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Batista NP, Rachid ZI, De Oliveira Silva D, Glaviano NR, Norte GE, Bazett-Jones DM. Reliability and validity of belt-stabilized and tension dynamometry for assessing hip strength and power in uninjured adults. Phys Ther Sport 2024; 69:59-66. [PMID: 39088900 DOI: 10.1016/j.ptsp.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 07/19/2024] [Accepted: 07/21/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES To investigate the intra-rater reliability and validity of belt-stabilized and tension dynamometry to assess hip muscle strength and power. DESIGN Repeated measures. SETTING Biomechanics laboratory. PARTICIPANTS Seventeen uninjured adults (age = 22.0 ± 2.3y; 13 females). MAIN OUTCOMES MEASURES Peak torque (strength) and rate of torque development (RTD; power) were measured for hip abduction, internal rotation, external rotation and extension using an isokinetic dynamometer, and belt-stabilized and tension dynamometry. RESULTS For peak torque assessment, belt-stabilized and tension dynamometry showed good (Intraclass Correlation Coefficient [ICC] = 0.848-0.899) and good-to-excellent (ICC = 0.848-0.942) reliability, respectively. For RTD, belt-stabilized dynamometry showed fair reliability for abduction (ICC = 0.524) and good reliability for hip internal rotation, external rotation, and extension (ICC = 0.702-0.899). Tension dynamometry showed good reliability for all motions when measuring RTD (ICC = 0.737-0.897). Compared to isokinetic dynamometry, belt-stabilized and tension dynamometry showed good-to-excellent correlations for peak torque assessment (r = 0.503-0.870), and fair-to-good correlations for RTD (r = 0.438-0.674). Bland-Altman analysis showed that measures from belt-stabilized and tension dynamometry had clinically meaningful disagreement with isokinetic dynamometry. CONCLUSION Tension dynamometry is reliable for assessing hip strength and power in all assessed motions. Belt-stabilized dynamometry is reliable for assessing internal rotation, external rotation, and extension. Validity of both methods is questionable, considering the lack of agreement with isokinetic dynamometry.
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Affiliation(s)
- Natanael P Batista
- School of Exercise and Rehabilitation Sciences, Health & Human Services, University of Toledo, Mail Stop 1199, 201 W. Bancroft St, Toledo, OH, 43606-3390, USA
| | - Zuleiha I Rachid
- School of Exercise and Rehabilitation Sciences, Health & Human Services, University of Toledo, Mail Stop 1199, 201 W. Bancroft St, Toledo, OH, 43606-3390, USA
| | - Danilo De Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Neal R Glaviano
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Grant E Norte
- Institute of Exercise Physiology and Rehabilitation Sciences, University of Central Florida, Orlando, FL, USA
| | - David M Bazett-Jones
- School of Exercise and Rehabilitation Sciences, Health & Human Services, University of Toledo, Mail Stop 1199, 201 W. Bancroft St, Toledo, OH, 43606-3390, USA.
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McNabb K, Sánchez MB, Selfe J, Reeves ND, Callaghan M. Handheld dynamometry: Validity and reliability of measuring hip joint rate of torque development and peak torque. PLoS One 2024; 19:e0308956. [PMID: 39150968 PMCID: PMC11329127 DOI: 10.1371/journal.pone.0308956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 08/01/2024] [Indexed: 08/18/2024] Open
Abstract
INTRODUCTION Measuring rate of torque development (RTD) and peak torque (PT) for hip muscle performance presents challenges in clinical practice. This study investigated the construct validity of a handheld dynamometer (HHD) versus an isokinetic dynamometer (IKD), and intra-rater repeated reliability for RTD and PT and their relationship in hip joint movements. METHODS Thirty healthy individuals (mean age = 30 ± 8 years, 13 males) underwent two test sessions in a single day. RTD (0-50, 0-100, 0-150, 0-200ms) and PT normalised to body mass in maximal voluntary isometric contractions were measured using a HHD and an IKD in hip flexion, extension, abduction, adduction, internal and external rotation. RESULTS For validity between the devices, RTD0-50 exhibited the largest significant systematic bias in all hip movements (3.41-11.99 Nm·s-1 kg-1) and widest limits-of-agreement, while RTD0-200 had the lowest bias (-1.33-3.99 Nm·s-1 kg-1) and narrowest limits-of-agreement. For PT, agreement between dynamometers was observed for hip flexion (0.08 Nm·kg-1), abduction (-0.09 Nm·kg-1), internal (-0.01 Nm·kg-1), and external rotation (0.05 Nm·kg-1). For reliability, intra-rater intraclass correlation coefficient (ICC2,1) ranged from moderate to good in RTD0-50 and RTD0-100 (0.5-0.88), and good to excellent in RTD0-150 and RTD0-200 (0.87-0.95) in all movements. The HHD displayed excellent intra-rater, relative reliability values (ICC2,1) in all movements (0.85-0.95). Pearson's correlation revealed good linear correlation between PT and RTD0-150 and RTD0-200 in all movements (r = .7 to .87, p = < .001). CONCLUSION Validity analysis demonstrated significant systematic bias and lack of agreement in RTD measures between the HHD and IKD. However, the HHD displays excellent to moderate intra-rater, relative reliability for RTD and PT measures in hip movements. Clinicians may use the HHD for hip muscle PT assessment but note, late phase RTD measures are more reliable, valid, and relate to PT than early phase RTD. Additionally, the correlation between RTD and PT at various time epochs was examined to better understand the relationship between these measures.
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Affiliation(s)
- Katherine McNabb
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - María B Sánchez
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - James Selfe
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - Neil D Reeves
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Michael Callaghan
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
- Centre for Musculoskeletal Research, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Department of Physiotherapy, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Öztürk D, Karaduman AA, Akbayrak T. Lower urinary tract symptoms in children with Duchenne muscular dystrophy: An evaluation in terms of functional level, posture, and muscle strength. Neurourol Urodyn 2024. [PMID: 39149820 DOI: 10.1002/nau.25575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/25/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
AIM To examine factors associated with lower urinary tract symptoms (LUTS) and lower urinary tract dysfunction (LUTD) in children with Duchenne muscular dystrophy (DMD). METHODS This cross-sectional study included 45 individuals diagnosed with DMD between the ages of 5 and 18 years. LUTS were evaluated with the Dysfunctional Voiding and Incontinence Scoring System, functional levels with the Brooke Upper Extremity Functional Classification and the Vignos Scale, lumbar lordosis angle with a bubble inclinometer, pelvic inclination angles with a digital inclinometer, and muscle strength with a hand-held dynamometer. RESULTS The mean age of the children was calculated as 9.00 ± 3.32 years, body weight as 31.10 ± 12.59 kg, and height as 125.87 ± 18.46 cm. LUTD was detected in 20 children (44.44%). There was an association between high LUTD severity and low strength of the following muscles: bilateral hip flexor (Dominant: r = -0.338, p = 0.023; nondominant: r = -0.411, p = 0.005), quadriceps femoris (Dominant: r = -0.445, p = 0.002; nondominant: r = -0.504, p < 0.001), elbow flexor (Dominant: r = -0.461, p = 0.001; nondominant: r = -0.455, p = 0.002), and elbow extensor (Dominant: r = -0.442, p = 0.002; nondominant: r = -0.450, p = 0.002). Upper extremity functionality level was significantly higher in the LUTD-negative group (p = 0.004). There was no relationship between lumbar lordosis and pelvic inclination angles and LUTS symptoms (p > 0.05). CONCLUSION To provide the adequate care for bladder health in children with DMD, it is essential to focus on parameters that will increase functionality and independence in this population.
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Affiliation(s)
- Demet Öztürk
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aynur Ayşe Karaduman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | - Türkan Akbayrak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Fleming BC, Baranker B, Badger GJ, Kiapour AM, Ecklund K, Micheli LJ, Murray MM. Bridge-Enhanced Anterior Cruciate Ligament Restoration: 6-Year Results From the First-in-Human Cohort Study. Orthop J Sports Med 2024; 12:23259671241260632. [PMID: 39143986 PMCID: PMC11322937 DOI: 10.1177/23259671241260632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/02/2024] [Indexed: 08/16/2024] Open
Abstract
Background Bridge-enhanced anterior cruciate ligament restoration (BEAR) combines suture repair of the anterior cruciate ligament (ACL) with an extracellular matrix implant plus autologous blood to facilitate native ACL healing. Purpose/Hypothesis The purpose of this study was to compare the 6-year follow-up outcomes of patients who underwent the BEAR procedure with those of a nonrandomized concurrent control group receiving autograft ACL reconstruction (ACLR) in the first-in-human safety study of the BEAR implant (BEAR I trial). Based on the 2-year results, it was hypothesized that isometric hamstring strength after the BEAR procedure would be greater than that after ACLR and that there would be no other differences in outcomes at 6 years. Study Design Cohort study, Level of evidence, 2. Methods Ten patients underwent BEAR and 10 received ACLR with a 4-stranded hamstring autograft. Outcomes assessed included the record of subsequent surgeries, the International Knee Documentation Committee (IKDC) Subjective Knee Score, IKDC physical examination grade, the Knee injury and Osteoarthritis Outcome Score, instrumented knee laxity, functional outcomes (ie, muscle strength assessments and hop testing), and qualitative magnetic resonance imaging assessment. Comparisons between treatments were based on computations of the mean differences and the associated 95% CIs. Results One patient in the BEAR group and 3 patients in the ACLR group were lost to follow-up. In the period between 2 and 6 years, 1 patient in each group underwent revision surgery. There were no differences between groups at the 6-year follow-up in any of the outcome measures except for isometric hamstring strength, which was approximately equal to that of the contralateral knee in the BEAR group and <44% of that in the contralateral knee in the ACLR group (P < .01). Conclusion This preliminary study suggests that the outcomes of BEAR and ACLR with a hamstring tendon graft may be similar at the 6-year follow-up and warrants investigation of the BEAR procedure in a larger cohort of patients.
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Affiliation(s)
- Braden C. Fleming
- Department of Orthopaedics, Brown University, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Ben Baranker
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gary J. Badger
- Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA
| | - Ata M. Kiapour
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kirsten Ecklund
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lyle J. Micheli
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Martha M. Murray
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
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Alotaibi M, Arnold BL, Munk N, Dierks T, Altenburger P, Alqabbani S, Almuwais A. The pilot study of the effect of six-week robot-assisted ankle training on mobility and strength of lower extremity and life habits for children with cerebral palsy. Heliyon 2024; 10:e34318. [PMID: 39114037 PMCID: PMC11303995 DOI: 10.1016/j.heliyon.2024.e34318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Background Children with cerebral palsy often have weak ankle muscles and reduced ankle dorsiflexion, which leads to activity limitations and eventually affects quality of life. Robotic ankle training was recently developed to facilitates muscle function through a high repetition of exercises. This study investigated the effect of six-week ankle training using the Anklebot device to improve lower limb structural and functional impairments and the resulting impact on quality of life. Methods Five children with spastic cerebral palsy aged between 4 and 11 years participated in six weeks of bilateral ankle assistive training using the Anklebot device. All lower limb muscle strength was measured with a hand-held dynameter, and range of motion was measured with a goniometer, at four different time points. Muscle architecture was assessed using a portable diagnostic ultrasound device, and quality of life was assessed using the Life Habits for Children scale, at two points in time only. Results Muscle strength and range of motion for all lower limb joints demonstrated significant improvement on both sides after training. The ankle muscle architecture showed non-significant improvement, while an overall significant improvement in the total score of the Life Habits for Children scale was detected after training. Conclusion Robot-assisted task-specific ankle training provides promising effects by allowing the required repetition to improve structural and functional muscle and joint impairments, which has a positive influence on the children's quality of life. However, due to a limited sample size, these results should be considered as preliminary; further study is needed.
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Affiliation(s)
- Madawi Alotaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Brent L. Arnold
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Niki Munk
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Tracy Dierks
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Peter Altenburger
- Department of Health Sciences, School of Health and Rehabilitation Sciences, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Samiah Alqabbani
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Afrah Almuwais
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Petersson N, Jørgensen SL. Blood flow restriction training for an individual with Kellgren-Lawrence grade 4 ankle osteoarthritis following childhood clubfoot repair: A case report. Physiother Theory Pract 2024:1-6. [PMID: 39015007 DOI: 10.1080/09593985.2024.2377752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Ankle osteoarthritis (OA) is a disease involving pain and decreased physical function which can attenuate the tolerance to perform high-load resistance training. Low-load blood flow restriction (BFR) training has been demonstrated to improve muscle strength, muscle size, and physical function in patients suffering from OA. OBJECTIVE We examined the effects of 12 weeks of BFR-training performed 4 times a week in an individual with Kellgren-Lawrence (KL) grade 4 ankle OA. CASE DESCRIPTION A 32-year-old woman with KL grade 4 right ankle OA subsequent to a clubfoot repair in childhood performed 12 weeks of BFR-training. Four exercises with concurrent blood flow restriction (60% of arterial occlusion pressure) targeting the lower leg were performed 4 times/week. The following outcome measures were collected at baseline and 12 weeks after BFR-training: The Foot and Ankle Outcome Score (FAOS), calf circumference, maximal isometric muscle strength, single-leg heel raise test, single-leg stance test, and lateral side-hop test. OUTCOMES Adherence to the training was 93.75%. The patient demonstrated improvements in FAOS subscale symptoms, pain, and sports/recreational activities by 19-47 points (minimal detectable change (MDC) = 18-21.5 points); maximal muscle strength in plantarflexion (36%), eversion (55%), and inversion (38%) (MDC for plantarflexion = 16.81-29.97%). The single-leg heel raise test and the lateral side-hop test improved with 66% and 51%, respectively. Calf circumference was maintained. CONCLUSION BFR-training improved patient-reported outcomes, lower leg muscle strength, and physical function in an individual suffering from KL grade 4 ankle OA following childhood clubfoot repair.
