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Gabriel A, Fuchs K, Haller B, Sulowska-Daszyk I, Horstmann T, Konrad A. A four-week minimalist shoe walking intervention influences foot posture and balance in young adults-a randomized controlled trial. PLoS One 2024; 19:e0304640. [PMID: 38900749 PMCID: PMC11189255 DOI: 10.1371/journal.pone.0304640] [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: 02/15/2024] [Accepted: 05/11/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Minimalist shoes (MS) are beneficial for foot health. The foot is a part of the posterior chain. It is suggested that interventions on the plantar foot sole also affect the upper segments of the body. This study aimed to investigate the local and remote effects along the posterior chain of four weeks of MS walking in recreationally active young adults. METHODS 28 healthy participants (15 female, 13 male; 25.3 ± 5.3 years; 70.2 ± 11.9 kg; 175.0 ± 7.8 cm) were randomly assigned to a control- or intervention group. The intervention group undertook a four-week incremental MS walking program, which included 3,000 steps/day in the first week, increasing to 5,000 steps/day for the remaining three weeks. The control group walked in their preferred shoe (no MS). We assessed the following parameters in a laboratory at baseline [M1], after the four-week intervention [M2], and after a four-week wash-out period [M3]: Foot parameters (i.e., Foot Posture Index-6, Arch Rigidity Index), static single-leg stance balance, foot-, ankle-, and posterior chain range of motion, and muscle strength of the posterior chain. We fitted multiple hierarchically built mixed models to the data. RESULTS In the MS group, the Foot Posture Index (b = -3.72, t(51) = -6.05, p < .001, [-4.94, 2.51]) and balance (b = -17.96, t(49) = -2.56, p = .01, [-31.54, 4.37]) significantly improved from M1 to M2, but not all other parameters (all p >.05). The improvements remained at M3 (Foot Posture Index: b = -1.71, t(51) = -2.73, p = .009, [-4,94,0.48]; balance: b = -15.97, t(49) = -2.25, p = .03, [-29.72, 2.21]). DISCUSSION Walking in MS for four weeks might be advantageous for foot health of recreationally active young adults but no chronic remote effects should be expected.
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Affiliation(s)
- Anna Gabriel
- Professorship for Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Katharina Fuchs
- Professorship for Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, School of Medicine and Health, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Iwona Sulowska-Daszyk
- Institute of Clinical Rehabilitation, University of Physical Education in Kraków, Kraków, Poland
| | - Thomas Horstmann
- Professorship for Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
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Gabriel A, Konrad A, Herold N, Horstmann T, Schleip R, Paternoster FK. Testing the Posterior Chain: Diagnostic Accuracy of the Bunkie Test versus the Isokinetic Hamstrings/Quadriceps Measurement in Patients with Self-Reported Knee Pain and Healthy Controls. J Clin Med 2024; 13:1011. [PMID: 38398324 PMCID: PMC10889369 DOI: 10.3390/jcm13041011] [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: 12/18/2023] [Revised: 01/18/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: The isokinetic measurement (IM) of the leg muscles is well established but costly, whereas the Bunkie Test (BT) is a rarely investigated but easy-to-conduct functional test to evaluate the total posterior chain. Although the tests differ in aim and test structures, both have their justification in the assessment process. Therefore, this study evaluated the diagnostic accuracy of the BT and the IM. (2) Methods: 21 participants (9 female, 12 male; age, 26.2 ± 5.26 years; weight 73.8 ± 14.6 kg; height 176.0 ± 9.91 cm) and 21 patients (9 female, 12 male; age, 26.5 ± 5.56 years; weight, 72.6 ± 16.9 kg; height 177.0 ± 10.1 cm) with self-reported pain in the knee performed the IM and the BT. For IM, we calculated the ratio of the knee mean flexor/extensor peak torque (H/Q ratio) for 60°/s and 120°/s, and BT performance was measured in seconds. We classified the IM (<0.6 H/Q ratio) and the BT (leg difference ≥4 s) as binary results according to the literature. We calculated the sensitivity and specificity, which we compared with the Chi-Square test, and the 95% confidence intervals (CI). A p-value of ≤0.05 is considered significant. (3) Results: The sensitivity for the BT was 0.89, 95% CI [0.67, 0.99], and the specificity was 0.52 [0.30, 0.74]. For the IM, the sensitivity was 0.14 [0.03, 0.36] for 60°/s and 0.05 [0.00, 0.24] for 120°/s, and the specificity was 0.70 [0.46, 0.88] for 60°/s and 0.90 [0.68, 0.99] for 120°/s. The results of the Chi-Square tests were significant for the BT (χ2 (1) = 6.17, p = 0.01) but not for the IM (60°/s: χ2 (1) = 0.70, p = 0.40; 120°/s: χ2 (1) = 0.00, p = 0.97). (4) Conclusions: Patients were more likely to obtain a positive test result for the BT but not for the IM.
