motion revealed that only 57% had less than 3-mm side-to-side difference; 30% had 3- to 5-mm; and 13% had 6- to 9-mm. Mean hamstring muscle strength measured with the Cybex II dynamometer was 94% at 60 and 96% at 100 deg/sec. When evaluated with the Zarins scale, 90% were rated good or excellent, 6% fair, and 4% poor. This reconstructive procedure restores functional, but not necessarily normal, stability in most anterior cruciate ligament-deficient knees. It allows patients to increase activity levels without significant risk of additional injuries.

Adult↗

Measurement of quadriceps muscle strength and bulk in juvenile chronic arthritis. A prospective, longitudinal, 2 year survey.

OBJECTIVE: In a prospective survey over a 2-year period we studied strength and bulk of the quadriceps muscle in the thighs of children with juvenile chronic arthritis (JCA). METHODS: Every third month for 2 years we measured isometric muscle strength in knee extensors with a hand-held dynamometer in 20 children with JCA. Ultrasound equipment was used to measure thigh muscle bulk. A joint evaluation was made using a standard severity score. The children had their ordinary medical treatment and physiotherapy during the observation period. RESULTS: Children with high severity scores in the knee or hip had least strength and muscle bulk. In the 4 children with the highest severity scores muscle strength was reduced to half of that expected. In 10 of the children there were clear variations in severity scores during the study period, for either better or worse. In these children an increase in the severity score correlated significantly with reduction in muscle strength and bulk (p < 0.05). The muscle strength and bulk changed in parallel in these children. Other factors, although not independent, such as polyarticular JCA, long duration of disease, and steroid treatment, also reduced muscle strength. CONCLUSION: The presence and intensity of local arthritis is one important factor affecting muscle function in JCA. Normal muscle strength and bulk is rapidly lost near an inflamed joint. It is difficult to maintain or achieve normal muscle function in the presence of active arthritis despite medical and physical treatment. We assume that the muscle weakness is in part caused by atrophy of the muscle, which is influenced by local arthritis.

Adolescent↗

Two early dynamometers. An historical account of the earliest measurements to study human muscular strength.

An account of two of the earliest dynamometers is presented, together with results of the first experiments attained with them. The Graham--Desaguliers dynamometer was developed in London in 1763 to measure human muscular force, in such a way that synergistic muscles could not impart a false mechanical advantage to the test. The Regnier dynamometer was invented in Paris in 1798 to measure the traction properties of artillery-horses, but was desinged as an all-purpose instrument to measure specific human muscle groups as well. Dynamometers were developed to record human strength along a continuum, to remove the need for a dead-weight or biological standard, and to measure many different groups of muscles, not just those of lifting or pushing. The foundations of modern clinical dynamometry are described.

England↗

A comparison of hand-grip dynamometry and arm muscle size amongst Africans in North-East Nigeria.

Grip strength, measured with a Harpenden hand-grip dynamometer, and anthropometric measurements of upper limb muscle size were performed on 328 healthy Africans and on 148 African patients admitted to medical wards of the General Hospital, Maiduguri. In healthy subjects grip strength was constant between the ages of 18 and 44 years, and at 2 s.d. below the mean cut-off levels of 30 kg and 19 kg were chosen respectively for men and women. Medical patients had a reduction in arm muscle circumference and arm muscle area, and 60 per cent had a grip strength below the cut-off level. In male and female patients there was a strong positive correlation between grip strength and anthropometric measurements, although the ratio of grip strength to arm muscle area (G/A) was reduced compared with healthy subjects. Grip strength is a simple, cheap and reproducible index of muscle function, and further studies should be undertaken to define more clearly its role in the assessment of adult nutrition in the tropics.

Adolescent↗

Two-year follow-up of conservative treatment of knee ligament injuries.