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Lee AK, Marecek GS, Collinge CA. Standardization and Reproducibility of Dynamic Stress Testing for Occult Pelvic Ring Instability. J Am Acad Orthop Surg 2024:00124635-990000000-01048. [PMID: 39018575 DOI: 10.5435/jaaos-d-23-00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/16/2024] [Indexed: 07/19/2024] Open
Abstract
INTRODUCTION Examination under anesthesia (EUA) (stress fluoroscopy) is commonly done after pelvic ring injury to identify occult instability because unstable disruptions may displace causing morbidity. The force applied during EUA for these injuries has not been standardized. The purpose of this study was to examine the forces used during the EUA by experienced orthopaedic trauma pelvic surgeons. METHODS Orthopaedic traumatologists performed simulated EUA on a cadaver at two North American pelvis and acetabular courses using internal rotation (IR), external rotation, and push-pull maneuvers while wearing a handheld dynamometer to measure force. All surgeons used a comparable method, and each performed EUA multiple times. Maximum forces were measured in Newton (N). RESULTS Eighteen surgeons participated. Four had been practicing for <5 years, six for 5 to 10 years, six for 11 to 20 years, and two for >20 years. Surgeons applied a force ranging from 40.4 to 374.9 N during IR, 72.9 to 338.4 N during external rotation, and 25 to 323 N during push-pull, with notable variability seen between surgeons. Three surgeons (18%) had >50-N variability on serial trials of a single EUA maneuver (IR). DISCUSSION This is the first study evaluating the forces applied during pelvic EUA used to assess ring stability. Notable variability existed among surgeons performing EUA and in serial examinations by the same surgeon. Additional study is needed to standardize the displacement measured and threshold for instability that guides management.
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Affiliation(s)
- Adam Keith Lee
- From the University of Chicago Medical Center, Chicago, IL (Lee), Cedars Sinai Medical Center, Los Angeles, CA (Marecek), and Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX (Collinge)
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Lee AK, Collinge CA. Assessment of Force Applied During Examination Under Anesthesia Used to Determine Stability in Posterior Wall Acetabular Fractures. J Am Acad Orthop Surg 2024:00124635-990000000-01034. [PMID: 38996345 DOI: 10.5435/jaaos-d-21-00763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVES Determination of hip instability associated with posterior wall acetabular fractures may be difficult. Thus, dynamic stress examination under anesthesia (EUA) was developed as a tool for guiding treatment. EUA uses positioning of the hip and application of force across the hip to detect instability. While aspects of the EUA technique seems consistently described in the literature and practiced by surgeons, some components are ill-defined. The goal of this study was to assess standardization of applied force during EUA among experienced acetabular surgeons. METHODS Fellowship-trained orthopaedic trauma surgeons with experience in acetabular fracture treatment performed EUA for posterior wall instability on an intact, fresh human cadaver. All surgeons used a similar method, and each expert performed EUA multiple times separated by a brief hiatus. The maximum force applied along the femur's vector in Newtons (N) was measured using a hand-held digital dynamometer. RESULTS The EUAs of 19 surgeons were evaluated. Five surgeons had been practicing for <5 years, six for 6 to 10 years, five for 11 to 20 years, and three for >20 years. The mean force applied during EUA was 173N, with a notable variability between surgeons (range, 77-368N). Notable variability was also observed between sequential measures of individual surgeons with six surgeons (31.6%) having a >50N range on repeat trials. CONCLUSION This is the first study to report force applied during an EUA to assess for posterior wall acetabular fracture stability. Notable variability was observed among surgeons performing the examination and in repeated examinations by the same surgeon, suggesting that results of EUA may be surgeon-dependent. Further study is needed to determine what optimal applied force should be used to assess hip stability after a posterior wall acetabular fracture. LEVEL OF EVIDENCE Level V. An assessment of a diagnostic tool.
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Affiliation(s)
- Adam Keith Lee
- From the Dignity Health Medical Group - St. Joseph's Hospital and Medical Center, Phoenix, AZ (Lee), Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX (Collinge)
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Ohmi T, Katagiri H, Amemiya M, Ikematsu K, Miyazaki M, Koga H, Yagishita K. Gait analysis of patients with knee osteoarthiritis who can run versus cannot run. Gait Posture 2024; 112:67-72. [PMID: 38744023 DOI: 10.1016/j.gaitpost.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Many middle-aged and older adults participate in running to maintain their health and fitness; however, some have to stop running due to osteoarthritis-attributed knee pain. It was unclear whether gait biomechanics and knee physical findings differ between those who can and cannot run. RESEARCH QUESTION What are the gait and knee physical findings of patients with knee osteoarthritis who remain capable of running in comparison to those who are not capable of running? METHODS This was a cross-sectional study, which recruited 23 patients over the age of 40 who had been diagnosed with knee osteoarthritis. Their knee joint ranges of motion and muscle strength, knee pain, and the maximum gait speed (walk as fast as possible) were measured. Knee alignment was calculated from X-ray images, and the knee joint extension angle and adduction moment during a self-selected gait speed were determined using motion analysis. Participants were divided into two groups-those able to run (n=11) and those unable to run (n=12). The measured and calculated outcomes were compared between groups, and logistic regression analyses of significantly different outcomes were performed. RESULTS There were significant group differences in the maximum knee extension angle during stance phase (p = 0.027), maximum gait speed during the 10-m walk test (p = 0.014), knee pain during gait (p = 0.039) and medial proximal tibial angle by X-ray (p = 0.035). Logistic regression analyses revealed that the maximum knee extension angle during stance phase (OR: 1.44, 95%CI: 1.06¬1.94, p = 0.02) was a significant factor. SIGNIFICANCE The ability to extend the knee during gait is an important contributing factor in whether participants with knee osteoarthritis are capable of running.
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Affiliation(s)
- Takehiro Ohmi
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
| | - Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Masaki Amemiya
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Koji Ikematsu
- Department of Rehabilitation, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Midori Miyazaki
- Department of Rehabilitation, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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Gam S, Petz AK, Bjerre LR, Bøgild J, Nielsen AB, Sørensen RN, Kolind MI, Gram B, Hansen S, Aagaard P. Intersession reliability of lower limb muscle strength assessments in adults with obesity eligible for bariatric surgery. Clin Physiol Funct Imaging 2024; 44:303-312. [PMID: 38462744 DOI: 10.1111/cpf.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/22/2023] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The aim of this study was to examine the test-retest reliability in lower limb muscle strength and rate of torque development (RTD) using isokinetic dynamometry in adults with obesity, with a body mass index (BMI) ≥ 35 kg/m2. METHOD Thirty-two adults with a BMI of 43.8 ± 6.6 kg/m2 eligible for bariatric surgery were enroled in the study. Isokinetic and isometric knee extensor (KE) and flexor (KF) strength were assessed in an isokinetic dynamometer (Biodex 4) during three test sessions separated by 3-7 days. RESULTS There were no statistical differences in peak KE and KF torque for any test modalities between sessions. Intraclass correlation (ICC) was 0.91-0.94 between sessions 1 and 2 and 0.94-0.97 between sessions 2 and 3. Standard error of measurement (SEM%) and coefficient of variation (CV) ranged across test sessions from 4.3% to 7.3%. KE RTD showed high test-retest reliability following familiarization, with ICC, CV and SEM% values ranging from 0.84 to 0.90, 13.3%-20.3% and 14.6%-24.9%, respectively. CONCLUSION Maximal lower limb muscle strength measured by isokinetic dynamometry showed excellent test-retest reliability manifested by small measurement errors and low CV. Reliability was slightly improved by including a familiarization session. KE RTD but not KF RTD demonstrated high test-retest reliability following familiarization. The present data indicate that isokinetic dynamometry can be used to detect even small changes in lower limb muscle strength in adults with obesity.
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Affiliation(s)
- Søren Gam
- Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
| | - Anders K Petz
- Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lukas R Bjerre
- Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jeppe Bøgild
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders B Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rikke N Sørensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mikkel I Kolind
- Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
| | - Bibi Gram
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research unit of Endocrinology: Bariatrics and Diabetes, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Stinus Hansen
- Department of Diabetes and Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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11
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Lopes HS, Waiteman MC, Priore LB, Glaviano NR, Bazett-Jones DM, Briani RV, Azevedo FM. There is more to the knee joint than just the quadriceps: A systematic review with meta-analysis and evidence gap map of hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:521-536. [PMID: 37669706 PMCID: PMC11184318 DOI: 10.1016/j.jshs.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/25/2023] [Accepted: 07/10/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Impairments in hamstring strength, flexibility, and morphology have been associated with altered knee biomechanics, pain, and function. Determining the presence of these impairments in individuals with gradual-onset knee disorders is important and may indicate targets for assessment and rehabilitation. This systematic review aimed to synthesize the literature to determine the presence of impairments in hamstring strength, flexibility, and morphology in individuals with gradual-onset knee disorders. METHODS Five databases (MEDLINE, Embase, CINAHL, SPORTDiscus, and Web of Science) were searched from inception to September 2022. Only studies comparing hamstring outcomes (e.g., strength, flexibility, and/or morphology) between individuals with gradual-onset knee disorders and their unaffected limbs or pain-free controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation, and evidence gap maps were created. RESULTS Seventy-nine studies across 4 different gradual-onset knee disorders (i.e., knee osteoarthritis (OA), patellofemoral pain (PFP), chondromalacia patellae, and patellar tendinopathy) were included. Individuals with knee OA presented with reduced hamstring strength compared to pain-free controls during isometric (standard mean difference (SMD) = -0.76, 95% confidence interval (95%CI) : -1.32 to -0.21) and concentric contractions (SMD = -0.97, 95%CI : -1.49 to -0.45). Individuals with PFP presented with reduced hamstring strength compared to pain-free controls during isometric (SMD = -0.48, 95%CI : -0.82 to -0.14), concentric (SMD = -1.07, 95%CI : -2.08 to -0.06), and eccentric contractions (SMD = -0.59, 95%CI : -0.97 to -0.21). No differences were observed in individuals with patellar tendinopathy. Individuals with PFP presented with reduced hamstring flexibility when compared to pain-free controls (SMD = -0.76, 95%CI : -1.15 to -0.36). Evidence gap maps identified insufficient evidence for chondromalacia patellae and hamstring morphology across all gradual-onset knee disorders. CONCLUSION Our findings suggest that assessing and targeting impairments in hamstring strength and flexibility during rehabilitation may be recommended for individuals with knee OA or PFP.
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Affiliation(s)
- Helder S Lopes
- School of Science and Technology, Physical Therapy Department, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil.
| | - Marina C Waiteman
- School of Science and Technology, Physical Therapy Department, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Liliam B Priore
- School of Science and Technology, Physical Therapy Department, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Neal R Glaviano
- Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT 06269, USA
| | - David M Bazett-Jones
- School of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, OH 43606, USA
| | - Ronaldo V Briani
- School of Science and Technology, Physical Therapy Department, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Fábio M Azevedo
- School of Science and Technology, Physical Therapy Department, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
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12
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Hinnekens S, Fickers É, Vervloet G. Effectiveness of the Copenhagen adduction modified position stage 1: EMG measurements and hand-held dynamometer analysis in young and healthy men. J Bodyw Mov Ther 2024; 39:251-257. [PMID: 38876635 DOI: 10.1016/j.jbmt.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES To verify the effectiveness of the use of a modified position of the Copenhagen Adduction (CA) stage 1 compared to the original position. DESIGN Cross-sectional study. SETTING Laboratory. PARTICIPANTS 31 healthy men aged 23.7 ± 1.9 years with no recent or chronic general pathology. MAIN OUTCOME MEASURES Differences between EMG amplitudes for the adductor longus (AL), rectus femoris (RF) and semi tendinous (ST) during dynamic contractions and adductor maximal isometric voluntary contraction (MIVC) force values between CA stage 1 standard and modified positions were assessed with either Wilcoxon or paired t-test. RESULTS No significant differences were observed for EMG amplitudes of the AL (p-value = 0.724) and for the RF muscle (p-value = 0.337) and for the adductor force (p-value = 0.361) between the two positions. A significant difference was obtained for the ST (p-value<0.001) mainly explained by the adapted position of the non-dominant leg which unlocked the hip joint and generated less muscle activity in the hamstrings. CONCLUSIONS Muscle activity of the AL muscle and adductor force being similar in both positions, the CA stage 1 modified position could be of interest for rehabilitation after adductor injury or strengthening of the adductors in elite athletes.
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Affiliation(s)
- Simon Hinnekens
- Mechatronic, Electrical Energy & Dynamic Systems (MEED), Institute of Mechanics, Materials & Civil Engineering (iMMC), Université catholique de Louvain, Place du Levant 2/L5.04.02, 1348, Louvain-la-Neuve, Belgium.
| | - Élène Fickers
- Faculté des Sciences de la Motricité (FSM), Université catholique de Louvain, Place Pierre de Coubertin 1, 1348, Louvain-La-Neuve, Belgium
| | - Grégory Vervloet
- Département des Sciences de la Motricité (ISEK), Haute École Bruxelles-Brabant, Avenue Charles Schaller 91, 1160, Bruxelles (Auderghem), Belgium.
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13
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Mitomo S, Aizawa J, Hirohata K, Ohmi T, Ohji S, Furuya H, Kawasaki T, Sakai Y, Yagishita K, Okawa A. Effects of differences in femoral anteversion and hip flexion angle on hip abductor muscles activity during clam exercise in females. PLoS One 2024; 19:e0305515. [PMID: 38913672 PMCID: PMC11195955 DOI: 10.1371/journal.pone.0305515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/01/2024] [Indexed: 06/26/2024] Open
Abstract
This study aimed to determine differences in the hip abductor muscle activity during clam exercise at different hip flexion and femoral anteversion angles. Thirty healthy females were divided into two groups based on the femoral anteversion angle: the excessive femoral anteversion group and the normal group. Clam exercise was performed at three different hip flexion angles (60°, 45°, and 30°). Tensor fascia latae, gluteus medius, and superior portion of gluteus maximus activities were measured during the exercise, and the results were normalized to the activity during maximum voluntary isometric contraction to calculate the gluteal-to-tensor fascia latae muscle activation index. The superior portion of gluteus maximus activities at a hip flexion of 60° and 45° were greater than that at 30°. The excessive femoral anteversion group had a lower gluteal-to-tensor fascia latae muscle activation index than the normal group; the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° was higher than that at 45°, and the gluteal-to-tensor fascia latae muscle activation index for hip flexion at 60° and 45° were higher than that at 30°. Therefore, the femoral anteversion angle and hip joint position were related to the activity of the hip abductor muscles during clam exercise. These findings may provide a rationale for instructing exercises to maximize the activity of the hip abductor muscles in individuals with an excessive femoral anteversion angle.