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Affiliation(s)
- Anna Gabriel
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, 8010 Graz, Austria
| | - Nadine Herold
- Department Sport and Health Sciences, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany;
| | - Thomas Horstmann
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
| | - Robert Schleip
- Department of Conservative and Rehabilitative Orthopedics, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany; (A.G.); (R.S.)
- Department of Medical Professions, Diploma University of Applied Sciences, 37242 Bad Sooden-Allendorf, Germany
| | - Florian K. Paternoster
- Department of Biomechanics in Sports, School of Medicine and Health, Technical University of Munich, 80992 Munich, Germany;
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Kang N, Wang Y, Chen G, Guo C, Zhang Z, Mei D, Morrow-Howell N, Wang D. Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:239-244. [PMID: 36600975 PMCID: PMC9806703 DOI: 10.1016/j.smhs.2022.10.001] [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: 12/13/2021] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/14/2022] Open
Abstract
Knee Osteoarthritis (KOA) is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women. The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise. However, a literature review outlined limitations in Tai Chi intervention implementations. This study aimed to address some of the gaps. This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests. The subjects were randomly assigned to Tai Chi or education groups. Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention. The difference-in-differences (DID) regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences. After the completion of the intervention, the Tai Chi group reported significantly improved KOA symptoms, physical fitness, and health status indicators than the control group. Specifically, the group differences were significantly larger at the baseline than at the follow-up. Our findings provide compelling evidence of the effects of the innovative Tai Chi exercise prescription specifically designed for KOA patients. The empirical evidence on its effectiveness in alleviating KOA symptoms and improving the overall health of middle-aged and elderly women with KOA suggested that Tai Chi intervention exercise has huge prospects for integration in KOA rehabilitation therapy.
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Affiliation(s)
- Ning Kang
- Institute of Population Research, Peking University, No.5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Yi Wang
- University of Iowa School of Social Work, 225B North Hall, Iowa City, IA, 52242, USA
| | - Gong Chen
- Institute of Population Research, Peking University, No.5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Chao Guo
- Institute of Population Research, Peking University, No.5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Zhanjia Zhang
- Department of Physical Education, Peking University, No.5 Yiheyuan Road Haidian District, Beijing, 100871, China
| | - Donghui Mei
- Capital Normal University, 105 West Third Ring Road North, Haidian District, Beijing, 100048, China
| | - Nancy Morrow-Howell
- Washington University in St. Louis, Brown School, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Dongmin Wang
- Department of Physical Education, Peking University, No.5 Yiheyuan Road Haidian District, Beijing, 100871, China,Corresponding author.
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Yamagata M, Tateuchi H, Asayama A, Ichihashi N. Influence of lower-limb muscle inactivation on medial and lateral knee contact forces during walking. Med Eng Phys 2022; 108:103889. [DOI: 10.1016/j.medengphy.2022.103889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/27/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
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Park S, Min S, Park SH, Yoo J, Jee YS. Influence of Isometric Exercise Combined With Electromyostimulation on Inflammatory Cytokine Levels, Muscle Strength, and Knee Joint Function in Elderly Women With Early Knee Osteoarthritis. Front Physiol 2021; 12:688260. [PMID: 34326779 PMCID: PMC8313868 DOI: 10.3389/fphys.2021.688260] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background and Objectives: Muscle strengthening exercise is suggested to beneficial for patients with knee osteoarthritis (OA) and electrical muscular stimulation is reported to be effective in improvement of muscle strength. This study examined whether isometric exercise combined with whole body-electromyostimulation (WB-EMS) can improve serum cytokine levels, muscle strength, and knee function in elderly women with early knee OA. Materials and Methods: This randomized controlled study included 75 participants assigned into three groups: the control group (CON), isometric exercise group (ISOM), and isometric exercise and electromyostimulation group (ISOM + EMS). The two exercise groups performed their respective programs for 8 weeks, 3 days a week, 30 min a day. The main exercises for both groups were performed continuously during the 20 min in an alternation of a 6-s contraction with a 4-s break. At pre- and post-intervention, anthropometric variables, muscle strength, Knee Injury and Osteoarthritis Outcome Score (KOOS), and blood sampling for biomarkers including interleukin-6, tumor necrosis factor-α, C-reactive protein, and resistin were performed. Results: All variables at pre-intervention showed no significant differences among the three groups. However, there were significant differences between groups for body composition, muscle strength, KOOS subscale scores, and biomarkers. ISOM + EMS group resulted in a significant reduction in body weight, fat mass, fat percentage, inflammatory cytokine levels, and increased muscle strength. An ISOM + EMS group had the best KOOS score among all groups. Conclusion: Isometric exercise combined with WB-EMS resulted in the best overall improvements in knee function and alleviating the pain and symptoms of patients with early knee OA. Further, reduced levels of inflammatory cytokines were observed. These non-pharmacologic, non-invasive interventions should be considered by healthcare specialists for elderly patients with early knee OA.
