Knee Extensor Strength and Gait Characteristics After Minimally Invasive Unicondylar Knee Arthroplasty vs Minimally Invasive Total Knee Arthroplasty: A Nonrandomized Controlled Trial.

PubMed

Braito, Matthias; Giesinger, Johannes M; Fischler, Stefan; Koller, Arnold; Niederseer, David; Liebensteiner, Michael C

2016-08-01

In light of the existing lack of evidence, it was the aim of this study to compare gait characteristics and knee extensor strength after medial unicondylar knee arthroplasty (MUKA) with those after total knee arthroplasty (TKA), given the same standardized minimally invasive surgery (MIS) approach in both groups. Patients scheduled for MIS-MUKA or MIS-TKA as part of clinical routine were invited to participate. A posterior cruciate ligament-retaining total knee design was used for all MIS-TKA. A 3-dimensional gait analysis was performed preoperatively with a VICON system and at 8 weeks postoperative to determine temporospatial parameters, ground reaction forces, joint angles, and joint moments. At the same 2 times, isokinetic tests were performed to obtain peak values of knee extensor torque. A multivariate analysis of variance was conducted and included the main effects time (before and after surgery) and surgical group and the group-by-time interaction effect. Fifteen MIS-MUKA patients and 17 MIS-TKA patients were eligible for the final analysis. The groups showed no differences regarding age, body mass index, sex, side treated, or stage of osteoarthritis. We determined neither intergroup differences nor time × group interactions for peak knee extensor torque or any gait parameters (temporospatial, ground reaction forces, joint angles, and joint moments). It is concluded that MUKA is not superior to TKA with regard to knee extensor strength or 3-dimensional gait characteristics at 8 weeks after operation. As gait characteristics and knee extensor strength are only 2 of the various potential outcome parameters (knee scores, activity scores…) and quadriceps strength might take a longer time to recover, our findings should be interpreted with caution. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Stance control knee mechanism for lower-limb support in hybrid neuroprosthesis

PubMed Central

To, Curtis S.; Kobetic, Rudi; Bulea, Thomas C.; Audu, Musa L.; Schnellenberger, John R.; Pinault, Gilles; Triolo, Ronald J.

2014-01-01

A hydraulic stance control knee mechanism (SCKM) was developed to fully support the knee against flexion during stance and allow uninhibited motion during swing for individuals with paraplegia using functional neuromuscular stimulation (FNS) for gait assistance. The SCKM was optimized for maximum locking torque for body-weight support and minimum resistance when allowing for free knee motion. Ipsilateral and contralateral position and force feedback were used to control the SCKM. Through bench and nondisabled testing, the SCKM was shown to be capable of supporting up to 70 N-m, require no more than 13% of the torque achievable with FNS to facilitate free motion, and responsively and repeatedly unlock under an applied flexion knee torque of up to 49 N-m. Preliminary tests of the SCKM with an individual with paraplegia demonstrated that it could support the body and maintain knee extension during stance without the stimulation of the knee extensor muscles. This was achieved without adversely affecting gait, and knee stability was comparable to gait assisted by knee extensor stimulation during stance. PMID:21938668

Knee Extensor and Flexor Torque Development with Concentric and Eccentric Isokinetic Training

ERIC Educational Resources Information Center

Miller, Larry E.; Pierson, Lee M.; Nickols-Richardson, Sharon M.; Wootten, David F.; Selmon, Serah E.; Ramp, Warren K.; Herbert, William G.

2006-01-01

This study assessed muscular torque and rate of torque development following concentric (CON) or eccentric (ECC) isokinetic training. Thirty-eight women were randomly assigned to either CON or ECC training groups. Training consisted of knee extension and flexion of the nondominant leg three times per week for 20 weeks (SD = 1). Eccentric training…

Barbell deadlift training increases the rate of torque development and vertical jump performance in novices.

PubMed

Thompson, Brennan J; Stock, Matt S; Shields, JoCarol E; Luera, Micheal J; Munayer, Ibrahim K; Mota, Jacob A; Carrillo, Elias C; Olinghouse, Kendra D

2015-01-01

The primary purpose of this study was to examine the effects of 10 weeks of barbell deadlift training on rapid torque characteristics of the knee extensors and flexors. A secondary aim was to analyze the relationships between training-induced changes in rapid torque and vertical jump performance. Fifty-four subjects (age, mean ± SD = 23 ± 3 years) were randomly assigned to a control (n = 20) or training group (n = 34). Subjects in the training group performed supervised deadlift training twice per week for 10 weeks. All subjects performed isometric strength testing of the knee extensors and flexors and vertical jumps before and after the intervention. Torque-time curves were used to calculate rate of torque development (RTD) values at peak and at 50 and 200 milliseconds from torque onset. Barbell deadlift training induced significant pre- to post-increases of 18.8-49.0% for all rapid torque variables (p < 0.01). Vertical jump height increased from 46.0 ± 11.3 to 49.4 ± 11.3 cm (7.4%; p < 0.01), and these changes were positively correlated with improvements in RTD for the knee flexors (r = 0.30-0.37, p < 0.01-0.03). These findings showed that a 10-week barbell deadlift training program was effective at enhancing rapid torque capacities in both the knee extensors and flexors. Changes in rapid torque were associated with improvements in vertical jump height, suggesting a transfer of adaptations from deadlift training to an explosive, performance-based task. Professionals may use these findings when attempting to design effective, time-efficient resistance training programs to improve explosive strength capacities in novices.

Assessment of isokinetic knee strength in elite young female basketball players: correlation with vertical jump.

PubMed

Rouis, M; Coudrat, L; Jaafar, H; Filliard, J-R; Vandewalle, H; Barthelemy, Y; Driss, T

2015-12-01

To explore the isokinetic concentric strength of the knee muscle groups, and the relationship between the isokinetic knee extensors strength and the vertical jump performance in young elite female basketball players. Eighteen elite female basketball players performed a countermovement jump, and an isokinetic knee test using a Biodex dynamometer. The maximal isokinetic peak torque of the knee extensor and flexor muscles was recorded at four angular velocities (90°/s, 180°/s, 240°/s and 300°/s) for the dominant and non-dominant legs. The conventional hamstring/quadriceps ratio (H/Q) was assessed at each angular velocity for both legs. There was no significant difference between dominant and non-dominant leg whatever the angular velocity (all P>0.05). However, the H/Q ratio enhanced as the velocity increased from 180°/s to 300°/s (P<0.05). Furthermore, low to high significant positive correlations were detected between the isokinetic measures of the knee extensors and the vertical jump height. The highest one was found for the knee extensors peak torque at a velocity of 240°/s (r=0.88, P<0.001). The results accounted for an optimal velocity at which a strong relationship could be obtained between isokinetic knee extensors strength and vertical jump height. Interestingly, the H/Q ratio of the young elite female basketball players in the present study was unusual as it was close to that generally observed in regular sportsmen.

Influence of patellofemoral bracing on pain, knee extensor torque, and gait function in females with patellofemoral pain.

PubMed

Powers, Christopher M; Doubleday, Kathryn L; Escudero, Carina

2008-01-01

Our purpose was to evaluate the effects of a patellofemoral brace on pain response, knee extensor torque production, and gait function in females with patellofemoral pain (PFP). Sixteen females between the ages of 14 and 46 with diagnosis of PFP participated. Knee extensor torque was measured by using a LIDO isokinetic dynamometer. Pain levels were documented by using the Visual Analog Pain Scale. Stride characteristics during the conditions of free walk, fast walk, ascend stairs, descend stairs, ascend ramp, and descend ramp were obtained with a stride analyzer unit. EMG activity of the vasti musculature was recorded by using indwelling, bipolar, wire electrodes. Knee joint motion was assessed by using a VICON motion analysis system. All testing was performed with and without the Bauerfeind Genutrain P3 patellofemoral brace. There were no significant differences in torque production, pain levels, and stride characteristics between braced and non-braced trials. In addition, there were no significant differences in mean vasti EMG between braced and non-braced trials. When averaged across all conditions, a small but statistically significant increase in knee flexion was found during the braced trials. Although the current study did not find significant improvements in the clinical measures evaluated, 8 of the 16 subjects did experience a decrease in knee pain. This finding suggests that certain patients with PFP may respond favorably to bracing, and criteria must be established to determine which patients would best benefit from such an intervention.

Effect of rest interval on strength recovery in young and old women.

PubMed

Theou, Olga; Gareth, Jones R; Brown, Lee E

2008-11-01

This study compares the effects of rest intervals on isokinetic muscle torque recovery between sets of a knee extensor and flexor exercise protocol in physically active younger and older women. Twenty young (22.4 +/- 1.7 years) and 16 older (70.7 +/- 4.3 years) women performed three sets of eight maximum repetitions of knee extension/flexion at 60 degrees x s(-1). The rest interval between sets was 15, 30, and 60 seconds and was randomly assigned across three testing days. No significant interaction of rest by set by age group was observed. There was a significant decline in mean knee extensor torque when 15- and 30-second rest intervals were used between sets, but not when a 60-second rest interval was applied for both the young and the old women. No significant decline for mean knee flexor torque was observed in the older women when a 30-second rest interval was used, whereas a longer 60-second rest interval was required in younger women. Active younger and older women require similar rest intervals between sets of a knee extensor exercise (60 seconds) for complete recovery. However, older women recovered faster (30 seconds) than younger women (60 seconds) between sets of a knee flexor exercise. The exercise-to-rest ratio for knee extensors was similar for young and old women (1:2). Old women required only a 1:1 exercise-to-rest ratio for knee flexor recovery, whereas younger women required a longer 1:2 exercise-to-rest ratio. The results of the present study are specific to isokinetic testing and training and are more applicable in rehabilitation and research settings. Practitioners should consider age and gender when prescribing rest intervals between sets.

Effect of immobilization and retraining on torque-velocity relationship of human knee flexor and extensor muscles.

PubMed

Labarque, V L; Eijnde, B Op 't; Van Leemputte, M

2002-01-01

The effect of 2 weeks immobilization of the uninjured right knee and 10 weeks of retraining on muscle torque-velocity characteristics was investigated in nine young subjects. Left and right knee extension and flexion maximal voluntary isometric torque (Tmax) and dynamic torque at 60 degrees s(-1) (T60) and 180 degrees x s(-1) (T180) were measured before (PRE) and after immobilization (POST) and after 3 (R3) and 10 (R10) weeks of dynamic retraining. The torque-velocity relationship was quantified by expressing T60 and T180 relative to Tmax (NT60 and NT180, respectively). For the right extensor muscles, percutaneous biopsy samples were obtained from the vastus lateralis muscle and fibre type distribution was measured. POST extension and flexion torque (mean of Tmax, T60 and T180) decreased by 27% and 11%, respectively. During the course of the experiment, the changes in NT60 and NT180 were similar. POST extensor muscle NTV (mean of NT60 and NT180) was decreased significantly (12%, P<0.05), but no significant change was found for flexor muscle NTV (+ 3%). At R3 Tmax, dynamic torque and NTV were restored to normal. Unlike isometric torque, NTV did not change from R3 to R10. No changes in fibre type distribution were found. The adaptation of muscle length is suggested as the mechanism to explain the change in NTV.

Effects of Series Elasticity on the Human Knee Extension Torque-Angle Relationship in Vivo

ERIC Educational Resources Information Center

Kubo, Keitaro; Ohgo, Kazuya; Takeishi, Ryuichi; Yoshinaga, Kazunari; Tsunoda, Naoya; Kanehisa, Hiroaki; Fukunaga, Tetsuo

2006-01-01

The purpose of this study was to investigate the effects of series elasticity on the torque-angle relationship of the knee extensors in vivo. Forty-two men volunteered to take part in the present study. The participants performed maximal voluntary isometric contractions at eight knee-joint angles (40, 50, 60, 70, 80, 90, 100, 110[degree]). The…

Activation of plantar flexor muscles is constrained by multiple muscle synergies rather than joint torques

PubMed Central

Suzuki, Takahito; Kinugasa, Ryuta; Fukashiro, Senshi

2017-01-01

Behavioral evidence has suggested that a small number of muscle synergies may be responsible for activating a variety of muscles. Nevertheless, such dimensionality reduction may also be explained using the perspective of alternative hypotheses, such as predictions based on linear combinations of joint torques multiplied by corresponding coefficients. To compare the explanatory capacity of these hypotheses for describing muscle activation, we enrolled 12 male volunteers who performed isometric plantar flexor contractions at 10–100% of maximum effort. During each plantar flexor contraction, the knee extensor muscles were isometrically contracted at 0%, 50%, or 100% of maximum effort. Electromyographic activity was recorded from the vastus lateralis, medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus muscles and quantified using the average rectified value (ARV). At lower plantar flexion torque, regression analysis identified a clear linear relationship between the MG and soleus ARVs and between the MG and LG ARVs, suggesting the presence of muscle synergy (r2 > 0.65). The contraction of the knee extensor muscles induced a significant change in the slope of this relationship for both pairs of muscles (MG × soleus, P = 0.002; MG × LG, P = 0.006). Similarly, the slope of the linear relationship between the plantar flexion torque and the ARV of the MG or soleus changed significantly with knee extensor contraction (P = 0.031 and P = 0.041, respectively). These results suggest that muscle synergies characterized by non-mechanical constraints are selectively recruited according to whether contraction of the knee extensor muscles is performed simultaneously, which is relatively consistent with the muscle synergy hypothesis. PMID:29107958

Modelling the maximum voluntary joint torque/angular velocity relationship in human movement.

PubMed

Yeadon, Maurice R; King, Mark A; Wilson, Cassie

2006-01-01

The force exerted by a muscle is a function of the activation level and the maximum (tetanic) muscle force. In "maximum" voluntary knee extensions muscle activation is lower for eccentric muscle velocities than for concentric velocities. The aim of this study was to model this "differential activation" in order to calculate the maximum voluntary knee extensor torque as a function of knee angular velocity. Torque data were collected on two subjects during maximal eccentric-concentric knee extensions using an isovelocity dynamometer with crank angular velocities ranging from 50 to 450 degrees s(-1). The theoretical tetanic torque/angular velocity relationship was modelled using a four parameter function comprising two rectangular hyperbolas while the activation/angular velocity relationship was modelled using a three parameter function that rose from submaximal activation for eccentric velocities to full activation for high concentric velocities. The product of these two functions gave a seven parameter function which was fitted to the joint torque/angular velocity data, giving unbiased root mean square differences of 1.9% and 3.3% of the maximum torques achieved. Differential activation accounts for the non-hyperbolic behaviour of the torque/angular velocity data for low concentric velocities. The maximum voluntary knee extensor torque that can be exerted may be modelled accurately as the product of functions defining the maximum torque and the maximum voluntary activation level. Failure to include differential activation considerations when modelling maximal movements will lead to errors in the estimation of joint torque in the eccentric phase and low velocity concentric phase.

Are Females More Resistant to Extreme Neuromuscular Fatigue?

PubMed

Temesi, John; Arnal, Pierrick J; Rupp, Thomas; Féasson, Léonard; Cartier, Régine; Gergelé, Laurent; Verges, Samuel; Martin, Vincent; Millet, Guillaume Y

2015-07-01

Despite interest in the possibility of females outperforming males in ultraendurance sporting events, little is known about the sex differences in fatigue during prolonged locomotor exercise. This study investigated possible sex differences in central and peripheral fatigue in the knee extensors and plantar flexors resulting from a 110-km ultra-trail-running race. Neuromuscular function of the knee extensors and plantar flexors was evaluated via transcranial magnetic stimulation (TMS) and electrical nerve stimulation before and after an ultra-trail-running race in 20 experienced ultraendurance trail runners (10 females and 10 males matched by percent of the winning time by sex) during maximal and submaximal voluntary contractions and in relaxed muscle. Maximal voluntary knee extensor torque decreased more in males than in females (-38% vs -29%, P = 0.006) although the reduction in plantar flexor torque was similar between sexes (-26% vs -31%). Evoked mechanical plantar flexor responses decreased more in males than in females (-23% vs -8% for potentiated twitch amplitude, P = 0.010), indicating greater plantar flexor peripheral fatigue in males. Maximal voluntary activation assessed by TMS and electrical nerve stimulation decreased similarly in both sexes for both muscle groups. Indices of knee extensor peripheral fatigue and corticospinal excitability and inhibition changes were also similar for both sexes. Females exhibited less peripheral fatigue in the plantar flexors than males did after a 110-km ultra-trail-running race and males demonstrated a greater decrease in maximal force loss in the knee extensors. There were no differences in the magnitude of central fatigue for either muscle group or TMS-induced outcomes. The lower level of fatigue in the knee extensors and peripheral fatigue in the plantar flexors could partly explain the reports of better performance in females in extreme duration running races as race distance increases.

Gains in flexibility related to measures of muscular performance: impact of flexibility on muscular performance.

PubMed

Ferreira, Gustavo Nunes Tasca; Teixeira-Salmela, Luci Fuscaldi; Guimarães, Cristiano Queiroz

2007-07-01

Studies that investigated possible correlations between flexibility and muscular performance are scarce in the literature. Therefore, the purpose of this study was to investigate the impact of a program of static stretching on the flexibility of the hamstrings and on muscular performance of the knee flexors and extensors. Pre-post experimental design. University laboratory. Thirty subjects aged 22.8 +/- 4.9 years with bilaterally shortened hamstrings. Using a protocol that has been previously described, the intervention consisted of 30 sessions of static stretching, performed bilaterally five times a week for 6 weeks. Measures of knee range of motion and isokinetic muscular performance (peak torque, angle of peak torque, and work) of knee flexors and extensors at speeds of 60 and 300 degrees/s. After intervention, significant gains in measures of flexibility (P < 0.0001) were observed, with an average gain of the knee-extension angle of 12.6 degrees, ranging from -1.2 to 30.7 degrees. In addition, we found significant increases in the following parameters of muscular performance: angle of peak torque of hamstrings at 60 and 300 degrees/s (P < 0.0001 and 0.018) and for work at 60 and 300 degrees/s for knee flexors (P = 0.012 and 0.005) and for knee extensors (P < 0.0001). The intervention resulted in gains in measures of flexibility, and these gains had a positive impact on some parameters of muscular performance.

Peak torque and muscle balance in the knees of young U-15 and U-17 soccer athletes playing various tactical positions.

PubMed

Chiamonti Bona, Cleiton; Tourinho Filho, Hugo; Izquierdo, Mikel; Pires Ferraz, Ricardo M; Marques, Mário C

2017-01-01

Soccer is a sport that is practiced worldwide and has been investigated in its various aspects, particularly muscle strength, which is an essential motor skill for sports performance. The objective of this study was to investigate the peak torque and muscle balance on the knee extensor and flexor of young soccer players in the tactical positions of goalkeeper, defender, full back, midfielder, defensive midfielder and striker, as well as to determine which field position has the highest peak torque. Forty-nine male players were recruited and divided into two categories during the preparatory period of the season: the Under-15 (U-15) group (N.=23, mean age 14.7±0.5 years, body mass 58.2±10.5 kg, body height 168.5±7.6 cm), and the Under-17 (U-17) group (N.=26, mean age 16.8±0.4 years, body mass 69.2±7.9 kg, body height 176.2±6.6 cm). The U-17 athletes presented a higher peak torque in all the movements of flexion and extension in the two angular velocities (i.e. 60°/s and 300°/s), but only the dominant knee extensor at 300°/s was significantly different between the two categories as well as the percentage change in peak torque compared between U-15 and U-17 was always above 20%. The peak torque variation in the U-17 category (i.e. mostly above 20%) highlights a higher peak torque compared to U-15 athletes. The muscular deficit of the two categories presented a low average of 10-15%, indicating a good muscle balance between knee extensors and flexors. Finally, goalkeepers and defenders achieved the highest peak torque amongst the field positions.

Eccentric knee flexor torque following anterior cruciate ligament surgery.

PubMed

Osternig, L R; James, C R; Bercades, D T

1996-10-01

The purposes of this study were to compare eccentric knee flexor torque and muscle activation in the limbs of normal (NOR) subjects and in subjects who had undergone unilateral ACI, autograft surgical reconstruction (INJ) and to assess the effect of movement speed on EMG/ torque ratios and eccentric-concentric actions. Fourteen subjects (7 NOR and 7 INJ) were tested for knee eccentric flexor torque and EMG activity at four isokinetic speeds (15 degrees, 30 degrees, 45 degrees and 60 degrees.s-1). Results revealed that post-surgical limbs (ACL) produced significantly less (P < 0.05) eccentric torque and flexor EMG activity at 60 degrees.s-1 than uninjured (UNI) contralateral limbs. Eccentric torque rose significantly as speed increased from 45 degrees to 60 degrees.s-1 for surgical group uninjured limbs and NOR group left and right limbs. Eccentric flexor torque increased with speed for both groups and approximated equality with concentric extensor torque at 60 degrees.s-1 for INJ group ACL and UNI limbs. Concentric flexor muscle EMG/torque ratios were 30-191% greater than eccentric muscle actions across groups and speeds. The results suggest that ACL dysfunction may result in reduced eccentric flexor torque at rapid movement speeds, that eccentric flexor torque increases with movement speed and may have the capacity to counter forceful extensor concentric torque, and that eccentric muscle actions produce less muscle activation per unit force than concentric actions which may reflect reduced energy cost.

Genome-wide linkage scan for maximum and length-dependent knee muscle strength in young men: significant evidence for linkage at chromosome 14q24.3.

PubMed

De Mars, G; Windelinckx, A; Huygens, W; Peeters, M W; Beunen, G P; Aerssens, J; Vlietinck, R; Thomis, M A I

2008-05-01

Maintenance of high muscular fitness is positively related to bone health, functionality in daily life and increasing insulin sensitivity, and negatively related to falls and fractures, morbidity and mortality. Heritability of muscle strength phenotypes ranges between 31% and 95%, but little is known about the identity of the genes underlying this complex trait. As a first attempt, this genome-wide linkage study aimed to identify chromosomal regions linked to muscle and bone cross-sectional area, isometric knee flexion and extension torque, and torque-length relationship for knee flexors and extensors. In total, 283 informative male siblings (17-36 years old), belonging to 105 families, were used to conduct a genome-wide SNP-based multipoint linkage analysis. The strongest evidence for linkage was found for the torque-length relationship of the knee flexors at 14q24.3 (LOD = 4.09; p<10(-5)). Suggestive evidence for linkage was found at 14q32.2 (LOD = 3.00; P = 0.005) for muscle and bone cross-sectional area, at 2p24.2 (LOD = 2.57; p = 0.01) for isometric knee torque at 30 degrees flexion, at 1q21.3, 2p23.3 and 18q11.2 (LOD = 2.33, 2.69 and 2.21; p<10(-4) for all) for the torque-length relationship of the knee extensors and at 18p11.31 (LOD = 2.39; p = 0.0004) for muscle-mass adjusted isometric knee extension torque. We conclude that many small contributing genes rather than a few important genes are involved in causing variation in different underlying phenotypes of muscle strength. Furthermore, some overlap in promising genomic regions were identified among different strength phenotypes.

Comparison of isokinetic muscle strength and muscle power by types of warm-up.

PubMed

Sim, Young-Je; Byun, Yong-Hyun; Yoo, Jaehyun

2015-05-01

[Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.

Nonparetic Knee Extensor Strength Is the Determinant of Exercise Capacity of Community-Dwelling Stroke Survivors

PubMed Central

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

Objective. To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. Design. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. Results. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO2 peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Conclusions. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living. PMID:25197712

Nonparetic knee extensor strength is the determinant of exercise capacity of community-dwelling stroke survivors.

PubMed

Wang, Wei-Te; Huang, Ling-Tzu; Chou, Ya-Hui; Wei, Ta-Sen; Lin, Chung-Che

2014-01-01

To investigate the relationship among walking speed, exercise capacity, and leg strength in community dwelling stroke subjects and to evaluate which one was the leading determinant factor of them. This is a descriptive, cross-sectional study. Thirty-five chronic stroke patients who were able to walk independently in their community were enrolled. Walking speed was evaluated by using the 12-meter walking test. A maximal exercise test was used to determine the stroke subjects' exercise capacity. Knee extensor strength, measured as isokinetic torque, was assessed by isokinetic dynamometer. The main walking speed of our subjects was 0.52 m/s. Peak oxygen uptake (VO₂ peak) was 1.21 ± 0.43 L/min. Knee extensor strength, no matter whether paretic or nonparetic side, was significantly correlated to 12-meter walking speed and exercise capacity. Linear regression also showed the strength of the affected knee extensor was the determinant of walking speed and that of the nonparetic knee extensor was the determinant of exercise capacity in community dwelling stroke subjects. Walking speed and peak oxygen uptake were markedly decreased after stroke. Knee extensor strength of nonparetic leg was the most important determinant of exercise capacity of the community-dwelling stroke subjects. Knee extensor strengthening should be emphasized to help stroke patient to achieve optimal community living.

A lower extremity strength-based profile of NCAA Division I women's basketball and gymnastics athletes: implications for knee joint injury risk assessment.

PubMed

Thompson, Brennan J; Cazier, Curtis S; Bressel, Eadric; Dolny, Dennis G

2018-08-01

This study aimed to provide a comprehensive strength-based physiological profile of women's NCAA Division I basketball and gymnastic athletes; and to make sport-specific comparisons for various strength characteristics of the knee flexor and extensor muscles. A focus on antagonist muscle balance (hamstrings-to-quadriceps ratios, H:Q) was used to elucidate vulnerabilities in these at-risk female athletes. Fourteen NCAA Division I women's basketball and 13 gymnastics athletes performed strength testing of the knee extensors and flexors. Outcome measures included absolute and relative (body mass normalised) peak torque (PT), rate of torque development at 50, 100, 200 ms (RTD50 etc.) and H:Q ratios of all variables. The basketball athletes had greater absolute strength for all variables except for isokinetic PT at 240°s -1 and isometric RTD50 for the knee extensors. Gymnasts showed ~20% weaker body mass relative concentric PT for the knee flexors at 60 and 120°·s -1 , and decreased conventional H:Q ratios at 60 and 240°·s -1 (~15%). These findings suggest that collegiate level gymnastics athletes may be prone to increased ACL injury risk due to deficient knee flexor strength and H:Q strength imbalance. Coaches may use these findings when implementing injury prevention screening and/or for individualised strength training programming centered around an athletes strength-related deficits.

Gait biomechanics of skipping are substantially different than those of running.

PubMed

McDonnell, Jessica; Willson, John D; Zwetsloot, Kevin A; Houmard, Joseph; DeVita, Paul

2017-11-07

The inherit injury risk associated with high-impact exercises calls for alternative ways to achieve the benefits of aerobic exercise while minimizing excessive stresses to body tissues. Skipping presents such an alternative, incorporating double support, flight, and single support phases. We used ground reaction forces (GRFs), lower extremity joint torques and powers to compare skipping and running in 20 healthy adults. The two consecutive skipping steps on each limb differed significantly from each other, and from running. Running had the longest step length, the highest peak vertical GRF, peak knee extensor torque, and peak knee negative and positive power and negative and positive work. Skipping had the greater cadence, peak horizontal GRF, peak hip and ankle extensor torques, peak ankle negative power and work, and peak ankle positive power. The second vs first skipping step had the shorter step length, higher cadence, peak horizontal GRF, peak ankle extensor torque, and peak ankle negative power, negative work, and positive power and positive work. The first skipping step utilized predominately net negative joint work (eccentric muscle action) while the second utilized predominately net positive joint work (concentric muscle action). The skipping data further highlight the persistence of net negative work performed at the knee and net positive work performed at the ankle across locomotion gaits. Evidence of step segregation was seen in distribution of the braking and propelling impulses and net work produced across the hip, knee, and ankle joints. Skipping was substantially different than running and was temporally and spatially asymmetrical with successive foot falls partitioned into a dominant function, either braking or propelling whereas running had a single, repeated step in which both braking and propelling actions were performed equally. Copyright © 2017 Elsevier Ltd. All rights reserved.

Decrements in knee extensor and flexor strength are associated with performance fatigue during simulated basketball game-play in adolescent, male players.

PubMed

Scanlan, Aaron T; Fox, Jordan L; Borges, Nattai R; Delextrat, Anne; Spiteri, Tania; Dalbo, Vincent J; Stanton, Robert; Kean, Crystal O

2018-04-01

This study quantified lower-limb strength decrements and assessed the relationships between strength decrements and performance fatigue during simulated basketball. Ten adolescent, male basketball players completed a circuit-based, basketball simulation. Sprint and jump performance were assessed during each circuit, with knee flexion and extension peak concentric torques measured at baseline, half-time, and full-time. Decrement scores were calculated for all measures. Mean knee flexor strength decrement was significantly (P < 0.05) related to sprint fatigue in the first half (R = 0.65), with dominant knee flexor strength (R = 0.67) and dominant flexor:extensor strength ratio (R = 0.77) decrement significantly (P < 0.05) associated with sprint decrement across the entire game. Mean knee extensor strength (R = 0.71), dominant knee flexor strength (R = 0.80), non-dominant knee flexor strength (R = 0.75), mean knee flexor strength (R = 0.81), non-dominant flexor:extensor strength ratio (R = 0.71), and mean flexor:extensor strength ratio (R = 0.70) decrement measures significantly (P < 0.05) influenced jump fatigue during the entire game. Lower-limb strength decrements may exert an important influence on performance fatigue during basketball activity in adolescent, male players. Consequently, training plans should aim to mitigate lower-limb fatigue to optimise sprint and jump performance during game-play.

Knee Extensor Rate of Torque Development Before and After Arthroscopic Partial Meniscectomy, With Analysis of Neuromuscular Mechanisms.

PubMed

Cobian, Daniel G; Koch, Cameron M; Amendola, Annunziato; Williams, Glenn N

2017-12-01

Study Design Descriptive, prospective single-cohort longitudinal study. Background Though rapid torque development is essential in activities of daily living and sports, it hasn't been specifically tested by most physical therapists or incorporated into rehabilitation programs until late in the treatment process. Little evidence is available on quadriceps torque development capacity before and after arthroscopic knee surgery. Objectives To study knee extensor rate of torque development, contributing mechanisms, and associations with strength and patient-reported outcomes before and during the first 6 weeks after arthroscopic partial meniscectomy. Methods Twenty subjects (mean ± SD age, 42.3 ± 13.7 years; body mass index, 26.6 ± 3.1 kg/m 2 ) were tested before surgery, and at 2 and 5 weeks after surgery. Quadriceps muscle volume, strength, activation, rate of torque development, and patient-reported outcomes were evaluated across the study period. Results Significant side-to-side differences in quadriceps strength and voluntary rate of torque development were observed at each time point (P<.05). Changes in muscle activity were associated with changes in rapid torque development capacity. Side-to-side rate of torque development deficits after surgery were associated with lower patient-reported outcomes scores. Conclusion Diminished rapid torque development capacity is common in arthroscopic meniscal debridement patients. This reduced capacity is associated with an inability to quickly recruit and drive the quadriceps muscles (neural mechanisms) and not muscle atrophy or other peripheral factors tested. Patient-reported outcomes are associated with quadriceps rate of torque development, but not strength or muscle size. Rapid torque development warrants greater attention in rehabilitation. J Orthop Sports Phys Ther 2017;47(12):945-956. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7310.

Effects of squat lift training and free weight muscle training on maximum lifting load and isolinetic peak torque of young adults without impairments.

PubMed

Yeung, S S; Ng, G Y

2000-06-01

Manual lifting is a frequent cause of back injury, and there is no evidence as to which training mode can provide the best training effect for lifting performance and muscle force. The purpose of this study was to examine the effects of a squat lift training and a free weight muscle training program on the maximum lifting load and isokinetic peak torque in subjects without known neuromuscular or musculoskeletal impairments. Thirty-six adults (20 male, 16 female) without known neuromuscular or musculoskeletal impairments participated. The subjects' mean age was 21.25 years (SD=1.16, range=20-24). Subjects were divided into 3 groups. Subjects in group 1 (n=12) performed squat lift training. Subjects in group 2 (n=12) participated in free weight resistance training of their shoulder abductors, elbow flexors, knee extensors and trunk extensors. Subjects in group 3 (n=12) served as controls. The maximum lifting load and isokinetic peak torques of the trunk extensors, knee extensors, elbow flexors, and shoulder abductors of each subject were measured before and after the study. Training was conducted on alternate days for 4 weeks, with an initial load of 80% of each subject's maximum capacity and with the load increased by 5% weekly. All groups were comparable for all measured variables before the study. After 4 weeks, subjects in groups 1 and 2 demonstrated more improvement in maximum lifting load and isokinetic peak torque of the back extensors compared with the subjects in group 3, but the 2 training groups were not different. The findings demonstrate that both squat lift and free weight resistance training are equally effective in improving the lifting load and isokinetic back extension performance of individuals without impairments.

Loss of knee extensor torque complexity during fatiguing isometric muscle contractions occurs exclusively above the critical torque.

PubMed

Pethick, Jamie; Winter, Samantha L; Burnley, Mark

2016-06-01

The complexity of knee extensor torque time series decreases during fatiguing isometric muscle contractions. We hypothesized that because of peripheral fatigue, this loss of torque complexity would occur exclusively during contractions above the critical torque (CT). Nine healthy participants performed isometric knee extension exercise (6 s of contraction, 4 s of rest) on six occasions for 30 min or to task failure, whichever occurred sooner. Four trials were performed above CT (trials S1-S4, S1 being the lowest intensity), and two were performed below CT (at 50% and 90% of CT). Global, central, and peripheral fatigue were quantified using maximal voluntary contractions (MVCs) with femoral nerve stimulation. The complexity of torque output was determined using approximate entropy (ApEn) and the detrended fluctuation analysis-α scaling exponent (DFA-α). The MVC torque was reduced in trials below CT [by 19 ± 4% (means ± SE) in 90%CT], but complexity did not decrease [ApEn for 90%CT: from 0.82 ± 0.03 to 0.75 ± 0.06, 95% paired-samples confidence intervals (CIs), 95% CI = -0.23, 0.10; DFA-α from 1.36 ± 0.01 to 1.32 ± 0.03, 95% CI -0.12, 0.04]. Above CT, substantial reductions in MVC torque occurred (of 49 ± 8% in S1), and torque complexity was reduced (ApEn for S1: from 0.67 ± 0.06 to 0.14 ± 0.01, 95% CI = -0.72, -0.33; DFA-α from 1.38 ± 0.03 to 1.58 ± 0.01, 95% CI 0.12, 0.29). Thus, in these experiments, the fatigue-induced loss of torque complexity occurred exclusively during contractions performed above the CT. Copyright © 2016 the American Physiological Society.

Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial.