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Affiliation(s)
- Sho Mitomo
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Sports for Health Division, Japan Sports Agency, Tokyo, Japan
| | - Junya Aizawa
- Faculty of Health Science, Department of Physical Therapy, Juntendo University, Tokyo, Japan
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Hirohata
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takehiro Ohmi
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shunsuke Ohji
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidetaka Furuya
- Department of Rehabilitation, Sonoda Third Hospital, Tokyo, Japan
- Department of Rehabilitation, Sonoda Medical Institute Tokyo Spine Center, Tokyo, Japan
| | - Tomoko Kawasaki
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yayoi Sakai
- Department of Rehabilitation, Kawakita General Hospital, Tokyo, Japan
| | - Kazuyoshi Yagishita
- Clinical Center for Sports Medicine and Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Whyte E, O’Connor S, Tobin Jones H, McBride C, O’Flynn A, Quinn O, Behan F. The relationship between hamstring strength tests and sprint performance in female Gaelic footballers: A correlation and linear regression analysis. PLoS One 2024; 19:e0302901. [PMID: 38857230 PMCID: PMC11164353 DOI: 10.1371/journal.pone.0302901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/16/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To investigate the relationships between handheld dynamometer (HHD), isokinetic and Nordic hamstrings exercise (NHE) measurements of knee flexor strength and their association with sprinting performance. DESIGN Cross-sectional. METHODS The relationships between HHD (prone isometric, prone break and supine break knee flexor strength tests), isokinetic and NHE peak knee flexor strength measures were examined using Pearson product correlations on 38 female footballers. A linear regression analysis was also performed for each pair of dependent variables (10 and 30 metre sprint times) and independent predictor variables (average relative peak torque for HHD, isokinetic and NHE testing). RESULTS There were good correlations between HHD tests (r = 0.81-0.90, p < 0.001, R2 = 0.65-0.82), moderate correlations between HHD and isokinetic peak torque, (r = 0.61-0.67, p < 0.001, R2 = 0.37-0.44) and poor association between the HHD peak torques and isokinetic work (r = 0.44-0.46, p = 0.005-0.007, R2 = 0.20-0.21) and average power (r = 0.39-0.45, n = 36, p = 0.006-0.019, R2 = 0.15-0.22). There was a poor association between NHE peak torque and isokinetic total work (r = 0.34, p = 0.04, R2 = 0.12). No associations between knee flexor strength and sprint times were observed (p = 0.12-0.79, r2 = 0.002-0.086). CONCLUSIONS Moderate to good correlations within HHD testing and poor to moderate correlations between HHD and isokinetic testing were observed. HHD knee flexor torque assessment may be useful to regularly chart the progress of hamstring rehabilitation for female footballers. Knee flexor strength assessments were not associated with sprint times in female footballers. Other aspects of knee flexor strength and sprint performance should be investigated to assist clinicians in making return to running and sprinting decisions in this population.
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Affiliation(s)
- Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Ireland
| | - Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, Ireland
| | - Hannah Tobin Jones
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Cian McBride
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Aisling O’Flynn
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Oisin Quinn
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Fearghal Behan
- Department of Bioengineering, Imperial College London, London, United Kingdom
- Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland
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15
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Kadam A, Wani S, Gadekar G, Katage G, Garg K, Mungikar S. Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial. Arch Orthop Trauma Surg 2024; 144:2481-2489. [PMID: 38693286 DOI: 10.1007/s00402-024-05347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/16/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Patients are often instructed to avoid weight bearing on the proximal tibia for 6 - 12 weeks post-surgery to avoid fracture fixation failure. However, delayed weight bearing leads to delayed mobility, causing difficulties in daily activities; problems such as pain, limited knee ROM, reduced quadriceps muscle strength, and impaired functional outcomes are reported in long-term follow-up. This study primarily aimed to evaluate the feasibility and explore the effect size. The secondary aim was to determine the effectiveness of early weight bearing along with conventional physiotherapy on functional outcomes. MATERIALS AND METHODS A single-blinded pilot randomized controlled trial with 30 participants with proximal tibia type I, II, and III fractures were included; they were randomized using computer-based software. Seven patients were lost to follow-up. Group I received early weight bearing along with conventional physiotherapy whereas Group II received restricted weight bearing along with conventional physiotherapy. Assessments were made on post-operative day 3 (POD-03), at discharge, at 6 weeks, and at 12 weeks. Radiographs were recorded immediately after the operation, at discharge, and at 12 weeks. RESULTS A full-scale RCT is feasible with an effect size between 0.3 - 0.7. A statistically significant difference (p < 0.05) was found within both groups 12 weeks post-surgery in all outcome measures; the difference was more prominent in the intervention group. A statistically significant difference (p < 0.05) was found between both the groups post-12 weeks in all outcome measures except quadriceps isometric muscle strength. CONCLUSION A full-scale RCT for early weight bearing along with conventional physiotherapy for patients operated for Type I, II, and III proximal tibia fracture is feasible. Early weight bearing along with conventional physiotherapy could have a positive effect on reducing patient's pain perception and increasing knee joint mobility, quadriceps isometric muscle strength, knee function, and quality of life without any adverse effects. TRIAL REGISTRATION ClinicalTrialsRegistry.gov (CTRI/2022/10/046797).
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Affiliation(s)
- Anagha Kadam
- Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India
| | - Surendra Wani
- Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India.
| | - Girish Gadekar
- Department of Orthopedics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Goutami Katage
- Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India
| | - Kapil Garg
- Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India
| | - Sanket Mungikar
- Department of Musculoskeletal Physiotherapy, MGM Institute of Physiotherapy, Aurangabad, Maharashtra, India
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16
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Nuevo M, Rodríguez-Rodríguez D, Jauregui R, Fabrellas N, Zabalegui A, Conti M, Prat-Fabregat S. Telerehabilitation following fast-track total knee arthroplasty is effective and safe: a randomized controlled trial with the ReHub® platform. Disabil Rehabil 2024; 46:2629-2639. [PMID: 37403684 DOI: 10.1080/09638288.2023.2228689] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 06/18/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE After a total knee arthroplasty (TKA), ensuring rehabilitation is continued at home is essential for a successful recovery. The aim of this randomized clinical trial (NCT04155957) was to demonstrate the safety and efficacy of an interactive telerehabilitation system (ReHub®) to guide and provide feedback during exercise in the postoperative period of a fast-track TKA program. METHODS Fifty-two patients who underwent TKA were randomized to intervention (N = 26) or control (N = 26). Upon discharge, they followed a 4-week plan of 5 daily exercises and up to 10 physiotherapy home visits. The intervention group performed exercises with ReHub® autonomously, control did not use any auxiliary device. Data were collected 1) on the day of discharge, 2) after 2 weeks and 3) after 4 weeks. RESULTS Telerehabilitation patients showed higher adherence to exercise (p = 0.002) and greater quadriceps strength (p = 0.028). No significant differences between groups were found in other outcomes. Only 1 adverse event was linked to ReHub®. Patients gave the platform high System Usability Scale scores (83/100). CONCLUSION Interactive telerehabilitation with ReHub® during a post-TKA exercise program is effective, safe, and well-received by patients. It provides real-time performance feedback and ensures communication. Quadriceps strength and adherence to the exercise plan are improved with ReHub®.
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Affiliation(s)
- Montse Nuevo
- Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain
- Nursing Sciences, Faculty of Health Science, University Jaume I, Castellón de la Plana, Spain
| | | | | | - Núria Fabrellas
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Science, University of Barcelona, Barcelona, Spain
| | - Adela Zabalegui
- Department of Research and Teaching in Nursing, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marco Conti
- Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - Salvi Prat-Fabregat
- Clinic Institute of Medical and Surgical Specialties (ICEMEQ), Hospital Clinic of Barcelona, Barcelona, Spain
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17
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Jordan CM, Kim S, Glaviano NR. Hip rate of torque development, but not strength, is associated with single-leg squat kinematics in individuals with patellofemoral pain. Physiother Theory Pract 2024:1-9. [PMID: 38813879 DOI: 10.1080/09593985.2024.2360578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Isometric hip strength seems to have limited association with frontal plane kinematics in individuals with patellofemoral pain (PFP), but little is known about the association with hip rate of torque development (RTD). OBJECTIVE To explore the association of hip strength and RTD with trunk, pelvis, hip, and knee kinematics during a single-leg squat (SLS) in individuals with PFP. METHODS Twenty individuals with PFP participated in this study. Hip abductor and extensor strength and RTD (early phase and late phase) were assessed using a hand-held dynamometer. Lateral trunk motion, pelvic drop, hip frontal plane projection angle (HFPPA), and knee frontal plane projection angle (KFPPA) were evaluated during a SLS using a two-dimensional motion analysis. RESULTS Lower early and late phase hip abductor RTD were moderately associated with greater HFPPA (early phase: r = -0.501, p = .025; late phase: r = -0.580, p = .007) and KFPPA (early phase: r = -0.536, p = .015; late phase: r = -0.554, p = .011). Lower early phase hip extensor RTD was moderately associated with greater pelvic drop (r = 0.571, p = .009), HFPPA (r = -0.548, p = .012), and KFPPA (r = -0.530, p = .016). Hip abductor and extensor strength were not associated with any kinematic variables (p > .05). CONCLUSION Lower hip RTD, but not strength, was associated with greater frontal plane kinematics during a SLS in individuals with PFP, indicating that the ability to produce torque rapidly may be important for kinematic control during functional tasks.
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Affiliation(s)
- Cara M Jordan
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Sungwan Kim
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
- Institute for Sports Medicine, University of Connecticut, Storrs, CT, USA
| | - Neal R Glaviano
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
- Institute for Sports Medicine, University of Connecticut, Storrs, CT, USA
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18
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Sahu PK, Goodstadt N, Ramakrishnan A, Silfies SP. Test-retest reliability and concurrent validity of knee extensor strength measured by a novel device incorporated into a weight stack machine vs. handheld and isokinetic dynamometry. PLoS One 2024; 19:e0301872. [PMID: 38776288 PMCID: PMC11111025 DOI: 10.1371/journal.pone.0301872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/22/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND The current clinical gold standard for assessing isometric quadriceps muscle strength is an isokinetic dynamometer (IKD). However, in clinics without an IKD, clinicians default to using handheld dynamometers (HHD), which are less reliable and accurate than the IKD, particularly for large muscle groups. A novel device (ND) was developed that locks the weight stack of weight machines, and measures forces applied to the machine, turning this equipment into an isometric dynamometer. The objectives of this study were to characterize the test-retest reliability of the ND, determine the within-day and between-days inter-rater reliability and concurrent validity compared with that of the HHD, in healthy volunteers (HV) and individuals with knee osteoarthritis (OA) for measuring knee extensors isometric muscle force. MATERIALS AND METHODS 29 healthy (age = 28.4 ± 7.4 years) and 15 knee OA (age = 37.6 ± 13.4 years) participants completed three maximum force isometric strength testing trials on dominant side knee extensor muscles on three devices (ND, HHD, and IKD) in two separate sessions by two raters. The maximum force (Fmax) produced, and the force-time series were recorded. Reliability and validity were assessed using Intraclass Correlation Coefficient (ICC), Bland-Altman Plots, Pearson's r, and cross-correlations. RESULTS The ND demonstrated excellent test-retest reliability (ICC2,3 = 0.97). The within-day (ICC2,3 = 0.88) and between-day inter-rater reliability (ICC2,3 = 0.87) was good for HHD. The ND showed excellent within-day (ICC2,3 = 0.93) and good between-day (ICC2,3 = 0.89) inter-rater reliability. The Bland-Altman analysis revealed HHD systematic bias and underestimation of force particularly with quadriceps force values exceeding 450 N. Mean differences were found in maximum force between HHD vs. IKD (MDabs = 58 N, p < .001) but not the HHD vs. ND (MDabs = 24 N, p = .267) or ND vs. IKD (MDabs = 34 N, p = .051). The concurrent validity of Fmax (r = 0.81) and force-time curve correlation (0.96 ± 0.05) were the highest between the ND and IKD. CONCLUSIONS The ND's test-retest reliability and concurrent validity make it a potential strength assessment tool with utility in physical therapy and fitness settings for large muscle groups such as the knee extensors.
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Affiliation(s)
- Pradeep K. Sahu
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Noel Goodstadt
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Arun Ramakrishnan
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Sheri P. Silfies
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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19
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Michalas M, Katsaras S, Spetsioti S, Spaggoulakis D, Antonoglou A, Asimakos A, Katsaounou P, Christakou A. The Effect of Physiotherapy on Dyspnea, Muscle Strength and Functional Status in Patients with Long COVID Syndrome. J Pers Med 2024; 14:515. [PMID: 38793097 PMCID: PMC11121916 DOI: 10.3390/jpm14050515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Patients who were infected with COVID-19 may experience Long COVID syndrome. We examined the effectiveness of physiotherapy on dyspnea, muscle strength, and functional status in Long COVID syndrome. METHODS The exercise group underwent an 8-week supervised physiotherapeutic program consisting of interval aerobic exercise and strengthening exercises, each lasting 30 min. The control group did not engage in any exercise. Dyspnea, muscle strength, and functional status were assessed at the beginning and end of the intervention in both groups. RESULTS No significant baseline differences were found between the two groups. The exercise group demonstrated improvements compared to baseline in dyspnea, quadriceps muscle strength, and functional status. Specifically, there was a significant increase of 3.7 lifts in the 60-s sit-to-stand test (p = 0.01), an increase of 5.86 kg in right quadriceps muscle strength (p = 0.03), an increase of 8.26 kg in left quadriceps muscle strength (p = 0.01), and a decrease in dyspnea score by 0.95 points (p = 0.02). CONCLUSIONS Similar studies have reported improvements in dyspnea, muscle strength, and functional status in the exercise group. However, further research with larger sample sizes is needed to confirm these findings.
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Affiliation(s)
- Michail Michalas
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stefanos Katsaras
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (M.M.); (S.K.)
| | - Stavroula Spetsioti
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Dimitrios Spaggoulakis
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Archontoula Antonoglou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Andreas Asimakos
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Paraskevi Katsaounou
- First Department of Critical Care Medicine, Evangelismos Hospital, Medical School, National & Kapodistrian University of Athens, 10676 Athens, Greece; (S.S.); (D.S.); (A.A.); (A.A.); (P.K.)
| | - Anna Christakou
- Department Physiotherapy, Lab Biomechanics, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece
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20
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Eckenrode BJ, Kietrys DM, Brown A, Parrott JS, Noehren B. Effects of high frequency strengthening on pain sensitivity and function in female runners with chronic patellofemoral pain. Phys Ther Sport 2024; 67:31-40. [PMID: 38471409 DOI: 10.1016/j.ptsp.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To investigate the effects of a high frequency strengthening program on function, pain, and pain sensitization in female runners with chronic patellofemoral pain (PFP). DESIGN Cross-sectional study. SETTING University laboratory. PARTICIPANTS Thirty female runners (mean age 32 ± 8.1 years) with chronic PFP completed an 8-week home strengthening program. MAIN OUTCOME MEASURES Variables assessed at baseline, 8-weeks, and 12 weeks included single leg step down test (SLSD), pain, Anterior Knee Pain Scale (AKPS), University of Wisconsin Running Injury and Recovery Index (UWRI), and quantitative sensory testing. RESULTS There was large and statistically significant improvement at 8 and 12 weeks for average knee pain (ηp2 = 0.334, p < 0.001), worst knee pain (ηp2 = 0.351, p < 0.001), SLSD (ηp2 = 0.161, p = 0.001), AKPS (ηp2 = 0.463, p < 0.001), and UWRI (ηp2 = 0.366, p < 0.001). A medium to large effect and statistically significant improvement in pressure pain threshold testing was found for all local and remote structures (ηp2 range, 0.110 to 0.293, range p < 0.001 to p = 0.009) at 8 and 12 weeks. CONCLUSIONS There was a significant decrease in local and remote hyperalgesia via mechanical and thermal pain sensitivity testing in female runners with chronic PFP. There was a large effect and significant improvement in self-reported pain and function.