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Affiliation(s)
- Sunhee Park
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Sukyung Min
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Si-Hwa Park
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Jaehyun Yoo
- Department of Physical Education, Sahmyook University, Seoul, South Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
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Günaydin ÖE, Bayrakci Tunay V. Comparison of the added effects of kinesio taping and extracorporeal shockwave therapy to exercise alone in knee osteoarthritis. Physiother Theory Pract 2020; 38:661-669. [PMID: 32574094 DOI: 10.1080/09593985.2020.1780657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Pain and functional limitations affect quality of life of patients with knee osteoarthritis (OA). PURPOSE The purpose of this study was to compare the effects of two different applications (Kinesio taping; KT and Extracorporeal Shock Wave Therapy; ESWT) added to an home-exercise program on pain, strength and function in patients with knee OA. METHODS Sixty voluntary female subjects were randomly assigned into groups of; KT (n = 22), ESWT (n = 18) and control (CON) (n = 20) respectively. KT and ESWT were applied for 6 weeks and all the groups were taken home exercise program during 12 weeks in all groups. The outcome measures were; Visual Analog Scale for pain (during squat, rest and sleep), Isokinetic strength for quadriceps and hamstring strength, 'The Knee Injury and Osteoarthritis Outcome Survey', Timed Up & Go and 10 m Walk tests for function. The assessments were carried out at baseline, 6th and 12th weeks. RESULTS The mean age was 58.8 ± 6.2 years. Significant improvements were observed in all groups in all tests (p < .05). There was no difference found between groups (p > .05) except pain levels during sleep. CON group showed significant reduction in pain during sleep compared to ESWT group (p < .05). CONCLUSION KT and ESWT have similar effects in terms of decreasing pain, improving knee strength and function in patients with knee OA. However it can be said that if a well-designed home exercise program were done by the patients correctly and regularly then it will be the best treatment option for patients with knee OA.
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Affiliation(s)
- Özge Ece Günaydin
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Aydın Adnan Menderes University, Aydın, Turkey
| | - Volga Bayrakci Tunay
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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de Zwart A, van der Leeden M, Roorda L, van der Esch M, Twisk J, Lems W, Dekker J. Course and predictors of upper leg muscle strength over 48 months in subjects with knee osteoarthritis: Data from the osteoarthritis initiative. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100038. [DOI: 10.1016/j.ocarto.2020.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/03/2020] [Indexed: 11/25/2022] Open
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Alshami AM, Alhassany HA. Girth, strength, and flexibility of the calf muscle in patients with knee osteoarthritis: A case-control study. J Taibah Univ Med Sci 2020; 15:197-202. [PMID: 32647514 PMCID: PMC7336019 DOI: 10.1016/j.jtumed.2020.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives Reduced strength and girth in thigh muscles such as the quadriceps and the hamstrings have been observed in patients with knee osteoarthritis (OA). However, studies on the characteristics of calf muscles in these patients are lacking. This study aimed to evaluate the girth, strength, and flexibility of the calf muscle of patients with knee OA. Methods In this case–control study, we recruited 15 patients with knee OA and 15 healthy control participants. The girth, strength, and flexibility of the calf muscle were evaluated in one session using a flexible non-elastic tape measure (centimetre), a handheld dynamometer (Newton), and a standard goniometer (degree) to measure ankle dorsiflexion. Results Strength of the calf muscle strength was significantly lower in the patients with knee OA comapred with the control group (−42.03; 95% CI: −73.9, −10.1; p = .012). No significant differences in calf muscle girth (.27; 95% CI: −2.63, 3.16; p = .852) or flexibility (−1.93; 95% CI: −4.8, .93; p = .177) were found between the two groups. Conclusion In our study, patients with knee OA demonstrated reduced calf muscle strength. We recommend that the management of patients with knee OA include strengthening the calf muscles. Patients with knee OA did not have reduced girth or flexibility in the calf muscle. Patients with knee OA may demonstrate weakness in the calf muscle. Calf muscle strength should be included in the management of patients with knee OA.