PubMed

Giles, Lachlan; Webster, Kate E; McClelland, Jodie; Cook, Jill L

2017-12-01

Quadriceps strengthening exercises are part of the treatment of patellofemoral pain (PFP), but the heavy resistance exercises may aggravate knee pain. Blood flow restriction (BFR) training may provide a low-load quadriceps strengthening method to treat PFP. Seventy-nine participants were randomly allocated to a standardised quadriceps strengthening (standard) or low-load BFR. Both groups performed 8 weeks of leg press and leg extension, the standard group at 70% of 1 repetition maximum (1RM) and the BFR group at 30% of 1RM. Interventions were compared using repeated-measures analysis of variance for Kujala Patellofemoral Score, Visual Analogue Scale for 'worst pain' and 'pain with daily activity', isometric knee extensor torque (Newton metre) and quadriceps muscle thickness (cm). Subgroup analyses were performed on those participants with painful resisted knee extension at 60°. Sixty-nine participants (87%) completed the study (standard, n=34; BFR, n=35). The BFR group had a 93% greater reduction in pain with activities of daily living (p=0.02) than the standard group. Participants with painful resisted knee extension (n=39) had greater increases in knee extensor torque with BFR than standard (p<0.01). No between-group differences were found for change in Kujala Patellofemoral Score (p=0.31), worst pain (p=0.24), knee extensor torque (p=0.07) or quadriceps thickness (p=0.2). No difference was found between interventions at 6 months. Compared with standard quadriceps strengthening, low load with BFR produced greater reduction in pain with daily living at 8 weeks in people with PFP. Improvements were similar between groups in worst pain and Kujala score. The subgroup with painful resisted knee extension had larger improvements in quadriceps strength from BFR. 12614001164684. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Age Differences in Dynamic Fatigability and Variability of Arm and Leg Muscles: Associations with Physical Function

PubMed Central

Senefeld, Jonathon; Yoon, Tejin; Hunter, Sandra K.

2016-01-01

Introduction It is not known whether the age-related increase in fatigability of fast dynamic contractions in lower limb muscles also occurs in upper limb muscles. We compared age-related fatigability and variability of maximal-effort repeated dynamic contractions in the knee extensor and elbow flexor muscles; and determined associations between fatigability, variability of velocity between contractions and functional performance. Methods 35 young (16 males; 21.0±2.6 years) and 32 old (18 males; 71.3±6.2 years) adults performed a dynamic fatiguing task involving 90 maximal-effort, fast, concentric, isotonic contractions (1 contraction/3 s) with a load equivalent to 20% maximal voluntary isometric contraction (MVIC) torque with the elbow flexor and knee extensor muscles on separate days. Old adults also performed tests of balance and walking endurance. Results Old adults had greater fatigue-related reductions in peak velocity compared with young adults for both the elbow flexor and knee extensor muscles (P<0.05) with no sex differences (P>0.05). Old adults had greater variability of peak velocity during the knee extensor, but not during the elbow flexor fatiguing task. The age difference in fatigability was greater for the knee extensor muscles (35.9%) compared with elbow flexor muscles (9.7%, P<0.05). Less fatigability of the knee extensor muscles was associated with greater walking endurance (r=−0.34, P=0.048) and balance (r=−0.41, P=0.014) among old adults. Conclusions An age-related increase in fatigability of a dynamic fatiguing task was greater for the knee extensor compared with the elbow flexor muscles in males and females, and greater fatigability was associated with lesser walking endurance and balance. PMID:27989926

Low back and lower-limb muscle performance in male and female recreational runners with chronic low back pain.

PubMed

Cai, Congcong; Kong, Pui W

2015-06-01

Controlled laboratory study, cross-sectional. To compare lumbar extensor muscle fatigability, lumbar stabilizing muscle activation, and lower-limb strength between male and female runners with chronic low back pain (LBP) and healthy runners. Little is known about muscle performance in runners with chronic LBP. Eighteen recreational runners with chronic LBP (9 men, 9 women; mean age, 27.8 years) and 18 healthy recreational runners (9 men, 9 women; mean age, 24.6 years) were recruited. The median frequency slopes for bilateral iliocostalis and longissimus were calculated from electromyographic signals captured during a 2-minute Sorensen test. The thickness changes of the transversus abdominis and lumbar multifidus between resting and contraction were measured using an ultrasound scanner. Peak concentric torques of the bilateral hip extensors, hip abductors, and knee extensors were measured using an isokinetic dynamometer at 60°/s. The average values for both sides were used for statistical analysis. When averaged across sexes, peak knee extensor torque was 12.2% lower in the LBP group compared to the healthy group (mean difference, 0.29 Nm/kg; 95% confidence interval: 0.06, 0.53; P = .016). Male runners with chronic LBP exhibited smaller lumbar multifidus thickness changes compared to healthy male runners (mean difference, 0.13 cm; 95% confidence interval: 0.01, 0.25; P = .033). No other group differences were observed. Runners with chronic LBP exhibited diminished knee extensor strength compared to healthy runners. Male runners with chronic LBP demonstrated additional deficits in lumbar multifidus activation.

Sprint Acceleration Mechanics: The Major Role of Hamstrings in Horizontal Force Production

PubMed Central

Morin, Jean-Benoît; Gimenez, Philippe; Edouard, Pascal; Arnal, Pierrick; Jiménez-Reyes, Pedro; Samozino, Pierre; Brughelli, Matt; Mendiguchia, Jurdan

2015-01-01

Recent literature supports the importance of horizontal ground reaction force (GRF) production for sprint acceleration performance. Modeling and clinical studies have shown that the hip extensors are very likely contributors to sprint acceleration performance. We experimentally tested the role of the hip extensors in horizontal GRF production during short, maximal, treadmill sprint accelerations. Torque capabilities of the knee and hip extensors and flexors were assessed using an isokinetic dynamometer in 14 males familiar with sprint running. Then, during 6-s sprints on an instrumented motorized treadmill, horizontal and vertical GRF were synchronized with electromyographic (EMG) activity of the vastus lateralis, rectus femoris, biceps femoris, and gluteus maximus averaged over the first half of support, entire support, entire swing and end-of-swing phases. No significant correlations were found between isokinetic or EMG variables and horizontal GRF. Multiple linear regression analysis showed a significant relationship (P = 0.024) between horizontal GRF and the combination of biceps femoris EMG activity during the end of the swing and the knee flexors eccentric peak torque. In conclusion, subjects who produced the greatest amount of horizontal force were both able to highly activate their hamstring muscles just before ground contact and present high eccentric hamstring peak torque capability. PMID:26733889

Reproducibility of the time to peak torque and the joint angle at peak torque on knee of young sportsmen on the isokinetic dynamometer.

PubMed

Bernard, P-L; Amato, M; Degache, F; Edouard, P; Ramdani, S; Blain, H; Calmels, P; Codine, P

2012-05-01

Although peak torque has shown acceptable reproducibility, this may not be the case with two other often used parameters: time to peak torque (TPT) and the angle of peak torque (APT). Those two parameters should be used for the characterization of muscular adaptations in athletes. The isokinetic performance of the knee extensors and flexors in both limbs was measured in 29 male athletes. The experimental protocol consisted of three consecutive identical paradigms separated by 45 min breaks. Each test consisted of four maximal concentric efforts performed at 60 and 180°/s. Reproducibility was quantified by the standard error measurement (SEM), the coefficient of variation (CV) and by means of intra-class correlation coefficients (ICCs) with the calculation of 6 forms of ICCs. Using ICC as the indicator of reproducibility, the correlations for TPT of both limbs showed a range of 0.51-0.65 in extension and 0.50-0.63 in flexion. For APT, the values were 0.46-0.60 and 0.51-0.81, respectively. In addition, the calculated standard error of measurement (SEM) and CV scores confirmed the low level of absolute reproducibility. Due to their low reproducibility, neither TPT nor APT can serve as independent isokinetic parameters of knee flexor and extensor performance. So, given its reproducibility level, TPT and APT should not be used for the characterization of muscular adaptations in athletes. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Human torque velocity adaptations to sprint, endurance, or combined modes of training

NASA Technical Reports Server (NTRS)

Shealy, M. J.; Callister, R.; Dudley, G. A.; Fleck, S. J.

1992-01-01

We had groups of athletes perform sprint and endurance run training independently or concurrently for 8 weeks to examine the voluntary in vivo mechanical responses to each type of training. Pre- and posttraining angle-specific peak torque during knee extension and flexion were determined at 0, 0.84, 1.65, 2.51, 3.35, 4.19, and 5.03 radian.sec-1 and normalized for lean body mass. Knee extension torque in the sprint-trained group increased across all test velocities, the endurance-trained group increased at 2.51, 3.34, 4.19, and 5.03 radian.sec-1, and the group performing the combined training showed no change at any velocity. Knee flexion torque of the sprint and combined groups decreased at 0.84, 1.65, and 2.51 radian.sec-1. Knee flexion torque in the sprint-trained group also decreased at 0 radian.sec-1 and in the combined group at 3.34 radian.sec-1. Knee flexion torque in the endurance-trained group showed no change at any velocity of contraction. Mean knee flexion:extension ratios across the test velocities significantly decreased in the sprint-trained group. Knee extension endurance during 30 seconds of maximal contractions significantly increased in all groups. Only the sprint-trained group showed a significant increase in endurance of the knee flexors. These data suggest that changes in the voluntary in vivo mechanical characteristics of knee extensor and flexor skeletal muscles are specific to the type of run training performed.

Immediate effects of whole body vibration on patellar tendon properties and knee extension torque.

PubMed

Rieder, F; Wiesinger, H-P; Kösters, A; Müller, E; Seynnes, O R

2016-03-01

Reports about the immediate effects of whole body vibration (WBV) exposure upon torque production capacity are inconsistent. However, the changes in the torque-angle relationship observed by some authors after WBV may hinder the measurement of torque changes at a given angle. Acute changes in tendon mechanical properties do occur after certain types of exercise but this hypothesis has never been tested after a bout of WBV. The purpose of the present study was to investigate whether tendon compliance is altered immediately after WBV, effectively shifting the optimal angle of peak torque towards longer muscle length. Twenty-eight subjects were randomly assigned to either a WBV (n = 14) or a squatting control group (n = 14). Patellar tendon CSA, stiffness and Young's modulus and knee extension torque-angle relationship were measured using ultrasonography and dynamometry 1 day before and directly after the intervention. Tendon CSA was additionally measured 24 h after the intervention to check for possible delayed onset of swelling. The vibration intervention had no effects on patellar tendon CSA, stiffness and Young's modulus or the torque-angle relationship. Peak torque was produced at ~70° knee angle in both groups at pre- and post-test. Additionally, the knee extension torque globally remained unaffected with the exception of a small (-6%) reduction in isometric torque at a joint angle of 60°. The present results indicate that a single bout of vibration exposure does not substantially alter patellar tendon properties or the torque-angle relationship of knee extensors.

Interdependence of torque, joint angle, angular velocity and muscle action during human multi-joint leg extension.

PubMed

Hahn, Daniel; Herzog, Walter; Schwirtz, Ansgar

2014-08-01

Force and torque production of human muscles depends upon their lengths and contraction velocity. However, these factors are widely assumed to be independent of each other and the few studies that dealt with interactions of torque, angle and angular velocity are based on isolated single-joint movements. Thus, the purpose of this study was to determine force/torque-angle and force/torque-angular velocity properties for multi-joint leg extensions. Human leg extension was investigated (n = 18) on a motor-driven leg press dynamometer while measuring external reaction forces at the feet. Extensor torque in the knee joint was calculated using inverse dynamics. Isometric contractions were performed at eight joint angle configurations of the lower limb corresponding to increments of 10° at the knee from 30 to 100° of knee flexion. Concentric and eccentric contractions were performed over the same range of motion at mean angular velocities of the knee from 30 to 240° s(-1). For contractions of increasing velocity, optimum knee angle shifted from 52 ± 7 to 64 ± 4° knee flexion. Furthermore, the curvature of the concentric force/torque-angular velocity relations varied with joint angles and maximum angular velocities increased from 866 ± 79 to 1,238 ± 132° s(-1) for 90-50° knee flexion. Normalised eccentric forces/torques ranged from 0.85 ± 0.12 to 1.32 ± 0.16 of their isometric reference, only showing significant increases above isometric and an effect of angular velocity for joint angles greater than optimum knee angle. The findings reveal that force/torque production during multi-joint leg extension depends on the combined effects of angle and angular velocity. This finding should be accounted for in modelling and optimisation of human movement.

Muscular control of a learned movement: the speed control system hypothesis.

PubMed

Enoka, R M

1983-01-01

The "speed control system" hypothesis, which represents an attempt to identify an invariant characteristic of learned movements, postulates that movements of variable extent are controlled by regulating the intensity of muscle contractions such that the contraction duration remains constant. The contingency set originally utilized to develop this hypothesis was expanded by examining a movement that was multidirectional and multiarticular, and executed by large muscle groups generating near maximum torques. The investigation focused on the techniques utilized by weightlifters to control lower extremity displacement during the initial phase of the double knee bend execution of the "clean" in Olympic weightlifting. The combination of the quantified muscle activity and the angular velocity, both about the knee joint, revealed a sequence of shortening-lengthening muscle contractions throughout the movement. The first two periods of net muscular activity, one extensor and the other flexor, were utilized to examine the movement for invariant characteristics. As predicted by the speed control system hypothesis, the duration of the first period of net muscle torque activity (extensor) did not vary significantly, for either group of subjects, over the relative loads examined. The duration of the second period of activity (resultant flexor muscle torque), however, was not constant across loads, and further, the direction of the change depended upon the level of expertise. The more capable lifters tended to increase the duration of the resultant flexor involvement while the less skilled athletes utilized the reverse strategy when the load was increased. Conversely, the intensity of the muscle activity for both groups of subjects and both the extensor and flexor periods covaried with load, as predicted by the hypothesis. The speed control system hypothesis, therefore, provided an appropriate explanation for the first component of the movement, the period of extensor dominated (shortening contraction) muscle torque, but was inappropriate for the subsequent interval, a resultant flexor (largely lengthening contraction) muscle torque.

Short-Term High Intensity Plyometric Training Program Improves Strength, Power and Agility in Male Soccer Players

PubMed Central

Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

2013-01-01

The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 – 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer. PMID:23717351

Short-term high intensity plyometric training program improves strength, power and agility in male soccer players.

PubMed

Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

2013-03-01

The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 - 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer.

Greater Hip Extension but Not Hip Abduction Explosive Strength Is Associated With Lesser Hip Adduction and Knee Valgus Motion During a Single-Leg Jump-Cut

PubMed Central

Cronin, Baker; Johnson, Samuel T.; Chang, Eunwook; Pollard, Christine D.; Norcross, Marc F.

2016-01-01

Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane hip and knee motion during a single-leg jump-cutting task. Study Design: Descriptive laboratory study. Methods: Forty recreationally active females performed maximal isometric contractions and single-leg jump-cuts. From recorded torque data, hip extension and abduction RTD was calculated from torque onset to 200 ms after onset. Three-dimensional motion analysis was used to quantify frontal plane hip and knee kinematics during the movement task. For each RTD measure, jump-cut biomechanics were compared between participants in the highest (high) and lowest (low) RTD tertiles. Results: No differences in frontal plane hip and knee kinematics were identified between high and low hip abduction RTD groups. However, those in the high hip extension RTD group exhibited lower hip adduction (high, 3.8° ± 3.0°; low, 6.5° ± 3.0°; P = .019) and knee valgus (high, –2.5° ± 2.3°; low, –4.4° ± 3.2°; P = .046) displacements during the jump-cut. Conclusion: In movements such as cutting that are performed with the hip in a relatively abducted and flexed position, the ability of the gluteus medius to control hip adduction may be compromised. However, the gluteus maximus, functioning as a hip abductor, may take on a pivotal role in controlling hip adduction and knee valgus motion during these types of tasks. Clinical Relevance: Training with a specific emphasis on increasing explosive strength of the hip extensors may be a means through which to improve frontal plane hip and knee control during high-risk maneuvers such as cutting. PMID:27104207

A biomechanical comparison of back and front squats in healthy trained individuals.

PubMed

Gullett, Jonathan C; Tillman, Mark D; Gutierrez, Gregory M; Chow, John W

2009-01-01

The strength and stability of the knee plays an integral role in athletics and activities of daily living. A better understanding of knee joint biomechanics while performing variations of the squat would be useful in rehabilitation and exercise prescription. We quantified and compared tibiofemoral joint kinetics as well as muscle activity while executing front and back squats. Because of the inherent change in the position of the center of mass of the bar between the front and back squat lifts, we hypothesized that the back squat would result in increased loads on the knee joint and that the front squat would result in increased knee extensor and decreased back extensor muscle activity. A crossover study design was used. To assess the net force and torque placed on the knee and muscle activation levels, a combination of video and force data, as well as surface electromyographic data, were collected from 15 healthy trained individuals. The back squat resulted in significantly higher compressive forces and knee extensor moments than the front squat. Shear forces at the knee were small in magnitude, posteriorly directed, and did not vary between the squat variations. Although bar position did not influence muscle activity, muscle activation during the ascending phase was significantly greater than during the descending phase. The front squat was as effective as the back squat in terms of overall muscle recruitment, with significantly less compressive forces and extensor moments. The results suggest that front squats may be advantageous compared with back squats for individuals with knee problems such as meniscus tears, and for long-term joint health.

Effects of long term Tai Chi practice and jogging exercise on muscle strength and endurance in older people.

PubMed

Xu, D Q; Li, J X; Hong, Y

2006-01-01

To investigate the influence of regular Tai Chi (TC) practice and jogging on muscle strength and endurance in the lower extremities of older people. Twenty one long term older TC practitioners were compared with 18 regular older joggers and 22 sedentary counterparts. Maximum concentric strength of knee flexors and extensors was tested at angular velocities of 30 degrees/s and 120 degrees/s. Ankle dorsiflexors and plantar flexors were tested at 30 degrees/s and the dynamic endurance of the knee flexors and extensors was assessed at a speed of 180 degrees/s. The differences in the muscle strength of the knee joint amongst the three experimental groups were significant at the higher velocity. The strengths of knee extensors and flexors in the control group were significantly lower than those in the jogging group and marginally lower than those in the TC group. For the ankle joint, the subjects in both the TC and jogging groups generated more torque in their ankle dorsiflexors. In addition, the muscle endurance of knee extensors was more pronounced in TC practitioners than in controls. Regular older TC practitioners and joggers showed better scores than the sedentary controls on most muscle strength and endurance measures. However, the magnitude of the exercise effects on muscles might depend on the characteristics of different types of exercise.

Acute Postexercise Time Course Responses of Hypertrophic vs. Power-Endurance Squat Exercise Protocols on Maximal and Rapid Torque of the Knee Extensors.

PubMed

Conchola, Eric C; Thiele, Ryan M; Palmer, Ty B; Smith, Doug B; Thompson, Brennan J

2015-05-01

The aim of this study was to examine the effects of a medium-intensity high-volume vs. explosive squat protocol on the postexercise time course responses of maximal and rapid strength of the knee extensors. Seventeen resistance-trained men (mean ± SD: age = 22.0 ± 2.6 years) performed maximal voluntary contractions (MVCs) of the knee extensors before and after performing a squat workout using either a low-intensity fast velocity (LIFV) (5 × 16 at 40% 1 repetition maximum) or a traditional high-intensity slow velocity (TISV) (5 × 8 at 80% 1RM) exercise protocol. For each MVC, peak torque (PT), peak rate of torque development (RTDpeak), absolute (RTDabs), and relative RTD (RTDnorm) at early (0-50 milliseconds) and late (100-200 milliseconds) phases of muscle contraction were examined at pre- (Pre) and post-exercise at 0, 7, 15, and 30 (Post0...30) minutes. There were no intensity × time interactions for any variables (p = 0.098-0.832). Peak torque was greater at Pre than Post0 and Post7 (p = 0.001-0.016) but was not greater than Post15 and Post30 (p = 0.010-0.189). RTDpeak and early absolute RTD (RTD50abs) were greater at Pre than all postexercise time phases (p = 0.001-0.050); however, later absolute RTD (RTD100-200abs) was only greater at Pre than Post0 and Post30 (p = 0.013-0.048). Early relative RTD (RTD50norm) was only higher at Pre compared with Post0 (p = 0.023), whereas no differences were observed for later relative RTD (RTD100-200norm) (p = 0.920-0.990). Low-intensity fast velocity and TISV squat protocols both yielded acute decreases in maximal and rapid strength capacities following free-weight squats, with rapid strength showing slower recovery characteristics than maximal strength.

[Isokinetic profile of knee flexors and extensors in a population of rugby players].

PubMed

Larrat, E; Kemoun, G; Carette, P; Teffaha, D; Dugue, B

2007-06-01

We aimed to assess the isokinetic profile of the flexor and extensor muscles of the knee within a population of rugby players. This was a descriptive study. The rugby players underwent bilateral isokinetic assessment of knee flexion and extension on a CON-TREX MJ isokinetic dynamometer functioning at four angular frequencies - 90, 120, 180 and 240 degrees/s - in a concentric manner. The isokinetic parameters were peak torque, mean power, and mean work in relation to weight and femoral bicep: quadriceps ratio. The population included 16 "Federal 1" (semi-professional) rugby players with mean age 25 years (range 20-33 years). The players were divided into two groups: "forward" players (props, hookers, second line, third line) and "back" players (scrum, inside, center, wing, tail). The values of the isokinetic parameters did not reveal use of a preferred limb. Consequently, peak torque and mean power were higher in forward players than back players, whereas back players showed a higher relative power throughout the isokinetic test. Among rugby players, forward and back players showed differences in several isokinetic parameters. Accurate knowledge of the equilibrium between the knee's effector muscles is important for stability of the joint, to not only minimize articular accidents but also pinpoint force imbalances, thereby preventing muscular lesions during the sports season.

Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study.

PubMed

Dos Santos, Adriana Neves; Serikawa, Simoni Sayuri; Rocha, Nelci Adriana Cicuto Ferreira

2016-08-01

To verify the effect of Pilates exercises in a child with cerebral palsy (CP) with mild functional impairment. We evaluated average peak torque of ankle and knee extensors/flexors using a Biodex System, using concentric active-assisted test. We also evaluated amplitude of anterior-posterior and of medial-lateral displacement of the CoP and area of oscillation during quite standing with a BERTEC platform. We applied Pilates exercises for eight weeks. Peak torque/body weight of ankle and knee extensors/flexors of both affected and unaffected limbs increased after Pilates. Also, all kinetic variables decreased after Pilates' intervention. After one-month follow-up, isokinetic variable values were higher while kinetic variable values were lower than baseline values. Pilates may be an important rehabilitation technique for children with CP that present mild deficits in motor structures and high functional level, especially when the aims are to improve muscle strength and postural control during quite standing.

Alterations in neuromuscular function in girls with generalized joint hypermobility.

PubMed

Jensen, Bente Rona; Sandfeld, Jesper; Melcher, Pia Sandfeld; Johansen, Katrine Lyders; Hendriksen, Peter; Juul-Kristensen, Birgit

2016-10-03

Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings.

ASSOCIATION OF KNEE PAIN WITH A REDUCTION IN THIGH MUSCLE STRENGTH – A CROSS-SECTIONAL ANALYSIS INCLUDING 4553 OSTEOARTHRITIS INITIATIVE PARTICIPANTS

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2016-01-01

Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675

Genome-wide linkage scan for maximum and length-dependent knee muscle strength in young men: significant evidence for linkage at chromosome 14q24.3

PubMed Central

De Mars, G; Windelinckx, A; Huygens, W; Peeters, M W; Beunen, G P; Aerssens, J; Vlietinck, R; Thomis, M A I

2008-01-01

Background: Maintenance of high muscular fitness is positively related to bone health, functionality in daily life and increasing insulin sensitivity, and negatively related to falls and fractures, morbidity and mortality. Heritability of muscle strength phenotypes ranges between 31% and 95%, but little is known about the identity of the genes underlying this complex trait. As a first attempt, this genome-wide linkage study aimed to identify chromosomal regions linked to muscle and bone cross-sectional area, isometric knee flexion and extension torque, and torque–length relationship for knee flexors and extensors. Methods: In total, 283 informative male siblings (17–36 years old), belonging to 105 families, were used to conduct a genome-wide SNP-based multipoint linkage analysis. Results: The strongest evidence for linkage was found for the torque–length relationship of the knee flexors at 14q24.3 (LOD  = 4.09; p<10−5). Suggestive evidence for linkage was found at 14q32.2 (LOD  = 3.00; P = 0.005) for muscle and bone cross-sectional area, at 2p24.2 (LOD  = 2.57; p = 0.01) for isometric knee torque at 30° flexion, at 1q21.3, 2p23.3 and 18q11.2 (LOD  = 2.33, 2.69 and 2.21; p<10−4 for all) for the torque–length relationship of the knee extensors and at 18p11.31 (LOD  = 2.39; p = 0.0004) for muscle-mass adjusted isometric knee extension torque. Conclusions: We conclude that many small contributing genes rather than a few important genes are involved in causing variation in different underlying phenotypes of muscle strength. Furthermore, some overlap in promising genomic regions were identified among different strength phenotypes. PMID:18178634

Concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain.

PubMed

Boling, Michelle C; Padua, Darin A; Alexander Creighton, R

2009-01-01

Individuals suffering from patellofemoral pain have previously been reported to have decreased isometric strength of the hip musculature; however, no researchers have investigated concentric and eccentric torque of the hip musculature in individuals with patellofemoral pain. To compare concentric and eccentric torque of the hip musculature in individuals with and without patellofemoral pain. Case control. Research laboratory. Twenty participants with patellofemoral pain (age = 26.8 +/- 4.5 years, height = 171.8 +/- 8.4 cm, mass = 72.4 +/- 16.8 kg) and 20 control participants (age = 25.6 +/- 2.8 years, height = 169.5 +/- 8.9 cm, mass = 70.0 +/- 16.9 kg) were tested. Volunteers with patellofemoral pain met the following criteria: knee pain greater than or equal to 3 cm on a 10-cm visual analog scale, insidious onset of symptoms not related to trauma, pain with palpation of the patellar facets, and knee pain during 2 of the following activities: stair climbing, jumping or running, squatting, kneeling, or prolonged sitting. Control participants were excluded if they had a prior history of patellofemoral pain, knee surgery in the past 2 years, or current lower extremity injury that limited participation in physical activity. Concentric and eccentric torque of the hip musculature was measured on an isokinetic dynamometer. All volunteers performed 5 repetitions of each strength test. Separate multivariate analyses of variance were performed to compare concentric and eccentric torque of the hip extensors, abductors, and external rotators between groups. Average and peak concentric and eccentric torque of the hip extensors, abductors, and external rotators. Torque measures were normalized to the participant's body weight multiplied by height. The patellofemoral pain group was weaker than the control group for peak eccentric hip abduction torque (F(1,38) = 6.630, P = .014), and average concentric (F(1,38) = 4.156, P = .048) and eccentric (F(1,38) = 4.963, P = .032) hip external rotation torque. The patellofemoral pain group displayed weakness in eccentric hip abduction and hip external rotation, which may allow for increased hip adduction and internal rotation during functional movements.

Isokinetic Assessment and Musculoskeletal Complaints in Paralympic Athletes: A Longitudinal Study.

PubMed

Silva, Andressa; Zanca, Gisele; Alves, Eduardo Silva; Lemos, Valdir de Aquino; Gávea, Sebastião Augusto; Winckler, Ciro; Mattiello, Stela Márcia; Peterson, Ronnie; Vital, Roberto; Tufik, Sergio; De Mello, Marco Túlio

2015-10-01

The aim of this study was to assess and monitor the peak torque of the knee extensor and flexor muscles in flexion and extension and the reports of musculoskeletal complaints in members of the main Brazilian Paralympic athletics team through 1 yr. Fourteen healthy athletes from both sexes were assessed three times in 1 yr. The volunteers were assessed for the presence of musculoskeletal complaints and muscle strength at three time points: (1) at the onset of the preparatory phase on December 2009, (2) at a follow-up assessment on June 2010, and (3) before actual competition on December 2010. The athletes' self-reported musculoskeletal complaints were assessed in structured interviews, and the muscle strength was assessed by means of isokinetic dynamometry. The knee flexor and extensor muscle strength exhibited significant increase in both the right and left lower limbs at the second and third assessments compared with the first one (P < 0.05). Muscle imbalance was associated with knee and thigh complaints at all three assessments (P < 0.05). The knee flexor and extensor muscle strength exhibited a gradual increase in both lower limbs during the course of the three assessments. In parallel, muscle imbalance was associated with the occurrence of knee and thigh complaints.

Functional and morphological adaptations to aging in knee extensor muscles of physically active men.

PubMed

Baroni, Bruno Manfredini; Geremia, Jeam Marcel; Rodrigues, Rodrigo; Borges, Marcelo Krás; Jinha, Azim; Herzog, Walter; Vaz, Marco Aurélio

2013-10-01

It is not known if a physically active lifestyle, without systematic training, is sufficient to combat age-related muscle and strength loss. Therefore, the purpose of this study was to evaluate if the maintenance of a physically active lifestyle prevents muscle impairments due to aging. To address this issue, we evaluated 33 healthy men with similar physical activity levels (IPAQ = 2) across a large range of ages. Functional (torque-angle and torque-velocity relations) and morphological (vastus lateralis muscle architecture) properties of the knee extensor muscles were assessed and compared between three age groups: young adults (30 ± 6 y), middle-aged subjects (50 ± 7 y) and elderly subjects (69 ± 5 y). Isometric peak torques were significantly lower (30% to 36%) in elderly group subjects compared with the young adults. Concentric peak torques were significantly lower in the middle aged (18% to 32%) and elderly group (40% to 53%) compared with the young adults. Vastus lateralis thickness and fascicles lengths were significantly smaller in the elderly group subjects (15.8 ± 3.9 mm; 99.1 ± 25.8 mm) compared with the young adults (19.8 ± 3.6 mm; 152.1 ± 42.0 mm). These findings suggest that a physically active lifestyle, without systematic training, is not sufficient to avoid loss of strength and muscle mass with aging.

The relation between knee muscle strength and performance tests in orienteering athletes.

PubMed

Çinar-Medeni, Özge; Colakoglu, Fatma F; Yüce, Koray; Ipekoğlu, Gökhan; Baltaci, Gul

2016-11-01

The aim of this study was to analyze the effect of knee muscle strength on performance tests in orienteers. Thirty-seven orienteers were voluntarily included in this study. Isokinetic knee flexor and extensor muscles' strength was assessed at 120°/s velocity for both "dominant leg" (DL) and "non-dominant leg" (NDL). "Single-legged hop test" (SLHT), "flamingo balance test" (FBT), "star excursion balance test" (SEBT), vertical jump-and-reach test (for anaerobic power), T-drill test and 20-meter shuttle run test (for aerobic power) were carried out. Correlation and regression analyses were performed on the data. VO2max levels showed moderate correlations with DL's "flexor peak torque" (FPT) and NDL's "extensor peak torque" (EPT) and FPT values respectively (r=0.49, r=0.38, r=0.58). FPT of NDL was a predictor of VO2max level (R2=0.33). Anaerobic power has a relationship with EPT of NDL (r=0.43) and T-drill test with EPT and FPT values of both DL and NDL respectively (r=-0.35, r=-0.63, r=-0.53, r=-0.58). EPT of NDL was a predictor for anaerobic power (R2=0.19) and FPT of DL for agility (R2=0.40). Nonparametric linear regression results showed that EPT is a predictor in DL (median slope=-0.71, P=0.01), and FPT in NDL (median slope=-0.90, P=0.006) for FBT. FPT was a predictor of SEBT scores for both legs (0.13

Anatomical and neuromuscular variables strongly predict maximum knee extension torque in healthy men.

PubMed

Trezise, J; Collier, N; Blazevich, A J

2016-06-01

This study examined the relative influence of anatomical and neuromuscular variables on maximal isometric and concentric knee extensor torque and provided a comparative dataset for healthy young males. Quadriceps cross-sectional area (CSA) and fascicle length (l f) and angle (θ f) from the four quadriceps components; agonist (EMG:M) and antagonist muscle activity, and percent voluntary activation (%VA); patellar tendon moment arm distance (MA) and maximal voluntary isometric and concentric (60° s(-1)) torques, were measured in 56 men. Linear regression models predicting maximum torque were ranked using Akaike's Information Criterion (AICc), and Pearson's correlation coefficients assessed relationships between variables. The best-fit models explained up to 72 % of the variance in maximal voluntary knee extension torque. The combination of 'CSA + θ f + EMG:M + %VA' best predicted maximum isometric torque (R (2) = 72 %, AICc weight = 0.38) and 'CSA + θ f + MA' (R (2) = 65 %, AICc weight = 0.21) best predicted maximum concentric torque. Proximal quadriceps CSA was included in all models rather than the traditionally used mid-muscle CSA. Fascicle angle appeared consistently in all models despite its weak correlation with maximum torque in isolation, emphasising the importance of examining interactions among variables. While muscle activity was important for torque prediction in both contraction modes, MA only strongly influenced maximal concentric torque. These models identify the main sources of inter-individual differences strongly influencing maximal knee extension torque production in healthy men. The comparative dataset allows the identification of potential variables to target (i.e. weaknesses) in individuals.

Validity and reliability of an instrumented leg-extension machine for measuring isometric muscle strength of the knee extensors.

PubMed

Ruschel, Caroline; Haupenthal, Alessandro; Jacomel, Gabriel Fernandes; Fontana, Heiliane de Brito; Santos, Daniela Pacheco dos; Scoz, Robson Dias; Roesler, Helio

2015-05-20

Isometric muscle strength of knee extensors has been assessed for estimating performance, evaluating progress during physical training, and investigating the relationship between isometric and dynamic/functional performance. To assess the validity and reliability of an adapted leg-extension machine for measuring isometric knee extensor force. Validity (concurrent approach) and reliability (test and test-retest approach) study. University laboratory. 70 healthy men and women aged between 20 and 30 y (39 in the validity study and 31 in the reliability study). Intraclass correlation coefficient (ICC) values calculated for the maximum voluntary isometric torque of knee extensors at 30°, 60°, and 90°, measured with the prototype and with an isokinetic dynamometer (ICC2,1, validity study) and measured with the prototype in test and retest sessions, scheduled from 48 h to 72 h apart (ICC1,1, reliability study). In the validity analysis, the prototype showed good agreement for measurements at 30° (ICC2,1 = .75, SEM = 18.2 Nm) and excellent agreement for measurements at 60° (ICC2,1 = .93, SEM = 9.6 Nm) and at 90° (ICC2,1 = .94, SEM = 8.9 Nm). Regarding the reliability analysis, between-days' ICC1,1 were good to excellent, ranging from .88 to .93. Standard error of measurement and minimal detectable difference based on test-retest ranged from 11.7 Nm to 18.1 Nm and 32.5 Nm to 50.1 Nm, respectively, for the 3 analyzed knee angles. The analysis of validity and repeatability of the prototype for measuring isometric muscle strength has shown to be good or excellent, depending on the knee joint angle analyzed. The new instrument, which presents a relative low cost and easiness of transportation when compared with an isokinetic dynamometer, is valid and provides consistent data concerning isometric strength of knee extensors and, for this reason, can be used for practical, clinical, and research purposes.