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Affiliation(s)
- Brian J Eckenrode
- Arcadia University, Department of Physical Therapy, Glenside, PA, 19038, USA.
| | - David M Kietrys
- Rutgers School of Health Professions, Department of Rehabilitation and Movement Sciences, Blackwood, NJ, 08012, USA
| | - Allison Brown
- Rutgers School of Health Professions, Department of Rehabilitation and Movement Sciences Newark, NJ, 07101, USA
| | - J Scott Parrott
- Rutgers School of Health Professions, Department of Interdisciplinary Studies, Blackwood, NJ, 08012, USA
| | - Brian Noehren
- University of Kentucky, Department of Physical Therapy, Lexington, KY, 40536, USA
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21
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MacLennan RJ, Hernandez-Sarabia JA, Reese SM, Shields JE, Smith CM, Stute K, Collyar J, Olmos AA, Danielson TL, MacLennan DL, Pagan JI, Girts RM, Harmon KK, Coker N, Carr JC, Ye X, Perry JW, Stock MS, DeFreitas JM. fNIRS is capable of distinguishing laterality of lower body contractions. Exp Brain Res 2024; 242:1115-1126. [PMID: 38483567 DOI: 10.1007/s00221-024-06798-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/31/2024] [Indexed: 07/13/2024]
Abstract
The use of functional near-infrared spectroscopy (fNIRS) for brain imaging during human movement continues to increase. This technology measures brain activity non-invasively using near-infrared light, is highly portable, and robust to motion artifact. However, the spatial resolution of fNIRS is lower than that of other imaging modalities. It is unclear whether fNIRS has sufficient spatial resolution to differentiate nearby areas of the cortex, such as the leg areas of the motor cortex. Therefore, the purpose of this study was to determine fNIRS' ability to discern laterality of lower body contractions. Activity in the primary motor cortex was recorded in forty participants (mean = 23.4 years, SD = 4.5, female = 23, male = 17) while performing unilateral lower body contractions. Contractions were performed at 30% of maximal force against a handheld dynamometer. These contractions included knee extension, knee flexion, dorsiflexion, and plantar flexion of the left and right legs. fNIRS signals were recorded and stored for offline processing and analysis. Channels of fNIRS data were grouped into regions of interest, with five tolerance conditions ranging from strict to lenient. Four of five tolerance conditions resulted in significant differences in cortical activation between hemispheres. During right leg contractions, the left hemisphere was more active than the right hemisphere. Similarly, during left leg contractions, the right hemisphere was more active than the left hemisphere. These results suggest that fNIRS has sufficient spatial resolution to distinguish laterality of lower body contractions. This makes fNIRS an attractive technology in research and clinical applications in which laterality of brain activity is required during lower body activity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xin Ye
- University of Hartford, West Hartford, USA
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22
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Girdwood M, Culvenor AG, Patterson B, Haberfield M, Rio EK, Hedger M, Crossley KM. No sign of weakness: a systematic review and meta-analysis of hip and calf muscle strength after anterior cruciate ligament injury. Br J Sports Med 2024; 58:500-510. [PMID: 38537939 DOI: 10.1136/bjsports-2023-107536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE We aimed to determine hip and lower-leg muscle strength in people after ACL injury compared with an uninjured control group (between people) and the uninjured contralateral limb (between limbs). DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, EMBASE, CINAHL, Scopus, Cochrane CENTRAL and SportDiscus to 28 February 2023. ELIGIBILITY CRITERIA Primary ACL injury with mean age 18-40 years at time of injury. Studies had to measure hip and/or lower-leg muscle strength quantitatively (eg, dynamometer) and report muscle strength for the ACL-injured limb compared with: (i) an uninjured control group and/or (ii) the uninjured contralateral limb. Risk of bias was assessed according to Cochrane Collaboration domains. RESULTS Twenty-eight studies were included (n=23 measured strength ≤12 months post-ACL reconstruction). Most examined hip abduction (16 studies), hip extension (12 studies) and hip external rotation (7 studies) strength. We found no meaningful difference in muscle strength between people or between limbs for hip abduction, extension, internal rotation, flexion or ankle plantarflexion, dorsiflexion (estimates ranged from -9% to +9% of comparator). The only non-zero differences identified were in hip adduction (24% stronger on ACL limb (95% CI 8% to 42%)) and hip external rotation strength (12% deficit on ACL limb (95% CI 6% to 18%)) compared with uninjured controls at follow-ups >12 months, however both results stemmed from only two studies. Certainty of evidence was very low for all outcomes and comparisons, and drawn primarily from the first year post-ACL reconstruction. CONCLUSION Our results do not show widespread or substantial muscle weakness of the hip and lower-leg muscles after ACL injury, contrasting deficits of 10%-20% commonly reported for knee extensors and flexors. As it is unclear if deficits in hip and lower-leg muscle strength resolve with appropriate rehabilitation or no postinjury or postoperative weakness occurs, individualised assessment should guide training of hip and lower-leg strength following ACL injury. PROSPERO REGISTRATION NUMBER CRD42020216793.
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Affiliation(s)
- Michael Girdwood
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Brooke Patterson
- Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Melissa Haberfield
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Ebonie Kendra Rio
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
- The Victorian Institute of Sport, Melbourne, Victoria, Australia
- The Australian Ballet, Melbourne, Victoria, Australia
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23
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Servant G, Bothorel H, Pernoud A, Fourchet F, Christofilopoulos P. Hip Arthroscopy Followed by 6-Month Rehabilitation Leads to Improved Periarticular Muscle Strength, Except for Abductors and External Rotators. Arthrosc Sports Med Rehabil 2024; 6:100900. [PMID: 38379599 PMCID: PMC10878845 DOI: 10.1016/j.asmr.2024.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
Purpose To evaluate the variations in hip muscles strength following arthroscopy and 6-month rehabilitation in patients treated for femoroacetabular impingement (FAI). Methods A retrospective analysis was carried out on a series of patients who were arthroscopically treated for FAI at La Tour Hospital between 2020 and 2022. Bilateral isometric strengths of 8 hip-related muscles (abductors, adductors, hamstrings, quadriceps, extensors, flexors, internal and external rotators) were assessed using a handheld dynamometer before surgery and postoperatively after 6 months of rehabilitation in terms of relative strength changes between time points. Results A total of 29 patients (aged 26.9 ± 7.1 years, 86% of women) were included. Except for the abductors, which remained of comparable strength than before surgery, a statistically significant (P < .05) increase in hip muscle strength on the operated side could be noted at 6 postoperative months for hamstrings (9% ± 17%, P = .041), quadriceps (11% ± 27%, P = .045), extensors (17% ± 32%, P = .006), flexors (17% ± 29%, P = .003), adductors (18% ± 23%, P < .001), and internal rotators (32% ± 36%, P < .001). The proportion of patients who reached a strength level above their preoperative status ranged from 62% (quadriceps) to 86% (adductors and flexors), depending on the muscle studied. The external rotators were the only muscles that remained significantly weakened at 6 months on both operated (-13% ± 26%, P = .002) and nonoperated (-17% ± 25%, P < .001) sides, with a decrease beyond 15% in almost half of the patients (45% and 48%, respectively). Conclusions Arthroscopic treatment followed by 6-month rehabilitation granted to most FAI patients a higher strength level for several hip muscles, except for abductors and external rotators, which remained comparable and weakened, respectively. Level of Evidence Level IV, therapeutic case series.
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Affiliation(s)
- Guillaume Servant
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
| | - Hugo Bothorel
- Research Department, La Tour Hospital, Meyrin, Switzerland
| | | | - François Fourchet
- Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Meyrin, Switzerland
- French Society of Sports Physical Therapist (SFMKS Lab), Pierrefitte-sur-Seine, France
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24
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Bates K, Zeppieri G, Young C, Bruner M, Moser M, Farmer KW, Pozzi F. Preseason lower extremity range of motion, flexibility, and strength in relation to in-season injuries in NCAA division I gymnasts. PHYSICIAN SPORTSMED 2024; 52:200-206. [PMID: 37216208 PMCID: PMC10803174 DOI: 10.1080/00913847.2023.2215775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/21/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season. METHODS Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,' Ober's, Ely's tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups. RESULTS During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: -10.6°; 95% confidence interval: -16.5, -4.6; p < 0.01) and lower hip abduction strength (mean difference: -4.7% of body weight; 95% confidence interval: -9.2, -0.3; p = 0.04). CONCLUSION Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing.
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Affiliation(s)
- Kaysha Bates
- Victory lab PT and performance, Jackson, Wyoming, USA
- Sport Physical Therapy Residency Program, University of Florida Health, Gainesville, FL, USA
| | - Giorgio Zeppieri
- Department of Rehabilitation, University of Florida Health, Gainesville, FL, USA
| | - Candace Young
- Sport Physical Therapy Residency Program, University of Florida Health, Gainesville, FL, USA
- Department of Rehabilitation, Hospital for Special Surgery, New York, NY, USA
| | - Michelle Bruner
- Department of Orthopaedics and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Moser
- Department of Orthopaedics and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Kevin W. Farmer
- Department of Orthopaedics and Sports Medicine, University of Florida, Gainesville, FL, USA
| | - Federico Pozzi
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
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25
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Qi H, Tian D, Luan F, Yang R, Zeng N. Pathophysiological changes of muscle after ischemic stroke: a secondary consequence of stroke injury. Neural Regen Res 2024; 19:737-746. [PMID: 37843207 PMCID: PMC10664100 DOI: 10.4103/1673-5374.382221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/30/2023] [Accepted: 06/01/2023] [Indexed: 10/17/2023] Open
Abstract
Sufficient clinical evidence suggests that the damage caused by ischemic stroke to the body occurs not only in the acute phase but also during the recovery period, and that the latter has a greater impact on the long-term prognosis of the patient. However, current stroke studies have typically focused only on lesions in the central nervous system, ignoring secondary damage caused by this disease. Such a phenomenon arises from the slow progress of pathophysiological studies examining the central nervous system. Further, the appropriate therapeutic time window and benefits of thrombolytic therapy are still controversial, leading scholars to explore more pragmatic intervention strategies. As treatment measures targeting limb symptoms can greatly improve a patient's quality of life, they have become a critical intervention strategy. As the most vital component of the limbs, skeletal muscles have become potential points of concern. Despite this, to the best of our knowledge, there are no comprehensive reviews of pathophysiological changes and potential treatments for post-stroke skeletal muscle. The current review seeks to fill a gap in the current understanding of the pathological processes and mechanisms of muscle wasting atrophy, inflammation, neuroregeneration, mitochondrial changes, and nutritional dysregulation in stroke survivors. In addition, the challenges, as well as the optional solutions for individualized rehabilitation programs for stroke patients based on motor function are discussed.
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Affiliation(s)
- Hu Qi
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Dan Tian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Fei Luan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Ruocong Yang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Nan Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
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26
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Kamel AM, Ghuiba K, Abd Allah DS, Fayaz NA, Abdelkader NA. Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain syndrome: a randomized controlled trial. J Orthop Surg Res 2024; 19:207. [PMID: 38561773 PMCID: PMC10983661 DOI: 10.1186/s13018-024-04688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Patellofemoral pain syndrome is considered a common cause of anterior knee pain that could disturb function and limit daily activities. The purpose of the study was to investigate the effect of adding short foot exercise on pain, function, balance, and hip abductors, and quadriceps muscles strength in the treatment of patients with patellofemoral pain syndrome. METHODS Twenty-eight male and female patients with patellofemoral pain syndrome with age ranged from 18 to 35 years old participated in this study. They were equally and randomly assigned into two groups; the study group which received short foot exercise in addition to hip and knee exercises (n = 14) and thecontrol group which received hip and knee exercises only (n = 14). Participants received their interventions during 6 consecutive weeks (12 sessions). Pain intensity, function, abductors quadriceps muscle strength, and balance were assessed using the Visual Analog Scale, anterior knee pain scale (AKPS), hand-held dynamometer, and the Biodex Balance System respectively. All measurements were taken before and after 6 weeks of intervention in both groups. Multivariate analysis of variance was performed to compare the within and between groups effects for measured variables. RESULTS The within-group comparison showed significant improvement in pain severity, function, balance, and hip abductors, and quadriceps muscles strength in both groups post-treatment compared with pre-treatment. Between groups analysis, however, showed no significant statistical difference between both groups in all variables, except in pain, function, and mediolateral stability which showed better improvement compared to the control group. CONCLUSIONS Adding short foot exercise to hip and knee exercises improved pain, function, and mediolateral stability in patients with patellofemoral pain syndrome. TRIAL REGISTRATION clinicaltrials.gov. NO: NCT05383781. Date 19/ 5/2022.