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Affiliation(s)
- Ali M Alshami
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Hussein A Alhassany
- Medical Rehabilitation Department, Eradah Hospital for Mental Health, Jazan, KSA
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9
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de Zwart AH, van der Leeden M, Roorda LD, Visser M, van der Esch M, Lems WF, Dekker J. Dietary protein intake and upper leg muscle strength in subjects with knee osteoarthritis: data from the osteoarthritis initiative. Rheumatol Int 2019; 39:277-284. [DOI: 10.1007/s00296-018-4223-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/04/2018] [Indexed: 01/01/2023]
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10
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Gkrilias P, Tsepis E, Kokkalis Z, Panagiotopoulos E, Megas P. The relationship between isokinetic strength and functional performance tests in patients with knee osteoarthritis. J Phys Ther Sci 2018; 30:888-891. [PMID: 29950786 PMCID: PMC6016287 DOI: 10.1589/jpts.30.888] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 03/28/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The main purpose of the study was to examine the relationship of a battery of
frequently used functional assessment tests with quadriceps and hamstrings isokinetic
strength in Knee-osteoarthritis (OA) patients. Secondarily, the predictability of
isokinetic strength on these performance variables was also assessed. [Subjects and
Methods] Seventeen males and 23 females with Knee-OA, were assessed via a) the common
functional tests: 6-minute walk test, Timed up-and-go test, 30-second chair test and
12-stair test and b) isokinetic concentric extension-flexion at 120°/s and 180°/s.
[Results] Both Knee Extension and Flexion Peak Torque per Body weight showed moderate to
strong, statistically significant correlation, with all 4-functional performance tests,
for both velocities. Both 12-stair test and 30-second chair test were significant
predictors in all analyses, while the 6-minute walk test was an additional significant
predictor of the 120°/s knee flexion. [Conclusion] Thigh muscle strength in both tested
velocities proved to be significantly correlated with functional performance. The 12-stair
test and 30-second chair test results were significant predictors for isokinetic extension
and flexion in both velocities. It appears that those two tests challenge the knee and the
surrounding musculature in a manner that reflects muscle strength.
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Affiliation(s)
- Panagiotis Gkrilias
- Department of Orthopaedics, School of Medicine, University of Patras: Rio Patras 26504, Greece.,Department of Physical Therapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, Greece
| | - Elias Tsepis
- Department of Physical Therapy, School of Health and Welfare, Technological Educational Institute (TEI) of Western Greece, Greece
| | - Zinon Kokkalis
- Department of Orthopaedics, School of Medicine, University of Patras: Rio Patras 26504, Greece
| | - Elias Panagiotopoulos
- Department of Orthopaedics, School of Medicine, University of Patras: Rio Patras 26504, Greece.,Rehabilitation Clinic, Department of Medicine, University of Patras, Greece
| | - Panagiotis Megas
- Department of Orthopaedics, School of Medicine, University of Patras: Rio Patras 26504, Greece
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Ghandali E, Moghadam ST, Hadian MR, Olyaei G, Jalaie S, Sajjadi E. The effect of Tai Chi exercises on postural stability and control in older patients with knee osteoarthritis. J Bodyw Mov Ther 2017; 21:594-598. [DOI: 10.1016/j.jbmt.2016.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 08/24/2016] [Accepted: 09/01/2016] [Indexed: 11/30/2022]
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Lim SJ, Cho SH, Nam GS. The effects of standing balance in anteroposterior and mediolateral directions on knee strengthening in post-total knee replacement. J Phys Ther Sci 2016; 28:261-3. [PMID: 26957770 PMCID: PMC4756016 DOI: 10.1589/jpts.28.261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/20/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the association between
muscle-strengthening exercises applied to the knee extensor muscles and the maintenance of
standing balance in both, the anteroposterior and mediolateral directions in patients who
had undergone total knee replacement. [Subjects and Methods] Thirty patients who underwent
total knee replacement with bilateral artificial joints participated in this study. During
the eight-week study period, the load on the knee extensors was gradually increased, and
the standing balance ability was measured by differentiating the anteroposterior and
mediolateral directions both, before and after the experimental period. [Results] In both,
the anteroposterior and the mediolateral directions, there were statistically significant
increases after the eight-week experiment, with a 29% increase in standing balance
maintenance in the anteroposterior direction and a 22% increase in the mediolateral
direction. [Conclusion] In patients who underwent bilateral total knee replacement,
strengthening exercises applied to the knee extensor muscles with gradually increasing
load positively affected standing balance in both anteroposterior and mediolateral
directions.