Effect of plyometric training on lower limb biomechanics in females.

PubMed

Baldon, Rodrigo de Marche; Moreira Lobato, Daniel F; Yoshimatsu, Andre P; dos Santos, Ana Flávia; Francisco, Andrea L; Pereira Santiago, Paulo R; Serrão, Fábio V

2014-01-01

To verify the effects of plyometric training on lower limb kinematics, eccentric hip and knee torques, and functional performance. Cohort study. Research laboratory. Thirty-six females were divided into a training group (TG; n = 18) that carried out the plyometric training for 8 weeks, and a control group (CG; n = 18) that carried out no physical training. Twenty-four plyometric training sessions during approximately 8 weeks with 3 sessions per week on alternate days. Lower limb kinematics (maximum excursion of hip adduction, hip medial rotation, and knee abduction during the single leg squat), eccentric hip (abductor, adductor, medial, and lateral rotator) isokinetic peak torques and knee (flexor and extensor) isokinetic peak torques, and functional performance (triple hop test and the 6-m timed hop test). After 8 weeks, only the TG significantly reduced the values for the maximum excursion of knee abduction (P = 0.01) and hip adduction (P < 0.001). Similarly, only the TG significantly increased the eccentric hip abductor (P < 0.001) and adductor (P = 0.01) torques. Finally, only the TG significantly increased the values in the triple hop test (P < 0.001) and significantly decreased the values in the 6-m timed hop test (P < 0.001) after intervention. Plyometric training alters lower limb kinematics and increases eccentric hip torque and functional performance, suggesting the incorporation of these exercises in preventive programs for ACL injuries.

Explosive Strength Imbalances in Professional Basketball Players

PubMed Central

Schiltz, Marc; Lehance, Cédric; Maquet, Didier; Bury, Thierry; Crielaard, Jean-Michel; Croisier, Jean-Louis

2009-01-01

Context: Despite the high rate of lower limb injuries in basketball players, studies of the dominant-limb effect in elite athletes often neglect injury history. Objective: To determine lower limb explosive-strength asymmetries in professional basketball players compared with junior basketball players and control participants. Design: Cohort study. Setting: Academic medical institution. Patients or Other Participants: 15 professional basketball players, 10 junior basketball players, and 20 healthy men. Main Outcome Measure(s): We performed an isokinetic examination to evaluate the knee extensor (Ext) and flexor (Fl) concentric peak torque at 60°·s−1 and 240°·s−1 and (Fl only) eccentric peak torque at 30°·s−1 and 120°·s−1. Functional evaluation included countermovement jump, countermovement jump with arms, 10-m sprint, single-leg drop jump, and single-leg, 10-second continuous jumping. Variables were compared among groups using analysis of variance or a generalized linear mixed model for bilateral variables. Results: The 2 groups of basketball players demonstrated better isokinetic and functional performances than the control group did. No differences in functional or relative isokinetic variables were noted between professional and junior basketball players. Professional players with a history of knee injury failed to reach normal knee extensor strength at 60°·s−1. Knee Ext (60°·s−1) and Fl (eccentric 120°·s−1) torque values as well as 10-second continuous jumping scores were higher in those professional players without a history of knee injury than those with such a history. Compared with the group without a history of knee injury, the group with a history of knee injury maintained leg asymmetry ratios greater than 10% for almost all isokinetic variables and more than 15% for unilateral functional variables. Conclusions: The relative isokinetic and functional performances of professional basketball players were similar to those of junior players, with no dominant-side effect. A history of knee injury in the professional athlete, however, was reflected in bilateral isokinetic and functional asymmetries and should be considered in future studies of explosive strength. PMID:19180217

The comparison of muscle strength and short-term endurance in the different periods of type 2 diabetes

PubMed Central

2014-01-01

Background Patients with type 2 diabetes (T2DM) are subjected to reduction in the quality and oxidative capacity of muscles. The effect of duration of diabetes on the muscle endurance response is not clear and strength as well. Objective The aim of this study was the assessment of strength and endurance of knee extensor and flexor in the patients with T2DM < 10 and T2DM > 10 years in comparison with age, sex, BMI, ABI and PAI-matched health control subjects. Methods Isometric maximal peak torque (MPT) of knee extensor and flexor before and after 40 isokinetic repetitions with velocity of 150 degree/s were recorded in 18 patients with T2DM < 10 Y , 12 patients with T2DM > 10 Y and 20 matched health control (HC) groups. Results Both diabetic patient groups had significant lower isometric and isotonic knee extensor and flexor strength than HC. The endurance indices indicated that whereas the isometric MPT of flexor movement was reduced after isokinetic protocol in the both patient groups in comparison with HC, the less decline was seen in the isotonic torque and work during isokinetic protocol in the T2DM > 10 Y group in comparison with two other groups. The HbA1c and FPG were significantly correlated with strength not with endurance indices. Conclusions It seems the progression of diabetes accompanied with vascular, neural and muscular deficits activate, some adaptive and compensatory processes which can maintain muscle performance. PMID:24476108

ISOKINETIC KNEE MUSCLE STRENGTH PROFILE IN BRAZILIAN MALE SOCCER, FUTSAL, AND BEACH SOCCER PLAYERS: A CROSS-SECTIONAL STUDY

PubMed Central

Mascarin, Naryana C.; Vargas, Valentine Z.; Vancini, Rodrigo L.; Andrade, Marília S.

2017-01-01

Background Anterior cruciate ligament injury is higher in soccer athletes as compared to athletes of other sports. Risk factors for anterior cruciate ligament injury include low knee hamstring/quadriceps strength ratio and bilateral strength deficits. Purpose To investigate isokinetic thigh muscles strength, hamstring/quadriceps strength ratio, and bilateral strength comparisons in athletes who participate in professional soccer, futsal, and beach soccer. Study Design Cross-sectional study. Methods Brazilian professional soccer (n=70), futsal (n=30), and beach soccer (n=12) players were isokinetically assessed to examine strength of knee extensors and flexors at 60 degrees/second in concentric mode, to measure peak torque of dominant and non-dominant limbs. Results In the dominant limb, for extensors muscles, futsal players presented significantly lower peak torque values (223.9 ± 33.4 Nm) than soccer (250.9 ± 43.0 Nm; p=0.02) and beach soccer players (253.1 ± 32.4 Nm; p=0.03). Peak torque for extensor muscles in the non-dominant limb was significantly lower in futsal (224.0 ± 35.8 Nm) than in beach soccer players (256.8 ± 39.8 Nm; p=0.03). Hamstring/quadriceps strength ratio for dominant limbs for futsal (57.6 ± 10.1%), soccer (53.5 ± 8.8%), and beach soccer (56.3 ± 8.4%) players presented no significant differences between groups; however, the mean values were lower than recommended values found in the literature. There were no strength deficits for any of the evaluated groups when compared bilaterally. Conclusions Futsal athletes presented lower values for quadriceps strength than soccer and beach soccer athletes. Futsal, soccer, and beach soccer players presented no strength asymmetries, but they presented with strength imbalance in hamstring/quadriceps strength ratio. Level of Evidence 3 PMID:29234562

A Comparison of Total and Intrinsic Muscle Stiffness Among Flexors and Extensors of the Ankle, Knee and Elbow

NASA Technical Reports Server (NTRS)

Lemoine, Sandra M.

1997-01-01

This study examined 3 methods that assessed muscle stiffness. Muscle stiffness has been quantified by tissue reactive force (transverse stiffness), vibration, and force (or torque) over displacement. Muscle stiffness also has two components: reflex (due to muscle sensor activity) and intrinsic (tonic firing of motor units, elastic nature of actin and myosin cross bridges, and connective tissue). This study compared three methods of measuring muscle stiffness of agonist-antagonist muscle pairs of the ankle, knee and elbow.

Alterations of the in vivo torque-velocity relationship of human skeletal muscle following 30 days exposure to simulated microgravity

NASA Technical Reports Server (NTRS)

Dudley, Gary A.; Duvoisin, Marc; Convertino, Victor A.; Buchanan, Paul

1989-01-01

The effect of a continuous 30-d-long 6-deg headdown bedrest (BR) on the force output ability of skeletal muscles was investigated in human subjects by measuring peak angle specific torque of the knee extensor (KE) and knee flexor (KF) muscle groups of both limbs during unilateral efforts at four speeds (0.52. 1.74, 2.97, and 4.19 rad/sec) during eccentric action. It was found that, for the KE muscle group, the headdown BR resulted in decreases, by 19 percent on the average, of peak angle specific torque; on the other hand, the strength of the KF muscles was not altered significantly. A post-BR recovery for 30 days was found to restore muscle strength of the KE muscle group to about 92 percent of the pre-BR values. Changes of strength were not affected by the type of speed of muscle action.

Isokinetic and isometric strength in osteoarthrosis of the knee. A comparative study with healthy women.

PubMed

Tan, J; Balci, N; Sepici, V; Gener, F A

1995-01-01

Dynamic stability of the knee joint depends on the appropriate strength ratio of quadriceps and hamstring muscles. The purpose of this investigation was to determine the maximum peak torque (MPT) and MPT ratios of hamstrings to quadriceps (H/Q) muscles in patients with knee osteoarthritis (OA). Two groups of patients were included in the study. The first group consisted of 30 patients (Group A) with the clinical and radiologic findings of knee OA. The second group consisted of 30 patients (Group B) exhibiting knee joint pain without roentgenologic findings of knee OA. The findings of two patient groups were compared with each other and also with 30 healthy subjects (Group C). Isokinetic (at 60 degrees/s and at 180 degrees/s) and isometric (at 30 degrees and at 60 degrees of knee flexion) tests were performed by the rate-limiting isokinetic dynamometer system. Isokinetic and isometric MPT loss of knee flexors and extensors was found in both patient groups with respect to controls, but MPT ratios of H/Q muscles did not show a statistically significant difference compared with the control group. This may be related to the equal strength loss of knee flexors and knee extensors in patients with knee OA. It is concluded that strengthening exercises of hamstring muscles is as important as quadriceps strengthening in rehabilitation of knee OA.

Muscle Fatigue during Intermittent Exercise in Individuals with Mental Retardation

ERIC Educational Resources Information Center

Zafeiridis, Andreas; Giagazoglou, Paraskevi; Dipla, Konstantina; Salonikidis, Konstantinos; Karra, Chrisanthi; Kellis, Eleftherios

2010-01-01

This study examined fatigue profile during intermittent exercise in 10 men with mild to moderate mental retardation (MR) and 10 men without mental retardation (C). They performed 4 x 30 s maximal knee extensions and flexions with 1-min rest on an isokinetic dynamometer. Peak torque of flexors (PTFL) and extensors (PTEX), total work (TW), and…

Hip Strength in Patients with Quadriceps Strength Deficits after ACL Reconstruction.

PubMed

Bell, David R; Trigsted, Stephanie M; Post, Eric G; Walden, Courtney E

2016-10-01

Quadriceps strength deficits persist for years after anterior cruciate ligament (ACL) reconstruction, and patients with these deficits often shift torque demands away from the knee extensors to the hip during functional tasks. However, it is not clear how quadriceps strength deficits may affect hip strength. Therefore, the purpose of this study was to investigate differences in lower extremity strength in individuals with ACL reconstruction with differing levels of quadriceps strength asymmetry. Isometric strength was recorded bilaterally in 135 participants (73 control and 62 with unilateral ACL reconstruction, time from surgery = 30.9 ± 17.6 months) from the knee extensors and flexors, hip extensors and abductors, and hip internal and external rotator muscle groups. Symmetry indices (limb symmetry index (LSI)) were created based on quadriceps strength, and subjects with ACL reconstruction were subdivided (high quadriceps (LSI ≥ 90%), n = 37; low quadriceps (LSI < 85%), n = 18). Individual group (control vs high quadriceps vs low quadriceps) by limb (reconstructed/nondominant vs healthy/dominant) repeated-measures ANOVA was used to compare strength (%BW) for each of the six joint motions of interest (knee extensors/flexors, hip abductors/extensors/external, and internal rotators) while controlling for time from surgery. An interaction was observed for quadriceps strength (P < 0.001), and the reconstructed limb in the low quadriceps group was weaker than all other limbs. A main effect for group was observed with the low quadriceps group having greater hip extension (P = 0.007) strength in both limbs compared with the other groups. Knee flexion strength was weaker in the reconstructed limb of the high quadriceps group (P = 0.047) compared with all other groups and limbs. Individuals with ACL reconstruction and involved limb quadriceps weakness have greater hip extension strength in both limbs compared with patients with bilateral strength symmetry and controls.

Isokinetic and Electromyographic Properties of Muscular Endurance in Short and Long-Term Type 2 Diabetes

PubMed Central

Hatef, Boshra; Ghanjal, Ali; Meftahi, Gholam Hossein; Askary-Ashtiani, Ahmadreza

2016-01-01

Background: Patients with type 2 diabetes mellitus (T2DM) are subject to progressive reduction of muscle mass and strength. The aim of this study was to assess muscle forces and electromyography (EMG) indices in short and long-term diabetes during an isokinetic exercise. Methods: The peak torque, work, mean power frequency (MPF) and root mean square (RMS) of knee flexors and extensors during 40 isokinetic knee extension-flexion repetitions with a velocity of 150 degree/s were recorded. 18 patients with less than 10 years with T2DM and 12 patients with equal and more than 10 years of disease were compared with 20 gender, body mass index, physical activity and peripheral circulation matched healthy controls. Results: The fatigue index and slope of line across the peak torque values of the knee flexor indicate that patients with long-term T2DM were significantly more resistant to fatigue in comparison with the two other groups (p<0.009). Whereas the MPF decrease during isokinetic protocol interact with grouping in the medial hamstring (p<0.042), but it was independent to groups in other muscles (p<0.0001). The increase of RMS after fatigue protocol interacted with sex for the medial hamstring and vastus lateralis (p<0.039) and interacted with group for the extensor muscles (p<0.045). Discussion & Conclusion: It seems that long-term T2DM cause some neuromuscular adaptations to maintain knee flexor muscle performance during functional activity especially postural control. PMID:27045412

Core stability training on lower limb balance strength.

PubMed

Dello Iacono, Antonio; Padulo, Johnny; Ayalon, Moshe

2016-01-01

This study aimed to assess the effects of core stability training on lower limbs' muscular asymmetries and imbalances in team sport. Twenty footballers were divided into two groups, either core stability or control group. Before each daily practice, core stability group (n = 10) performed a core stability training programme, while control group (n = 10) did a standard warm-up. The effects of the core stability training programme were assessed by performing isokinetic tests and single-leg countermovement jumps. Significant improvement was found for knee extensors peak torque at 3.14 rad · s(-1) (14%; P < 0.05), knee flexors peak torque at 1.05 and 3.14 rad · s(-1) (19% and 22% with P < 0.01 and P < 0.01, respectively) and peak torque flexors/extensors ratios at 1.05 and 3.14 rad · s(-1) (7.7% and 8.5% with P < 0.05 and P < 0.05, respectively) only in the core stability group. The jump tests showed a significant reduction in the strength asymmetries in core stability group (-71.4%; P = 0.02) while a concurrent increase was seen in the control group (33.3%; P < 0.05). This study provides practical evidence in combining core exercises for optimal lower limbs strength balance development in young soccer players.

Comparison of lower limb kinetics during vertical jumps in turnout and neutral foot positions by classical ballet dancers.

PubMed

Imura, Akiko; Iino, Yoichi

2017-03-01

The purpose of this study was to investigate the effect of hip external rotation (turnout) on lower limb kinetics during vertical jumps by classical ballet dancers. Vertical jumps in a turnout (TJ) and a neutral hip position (NJ) performed by 12 classical female ballet dancers were analysed through motion capture, recording of the ground reaction forces, and inverse dynamics analysis. At push-off, the lower trunk leaned forward 18.2° and 20.1° in the TJ and NJ, respectively. The dancers jumped lower in the TJ than in the NJ. The knee extensor and hip abductor torques were smaller, whereas the hip external rotator torque was larger in the TJ than in the NJ. The work done by the hip joint moments in the sagittal plane was 0.28 J/(Body mass*Height) and 0.33 J/(Body mass*Height) in the TJ and NJ, respectively. The joint work done by the lower limbs were not different between the two jumps. These differences resulted from different planes in which the lower limb flexion-extension occurred, i.e. in the sagittal or frontal plane. This would prevent the forward lean of the trunk by decreasing the hip joint work in the sagittal plane and reduce the knee extensor torque in the jump.

Effects of combined electromyostimulation and gymnastics training in prepubertal girls.

PubMed

Deley, Gaëlle; Cometti, Carole; Fatnassi, Anaïs; Paizis, Christos; Babault, Nicolas

2011-02-01

This study investigated the effects of a 6-week combined electromyostimulation (EMS) and gymnastic training program on muscle strength and vertical jump performance of prepubertal gymnasts. Sixteen young women gymnasts (age 12.4 ± 1.2 yrs) participated in this study, with 8 in the EMS group and the remaining 8 as controls. EMS was conducted on knee extensor muscles for 20 minutes 3 times a week during the first 3 weeks and once a week during the last 3 weeks. Gymnasts from both groups underwent similar gymnastics training 5-6 times a week. Isokinetic torque of the knee extensors was determined at different eccentric and concentric angular velocities ranging from -60 to +240° per second. Jumping ability was evaluated using squat jump (SJ), counter movement jump (CMJ), reactivity test, and 3 gymnastic-specific jumps. After the first 3 weeks of EMS, maximal voluntary torque was increased (+40.0 ± 10.0%, +35.3 ± 11.8%, and +50.6 ± 7.7% for -60, +60, and +240°s⁻¹, respectively; p < 0.05), as well as SJ, reactivity test and specific jump performances (+20.9 ± 8.3%, +20.4 ± 26.2% and +14.9 ± 17.2% respectively; p < 0.05). Six weeks of EMS were necessary to improve the CMJ (+10.1 ± 10.0%, p < 0.05). Improvements in jump ability were still maintained 1 month after the end of the EMS training program. To conclude, these results first demonstrate that in prepubertal gymnasts, a 6-week EMS program, combined with the daily gymnastic training, induced significant increases both in knee extensor muscle strength and nonspecific and some specific jump performances.

Leg extensor muscle strength, postural stability, and fear of falling after a 2-month home exercise program in women with severe knee joint osteoarthritis.

PubMed

Rätsepsoo, Monika; Gapeyeva, Helena; Sokk, Jelena; Ereline, Jaan; Haviko, Tiit; Pääsuke, Mati

2013-01-01

BACKGROUND AND OBJECTIVE. The aim of this study was to compare the leg extensor muscle strength, the postural stability, and the fear of falling in the women with severe knee joint osteoarthritis (OA) before and after a 2-month home exercise program (HEP). MATERIAL AND METHODS. In total, 17 women aged 46-72 years with late-stage knee joint OA scheduled for total knee arthroplasty participated in this study before and after the 2-month HEP with strengthening, stretching, balance, and step exercises. The isometric peak torque (PT) of the leg extensors and postural stability characteristics when standing on a firm or a foam surface for 30 seconds were recorded. The fear of falling and the pain intensity (VAS) were estimated. RESULTS. A significant increase in the PT and the PT-to-body weight (PT-to-BW) ratio of the involved leg as well as the bilateral PT and the PT-to-BW ratio was found after the 2-month HEP compared with the data before the HEP (P<0.05). The PT and the PT-to-BW ratio of the involved leg were significantly lower compared with the uninvolved leg before the HEP (P<0.05). The center of the pressure sway length (foam surface) decreased significantly after the HEP (P<0.05). Significant correlations were found between the PT of the involved leg and the bilateral PT and the fear of falling and between the PT of the involved leg and the postural sway (foam surface) before the HEP. CONCLUSIONS. After the 2-month HEP, the leg extensor muscle strength increased and the postural sway length on a foam surface decreased. The results indicate that the increased leg extensor muscle strength improves postural stability and diminishes the fear of falling in women with late-stage knee joint OA.

Effect of sex and fatigue on muscle stiffness and musculoarticular stiffness of the knee joint in a young active population.

PubMed

Wang, Dan; De Vito, Giuseppe; Ditroilo, Massimiliano; Delahunt, Eamonn

2017-08-01

The purpose of this study was to investigate the influence of sex and fatigue on knee extensor peak torque (PT), muscle stiffness (MS) of the vastus lateralis (VL) and knee joint musculoarticular stiffness (MAS) in young adults. Twenty-two male and 22 female recreational athletes participated. Males were characterised by higher relaxed [pre-: males 364.43 (52.00) N · m -1 , females 270.27 (37.25) N · m -1 ; post-: males 446.75 (83.27) N · m -1 , females 307.39 (38.58) N · m -1 ] and contracted [pre-: males 495.07 (71.04) N · m -1 , females 332.34 (85.42) N · m -1 ; post-: males 546.37 (90.74) N · m -1 , females 349.21 (85.55) N · m -1 ] MS of the VL, and knee joint MAS [pre-: males 1450.11 (507.98) N · m -1 , females 1027.99 (227.33) N · m -1 ; post-: males 1345.81 (404.90) N · m -1 , females 952.78 (192.38) N · m -1 ] than females pre- and post-fatigue. A similar finding was observed in pre-fatigue normalised knee extensor PT [pre-: males 2.77 (0.42) N · m kg -1 , females 2.41 (0.40) N · m kg -1 , post-: males 2.53 (0.54) N · m kg -1 , females 2.26 (0.44) N · m kg -1 ]. After the fatigue protocol, normalised knee extensor PT and knee joint MAS decreased, whilst relaxed and contracted MS of the VL increased in both sexes. These observed differences may contribute to the higher risk of knee injury in females and following the onset of fatigue.

Effects of Pilates on muscle strength, postural balance and quality of life of older adults: a randomized, controlled, clinical trial

PubMed Central

Campos de Oliveira, Laís; Gonçalves de Oliveira, Raphael; Pires-Oliveira, Deise Aparecida de Almeida

2015-01-01

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults. PMID:25931749

Tennis in hot and cool conditions decreases the rapid muscle torque production capacity of the knee extensors but not of the plantar flexors

PubMed Central

Girard, Olivier; Racinais, Sébastien; Périard, Julien D

2014-01-01

Objectives To assess the time course of changes in rapid muscle force/torque production capacity and neuromuscular activity of lower limb muscles in response to prolonged (∼2 h) match-play tennis under heat stress. Methods The rates of torque development (RTD) and electromyographic activity (EMG; ie, root mean square) rise were recorded from 0 to 30, –50, –100 and –200 ms during brief (3–5 s) explosive maximal isometric voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), along with the peak RTD within the entirety of the torque-time curve. These values were recorded in 12 male tennis players before (prematch) and after (postmatch, 24 and 48 h) match-play in HOT (∼37°C) and COOL (∼22°C) conditions. Results The postmatch core temperature was greater in the HOT (∼39.4°C) vs COOL (∼38.7°C) condition (p<0.05). Reductions in KE RTD occurred within the 0–200 ms epoch after contraction onset postmatch and at 24 h, compared with prematch, independent of environmental conditions (p<0.05). A similar reduction in the KE peak RTD was also observed postmatch relative to prematch (p<0.05). No differences in KE RTD values were observed after normalisation to MVC torque. Furthermore, the rate of KE EMG activity rise remained unchanged. Conversely, the PF contractile RTD and rate of EMG activity rise were unaffected by the exercise or environmental conditions. Conclusions In the KE, a reduction in maximal torque production capacity following prolonged match-play tennis appears to account for the decrease in the rate of torque development, independent of environmental conditions, while remaining unchanged in the PF. PMID:24668381

Vastus lateralis single motor unit EMG at the same absolute torque production at different knee angles.

PubMed

Altenburg, T M; de Haan, A; Verdijk, P W L; van Mechelen, W; de Ruiter, C J

2009-07-01

Single motor unit electromyographic (EMG) activity of the knee extensors was investigated at different knee angles with subjects (n = 10) exerting the same absolute submaximal isometric torque at each angle. Measurements were made over a 20 degrees range around the optimum angle for torque production (AngleTmax) and, where feasible, over a wider range (50 degrees ). Forty-six vastus lateralis (VL) motor units were recorded at 20.7 +/- 17.9 %maximum voluntary contraction (%MVC) together with the rectified surface EMG (rsEMG) of the superficial VL muscle. Due to the lower maximal torque capacity at positions more flexed and extended than AngleTmax, single motor unit recruitment thresholds were expected to decrease and discharge rates were expected to increase at angles above and below AngleTmax. Unexpectedly, the recruitment threshold was higher (P < 0.05) at knee angles 10 degrees more extended (43.7 +/- 22.2 N.m) and not different (P > 0.05) at knee angles 10 degrees more flexed (35.2 +/- 17.9 N.m) compared with recruitment threshold at AngleTmax (41.8 +/- 21.4 N.m). Also, unexpectedly the discharge rates were similar (P > 0.05) at the three angles: 11.6 +/- 2.2, 11.6 +/- 2.1, and 12.3 +/- 2.1 Hz. Similar angle independent discharge rates were also found for 12 units (n = 5; 7.4 +/- 5.4 %MVC) studied over the wider (50 degrees ) range, while recruitment threshold only decreased at more flexed angles. In conclusion, the similar recruitment threshold and discharge behavior of VL motor units during submaximal isometric torque production suggests that net motor unit activation did not change very much along the ascending limb of the knee-angle torque relationship. Several factors such as length-dependent twitch potentiation, which may contribute to this unexpected aspect of motor control, are discussed.

Muscular activity and torque of the foot dorsiflexor muscles during decremental isometric test: A cross-sectional study.

PubMed

Ruiz-Muñoz, Maria; González-Sánchez, Manuel; Martín-Martín, Jaime; Cuesta-Vargas, Antonio I

2017-06-01

To analyse the torque variation level that could be explained by the muscle activation (EMG) amplitude of the three major foot dorsiflexor muscles (tibialis anterior (TA), extensor digitorum longus (EDL), extensor hallucis longus (EHL)) during isometric foot dorsiflexion at different intensities. In a cross-sectional study, forty-one subjects performed foot dorsiflexion at 100%, 75%, 50% and 25% of maximal voluntary contractions (MVC) with the hip and knee flexed 90° and the ankle in neutral position (90° between leg and foot). Three foot dorsiflexions were performed for each intensity. Outcome variables were: maximum (100% MVC) and relative torque (75%, 50%, 25% MVC), maximum and relative EMG amplitude. A linear regression analysis was calculated for each intensity of the isometric foot dorsiflexion. The degree of torque variation (dependent variable) from the independent variables explain (EMG amplitude of the three major foot dorsiflexor muscles) the increases when the foot dorsiflexion intensity is increased, with values of R 2 that range from 0.194 (during 25% MVC) to 0.753 (during 100% MVC). The reliability of the outcome variables was excellent. The EMG amplitude of the three main foot dorsiflexors exhibited more variance in the dependent variable (torque) when foot dorsiflexion intensity increases. Copyright © 2016 Elsevier Ltd. All rights reserved.

The effect of the training with the different combinations of frequency and peak-to-peak vibration displacement of whole-body vibration on the strength of knee flexors and extensors

PubMed Central

Król, P; Sobota, G; Polak, A; Bacik, B; Juras, G

2017-01-01

Whole-body vibration training has become a popular method used in sports and physiotherapy. The study aimed to evaluate the effect of different vibration frequency and peak-to-peak displacement combinations on men knee flexors and extensors strength in isokinetic conditions. The sample consisted of 49 male subjects randomly allocated to seven comparative groups, six of which exercised on a vibration platform with parameters set individually for the groups. The experimental groups were exposed to vibrations 3 times a week for 4 weeks. The pre- and post- isokinetic strength tests, with the angular velocities of 240°/s and 30°/s, were recorded prior to and 2 days after the training. After 4 weeks of whole-body vibration training, a significant increase was noted regarding the mean values of peak torque, average peak torque and total work for knee flexors at high angular velocity in Groups I (60 Hz/4 mm) and V (40 Hz/2 mm) (p<0.05). The mean percentage values of post-training changes to study parameters suggest that the training had the most beneficial effect in Groups I (60 Hz/4 mm) and IV (60 Hz/2 mm) (p<0.05). Whole-body vibrations during static exercise beneficially affected knee flexor strength profile in young men at high angular velocity. The combinations of 60 Hz/4 mm seem to have the most advantageous effects on muscle strength parameters. PMID:28566806

Musculoskeletal profile of middle-aged Ving Tsun Chinese martial art practitioners

PubMed Central

Fong, Shirley S.M.; Chan, Jessie S.M.; Bae, Young-Hyeon; Yam, Timothy T.T.; Chung, Louisa M.Y.; Ma, Ada W.W.; Kuisma, Raija

2017-01-01

Abstract This cross-sectional exploratory study aimed to quantify and compare the axial and appendicular bone mineral density (BMD), muscle mass, and muscle strength of middle-aged practitioners of Ving Tsun (VT; a hard-style Chinese martial art) with those of nonpractitioners. Eighteen VT practitioners (mean age ± standard deviation = 51.8 ± 17.7 years; 12 men and six women) and 36 active controls (mean age ± standard deviation = 58.7 ± 11.0 years; 18 men and 18 women) participated in the study. All participants underwent a 1-day battery of musculoskeletal examinations. The BMD of the total radius, total hip, femoral neck, and lumbar spine was measured using dual-energy X-ray absorptiometry, as was the lean mass of the arm, leg, and trunk. Muscle strength of the upper and lower limbs was assessed using a Jamar dynamometer and an isokinetic dynamometer at 60°/second, respectively. VT-trained participants had a 11.5% higher total radius BMD (P = 0.023), a 17.8% higher leg lean mass (P = 0.014), a 56.4% higher isokinetic body weight-adjusted peak torque of the knee extensors (P < 0.001), a 60.8% higher isokinetic body weight-adjusted peak torque of knee flexors (P < 0.001), and a 31.4% shorter time to reach peak torque in the knee flexors (P = 0.001) than the active controls. No significant differences were found in any of the other musculoskeletal outcomes between the 2 groups (P > 0.05). Middle-aged VT practitioners displayed a higher total radius BMD and leg lean mass and better knee extensor and flexor muscular performances than their healthy active counterparts. Healthcare professionals may consider using this alternative method of training to improve the musculoskeletal health of middle-aged adults. PMID:28121945

Musculoskeletal profile of middle-aged Ving Tsun Chinese martial art practitioners: A cross-sectional study.

PubMed

Fong, Shirley S M; Chan, Jessie S M; Bae, Young-Hyeon; Yam, Timothy T T; Chung, Louisa M Y; Ma, Ada W W; Kuisma, Raija

2017-01-01

This cross-sectional exploratory study aimed to quantify and compare the axial and appendicular bone mineral density (BMD), muscle mass, and muscle strength of middle-aged practitioners of Ving Tsun (VT; a hard-style Chinese martial art) with those of nonpractitioners.Eighteen VT practitioners (mean age ± standard deviation = 51.8 ± 17.7 years; 12 men and six women) and 36 active controls (mean age ± standard deviation = 58.7 ± 11.0 years; 18 men and 18 women) participated in the study. All participants underwent a 1-day battery of musculoskeletal examinations. The BMD of the total radius, total hip, femoral neck, and lumbar spine was measured using dual-energy X-ray absorptiometry, as was the lean mass of the arm, leg, and trunk. Muscle strength of the upper and lower limbs was assessed using a Jamar dynamometer and an isokinetic dynamometer at 60°/second, respectively.VT-trained participants had a 11.5% higher total radius BMD (P = 0.023), a 17.8% higher leg lean mass (P = 0.014), a 56.4% higher isokinetic body weight-adjusted peak torque of the knee extensors (P < 0.001), a 60.8% higher isokinetic body weight-adjusted peak torque of knee flexors (P < 0.001), and a 31.4% shorter time to reach peak torque in the knee flexors (P = 0.001) than the active controls. No significant differences were found in any of the other musculoskeletal outcomes between the 2 groups (P > 0.05).Middle-aged VT practitioners displayed a higher total radius BMD and leg lean mass and better knee extensor and flexor muscular performances than their healthy active counterparts. Healthcare professionals may consider using this alternative method of training to improve the musculoskeletal health of middle-aged adults.

Fatigue reduces the complexity of knee extensor torque fluctuations during maximal and submaximal intermittent isometric contractions in man

PubMed Central

Pethick, Jamie; Winter, Samantha L; Burnley, Mark

2015-01-01

Neuromuscular fatigue increases the amplitude of fluctuations in torque output during isometric contractions, but the effect of fatigue on the temporal structure, or complexity, of these fluctuations is not known. We hypothesised that fatigue would result in a loss of temporal complexity and a change in fractal scaling of the torque signal during isometric knee extensor exercise. Eleven healthy participants performed a maximal test (5 min of intermittent maximal voluntary contractions, MVCs), and a submaximal test (contractions at a target of 40% MVC performed until task failure), each with a 60% duty factor (6 s contraction, 4 s rest). Torque and surface EMG signals were sampled continuously. Complexity and fractal scaling of torque were quantified by calculating approximate entropy (ApEn), sample entropy (SampEn) and the detrended fluctuation analysis (DFA) scaling exponent α. Fresh submaximal contractions were more complex than maximal contractions (mean ± SEM, submaximal vs. maximal: ApEn 0.65 ± 0.09 vs. 0.15 ± 0.02; SampEn 0.62 ± 0.09 vs. 0.14 ± 0.02; DFA α 1.35 ± 0.04 vs. 1.55 ± 0.03; all P < 0.005). Fatigue reduced the complexity of submaximal contractions (ApEn to 0.24 ± 0.05; SampEn to 0.22 ± 0.04; DFA α to 1.55 ± 0.03; all P < 0.005) and maximal contractions (ApEn to 0.10 ± 0.02; SampEn to 0.10 ± 0.02; DFA α to 1.63 ± 0.02; all P < 0.01). This loss of complexity and shift towards Brownian-like noise suggests that as well as reducing the capacity to produce torque, fatigue reduces the neuromuscular system's adaptability to external perturbations. PMID:25664928

MUSCLE WEAKNESS, FATIGUE, AND TORQUE VARIABILITY: EFFECTS OF AGE AND MOBILITY STATUS

PubMed Central

KENT-BRAUN, JANE A.; CALLAHAN, DAMIEN M.; FAY, JESSICA L.; FOULIS, STEPHEN A.; BUONACCORSI, JOHN P.