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Affiliation(s)
- Abdallah Mohamed Kamel
- Department of Physical Therapy for Musculoskeletal disorders and its Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Karim Ghuiba
- Department of Physical Therapy for Musculoskeletal disorders and its Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Dina S Abd Allah
- Department of Physical Therapy for Musculoskeletal disorders and its Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nadia Abdelazem Fayaz
- Department of Physical Therapy for Musculoskeletal disorders and its Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Nasr Awad Abdelkader
- Department of Physical Therapy for Musculoskeletal disorders and its Surgeries, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
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27
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Boyanmış AH, Kesilmiş İ, Akın M, Yilmaz B, Uslular A, Karac Ocal Y, Andre H. A Comparison of Different Strength Measurement in Taekwondo: Herman Trainer, Manual Tester, and Standing Long Jump. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:550. [PMID: 38674196 PMCID: PMC11052195 DOI: 10.3390/medicina60040550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Background and Objective: The accurate prediction of strength development relies on identifying the most appropriate measurement methods. This study compared diverse strength measurement techniques to assess their effectiveness in predicting strength development. Participants were taekwondo athletes competing at the red-black belt level or above. Methods: Technical striking forces (palding, dollyeo chagi, dwit chagi, and yeop chagi) were measured using a Herman Digital Trainer fixed to a striking stand. Quadriceps and hamstring strength were assessed with a Lafayette force measuring device. Explosive leg strength was evaluated through a standing long jump test, normalized for leg length. The Pearson correlation coefficient was used to examine relationships between measurement methods. Results: The standing long jump test showed no significant correlation with other strength assessments. A moderate positive correlation was found between Herman digital trainer measurements and Lafayette digital hand-held dynamometer results. A high positive correlation (r = 0.736, p < 0.001) emerged between hamstring strength and palding chagi technical strike force results. Technical strike kicks showed a significant positive correlation with each other and, also, a right foot-left foot correlation was observed. Conclusions: It was concluded that the standing long jump test, which was shown as one of the explosive leg strength measurement methods in field studies as an alternative to laboratory tests, did not correlate with other strength tests; therefore, this test is weak and insufficient to predict strength skills in taekwondo. In addition, this study showed that the hamstring muscle was more predictive in the measurement of technical strength. In future studies, it might be more useful to measure hamstring muscle strength or technical kick strength instead of a standing long jump field test.
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Affiliation(s)
- Ayşe Hazal Boyanmış
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - İnci Kesilmiş
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Manolya Akın
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Buse Yilmaz
- Faculty of Sports Sciences, Mersin University, Mersin 33110, Turkey; (İ.K.); (M.A.); (B.Y.)
| | - Aşina Uslular
- Faculty of Sports Sciences, Kütahya Dumlupınar University, Kütahya 43100, Turkey;
| | - Yesim Karac Ocal
- Faculty of Sports Sciences, Yozgat Bozok University, Yozgat 66200, Turkey; (Y.K.O.); (H.A.)
| | - Hulya Andre
- Faculty of Sports Sciences, Yozgat Bozok University, Yozgat 66200, Turkey; (Y.K.O.); (H.A.)
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Donoso-Úbeda E, Ucero-Lozano R, Meroño-Gallut J, Cuesta-Barriuso R, Pérez-Llanes R. Safety and efficacy of myofascial release therapy in the treatment of patients with hemophilic ankle arthropathy. Single-blind randomized clinical trial. Physiother Theory Pract 2024:1-10. [PMID: 38530214 DOI: 10.1080/09593985.2024.2334752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Hemophilia is characterized by degenerative joint damage. Patients with hemophilic arthropathy present joint damage, reduced range of motion, and decreased strength and functional capacity. Myofascial release therapy aims to decrease pain and improve tissue mobility and functionality. OBJECTIVES To evaluate the safety and efficacy of myofascial release therapy in patients with hemophilic ankle arthropathy. METHOD Single-blind randomized controlled trial. Fifty-eight adult patients with hemophilia were randomly allocated to the experimental group (myofascial release therapy with foam roller) or the control group (no intervention whatsoever). The daily home protocol of myofascial release therapy for the lower limbs using a foam roller lasted eight consecutive weeks. The primary variable was the safety of myofascial release therapy (weekly telephone follow-up). The secondary variables were pain intensity (visual analog scale), range of motion (goniometer), functional capacity (2-Minute Walk Test) and muscle strength (dynamometer), at baseline and at 8 and 10 weeks. RESULTS During the experimental phase, none of the patients in the experimental group developed ankle hemarthrosis. There were statistically significant changes in time*group interaction in ankle dorsal flexion (F[1.75] = 10.72; p < .001), functional capacity (F[1.16] = 5.24; p = .009) and gastrocnemius strength (F[2] = 26.01; p < .001). The effect size of the changes after the intervention was medium-large in pain intensity (d = -1.77), functional capacity (d = 1.34) and gastrocnemius strength (d = 0.76). CONCLUSION Myofascial release therapy is a safe form of physical therapy for patients with hemophilia. Myofascial release therapy can effectively complement prophylactic pharmacological treatment in patients with hemophilic arthropathy, improving range of motion in dorsal flexion, functional capacity and gastrocnemius strength.
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Affiliation(s)
- Elena Donoso-Úbeda
- Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
| | - Roberto Ucero-Lozano
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, European University of Madrid, Madrid, Spain
| | - Javier Meroño-Gallut
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Tú. Bienestar 360°, Physiotherapy and Medical Center, San Javier, Murcia, Spain
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain
| | - Raúl Pérez-Llanes
- InHeFis Research Group, Instituto Asturiano de Investigación ,Sanitaria (ISPA), Oviedo, Spain
- Department of Physiotherapy, University of Murcia, Murcia, Spain
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29
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Kohlbrenner D, Kuhn M, Manettas A, Aregger C, Peterer M, Greco N, Sievi NA, Clarenbach C. Low-load blood flow restriction strength training in patients with COPD: a randomised single-blind pilot study. Thorax 2024; 79:340-348. [PMID: 38129116 PMCID: PMC10958309 DOI: 10.1136/thorax-2023-220546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The objective of this study is to compare the effectiveness of lower limb low-load blood flow restriction training (LL-BFRT) with high-load strength training (HL-ST) as part of an outpatient pulmonary rehabilitation programme on leg strength in patients with chronic obstructive pulmonary disease (COPD). METHODS Participants were randomised to LL-BFRT or HL-ST (24 sessions). LL-BFRT was done at 30% 1-repetition maximum (1-RM) with 70% arterial occlusion pressure. HL-ST was done at 70% 1-RM. Primary outcome was isometric strength of knee extensors and flexors. Secondary outcomes were 1-RM, functional exercise capacity, physical activity, symptom burden and health-related quality of life. Perceptions of dyspnoea and leg fatigue were recorded after every exercise. We compared groups with t-tests. RESULTS We included 30 participants (13 women, 17 men, 64 (9) years, forced expiratory volume in 1 s 47 (18)% pred.), 24 completed the study. Isometric knee extensor strength improved to a clinically relevant degree in both legs in both groups (LL-BFRT: right leg 9 (20) Nm, left leg 10 (18) Nm; HL-ST: right leg 15 (26) Nm, left leg 16 (30) Nm, data are mean (SD)), without statistically significant or clinically relevant between-group differences (right leg mean difference= -6.4, 95% CI= -13.20 to 25.92 Nm, left leg mean difference= -5.6, 95% CI= -15.44 to 26.55 Nm). 1 min sit-to-stand test performance improved to a clinically relevant degree only in the LL-BFRT group (4 (4) vs 1 (5) repetitions). Interestingly, physical activity improved to a clinically relevant degree only in the LL-BFRT group (1506 (2441) vs -182 (1971) steps/day). LL-BFRT lowered perceived in-exercise dyspnoea and increased leg fatigue compared with HL-ST in the initial 12 trainings. CONCLUSION In patients with stable COPD undergoing outpatient pulmonary rehabilitation, LL-BFRT was not superior to HL-ST in improving leg strength. LL-BFRT led to similar strength gains as HL-ST while reducing perceptions of dyspnoea in the initial training phase. TRIAL REGISTRATION NUMBER NCT04151771.
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Affiliation(s)
- Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Manuel Kuhn
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Anastasios Manettas
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
- Biomechanics and Ergonomics, ErgoMech Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Céline Aregger
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Peterer
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Nicola Greco
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Clarenbach
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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D’Ors-Vilardebó C, Cebrià i Iranzo MÀ, González-King-Garibotti C, Vázquez-Arce MI, Calvache-Mateo A, López-López L, Valenza MC. Association between Post-Hospitalization Psychological Distress, Exercise Capacity, Physical Function and Health Status in COVID-19 Survivors. Healthcare (Basel) 2024; 12:577. [PMID: 38470688 PMCID: PMC10930704 DOI: 10.3390/healthcare12050577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
This study aims to determine whether post-hospitalization psychological distress is associated with exercise capacity, physical function and health status in COVID-19 survivors. In this observational study, hospitalized COVID patients were included and divided into two groups according to the mental component summary subscale of the 12-item Short-Form Health Survey. Patients with a score ≤ 45 were included in the psychological distress group, and patients with a score > 45 were included in the non-psychological distress group. The main variables were exercise capacity, physical function, and health status. Patients were evaluated at discharge, 3 months, and at 6 months follow-up. Finally, a total of 60 patients were included in the study. Significant differences were found in exercise capacity, physical function, and health status (p < 0.05), with worse results in the group with psychological distress at discharge and 3 months follow-up. At 6 months after discharge, COVID patients with psychological distress exhibited worse results in exercise capacity, physical function, and health status, being significant exercise capacity and physical function (p < 0.05). It can be concluded that COVID patients with psychological distress at hospital discharge reported worse exercise capacity, physical function and health status at hospital discharge, 3 months and 6 months follow-up.
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Affiliation(s)
- Clara D’Ors-Vilardebó
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), 46026 Valencia, Spain
| | - Maria Àngels Cebrià i Iranzo
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), 46026 Valencia, Spain
- Physiotherapy Department, University of Valencia, 46026 Valencia, Spain
| | - Carola González-King-Garibotti
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), 46026 Valencia, Spain
| | - María Isabel Vázquez-Arce
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), 46026 Valencia, Spain
| | - Andrés Calvache-Mateo
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, 18016 Granada, Spain
| | - Laura López-López
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, 18016 Granada, Spain
| | - Marie Carmen Valenza
- Physiotherapy Department, Faculty of Health Sciences, University of Granada, Av. De la Ilustración, 60, 18016 Granada, Spain
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31
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Soysal Tomruk M, Tomruk M, Kalemci O. Comparisons of postural control, proprioception, muscle strength, pain and disability between individuals with acute, subacute and chronic low back pain. Somatosens Mot Res 2024; 41:26-33. [PMID: 36634047 DOI: 10.1080/08990220.2023.2165057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE/AIM Postural control, proprioception and lower extremity muscle strength are affected in individuals with low back pain (LBP). However, it is yet unknown whether these variables differentiate between acute, subacute and chronic stages of LBP. The aim was to investigate if there were any differences in postural control, proprioception, lower extremity muscle strength, pain intensity and disability between individuals in the different stages of LBP. MATERIALS AND METHODS In this cross-sectional study, 124 individuals with LBP were grouped as acute LBP (ALBP) (n = 38), subacute LBP (SLBP) (n = 30) and chronic LBP (CLBP) (n = 56) groups. Postural control was assessed via computerised technology. Lumbar proprioception, lower extremity muscle strength, pain intensity and disability were assessed using Joint Repositioning Error Test, hand-held dynamometer, Numeric Rating Scale and Oswestry Disability Index (ODI), respectively. Kruskal-Wallis Tests, ANCOVA and post hoc Mann-Whitney U-Test with Bonferroni correction were performed. RESULTS While there were no significant differences in terms of postural control, proprioception and pain intensity (p > 0.05), significant differences were found in terms of lower extremity muscle strength and ODI scores between groups when adjusted for age (p < 0.05). Individuals with CLBP demonstrated poorer lower extremity muscle strength than those with ALBP and SLBP, and higher disability than those with ALBP (p < 0.017). CONCLUSIONS Although postural control, proprioception and pain intensity were similar between individuals with acute, subacute and chronic LBP, muscle strength and disability seem to worsen stepwise as the pain becomes chronic. Muscle strength and disability should be taken into account while evaluating and/or managing individuals with acute and subacute stages of LBP.
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Affiliation(s)
- Melda Soysal Tomruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Murat Tomruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Orhan Kalemci
- Faculty of Medicine, Department of Neurosurgery, Dokuz Eylül University, İzmir, Turkey
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Kristiansen J, Eddy C, Magnusson SP. Reliability and Validity of the End Range Hamstring Strength Test with Handheld Dynamometry. Int J Sports Phys Ther 2024; 19:268-274. [PMID: 38439772 PMCID: PMC10909305 DOI: 10.26603/001c.94011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024] Open
Abstract
Background and Purpose Hamstring strength testing is crucial in assessing this important muscle group during rehabilitation and injury prevention. The purpose of this study was to evaluate the reliability and validity of measuring strength in a maximally lengthened position using a handheld dynamometer (HHD) compared to isokinetic testing. Methods Twenty healthy and active participants were recruited, and isometric strength testing was performed both on the Biodex machine and isometric end-range hamstring testing with the HHD on two occasions. Results Significant strong correlations (r= 0.87, p < 0.0001) were found between strength testing on the Biodex machine and the HHD for both the right and left sides. Bland-Altman plots demonstrated agreement between the two measurements. Excellent intra-rater reliability (ICC= 0.91-0.93) and moderate to good inter-rater reliability (ICC = 0.71-0.83) for the HHD test was demonstrated. Conclusions The HHD provides a reliable and valid alternative to isokinetic testing for assessing hamstring strength in a maximally lengthened position. This assessment can be valuable in monitoring rehabilitation progress and detecting deficits before and after returning to play. The HHD is an accessible and cost-effective option for assessing hamstring strength at long lengths in a clinical setting. Level of evidence 3.
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Affiliation(s)
| | - Christina Eddy
- Department of Physical and Occupational Therapy Bispebjerg Hospital
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33
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Hao XY, Zhang K, Huang XY, Yang F, Sun SY. Muscle strength and non-alcoholic fatty liver disease/metabolic-associated fatty liver disease. World J Gastroenterol 2024; 30:636-643. [PMID: 38515958 PMCID: PMC10950621 DOI: 10.3748/wjg.v30.i7.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
This editorial comments on an article published in a recent issue of World Journal of Gastroenterology, entitled “Association of low muscle strength with metabolic dysfunction-associated fatty liver disease: A nationwide study”. We focused on the association between muscle strength and the incidence of non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD), as well as the mechanisms underlying the correlation and related clinical applications. NAFLD, which is now redefined as MAFLD, is one of the most common chronic liver diseases globally with an increasing prevalence and is characterized by malnutrition, which may contribute to decreased muscle strength. Reduction of muscle strength reportedly has a pathogenesis similar to that of NAFLD/ MAFLD, including insulin resistance, inflammation, sedentary behavior, as well as insufficient vitamin D. Multiple studies have focused on the relationship between sarcopenia or muscle strength and NAFLD. However, studies investigating the relationship between muscle strength and MAFLD are limited. Owing to the shortage of specific medications for NAFLD/MAFLD treatment, early detection is essential. Furthermore, the relationship between muscle strength and NAFLD/MAFLD suggests that improvements in muscle strength may have an impact on disease prevention and may provide novel insights into treatments including dietary therapy, as well as tailored physical activity.