Sixteen patients with old knee ligament injuries and symptoms of instability or pain were treated with a 3-month thigh muscle strength training program. Nine patients had a tear of the anterior and six patients a tear of the posterior cruciate ligament. One patient had a tear of both cruciates. Knee function was determined with a knee scoring scale, and thigh muscle strength with a Cybex-II dynamometer before training, after 1 and 3 months of training, and at a late follow-up after 2 years. Ten patients who increased their quadriceps strength by more than 15 per cent increased their score over 30 per cent. Three patients who showed a minor increase in strength did not increase their score significantly. Three patients did not increase their strength at all. All of these admitted a reluctance to train. Four patients, all with anterior cruciate ligament tears, were operated on after the 3-month training period. All four patients increased their strength. Two of them increased their functional score also, but they strove for a very high activity level and were therefore operated on. The other two patients had no symptomatic relief and were therefore also operated on. Improvements in muscle strength and knee function were unchanged at the 2-year follow up. Before planning a knee ligament reconstruction, a period of strength training is recommended.

Adult↗

[Traumatic total rupture of the musculus pectoralis major tendon].

Total or partial rupture of the major pectoral muscle is a rare lesion. Early treatment is recommended to regain full strength in the shoulder, but even without surgery 70 to 90% of original strength may be recovered within a year after trauma. We report a case in which a carpenter three months after total rupture of the major pectoral muscle tendon on the dominant side had spontaneously recovered sufficiently to perform his usual job. The diagnosis was visualized by MR imaging. The muscle strength was tested by use of a dynamometer.

Athletic Injuries↗

Muscle strength testing following surgery for acetabular fractures.

A retrospective clinical analysis was performed on 30 patients who underwent surgery for acetabular fractures. In addition to clinical and radiographic evaluations, muscle strength was tested using an isokinetic dynamometer. Average follow-up time was 21 months. Joint surface and congruency were restored within 3 mm in 29 of 30 cases. The average hip score was 83. Eight patients had an unsatisfactory result. Only 14 patients had a normal gait, while seven patients had a Trendelenburg gait. The overall strength deficit was 27%. This mean strength deficit was highly correlated with the hip-rating score. The greatest loss of strength was in abduction, where the average deficit was 50%. The loss of abduction strength was significantly greater for patients operated on through posterior approaches. Among patients operated on through a Kocher-Langenbeck approach, those with transverse fractures had significantly larger losses of abduction strength than those with posterior wall fractures.

Acetabulum↗

Upper and lower extremity muscle fatigue after a baseball pitching performance.

BACKGROUND: Previous studies have estimated joint torques and electromyogram activity associated with the pitching motion. Although previous studies have investigated the influence of extended pitching (fatigue) on kinematic and kinetic parameters, no attempts have been made to quantify the fatigue associated with a pitching performance. PURPOSE: Considering previous investigations on muscle activity during pitching, this study investigated muscle fatigue in upper and lower extremity muscle groups after a pitching performance. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirteen baseball pitchers from 4 universities and 1 independent minor league team were tested before and after 19 games. Pitchers threw an average of 99 pitches during an average of 7 innings. Shoulder, scapular, and lower extremity muscle strengths were assessed using a handheld dynamometer before and after the pitching performances. RESULTS: Baseline strength tests revealed that the pitching arm was 12% weaker (P=.02) in the empty can test (supraspinatus) compared to the contralateral side. Postgame shoulder strength tests revealed selective fatigue of 15% in shoulder flexion (P=.02), 18% fatigue in internal rotation (P=.03), and 11% fatigue in shoulder adduction (P = .01). Minimal fatigue was noted in the empty can test, scapular stabilizers, and hip musculature. CONCLUSIONS: A trend toward significant baseline strength in internal rotation together with significant selective postgame fatigue on internal rotation of the dominant upper extremity indicate that the internal rotators experience a high performance demand during pitching. Weakness in the empty can test on the dominant arm combined with minimal postgame fatigue was surprising given that studies and injury patterns have indicated a high performance demand on the supraspinatus during pitching.

Adult↗

Correlation of trunk muscle strength with age in children 5 to 18 years old.