2013-01-01

Introduction Whereas deficits in muscle function, particularly power production, develop in old age and are risk factors for mobility impairment, a complete understanding of muscle fatigue during dynamic contractions is lacking. We tested hypotheses related to torque-producing capacity, fatigue resistance, and variability of torque production during repeated maximal contractions in healthy older, mobility-impaired older, and young women. Methods Knee extensor fatigue (decline in torque) was measured during 4 min of dynamic contractions. Torque variability was characterized using a novel 4-component logistic regression model. Results Young women produced more torque at baseline and during the protocol than older women (P < 0.001). Although fatigue did not differ between groups (P = 0.53), torque variability differed by group (P = 0.022) and was greater in older impaired compared with young women (P = 0.010). Conclusions These results suggest that increased torque variability may combine with baseline muscle weakness to limit function, particularly in older adults with mobility impairments. PMID:23674266

Contraction type influences the human ability to use the available torque capacity of skeletal muscle during explosive efforts

PubMed Central

Tillin, Neale A.; Pain, Matthew T. G.; Folland, Jonathan P.

2012-01-01

The influence of contraction type on the human ability to use the torque capacity of skeletal muscle during explosive efforts has not been documented. Fourteen male participants completed explosive voluntary contractions of the knee extensors in four separate conditions: concentric (CON) and eccentric (ECC); and isometric at two knee angles (101°, ISO101 and 155°, ISO155). In each condition, torque was measured at 25 ms intervals up to 150 ms from torque onset, and then normalized to the maximum voluntary torque (MVT) specific to that joint angle and angular velocity. Explosive voluntary torque after 50 ms in each condition was also expressed as a percentage of torque generated after 50 ms during a supramaximal 300 Hz electrically evoked octet in the same condition. Explosive voluntary torque normalized to MVT was more than 60 per cent larger in CON than any other condition after the initial 25 ms. The percentage of evoked torque expressed after 50 ms of the explosive voluntary contractions was also greatest in CON (ANOVA; p < 0.001), suggesting higher concentric volitional activation. This was confirmed by greater agonist electromyography normalized to Mmax (recorded during the explosive voluntary contractions) in CON. These results provide novel evidence that the ability to use the muscle's torque capacity explosively is influenced by contraction type, with concentric contractions being more conducive to explosive performance due to a more effective neural strategy. PMID:22258636

Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement.

PubMed

Wang, Henry; Foster, Jonathan; Franksen, Natasha; Estes, Jill; Rolston, Lindsey

2018-04-01

Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs. The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Twelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking. The TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05). This study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.

Neuromuscular adjustments of the knee extensors and plantar flexors following match-play tennis in the heat

PubMed Central

Périard, Julien D; Girard, Olivier; Racinais, Sébastien

2014-01-01

Objectives This study tested the hypothesis that impairments in lower limb maximal strength and voluntary activation (VA) are exacerbated following match-play tennis in hot compared with cool conditions. Methods Torque and VA were evaluated during brief (5 s) and sustained (20 s) maximal voluntary isometric contractions of the knee extensors (KE) and plantar flexors (PF) in 12 male tennis players before (pre) and after (post, 24 h and 48 h) ∼115 min of play in hot (∼37°C) and cool (∼22°C) conditions. Results Rectal temperature was higher following play in hot than in cool (∼39.2 vs ∼38.5°C; p<0.05). Torque production decreased from prematch to postmatch during the brief and sustained contractions in hot (KE: ∼22%; PF: ∼13%) and cool (KE: ∼9%, PF: ∼7%) (p<0.05). KE strength losses in hot were greater than in cool (p<0.05) and persisted for 24 h (p<0.05). Postmatch brief and sustained KE VA was lower in hot than in cool (p<0.05), in which VA was maintained. PF VA was maintained throughout the protocol. Peak twitch torque and maximum rates of torque development and relaxation in the KE and PF were equally reduced postmatch relative to prematch in hot and cool conditions (p<0.05), and were restored near baseline within 24 h. Conclusions Neuromuscular system integrity of the lower limbs is compromised immediately following match-play tennis in hot and cool conditions due to the development of peripheral fatigue. The larger and persistent KE strength losses observed under heat stress are associated with greater levels of central fatigue especially during sustained contractions. PMID:24668379

Knee strength ratios in competitive female athletes

PubMed Central

Murawa, Michal; Mackala, Krzysztof; Dworak, Lechoslaw Bogdan

2018-01-01

Knee strength ratios are related to the movement patterns, sport-specific training and knee injuries in athletes. The purpose of this study was to determine the ratios in the concentric isokinetic strength of the hamstrings and quadriceps and the isometric strength of the knee extensors. In female basketball players (n = 14) and female volleyball players (n = 12) were evaluated: the hamstrings to quadriceps peak torque ratio (H/Q) and side-to-side peak torque ratio (TR) for hamstrings and quadriceps; the ratio of the maximal bilateral strength to the summed maximal unilateral strength (B/U) and side-to-side maximal strength ratio (SR) for knee extensors. For the H/Q values, a 2 × 2 × 3 mixed-factorial analysis of variance and Bonferroni post hoc test were computed. The H/Q values increased from 48.0 (3.9)% at 60°/s to 70.4 (7.9)% at 300°/s. Furthermore, there were significant differences in the H/Q values between 300°/s and 180°/s, 300°/s and 60°/s in basketball and volleyball athletes, and between 180°/s and 60°/s only in basketball athletes (p < .05). Significantly higher H/Q results at 60°/s demonstrated basketball players than volleyball players (p < .05). Differences in the TR and SR mean values ranged from 4.4% to 8.6% and indicated no significant side-to-side strength deficits (p > .05). In both groups, greater isometric strength developed bilaterally was found (B/U > 100%). The findings revealed the magnitude of knee strength ratios in female athletes determined by sport-specific movements in basketball and volleyball. This study highlighted the importance of the bilateral strength deficit and muscular balance between the hamstrings and quadriceps in basketball and volleyball athletes in activities related to their movement patterns and specific training. PMID:29315348

Knee extension range of motion and self-report physical function in total knee arthroplasty: mediating effects of knee extensor strength

PubMed Central

2013-01-01

Background Knee extensor strength and knee extension range of motion (ROM) are important predictors of physical function in patients with a total knee arthroplasty (TKA). However, the relationship between the two knee measures remains unclear. The purpose of this study was to examine whether changes in knee extensor strength mediate the association between changes in knee extension ROM and self-report physical function. Methods Data from 441 patients with a TKA were collected preoperatively and 6 months postoperatively. Self-report measure of physical function was assessed by the Short Form 36 (SF-36) questionnaire. Knee extensor strength was measured by handheld dynamometry and knee extension ROM by goniometry. A bootstrapped cross product of coefficients approach was used to evaluate mediation effects. Results Mediation analyses, adjusted for clinicodemographic measures, revealed that the association between changes in knee extension ROM and SF-36 physical function was mediated by changes in knee extensor strength. Conclusions In patients with TKA, knee extensor strength mediated the influence of knee extension ROM on physical function. These results suggest that interventions to improve the range of knee extension may be useful in improving knee extensor performance. PMID:23332039

Characteristics and Preliminary Observations of the Influence of Electromyostimulation on the Size and Function of Human Skeletal Muscle During 30 Days of Simulated Microgravity

NASA Technical Reports Server (NTRS)

Duvoisin, Marc R.; Convertino, Victor A; Buchanan, Paul; Gollinick, Philip D.; Dudley, Gary A.

1989-01-01

During 30 days (d) of bedrest, the practicality of using Elec- troMyoStimulation (EMS) as a deterrent to atrophy and strength loss of lower limb musculature was examined. An EMS system was developed that provided variable but quantifiable levels of EMS, and measured torque. The dominant log of three male subjects was stimulated twice daily in a 3-d on/1-d off cycle during bedrest. The non-dominant leg of each subject acted as a control. A stimulator, using a 0.3 ms monophasic 60 Hz pulse waveform, activated muscle tissue for 4 s. The output waveform from the stimulator was sequenced to the Knee Extensors (KE), Knee Flex- ors (KF), Ankle Extensors (AE), and Ankle Flexors (AF), and caused three isometric contractions of each muscle group per minute. Subject tolerance determined EMS Intensity. Each muscle group received four 5-min bouts of EMS each session with a 10 -min rest between bouts. EMS and torque levels for each muscle action were recorded directly an a computer. Overall average EMS Intensity was 197, 197, 195, and 188 mA for the KE, KF, AF, and AE, respectively. Overall average torque development for these muscle groups was 70, 16, 12, and 27 Nm, respectively. EMS intensity doubled during the study, and average torque increased 2.5 times. Average maximum torque throughout a session reached 54% of maximal voluntary for the KE and 29% for the KF. Reductions in leg volume, muscle compartment size, cross-sectional area of slow and fast-twitch fibers, strength, and aerobic enzyme activities, and increased log compliance were attenuated in the legs which received EMS during bedrest. These results indicate that similar EMS levels induce different torques among different muscle groups and that repeated exposure to EMS increases tolerance and torque development. Longer orien- tation periods, therefore, may enhance its effectiveness. Our preliminary data suggest that the efficacy of EMS as an effective countermeasure for muscle atrophy and strength loss during long duration space travel warrants further investigation.

Knee strength, power and stair performance of the elderly 5 years after unicompartmental knee arthroplasty.

PubMed

Li, Yumeng; Kakar, Rumit S; Fu, Yang-Chieh; Mahoney, Ormonde M; Kinsey, Tracy L; Simpson, Kathy J

2018-04-13

Unicompartmental knee arthroplasty (UKA) has been shown to demonstrate some satisfactory short-term outcomes. However, to our knowledge, there have been no reports on midterm or long-term knee extensor strength and leg extensor power post-UKA. Therefore, the purposes of this study were: (1) to assess the isokinetic knee extensor strength, leg extensor power and stair performance of elderly participants at 5 years UKA post-operation; (2) to compare the differences in knee extensor strength and leg extensor power between the UKA and contralateral healthy limbs. Nineteen elderly participants (75 ± 5 years) who had a medial or a lateral compartment UKA at 5 years post-operation were recruited. The isokinetic knee extensor strength and leg extensor power were measured. The stair performance was tested on a 4-step stair, and ascent and descent velocities were calculated. The pain level was assessed. The UKA limbs' knee extensor strength and leg extensor power were 1.01 ± 0.39 Nm/kg and 0.98 ± 0.27 W/kg, respectively. The stair ascent and descent velocities were 0.37 ± 0.07 and 0.38 ± 0.11 m/s, respectively. In addition, the UKA limbs exhibited comparable knee strength and leg power relative to the contralateral limbs. In general, the knee extensor strength and leg extensor power exhibited by the UKA limbs at 5 years post-operation may be typical in comparison with the normative data. We suggest that UKA is a satisfactory treatment in regard to the recovery of knee strength, leg power and ability to climb up and down stairs.

Isokinetic Leg Strength and Power in Elite Handball Players

PubMed Central

González-Ravé, José M.; Juárez, Daniel; Rubio-Arias, Jacobo A.; Clemente-Suarez, Vicente J; Martinez-Valencia, María A; Abian-Vicen, Javier

2014-01-01

Isokinetic strength evaluation of the knee flexion and extension in concentric mode of contraction is an important part of the comprehensive evaluation of athletes. The aims of this study were to evaluate the isokinetic knee peak torque in both the extension and flexion movement in the dominant and non-dominant leg, and the relationship with jumping performance. Twelve elite male handball players from the top Spanish handball division voluntary participated in the study (age 27.68 ± 4.12 years; body mass 92.89 ± 12.34 kg; body height 1.90 ± 0.05 m). The knee extensor and flexor muscle peak torque of each leg were concentrically measured at 60º/s and 180º/s with an isokinetic dynamometer. The Squat Jump and Countermovement Jump were performed on a force platform to determine power and vertical jump height. Non-significant differences were observed between legs in the isokinetic knee extension (dominant= 2.91 ± 0.53 Nm/kg vs non-dominant = 2.70 ± 0.47 Nm/kg at 60º/s; dominant = 1.90 ± 0.31 Nm/kg vs non-dominant = 1.83 ± 0.29 Nm/kg at 180º/s) and flexion peak torques (dominant = 1.76 ± 0.29 Nm/kg vs non-dominant = 1.72 ± 0.39 Nm/kg at 60º/s; dominant = 1.30 ± 0.23 Nm/kg vs non-dominant = 1.27 ± 0.35 Nm/kg at 180º/s). Low and non-significant correlation coefficients were found between the isokinetic peak torques and vertical jumping performance (SJ = 31.21 ± 4.32 cm; CMJ = 35.89 ± 4.20 cm). Similar isokinetic strength was observed between the legs; therefore, no relationship was found between the isokinetic knee flexion and extension peak torques as well as vertical jumping performance in elite handball players. PMID:25114749

Isokinetic leg strength and power in elite handball players.

PubMed

González-Ravé, José M; Juárez, Daniel; Rubio-Arias, Jacobo A; Clemente-Suarez, Vicente J; Martinez-Valencia, María A; Abian-Vicen, Javier

2014-06-28

Isokinetic strength evaluation of the knee flexion and extension in concentric mode of contraction is an important part of the comprehensive evaluation of athletes. The aims of this study were to evaluate the isokinetic knee peak torque in both the extension and flexion movement in the dominant and non-dominant leg, and the relationship with jumping performance. Twelve elite male handball players from the top Spanish handball division voluntary participated in the study (age 27.68 ± 4.12 years; body mass 92.89 ± 12.34 kg; body height 1.90 ± 0.05 m). The knee extensor and flexor muscle peak torque of each leg were concentrically measured at 60º/s and 180º/s with an isokinetic dynamometer. The Squat Jump and Countermovement Jump were performed on a force platform to determine power and vertical jump height. Non-significant differences were observed between legs in the isokinetic knee extension (dominant= 2.91 ± 0.53 Nm/kg vs non-dominant = 2.70 ± 0.47 Nm/kg at 60º/s; dominant = 1.90 ± 0.31 Nm/kg vs non-dominant = 1.83 ± 0.29 Nm/kg at 180º/s) and flexion peak torques (dominant = 1.76 ± 0.29 Nm/kg vs non-dominant = 1.72 ± 0.39 Nm/kg at 60º/s; dominant = 1.30 ± 0.23 Nm/kg vs non-dominant = 1.27 ± 0.35 Nm/kg at 180º/s). Low and non-significant correlation coefficients were found between the isokinetic peak torques and vertical jumping performance (SJ = 31.21 ± 4.32 cm; CMJ = 35.89 ± 4.20 cm). Similar isokinetic strength was observed between the legs; therefore, no relationship was found between the isokinetic knee flexion and extension peak torques as well as vertical jumping performance in elite handball players.

Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running.

PubMed

Teng, Hsiang-Ling; Powers, Christopher M

2016-07-01

Diminished hip-muscle performance has been proposed to contribute to various knee injuries. To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip- and knee-extensor work during running. Descriptive laboratory study. Musculoskeletal biomechanical laboratory. A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 ± 7.0 years, height = 1.74 ± 0.69 m, mass = 71.1 ± 8.2 kg) and 20 women (age = 26.2 ± 5.8 years, height = 1.65 ± 0.74 m, mass = 60.6 ± 6.6 kg), participated. Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip- and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work. Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with knee-extensor work (r = -0.39, P = .01). All the correlations remained after adjusting for sex. Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee.

Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running

PubMed Central

Teng, Hsiang-Ling; Powers, Christopher M.

2016-01-01

Context:  Diminished hip-muscle performance has been proposed to contribute to various knee injuries. Objective:  To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip- and knee-extensor work during running. Design:  Descriptive laboratory study. Setting:  Musculoskeletal biomechanical laboratory. Patients or Other Participants:  A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 ± 7.0 years, height = 1.74 ± 0.69 m, mass = 71.1 ± 8.2 kg) and 20 women (age = 26.2 ± 5.8 years, height = 1.65 ± 0.74 m, mass = 60.6 ± 6.6 kg), participated. Main Outcome Measure(s):  Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip- and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work. Results:  Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with knee-extensor work (r = −0.39, P = .01). All the correlations remained after adjusting for sex. Conclusions:  Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee. PMID:27513169

Gender differences in the circadian variations in muscle strength assessed with and without superimposed electrical twitches.

PubMed

Giacomoni, Magali; Edwards, Ben; Bambaeichi, Effat

The circadian rhythm in muscle strength was analysed in 12 males (28 +/- 4 years, 79.6 +/- 12.3 kg, 1.80 +/- 0.05 m) and eight females (28 +/- 4 years, 60.3 +/- 5.5 kg, 1.61 +/- 0.08 m). After two familiarization sessions, participants were tested at six different times of the day (02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours), the order of which was randomly assigned over 3-4 days. Rectal temperature (T(rec)) was measured over 30 min before each test. Peak isokinetic torques (PT) of knee extensors and flexors were then measured at 1.05 rad s(-1) and 3.14 rad s(-1) through a 90 degrees range of motion. Maximal isometric voluntary contraction (MVC) of knee extensors and flexors was measured at 60 degrees of knee flexion and the MVC of knee extensors was also assessed with superimposed electrical twitches (50 Hz, 250 V, 200 mus pulse width) in order to control for motivational effects. Three trials were performed in each condition, separated by 3 min recovery, and the highest values were retained for subsequent analyses. A significant circadian rhythm was observed for T(rec) in both males and females (acrophase, Phi, 17:29 and 16:40 hours; mesor, Me, 37.0 and 36.8 degrees C; amplitude, A, 0.28 and 0.33 degrees C for males and females, respectively). The mesor of T(rec) was higher in males than in females (p < 0.05). Significant circadian rhythms were observed for knee extensor PT at 3.14 rad s(-1) in males (Phi, 17:06 hours; Me, 178.2 N m; A, 4.7 N m) and for knee extensor PT at 1.05 rad s(-1) in females (Phi, 15:35 hours; Me, 128.7 N m; A, 3.7 N m). In males, the MVC of knee extensors demonstrated a significant circadian rhythm, but only when electrical twitches were superimposed (Phi, 16:17 h; Me, 302.1 N m; A, 13.6 N m). Acrophases of all indices of muscle strength were not statistically different between the two groups and were located in the afternoon (12:47 < Phi < 17:16 hours). The amplitude (percentage of mesor) of extensors MVC (electrically stimulated) was higher in males (6.4%) than in females (4.2%; p < 0.05). Significant circadian rhythms were not consistently observed for all indices of muscle strength whatever the gender. Our group of female subjects tended to show lower circadian amplitudes than the males. In males, maximal voluntary contraction of electrically stimulated muscles followed a circadian curve, which was not significant without the superimposed twitches. These results suggest that motivation could have a masking effect on the circadian rhythm in muscle performance and strengthen the view that peripheral factors are implicated in this rhythm.

Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise.

PubMed

Paquette, Max R; Peel, Shelby A; Schilling, Brian K; Melcher, Dan A; Bloomer, Richard J

2017-06-01

Runners often experience delayed onset muscle soreness (DOMS), especially of the knee extensors, following prolonged running. Sagittal knee joint biomechanics are altered in the presence of knee extensor DOMS but it is unclear how muscle soreness affects lower limb biomechanics in other planes of motion. The purpose of this study was to assess the effects of knee extensor DOMS on three-dimensional (3D) lower limb biomechanics during running. Thirty-three healthy men (25.8 ± 6.8 years; 84.1 ± 9.2 kg; 1.77 ± 0.07 m) completed an isolated eccentric knee extensor damaging protocol to elicit DOMS. Biomechanics of over-ground running at a set speed of 3.35 m s -1 ±5% were measured before eccentric exercise (baseline) and, 24 h and 48 h following exercise in the presence of knee extensor DOMS. Knee flexion ROM was reduced at 48 h (P = 0.01; d = 0.26), and peak knee extensor moment was reduced at 24 h (P = 0.001; d = 0.49) and 48 h (P < 0.001; d = 0.68) compared to baseline. Frontal and transverse plane biomechanics were unaffected by the presence of DOMS (P > 0.05). Peak positive ankle and knee joint powers and, peak negative knee joint power were all reduced from baseline to 24 h and 48 h (P < 0.05). These findings suggest that knee extensor DOMS greatly influences sagittal knee joint angular kinetics and, reduces sagittal power production at the ankle joint. However, knee extensor DOMS does not affect frontal and transverse plane lower limb joint biomechanics during running.

Sex Differences in Neuromuscular Fatigability of the Knee Extensors Post-Stroke

PubMed Central

Kirking, Meghan; Berrios Barillas, Reivian; Nelson, Philip Andrew; Hunter, Sandra Kay; Hyngstrom, Allison

2017-01-01

Background and Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke. Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target torque. Electromyography was used to determine muscle activation and contractile properties were assessed with electrical stimulation of the quadriceps muscles. Results: Individuals with stroke had a briefer task duration (greater fatigability) than nonstroke individuals (24.1 ± 17 min vs. 34.9 ± 16 min). Men were more fatigable than women for both nonstroke controls and individuals with stroke (17.9 ± 9 min vs. 41.6 ± 15 min). Individuals with stroke had less fatigue-related changes in muscle contractile properties and women with stroke differed in their muscle activation strategy during the fatiguing contractions. Conclusions: Men and women fatigue differently post-stroke and this may be due to the way they neurally activate muscle groups. PMID:28085089

Association of Quadriceps Strength and Psychosocial Factors With Single-Leg Hop Performance in Patients With Meniscectomy.

PubMed

Hsu, Chao-Jung; George, Steven Z; Chmielewski, Terese L

2016-12-01

Clinicians use the single-leg hop test to assess readiness for return to sports after knee injury. Few studies have reported the results of single-leg hop testing after meniscectomy. Additionally, the contributions of impairments in quadriceps strength and psychosocial factors to single-leg hop performance are unknown. To compare single-leg hop performance (distance and landing mechanics) between limbs and to examine the association of single-leg hop performance with quadriceps strength and psychosocial factors in patients with meniscectomy. Descriptive laboratory study. A total of 22 subjects who underwent meniscectomy for traumatic meniscal tears received either standard rehabilitation alone or with additional quadriceps strengthening. Testing was conducted immediately postrehabilitation and at 1 year postsurgery. A single-leg hop test was performed bilaterally, and hop distance was used to create a hop symmetry index. Landing mechanics (peak knee flexion angle, knee extension moment, and peak vertical ground-reaction force) were analyzed with a motion-capture system and a force plate. An isokinetic dynamometer (60 deg/s) assessed knee extensor peak torque and rate of torque development (RTD 0-200ms and RTD 0-peak torque ). Questionnaires assessed fear of reinjury (Tampa Scale for Kinesiophobia [TSK-11]) and self-efficacy (Knee Activity Self-Efficacy [KASE]). Rehabilitation groups did not significantly differ in single-leg hop performance; therefore, groups were combined for further analyses. The mean hop symmetry index was 88.6% and 98.9% at postrehabilitation and 1 year postsurgery, respectively. Compared with the nonsurgical limb, the surgical limb showed decreased peak knee flexion angle at postrehabilitation and decreased knee extension moment at 1 year postsurgery. The hop symmetry index was positively associated with peak torque, RTD 0-200ms , and the KASE score at postrehabilitation. Moreover, at postrehabilitation, the peak knee flexion angle was positively associated with peak torque and RTD 0-200ms , and the knee extension moment was positively associated with RTD 0-200ms . At 1 year postsurgery, peak knee flexion angle and knee extension moment were both positively associated with peak torque, RTD 0-200ms , and RTD 0-peak torque . Although the hop symmetry index could be considered satisfactory for returning to sports, asymmetries in landing mechanics still exist in the first year postmeniscectomy. Greater quadriceps strength was associated with greater single-leg hop distance and better landing mechanics at both postrehabilitation and 1 year postsurgery. Knee activity self-efficacy was the only psychosocial factor associated with single-leg hop performance and isolated to a positive association with single-leg hop distance at postrehabilitation. Rate of development is not typically measured in the clinic but can be an additional quadriceps measure to monitor for single-leg hop performance. Quadriceps strength and psychosocial factors appear to have separate influence on single-leg hop performance after meniscectomy, which has implications for developing appropriate interventions for optimal single-leg hop performance.

Association of Quadriceps Strength and Psychosocial Factors With Single-Leg Hop Performance in Patients With Meniscectomy

PubMed Central

Hsu, Chao-Jung; George, Steven Z.; Chmielewski, Terese L.

2016-01-01

Background: Clinicians use the single-leg hop test to assess readiness for return to sports after knee injury. Few studies have reported the results of single-leg hop testing after meniscectomy. Additionally, the contributions of impairments in quadriceps strength and psychosocial factors to single-leg hop performance are unknown. Purpose: To compare single-leg hop performance (distance and landing mechanics) between limbs and to examine the association of single-leg hop performance with quadriceps strength and psychosocial factors in patients with meniscectomy. Study Design: Descriptive laboratory study. Methods: A total of 22 subjects who underwent meniscectomy for traumatic meniscal tears received either standard rehabilitation alone or with additional quadriceps strengthening. Testing was conducted immediately postrehabilitation and at 1 year postsurgery. A single-leg hop test was performed bilaterally, and hop distance was used to create a hop symmetry index. Landing mechanics (peak knee flexion angle, knee extension moment, and peak vertical ground-reaction force) were analyzed with a motion-capture system and a force plate. An isokinetic dynamometer (60 deg/s) assessed knee extensor peak torque and rate of torque development (RTD0-200ms and RTD0–peak torque). Questionnaires assessed fear of reinjury (Tampa Scale for Kinesiophobia [TSK-11]) and self-efficacy (Knee Activity Self-Efficacy [KASE]). Results: Rehabilitation groups did not significantly differ in single-leg hop performance; therefore, groups were combined for further analyses. The mean hop symmetry index was 88.6% and 98.9% at postrehabilitation and 1 year postsurgery, respectively. Compared with the nonsurgical limb, the surgical limb showed decreased peak knee flexion angle at postrehabilitation and decreased knee extension moment at 1 year postsurgery. The hop symmetry index was positively associated with peak torque, RTD0-200ms, and the KASE score at postrehabilitation. Moreover, at postrehabilitation, the peak knee flexion angle was positively associated with peak torque and RTD0-200ms, and the knee extension moment was positively associated with RTD0-200ms. At 1 year postsurgery, peak knee flexion angle and knee extension moment were both positively associated with peak torque, RTD0-200ms, and RTD0–peak torque. Conclusion: Although the hop symmetry index could be considered satisfactory for returning to sports, asymmetries in landing mechanics still exist in the first year postmeniscectomy. Greater quadriceps strength was associated with greater single-leg hop distance and better landing mechanics at both postrehabilitation and 1 year postsurgery. Knee activity self-efficacy was the only psychosocial factor associated with single-leg hop performance and isolated to a positive association with single-leg hop distance at postrehabilitation. Clinical Relevance: Rate of development is not typically measured in the clinic but can be an additional quadriceps measure to monitor for single-leg hop performance. Quadriceps strength and psychosocial factors appear to have separate influence on single-leg hop performance after meniscectomy, which has implications for developing appropriate interventions for optimal single-leg hop performance. PMID:28210647

Alterations of the In Vivo Torque-Velocity Relationship of Human Skeletal Muscle Following 30 Days Exposure to Simulated Microgravity

NASA Technical Reports Server (NTRS)

Dudley, Gary A.; Duvoisin, Marc R.; Convertino, Victor A.; Buchanan, Paul

1989-01-01

The purpose of this study was to examine the effect of 30 d of 6 deg headdown bedrest (BR) on the in vivo strength of skeletal muscle. Peak angle specific (0.78 rad below horizontal) torque of the knee extensor (KE) and flexor (KF) muscle groups of both limbs was assessed during unilateral efforts at four speeds (0.52, 1.74, 2.97 and 4.19 rad/s) during concentric and at three speeds (0.52, 1.74 and 2.97 rad/s) during eccentric actions. The average decrease (P less than 0.05) of peak angle specific torque directly post-BR for the KE across speeds of concentric and eccentric actions was about 19% (n = 7). Recovery for 30 d following BR markedly improved strength to about 92% (P greater than 0.05) of 'normal'. Strength of the KF was not altered (P greater than 0.05) by BR (about a 6% decrease independent of speed and type of muscle action). Changes of strength were not affected by the type or speed of muscle action. The results indicate that strength of ex-tensor more than of flexor muscle groups of the lower limb is decreased by 30 d of bedrest and that this response does not alter the nature of the in vivo torque-velocity relation.

Cross-sectional association between muscle strength and self-reported physical function in 195 hip osteoarthritis patients.

PubMed

Hall, Michelle; Wrigley, Tim V; Kasza, Jessica; Dobson, Fiona; Pua, Yong Hao; Metcalf, Ben R; Bennell, Kim L

2017-02-01

This study aimed to evaluate associations between strength of selected hip and knee muscles and self-reported physical function, and their clinical relevance, in men and women with hip osteoarthritis (OA). Cross-sectional data from 195 participants with symptomatic hip OA were used. Peak isometric torque of hip extensors, flexors, and abductors, and knee extensors were measured, along with physical function using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. Separate linear regressions in men and women were used to determine the association between strength and physical function accounting for age, pain, and radiographic disease severity. Subsequently, magnitudes of strength associated with estimates of minimal clinically important improvement (MCII) in physical function were estimated according to severity of difficulty with physical function. For men, greater strength of the hip extensors, hip flexors and knee extensors were each associated with better physical function. For women, greater muscle strength of all tested muscles were each associated with better physical function. For men and women, increases in muscle strength between 17-32%, 133-223%, and 151-284% may be associated with estimates of MCII in physical function for those with mild, moderate, and severe physical dysfunction, respectively. Greater isometric strength of specific hip and thigh muscle groups may be associated with better self-reported physical function in men and women. In people with mild physical dysfunction, an estimate of MCII in physical function may be associated with attainable increases in strength. However, in patients with more severe dysfunction, greater and perhaps unattainable strength increases may be associated with an estimate of MCII in physical function. Longitudinal studies are required to validate these observations. Copyright © 2017 Elsevier Inc. All rights reserved.

Sex differences in neuromuscular function after repeated eccentric contractions of the knee extensor muscles.

PubMed

Lee, Andrea; Baxter, Jake; Eischer, Claire; Gage, Matt; Hunter, Sandra; Yoon, Tejin

2017-06-01

This study examined the mechanisms for force and power reduction during and up to 48 h after maximal eccentric contractions of the knee extensor muscles in young men and women. 13 men (22.8 ± 2.6 years) and 13 women (21.6 ± 2.2 years) performed 150 maximal effort eccentric contractions (5 sets of 30) with the knee extensor muscles at 60° s -1 . Maximal voluntary isometric contractions (MVIC) and maximal voluntary concentric contractions (MVCC) were performed before and after the 150 eccentric contractions. The MVCCs involved a set of two isokinetic contractions at 60° s -1 and sets of isotonic contractions performed at seven different resistance loads (1 N m, 10, 20, 30, 40, 50, and 60% MVIC). Electrical stimulation was used during the MVICs and at rest to determine changes in voluntary activation and contractile properties. At baseline, men were stronger than women (MVIC: 276 ± 48 vs. 133 ± 37 N m) and more powerful (MVCC: 649 ± 77 vs. 346 ± 78 W). At termination of the eccentric contractions, voluntary activation, resting twitch amplitude, and peak power during concentric contractions at the seven loads and at 60° s -1 decreased (P < 0.05) similarly in the men and women. At 48 h post-exercise, the MVIC torque, power (for loads ≥20-60% MVIC), and voluntary activation remained depressed (P < 0.05), but the resting twitch had returned to baseline (P > 0.05) with no sex differences. Central mechanisms were primarily responsible for the depressed maximal force production up to 48 h after repeated eccentric contractions of the knee extensors and these mechanisms were similar in men and women.

Understanding movement control in infants through the analysis of limb intersegmental dynamics.

PubMed

Schneider, K; Zernicke, R F; Ulrich, B D; Jensen, J L; Thelen, E

1990-12-01

One important component in the understanding of the control of limb movements is the way in which the central nervous system accounts for joint forces and torques that may be generated not only by muscle actions but by gravity and by passive reactions related to the movements of limb segments. In this study, we asked how the neuromotor system of young infants controls a range of active and passive forces to produce a stereotypic, nonintentional movement. We specifically analyzed limb intersegmental dynamics in spontaneous, cyclic leg movements (kicking) of varying intensity in supine 3-month-old human infants. Using inverse dynamics, we calculated the contributions of active (muscular) and passive (motion-dependent and gravitational) torque components at the hip, knee, and ankle joints from three-dimensional limb kinematics. To calculate joint torques, accurate estimates were needed of the limb's anthropometric parameters, which we determined using a model of the human body. Our analysis of limb intersegmental dynamics explicitly quantified the complex interplay of active and passive forces producing the simple, involuntary kicking movements commonly seen in 3-month-old infants. our results revealed that in nonvigorous kicks, hip joint reversal was the result of an extensor torque due to gravity, opposed by the combined flexor effect of the muscle torque and the total motion-dependent torque. The total motion-dependent torque increased as a hip flexor torque in more vigorous kicks; an extensor muscle torque was necessary to counteract the flexor influences of the total motion-dependent torque and, in the case of large ranges of motion, a flexor gravity torque as well. Thus, with changing passive torque influences due to motions of the linked segments, the muscle torques were adjusted to produce a net torque to reverse the kicking motion. As a consequence, despite considerable heterogeneity in the intensity, range of motion, coordination, and movement context of each kick, smooth trajectories resulted from the muscle torque, counteracting and complementing not only gravity but also the motion-dependent torques generated by movement of the linked segments.

Effects of High Velocity Elastic Band versus Heavy Resistance Training on Hamstring Strength, Activation, and Sprint Running Performance

PubMed Central

Janusevicius, Donatas; Snieckus, Audrius; Skurvydas, Albertas; Silinskas, Viktoras; Trinkunas, Eugenijus; Cadefau, Joan Aureli; Kamandulis, Sigitas

2017-01-01

Hamstring muscle injuries occur during high-speed activities, which suggests that muscular strength at high velocities may be more important than maximal strength. This study examined hamstring adaptations to training for maximal strength and for strength at high velocities. Physically active men (n = 25; age, 23.0 ± 3.2 years) were randomly divided into: (1) a resistance training (RT, n = 8) group, which performed high-load, low-velocity concentric–eccentric hamstring contractions; (2) a resistance training concentric (RTC; n = 9) group, which performed high-load, low-velocity concentric-only hamstring contractions; and (3) a high-velocity elastic band training (HVT, n = 8) group, which performed low-load, high-velocity concentric–eccentric hamstring contractions. Pre- and posttraining tests included hamstring strength on a hamstring-curl apparatus, concentric knee extension–flexion at 60°/s, 240°/s, and 450°/s, eccentric knee flexion at 60°/s and 240°/s, hamstring and quadriceps coactivation, knee flexion and extension frequency in the prone position, and 30-m sprint running speed from a stationary start and with a running start. Knee flexor torque increased significantly by 21.1% ± 8.1% in the RTC group and 16.2% ± 4.2% in the RT group (p < 0.05 for both groups). Hamstring coactivation decreased significantly in both groups. In the HVT group, knee flexion and extension frequency increased by 17.8% ± 8.2%, concentric peak torque of the knee flexors at 450°/s increased by 31.0% ± 12.0%, hamstring coactivation decreased, and running performance over 30 m improved (p < 0.05 for all parameters). These findings suggest that resistance training at high velocities is superior to traditional heavy resistance training for increasing knee flexor strength at high velocities, movement frequency, and sprint running performance. These findings also indicate that traditional training approaches are effective for increasing knee flexor strength and reducing knee extensor coactivation, but this outcome is limited to low and moderate speeds. Key points Resistance training performed at high load and low velocities increases knee flexor strength and decreases hamstring coactivation, whereas does not change strength at high velocity. Elastic band training at high velocities increases strength and decreases hamstring coactivation, particularly at high muscle velocities. Elastic band hamstring training at high velocities has positive effects on both knee flexors and knee extensors, and these benefits transfer positively to sprint performance. PMID:28630577

Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age.