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Affiliation(s)
- Xuan-Yu Hao
- Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Kai Zhang
- Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xing-Yong Huang
- Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Fei Yang
- Department of Gastroenterology, Endoscopic Center, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Si-Yu Sun
- Department of Gastroenterology, Endoscopic Center, Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic Techniques, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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Korsholm MB, Pødenphanth TW, Strømgaard SK, Petersen LW, Alexandersen C, Hoffmann SS, Rasmusen HK, Suetta C, Damgaard K, Pressel E, Dela F. Are statins making older persons weaker? A discontinuation study of muscular side effects. GeroScience 2024; 46:853-865. [PMID: 37225942 PMCID: PMC10828417 DOI: 10.1007/s11357-023-00817-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/02/2023] [Indexed: 05/26/2023] Open
Abstract
Thirteen percent of the Danish population are treated with a statin-half of these are in primary prevention, and most are > 65 years old. Statins have known muscular side effects (i.e., myalgia) correlated to reduced muscle performance. This study examines if years of statin treatment in older people introduce subclinical muscle discomfort and loss of muscle mass and strength. In total, 98 participants (71.1 ± 3.6 years (mean ± SD)), who were in primary prevention treatment for elevated plasma cholesterol with a statin, were included in this study. Statin treatment was discontinued for 2 months and then re-introduced for 2 months. Primary outcomes included muscle performance and myalgia. Secondary outcomes included lean mass and plasma cholesterol. Functional muscle capacity measured as a 6-min walk test increased after discontinuation (from 542 ± 88 to 555 ± 91 m, P < 0.05) and remained increased after re-introduction (557 ± 94 m). Similar significant results were found with a chair stand test (15.7 ± 4.3 to 16.3 ± 4.9 repetitions/30 s) and a quadriceps muscle test. Muscle discomfort during rest did not change significantly with discontinuation (visual analog scale from 0.9 ± 1.7 to 0.6 ± 1.4) but increased (P < 0.05) with the re-introduction (to 1.2 ± 2.0) and muscle discomfort during activity decreased (P < 0.05) with discontinuation (from 2.5 ± 2.6 to 1.9 ± 2.3). After 2 weeks of discontinuation, low-density lipoprotein cholesterol increased from 2.2 ± 0.5 to 3.9 ± 0.8 mM and remained elevated until the re-introduction of statins (P < 0.05). Significant and lasting improvements in muscle performance and myalgia were found at the discontinuation and re-introduction of statins. The results indicate a possible statin-related loss of muscle performance in older persons that needs further examination.
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Affiliation(s)
- Morten Bruun Korsholm
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | | | - Sofie Kirstine Strømgaard
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Linda Wiuff Petersen
- Department of Medicine, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark
| | - Christina Alexandersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark
| | - Sarah Samama Hoffmann
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Hanne K Rasmusen
- Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Charlotte Suetta
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | - Kirsten Damgaard
- Department of Neurology and Geriatrics, Copenhagen University Hospital - Næstved, Slagelse and Ringsted, Slagelse, Denmark
| | - Eckart Pressel
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark
| | - Flemming Dela
- Department of Geriatric and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, NV, Denmark.
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.
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Collimore AN, Alvarez JT, Sherman DA, Gerez LF, Barrow N, Choe DK, Binder-Macleod S, Walsh CJ, Awad LN. A Portable, Neurostimulation-Integrated, Force Measurement Platform for the Clinical Assessment of Plantarflexor Central Drive. Bioengineering (Basel) 2024; 11:137. [PMID: 38391623 PMCID: PMC10885982 DOI: 10.3390/bioengineering11020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/15/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Plantarflexor central drive is a promising biomarker of neuromotor impairment; however, routine clinical assessment is hindered by the unavailability of force measurement systems with integrated neurostimulation capabilities. In this study, we evaluate the accuracy of a portable, neurostimulation-integrated, plantarflexor force measurement system we developed to facilitate the assessment of plantarflexor neuromotor function in clinical settings. Two experiments were conducted with the Central Drive System (CEDRS). To evaluate accuracy, experiment #1 included 16 neurotypical adults and used intra-class correlation (ICC2,1) to test agreement of plantarflexor strength capacity measured with CEDRS versus a stationary dynamometer. To evaluate validity, experiment #2 added 26 individuals with post-stroke hemiparesis and used one-way ANOVAs to test for between-limb differences in CEDRS' measurements of plantarflexor neuromotor function, comparing neurotypical, non-paretic, and paretic limb measurements. The association between paretic plantarflexor neuromotor function and walking function outcomes derived from the six-minute walk test (6MWT) were also evaluated. CEDRS' measurements of plantarflexor neuromotor function showed high agreement with measurements made by the stationary dynamometer (ICC = 0.83, p < 0.001). CEDRS' measurements also showed the expected between-limb differences (p's < 0.001) in maximum voluntary strength (Neurotypical: 76.21 ± 13.84 ft-lbs., Non-paretic: 56.93 ± 17.75 ft-lbs., and Paretic: 31.51 ± 14.08 ft-lbs.), strength capacity (Neurotypical: 76.47 ± 13.59 ft-lbs., Non-paretic: 64.08 ± 14.50 ft-lbs., and Paretic: 44.55 ± 14.23 ft-lbs.), and central drive (Neurotypical: 88.73 ± 1.71%, Non-paretic: 73.66% ± 17.74%, and Paretic: 52.04% ± 20.22%). CEDRS-measured plantarflexor central drive was moderately correlated with 6MWT total distance (r = 0.69, p < 0.001) and distance-induced changes in speed (r = 0.61, p = 0.002). CEDRS is a clinician-operated, portable, neurostimulation-integrated force measurement platform that produces accurate measurements of plantarflexor neuromotor function that are associated with post-stroke walking ability.
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Affiliation(s)
- Ashley N Collimore
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Jonathan T Alvarez
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - David A Sherman
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
- Section of Rheumatology, Boston University, Boston, MA 02215, USA
| | - Lucas F Gerez
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Noah Barrow
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
| | - Dabin K Choe
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | | | - Conor J Walsh
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Louis N Awad
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA
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Yang Y, Zeng Z, van Schooten KS, Sum RKW, Shen J, Ho CY, Chan KP, Cheong D. Effects of a multicomponent physical activity programme, Mobility-Fit, compared with a standard care lower limb strengthening programme, to promote safe mobility among older adults in care facilities: protocol for a cluster randomised controlled trial. BMJ Open 2024; 14:e082403. [PMID: 38267249 PMCID: PMC10823931 DOI: 10.1136/bmjopen-2023-082403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Upper limb and core strength training is essential for older adults to safely perform daily activities. However, existing exercise programmes mainly focus on lower limb strength and are not designed or delivered to suit people with different functional capacities. This study describes the design of a two-arm cluster randomised controlled trial to examine the effects of a multicomponent physical activity (PA) programme, Mobility-Fit, on mobility and frailty in older adults living in care facilities. METHODS AND ANALYSIS 160 older adults from 20 care facilities in Hong Kong will be recruited and randomised by care facilities (1:1) to an intervention or a control group. Participants in the intervention group will attend the Mobility-Fit programme, led by facility-based instructors, three times per week, 45 min per session, for 12 weeks, while the control group will participate in a standard care lower limb strengthening programme offered by the care facility. Participants will then be followed up for 9 months. Mobility-Fit comprises agility, postural coordination, balance and strength training, with suitable dosage based on participant's baseline physical and cognitive function. The primary outcomes encompass upper and lower limb strength, trunk stability, reaction time, mobility function and fall efficacy. Secondary outcomes comprise daily PA level and performance, frailty, cognitive function and quality of life. A repeated measures analysis of variance (ANOVA) and generalised estimating equation (GEE) will be used to examine changes in outcomes over time and between groups. Data will be analysed following the intention-to-treat principles. We will also evaluate programme implementation and health economics throughout the follow-up period. ETHICS AND DISSEMINATION Ethical approval was acquired in November 2022 from the Joint CUHK-NTEC Clinical Research Ethics Committee in Hong Kong (CREC-2022-459). Informed consent will be obtained from participants. The results of the study will be disseminated through peer-reviewed articles, conference presentations and social media. TRIAL REGISTRATION NUMBER ChiCTR2300072709.
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Affiliation(s)
- Yijian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Jockey Club Institute of Aging, The Chinese University of Hong Kong, Hong Kong, China
| | - Ziwei Zeng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Kimberley S van Schooten
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiahao Shen
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Cheuk-Yin Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka-Po Chan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Debbie Cheong
- B.C. Recreation and Parks Association (BCRPA), Vancouver, British Columbia, Canada
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37
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Gultekin SC, Cakir AB, Guc ZG, Ozalp FR, Keskinkilic M, Yavuzsen T, Yavuzsen HT, Karadibak D. The comparison of functional status and health-related parameters in ovarian cancer survivors with healthy controls. Support Care Cancer 2024; 32:119. [PMID: 38252310 PMCID: PMC10803560 DOI: 10.1007/s00520-024-08311-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE The primary purpose of this study was to evaluate functional status and health-related parameters in ovarian cancer (OC) survivors and to compare these parameters with healthy controls. The secondary purpose of this study was to compare these parameters in early and advanced OC survivors. METHODS Thirty-two OC survivors (n = 15 early stage; n = 17 advanced stage) with no evidence/suspicion of cancer recurrence after completing adjuvant local and systemic treatments for at least 12 months and 32 healthy controls were recruited for functional- and health-related assessments. Participants were assessed using the following methods of measuring the following: 6-min walk test (6MWT) for functional exercise capacity, 30-s chair stand test (30 s-CST) for functional fitness and muscle endurance, a handheld dynamometer for peripheral muscle strength, and a handheld dynamometer for lower extremity strength, Medical Micro RPM for respiratory muscle strength, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, and Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) for performance status, Checklist Individual Strength (CIS) for fatigue, Treatment/Gynecological Oncology-Neurotoxicity (FACT/GOG-NTX) for neuropathy, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression level, and the World Health Organization-Five Well-Being Index (WHO-5) for generic quality of life. RESULTS All OC survivors underwent surgery and chemotherapy, and only 9.4% received radiotherapy in addition to chemotherapy. The median recurrence-free period post-completion of adjuvant treatments was 24.00 (12.00-75.00) months. OC survivors had lower 6MWT (m) (p < 0.001, r = 1.50), peripheral muscle strength (p = 0.005, r = 0.72), knee extension (p < 0.001, r = 1.54), and respiratory muscle strength (maximal inspiratory pressure) (p < 0.001, r = 1.90) (maximal expiratory pressure) (p < 0.001, r = 1.68) compared to healthy controls. HADS-A (p = 0.005, r = 0.75) and CIS scores (p = 0.025, r = 0.59) were also higher in the OC survivors. Early-stage OC survivors had better 6MWT (m) than advanced-stage OC survivors (p = 0.005, r = 1.83). Peripheral muscle strength was lower in advanced-stage OC survivors (p = 0.013, r = 0.92). FACT/GOG-NTX scores were higher in early-stage OC survivors (p < 0.001, r = 1.42). No significant differences were observed between early- and advanced-stage OC survivors in other measures (p < 0.05). CONCLUSION The findings suggest functional status, and health-related parameters are negatively affected in OC survivors. Additionally, higher levels of fatigue, neuropathy anxiety, and depression were reported in advanced OC survivors.
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Affiliation(s)
- Sukriye Cansu Gultekin
- Faculty of Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Ahmet Burak Cakir
- Faculty of Physical Therapy and Rehabilitation, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Zeynep Gulsum Guc
- Department of Medical Oncology, Izmir Katip Celebi University, Izmir, Turkey
| | - Faruk Recep Ozalp
- Department of Cardiopulmonary Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Merve Keskinkilic
- Department of Cardiopulmonary Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Tugba Yavuzsen
- Department of Cardiopulmonary Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Husnu Tore Yavuzsen
- Clinic of Gynecology and Obstetrics, Buca Obstetrics Gynecology and Pediatrics Disease Hospital, Izmir, Turkey
| | - Didem Karadibak
- Department of Cardiopulmonary Physiotherapy-Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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Ramadan AM, ElDeeb AM, Ramadan AA, Aleshmawy DM. Effect of combined Kinesiotaping and resistive exercise on muscle strength and quality of life in breast cancer survivors: a randomized clinical trial. J Egypt Natl Canc Inst 2024; 36:1. [PMID: 38221574 DOI: 10.1186/s43046-023-00205-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Breast cancer (BC) and its treatment affect women's tissue architecture and physiology, which leads to impaired muscle strength and joint dysfunction, affecting quality of life (QOL). Most evidence has focused on exercises; however, due to the complexity and heterogeneity of patients' rehabilitation needs, further research is required to investigate more adjunctive methods to help optimal rehabilitation according to patients' needs, preferences, and effective interventions. METHODS This study aimed to determine the effect of Kinesiotaping (KT) combined with resistive exercise on muscle strength and QOL in breast cancer survivors (BCS). Forty premenopausal BCS treated with chemotherapy postmastectomy participated in this study. Their age ranged from 40 to 55 years, and their body mass index (BMI) was 25-29.9 kg/m2. They were randomly distributed into two equal groups. The control group received resistive exercise two times/week for 12 weeks, while the study group received resistive exercise and KT applied to the lower limbs. Hip, knee, and ankle muscle strength were measured using a hand-held dynamometer, and QOL was evaluated using 36-Item Short Form (SF-36) before and after treatment. RESULTS Both groups showed a significant increase (p = 0.0001) in the strength of hip flexors, knee extensors, flexors, ankle plantar flexors, and dorsiflexors, as well as SF-36 score after treatment. However, the study group showed a more significant increase in strength of hip flexors (p = 0.005), knee extensors (p = 0.01) and flexors (p = 0.02), ankle plantar flexors (p = 0.01), and dorsiflexors (p = 0.01), as well as SF-36 score (p = 0.006) than the control group. CONCLUSIONS KT plus resistive exercise is more effective than exercise alone for improving muscle strength and QOL in BCS. So, the KT can be recommended as a non-invasive, adjunctive method added to the protocol therapy for BCS to help better outcomes during the rehabilitation period.