OBJECTIVE: To determine the correlation of trunk muscle strength with age in children and the effect of gender on changes in trunk muscle strength. MATERIAL AND METHODS: Strength of the back extensors and back flexors was evaluated in 137 healthy boys and 109 healthy girls who were 5 to 18 years old. Anthropometric determinations of height and weight were done in all study subjects. Maximal back muscle strength was measured with an isometric dynamometer (BID-2000). Standardized positioning techniques were used to allow comparison with the follow-up evaluations. RESULTS: Regression analysis revealed significant increases in trunk strength with increasing age; the strength of the boys began diverging from that of the girls at age 9 to 10 years. Back extensor strength also increased with increasing height and weight, and expected differences were noted between boys and girls. Strength levels ranged from 80 to 774 newtons (18 to 174 lb). Mean back extensor strength in 2-year age intervals ranged from 153 newtons (34.4 lb) in girls 5 to 7 years old to 504 newtons (113.3 lb) in boys 16 to 18 years of age. (Each newton is equal to 0.2248 lb.) CONCLUSION: Results of this study demonstrated that age, height, and weight are all important predictors of trunk strength in children, and the effects of these factors are modulated by gender.

Adolescent↗

Acute effects of cold and muscle vibration on maximal grip strength and muscle endurance in normal subjects.

The objective of this study was to compare the acute effects of 10 minutes cold application and 50Hz, 90 seconds vibration of forearm muscles on maximum grip strength and muscle endurance in apparently healthy young adults. This within-subject factorial research study recruited eighty-nine subjects (49 males and 40 males) using a sample of convenience. Baseline maximum grip strength and endurance index were measured using a Jamar dynamometer. Cold and muscle vibration were applied within 48 hours interval to the forearm muscles of the subjects. Their grip strength and endurance index were measured; immediately, 5, and 10 minutes post-application of either stimuli. Data were analysed using independent t-test and one-way analysis of variance at 0.05 alpha. Results showed that neither vibration (P>0.05) nor cold (P>0.05) produced any significant effect on the maximum grip strength and the grip endurance at 5 and 10 minutes post application. The subjects however recorded significantly higher endurance index immediately post cold than they did immediately post vibration (P<0.05). We concluded that grip endurance was enhanced more by cold application than by muscle vibration. Cold rather than vibration may therefore be used to facilitate grip endurance during hand rehabilitation.

Acute Disease↗

Long-term nutritional and digestive consequences of pelvic radiation.

OBJECTIVE: To study long-term changes in nutritional status and gastrointestinal (GI) functions of 15 women previously treated with radiotherapy for gynecological cancer. Two years prior to this research, these patients had been assessed twice: before external radiotherapy and 5 weeks later, at the completion of the external dose (45-50 Gy). METHODS: Each patient was given complete clinical evaluation, consisting of dietary, physical activity and digestive symptoms questionnaires. Blood was drawn for routine clinical laboratory tests (hemoglobin, white blood cell count, creatinine, lipoproteins, glucose, total proteins, albumin, and C reactive protein). Body composition was assessed by classical anthropometric indicators and double beam X-ray absorptiometry (DEXA), while muscle strength was measured through a hand dynamometer. Resting energy expenditure (REE), obtained by indirect calorimetry, was subtracted from energy ingestion, derived from dietary records, to calculate energy balance. RESULTS: This third evaluation included fifteen patients. A significant increase in body mass index (BMI), % body fat and waist circumference were observed in comparison to earlier evaluations. The lean compartment decreased significantly, and REE descended in parallel. Meanwhile, total energy, fat and protein intake increased, compared to previous measurements. The changes in bowel habits observed during radiotherapy persisted at this third evaluation, with the exception of diarrhea, which was less reported. Abdominal bloating and rectal symptoms were the most prevalent complaints. CONCLUSIONS: After radiation treatment for gynecological cancer, patients gained more body fat than expected in Chilean women around menopause. In spite of high protein ingestion, the loss of fat-free mass observed during radiation treatment was not recovered along with weight increase. This is probably associated with infrequent physical activity, both during and after treatment, and hyperphagia.

Absorptiometry, Photon↗

Improvement of muscle strength in osteoarthritic knee patients after intraarticular knee injection of hyaluronan.