PubMed

Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch; Ageberg, Eva; Englund, Martin

2017-10-01

To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles.

PubMed

Kulmala, Juha-Pekka; Korhonen, Marko T; Ruggiero, Luca; Kuitunen, Sami; Suominen, Harri; Heinonen, Ari; Mikkola, Aki; Avela, Janne

2016-11-01

The knee and ankle extensors as human primary antigravity muscle groups are of utmost importance in a wide range of locomotor activities. Yet, we know surprisingly little about how these muscle groups work, and specifically, how close to their maximal capacities they function across different modes and intensity of locomotion. Therefore, to advance our understanding of locomotor constraints, we determined and compared relative operating efforts of the knee and ankle extensors during walking, running, and sprinting. Using an inverse dynamics biomechanical analysis, the muscle forces of the knee and ankle extensors during walking (1.6 m·s), running (4.1 m·s), and sprinting (9.3 m·s) were quantified and then related to maximum forces of the same muscle groups obtained from a reference hopping test that permitted natural elastic limb behavior. During walking, the relative effort of the ankle extensors was almost two times greater compared with the knee extensors (35% ± 6% vs 19% ± 5%, P < 0.001). Changing walking to running decreased the difference in the relative effort between the extensor muscle groups, but still, the ankle extensors operated at a 25% greater level than the knee extensors (84% ± 12% vs 63% ± 17%, P < 0.05). At top speed sprinting, the ankle extensors reached their maximum operating level, whereas the knee extensors still worked well below their limits, showing a 25% lower relative effort compared with the ankle extensors (96% ± 11% vs 72% ± 19%, P < 0.01). Regardless of the mode of locomotion, humans operate at a much greater relative effort at the ankle than knee extensor muscles. As a consequence, the great demand on ankle extensors may be a key biomechanical factor limiting our locomotor ability and influencing the way we locomote and adapt to accommodate compromised neuromuscular system function.

Gender Differences in Isokinetic Strength after 60 and 90 d Bed Rest

NASA Technical Reports Server (NTRS)

English, K. L.; Ploutz-Snyder, R. J.; Cromwell, R. L.; Ploutz-Snyder, L. L.

2010-01-01

Recent reports suggest that changes in muscle strength following disuse may differ between males and females. PURPOSE: To examine potential gender differences in strength changes following 60 and 90 d of experimental bed rest. METHODS: Isokinetic extensor and flexor strength of the knee (60deg and 180deg/s, concentric only), ankle (30deg/s, concentric and eccentric), and trunk (60deg/s, concentric only) were measured following 60 d (males: n=4, 34.5+/-9.6 y; females: n=4, 35.5+/-8.2 y) and 90 d (males: n=10, 31.4+/-4.8 y; females: n=5, 37.6+/-9.9 y) of 6-degree head-down-tilt bed rest (BR; N=23). Subjects were fed a controlled diet (55%/15%/ 30%, CHO/PRO/FAT) that maintained body weight within 3% of the weight recorded on Day 3 of bed rest. After a familiarization session, testing was conducted 6 d before BR and 2 d after BR completion. Peak torque and total work were calculated for the tests performed. To allow us to combine data from both 60- and 90-d subjects, we used a mixed-model statistical analysis in which time and gender were fixed effects and bed rest duration was a random effect. Log-transformations of strength measures were utilized when necessary in order to meet statistical assumptions. RESULTS: Main effects were seen for both time and gender (p<0.05), showing decreased strength in response to bed rest for both males and females, and males stronger than females for most strength measures. Only one interaction effect was observed: females exhibited a greater loss of trunk extensor peak torque at 60 d versus pre-BR, relative to males (p=0.004). CONCLUSION: Sixty and 90 d of BR induced significant losses in isokinetic muscle strength of the locomotor and postural muscles of the knee, ankle, and trunk. Although males were stronger than females for most of the strength measures that we examined, only changes in trunk extensor peak torque were greater for females than males at day 60 of bed rest

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis.

PubMed

Pua, Yong-Hao; Liang, Zhiqi; Ong, Peck-Hoon; Bryant, Adam L; Lo, Ngai-Nung; Clark, Ross A

2011-12-01

Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study. Copyright © 2011 by the American College of Rheumatology.

Lower extremity joint kinetics and energetics during backward running.

PubMed

DeVita, P; Stribling, J

1991-05-01

The purpose of this study was to measure lower extremity joint moments of force and joint muscle powers used to perform backward running. Ten trials of high speed (100 Hz) sagittal plane film records and ground reaction force data (1000 Hz) describing backward running were obtained from each of five male runners. Fifteen trials of forward running data were obtained from one of these subjects. Inverse dynamics were performed on these data to obtain the joint moments and powers, which were normalized to body mass to make between-subject comparisons. Backward running hip moment and power patterns were similar in magnitude and opposite in direction to forward running curves and produced more positive work in stance. Functional roles of knee and ankle muscles were interchanged between backward and forward running. Knee extensors were the primary source of propulsion in backward running owing to greater moment and power output (peak moment = 3.60 N.m.kg-1; peak power = 12.40 W.kg-1) compared with the ankle (peak moment = 1.92 N.m.kg-1; peak power = 7.05 W.kg-1). The ankle plantarflexors were the primary shock absorbers, producing the greatest negative power (peak = -6.77 W.kg-1) during early stance. Forward running had greater ankle moment and power output for propulsion and greater knee negative power for impact attenuation. The large knee moment in backward running supported previous findings indicating that backward running training leads to increased knee extensor torque capabilities.

Plyometric Long Jump Training With Progressive Loading Improves Kinetic and Kinematic Swimming Start Parameters.

PubMed

Rebutini, Vanessa Z; Pereira, Gleber; Bohrer, Roberta C D; Ugrinowitsch, Carlos; Rodacki, André L F

2016-09-01

Rebutini, VZ, Pereira, G, Bohrer, RCD, Ugrinowitsch, C, and Rodacki, ALF. Plyometric long jump training with progressive loading improves kinetic and kinematic swimming start parameters. J Strength Cond Res 30(9): 2392-2398, 2016-This study was aimed to determine the effects of a plyometric long jump training program on torque around the lower limb joints and kinetic and kinematics parameters during the swimming jump start. Ten swimmers performed 3 identical assessment sessions, measuring hip and knee muscle extensors during maximal voluntary isometric contraction and kinetic and kinematics parameters during the swimming jump start, at 3 instants: INI (2 weeks before the training program, control period), PRE (2 weeks after INI measurements), and POST (24-48 hours after 9 weeks of training). There were no significant changes from INI to PRE measurements. However, the peak torque and rate of torque development increased significantly from PRE to POST measurements for both hip (47 and 108%) and knee (24 and 41%) joints. There were significant improvements to the horizontal force (7%), impulse (9%), and angle of resultant force (19%). In addition, there were significant improvements to the center of mass displacement (5%), horizontal takeoff velocity (16%), horizontal velocity at water entrance (22%), and peak angle velocity for the knee (15%) and hip joints (16%). Therefore, the plyometric long jump training protocol was effective to enhance torque around the lower limb joints and to control the resultant vector direction, to increase the swimming jump start performance. These findings suggest that coaches should use long jump training instead of vertical jump training to improve swimming start performance.

Executive function moderates the role of muscular fitness in determining functional mobility in older adults.

PubMed

Forte, Roberta; Pesce, Caterina; Leite, Joao Costa; De Vito, Giuseppe; Gibney, Eileen R; Tomporowski, Phillip D; Boreham, Colin A G

2013-06-01

Both physical and cognitive factors are known to independently predict functional mobility in older people. However, the combined predictive value of both physical fitness and cognitive factors on functional mobility has been less investigated. The aim of the present study was to assess if cognitive executive functions moderate the role of physical fitness in determining functional mobility of older individuals. Fifty-seven 65- to 75-year-old healthy participants performed tests of functional mobility (habitual and maximal walking speed, maximal walking speed while picking up objects/stepping over obstacles), physical fitness (peak power, knee extensors torque, back/lower limb flexibility, aerobic fitness), and executive function (inhibition and cognitive flexibility). Maximal walking speeds were predicted by physical fitness parameters and their interaction with cognitive factors. Knee extensor torque emerged as the main predictor of all tested locomotor performances at maximal speed. The effect of peak power and back/lower limb flexibility was moderated by executive functions. In particular, inhibition and cognitive flexibility differed in the way in which they moderate the role of fitness. High levels of cognitive flexibility seem necessary to take advantage of leg power for walking at maximal speed. In contrast, high levels of inhibitory capacity seem to compensate for low levels of back/lower limb flexibility when picking up movements are added to a locomotor task. These findings may have important practical implications for the design and implementation of multi-component training programs aimed at optimizing functional abilities in older adults.

Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction.

PubMed

Brunetti, O; Filippi, G M; Lorenzini, M; Liti, A; Panichi, R; Roscini, M; Pettorossi, V E; Cerulli, G

2006-11-01

Surgical reconstruction of the anterior cruciate ligament (ACL) may reduce, but it does not always eliminate, knee and body instability because of a persisting proprioceptive deficit. In order to enhance body stability, a new protocol of treatment has been proposed consisting of mechanical vibration (100 Hz frequency and < 20 microm amplitude) of the quadriceps muscle in the leg that has undergone ACL reconstruction. In our trials, stimulation was performed when the quadriceps muscle was kept isometrically contracted. Treatment was started one month after surgery. Vibration was applied for short periods over three consecutive days. Nine months after treatment, postural stability was re-evaluated with the subjects standing on one leg with open and with closed eyes. The postural stability of the subjects having undergone vibration treatment, standing on the operated leg was significantly improved one day after treatment when evaluated as mean of speed and elliptic area of the center of pressure. The improvement persisted and increased during the following weeks. Peak torques of the operated leg extensor muscles also increased and reached values close to that of the leg, which had not been operated. Conversely, the balance of the untreated subjects standing on the operated leg did not improve and the restoration of the extensor muscle peak torque was poor. It is concluded that short lasting proprioceptive activation by vibration may lead to a faster and more complete equilibrium recovery probably by permanently changing the network controlling knee posture.

Neuromuscular fatigue following constant versus variable-intensity endurance cycling in triathletes.

PubMed

Lepers, R; Theurel, J; Hausswirth, C; Bernard, T

2008-07-01

The aim of this study was to determine whether or not variable power cycling produced greater neuromuscular fatigue of knee extensor muscles than constant power cycling at the same mean power output. Eight male triathletes (age: 33+/-5 years, mass: 74+/-4 kg, VO2max: 62+/-5 mL kg(-1) min(-1), maximal aerobic power: 392+/-17 W) performed two 30 min trials on a cycle ergometer in a random order. Cycling exercise was performed either at a constant power output (CP) corresponding to 75% of the maximal aerobic power (MAP) or a variable power output (VP) with alternating +/-15%, +/-5%, and +/-10% of 75% MAP approximately every 5 min. Maximal voluntary contraction (MVC) torque, maximal voluntary activation level and excitation-contraction coupling process of knee extensor muscles were evaluated before and immediately after the exercise using the technique of electrically evoked contractions (single and paired stimulations). Oxygen uptake, ventilation and heart rate were also measured at regular intervals during the exercise. Averaged metabolic variables were not significantly different between the two conditions. Similarly, reductions in MVC torque (approximately -11%, P<0.05) after cycling were not different (P>0.05) between CP and VP trials. The magnitude of central and peripheral fatigue was also similar at the end of the two cycling exercises. It is concluded that, following 30 min of endurance cycling, semi-elite triathletes experienced no additional neuromuscular fatigue by varying power (from +/-5% to 15%) compared with a protocol that involved a constant power.

Measuring postural control during mini-squat posture in men with early knee osteoarthritis.

PubMed

Petrella, M; Gramani-Say, K; Serrão, P R M S; Lessi, G C; Barela, J A; Carvalho, R P; Mattiello, S M

2017-04-01

Studies have suggested a compromised postural control in individuals with knee osteoarthritis (OA) evidenced by larger and faster displacement of center of pressure (COP). However, quantification of postural control in the mini-squat posture performed by patients with early knee OA and its relation to muscle strength and self-reported symptoms have not been investigated. The main aim of this cross-sectional, observational, controlled study was to determine whether postural control in the mini-squat posture differs between individuals with early knee OA and a control group (CG) and verify the relation among knee extensor torque (KET) and self-reported physical function, stiffness and pain. Twenty four individuals with knee OA grades I and II (OAG) (mean age: 52.35±5.00) and twenty subjects without knee injuries (CG) (mean age: 51.40±8.07) participated in this study. Participants were assessed in postural control through a force plate (Bertec Mod. USA), which provided information about the anterior-posterior (AP) and medial-lateral (ML) COP displacement during the mini-squat, in isometric, concentric and eccentric knee extensor torque (KET) (90°/s) through an isokinetic dynamometer (BiodexMulti-Joint System3, Biodex Medical Incorporation, New York, NY, USA), and in self-reported symptoms through the WOMAC questionnaire. The main outcomes measured were the AP and ML COP amplitude and velocity of displacement; isometric, concentric, and eccentric KET and self-reported physical function, stiffness and pain. No significant differences were found between groups for postural control (p>0.05). Significant lower eccentric KET (p=0.01) and higher scores for the WOMAC subscales of pain (p=<0.001), stiffness (p=0.001) and physical function (p<0.001) were found for the OAG. Moderate and negative correlations were found between the AP COP amplitude of displacement and physical function (ρ=-0.40, p=0.02). Moderate and negative correlations were observed between the AP COP velocity of displacement and physical function (ρ=0.47, p=0.01) and stiffness (ρ=-0.45, p=0.02). The findings of the present study emphasize the importance of rehabilitation from the early degrees of knee OA to prevent postural instability and the need to include quadriceps muscle strengthening, especially by eccentric contractions. The relationship between the self-reported symptoms and a lower and slower COP displacement suggest that the postural control strategy during tasks with a semi-flexed knee should be further investigated. Copyright © 2017 Elsevier B.V. All rights reserved.

Muscle torque of healthy individuals and individuals with spastic hemiparesis after passive static streching.

PubMed

Tatsukawa DE Freitas, Sérgio Takeshi; DE Carvalho Abreu, Elizângela Márcia; Dos Reis, Mariane Cecilia; DE Souza Cunha, Bruna; Souza Moreira Prianti, Tamires; Pupio Silva Lima, Fernanda; Oliveira Lima, Mário

2016-01-01

Spasticity is one of the main causes of contracture, muscle weakness and subsequent functional incapacity. The passive static stretching can be included as having the purpose of increasing musculoskeletal flexibility, however, it also can influence the muscle torque. The objective is to verify the immediate effect of passive static stretching in the muscle strength of healthy and those who present spastic hemiparesis. There were assessed 20 subjects, 10 spastic hemiparetic (EG) and 10 healthy individuals (CG), including both sexes, aged between 22 and 78 years. The torque of extensor muscles of the knee was analyzed using isokinetic dynamometer. Results have shown that EG has less muscle torque compared to CG ( p < 0.01). In addition, EG presented a decrease in significance of muscle torque after stretching ( p < 0.05), however, it has not shown significant alteration in muscle torque of CG after performing the program that was prescribed. Immediately after the passive stretch, a significant torque decrease can be seen in hypertonic muscle; it is believed that this reduction may be associated with the physiological overlap between actin and myosin filaments and so preventing the muscle to develop a maximum contraction.

Physiological Interpretation of the Slope during an Isokinetic Fatigue Test.

PubMed

Bosquet, L; Gouadec, K; Berryman, N; Duclos, C; Gremeaux, V; Croisier, J-L

2015-07-01

To assess the relationship between selected measures (the slope and average performance) obtained during a high intensity isokinetic fatigue test of the knee (FAT) and relevant measures of anaerobic and aerobic capacities. 20 well-trained cyclists performed 3 randomly ordered sessions involving a FAT consisting in 30 reciprocal maximal concentric contractions of knee flexors and extensors at 180°.s(-1), a maximal continuous graded exercise test (GXT), and a Wingate anaerobic test (WAnT). The slope calculated from peak torque (PT) and total work (TW) of knee extensors was highly associated to maximal PT (r=-0.86) and maximal TW (r=-0.87) measured during FAT, and moderately associated to peak power output measured during the WAnT (r=-0.64 to -0.71). Average PT and average TW were highly associated to maximal PT (r=0.93) and maximal TW (r=0.96), to mean power output measured during WAnT (r=0.83-0.90) and moderately associated to maximal oxygen uptake (0.58-0.67). In conclusion, the slope is mainly determined by maximal anaerobic power, while average performance is a composite measure depending on both aerobic and anaerobic energy systems according to proportions that are determined by the duration of the test. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of 7-days dry immersion in combination with mechanical stimulation of foot support zones upon resistance to fatigue of knee extensors and flexors

NASA Astrophysics Data System (ADS)

Netreba, A. I.; Khusnutdiniva, D. R.; Vinogradova, O. L.; Kozlovskaya, I. B.

2005-08-01

The aim of investigation was to reveal the effect of supportlessness in combination with artificial stimulation of foot support zones on fatigue resistance of knee extensors and flexors in static and rhythmic tests. 10 volunteers were exposed to 7 days dry immersion (DI). 4 of them were subjected to mechanical stimulation of foot support zones. 7-day DI did not evoke any changes in fatigue resistance during rhythmic contractions of knee extensors and flexors in both groups. Static test revealed significant decrease of fatigue resistance of both knee flexors and extensors. In the group with stimulation of support zones unfavorable effects of immersion were minimized for knee extensors but not for flexors. Thus support withdrawal is associated with a decrease of fatigue resistance for both knee flexors and extensors only under conditions of static tension. Artificial stimulation of support zones of the foot selectively affects the posture muscles.

Correlation of the Y-Balance Test with Lower-limb Strength of Adult Women

PubMed Central

Lee, Dong-Kyu; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

2014-01-01

[Purpose] The purpose of this study was to elucidate the relationship between Y-balance test (YBT) distance and the lower-limb strength of adult women. [Subjects] Forty women aged 45 to 80 years volunteered for this study. [Methods] The participants were tested for maximal muscle strength of the lower limbs (hip extensors, hip flexors, hip abductors, knee extensors, knee flexors, and ankle dorsiflexors) and YBT distances in the anterior, posteromedial, and posterolateral directions. Pearson’s correlation coefficient was used to quantify the linear relationships between YBT distances and lower-limb strength. [Results] Hip extensor and knee flexor strength were positively correlated with YBT anterior distance. Hip extensor, hip abductor, and knee flexor strength were positively correlated with the YBT posteromedial distance. Hip extensor and knee flexor strength were positively correlated with YBT posterolateral distance. [Conclusion] There was a weak correlation between lower-limb strength (hip extensors, hip abductors, and knee flexors) and dynamic postural control as measured by the YBT. PMID:24926122

Neuromuscular adaptations induced by adjacent joint training.

PubMed

Ema, R; Saito, I; Akagi, R

2018-03-01

Effects of resistance training are well known to be specific to tasks that are involved during training. However, it remains unclear whether neuromuscular adaptations are induced after adjacent joint training. This study examined the effects of hip flexion training on maximal and explosive knee extension strength and neuromuscular performance of the rectus femoris (RF, hip flexor, and knee extensor) compared with the effects of knee extension training. Thirty-seven untrained young men were randomly assigned to hip flexion training, knee extension training, or a control group. Participants in the training groups completed 4 weeks of isometric hip flexion or knee extension training. Standardized differences in the mean change between the training groups and control group were interpreted as an effect size, and the substantial effect was assumed to be ≥0.20 of the between-participant standard deviation at baseline. Both types of training resulted in substantial increases in maximal (hip flexion training group: 6.2% ± 10.1%, effect size = 0.25; knee extension training group: 20.8% ± 9.9%, effect size = 1.11) and explosive isometric knee extension torques and muscle thickness of the RF in the proximal and distal regions. Improvements in strength were accompanied by substantial enhancements in voluntary activation, which was determined using the twitch interpolation technique and RF activation. Differences in training effects on explosive torques and neural variables between the two training groups were trivial. Our findings indicate that hip flexion training results in substantial neuromuscular adaptations during knee extensions similar to those induced by knee extension training. © 2017 The Authors. Scandinavian Journal of Medicine & Science In Sports Published by John Wiley & Sons Ltd.

Kinematic and kinetic analysis of the fouetté turn in classical ballet.

PubMed

Imura, Akiko; Iino, Yoichi; Kojima, Takeji

2010-11-01

The fouetté turn in classical ballet dancing is a continuous turn with the whipping of the gesture leg and the arms and the bending and stretching of the supporting leg. The knowledge of the movement intensities of both legs for the turn would be favorable for the conditioning of the dancer's body. The purpose of this study was to estimate the intensities. The hypothesis of this study was that the intensities were higher in the supporting leg than in the gesture leg. The joint torques of both legs were determined in the turns performed by seven experienced female classical ballet dancers with inverse dynamics using three high-speed cine cameras and a force platform. The hip abductor torque, knee extensor and plantar flexor torques of the supporting leg were estimated to be exerted up to their maximum levels and the peaks of the torques were larger than the peaks of their matching torques of the gesture leg. Thus, the hypothesis was partly supported. Training of the supporting leg rather than the gesture leg would help ballet dancers perform many revolutions of the fouetté turn continuously.

Relationship between leg extensor muscle strength and knee joint loading during gait before and after total knee arthroplasty.

PubMed

Vahtrik, Doris; Gapeyeva, Helena; Ereline, Jaan; Pääsuke, Mati

2014-01-01

The aim of the present study was to evaluate an isometric maximal voluntary contraction (MVC) force of the leg extensor muscles and its relationship with knee joint loading during gait prior and after total knee arthroplasty (TKA). Custom-made dynamometer was used to assess an isometric MVC force of the leg extensor muscles and 3-D motion analysis system was used to evaluate the knee joint loading during gait in 13 female patients (aged 49-68 years) with knee osteoarthritis. Patients were evaluated one day before, and three and six months following TKA in the operated and non-operated leg. Six months after TKA, MVC force of the leg extensor muscles for the operated leg did not differ significantly as compared to the preoperative level, whereas it remained significantly lower for the non-operated leg and controls. The knee flexion moment and the knee joint power during mid stance of gait was improved six months after TKA, remaining significantly lowered compared with controls. Negative moderate correlation between leg extensor muscles strength and knee joint loading for the operated leg during mid stance was noted three months after TKA. The correlation analysis indicates that due to weak leg extensor muscles, an excessive load is applied to knee joint during mid stance of gait in patients, whereas in healthy subjects stronger knee-surrounding muscles provide stronger knee joint loading during gait. III (correlational study). Copyright © 2013 Elsevier B.V. All rights reserved.

Electromechanical response times in the knee muscles in young and old women.

PubMed

Szpala, Agnieszka; Rutkowska-Kucharska, Alicja

2017-12-01

The aim of the study was to compare electromechanical response times [total reaction time (TRT), pre-motor time (PMT), and electromechanical delay] in the knee muscles in groups of young and older women during release of peak torque (PT). Fifty women (1 group approximately 20 years of age and the other approximately 60 years of age) participated in the study. PT and electromyographic activity were measured for flexors and extensors of the right and left knee in static conditions in response to a visual stimulus. Significantly longer TRTs (P = 0.05) and PMTs (P = 0.05) were found in the group of older women compared with the younger participants. Asymmetry was found between the older and the younger group of women in PT of knee flexors. Significantly longer TRT and PMT phases in the group of older women suggests a longer time for information processing in the central nervous system in older people. Muscle Nerve 56: E147-E153, 2017. © 2017 Wiley Periodicals, Inc.

Effect of cooling during inter-exercise periods on subsequent intramuscular water movement and muscle performance.

PubMed

Yanagisawa, O; Otsuka, S; Fukubayashi, T

2014-02-01

To evaluate the effects of cooling between exercise sessions on intramuscular water movement and muscle performance, the lower extremities of nine untrained men were assigned to either a cooling protocol (20-min water immersion, 15 °C) or a noncooling protocol. Each subject performed two exercise sessions involving maximal concentric knee extension and flexion (three repetitions, 60°/s; followed by 50 repetitions, 180°/s). The peak torque at 60°/s and total work, mean power, and decrease rate of torque value at 180°/s were evaluated. Axial magnetic resonance diffusion-weighted images of the mid-thigh were obtained before and after each exercise session. Apparent diffusion coefficient (ADC) values for the quadriceps and hamstrings were calculated for evaluating intramuscular water movement. Both groups exhibited significantly increased ADC values for the quadriceps and hamstrings after each exercise session. These ADC values returned to the pre-exercise level after water immersion. No significant difference was observed in muscle performance from first exercise session to the next in either group, except for increased total work and mean power in knee flexion in the cooled group. Cooling intervention between exercise sessions decreased exercise-induced elevation of intramuscular water movement and had some beneficial effects on muscle endurance of knee flexors, but not knee extensors. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An isokinetic training program for reducing falls in a community-dwelling older adult: a case report.

PubMed

Beebe, Justin A; Hines, Roger W; McDaniel, Laura T; Shelden, Brenda L

2013-01-01

With the population older than 65 years, projected to double by the year 2030, falls in older adults are a substantial health concern. Muscle strength deficits are one of the multifactorial components linked to increased fall risk, and decreasing these deficits has been one of the goals of interventions designed to decrease fall risk. These interventions have traditionally focused on improving peak torque; however, recent research suggests that exercise protocols that focus on the rate of torque development (RTD) may be more effective in decreasing fall risk. This case report examines clinical outcomes following implementation of an isokinetic strengthening protocol coupled with a balance program designed to reduce fall risk in a community-dwelling older adult. The individual was a 70-year-old woman with a history of 3 falls over the past 8 months and no related medical etiology who had self-limited her activities because of fear of another fall. She was classified as having substantial risk for future falls because of fall history, increased fear of falling, and below age norms on the Berg Balance Scale (BBS), and the Timed Up and Go (TUG). The treatment program consisted of 12 weeks of high-intensity isokinetic knee extensor training, high challenge dynamic gait and balance activities, and core strengthening. The isokinetic protocol consisted of 4 sets of 10 concentric-only repetitions at speeds of 240°/sec and 300°/sec for a total of 8 work sets. Dynamic gait activities incorporating directional and obstacle drills, and rocker and balance boards were used for balance training activities. Progressive theraband exercises were used for core strengthening. As her home program, the participant was encouraged to return to line dancing twice per week. During the 12-week protocol, the participant completed two 90-minute therapy sessions and two 90-minute dance classes per week. After the 12 weeks of treatment, knee extensor peak torque at 150 ms improved on the right from 67.8 N to 107.1 N (57.9% increase), and on the left from 65.1 N to 97.6 N (49.9% increase). The BBS score improved from 45 to 52; and the TUG improved from 14.0 to 8.6 seconds. Both final scores exceeded fall risk cutoffs (BBS = 48; TUG = 13.5 seconds) and the change score exceeded minimal detectable change (BBS = 7; TUG 5.4 seconds). The treatment program produced improvements in knee extensor peak torque and RTD, but more importantly, the final scores on the clinical outcome measures placed the participant above established fall-risk cutoff scores. Although future research with increased numbers of participants and a control group should be conducted to confirm this study's results, these findings support the use of isokinetic training to reduce fall risk in older adults.

Knee Extensor Strength and Risk of Structural, Symptomatic, and Functional Decline in Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

PubMed

Culvenor, Adam G; Ruhdorfer, Anja; Juhl, Carsten; Eckstein, Felix; Øiestad, Britt Elin

2017-05-01

To perform a systematic review and meta-analysis on the association between knee extensor strength and the risk of structural, symptomatic, or functional deterioration in individuals with or at risk of knee osteoarthritis (KOA). We systematically identified and methodologically appraised all longitudinal studies (≥1-year followup) reporting an association between knee extensor strength and structural (tibiofemoral, patellofemoral), symptomatic (self-reported, knee replacement), or functional (subjective, objective) decline in individuals with or at risk of radiographic or symptomatic KOA. Results were pooled for each of the above associations using meta-analysis, or if necessary, summarized according to a best-evidence synthesis. Fifteen studies were included, evaluating >8,000 participants (51% female), with a followup time between 1.5 and 8 years. Meta-analysis revealed that lower knee extensor strength was associated with an increased risk of symptomatic (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain: odds ratio [OR] 1.35, 95% confidence interval [95% CI] 1.10-1.67) and functional decline (WOMAC function: OR 1.38, 95% CI 1.00-1.89, and chair-stand task: OR 1.03, 95% CI 1.03-1.04), but not increased risk of radiographic tibiofemoral joint space narrowing (JSN) (OR 1.15, 95% CI 0.84-1.56). No trend in risk was observed for KOA status (present versus absent). Best-evidence synthesis showed inconclusive evidence for lower knee extensor strength being associated with increased risk of patellofemoral deterioration. Meta-analysis showed that lower knee extensor strength is associated with an increased risk of symptomatic and functional deterioration, but not tibiofemoral JSN. The risk of patellofemoral deterioration in the presence of knee extensor strength deficits is inconclusive. © 2016, American College of Rheumatology.

Salvage of the lower limb after a full thickness burn with loss of the knee extensor mechanism: a case report.

PubMed

Sarraf, Khaled M; Atherton, Duncan D; Jayaweera, Asantha R; Gibbons, Charles E; Jones, Isabel

2013-04-01

We report on a 79-year-old woman who underwent salvage of the knee and lower leg using a Whichita Fusion Nail for knee arthrodesis, combined with a medial gastrocnemius muscle flap for a 3% contact burn that resulted in loss of the extensor mechanism. This provided an alternative to above-knee amputation when extensor mechanism reconstruction was not feasible.

Muscle fascicle behavior during eccentric cycling and its relation to muscle soreness.

PubMed

Peñailillo, Luis; Blazevich, Anthony J; Nosaka, Kazunori

2015-04-01

A single bout of eccentric exercise confers a protective effect against muscle damage and soreness in subsequent eccentric exercise bouts, but the mechanisms underpinning this effect are unclear. This study compared vastus lateralis (VL) muscle-tendon behavior between two eccentric cycling bouts to test the hypothesis that muscle-tendon behavior would be different between bouts and would be associated with the protective effect. Eleven untrained men (27.1 ± 7.0 yr) performed two bouts of eccentric cycling (ECC1 and ECC2) separated by 2 wk for 10 min at 65% of maximal concentric workload (191.9 ± 44.2 W) each. Muscle soreness (by visual analog scale) and maximal voluntary isometric contraction (MVC) torque of the knee extensors were assessed before and 1-2 d after exercise. Using ultrasonography, VL fascicle length and angle changes during cycling were assessed, and tendinous tissue (TT) length changes were estimated. VL EMG amplitude, crank torque, and knee joint angles were measured during cycling. Soreness was greater (P < 0.0001) after ECC1 than ECC2, although MVC changes were not different between bouts (P = 0.47). No significant differences in peak EMG amplitude (normalized to EMG during MVC), crank peak torque, or knee angles were evident between bouts. However, fascicle elongation was 16% less during ECC2 than ECC1 (P < 0.01), indicating less fascicle strain in ECC2. Maximum TT length occurred at a smaller knee joint angle during ECC2 than ECC1 (P = 0.055). These results suggest that a lesser fascicle elongation and earlier TT elongation were associated with reduced muscle soreness after ECC2 than ECC1; thus, changes in muscle-tendon behavior may be an important mechanism underpinning the protective effect.

Surface EMG characteristics of people with multiple sclerosis during static contractions of the knee extensors.

PubMed

Scott, Sasha M; Hughes, Adrienne R; Galloway, Stuart D R; Hunter, Angus M

2011-01-01

This study was designed to determine whether any alterations existed in surface electromyography (sEMG) in people with multiple sclerosis (MS) during isometric contractions of the knee extensors. Fifteen people with MS and 14 matched controls (mean ± SD age and body mass index 53·7 ± 10·5 versus 54·6 ± 9·6 years and 27·7 ± 6·1 versus 26·5 ± 4, respectively) completed 20%, 40%, 60% and 80% of their maximal voluntary contraction (MVC) of the knee extensors. sEMG was recorded from the vastus lateralis where muscle fibre conduction velocity (MFCV) and sEMG amplitude (RMS) were assessed. Body composition was determined using dual-energy X-ray absorptiometry and physical activity with the use of accelerometry. People with MS showed significantly (P<0·05) faster MFCV during MVC (6·6 ± 2·7 versus 4·7 ± 1·4 m s(-1) ) and all submaximal contractions, while RMS was significantly (P<0·05) less (0·11 ± 0·03 versus 0·24 ± 0·06 mV) in comparison with the controls. MVC along with specific thigh lean mass to torque, rate of force development and mean physical activity were significantly (P<0·01) less in PwMS. People with MS have elevated MFCV alongside reduced RMS during isometric contraction. This elevation in MFCV should be accounted for when interpreting sEMG from people with MS. © 2010 University of Stirling. Clinical physiology and Functional Imaging © 2010 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Coordinated, multi-joint, fatigue-resistant feline stance produced with intrafascicular hind limb nerve stimulation.

PubMed

Normann, R A; Dowden, B R; Frankel, M A; Wilder, A M; Hiatt, S D; Ledbetter, N M; Warren, D A; Clark, G A

2012-04-01

The production of graceful skeletal movements requires coordinated activation of multiple muscles that produce torques around multiple joints. The work described herein is focused on one such movement, stance, that requires coordinated activation of extensor muscles acting around the hip, knee and ankle joints. The forces evoked in these muscles by external stimulation all have a complex dependence on muscle length and shortening velocities, and some of these muscles are biarticular. In order to recreate sit-to-stand maneuvers in the anesthetized feline, we excited the hind limb musculature using intrafascicular multielectrode stimulation (IFMS) of the muscular branch of the sciatic nerve, the femoral nerve and the main branch of the sciatic nerve. Stimulation was achieved with either acutely or chronically implanted Utah Slanted Electrode Arrays (USEAs) via subsets of electrodes (1) that activated motor units in the extensor muscles of the hip, knee and ankle joints, (2) that were able to evoke large extension forces and (3) that manifested minimal coactivation of the targeted motor units. Three hind limb force-generation strategies were investigated, including sequential activation of independent motor units to increase force, and interleaved or simultaneous IFMS of three sets of six or more USEA electrodes that excited the hip, knee and ankle extensors. All force-generation strategies evoked stance, but the interleaved IFMS strategy also reduced muscle fatigue produced by repeated sit-to-stand maneuvers compared with fatigue produced by simultaneous activation of different motor neuron pools. These results demonstrate the use of interleaved IFMS as a means to recreate coordinated, fatigue-resistant multi-joint muscle forces in the unilateral hind limb. This muscle activation paradigm could provide a promising neuroprosthetic approach for the restoration of sit-to-stand transitions in individuals who are paralyzed by spinal cord injury, stroke or disease.