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Affiliation(s)
- Sung-Joon Lim
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
| | - Sung-Hyoun Cho
- Department of Physical Therapy, Nambu University, Republic of Korea
| | - Gi-San Nam
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
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Jeon K, Seo BD, Lee SH. Comparative study on isokinetic capacity of knee and ankle joints by functional injury. J Phys Ther Sci 2016; 28:250-6. [PMID: 26957768 PMCID: PMC4756014 DOI: 10.1589/jpts.28.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/16/2015] [Indexed: 12/30/2022] Open
Abstract
[Purpose] To collect basic data for exercise programs designed to enhance functional knee
and ankle joint stability based on isokinetic measurement and muscle strength evaluations
in normal and impaired functional states. [Subjects and Methods] Twenty-four subjects were
randomly assigned to the athlete group and the control group (n = 12 each). Data were
collected of isokinetic knee extensor and flexor strength at 60°/sec, 180°/sec, and
240°/sec and ankle plantar and dorsiflexor strength at 30°/sec and 120°/sec. [Results]
Significant intergroup differences were observed in peak torque of the right extensors at
60°/sec, 180°/sec, and 240°/sec and the right flexors at 240°/sec. Significant differences
were observed in peak torque/body weight in the right extensors at 60°/sec, 180°/sec, and
240°/sec and in the right flexors at 180°/sec and 240°/sec. Significant peak torque
differences were noted in the left ankle joint dorsiflexor at 30°/sec and 120°/sec, right
plantar flexor at 120°/sec, left plantar flexor at 30°/sec, left dorsiflexor at 30°/sec
and 120°/sec, and right dorsiflexor at 120°/sec. [Conclusion] Isokinetic evaluation
stimulates muscle contraction at motion-dependent speeds and may contribute to the
development of intervention programs to improve knee and ankle joint function and correct
lower-extremity instability.
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Affiliation(s)
- Kyoungkyu Jeon
- Sport Science Institute, Incheon National University, Republic of Korea
| | - Byoung-Do Seo
- Department of Physical Therapy, College of Health, Kyungwoon University, Republic of Korea
| | - Sang-Ho Lee
- Department of Physical Education, College of Education, Hankuk University of Foreign Studies, Republic of Korea
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Cho Y, Ko Y, Lee W. Relationships among foot position, lower limb alignment, and knee adduction moment in patients with degenerative knee osteoarthritis. J Phys Ther Sci 2015; 27:265-8. [PMID: 25642088 PMCID: PMC4305578 DOI: 10.1589/jpts.27.265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 08/24/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to determine the relationships among the foot progression angle, foot rotation angle, lower limb alignment, and knee adduction moments in patients with degenerative knee osteoarthritis (OA). [Subjects] Forty-eight patients diagnosed with degenerative knee OA (Kellgren-Lawrence grades 2 and 3) were included. [Methods] To assess the lower extremity alignment and weight-bearing ratio, static radiographic measurement was used. Foot progression angle, foot rotation angle, and knee adduction moments were measured by using a three-dimensional motion analysis system. [Results] The results of this study were as follows: the foot progression angle in the early and late stance phase was significantly correlated with the first and second peak knee adduction moments; the weight-bearing ratio was significantly correlated with the first and second peak knee adduction moments; and the tibiofemoral angle was significantly correlated with the first and second peak knee adduction moments. [Conclusion] The results of the present study indicated that as the foot progression angle and the foot lateral rotation angle increased, the knee adduction moment decreased. The weight-bearing ratio and tibiofemoral angle assessment with mechanical axis alignment were correlated with the knee adduction moments. These parameters may be helpful for selecting therapeutic options for patients with degenerative knee OA.