OBJECTIVE: The objective of this study was to investigate whether the knee concentric and eccentric muscle strengths can be improved in patients with bilateral knee osteoarthritis after intraarticular hyaluronan injections. DESIGN: A total of 25 patients with bilateral knee osteoarthritis and with a radiographic Ahlbäck grading scale of I or II participated in this study. One session of intraarticular knee injection of hyaluronan was given to both knees (weekly intraarticular knee hyaluronan injections for a total of 5 wks). Knee concentric and eccentric muscle strengths were recorded between 10 and 90 degrees of knee flexion. The recordings were done on two angular velocities, 80 and 240 degrees/sec. This study took place in a tertiary medical center with a gait laboratory and a KIN-COM isokinetic dynamometer. RESULTS: An increase in concentric and eccentric muscle strength adjusted for body weight (P < 0.01) was observed in both knees, ranging between 5.1% and 27.7%. CONCLUSION: The decreased knee muscle contraction strength (concentric and eccentric) can be improved in knee osteoarthritis patients with an Ahlbäck grading scale of I or II after five weekly intraarticular knee injections of hyaluronan.

Adjuvants, Immunologic↗

Associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis and ankylosing spondylitis.

The aim of this study was to examine whether there are any associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Thirty-one patients with RA and 26 patients with AS belonging to Steinbrocker's functional class I-II were examined. Cardiovascular capacity was calculated from the expired air during a bicycle test and quadriceps muscle strength by the peak torque from an isokinetic dynamometer test. Walking time was the time it took to walk a distance of 160 m on a flat floor and to climb up and down a staircase. In patients with RA, flat floor walking and stair climbing times correlated inversely with quadriceps muscle strength and cardiovascular capacity. Similar results were seen in patients with AS, although the association between cardiovascular capacity and stair-climbing time was not statistically significant. Multiple regression analysis was performed for all patients with quadriceps muscle strength and cardiovascular capacity applied as independent variables in two separate models. Cardiovascular capacity explained 32% and quadriceps muscle strength 21% of the variance in flat floor walking time. Quadriceps muscle strength, together with diagnosis and age, explained 38% of the variance in stair-climbing time, and cardiovascular capacity together with age and pain explained 36% of the variance. In conclusion, in spite of cardiovascular capacity and quadriceps muscle strength being associated with walking times, the findings suggest that they play only a modest role in explaining rapid walking on flat floor and in stairs.

Activities of Daily Living↗

Modified sphygmomanometer versus strain gauge hand-held dynamometer.

The purpose of this study was to compare measurements of elbow flexor muscle strength obtained with a modified sphygmomanometer (MS) and a strain gauge hand-held dynamometer (HHD). Thirty-two healthy subjects performed two isometric contractions of about five seconds against each device. Repeated measurements with each device did not differ significantly and were correlated (r greater than .960) and reliable (intraclass correlation coefficients greater than .960). The means of two measurements obtained with each device were related in a curvilinear manner (R = .882), with MS measurements above 210 mmHg rising more slowly than corresponding HHD measurements. Although supporting the reliability of each device, the results suggest that the devices do not provide comparable measurements throughout the range of the MS. The MS may not be the best choice for obtaining accurate strength measurements of stronger individuals.

Adult↗

A comparison of make and break tests using a hand-held dynamometer and the Kin-Com.

The assessment of muscle strength is a task performed frequently by physical therapists. The purposes of this study were to determine whether intrasession test-retest reliability differs between make and break tests and strength tests that do not require an assessor (eg., isometric Kin-Com test) and hand-held dynamometer (HHD) assessments. The elbow flexor strength of 32 healthy, female volunteers was measured under four test conditions: Kin-Com make and break, and HHD make and break. Two measurements were performed for each test condition by the same rater. The results showed: 1) measurements obtained using the HHD deviated from a normal distribution, 2) comparable reliability coefficients for the make and break tests were obtained from the Kin-Com device, 3) there was a higher reliability coefficient for the make test compared with the break test for the HHD tests, and 4) the measured forces for the break tests were higher than the make tests. The results support the premise that hand-held dynamometry is a viable alternative to more costly modes of isometric strength measurements, provided the assessor's strength is greater than that of the specific muscle group being measured.

Adult↗