Coordinated, multi-joint, fatigue-resistant feline stance produced with intrafascicular hind limb nerve stimulation

NASA Astrophysics Data System (ADS)

Normann, R. A.; Dowden, B. R.; Frankel, M. A.; Wilder, A. M.; Hiatt, S. D.; Ledbetter, N. M.; Warren, D. A.; Clark, G. A.

2012-04-01

The production of graceful skeletal movements requires coordinated activation of multiple muscles that produce torques around multiple joints. The work described herein is focused on one such movement, stance, that requires coordinated activation of extensor muscles acting around the hip, knee and ankle joints. The forces evoked in these muscles by external stimulation all have a complex dependence on muscle length and shortening velocities, and some of these muscles are biarticular. In order to recreate sit-to-stand maneuvers in the anesthetized feline, we excited the hind limb musculature using intrafascicular multielectrode stimulation (IFMS) of the muscular branch of the sciatic nerve, the femoral nerve and the main branch of the sciatic nerve. Stimulation was achieved with either acutely or chronically implanted Utah Slanted Electrode Arrays (USEAs) via subsets of electrodes (1) that activated motor units in the extensor muscles of the hip, knee and ankle joints, (2) that were able to evoke large extension forces and (3) that manifested minimal coactivation of the targeted motor units. Three hind limb force-generation strategies were investigated, including sequential activation of independent motor units to increase force, and interleaved or simultaneous IFMS of three sets of six or more USEA electrodes that excited the hip, knee and ankle extensors. All force-generation strategies evoked stance, but the interleaved IFMS strategy also reduced muscle fatigue produced by repeated sit-to-stand maneuvers compared with fatigue produced by simultaneous activation of different motor neuron pools. These results demonstrate the use of interleaved IFMS as a means to recreate coordinated, fatigue-resistant multi-joint muscle forces in the unilateral hind limb. This muscle activation paradigm could provide a promising neuroprosthetic approach for the restoration of sit-to-stand transitions in individuals who are paralyzed by spinal cord injury, stroke or disease.

Muscle atrophy, voluntary activation disturbances, and low serum concentrations of IGF-1 and IGFBP-3 are associated with weakness in people with chronic stroke.

PubMed

Silva-Couto, Marcela de Abreu; Prado-Medeiros, Christiane Lanatovitz; Oliveira, Ana Beatriz; Alcântara, Carolina Carmona; Guimarães, Araci Teixeira; Salvini, Tania de Fatima; Mattioli, Rosana; de Russo, Thiago Luiz

2014-07-01

The muscle weakness that is exhibited poststroke is due to a multifactorial etiology involving the central nervous system and skeletal muscle changes. Insulinlike growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) have been described as biomarkers of neuromuscular performance in many conditions. However, no information about these biomarkers is available for people with chronic hemiparesis. The purpose of this study was to investigate possible factors involved in muscle weakness, such as IGF-1 and IGFBP-3 serum concentrations, muscle volume, and neuromuscular performance of the knee flexors and extensors, in people with chronic hemiparesis poststroke. This was a cross-sectional study. A cross-sectional study was performed on 14 individuals poststroke who were paired with healthy controls. Mobility, function, balance, and quality of life were recorded as outcome measures. Knee flexor and extensor muscle volumes and neuromuscular performance were measured using nuclear magnetic resonance imaging, dynamometry, and electromyography. The serum concentrations of IGF-1 and IGFBP-3 were quantified by enzyme-linked immunosorbent assay (ELISA). The hemiparetic group had low serum concentrations of IGF-1 (25%) and IGFBP-3 (40%); reduced muscle volume in the vastus medialis (32%), vastus intermedius (29%), biceps femoris (16%), and semitendinosus and semimembranosus (12%) muscles; reduced peak torque, power, and work of the knee flexors and extensors; and altered agonist and antagonist muscle activation compared with controls. Low serum concentrations of IGF-1 and IGFBP-3, deficits in neuromuscular performance, selective muscle atrophy, and decreased agonist muscle activation were found in the group with chronic hemiparesis poststroke. Both hemorrhagic and ischemic stroke were considered, and the data reflect a chronic poststroke population with good function. © 2014 American Physical Therapy Association.

What triggers the continuous muscle activity during upright standing?

PubMed

Masani, Kei; Sayenko, Dimitry G; Vette, Albert H

2013-01-01

The ankle extensors play a dominant role in controlling the equilibrium during bipedal quiet standing. Their primary role is to resist the gravity toppling torque that pulls the body forward. The purpose of this study was to investigate whether the continuous muscle activity of the anti-gravity muscles during standing is triggered by the joint torque requirement for opposing the gravity toppling torque, rather than by the vertical load on the lower limbs. Healthy adults subjects stood on a force plate. The ankle torque, ankle angle, and electromyograms from the right lower leg muscles were measured. A ground-fixed support device was used to support the subject at his/her knees, without changing the posture from the free standing one. During the supported condition, which eliminates the ankle torque requirement while maintaining both the vertical load on the lower limbs and the natural upright standing posture, the plantarflexor activity was attenuated to the resting level. Also, this attenuated plantarflexor activity was found only in one side when the ipsilateral leg was supported. Our results suggest that the vertical load on the lower limb is not determinant for inducing the continuous muscle activity in the anti-gravity muscles, but that it depends on the required joint torque to oppose the gravity toppling torque. Copyright © 2012 Elsevier B.V. All rights reserved.

Torque-angle-velocity Relationships and Muscle Performance of Professional and Youth Soccer Players.

PubMed

Mazuquin, B F; Dela Bela, L F; Pelegrinelli, A R M; Dias, J M; Carregaro, R L; Moura, F A; Selfe, J; Richards, J; Brown, L E; Cardoso, J R

2016-11-01

Soccer matches consist of a variety of different activities, including repeated sprints. Time to attain velocity (TTAV), load range (LR) and the torque-angle-velocity relationship (TAV 3D ) represent an important measurement of muscle performance, however there are few related studies. The aim of this study was to compare these outcomes between soccer players of different age category. 17 professional (PRO) and 17 under-17 (U17) soccer players were assessed for concentric knee flexion/extension at 60, 120 and 300°/s. For the extensor muscles, differences were found in favor of the U17 group for TTAV and LR outcomes at 120°/s, however, the PRO group maintained higher torques in both movement directions in comparison to the U17 in TAV 3D evaluation. These results suggest that muscle performance of the PRO group is more efficient than the U17 group. © Georg Thieme Verlag KG Stuttgart · New York.

The Artificial Gravity Bed Rest Pilot Project: Effects on Knee Extensor and Plantar Flexor Muscle Groups

NASA Technical Reports Server (NTRS)

Caiozzo, V. J.; Haddad, F.; Lee, S.; Baker, M.; Baldwin, K. M.

2007-01-01

The goal of this project was to examine the effects of artificial gravity (2.5 g) on skeletal muscle strength and key anabolic/catabolic markers known to regulate muscle mass. Two groups of subjects were selected for study: 1) a 21 day-bed rest (BR) control (C) group (N=7); and 2) an AG group (N=8), which was exposed to 21 days of bed-rest plus daily 1 hr exposures to AG (2.5 g). This particular experiment was part of an integrated AG Pilot Project sponsored by NASA/Johnson Space Center. The in vivo torque-velocity relationships of the knee extensors and plantar flexors of the ankle were determined pre and post treatment. Also, pre- and post treatment biopsy samples were obtained from both the vastus lateralis and soleus muscles and were used, in part, for a series of analyses on gene expression (mRNA abundance) of key factors implicated in the anabolic versus catabolic state of the muscle. Post/Pre toque-velocity determinations revealed greater decrements in knee extensor performance in the C versus AG group (P less than 0.04). The plantar flexor muscle group of the AG subjects actually demonstrated a net gain in torque-velocity relationship; whereas, in the C group the overall post/pre responses declined (AG vs C; P less than 0.001). Measurements of muscle fiber cross-sectional area (for both muscles) demonstrated a loss of approx. 20% in the C group while no losses were evident in the AG group. RT-PCR analyses of muscle biopsy specimens demonstrated that markers of growth and cytoskeletal integrity (IGF-1, IGF-1 BP4, mechano growth factor, total RNA, and pro-collagen 3a) were higher in the AG group, whereas catabolic markers (myostatin and atrogen) were elevated in the C group. Importantly, these patterns were seen in both muscles. Based on these observations we conclude that paradigms of AG have the potential to maintain the functional, biochemical, and structural homeostasis of skeletal muscle in the face of chronic unloading states. These findings also warrant further studies since it is likely that other robust paradigms of AG that employ various exercise strategies may be more effective in counteracting long duration unloading states as anticipated on the platforms of the Moon and Mars.

An investigation of leg and trunk strength and reaction times of hard-style martial arts practitioners.

PubMed

Donovan, Oliver O; Cheung, Jeanette; Catley, Maria; McGregor, Alison H; Strutton, Paul H

2006-01-01

The purpose of this study was to investigate trunk and knee strength in practitioners of hard-style martial arts. An additional objective was to examine reaction times in these participants by measuring simple reaction times (SRT), choice reaction times (CRT) and movement times (MT). Thirteen high-level martial artists and twelve sedentary participants were tested under isokinetic and isometric conditions on an isokinetic dynamometer. Response and movement times were also measured in response to simple and choice auditory cues. Results indicated that the martial arts group generated a greater body-weight adjusted peak torque with both legs at all speeds during isokinetic extension and flexion, and in isometric extension but not flexion. In isokinetic and isometric trunk flexion and extension, martial artists tended to have higher peak torques than controls, but they were not significantly different (p > 0.05). During the SRT and CRT tasks the martial artists were no quicker in lifting their hand off a button in response to the stimulus [reaction time (RT)] but were significantly faster in moving to press another button [movement time (MT)]. In conclusion, the results reveal that training in a martial art increases the strength of both the flexors and extensors of the leg. Furthermore, they have faster movement times to auditory stimuli. These results are consistent with the physical aspects of the martial arts. Key PointsMartial artists undertaking hard-style martial arts have greater strength in their knee flexor and extensor muscles as tested under isokinetic testing. Under isometric testing conditions they have stronger knee extensors only.The trunk musculature is generally higher under both conditions of testing in the martial artists, although not significantly.The total reaction times of the martial artists to an auditory stimulus were significantly faster than the control participants. When analysed further it was revealed that the decrease in reaction time was due to the movement time component of the total reaction time.The training involved for the practice of the hard-style martial arts increases the strength of muscles involved in kicking. This increased strength is not seen in the trunk muscles. Furthermore, martial artists have a faster response time; the cause of which appears to be only the faster movement time.

An Investigation Of Leg And Trunk Strength And Reaction Times Of Hard-Style Martial Arts Practitioners

PubMed Central

Donovan, Oliver O; Cheung, Jeanette; Catley, Maria; McGregor, Alison H.; Strutton, Paul H.

2006-01-01

The purpose of this study was to investigate trunk and knee strength in practitioners of hard-style martial arts. An additional objective was to examine reaction times in these participants by measuring simple reaction times (SRT), choice reaction times (CRT) and movement times (MT). Thirteen high-level martial artists and twelve sedentary participants were tested under isokinetic and isometric conditions on an isokinetic dynamometer. Response and movement times were also measured in response to simple and choice auditory cues. Results indicated that the martial arts group generated a greater body-weight adjusted peak torque with both legs at all speeds during isokinetic extension and flexion, and in isometric extension but not flexion. In isokinetic and isometric trunk flexion and extension, martial artists tended to have higher peak torques than controls, but they were not significantly different (p > 0.05). During the SRT and CRT tasks the martial artists were no quicker in lifting their hand off a button in response to the stimulus [reaction time (RT)] but were significantly faster in moving to press another button [movement time (MT)]. In conclusion, the results reveal that training in a martial art increases the strength of both the flexors and extensors of the leg. Furthermore, they have faster movement times to auditory stimuli. These results are consistent with the physical aspects of the martial arts. Key Points Martial artists undertaking hard-style martial arts have greater strength in their knee flexor and extensor muscles as tested under isokinetic testing. Under isometric testing conditions they have stronger knee extensors only. The trunk musculature is generally higher under both conditions of testing in the martial artists, although not significantly. The total reaction times of the martial artists to an auditory stimulus were significantly faster than the control participants. When analysed further it was revealed that the decrease in reaction time was due to the movement time component of the total reaction time. The training involved for the practice of the hard-style martial arts increases the strength of muscles involved in kicking. This increased strength is not seen in the trunk muscles. Furthermore, martial artists have a faster response time; the cause of which appears to be only the faster movement time. PMID:24376366

The effect of warm-ups with stretching on the isokinetic moments of collegiate men.

PubMed

Park, Hyoung-Kil; Jung, Min-Kyung; Park, Eunkyung; Lee, Chang-Young; Jee, Yong-Seok; Eun, Denny; Cha, Jun-Youl; Yoo, Jaehyun

2018-02-01

Performing warm-ups increases muscle temperature and blood flow, which contributes to improved exercise performance and reduced risk of injuries to muscles and tendons. Stretching increases the range of motion of the joints and is effective for the maintenance and enhancement of exercise performance and flexibility, as well as for injury prevention. However, stretching as a warm-up activity may temporarily decrease muscle strength, muscle power, and exercise performance. This study aimed to clarify the effect of stretching during warm-ups on muscle strength, muscle power, and muscle endurance in a nonathletic population. The subjects of this study consisted of 13 physically active male collegiate students with no medical conditions. A self-assessment questionnaire regarding how well the subjects felt about their physical abilities was administered to measure psychological readiness before and after the warm-up. Subjects performed a non-warm-up, warm-up, or warm-up regimen with stretching prior to the assessment of the isokinetic moments of knee joints. After the measurements, the respective variables were analyzed using nonparametric tests. First, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 60°/sec, which were assessed to measure muscle strength. Second, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 180°/sec, which were assessed to measure muscle power. Third, the total work of the knee joints at 240°/sec, intended to measure muscle endurance, was highest in the aerobic-stretch-warm-ups (ASW) group, but no statistically significant differences were found among the groups. Finally, the psychological readiness for physical activity according to the type of warm-up was significantly higher in ASW. Simple stretching during warm-ups appears to have no effect on variables of exercise physiology in nonathletes who participate in routine recreational sport activities. However, they seem to have a meaningful effect on exercise performance by affording psychological stability, preparation, and confidence in exercise performance.

The Interaction of Trunk-Load and Trunk-Position Adaptations on Knee Anterior Shear and Hamstrings Muscle Forces During Landing

PubMed Central

Kulas, Anthony S.; Hortobágyi, Tibor; DeVita, Paul

2010-01-01

Abstract Context: Because anterior cruciate ligament (ACL) injuries can occur during deceleration maneuvers, biomechanics research has been focused on the lower extremity kinetic chain. Trunk mass and changes in trunk position affect lower extremity joint torques and work during gait and landing, but how the trunk affects knee joint and muscle forces is not well understood. Objective: To evaluate the effects of added trunk load and adaptations to trunk position on knee anterior shear and knee muscle forces in landing. Design: Crossover study. Setting: Controlled laboratory environment. Patients or Other Participants: Twenty-one participants (10 men: age  =  20.3 ± 1.15 years, height  =  1.82 ± 0.04 m, mass  =  78.2 ± 7.3 kg; 11 women: age  =  20.0 ± 1.10 years, height  =  1.72 ± 0.06 m, mass  =  62.3 ± 6.4 kg). Intervention(s): Participants performed 2 sets of 8 double-leg landings under 2 conditions: no load and trunk load (10% body mass). Participants were categorized into one of 2 groups based on the kinematic trunk adaptation to the load: trunk flexor or trunk extensor. Main Outcome Measure(s): We estimated peak and average knee anterior shear, quadriceps, hamstrings, and gastrocnemius forces with a biomechanical model. Results: We found condition-by-group interactions showing that adding a trunk load increased peak (17%) and average (35%) knee anterior shear forces in the trunk-extensor group but did not increase them in the trunk-flexor group (peak: F1,19  =  10.56, P  =  .004; average: F1,19  =  9.56, P  =  .006). We also found a main effect for condition for quadriceps and gastrocnemius forces. When trunk load was added, peak (6%; F1,19  =  5.52, P  =  .030) and average (8%; F1,19  =  8.83, P  =  .008) quadriceps forces increased and average (4%; F1,19  =  4.94, P  =  .039) gastrocnemius forces increased, regardless of group. We found a condition-by-group interaction for peak (F1,19  =  5.16, P  =  .035) and average (F1,19  =  12.35, P  =  .002) hamstrings forces. When trunk load was added, average hamstrings forces decreased by 16% in the trunk-extensor group but increased by 13% in the trunk-flexor group. Conclusions: Added trunk loads increased knee anterior shear and knee muscle forces, depending on trunk adaptation strategy. The trunk-extensor adaptation to the load resulted in a quadriceps-dominant strategy that increased knee anterior shear forces. Trunk-flexor adaptations may serve as a protective strategy against the added load. These findings should be interpreted with caution, as only the face validity of the biomechanical model was assessed. PMID:20064042

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy

PubMed Central

Shin, Hyung-Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok

2016-01-01

Purpose This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Materials and Methods Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Results Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). Conclusion There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait. PMID:26632404

Relationships between Isometric Muscle Strength, Gait Parameters, and Gross Motor Function Measure in Patients with Cerebral Palsy.

PubMed

Shin, Hyung Ik; Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Lee, In Hyeok; Park, Moon Seok

2016-01-01

This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included. Preoperatively, peak isometric muscle strength was measured for the hip flexor, hip extensor, knee flexor, and knee extensor muscle groups using a handheld dynamometer, and three-dimensional (3D) gait analysis and gross motor function measure (GMFM) scoring were also performed. Correlations between peak isometric strength and GMFM, gait kinematics, and gait kinetics were analyzed. Peak isometric muscle strength of all muscle groups was not related to the GMFM score and the gross motor function classification system level. Peak isometric strength of the hip extensor and knee extensor was significantly correlated with the mean pelvic tilt (r=-0.588, p=0.003 and r=-0.436, p=0.033) and maximum pelvic obliquity (r=-0.450, p=0.031 and r=-0.419, p=0.041). There were significant correlations between peak isometric strength of the knee extensor and peak knee extensor moment in early stance (r=0.467, p=0.021) and in terminal stance (r=0.416, p=0.043). There is no correlation between muscle strength and gross motor function. However, this study showed that muscle strength, especially of the extensor muscle group of the hip and knee joints, might play a critical role in gait by stabilizing pelvic motion and decreasing energy consumption in a flexed knee gait.

THE INFLUENCE OF SEX AND MATURATION ON LANDING BIOMECHANICS: IMPLICATIONS FOR ACL INJURY

PubMed Central

Sigward, S. M.; Pollard, C. D.; Powers, C. M.

2010-01-01

During landing and cutting, females exhibit greater frontal plane moments at the knee (internal knee adductor moments or external knee abduction moments) and favor use of the knee extensors over the hip extensors to attenuate impact forces when compared to males. However, it is not known when this biomechanical profile emerges. The purpose of this study was to compare landing biomechanics between sexes across maturation levels. One hundred and nineteen male and female soccer players (9–22 years) participated. Subjects were grouped based on maturational development. Lower extremity kinematics and kinetics were obtained during a drop-land task. Dependent variables included the average internal knee adductor moment and sagittal plane knee/hip moment and energy absorption ratios during the deceleration phase of landing. When averaged across maturation levels, females demonstrated greater internal knee adductor moments (0.06±0.03 vs. 0.01±0.02 Nm/kg*m; P<0.005), knee/hip extensor moment ratios (2.0±0.1 vs. 1.4±0.1 Nm/kg*m; P<0.001), and knee/hip energy absorption ratios (2.9±0.1 vs. 1.96±0.1 Nm/kg*m; P<0.001) compared to males. Higher knee adductor moments combined with disproportionate use of knee extensors relative to hip extensors observed in females reflects a biomechanical pattern that increases ACL loading. This biomechanical strategy already was established in pre-pubertal female athletes. PMID:21210853

Early reduction in toe flexor strength is associated with physical activity in elderly men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-05-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18-23 years) and elderly (n=60, 65-88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men's mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

Characterizing Knee Loading Asymmetry in Individuals Following Anterior Cruciate Ligament Reconstruction Using Inertial Sensors

PubMed Central

Sigward, Susan M.; Chan, Ming-Sheng M.; Lin, Paige E.

2016-01-01

Limitations in the ability to identify knee extensor loading deficits during gait in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. A recent study suggested that shank angular velocity, directly output from inertial sensors, differed during gait between individuals post-ACLr and controls. However, it is not clear if this kinematic variable relates to knee moments calculated using joint kinematics and ground reaction forces. Heel rocker mechanics during loading response of gait, characterized by rapid shank rotation, require knee extensor control. Measures of shank angular velocity may be reflective of knee moments. This study investigated the relationship between shank angular velocity and knee extensor moment during gait in individuals (n=19) 96.7±16.8 days post-ACLr. Gait was assessed concurrently using inertial sensors and a marker-based motion system with force platforms. Peak angular velocity and knee extensor moment were strongly correlated (r=0.75, p<0.001) and between limb ratios of angular velocity predicted between limb ratios of extensor moment (r2=0.57 ,p<0.001) in the absence of between limb differences in spatiotemporal gait parameters. The strength of these relationships indicate that shank kinematic data offer meaningful information regarding knee loading and provide a potential alternative to full motion analysis systems for identification of altered knee loading following ACLr PMID:27395452

Reliability of a Novel High Intensity One Leg Dynamic Exercise Protocol to Measure Muscle Endurance

PubMed Central

Lepers, Romuald; Marcora, Samuele M.

2016-01-01

We recently developed a high intensity one leg dynamic exercise (OLDE) protocol to measure muscle endurance and investigate the central and peripheral mechanisms of muscle fatigue. The aims of the present study were to establish the reliability of this novel protocol and describe the isokinetic muscle fatigue induced by high intensity OLDE and its recovery. Eight subjects performed the OLDE protocol (time to exhaustion test of the right leg at 85% of peak power output) three times over a week period. Isokinetic maximal voluntary contraction torque at 60 (MVC60), 100 (MVC100) and 140 (MVC140) deg/s was measured pre-exercise, shortly after exhaustion (13 ± 4 s), 20 s (P20) and 40 s (P40) post-exercise. Electromyographic (EMG) signal was analyzed via the root mean square (RMS) for all three superficial knee extensors. Mean time to exhaustion was 5.96 ± 1.40 min, coefficient of variation was 8.42 ± 6.24%, typical error of measurement was 0.30 min and intraclass correlation was 0.795. MVC torque decreased shortly after exhaustion for all angular velocities (all P < 0.001). MVC60 and MVC100 recovered between P20 (P < 0.05) and exhaustion and then plateaued. MVC140 recovered only at P40 (P < 0.05). High intensity OLDE did not alter maximal EMG RMS of the three superficial knee extensors during MVC. The results of this study demonstrate that this novel high intensity OLDE protocol could be reliably used to measure muscle endurance, and that muscle fatigue induced by high intensity OLDE should be examined within ~ 30 s following exhaustion. PMID:27706196

Lower-volume muscle-damaging exercise protects against high-volume muscle-damaging exercise and the detrimental effects on endurance performance.

PubMed

Burt, Dean; Lamb, Kevin; Nicholas, Ceri; Twist, Craig

2015-07-01

This study examined whether lower-volume exercise-induced muscle damage (EIMD) performed 2 weeks before high-volume muscle-damaging exercise protects against its detrimental effect on running performance. Sixteen male participants were randomly assigned to a lower-volume (five sets of ten squats, n = 8) or high-volume (ten sets of ten squats, n = 8) EIMD group and completed baseline measurements for muscle soreness, knee extensor torque, creatine kinase (CK), a 5-min fixed-intensity running bout and a 3-km running time-trial. Measurements were repeated 24 and 48 h after EIMD, and the running time-trial after 48 h. Two weeks later, both groups repeated the baseline measurements, ten sets of ten squats and the same follow-up testing (Bout 2). Data analysis revealed increases in muscle soreness and CK and decreases in knee extensor torque 24-48 h after the initial bouts of EIMD. Increases in oxygen uptake [Formula: see text], minute ventilation [Formula: see text] and rating of perceived exertion were observed during fixed-intensity running 24-48 h after EIMD Bout 1. Likewise, time increased and speed and [Formula: see text] decreased during a 3-km running time-trial 48 h after EIMD. Symptoms of EIMD, responses during fixed-intensity and running time-trial were attenuated in the days after the repeated bout of high-volume EIMD performed 2 weeks after the initial bout. This study demonstrates that the protective effect of lower-volume EIMD on subsequent high-volume EIMD is transferable to endurance running. Furthermore, time-trial performance was found to be preserved after a repeated bout of EIMD.

The acute effect of Quercetin on muscle performance following a single resistance training session.

PubMed

Patrizio, Federica; Ditroilo, Massimiliano; Felici, Francesco; Duranti, Guglielmo; De Vito, Giuseppe; Sabatini, Stefania; Sacchetti, Massimo; Bazzucchi, Ilenia

2018-05-01

To examine the effect of acute quercetin (Q) ingestion on neuromuscular function, biomarkers of muscle damage, and rate of perceived exertion (RPE) in response to an acute bout of resistance training. 10 young men (22.1 ± 1.8 years, 24.1 ± 3.1 BMI) participated in a randomized, double-blind, crossover study. Subjects consumed Q (1 g/day) or placebo (PLA) 3 h prior to a resistance training session which consisted of 3 sets of 8 repetitions at 80% of the one repetition maximum (1RM) completed bilaterally for eight different resistance exercises. Electromyographic (EMG) signals were recorded from the knee extensor muscles during maximal isometric (MVIC) and isokinetic voluntary contractions, and during an isometric fatiguing test. Mechanical and EMG signals, biomarkers of cell damage, and RPE score were measured PRE, immediately POST, and 24 h (blood indices only) following the resistance exercise. After a single dose of Q, the torque-velocity curve of knee extensors was enhanced and after the resistance exercise, subjects showed a lower MVIC reduction (Q: 0.91 ± 6.10%, PLA: 8.66 ± 5.08%) with a greater rate of torque development (+ 10.6%, p < 0.005) and neuromuscular efficiency ratio (+ 28.2%, p < 0.005). Total volume of the resistance exercises was significantly greater in Q (1691.10 ± 376.71 kg rep) compared to PLA (1663.65 ± 378.85 kg rep) (p < 0.05) with a comparable RPE score. No significant differences were found in blood marker between treatments. The acute ingestion of Q may enhance the neuromuscular performance during and after a resistance training session.

Lean muscle volume of the thigh has a stronger relationship with muscle power than muscle strength in women with knee osteoarthritis.

PubMed

Davison, Michael J; Maly, Monica R; Keir, Peter J; Hapuhennedige, Sandani M; Kron, Amie T; Adachi, Jonathan D; Beattie, Karen A

2017-01-01

Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and physical performance in women with knee OA. Women (n=20) 55years or older with symptomatic, radiographic knee osteoarthritis underwent a 3.0T magnetic resonance imaging scan of the thigh of their most symptomatic knee. Axial fat-separated images were analyzed using software to quantify intramuscular fat and lean muscle volumes of the quadriceps and hamstrings. To quantify strength and power of the knee extensors and flexors, participants performed maximum voluntary isometric contraction and isotonic knee extensions and flexions, respectively. Electromyography of the quadriceps and hamstrings was measured. Participants also completed five physical performance tests. Quadriceps and hamstrings lean muscle volumes were related to isotonic knee extensor (B=0.624; p=0.017) and flexor (B=1.518; p=0.032) power, but not knee extensor (B=0.001; p=0.615) or flexor (B=0.001; p=0.564) isometric strength. Intramuscular fat fractions were not related to isotonic knee extensor or flexor power, nor isometric strength. No relationships were found between intramuscular fat or lean muscle volume and physical performance. Muscle power may be more sensitive than strength to lean muscle mass in women with knee osteoarthritis. Thigh lean muscle mass, but neither intramuscular nor intermuscular fat, is related to knee extensor and flexor power in women with knee osteoarthritis. Copyright © 2016 Elsevier Ltd. All rights reserved.

The influence of sex and maturation on landing biomechanics: implications for anterior cruciate ligament injury.

PubMed

Sigward, S M; Pollard, C D; Powers, C M

2012-08-01

During landing and cutting, females exhibit greater frontal plane moments at the knee (internal knee adductor moments or external knee abduction moments) and favor the use of the knee extensors over the hip extensors to attenuate impact forces when compared with males. However, it is not known when this biomechanical profile emerges. The purpose of this study was to compare landing biomechanics between sexes across maturation levels. One hundred and nineteen male and female soccer players (9-22 years) participated. Subjects were grouped based on maturational development. Lower extremity kinematics and kinetics were obtained during a drop-land task. Dependent variables included the average internal knee adductor moment and sagittal plane knee/hip moment and energy absorption ratios during the deceleration phase of landing. When averaged across maturation levels, females demonstrated greater internal knee adductor moments (0.06±0.03 vs 0.01±0.02 N m/kg m; P<0.005), knee/hip extensor moment ratios (2.0±0.1 vs 1.4±0.1 N m/kg m; P<0.001) and knee/hip energy absorption ratios (2.9±0.1 vs 1.96±0.1 N m/kg m; P<0.001) compared with males. Higher knee adductor moments combined with disproportionate use of knee extensors relative to hip extensors observed in females reflect a biomechanical pattern that increases anterior cruciate ligament loading. This biomechanical strategy already was established in pre-pubertal female athletes. © 2011 John Wiley & Sons A/S.

Early reduction in toe flexor strength is associated with physical activity in elderly men

PubMed Central

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-01-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men. PMID:27313353

Impaired muscle strength may contribute to fatigue in patients with aneurysmal subarachnoid hemorrhage.

PubMed

Harmsen, Wouter J; Ribbers, Gerard M; Zegers, Bart; Sneekes, Emiel M; Praet, Stephan F E; Heijenbrok-Kal, Majanka H; Khajeh, Ladbon; van Kooten, Fop; Neggers, Sebastiaan J C M M; van den Berg-Emons, Rita J

2017-03-01

Patients with aneurysmal subarachnoid hemorrhage (a-SAH) show long-term fatigue and face difficulties in resuming daily physical activities. Impaired muscle strength, especially of the lower extremity, impacts the performance of daily activities and may trigger the onset of fatigue complaints. The present study evaluated knee muscle strength and fatigue in patients with a-SAH. This study included 33 patients, 6 months after a-SAH, and 33 sex-matched and age-matched healthy controls. Isokinetic muscle strength of the knee extensors and flexors was measured at 60 and 180°/s. Maximal voluntary muscle strength was defined as peak torque and measured in Newton-meter. Fatigue was examined using the Fatigue Severity Scale. In patients with a-SAH, the maximal knee extension was 22% (60°/s) and 25% (180°/s) lower and maximal knee flexion was 33% (60°/s) and 36% (180°/s) lower compared with that of matched controls (P≤0.001). The Fatigue Severity Scale score was related to maximal knee extension (60°/s: r=-0.426, P=0.015; 180°/s: r=-0.376, P=0.034) and flexion (60°/s: r=-0.482, P=0.005; 180°/s: r=-0.344, P=0.083). The knee muscle strength was 28-47% lower in fatigued (n=13) and 11-32% lower in nonfatigued (n=20) patients; deficits were larger in fatigued patients (P<0.05), particularly when the muscle strength (peak torque) was measured at 60°/s. The present results indicate that patients with a-SAH have considerably impaired knee muscle strength, which is related to more severe fatigue. The present findings are exploratory, but showed that knee muscle strength may play a role in the severity of fatigue complaints, or vice versa. Interventions targeting fatigue after a-SAH seem necessary and may consider strengthening exercise training in order to treat a debilitating condition.

Knee stabilisation following infected knee arthroplasty with bone loss and extensor mechanism impairment using a modular cemented nail.

PubMed

Rao, M C; Richards, O; Meyer, C; Jones, R Spencer

2009-12-01

Infected Total Knee Replacement with significant bone loss and loss of extensor mechanism poses a difficult management problem. Arthrodesis relying on bony union can be difficult to achieve and can result in significant limb shortening. We retrospectively looked at the outcome of seven patients with significant bone loss and extensor mechanism insufficiency following infected TKR who underwent knee stabilisation using a modular cemented nail. The nail relied on the strong coupling mechanism between the modular femoral and tibial components. Pain score improved from a mean of 7.9 pre-operatively to 1.5 post-operatively at a mean follow up of 39.6 months (range 7-68) months. Two patients underwent technically easy revision nailing for recurrent infection and aseptic loosening. The Endo-Model(R) Knee Fusion Nail (Newsplint, UK/Waldemar Link, GmbH & Co. KG, Hamburg, Germany) has good early results in terms of pain relief and provides a stable knee in cases with significant bone loss and extensor mechanism insufficiency following an infected TKR thus avoiding an above knee amputation.

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy.

PubMed

Aye, Thanda; Thein, Soe; Hlaing, Thaingi

2016-01-01

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy.

Effects of strength training program on hip extensors and knee extensors strength of lower limb in children with spastic diplegic cerebral palsy

PubMed Central

Aye, Thanda; Thein, Soe; Hlaing, Thaingi

2016-01-01

[Purpose] The purpose of this study was to determine whether strength training programs for hip extensors and knee extensors improve gross motor function of children with cerebral palsy in Myanmar. [Subjects and Methods] Forty children (25 boys and 15 girls, mean age: 6.07 ± 2.74 years) from National Rehabilitation Hospital, Yangon, Myanmar, who had been diagnosed with spastic diplegic cerebral palsy, Gross Motor Classification System I and II participated in a 6-week strength training program (45 minutes per day, 3 days per week) on hip and knee extensors. Assessment was made, before and after intervention, of the amount of training weight in pounds, as well as Gross Motor Function Measure (GMFM) dimensions D (standing) and E (walking, running, jumping). [Results] All scores had increased significantly after the strength-training program. [Conclusion] A simple method of strength-training program for hip and knee extensors might lead to improved muscle strength and gross motor function in children with spastic diplegic cerebral palsy. PMID:27065561

Rhythmic Isometric Fatigue Patterns of the Elbow Flexors and Knee Extensors

ERIC Educational Resources Information Center

Ordway, George A.; And Others

1977-01-01

During a rhythmic, all-out task, the rates of fatigue experienced by elbow flexor and knee extendor muscle groups tend to differ, with the elbow flexors fatiguing more rapidly initially, but reaching a plateau at a relatively higher level than the knee extensors. (Author)

Analysis of elbow muscle strength parameters in Brazilian jiu-jitsu practitioners.