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Affiliation(s)
- Alaa M Ramadan
- Department of Physical Therapy for Obstetrics and Gynecology, Faculty of Physical Therapy, October 6 University, Giza, Egypt
| | - Abeer M ElDeeb
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Ahmed A Ramadan
- Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Dina M Aleshmawy
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Sun S, Tang T, Shi P, Yang C, Wang W, Chen L, Wei M. Standing on single foot-binding test yields satisfactory results as a novel method for the diagnosis of distal tibiofibular syndesmosis instability: a prospective, cross-sectional diagnostic-accuracy study. BMC Musculoskelet Disord 2024; 25:53. [PMID: 38216973 PMCID: PMC10785373 DOI: 10.1186/s12891-023-07155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/26/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Non-invasive diagnosis of distal tibiofibular syndesmosis instability (DTSI) was a great challenge to clinicians. We designed a new method, the Standing on single foot-Binding test, and investigated the accuracy of the test in the diagnosis of distal tibiofibular syndesmosis instability in adults with a history of ankle injury. METHODS 85 participants with ankle injury were subjected to the Standing on single foot-Binding test, MRI and palpation to detect the distal tibiofibular syndesmosis instability (DTSI) and the findings were compared with ankle arthroscopic results. Both participants and arthroscopist were blind to the predicted results of the clinical tests. Sensitivity, specificity, PPV, NPV, LR+, LR - and their 95% CIs were calculated for each of the clinical tests as well as for the positive clinical diagnosis. RESULTS The Standing on single foot-Binding test (SOSF-B test) outperformed MRI and palpation, in terms of sensitivity (87.5%/84.38%), specificity (86.79%/86.79%), PPV (80%/79.41%), NPV (92%/91.2%), LR+ (6.625/6.39), LR- (0.14/0.18) and diagnostic accuracy (87.06/85.88), among others, in the diagnosis of distal tibiofibular syndesmosis instability (DTSI). The diagnostic performance of 20° SOSF-B test was virtually identical to that of 0° SOSF-B test. According to the prevalence (28.7%) of DTSI and LR of four tests, the post-test probability could be used in clinical practice for the prediction of DTSI. CONCLUSION This prospective and double-blind diagnostic test showed that the SOSF-B test is clinically feasible for the diagnosis of distal tibiofibular syndesmosis instability (DTSI), and new diagnostic tools for rapid screening of distal tibiofibular syndesmosis instability (DTSI). LEVEL OF EVIDENCE II.
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Affiliation(s)
- Shouqi Sun
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China
| | - Tianshi Tang
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China
| | - Pengtao Shi
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China
| | - Chen Yang
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China
| | - Wenjuan Wang
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China.
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China.
| | - Lei Chen
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China.
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China.
| | - Min Wei
- Medical School of Chinese PLA, (BEIJING, Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics, the Fourth Medical Center, Chinese PLA General Hospital (BEIJING, Beijing, China.
- Department of Orthopedics/Chinese National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation (BEIJING, Chinese PLA General Hospital, Beijing, China.
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Zhang Y, Chen M, Liu H, He Y, Li Y, Shen P, Chen Y, Huang J, Liu C. Effect of different isometric trunk extension intensities on the muscle stiffness of the lumbar and lower limbs. Front Physiol 2024; 14:1337170. [PMID: 38239887 PMCID: PMC10794496 DOI: 10.3389/fphys.2023.1337170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024] Open
Abstract
Purpose: To investigate the effect of isometric prone trunk extension (IPTE) contraction intensity on the stiffness of erector spinae (ES), semitendinosus (ST), biceps femoris (BF), and gastrocnemius muscles to understand the overall muscle mechanical behavior during IPTE and to explore the mechanisms of oordinated contraction of the body kinetic chain. Methods: Twenty healthy females were recruited, and participants underwent IPTE at three contraction intensities, i.e., 0% maximum voluntary isometric contraction (MVIC), 30% MVIC, and 60% MVIC, and muscle stiffness was measured using MyotonPRO. Results: Muscle stiffness was moderately to strongly positively correlated with contraction intensity (r = 0.408-0.655, p < 0.001). The percentage increase in stiffness at low intensity was much greater in ES than in lower limb muscles and greater in ST and BF than in gastrocnemius, whereas at moderate intensity, the percentage increase in stiffness decreased in all muscles, and the percentage increase in stiffness in ES was lower than that in ST. There was a moderate to strong positive correlation between ES stiffness variation and ST (r = 0.758-0.902, p < 0.001), BF (r = 0.454-0.515, p < 0.05), MG (r = 0.643-0.652, p < 0.01), LG (r = 0.659-0.897, p < 0.01). Conclusion: IPTE significantly affected the stiffness of lumbar and lower limb muscles, and low-intensity IPTE activated the ES more efficiently. There were significant coordinated muscle contractions between ES, ST, and LG. This provides preliminary evidence for exploring the overall modulation pattern of the lumbar and lower limb muscles' kinetic chains. In future studies, we will combine other stiffness assessment methods (such as Magnetic Resonance Elastography, Shear Wave Elastography, or electromyography) to corroborate our findings.
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Affiliation(s)
| | | | | | | | | | | | | | - Jiapeng Huang
- Clinical Medical College of Acupuncture, Moxibustion, and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chunlong Liu
- Clinical Medical College of Acupuncture, Moxibustion, and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Longo D, Ammannati L, Melchiorre D, Serafini I, Bagni MA, Ferrarello F. The Muscle Shortening Maneuver: a noninvasive approach to the treatment of peroneal nerve injury. A case report. Physiother Theory Pract 2024; 40:176-183. [PMID: 35912501 DOI: 10.1080/09593985.2022.2106915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/15/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND The treatment of peripheral nerve injuries is a debated topic. The Muscle Shortening Maneuver (MSM), a physiotherapy approach, is noninvasive and free of side effects; it consists of a muscle shortening and a solicitation in traction applied simultaneously. OBJECTIVE The focus of this report is to describe the effects of the MSM combined with walking retraining in a patient with incomplete injury of the peroneal nerve. DESCRIPTION The patient was a 17-year-old man, who underwent osteotomy surgery of the proximal two-thirds of the fibula, due to an Ewing sarcoma that caused a partial injury of the left peroneal nerve. Our assessment plan of the left ankle movement ability comprised range of movement, muscle strength, and surface electromyography (EMG); and a gait analysis was conducted by using an iPhone application. MSM and walking retraining were administered twice and once a week, respectively, for 4 weeks. OUTCOMES The active range of movement substantially improved in dorsiflexion (≥15°), whereas slightly decreased in plantar flexion (-5°). Aside from the tibialis anterior, an increase in muscle strength was detected. Surface EMG showed an increased activation, particularly in the peroneus longus. A decrease in gait speed and step length was recorded from the gait analysis, with a better bilateral symmetry. CONCLUSIONS Positive outcomes were reported without evidence of risk or adverse events for the participant.
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Affiliation(s)
- Diego Longo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Biological Systems Movement Research Laboratory, Pistoia Italy
| | - Lorenzo Ammannati
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Daniela Melchiorre
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Biological Systems Movement Research Laboratory, Pistoia Italy
| | - Isabella Serafini
- Department of Functional Rehabilitation Activities, Azienda USL Toscana Centro, Ex Filanda, V. Cesare Battisti 30, Pescia, Italy
| | - Maria Angela Bagni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Biological Systems Movement Research Laboratory, Pistoia Italy
| | - Francesco Ferrarello
- Department of Functional Rehabilitation Activities, Azienda USL Toscana Centro, c/o CSS Giovannini, Prato, Italy
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Maniglio M, Maruccia M, Morandi M, Martineau J, Sapino G, Elia R, Pignatti M, di Summa PG. Comparisons of the morbidities of a double gastrocnemius flap and a medial gastrocnemius flap in the orthoplastic reconstruction around the knee. Microsurgery 2024; 44:e31114. [PMID: 37861063 DOI: 10.1002/micr.31114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 07/22/2023] [Accepted: 09/06/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The pedicled gastrocnemius flap is commonly used to treat lower limb defects. Either the medial, lateral, or both heads can be used. When extended soft tissue defects are present, a double gastrocnemius (DG) flap may be used. However, no data of the additional donor site morbidity compared to a medial gastrocnemius (MG) flap are available. The aim of this study was to compare the donor site morbidity of a DG with that of a MG. METHODS Patients with a soft tissue defect around the knee, treated with a gastrocnemius flap between 2018 and 2021 at the University Hospital of Lausanne and Bari, with a minimum follow-up of 12 months, were included. According to the size and the position of the defect, it was decided whether one (10 patients) or two (9 patients) heads of the gastrocnemius were necessary for the coverage. The mean age was 61 years (range 42-82) in DG, and 63 years (range 45-78) in MG. The average defect size was 89.8 cm2 in the DG group and 53.4 cm2 in the MG group. The etiologies were trauma (n = 10), infection (n = 7) and sarcoma (n = 2). A medial approach or a posterior midline approach was used for the harvesting of the gastrocnemius muscle. Once the flap was harvested, it was rotated and transposed anteriorly over the defect, either through a subcutaneous tunnel or by dividing the intervening skin bridge, depending on the soft tissue defect. A split-thickness skin graft was used to close the skin over the remaining exposed muscle flap. The active range of motion of the ankle and knee joints was measured. Muscle strength was assessed with a hand-held dynamometer and by the ability to stand on tiptoe. Physical function was evaluated through the Lower Extremity Functional Scale (LEFS). RESULTS The two groups were homogeneous, with no significant difference in age, sex, and BMI. All flaps survived in both groups. Both groups showed lower values in strength and range of motion of the operated leg, when compared to contralateral side. In plantar flexion, this accounted for a reduction in MG by 3.8 ± 1.0 kg of strength and 8 ± 3° of ROM, and in DG by 4.7 ± 1.7 kg and 16 ± 4°, respectively. For knee flexion, the reduction in MG was 4.4 ± 0.6 kg and 16 ± 7°, while in DG 5.6 ± 1.0 kg and 28 ± 6°. In the MG group, 60% were able to stand on the tiptoe of the operated leg, as opposed to 0% in DG. The average LEFS score in DG was lower by 10.9 points (p < .05). Questions concerning running and jumping had a lower score in DG (p < .01). CONCLUSIONS The harvesting of both gastrocnemii led to significant additional donor site morbidity compared to the harvesting of the medial gastrocnemius alone. However, the additional morbidity did not have an impact on activities of daily living and walking, even though it limited the ability to perform more demanding tasks such as running and jumping. Therefore, based on our study, the choice of a DG flap should be critically assessed in younger, more demanding patients.
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Affiliation(s)
- Mauro Maniglio
- Department of Plastic and Hand Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Michele Maruccia
- Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Ionac Area (DIMIPRE-J), University of Bari Aldo Moro, piazza giulio cesare, Bari, Italy
| | - Marco Morandi
- Department of Plastic and Hand Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Jérôme Martineau
- Department of Plastic and Hand Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Gianluca Sapino
- Department of Plastic and Hand Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Rossella Elia
- Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Ionac Area (DIMIPRE-J), University of Bari Aldo Moro, piazza giulio cesare, Bari, Italy
| | - Marco Pignatti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero Universitaria (AOU), Policlinico di Sant'Orsola di Bologna, Bologna, Italy
| | - Pietro G di Summa
- Department of Plastic and Hand Surgery, Lausanne University Hospital, Lausanne, Switzerland
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Karapınar M, Ayyıldız VA, Unal M, Fırat T. Effect of intramuscular fat in the thigh muscles on muscle architecture and physical performance in the middle-aged women with knee osteoarthritis. J Orthop Sci 2024; 29:194-199. [PMID: 36460557 DOI: 10.1016/j.jos.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/06/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND We investigated intramuscular fat (IMF) in quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (KOA). We also examined the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the women with KOA. METHODS In this cross-sectional study, 72 women were included. Body muscle and fat mass were measured by BIA, isometric muscle strength was evaluated by hand-held dynamometer. IMF and muscle architecture were calculated from rectus femoris (RF), vastus intermedius (VIM), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) using B-mode ultrasonography. KOA-related symptoms and functions were assessed with KOOS. The functional performance assessments were evaluated with Stair Climbing Test, 20-Meter Walking Test. RESULTS Women with KOA had more IMF in RF, VIM, VL, VM and BF, ST, SM muscles compared to the healthy women. Pennation angles decreased as the IMF in the RF, VM, BF and ST decreased. As the IMF of the RF and VM increased isometric knee extensor strength decreased and KOOS symptom score, pain score and ADL score increased in women with KOA. Walking and stair climbing speed deteriorated as the IMF in RF, VIM, VM, BF increased in the middle-aged women. As the IMF in BF increased isometric knee flexor strength decreased and KOOS scores increased. Physical performance scores deteriorated as the IMF in BF increased in middle-aged women with KOA. CONCLUSION IMF in QF and hamstring muscles were higher in the middle-aged women with KOA group compared with that in the healthy group. Weakness of the QF and hamstring muscles may due to the changes in architectural properties of muscle depending on muscular infiltration. IMF in knee muscles is an important determining factor in performance and physical function of middle-aged women with KOA.
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Affiliation(s)
- Merve Karapınar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Suleyman Demirel University, Isparta, Turkey.
| | - Veysel Atilla Ayyıldız
- Department of Radiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Meriç Unal
- Department of Orthopaedics and Traumatology, Private Meddem Hospital, Isparta, Turkey
| | - Tüzün Fırat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Louis M, Hwang R, Sabapathy S, Roberts LA, Morris NR. High-Intensity Small Muscle Mass Training in Patients With Heart Failure: Rationale and Design of a Randomized Controlled Trial. Phys Ther 2024; 104:pzad130. [PMID: 37758445 DOI: 10.1093/ptj/pzad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/20/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Small muscle mass training localized to the quadriceps femoris muscle group has been proposed as an intervention to reverse heart failure-related skeletal muscle impairments. Although this training paradigm has demonstrated efficacy in heart failure, it remains to be evaluated in a conventional clinical context. Hence, the aim of this proposed study is to determine the effects of integrating high-intensity small muscle mass training (HISMT) isolated to the knee extensor muscles within a standard heart failure rehabilitation program. METHODS This single-blind, randomized controlled trial will aim to recruit 70 participants with heart failure. Participants will be randomized to either (1) standard training: combination of upper and lower extremity cardiovascular and resistance-based exercises, or (2) HISMT plus modified standard training: bilateral knee extensor HISMT and a modified version of the standard training, so that the total volume of work will be similar to standard training alone. The training interventions will be undertaken twice weekly for 12 weeks in an outpatient clinical setting. Outcome measurements will be performed at baseline and after the 12-week intervention period. The primary outcome will be exercise capacity (6-Minute Walk Test), with secondary outcomes being physical performance measures, muscle strength, and health-related quality of life. Data will be analyzed using the intention-to-treat principle. IMPACT This study will address a gap in the literature regarding the efficacy of small muscle training under routine clinical conditions for individuals with heart failure. The findings will also provide insight into the effects of HISMT within a heart failure rehabilitation program, thus enabling the optimization of exercise prescription for this patient population.