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Affiliation(s)
- YuMi Cho
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - YoungJun Ko
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Wanhee Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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Efficacy of rehabilitation programs for improving muscle strength in people with hip or knee osteoarthritis: a systematic review with meta-analysis. Osteoarthritis Cartilage 2014; 22:1752-73. [PMID: 25065642 DOI: 10.1016/j.joca.2014.07.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 06/27/2014] [Accepted: 07/10/2014] [Indexed: 02/02/2023]
Abstract
To analyse the effect of exercise-based rehabilitation programs for improving lower limb muscle strength in individuals with hip or knee osteoarthritis (OA). A systematic search utilizing seven databases identified randomized controlled trials (RCTs) evaluating lower limb strength outcomes of exercise-based interventions for participants with hip or knee OA. All studies were screened for eligibility and methodological quality. Quality of evidence was assessed using Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Data were pooled and meta-analyses performed where appropriate. Forty RCTs were included and the majority (77%) involved resistance based exercise programs. For knee OA populations, there was high quality evidence for improved knee extension (standardized mean difference (SMD) = 0.47, 95% confidence intervals (CI) 0.29, 0.66) and flexion strength (SMD = 0.74, 95% CI 0.56, 0.92) with low-intensity resistance program when compared to a control at short term (ST) follow-up. There was moderate quality evidence for a large effect favouring high-intensity resistance programs (SMD = 0.76, 95% CI 0.47, 1.06) when compared to a control. This effect was sustained at intermediate term (IT) follow-up (SMD = 0.80, 95% CI 0.44, 1.17). Few studies reported on outcomes at long term (LT) follow-up. Only one study reported on a population with hip OA. When compared to a control group, high-intensity resistance exercise demonstrated moderate quality of evidence for large and sustained improvements for knee muscle strength in knee OA patients. Further work is needed to compare different modes of exercise at a LT follow-up for knee OA patients and to address the dearth of literature evaluating exercise interventions in people with hip OA.
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Hafez AR, Al-Johani AH, Zakaria AR, Al-Ahaideb A, Buragadda S, Melam GR, Kachanathu SJ. Treatment of knee osteoarthritis in relation to hamstring and quadriceps strength. J Phys Ther Sci 2013; 25:1401-5. [PMID: 24396198 PMCID: PMC3881465 DOI: 10.1589/jpts.25.1401] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/07/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To assess the effect of hamstring and quadriceps strengthening exercises on pain intensity, gait velocity, maximum isometric strength, and activities of daily living of patients with knee osteoarthritis (OA). [Subjects and Methods] A total of 20 patients with knee OA, 50 to 65 years of age (57.65 ± 4.78 years), received hot packs, strengthening exercises for the quadriceps and the hamstring muscles and stretching exercises for hamstring muscles. Outcome measures included: the Western Ontario and McMaster Universities OA index questionnaire (WOMAC) scores for assessing health status and health outcomes of knee OA; self-reported pain intensity scores, measured using a visual analogue scale; the 50 ft walk test (a measure of gait velocity and function); and handheld dynamometry (a tool used to measure maximum isometric strength of knee extension and flexion). [Results] There was a significant difference between pre- and post-intervention measures of pain intensity, 50 ft walk times, hamstring strength, and quadriceps strength. Significant differences in WOMAC measures were also observed in the subscales of pain, stiffness and physical function, as well as WOMAC total scores. [Conclusion] Strengthening the hamstring muscles in addition to strengthening the quadriceps muscles proved to be beneficial for perceived knee pain, range of motion, and decreasing the limitation of functional performance of patients with knee OA.