PubMed

Follmer, Bruno; Dellagrana, Rodolfo André; de Lima, Luis Antonio Pereira; Herzog, Walter; Diefenthaeler, Fernando

2017-12-01

Upper-body dynamic and isometric maximum strength are essential components for success in Brazilian jiu-jitsu (BJJ). This study was aimed at analysing strength parameters in the elbow flexor and extensor muscles of BJJ practitioners. Participants (n = 28) performed maximum isometric contractions of elbow flexors and extensors to determine peak torque (PT), rate of force development (RFD), and the torque-angle (T-A) relationship at elbow angles of 45°, 60°, 75°, 90°, 105°, and 120°. Additionally, concentric and eccentric PTs were measured at 1.04 rad·s -1 . Student t-test and ANOVA were performed using α = 0.05. Elbow flexors were stronger isometrically (P < 0.001, ES = 1.23) but weaker concentrically (P < 0.05, ES = 0.54) than extensor muscles, possibly because of the extensive grip disputes and pushing of opponents in BJJ. The T-A relationship had an inverted "U"-shape. Torque differences across elbow angles were moderate (ES = 0.62) for the extensor and large (ES = 0.92) for the flexor muscles. Isometric torque was greatest for elbow angles of 105° and 75° and smallest for 45° and 120° for extensor and flexor muscles, respectively. Elbow flexors had a greater RFD than extensors, regardless of elbow angle. The present study provides comprehensive results for elbow muscle strength in BJJ practitioners.

Extensor Mechanism Disruption after Total Knee Arthroplasty: A Case Series and Review of Literature.

PubMed

Vaishya, Raju; Agarwal, Amit Kumar; Vijay, Vipul

2016-02-04

Extensor mechanism disruption following total knee arthroplasty (TKA) is a rare but devastating complication. These patients may require revision of the implants, but even then, it may not be possible to restore the normal function of the knee after the disruption. The patterns of extensor mechanism disruption can broadly be classified into three types: suprapatellar (quadriceps tendon rupture), transpatellar (patellar fracture), or infrapatellar (patellar tendon rupture). Infrapatellar tendon ruptures are the worst injuries, as they carry maximum morbidity and are challenging to manage. The disruption of the extensor mechanism may occur either intra-operatively or in the immediate postoperative period due to an injury. The treatment of extensor mechanism complications after TKA may include either nonsurgical management or surgical intervention in the form of primary repair or reconstruction with autogenous, allogeneic, or synthetic substitutes. We have provided an algorithm for the management of extensor mechanism disruption after TKA.

Relationship between strength qualities and short track speed skating performance in young athletes.

PubMed

Felser, S; Behrens, M; Fischer, S; Heise, S; Bäumler, M; Salomon, R; Bruhn, S

2016-02-01

This study analyzed the relationships between isometric as well as concentric maximum voluntary contraction (MVC) strength of the leg muscles and the times as well as speeds over different distances in 17 young short track speed skaters. Isometric as well as concentric single-joint MVC strength and multi-joint MVC strength in a stable (without skates) and unstable (with skates) condition were tested. Furthermore, time during maximum skating performances on ice was measured. Results indicate that maximum torques during eversion and dorsal flexion have a significant influence on skating speed. Concentric MVC strength of the knee extensors was higher correlated with times as well as speeds over the different distances than isometric MVC strength. Multi-joint MVC testing revealed that the force loss between measurements without and with skates amounts to 25%, while biceps femoris and soleus showed decreased muscle activity and peroneus longus, tibialis anterior, as well as rectus femoris exhibited increased muscle activity. The results of this study depict evidence that the skating times and speeds are primarily influenced by concentric MVC strength of the leg extensors. To be able to transfer the strength onto ice in an optimal way, it is necessary to stabilize the knee and ankle joints. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Dietary and performance assessment of elite soccer players during a period of intense training.

PubMed

Rico-Sanz, J; Frontera, W R; Molé, P A; Rivera, M A; Rivera-Brown, A; Meredith, C N

1998-09-01

This study examined the nutritional and performance status of elite soccer players during intense training. Eight male players (age 17+/-2 years) of the Puerto Rican Olympic Team recorded daily activities and food intake over 12 days. Daily energy expenditure was 3,833+/-571 (SD) kcal, and energy intake was 3,952+/-1,071 kcal, of which 53.2+/-6.2% (8.3 g x kg BW(-1)) was from carbohydrates (CHO), 32.4+/-4.0% from fat, and 14.4+/-2.3% from protein. With the exception of calcium, all micronutrients examined were in accordance with dietary guidelines. Body fat was 7.6+/-1.1% of body weight. Time to completion of three runs of the soccer-specific test was 37.65+/-0.62 s, and peak torques of the knee flexors and extensors at 60 degrees x s(-1) were 139+/-6 and 225+/-9 N x m, respectively. Players' absolute amounts of CHO seemed to be above the minimum recommended intake to maximize glycogen storage, but calcium intakes were below recommended. Their body fat was unremarkable, and they had a comparatively good capacity to endure repeated bouts of intense soccer-specific exercise and to exert force with their knee extensors and flexors.

Characteristics of fast voluntary and electrically evoked isometric knee extensions during 56 days of bed rest with and without exercise countermeasure

PubMed Central

Gerrits, K. H. L.; Rittweger, J.; Felsenberg, D.; Stegeman, D. F.; de Haan, A.

2008-01-01

The contractile characteristics of fast voluntary and electrically evoked unilateral isometric knee extensions were followed in 16 healthy men during 56 days of horizontal bed rest and assessed at bed rest days 4, 7, 10, 17, 24, 38 and 56. Subjects were randomized to either an inactive control group (Ctrl, n = 8) or a resistive vibration exercise countermeasure group (RVE, n = 8). No changes were observed in neural activation, indicated by the amplitude of the surface electromyogram, or the initial rate of voluntary torque development in either group during bed rest. In contrast, for Ctrl, the force oscillation amplitude at 10 Hz stimulation increased by 48% (P < 0.01), the time to reach peak torque at 300 Hz stimulation decreased by 7% (P < 0.01), and the half relaxation time at 150 Hz stimulation tended to be slightly reduced by 3% (P = 0.056) after 56 days of bed rest. No changes were observed for RVE. Torque production at 10 Hz stimulation relative to maximal (150 Hz) stimulation was increased after bed rest for both Ctrl (15%; P < 0.05) and RVE (41%; P < 0.05). In conclusion, bed rest without exercise countermeasure resulted in intrinsic speed properties of a faster knee extensor group, which may have partly contributed to the preserved ability to perform fast voluntary contractions. The changes in intrinsic contractile properties were prevented by resistive vibration exercise, and voluntary motor performance remained unaltered for RVE subjects as well. PMID:18386049

Lower extremity muscle functions during full squats.

PubMed

Robertson, D G E; Wilson, Jean-Marie J; St Pierre, Taunya A

2008-11-01

The purpose of this research was to determine the functions of the gluteus maximus, biceps femoris, semitendinosus, rectus femoris, vastus lateralis, soleus, gastrocnemius, and tibialis anterior muscles about their associated joints during full (deep-knee) squats. Muscle function was determined from joint kinematics, inverse dynamics, electromyography, and muscle length changes. The subjects were six experienced, male weight lifters. Analyses revealed that the prime movers during ascent were the monoarticular gluteus maximus and vasti muscles (as exemplified by vastus lateralis) and to a lesser extent the soleus muscles. The biarticular muscles functioned mainly as stabilizers of the ankle, knee, and hip joints by working eccentrically to control descent or transferring energy among the segments during scent. During the ascent phase, the hip extensor moments of force produced the largest powers followed by the ankle plantar flexors and then the knee extensors. The hip and knee extensors provided the initial bursts of power during ascent with the ankle extensors and especially a second burst from the hip extensors adding power during the latter half of the ascent.

Effects of training and weight support on muscle activation in Parkinson's disease.

PubMed

Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R

2013-12-01

The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3 km/h) were measured before, at the mid-point, and after training. Increasing BW support decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without BW support shorter knee extensor muscle off-activation time and increased relative peak muscle activation was observed in PD patients and did not improve with 8 weeks of training. In conclusion, patients with PD walked with excessive activation of the knee extensor and flexor muscles when compared to healthy participants. Specialized locomotor training may facilitate adaptive processes related to motor control of walking in PD patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of hypnotic suggestion on knee extensor neuromuscular properties in resting and fatigued states

PubMed Central

Antonini Philippe, Roberta; Guglielmo, Luiz Guilherme A.

2018-01-01

Purpose The aim of this study was to investigate whether hypnotic suggestions can alter knee extensor neuromuscular function at rest and during exercise. Methods Thirteen healthy volunteers (8 men and 5 women, 27 ± 3 years old) took part in this counterbalanced, crossover study including two experimental (hypnosis and control) sessions. Knee extensor neuromuscular function was tested before and after hypnosis suggestion by using a combination of voluntary contraction, transcutaneous femoral nerve electrical stimulation and transcranial magnetic stimulation (TMS). A fatiguing exercise (sustained submaximal contraction at 20% maximal voluntary contraction (MVC) force) was also performed to evaluate the potential influence of hypnosis on the extent and origin of neuromuscular adjustments. Results Hypnosis did not (p>0.05) alter MVC force or knee extensor neural properties. Corticospinal excitability, assessed with the amplitude of knee extensor motor evoked potentials, was also unchanged (p>0.05), as was the level of intracortical inhibition assessed with paired pulse TMS (short-interval intracortical inhibition, SICI). Time to task failure (~300 s) was not different (p>0.05) between the two sessions; accordingly, hypnosis did not influence neuromuscular adjustments measured during exercise and at task failure (p>0.05). Conclusion Hypnotic suggestions did not alter neuromuscular properties of the knee extensor muscles under resting condition or during/after exercise, suggesting that hypnosis-induced improvement in exercise performance and enhanced corticospinal excitability might be limited to highly susceptible participants. PMID:29684047

Selective hypertrophy of the quadriceps musculature after 14 weeks of isokinetic and conventional resistance training.

PubMed

Matta, Thiago Torres; Nascimento, Francisco Xavier; Trajano, Gabriel S; Simão, Roberto; Willardson, Jeffrey Michael; Oliveira, Liliam Fernandes

2017-03-01

One of the fundamental adaptations observed with resistance training (RT) is muscle hypertrophy. Conventional and isokinetic machines provide different forms of mechanical stress, and it is possible that these two training modes could promote differing degrees of hypertrophic adaptations. There is a lack of data comparing the selective hypertrophy of the quadriceps musculature after training with a conventional knee extension machine versus an isokinetic machine. The purpose of this study was to evaluate the selective hypertrophy of the quadriceps musculature and knee extension maximal isometric torque after 14 weeks of conventional versus isokinetic RT. Thirty-five men were assigned to three groups: control group and training groups (conventional and isokinetic) performed three sets of unilateral knee extensions per session with a progressive loading scheme twice a week. Prior to and following the intervention, maximal isometric knee extensor torque was measured using an isokinetic dynamometer, and muscle thickness (MT) of quadriceps femoris muscles was assessed via ultrasound. The results indicated non-uniform changes in MT between the muscles that comprise the quadriceps femoris group. For the conventional group, significantly greater increases in rectus femoris thickness were evident versus all other quadriceps muscles (14%). For the isokinetic group, increases in RF thickness (11%) were significantly greater in comparison with the vastus intermedius only. Although the muscle thickness did not increase for all the quadriceps femoris muscles, the relative rectus femoris adaptation suggested a selective hypertrophy favouring this portion. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on muscle force production in people with spinal cord injury (SCI).

PubMed

Bochkezanian, Vanesa; Newton, Robert U; Trajano, Gabriel S; Vieira, Amilton; Pulverenti, Timothy S; Blazevich, Anthony J

2018-02-13

Neuromuscular electrical stimulation (NMES) is commonly used in skeletal muscles in people with spinal cord injury (SCI) with the aim of increasing muscle recruitment and thus muscle force production. NMES has been conventionally used in clinical practice as functional electrical stimulation (FES), using low levels of evoked force that cannot optimally stimulate muscular strength and mass improvements, and thus trigger musculoskeletal changes in paralysed muscles. The use of high intensity intermittent NMES training using wide-pulse width and moderate-intensity as a strength training tool could be a promising method to increase muscle force production in people with SCI. However, this type of protocol has not been clinically adopted because it may generate rapid muscle fatigue and thus prevent the performance of repeated high-intensity muscular contractions in paralysed muscles. Moreover, superimposing patellar tendon vibration onto the wide-pulse width NMES has been shown to elicit further increases in impulse or, at least, reduce the rate of fatigue in repeated contractions in able-bodied populations, but there is a lack of evidence to support this argument in people with SCI. Nine people with SCI received two NMES protocols with and without superimposing patellar tendon vibration on different days (i.e. STIM and STIM+vib), which consisted of repeated 30 Hz trains of 58 wide-pulse width (1000 μs) symmetric biphasic pulses (0.033-s inter-pulse interval; 2 s stimulation train; 2-s inter-train interval) being delivered to the dominant quadriceps femoris. Starting torque was 20% of maximal doublet-twitch torque and stimulations continued until torque declined to 50% of the starting torque. Total knee extensor impulse was calculated as the primary outcome variable. Total knee extensor impulse increased in four subjects when patellar tendon vibration was imposed (59.2 ± 15.8%) but decreased in five subjects (- 31.3 ± 25.7%). However, there were no statistically significant differences between these sub-groups or between conditions when the data were pooled. Based on the present results there is insufficient evidence to conclude that patellar tendon vibration provides a clear benefit to muscle force production or delays muscle fatigue during wide-pulse width, moderate-intensity NMES in people with SCI. ACTRN12618000022268 . Date: 11/01/2018. Retrospectively registered.

Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study.

PubMed

Kömürcü, Erkam; Yüksel, Halil Yalçın; Ersöz, Murat; Aktekin, Cem Nuri; Hapa, Onur; Çelebi, Levent; Akbal, Ayla; Biçimoğlu, Ali

2014-12-01

The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups. In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees. No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (-4.2%) than in Group 1 (-23.1%). For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure. II.

The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise.

PubMed

Legault, Zachary; Bagnall, Nicholas; Kimmerly, Derek S

2015-10-01

The study aimed to examine the effects that L-glutamine supplementation has on quadriceps muscle strength and soreness ratings following eccentric exercise. It was hypothesized that glutamine ingestion would quicken the recovery rate of peak force production and decrease muscle soreness ratings over a 72-hr recovery period. Sixteen healthy participants (8♀/8♂; 22 ± 4 years) volunteered in a double-blind, randomized, placebo-controlled crossover study. Supplement conditions consisted of isoenergetic placebo (maltodextrin, 0.6 g·kg-1·day-1) and L-glutamine (0.3 g·kg-1·day-1 + 0.3 g·kg-1·day-1 maltodextrin) ingestion once per day over 72 hr. Knee extensor peak torque at 0°, 30°, and 180° per second and muscle soreness were measured before, immediately following, 24, 48, and 72 hr posteccentric exercise. Eccentric exercise consisted of 8 sets (10 repetitions/set) of unilateral knee extension at 125% maximum concentric force with 2-min rest intervals. L-glutamine resulted in greater relative peak torque at 180°/sec both immediately after (71 ± 8% vs. 66 ± 9%), and 72 hr (91 ± 8% vs. 86 ± 7%) postexercise (all, p < .01). In men, L-glutamine produced greater (p < .01) peak torques at 30°/ sec postexercise. Men also produced greater normalized peak torques at 30°/sec (Nm/kg) in the L-glutamine condition than women (all, p < .05). In the entire sample, L-glutamine resulted in lower soreness ratings at 24 (2.8 ± 1.2 vs. 3.4 ± 1.2), 48 (2.6 ± 1.4 vs. 3.9 ± 1.2), and 72 (1.7 ± 1.2 vs. 2.9 ± 1.3) hr postexercise (p < .01). The L-glutamine supplementation resulted in faster recovery of peak torque and diminished muscle soreness following eccentric exercise. The effect of L-glutamine on muscle force recovery may be greater in men than women.

Validity of trunk extensor and flexor torque measurements using isokinetic dynamometry.

PubMed

Guilhem, Gaël; Giroux, Caroline; Couturier, Antoine; Maffiuletti, Nicola A

2014-12-01

This study aimed to evaluate the validity and test-retest reliability of trunk muscle strength testing performed with a latest-generation isokinetic dynamometer. Eccentric, isometric, and concentric peak torque of the trunk flexor and extensor muscles was measured in 15 healthy subjects. Muscle cross sectional area (CSA) and surface electromyographic (EMG) activity were respectively correlated to peak torque and submaximal isometric torque for erector spinae and rectus abdominis muscles. Reliability of peak torque measurements was determined during test and retest sessions. Significant correlations were consistently observed between muscle CSA and peak torque for all contraction types (r=0.74-0.85; P<0.001) and between EMG activity and submaximal isometric torque (r ⩾ 0.99; P<0.05), for both extensor and flexor muscles. Intraclass correlation coefficients were comprised between 0.87 and 0.95, and standard errors of measurement were lower than 9% for all contraction modes. The mean difference in peak torque between test and retest ranged from -3.7% to 3.7% with no significant mean directional bias. Overall, our findings establish the validity of torque measurements using the tested trunk module. Also considering the excellent test-retest reliability of peak torque measurements, we conclude that this latest-generation isokinetic dynamometer could be used with confidence to evaluate trunk muscle function for clinical or athletic purposes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Semimembranosus Release for Medial Soft Tissue Balancing Does Not Weaken Knee Flexion Strength in Patients Undergoing Varus Total Knee Arthroplasty.

PubMed

Jang, Sung Won; Koh, In Jun; Kim, Man Soo; Kim, Ju Yeong; In, Yong

2016-11-01

The sequential medial release technique including semimembranosus (semiM) release is effective and safe during varus total knee arthroplasty (TKA). However, there are concerns about weakening of knee flexion strength after semiM release. We determined whether semiM release to balance the medial soft tissue decreased knee flexion strength after TKA. Fifty-nine consecutive varus knees undergoing TKA were prospectively enrolled. A 3-step sequential release protocol which consisted of release of (1) the deep medial collateral ligament (dMCL), (2) the semiM, and (3) the superficial medial collateral ligament based on medial tightness. Gap balancing was obtained after dMCL release in 31 knees. However, 28 knees required semiM release or more after dMCL release. Isometric muscle strength of the knee was compared 6 months postoperatively between the semiM release and semiM nonrelease groups. Knee stability and clinical outcomes were also compared. No differences in knee flexor or extensor peak torque were observed between the groups 6 months postoperatively (P = .322 and P = .383, respectively). No group difference was observed in medial joint opening angle on valgus stress radiographs (P = .327). No differences in the Knee Society or Western Ontario and McMaster Universities Osteoarthritis Index scores were detected between the groups (P = .840 and P = .682, respectively). These results demonstrate that semiM release as a sequential step to balance medial soft tissue in varus knees did not affect knee flexion strength after TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

ARE THERE DIFFERENCES IN STRENGTH TESTS USING ISOKINETIC DYNAMOMETRY BETWEEN FIELD AND INDOOR PROFESSIONAL SOCCER PLAYERS?

PubMed Central

de Aguiar Leonardi, Adriano Barros; Martinelli, Mauro Olivio; Junior, Aires Duarte

2015-01-01

Objective: The objective of this study was to conduct a comparative analysis on isokinetic strength assessments between field and indoor male professional soccer players and correlate the findings with the higher levels of injury risk described in the literature. Methods: We analyzed 16 field soccer players and 15 indoor soccer players. All these professionals were male. Isokinetic muscle strength assessments were made on their knees. Results: The mean weight was 81.81 kg for field soccer and 80.33 kg for indoor soccer. The right and left peak extensor torque left and right for field soccer and indoor soccer were, respectively, 302.50 and 313.31 Nm and 265.20 and 279.80 Nm, and for flexors, 178 and 184.88 Nm and 158.27 and 154 Nm. The peak torque rates according to body weight for the left and right extensors for field soccer and indoor soccer were, respectively, 3.84 and 3.7 Nm/kg and 3.32 and 3.52 Nm/kg, and for flexors, 2.17 and 2.26 Nm/kg and 1.98 and 1.93 Nm/kg. The balance relationships between flexors and extensors on the right and left sides for field soccer and indoor soccer were, respectively, 59.81 and 59.44% and 60.47% and 54.80%. The relationships for extensors between the right and left sides for field soccer and indoor soccer were, respectively, 11.44 and 9.20%, and for the flexors, 7.31 and 8.80%. Conclusions: In accordance with international parameters, comparative analysis on isokinetic strength assessments between field and indoor male professional soccer players before the season showed that there was muscle balance and low probability of injury. There were no statistically significant differences in the parameters analyzed between the players of the two types of soccer. PMID:27042649

Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study.

PubMed

Bieler, Theresa; Magnusson, Stig Peter; Christensen, Helle Elisabeth; Kjaer, Michael; Beyer, Nina

2017-07-01

To investigate between-leg differences in hip and thigh muscle strength and leg extensor power in patients with unilateral hip osteoarthritis. Further, to compare between-leg differences in knee extensor strength and leg extensor power between patients and healthy peers. Seventy-two patients (60-87 years) with radiographic and symptomatic hip osteoarthritis not awaiting hip replacement and 35 healthy peers (63-82 years) were included. Hip and thigh muscle strength and leg extensor power were measured in patients and knee extensor strength and leg extensor power in healthy. The symptomatic extremity in patients was significantly (p < 0.05, paired t-test) weaker compared with the non-symptomatic extremity for five hip muscles (8-17%), knee extensors (11%) and leg extensor power (19%). Healthy older adults had asymmetry in knee extensor strength (6%, p < 0.05) comparable to that found in patients, but had no asymmetry in leg extensor power. Patients had generalized weakening of the affected lower extremity and numerically the largest asymmetry was evident for leg extensor power. In contrast, healthy peers had no asymmetry in leg extensor power. These results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with hip osteoarthritis. Implications for Rehabilitation Even in patients with mild symptoms not awaiting hip replacement a generalized muscle weakening of the symptomatic lower extremity seems to be present. Between-leg differences in leg extensor power (force × velocity) appears to be relatively large (19%) in patients with unilateral hip osteoarthritis in contrast to healthy peers who show no asymmetry. Compared to muscle strength the relationship between functional performance and leg extensor power seems to be stronger, and more strongly related to power of the symptomatic lower extremity. Our results indicate that exercise interventions focusing on improving leg extensor power of the symptomatic lower extremity and reducing asymmetry may be beneficial for patients with mild symptoms not awaiting hip replacement.

Neuromuscular electrical stimulation of the hindlimb muscles for movement therapy in a rodent model.

PubMed

Ichihara, Kazuhiko; Venkatasubramanian, Ganapriya; Abbas, James J; Jung, Ranu

2009-01-30

Neuromuscular electrical stimulation (NMES) can provide functional movements in people after central nervous system injury. The neuroplastic effects of long-term NMES-induced repetitive limb movement are not well understood. A rodent model of neurotrauma in which NMES can be implemented may be effective for such investigations. We present a rodent model for NMES of the flexor and extensor muscles of the hip, knee, and ankle hindlimb muscles. Custom fabricated intramuscular stimulating electrodes for rodents were implanted near identified motor points of targeted muscles in ten adult, female Long Evans rats. The effects of altering NMES pulse stimulation parameters were characterized using strength duration curves, isometric joint torque recruitment curves and joint angle measures. The data indicate that short pulse widths have the advantage of producing graded torque recruitment curves when current is used as the control parameter. A stimulus frequency of 75 Hz or more produces fused contractions. The data demonstrate ability to accurately implant the electrodes and obtain selective, graded, repeatable, strong muscle contractions. Knee and ankle angular excursions comparable to those obtained in normal treadmill walking in the same rodent species can be obtained by stimulating the target muscles. Joint torques (normalized to body weight) obtained were larger than those reported in the literature for small tailed therian mammals and for peak isometric ankle plantarflexion in a different rodent species. This model system could be used for investigations of NMES assisted hindlimb movement therapy.

The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C; Milligan, Peter; Clinton, Melissa; Amis, Andrew A

2015-11-01

To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. Randomised controlled trial, Level II.

Knee isokinetic performance following anterior cruciate ligament reconstruction: patellar tendon versus hamstrings graft.

PubMed

Machado, Felipe; Debieux, Pedro; Kaleka, Camila Cohen; Astur, Diego; Peccin, Maria Stella; Cohen, Moisés

2018-02-01

To compare knee isokinetic performance six months after reconstruction of the anterior cruciate ligament using grafts from either the patellar tendon or the hamstrings among patients who underwent the same rehabilitation protocol. Thirty-four patients were evaluated (17 with grafts from the patellar tendon and 17 with grafts from the hamstrings). Operated and non-operated knees were compared with regards to the variables of peak torque, work and the hamstring/quadriceps relationship at velocities of 60º/s and 180º/s and power of 180º/s after six months of surgery. The patients with ACL reconstruction using the patellar tendon (BPTB) showed quadriceps deficits for all variables, but the flexor musculature was balanced. In the hamstring group, both the extensors and the flexors showed deficits for the variables analyzed, except for hamstring power at 180º/s. Patients in the patellar tendon group had a greater quadriceps deficit compared with those in the hamstrings group. Patients in the hamstrings group had a greater muscular deficit in the flexor mechanism compared with the contralateral knee. An unbalanced H/Q ratio was observed regardless of graft type, but this was more evident in the BPTB group.

Do patients with knee osteoarthritis perform sit-to-stand motion efficiently?

PubMed

Anan, Masaya; Shinkoda, Koichi; Suzuki, Kentaro; Yagi, Masahide; Ibara, Takuya; Kito, Nobuhiro

2015-02-01

The sit-to-stand motion (STS) is a frequently executed activity that is affected by weakness in the quadriceps femoris muscle and knee joint pain in patients with knee osteoarthritis (OA). We investigated whether patients with knee OA can efficiently perform STS through mechanical energy transfer assessments. Participants were 20 women with knee OA and 17 age-matched asymptomatic controls. The center of mass (COM), segment angles, joint moments, and powers during STS were measured. The negative mechanical work in the proximal portion of the shank, negative mean powers in the distal portion of the pelvis and proximal portion of the shank, and the positive mean power in the proximal and distal portions of the thigh were significantly lower in the knee OA group than in the control group. Patients with knee OA primarily performed thoracic forward lean movement, shifting their COM closer to the base of support provided by the feet alone, in an attempt to achieve stability at and after buttocks-off. However, control ability, which generates and absorbs kinetic energy quickly, was not enhanced in these patients, and their motion was unable to increase absorption of the mechanical energy in hip extensors and reduce the load on knee extensors. Furthermore, STS in patients with knee OA had reduced energy absorption in the knee extensors from the shank forward lean movement after buttocks-off, had reduced knee extensor efficiency, and made greater use of physiological energy. These findings suggest that, from the standpoint of mechanical energy transfer, patients with knee OA do not perform STS efficiently. Copyright © 2014 Elsevier B.V. All rights reserved.

A comparison of muscle stiffness and musculoarticular stiffness of the knee joint in young athletic males and females.

PubMed

Wang, Dan; De Vito, Giuseppe; Ditroilo, Massimiliano; Fong, Daniel T P; Delahunt, Eamonn

2015-06-01

The objective of this study was to investigate the gender-specific differences in peak torque (PT), muscle stiffness (MS) and musculoarticular stiffness (MAS) of the knee joints in a young active population. Twenty-two male and twenty-two female recreational athletes participated. PT of the knee joint extensor musculature was assessed on an isokinetic dynamometer, MS of the vastus lateralis (VL) muscle was measured in both relaxed and contracted conditions, and knee joint MAS was quantified using the free oscillation technique. Significant gender differences were observed for all dependent variables. Females demonstrated less normalized PT (mean difference (MD)=0.4Nm/kg, p=0.005, η(2)=0.17), relaxed MS (MD=94.2N/m, p<.001, η(2)=0.53), contracted MS (MD=162.7N/m, p<.001, η(2)=0.53) and MAS (MD=422.1N/m, p<.001, η(2)=0.23) than males. MAS increased linearly with the external load in both genders with males demonstrating a significantly higher slope (p=0.019) than females. The observed differences outlined above may contribute to the higher knee joint injury incidence and prevalence in females when compared to males. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strength characterization of knee flexor and extensor muscles in Prader-Willi and obese patients.

PubMed

Capodaglio, Paolo; Vismara, Luca; Menegoni, Francesco; Baccalaro, Gabriele; Galli, Manuela; Grugni, Graziano

2009-05-06

despite evidence of an obesity-related disability, there is a lack of objective muscle functional data in overweight subjects. Only few studies provide instrumental strength measurements in non-syndromal obesity, whereas no data about Prader-Willi syndrome (PWS) are reported. The aim of our study was to characterize the lower limb muscle function of patients affected by PWS as compared to non-syndromal obesity and normal-weight subjects. We enrolled 20 obese (O) females (age: 29.1 +/- 6.5 years; BMI: 38.1 +/- 3.1), 6 PWS females (age: 27.2 +/- 4.9 years; BMI: 45.8 +/- 4.4) and 14 healthy normal-weight (H) females (age: 30.1 +/- 4.7 years; BMI: 21 +/- 1.6). Isokinetic strength during knee flexion and extension in both lower limbs at the fixed angular velocities of 60 degrees /s, 180 degrees /s, 240 degrees /s was measured with a Cybex Norm dynamometer. the H, O and PWS populations appear to be clearly stratified with regard to muscle strength.: PWS showed the lowest absolute peak torque (PT) for knee flexor and extensor muscles as compared to O (-55%) and H (-47%) (P = 0.00001). O showed significantly higher strength values than H as regard to knee extension only (P = 0.0014). When strength data were normalised by body weight, PWS showed a 50% and a 70% reduction in PT as compared to O and H, respectively. Knee flexors strength values were on average half of those reported for extension in all of the three populations. the novel aspect of our study is the determination of objective measures of muscle strength in PWS and the comparison with O and H patients. The objective characterization of muscle function performed in this study provides baseline and outcome measures that may quantify specific strength deficits amendable with tailored rehabilitation programs and monitor effectiveness of treatments.

Strength characterization of knee flexor and extensor muscles in Prader-Willi and obese patients

PubMed Central

Capodaglio, Paolo; Vismara, Luca; Menegoni, Francesco; Baccalaro, Gabriele; Galli, Manuela; Grugni, Graziano

2009-01-01

Background despite evidence of an obesity-related disability, there is a lack of objective muscle functional data in overweight subjects. Only few studies provide instrumental strength measurements in non-syndromal obesity, whereas no data about Prader-Willi syndrome (PWS) are reported. The aim of our study was to characterize the lower limb muscle function of patients affected by PWS as compared to non-syndromal obesity and normal-weight subjects. Methods We enrolled 20 obese (O) females (age: 29.1 ± 6.5 years; BMI: 38.1 ± 3.1), 6 PWS females (age: 27.2 ± 4.9 years; BMI: 45.8 ± 4.4) and 14 healthy normal-weight (H) females (age: 30.1 ± 4.7 years; BMI: 21 ± 1.6). Isokinetic strength during knee flexion and extension in both lower limbs at the fixed angular velocities of 60°/s, 180°/s, 240°/s was measured with a Cybex Norm dynamometer. Results the H, O and PWS populations appear to be clearly stratified with regard to muscle strength.: PWS showed the lowest absolute peak torque (PT) for knee flexor and extensor muscles as compared to O (-55%) and H (-47%) (P = 0.00001). O showed significantly higher strength values than H as regard to knee extension only (P = 0.0014). When strength data were normalised by body weight, PWS showed a 50% and a 70% reduction in PT as compared to O and H, respectively. Knee flexors strength values were on average half of those reported for extension in all of the three populations. Conclusion the novel aspect of our study is the determination of objective measures of muscle strength in PWS and the comparison with O and H patients. The objective characterization of muscle function performed in this study provides baseline and outcome measures that may quantify specific strength deficits amendable with tailored rehabilitation programs and monitor effectiveness of treatments. PMID:19419559

Evaluation of the Combined Application of Neuromuscular Electrical Stimulation and Volitional Contractions on Thigh Muscle Strength, Knee Pain and Physical Performance in Women at Risk for Knee Osteoarthritis: A Randomized Controlled Trial.

PubMed

Rabe, Kaitlin G; Matsuse, Hiroo; Jackson, Anthony; Segal, Neil A

2018-05-28

Knee osteoarthritis (OA) is a leading cause of disability that is associated with quadriceps weakness. However, strengthening in people with or with risk factors for knee OA can be poorly tolerated. To assess the efficacy of a twelve-week low-load exercise program, using a hybrid training system (HTS) that utilizes the combination of neuromuscular electrical stimulation and volitional contractions, for improving thigh muscle strength, knee pain and physical performance in women with or with risk factors for knee OA. Randomized, single-blind, controlled trial SETTING: Exercise training laboratory PARTICIPANTS: Forty-two women, age 44-85 years, with risk factors for knee OA INTERVENTIONS: Participants randomized to 12 weeks of biweekly low-load resistance training either with HTS or on an isokinetic dynamometer (control). Maximum isokinetic knee extensor torque. Secondary measures included: maximum isokinetic knee flexor torque, knee pain (KOOS), and timed 20-meter walk and chair-stand tests. HTS and control both resulted in muscle strengthening, reduced knee pain and improved physical performance. HTS group quadriceps and hamstring strength increased by 0.06±0.04 Nm/kg (p>.05) and 0.05±0.02 Nm/kg (p=.02), respectively. Control group quadriceps and hamstring strength increased by 0.03±0.04 Nm/kg (p>.05) and 0.06±0.02 Nm/kg (p=.009), respectively. Knee pain improved by 11.9±11.5 points (p<.001) for the HTS group and 14.1±15.4 points (p=.001) for the control group. 20-meter walk time decreased by 1.60±2.04 seconds (p=.005) and 0.95±1.2 seconds (p=.004), and chair stand time decreased by 4.8±10.0 seconds (p>.05) and 1.9±4.7 seconds (p>.05) in the HTS and control groups, respectively. These results did not differ statistically between HTS and control groups. These results suggest HTS is effective for improving pain and physical performance in women with risk factors for knee OA. However, HTS does not appear to be superior to low-load resistance training for improving muscle strength, pain or physical function. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Decreased torque and electromyographic activity in the extensor thigh muscles in chondromalacia patellae.