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Affiliation(s)
- Menaka Louis
- Chronic Disease and Post-Acute Programs, Gold Coast Hospital and Health Service, Robina Health Precinct, Robina, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Rita Hwang
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- Department of Physiotherapy, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Surendran Sabapathy
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
| | - Llion Arwyn Roberts
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Norman Rolston Morris
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
- The Menzies Health Institute, Griffith University, Southport, Queensland, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, Queensland, Australia
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Polat K, Karadibak D, Güç ZGS, Yavuzşen T, Öztop İ. The Relationship between Exercise Capacity and Muscle Strength, Physical Activity, Fatigue and Quality of Life in Patients with Cancer Cachexia. Nutr Cancer 2023; 76:55-62. [PMID: 37917566 DOI: 10.1080/01635581.2023.2276486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Exercise capacity is a significant determinant of mortality for cancer patients, so knowing the possible determinants of exercise capacity will produce physical and psychological benefits for individuals with cancer cachexia. PURPOSE To investigate the relationship between exercise capacity on peripheric and respiratory muscle strength, physical activity, fatigue and quality of life in subjects with cancer cachexia. METHODS The study included 31 patients diagnosed with cancer cachexia. Functional capacity was assessed by 6-Minute Walk Test, hand grip strength and proximal muscle mass by hand dynamometer, respiratory muscle strength by the Maximum Expiratory Pressure and Maximum Inspiratory Pressure measurements, physical activity by International Physical Activity Questionnaire Short Form, fatigue by Brief Fatigue Inventory, and quality of life by EORT-QLQ-C30. The relationship between functional capacity and continuous independent variables was determined using Spearman's or Pearson's tests. RESULTS A strong positive correlation was observed between exercise capacity and expiratory muscle strength (r = 0.75, p < 0.001), activity level (r = 0.68, p < 0.001), and quality of life global health status (r = 0.74, p < 0.001). Conversely, a strong negative correlation was found between exercise capacity and fatigue severity (r = -0.64, p < 0.001). CONCLUSION Higher exercise capacity in cancer cachexia patients is linked to reduced fatigue, improved respiratory muscle strength, increased physical activity levels, and enhanced quality of life. When designing rehabilitation programs or exercise interventions for individuals with cancer cachexia, it is crucial to assess their exercise capacity and tailor the programs accordingly.
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Affiliation(s)
- Karya Polat
- Health Science Institute, Katip Celebi University, İzmir, Turkey
| | - Didem Karadibak
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, İzmir, Turkey
| | | | - Tuğba Yavuzşen
- Medicine Faculty Medical Oncology Subdivision, Dokuz Eylul University, İzmir, Turkey
| | - İlhan Öztop
- Medicine Faculty Medical Oncology Subdivision, Dokuz Eylul University, İzmir, Turkey
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Park KH, Lee H, Park EY, Sung JH, Song MK, An M, Bang E, Baek SY, Do Y, Lee S, Lim Y. Effects of an urban forest healing program on cancer-related fatigue in cancer survivors. Support Care Cancer 2023; 32:4. [PMID: 38051396 DOI: 10.1007/s00520-023-08214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE This study aimed to examine the effects of an eight-session structured urban forest healing program for cancer survivors with fatigue. BACKGROUND Cancer-related fatigue (CRF) is a complex and multifactorial common symptom among cancer survivors that limits quality of life (QoL). Although health benefits of forest healing on physiological, physical, and psychological aspect as well as on the immune system have been reported in many studies, there is limited evidence on the efficacy of specialized forest program for cancer survivors. METHOD A single-blinded, pre-test and post-test control group clinical trial was conducted with -75 cancer survivors assigned to either the forest healing group or the control group. The intervention was an eight-session structured urban forest program provided at two urban forests with easy accessibility. Each session consists of three or four major activities based on six forest healing elements such as landscape, phytoncides, anions, sounds, sunlight, and oxygen. Complete data of the treatment-adherent sample (≥ 6 sessions) was used to examine whether sociodemographic, clinical, physiological (respiratory function, muscle strength, balance, 6-min walking test) and psychological (distress, mood state, sleep quality, QoL) characteristics at baseline moderated the intervention effect on fatigue severity at 9 weeks. RESULTS Significant time-group interactions were observed muscle strength, balance, 6-min walking test, distress, fatigue, moods, and QoL. The mean difference in fatigue between pre- and post-forest healing program was 9.1 (95% CI 6.2 to 11.9), 11.9 (95% CI 7.6 to 16.1) in moods, and -93.9 (95% CI -123.9 to -64.0) in QoL, showing significant improvements in forest healing group, but no significant improvements in the control group. CONCLUSION This study suggests that a forest healing program positively impacts the lives of cancer survivors, by addressing both physical and psychological challenges associated with CRF. TRIAL REGISTRATION NUMBER KCT0008447 (Date of registration: May 19, 2023).
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Affiliation(s)
- Kwang-Hi Park
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea.
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea.
| | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
| | - Eun Young Park
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Korea
| | - Min Kyung Song
- Department of Nursing, College of Medicine, University of Ulsan, Ulsan, Korea
| | - Miyoung An
- Department of Nursing, Yeoju Institute of Technology, Yeoju, Korea
| | - Esther Bang
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea
| | - Sang Yi Baek
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Yerim Do
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
| | - Sieun Lee
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Youngeun Lim
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
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Donoso-Úbeda E, Pérez-Llanes R, Meroño-Gallut J, Ucero-Lozano R, Cuesta-Barriuso R. Foam roller-based self-induced myofascial therapy in patients with hemophilic knee arthropathy: a multicenter, single-blind, randomized clinical study. Eur J Phys Rehabil Med 2023; 59:763-771. [PMID: 37869759 PMCID: PMC10795767 DOI: 10.23736/s1973-9087.23.07944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/05/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Hemophilia is a congenital coagulopathy characterized by degenerative joint damage. Self-induced myofascial therapy aims to decrease pain and improve tissue mobility, functionality and proprioception. AIM The aim of this study was to evaluate the safety and efficacy of self-induced myofascial release in patients with hemophilic knee arthropathy. DESIGN This is a randomized clinical study. SETTING This study was carried out in different patient associations. POPULATION Fifty-two patients with hemophilia were included in the study. METHODS Patients were randomized to the experimental group (daily home protocol of foam roller-based self-induced myofascial therapy for 8 weeks) or the control group (no intervention). The variables were the frequency of hemarthrosis (self-reporting), pain intensity (visual analog scale), range of motion (goniometry) and muscle strength (dynamometry). All variables were evaluated at baseline, post-treatment and after a 10-week follow-up. RESULTS The patients included in the experimental group showed significant improvements in terms of a decrease in frequency of hemarthrosis (mean difference [MD]=-0.61; 95% confidence interval [CI]: -0.81; -0.41) and pain intensity (MD=-0.33; 95% CI: -0.48, -0.18), increased range of motion (MD=0.88; 95% CI: 0.39; 1.37), strength in quadriceps (MD=0.88; 95% CI: 0.39; 1.37). (MD=12.39; 95% CI: 3.44; 21.34) and hamstrings (MD=7.85; 95% CI: 0.60; 15.11). There were intergroup differences in the frequency of hemarthrosis (F=14.51; P<0.001), pain intensity (F=9.14; P<0.001) and range of motion (F=13.58; P<0.001). CONCLUSIONS Self-induced myofascial therapy can be an effective complementary technique in the treatment of patients with hemophilic arthropathy. Self-induced myofascial therapy can reduce the frequency of knee hemarthrosis in patients with hemophilia. This technique can improve pain intensity and range of motion in patients with hemophilic knee arthropathy. CLINICAL REHABILITATION IMPACT Hemophilic knee arthropathy is characterized by chronic pain, decreased range of motion, and periarticular muscle atrophy. Foam roller-based self-induced myofascial therapy can reduce the frequency of hemarthrosis and pain intensity and improve range of motion in patients with hemophilic arthropathy. Foam roller-based self-induced myofascial therapy is safe and effective in the treatment of patients with hemophilia. The inclusion of self-induced myofascial therapy exercises in the approach to degenerative joint pathologies may be an effective and safe treatment option.
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Affiliation(s)
- Elena Donoso-Úbeda
- Department of Physiotherapy, UCAM Catholic University of Murcia, Murcia, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain
| | - Raúl Pérez-Llanes
- Department of Physiotherapy, UCAM Catholic University of Murcia, Murcia, Spain
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain
| | - Javier Meroño-Gallut
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain
- Service of Physiotherapy, Tu Bienestar 360°, San Javier, Spain
| | - Roberto Ucero-Lozano
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain
- Department of Physiotherapy, European University of Madrid, Madrid, Spain
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria, Oviedo, Spain -
- Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain
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Tsai PL, Wang CP, Fang YY, Chen YJ, Chen SC, Chen MR, Ko JY, Lin JJ, Lou PJ, Lai YH. Return to work in head and neck cancer survivors: its relationship with functional, psychological, and disease-treatment factors. J Cancer Surviv 2023; 17:1715-1724. [PMID: 35900687 DOI: 10.1007/s11764-022-01224-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Return to work (RTW) is important for survivors of head and neck cancer (HNC). The purposes of the study were to investigate the RTW ratio among HNC survivors and identify factors significantly affecting RTW in this population. METHODS A cross-sectional study with consecutive sampling was conducted in a medical center in Taiwan, with 111 patients with HNC who had completed major treatments within 5 years and were employed before their cancer diagnosis enrolled as participants. Cervical range of motion (CROM) functionality, handgrip and hip flexor strength, maximal mouth opening (MMO), selected symptoms, depression, and disease/treatment-related factors were assessed. All of the factors were analyzed using t-test, chi-square test, and multiple logistic regression. RESULTS Less than half (44.1%, n = 49) of the participants had returned to work. The t-test/chi-square test results showed the RTW group to be younger in age and better educated; have better handgrip/hip flexor strength, MMO, and CROM; have less speech difficulty and pain; and have less-advanced cancer than the non-RTW group. Further analysis of the above significant variables by logistic regression revealed early cancer stage, dominant handgrip strength, and less speech difficulty were the robust factors related to RTW. CONCLUSIONS The RTW ratio is low in HNC survivors. RTW in HNC survivors is a multifactorial and complicated issue and needs to be further examined. IMPLICATIONS FOR CANCER SURVIVORS Assessing the factors related to RTW systematically and developing comprehensive interventions and rehabilitation programs to reduce related dysfunctions are necessary to enhance RTW ability in HNC survivors.
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Affiliation(s)
- Pi-Ling Tsai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Ping Wang
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Yuan-Yuan Fang
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Shu-Ching Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Ru Chen
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jenq-Yuh Ko
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Jiu-Jenq Lin
- College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Jen Lou
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- National Taiwan University Cancer Center, Taipei, Taiwan.
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Bruyneel AV, Pourchet T, Reinmann A. Dance after stroke improves motor recovery in the subacute phase: A randomized controlled trial. Heliyon 2023; 9:e22275. [PMID: 38053900 PMCID: PMC10694307 DOI: 10.1016/j.heliyon.2023.e22275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/28/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
Purpose The objective of this study was to investigate the effects of a dance program, combined with conventional treatments, on the motor recovery and quality of life of stroke survivors in comparison with conventional treatments alone. Materials and methods A total of 16 subacute stroke survivors were randomized into two groups: a dance group (DG) and a conventional treatments group (CG). Stroke severity, cognitive abilities, and motor capacities were assessed at baseline. For six weeks, all participants underwent standard rehabilitation. However, in the DG, participants attended an additional weekly dance class. In both groups, the Mini-BESTest, Functional Independence Measure (FIM), ABC-Scale, Lower Extremity Motor Coordination Test (LEMOCOT), quadriceps strength, and Stroke-Specific Quality of Life Scale (SS-QOL) were measured at weeks 4 and 6. Nonparametric statistical tests were applied. Results Compared to the CG, the DG significantly improved recovery of balance, coordination, and FIM after four or six weeks. No differences were observed for quadriceps strength, SS-QOL, or cognition. Participants were completely satisfied with the dance class, and no adverse effects were observed. Conclusions This study was discontinued following the COVID-19 health crisis. However, the analysis revealed numerous beneficial effects of dance practice for subacute stroke survivors. The results contribute significantly to the advancement of artistic practices in stroke rehabilitation.
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Affiliation(s)
- Anne-Violette Bruyneel
- Physiotherapy Department, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Thomas Pourchet
- Physiotherapy Department, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Aline Reinmann
- Physiotherapy Department, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Waiteman MC, Garcia MC, Briani RV, Norte G, Glaviano NR, De Azevedo FM, Bazett-Jones DM. Can Clinicians Trust Objective Measures of Hip Muscle Strength From Portable Dynamometers? A Systematic Review With Meta-analysis and Evidence Gap Map of 107 Studies of Reliability and Criterion Validity Using the COSMIN Methodology. J Orthop Sports Phys Ther 2023; 53:655-672. [PMID: 37787581 DOI: 10.2519/jospt.2023.12045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
OBJECTIVE: To summarize the evidence on reliability and criterion validity of hip muscle strength testing using portable dynamometers. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: Five databases were searched from inception to March 2023. STUDY SELECTION CRITERIA: We included studies investigating reliability or criterion validity of hip flexor, extensor, abductor, adductor, or internal/external rotator strength testing with portable dynamometers in injury-free individuals or those with pelvic/lower limb musculoskeletal disorders. DATA SYNTHESIS: We performed meta-analyses for each muscle group, position, and method of fixation. We rated pooled results as sufficient (>75% of studies with correlations ≥0.70), insufficient (>75% of studies with correlations <0.70), or inconsistent (sufficient/insufficient results). We assessed the quality of evidence, created evidence gap maps, and made clinical recommendations. RESULTS: We included a total of 107 studies (reliability 103, validity 14). The intrarater and interrater reliability for hip muscle strength testing across different positions and methods of fixation was sufficient (intraclass correlation coefficient = 0.78-0.96) with low- to high-quality evidence. Criterion validity was less investigated and mostly inconsistent (very low-to moderate-quality evidence) with a wide range of correlations (r = 0.40-0.93). CONCLUSION: Hip muscle strength testing using portable dynamometers is reliable. The use of portable dynamometers as clinical surrogates for measuring strength using an isokinetic dynamometer requires further investigation. Clinicians testing hip muscle strength with portable dynamometers should use external fixation seated for hip flexors, prone or supine for hip extensors, side-lying or supine for abductors and adductors, and prone and seated for internal and external rotators. J Orthop Sports Phys Ther 2023;53(11):655-672. Epub 3 October 2023. doi:10.2519/jospt.2023.12045.
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