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Affiliation(s)
| | - Ahmed H Al-Johani
- Rehabilitation Medical Hospital in AL-Medina AL-Manwerah, Saudi Arabia
| | | | - Abdulaziz Al-Ahaideb
- Department of Orthopedics, College of Medicine, King Saud University, Saudi Arabia
| | - Syamala Buragadda
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Ganeswara Rao Melam
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Shaji J Kachanathu
- Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Lim KO, Lee DY, Shin WS. The effects of a warm whirlpool bath on pain and stiffness of patients with chronic stroke induced knee osteoarthritis. J Phys Ther Sci 2013; 25:873-5. [PMID: 24259873 PMCID: PMC3820387 DOI: 10.1589/jpts.25.873] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/15/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study set out to investigate the effects of leg immersion in warm water on pain, and stiffness of patients with stroke-induced chronic osteoarthritis. [Subjects] Forty-four patients with chronic stroke were randomly assigned to either the whirlpool group (n=24) or the control group (n=20). [Methods] Subjects in the whirlpool group immersed their legs in a whirlpool bath at 40 °C for 40 minutes 5 times a week for 8 weeks. The control group of patients was instructed to perform activities as usual without using a whirlpool bath. Pre-immersion and post-immersion measurements of the Western Ontario and McMaster University arthritis index (WOMAC)-pain and stiffness indexes were compared to determine the effects of the intervention. The paired t-test was performed to test the significance of differences before and after the experiment. The independent t-test was conducted in order to test the significance of differences between the whirlpool and control groups. Statistical significance was accepted for values of p<0.05. [Results] The WOMAC-pain score, and stiffness index were significantly lower after the intervention. [Conclusion] Immersion of the lower extremities in a whirlpool bath was beneficial for patients with chronic stroke-induced knee osteoarthritis.
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Affiliation(s)
- Kun-Ok Lim
- Department of Dental Hygiene, Sunmoon University
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Alnahdi AH, Zeni JA, Snyder-Mackler L. Muscle impairments in patients with knee osteoarthritis. Sports Health 2012; 4:284-92. [PMID: 23016099 PMCID: PMC3435919 DOI: 10.1177/1941738112445726] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Context: Muscle impairments associated with knee osteoarthritis (OA) are the primary underlying cause of functional limitations. Understanding the extent of muscle impairments, its relationship with physical function and disease progression, and the evidence behind exercise therapy that targets muscle impairments is crucial. Evidence Acquisition: An electronic search for relevant articles using MEDLINE and CINHAL databases up to September 2011 was performed. In addition to the electronic search, retrieved articles were searched manually for relevant studies. Results: Quadriceps, hamstrings, and hip muscles are significantly impaired in subjects with knee OA compared with age-matched controls. Muscle strength, especially quadriceps, is a major determinant of both performance-based and self-reported physical function. Whether stronger quadriceps is protective against knee OA onset and progression is not clear. Exercise therapy, including global and targeted resistance training, is effective in reducing pain and improving function in subjects with knee OA. Conclusions: Subjects with knee OA have significant muscle impairments. These muscle impairments affect physical function and should be targeted in therapy. Further research is needed to explore the relationship between quadriceps strength and knee OA initiation and progression and to determine the optimal exercise prescription that augments outcomes in this patient population.
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Affiliation(s)
- Ali H Alnahdi
- Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, Delaware, and King Saud University, Riyadh, Saudi Arabia
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[Comparison of the effectiveness of isokinetic vs isometric therapeutic exercise in patients with osteoarthritis of knee]. ACTA ACUST UNITED AC 2011; 8:10-4. [PMID: 22178252 DOI: 10.1016/j.reuma.2011.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 08/09/2011] [Accepted: 08/31/2011] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Osteoarthritis is a chronic joint disease; isometric exercise leads to the development of mechanical work and isokinetic exercise leads to better joint mobility. OBJECTIVES To compare the effectiveness of isometric versus isokinetic therapeutic exercises in patients with knee osteoarthritis. MATERIAL AND METHODS Quasiexperimental study in a population of 45 to 75 year old patients with a diagnosis of knee osteoarthritis. Group 1 (experimental) was put under isokinetic exercises and group 2 (control) under isometric exercises. The sample size was of 33 patients per group; the allocation to the experimentation or control group was nonrandom, but stratified by degrees of knee osteoarthritis. The effectiveness of the exercise was measured in three dimensions: muscle strength, joint range and pain. The intervention lasted eight weeks and the physical activity was carried out every third day. The statistical analysis included averages, standard deviation, percentage, Chi square test, z test for two populations, t test for two independent populations and twin t test. RESULTS The analysis of muscle strength comparing the categories independently demonstrates differences at 8 weeks; 33.3% of the isokinetic exercise is in the normal category and 15.2% in the isometric exercise (p= 0.04). There was not difference of joint range between groups, despite finding a stage I range in 100.0% of the isokinetic group and 97.0% in the isometric (p> 0.05) group. Pain was milder in the isokinetic exercise group at 8 weeks (p= 0.01) CONCLUSIONS Isokinetic exercises have a greater effectiveness than isometric exercises for muscle strength and pain in patients with knee osteoarthritis. However, other studies with randomized designs are needed.
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