PubMed

Väätäinen, U; Airaksinen, O; Jaroma, H; Kiviranta, I

1995-01-01

The alterations in thigh muscle properties of chondromalacia patellae patients during isometric and dynamic endurance tests were studied using a variokinetic knee testing system linked to surface EMG. A total of 41 patients (chondromalacia group) with arthroscopically certified chondromalacia of the patella were studied. The control group consisted of 31 healthy adult volunteers with no history of knee pain or trauma. Peak torque values were 21% (p < 0.01) and force output values 25% (p < 0.05) lower on the symptomatic side of the chondromalacia group than in the control group. The decrease in the ratio between integrated EMG (IEMG) and measured force were found in all parts of the quadriceps femoris muscle in patients with chondromalacia of the patella in isometric extension. No change in the normalized IEMG levels of the thigh muscles were found between chondromalacia patients and controls in dynamic endurance test. The severity of the chondromalacia of the patella did not affect the level of electromyographic activation in thigh muscles. The ratio of normalized EMG levels of vastus medialis and vastus lateralis did not differ between the groups. The present study showed that chondromalacia patellae patients have reduced force and electromyographic activation levels of quadriceps femoris muscle. Especially, the explosive strength of the quadriceps femoris muscle is reduced.

Estimation of muscle torque in various combat sports.

PubMed

Pędzich, Wioletta; Mastalerz, Andrzej; Sadowski, Jerzy

2012-01-01

The purpose of the research was to compare muscle torque of elite combat groups. Twelve taekwondo WTF athletes, twelve taekwondo ITF athletes and nine boxers participated in the study. Measurements of muscle torques were done under static conditions on a special stand which belonged to the Department of Biomechanics. The sum of muscle torque of lower right and left extremities of relative values was significantly higher for taekwondo WTF athletes than for boxers (16%, p < 0.001 for right and 10%, p < 0.05 for left extremities) and taekwondo ITF (10%, p < 0.05 for right and 8% for left extremities). Taekwondo ITF athletes attained significantly higher absolute muscle torque values than boxers for elbow flexors (20%, p < 0.05 for right and 11% for left extremities) and extensors (14% for right and 18%, p < 0.05 for left extremities) and shoulder flexors (10% for right and 12%, p < 0.05 for left extremities) and extensors (11% for right and 1% for left extremities). Taekwondo WTF and taekwondo ITF athletes obtained significantly different relative values of muscle torque of the hip flexors (16%, p < 0.05) and extensors (11%, p < 0.05) of the right extremities.

How joint torques affect hamstring injury risk in sprinting swing-stance transition.

PubMed

Sun, Yuliang; Wei, Shutao; Zhong, Yunjian; Fu, Weijie; Li, Li; Liu, Yu

2015-02-01

The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases.

How Joint Torques Affect Hamstring Injury Risk in Sprinting Swing–Stance Transition

PubMed Central

SUN, YULIANG; WEI, SHUTAO; ZHONG, YUNJIAN; FU, WEIJIE; LI, LI; LIU, YU

2015-01-01

ABSTRACT Purpose The potential mechanisms of hamstring strain injuries in athletes are not well understood. The study, therefore, was aimed at understanding hamstring mechanics by studying loading conditions during maximum-effort overground sprinting. Methods Three-dimensional kinematics and ground reaction force data were collected from eight elite male sprinters sprinting at their maximum effort. Maximal isometric torques of the hip and knee were also collected. Data from the sprinting gait cycle were analyzed via an intersegmental dynamics approach, and the different joint torque components were calculated. Results During the initial stance phase, the ground reaction force passed anteriorly to the knee and hip, producing an extension torque at the knee and a flexion torque at the hip joint. Thus, the active muscle torque functioned to produce flexion torque at the knee and extension torque at the hip. The maximal muscle torque at the knee joint was 1.4 times the maximal isometric knee flexion torque. During the late swing phase, the muscle torque counterbalanced the motion-dependent torque and acted to flex the knee joint and extend the hip joint. The loading conditions on the hamstring muscles were similar to those of the initial stance phase. Conclusions During both the initial stance and late swing phases, the large passive torques at both the knee and hip joints acted to lengthen the hamstring muscles. The active muscle torques generated mainly by the hamstrings functioned to counteract those passive effects. As a result, during sprinting or high-speed locomotion, the hamstring muscles may be more susceptible to high risk of strain injury during these two phases. PMID:24911288

Ballistic movements of jumping legs implemented as variable components of cricket behaviour.

PubMed

Hustert, R; Baldus, M

2010-12-01

Ballistic accelerations of a limb or the whole body require special joint mechanisms in many animals. Specialized joints can be moved by stereotypic or variable motor control during motor patterns with and without ballistic components. As a model of variable motor control, the specialized femur-tibia (knee) joints of cricket (Acheta domesticus) hindlegs were studied during ballistic kicking, jumping and swimming and in non-ballistic walking. In this joint the tendons of the antagonistic flexor and the extensor muscles attach at different distances from the pivot and the opposed lever arms form an angle of 120 deg. A 10:1 ratio of their effective lever arms at full knee flexion helps to prepare for most ballistic extensions: the tension of the extensor can reach its peak while it is restrained by flexor co-contraction. In kicks, preparatory flexion is rapid and the co-contraction terminates just before knee extensions. Therefore, mainly the stored tension of the extensor muscle accelerates the small mass of the tibia. Jumps are prepared with slower extensor-flexor co-contractions that flex both knees simultaneously and then halt to rotate both legs outward to a near horizontal level. From there, catapult extension of both knees accelerates the body, supported by continued high frequency motor activity to their tibia extensor muscles during the ongoing push-off from the substrate. Premature extension of one knee instantly takes load from the lagging leg that extends and catches up, which finally results in a straight jump. In swimming, synchronous ballistic power strokes of both hindlegs drive the tibiae on a ventral-to-posterior trajectory through the water, well coordinated with the swimming patterns of all legs. In walking, running and climbing the steps of the hindlegs range between 45 deg flexion and 125 deg extension and use non-ballistic, alternating activity of knee flexor and extensor muscles. Steep climbing requires longer bursts from the extensor tibiae muscles when they support the extended hindlegs against gravity forces when the body hangs over. All ballistic movements of cricket knees are elicited by a basic but variable motor pattern: knee flexions by co-contraction of the antagonists prepare catapult extensions with speeds and forces as required in the different behaviours.

Side Differences of Thigh Muscle Cross-Sectional Areas and Maximal Isometric Muscle Force in Bilateral Knees with the Same Radiographic Disease Stage, but Unilateral Frequent Pain – Data from the Osteoarthritis Initiative

PubMed Central

Sattler, Martina; Dannhauer, Torben; Hudelmaier, Martin; Wirth, Wolfgang; Sänger, Alexandra M.; Kwoh, C. Kent; Hunter, David J.; Eckstein, Felix

2012-01-01

Objective To determine whether anatomical thigh muscle cross-sectional areas (MCSAs) and strength differ between osteoarthritis (OA) knees with frequent pain compared with contralateral knees without pain, and to examine the correlation between MCSAs and strength in painful versus painless knees. Methods 48 subjects (31 women; 17 men; age 45–78 years) were drawn from 4796 Osteoarthritis Initiative (OAI) participants, in whom both knees displayed the same radiographic stage (KLG2 or 3), one with frequent pain (most days of the month within the past 12 months) and the contralateral one without pain. Axial MR images were used to determine MCSAs of extensors, flexors and adductors at 35% femoral length (distal to proximal) and in two adjacent 5 mm images. Maximal isometric extensor and flexor forces were used as provided from the OAI data base. Results Painful knees showed 5.2% lower extensor MCSAs (p=0.00003; paired t-test), and 7.8% lower maximal extensor muscle forces (p=0.003) than contra-lateral painless knees. There were no significant differences in flexor forces, or flexor and adductor MCSAs (p>0.39). Correlations between force and MCSAs were similar in painful and painless OA knees (0.44

The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials.

PubMed

Bartholdy, Cecilie; Juhl, Carsten; Christensen, Robin; Lund, Hans; Zhang, Weiya; Henriksen, Marius

2017-08-01

To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain, and disability. A systematic search in 5 electronic databases was performed to identify randomized controlled trials comparing exercise interventions with no intervention in knee OA, and reporting changes in muscle strength and in pain or disability assessed as standardized mean differences (SMD) with 95% confidence intervals (95% CI). Interventions were categorized as ACSM interventions or not-ACSM interventions and compared using stratified random effects meta-analysis models. Associations between knee extensor strength gain and changes in pain/disability were assessed using meta-regression analyses. The 45 eligible trials with 4699 participants and 56 comparisons (22 ACSM interventions) were included in this analysis. A statistically significant difference favoring the ACSM interventions with respect to knee extensor strength was found [SMD difference: 0.448 (95% CI: 0.091-0.805)]. No differences were observed regarding effects on pain and disability. The meta-regressions indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively. Exercise interventions following the ACSM criteria for strength training provide superior outcomes in knee extensor strength but not in pain or disability. An increase of less than 30% in knee extensor strength is not likely to be clinically beneficial in terms of changes in pain and disability (PROSPERO: CRD42014015344). Copyright © 2017 Elsevier Inc. All rights reserved.

Vibration Therapy Is No More Effective Than the Standard Practice of Massage and Stretching for Promoting Recovery From Muscle Damage After Eccentric Exercise.

PubMed

Fuller, Joel T; Thomson, Rebecca L; Howe, Peter R C; Buckley, Jonathan D

2015-07-01

The purpose of this study was to determine if vibration therapy is more effective than the standard treatment of stretching and massage for improving recovery of muscle strength and reducing muscle soreness after muscle damage induced by eccentric exercise. A randomized, single-blinded parallel intervention trial design was used. Research laboratory. Fifty untrained men aged 18 to 30 years completed the study. Participants performed 100 maximal eccentric muscle actions (ECCmax) of the right knee extensor muscles. For the next 7 days, 25 participants applied cycloidal vibration therapy to the knee extensors twice daily and 25 participants performed stretching and sports massage (SSM) twice daily. Changes in markers of muscle damage [peak isometric torque (PIT), serum creatine kinase (CK), and serum myoglobin (Mb)], muscle soreness (visual analog scale), and inflammation [serum C-reactive protein (CRP)] were assessed. After ECCmax, there was no difference in recovery of PIT and muscle soreness or serum CK, Mb, and CRP levels between vibration and SSM groups (P > 0.28). Cycloidal vibration therapy is no more effective than the standard practice of stretching and massage to promote muscle recovery after the performance of muscle-damaging exercise. Prescription of vibration therapy after maximal exercise involving eccentric muscle damage did not alleviate signs and symptoms of muscle damage faster than the standard prescription of stretching and massage.

Knee-Extension Torque Variability and Subjective Knee Function in Patients with a History of Anterior Cruciate Ligament Reconstruction.

PubMed

Goetschius, John; Hart, Joseph M

2016-01-01

When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Descriptive laboratory study. Laboratory. A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P < .05). Torque variability and strength were correlated with IKDC scores (P < .05). Torque variability, strength, and CAR were correlated with each other (P < .05). Torque variability alone accounted for 14.3% of the variance in IKDC scores. The combination of torque variability and number of months after surgery accounted for 21% of the variance in IKDC scores. Strength and CAR were excluded from the regression model. Knee-extension torque variability was moderately associated with IKDC scores in patients with a history of ACL-R. Torque variability combined with months after surgery predicted 21% of the variance in IKDC scores in these patients.

ASSOCIATION OF ISOMETRIC STRENGTH OF HIP AND KNEE MUSCLES WITH INJURY RISK IN HIGH SCHOOL CROSS COUNTRY RUNNERS.

PubMed

Luedke, Lace E; Heiderscheit, Bryan C; Williams, D S Blaise; Rauh, Mitchell J

2015-11-01

High school cross country runners have a high incidence of overuse injuries, particularly to the knee and shin. As lower extremity strength is modifiable, identification of strength attributes that contribute to anterior knee pain (AKP) and shin injuries may influence prevention and management of these injuries. To determine if a relationship existed between isometric hip abductor, knee extensor and flexor strength and the incidence of AKP and shin injury in high school cross country runners. Sixty-eight high school cross country runners (47 girls, 21 boys) participated in the study. Isometric strength tests of hip abductors, knee extensors and flexors were performed with a handheld dynamometer. Runners were prospectively followed during the 2014 interscholastic cross country season for occurrences of AKP and shin injury. Bivariate logistic regression was used to examine risk relationships between strength values and occurrence of AKP and shin injury. During the season, three (4.4%) runners experienced AKP and 13 (19.1%) runners incurred a shin injury. Runners in the tertiles indicating weakest hip abductor (chi-square = 6.140; p=0.046), knee extensor (chi-square = 6.562; p=0.038), and knee flexor (chi-square = 6.140; p=0.046) muscle strength had a significantly higher incidence of AKP. Hip and knee muscle strength was not significantly associated with shin injury. High school cross country runners with weaker hip abductor, knee extensor and flexor muscle strength had a higher incidence of AKP. Increasing hip and knee muscle strength may reduce the likelihood of AKP in high school cross country runners. 2b.

Fatigue reduction during aggregated and distributed sequential stimulation.

PubMed

Bergquist, Austin J; Babbar, Vishvek; Ali, Saima; Popovic, Milos R; Masani, Kei

2017-08-01

Transcutaneous neuromuscular electrical stimulation (NMES) can generate muscle contractions for rehabilitation and exercise. However, NMES-evoked contractions are limited by fatigue when they are delivered "conventionally" (CONV) using a single active electrode. Researchers have developed "sequential" (SEQ) stimulation, involving rotation of pulses between multiple "aggregated" (AGGR-SEQ) or "distributed" (DISTR-SEQ) active electrodes, to reduce fatigue (torque-decline) by reducing motor unit discharge rates. The primary objective was to compare fatigue-related outcomes, "potentiation," "variability," and "efficiency" between CONV, AGGR-SEQ, and DISTR-SEQ stimulation of knee extensors in healthy participants. Torque and current were recorded during testing with fatiguing trains using each NMES type under isometric and isokinetic (180°/s) conditions. Compared with CONV stimulation, SEQ techniques reduced fatigue-related outcomes, increased potentiation, did not affect variability, and reduced efficiency. SEQ techniques hold promise for reducing fatigue during NMES-based rehabilitation and exercise; however, optimization is required to improve efficiency. Muscle Nerve 56: 271-281, 2017. © 2016 Wiley Periodicals, Inc.

Method to Reduce Muscle Fatigue During Transcutaneous Neuromuscular Electrical Stimulation in Major Knee and Ankle Muscle Groups.

PubMed

Sayenko, Dimitry G; Nguyen, Robert; Hirabayashi, Tomoyo; Popovic, Milos R; Masani, Kei

2015-09-01

A critical limitation with transcutaneous neuromuscular electrical stimulation as a rehabilitative approach is the rapid onset of muscle fatigue during repeated contractions. We have developed a method called spatially distributed sequential stimulation (SDSS) to reduce muscle fatigue by distributing the center of electrical field over a wide area within a single stimulation site, using an array of surface electrodes. To extend the previous findings and to prove feasibility of the method by exploring the fatigue-reducing ability of SDSS for lower limb muscle groups in the able-bodied population, as well as in individuals with spinal cord injury (SCI). SDSS was delivered through 4 active electrodes applied to the knee extensors and flexors, plantarflexors, and dorsiflexors, sending a stimulation pulse to each electrode one after another with 90° phase shift between successive electrodes. Isometric ankle torque was measured during fatiguing stimulations using SDSS and conventional single active electrode stimulation lasting 2 minutes. We demonstrated greater fatigue-reducing ability of SDSS compared with the conventional protocol, as revealed by larger values of fatigue index and/or torque peak mean in all muscles except knee flexors of able-bodied individuals, and in all muscles tested in individuals with SCI. Our study has revealed improvements in fatigue tolerance during transcutaneous neuromuscular electrical stimulation using SDSS, a stimulation strategy that alternates activation of subcompartments of muscles. The SDSS protocol can provide greater stimulation times with less decrement in mechanical output compared with the conventional protocol. © The Author(s) 2014.

Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions.

PubMed

Behrens, Martin; Mau-Moeller, Anett; Mueller, Karoline; Heise, Sandra; Gube, Martin; Beuster, Nico; Herlyn, Philipp K E; Fischer, Dagmar-C; Bruhn, Sven

2016-02-01

This study investigated effects of plyometric training (6 weeks, 3 sessions/week) on maximum voluntary contraction (MVC) strength and neural activation of the knee extensors during isometric, concentric and eccentric contractions. Twenty-seven participants were randomly assigned to the intervention or control group. Maximum voluntary torques (MVT) during the different types of contraction were measured at 110° knee flexion (180°=full extension). The interpolated twitch technique was applied at the same knee joint angle during isometric, concentric and eccentric contractions to measure voluntary activation. In addition, normalized root mean square of the EMG signal at MVT was calculated. The twitch torque signal induced by electrical nerve stimulation at rest was used to evaluate training-related changes at the muscle level. In addition, jump height in countermovement jump was measured. After training, MVT increased by 20Nm (95% CI: 5-36Nm, P=0.012), 24Nm (95% CI: 9-40Nm, P=0.004) and 27Nm (95% CI: 7-48Nm, P=0.013) for isometric, concentric and eccentric MVCs compared to controls, respectively. The strength enhancements were associated with increases in voluntary activation during isometric, concentric and eccentric MVCs by 7.8% (95% CI: 1.8-13.9%, P=0.013), 7.0% (95% CI: 0.4-13.5%, P=0.039) and 8.6% (95% CI: 3.0-14.2%, P=0.005), respectively. Changes in the twitch torque signal of the resting muscle, induced by supramaximal electrical stimulation of the femoral nerve, were not observed, indicating no alterations at the muscle level, whereas jump height was increased. Given the fact that the training exercises consisted of eccentric muscle actions followed by concentric contractions, it is in particular relevant that the plyometric training increased MVC strength and neural activation of the quadriceps muscle regardless of the contraction mode. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Somatotype variables related to muscle torque and power in judoists.

PubMed

Lewandowska, Joanna; Buśko, Krzysztof; Pastuszak, Anna; Boguszewska, Katarzyna

2011-12-01

The purpose of this study was to examine the relationship between somatotype, muscle torque and power output in judoists. Thirteen judoists (age 18.4±3.1 years, body height 178.6±8.2 cm, body mass 82.3±15.9 kg) volunteered to participate in this study. Somatotype was determined using the Heath-Carter method. Maximal muscle torques of elbow, shoulder, knee, hip and trunk flexors as well as extensors were measured under static conditions. Power outputs were measured in 5 maximal cycle ergometer exercise bouts, 10 s each, at increasing external loads equal to 2.5, 5.0, 7.5, 10.0 and 12.5% of body weight. The Pearson's correlation coefficients were calculated between all parameters. The mean somatotype of judoists was: 3.5-5.9-1.8 (values for endomorphy, mesomorphy and ectomorphy, respectively). The values (mean±SD) of sum of muscle torque of ten muscle groups (TOTAL) was 3702.2±862.9 N x m. The power output ranged from 393.2±79.4 to 1077.2±275.4 W. The values of sum of muscle torque of right and left upper extremities (SUE), sum of muscle torque of right and left lower extremities (SLE), sum of muscle torque of the trunk (ST) and TOTAL were significantly correlated with the mesomorphic component (0.68, 0.80, 0.71 and 0.78, respectively). The ectomorphic component correlated significantly with values of SUE, SLE, ST and TOTAL (-0.69, -0.81, -0.71 and -0.79, respectively). Power output was also strongly correlated with both mesomorphy (positively) and ectomorphy (negatively). The results indicated that the values of mesomorphic and ectomorphic somatotype components influence muscle torque and power output, thus body build could be an important factor affecting results in judo.

Absolute Reliability and Concurrent Validity of Hand Held Dynamometry and Isokinetic Dynamometry in the Hip, Knee and Ankle Joint: Systematic Review and Meta-analysis

PubMed Central

Chamorro, Claudio; Armijo-Olivo, Susan; De la Fuente, Carlos; Fuentes, Javiera; Javier Chirosa, Luis

2017-01-01

Abstract The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors. PMID:29071305

A Multiple Degree of Freedom Lower Extremity Isometric Device to Simultaneously Quantify Hip, Knee and Ankle Torques

PubMed Central

Sánchez, Natalia; Acosta, Ana Maria; Stienen, Arno H.A.

2015-01-01

Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation and validation of a multiple degree of freedom, lower extremity isometric device (the MultiLEIT) that accurately quantifies simultaneous torques at the hip, knee and ankle. The system was mechanically validated and then implemented with two healthy control individuals and two post-stroke individuals to test usability and patient acceptance. Data indicated different joint torque coupling strategies used by both healthy individuals. In contrast, data showed the same torque coupling patterns in both post-stroke individuals, comparable to those described in the clinic. Successful implementation of the MultiLEIT can contribute to the understanding of the underlying mechanisms responsible for abnormal movement patterns and aid in the design of therapeutic interventions. PMID:25163064

Reliability and Validity of Isometric Knee Extensor Strength Test With Hand-Held Dynamometer Depending on Its Fixation: A Pilot Study

PubMed Central

Kim, Won Kuel; Seo, Kyung Mook; Kang, Si Hyun

2014-01-01

Objective To determine the reliability and validity of hand-held dynamometer (HHD) depending on its fixation in measuring isometric knee extensor strength by comparing the results with an isokinetic dynamometer. Methods Twenty-seven healthy female volunteers participated in this study. The subjects were tested in seated and supine position using three measurement methods: isometric knee extension by isokinetic dynamometer, non-fixed HHD, and fixed HHD. During the measurement, the knee joints of subjects were fixed at a 35° angle from the extended position. The fixed HHD measurement was conducted with the HHD fixed to distal tibia with a Velcro strap; non-fixed HHD was performed with a hand-held method without Velcro fixation. All the measurements were repeated three times and among them, the maximum values of peak torque were used for the analysis. Results The data from the fixed HHD method showed higher validity than the non-fixed method compared with the results of the isokinetic dynamometer. Pearson correlation coefficients (r) between fixed HHD and isokinetic dynamometer method were statistically significant (supine-right: r=0.806, p<0.05; seating-right: r=0.473, p<0.05; supine-left: r=0.524, p<0.05), whereas Pearson correlation coefficients between non-fixed dynamometer and isokinetic dynamometer methods were not statistically significant, except for the result of the supine position of the left leg (r=0.384, p<0.05). Both fixed and non-fixed HHD methods showed excellent inter-rater reliability. However, the fixed HHD method showed a higher reliability than the non-fixed HHD method by considering the intraclass correlation coefficient (fixed HHD, 0.952-0.984; non-fixed HHD, 0.940-0.963). Conclusion Fixation of HHD during measurement in the supine position increases the reliability and validity in measuring the quadriceps strength. PMID:24639931

The effect of whole-body vibration therapy on bone metabolism, motor function, and anthropometric parameters in women with postmenopausal osteoporosis.

PubMed

Luo, Xiaotian; Zhang, Jifeng; Zhang, Chi; He, Chengqi; Wang, Pu

2017-11-01

To review the research literature on the effectiveness of whole-body vibration (WBV) therapy in women with postmenopausal osteoporosis. A systematic review was conducted by two independent reviewers. Mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with the I 2 test. The Cochrane risk of bias tool was used to assess the methodological quality of the selected studies. Nine randomized controlled trials involving 625 patients met the inclusion criteria. No significant improvement was found in bone mineral density (BMD) (SMD = -0.06, 95%CI= -0.22-0.11, p = 0.50); bone turnover markers (MD = -0.25, 95%CI= -0.54-0.03, p = 0.08); anthropometric parameters, including muscle mass, fat mass, body mass index (BMI), and weight (SMD = 0.02, 95%CI= -0.16-0.21, p = 0.81); or maximal isotonic knee extensor strength (SMD = 0.16, 95%CI= -0.63-0.95, p = 0.69). However, maximal isometric knee extensor strength improved (SMD = 0.71, 95%CI = 0.34-1.08, p = 0.0002). WBV is beneficial for enhancing maximal isometric knee extensor strength, but it has no overall treatment effect on BMD, bone turnover markers, anthropometric parameters, or maximal isotonic knee extensor strength in women with postmenopausal osteoporosis. Implication of rehabilitation Osteoporosis is the leading underlying cause of fractures in postmenopausal women, whole body vibration (WBV) has received much attention as a potential intervention for the management of osteoporosis in recent years. Whole body vibration is beneficial for enhancing maximal isometric knee extensor strength in women with postmenopausal osteoporosis. Whole body vibration has no overall treatment effect on bone mineral density, bone turnover markers, anthropometric parameters and maximal isotonic knee extensor strength in women with postmenopausal osteoporosis.

Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis.

PubMed

Citaker, Seyit; Guclu-Gunduz, Arzu; Yazici, Gokhan; Bayraktar, Deniz; Nazliel, Bijen; Irkec, Ceyla

2013-01-01

Muscle strength and standing balance decrease in patients with Multiple Sclerosis (MS). The aim of the present study was to investigate the relationship between the lower extremity isometric muscle strength and standing balance in patients with MS. Forty-seven patients with MS and 10 healthy volunteers were included. Neurological disability level was assessed using Expanded Disability Status Scale (EDSS). Isometric strength of seven lower extremity muscles (hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor) was assessed using hand-held dynamometer. Duration of static one-leg standing balance was measured using digital chronometer. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength, and duration of one-leg standing balance were decreased in patients with MS when compared with controls (p < 0.05). All assessed lower extremity isometric muscle strength and EDSS level was related duration of one-leg standing balance in patients with MS. All assessed lower extremity isometric muscle strength (except ankle dorsal flexor) was related with EDSS. Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength decreases in ambulatory MS patients. Lower extremity muscle weakness and neurological disability level are related with imbalance in MS population. Hip and knee region muscles weakness increases the neurological disability level. For the better balance and decrease neurological disability level whole lower extremity muscle strengthening should be included in rehabilitation programs.

Ischemic conditioning increases strength and volitional activation of paretic muscle in chronic stroke: a pilot study.

PubMed

Hyngstrom, Allison S; Murphy, Spencer A; Nguyen, Jennifer; Schmit, Brian D; Negro, Francesco; Gutterman, David D; Durand, Matthew J

2018-05-01

Ischemic conditioning (IC) on the arm or leg has emerged as an intervention to improve strength and performance in healthy populations, but the effects on neurological populations are unknown. The purpose of this study was to quantify the effects of a single session of IC on knee extensor strength and muscle activation in chronic stroke survivors. Maximal knee extensor torque measurements and surface EMG were quantified in 10 chronic stroke survivors (>1 yr poststroke) with hemiparesis before and after a single session of IC or sham on the paretic leg. IC consisted of 5 min of compression with a proximal thigh cuff (inflation pressure = 225 mmHg for IC or 25 mmHg for sham) followed by 5 min of rest. This was repeated five times. Maximal knee extensor strength, EMG magnitude, and motor unit firing behavior were measured before and immediately after IC or sham. IC increased paretic leg strength by 10.6 ± 8.5 Nm, whereas no difference was observed in the sham group (change in sham = 1.3 ± 2.9 Nm, P = 0.001 IC vs. sham). IC-induced increases in strength were accompanied by a 31 ± 15% increase in the magnitude of muscle EMG during maximal contractions and a 5% decrease in motor unit recruitment thresholds during submaximal contractions. Individuals who had the most asymmetry in strength between their paretic and nonparetic legs had the largest increases in strength ( r 2  = 0.54). This study provides evidence that a single session of IC can increase strength through improved muscle activation in chronic stroke survivors. NEW & NOTEWORTHY Present rehabilitation strategies for chronic stroke survivors do not optimally activate paretic muscle, and this limits potential strength gains. Ischemic conditioning of a limb has emerged as an effective strategy to improve muscle performance in healthy individuals but has never been tested in neurological populations. In this study, we show that ischemic conditioning on the paretic leg of chronic stroke survivors can increase leg strength and muscle activation while reducing motor unit recruitment thresholds.

Strength and hypertrophy responses to constant and decreasing rest intervals in trained men using creatine supplementation.

PubMed

Souza-Junior, Tácito P; Willardson, Jeffrey M; Bloomer, Richard; Leite, Richard D; Fleck, Steven J; Oliveira, Paulo R; Simão, Roberto

2011-10-27

The purpose of the current study was to compare strength and hypertrophy responses to resistance training programs that instituted constant rest intervals (CI) and decreasing rest intervals (DI) between sets over the course of eight weeks by trained men who supplemented with creatine monohydrate (CR). Twenty-two recreationally trained men were randomly assigned to a CI group (n = 11; 22.3 ± 1 years; 77.7 ± 5.4 kg; 180 ± 2.2 cm) or a DI group (n = 11; 22 ± 2.5 years; 75.8 ± 4.9 kg; 178.8 ± 3.4 cm). Subjects in both groups supplemented with CR; the only difference between groups was the rest interval instituted between sets; the CI group used 2 minutes rest intervals between sets and exercises for the entire 8-weeks of training, while the DI group started with a 2 minute rest interval the first two weeks; after which the rest interval between sets was decreased 15 seconds per week (i.e. 2 minutes decreasing to 30 seconds between sets). Pre- and post-intervention maximal strength for the free weight back squat and bench press exercises and isokinetic peak torque were assessed for the knee extensors and flexors. Additionally, muscle cross-sectional area (CSA) of the right thigh and upper arm was measured using magnetic resonance imaging. Both groups demonstrated significant increases in back squat and bench press maximal strength, knee extensor and flexor isokinetic peak torque, and upper arm and right thigh CSA from pre- to post-training (p ≤ 0.0001); however, there were no significant differences between groups for any of these variables. The total volume for the bench press and back squat were significantly greater for CI group versus the DI group. We report that the combination of CR supplementation and resistance training can increase muscular strength, isokinetic peak torque, and muscle CSA, irrespective of the rest interval length between sets. Because the volume of training was greater for the CI group versus the DI group, yet strength gains were similar, the creatine supplementation appeared to bolster adaptations for the DI group, even in the presence of significantly less volume. However, further research is needed with the inclusion of a control group not receiving supplementation combined and resistance training with decreasing rest intervals to further elucidate such hypotheses.

Effects of Progressive Resistance Strength Training on Knee Biomechanics During Single Leg Step-up in Persons with Mild Knee Osteoarthritis

PubMed Central

McQuade, Kevin James; de Oliveira, Anamaria Siriani

2011-01-01

Background The goal of this study was to determine if increasing strength in primary knee extensors and flexors would directly affect net knee joint moments during a common functional task in persons with knee osteoarthritis. Methods An exploratory single sample clinical trial with pre-post treatment measures was used to study volunteers with clinical diagnosis of mild knee OA in one knee. Subjects participated in an individually supervised training program 3 times a week for eight weeks consisting of progressive resistive exercises for knee extensors and knee flexors. Pre and post training outcome assessments included: 1. Net internal knee joint moments, 2. Electromyography of primary knee extensors and flexors, and 3. Self-report measures of knee pain and function. The distribution of lower extremity joint moments as a percent of the total support moment was also investigated. Findings Pain, symptoms, activities of daily life, quality of life, stiffness, and function scores showed significant improvement following strength training. Knee internal valgus and hip internal rotation moments showed increasing but non-statistically significant changes post-training. There were no significant differences in muscle co-contraction activation of the Quadriceps and Hamstrings. Interpretations While exercise continues to be an important element of OA management, the results of this study suggest improvements in function, pain, and other symptoms, as a result of strength training may not be causally related to specific biomechanical changes in net joint moments. PMID:21514018

Dynamic restraint capacity of the hamstring muscles has important functional implications after anterior cruciate ligament injury and anterior cruciate ligament reconstruction.

PubMed

Bryant, Adam L; Creaby, Mark W; Newton, Robert U; Steele, Julie R

2008-12-01

The purpose of this study was to investigate the relation between knee functionality of anterior cruciate ligament deficient (ACLD) and anterior cruciate ligament reconstruction (ACLR) patients and hamstring antagonist torque generated during resisted knee extension. Cross-sectional. Laboratory based. Male ACLD subjects (n=10) (18-35 y) and 27 matched males who had undergone ACLR (14 patella tendon [PT] grafts and 13 combined semitendinosus/gracilis tendon grafts). Not applicable. Knee functionality was rated (0- to 100-point scale) by using the Cincinnati Knee Rating System. Using electromyography data from the semitendinosus (ST) and biceps femoris muscles, we created a mathematical model to estimate the opposing torque generated by the hamstrings during isokinetic knee extension in 10 degrees intervals from 80 degrees to 10 degrees knee flexion. Pearson product-moment correlations revealed that more functional ACLD subjects generated significantly (P<.05) higher hamstring antagonist torque throughout knee extension. In contrast, more functional PT subjects produced significantly lower hamstring antagonist torque at 80 degrees to 70 degrees knee flexion, whereas no significant associations were found between hamstring antagonist torque and knee functionality for the ST/gracilis tendon subjects. An increased hamstring antagonist torque generated by the more functional ACLD subjects, reflective of increased hamstring contractile force, is thought to represent a protective mechanism to compensate for mechanical instability. The restoration of anterior knee stability through ACLR negates the need for augmented hamstring antagonist torque.

Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy.

PubMed

Handsaker, Joseph C; Brown, Steven J; Bowling, Frank L; Cooper, Glen; Maganaris, Constantinos N; Boulton, Andrew J M; Reeves, Neil D

2014-11-01

Although patients with diabetic peripheral neuropathy (DPN) are more likely to fall than age-matched controls, the underlying causative factors are not yet fully understood. This study examines the effects of diabetes and neuropathy on strength generation and muscle activation patterns during walking up and down stairs, with implications for fall risk. Sixty-three participants (21 patients with DPN, 21 diabetic controls, and 21 healthy controls) were examined while walking up and down a custom-built staircase. The speed of strength generation at the ankle and knee and muscle activation patterns of the ankle and knee extensor muscles were analyzed. Patients with neuropathy displayed significantly slower ankle and knee strength generation than healthy controls during stair ascent and descent (P < 0.05). During ascent, the ankle and knee extensor muscles were activated significantly later by patients with neuropathy and took longer to reach peak activation (P < 0.05). During descent, neuropathic patients activated the ankle extensors significantly earlier, and the ankle and knee extensors took significantly longer to reach peak activation (P < 0.05). Patients with DPN are slower at generating strength at the ankle and knee than control participants during walking up and down stairs. These changes, which are likely caused by altered activations of the extensor muscles, increase the likelihood of instability and may be important contributory factors for the increased risk of falling. Resistance exercise training may be a potential clinical intervention for improving these aspects and thereby potentially reducing fall risk. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Elbow flexor fatigue modulates central excitability of the knee extensors.

PubMed

Aboodarda, Saied Jalal; Copithorne, David B; Power, Kevin E; Drinkwater, Eric; Behm, David G

2015-09-01

The present study investigated the effects of exercise-induced elbow flexor fatigue on voluntary force output, electromyographic (EMG) activity and motoneurone excitability of the nonexercised knee extensor muscles. Eleven participants attended 3 testing sessions: (i) control, (ii) unilateral fatiguing elbow flexion and (iii) bilateral fatiguing elbow flexion (BiFlex). The nonfatigued knee extensor muscles were assessed with thoracic motor evoked potentials (TMEPs), maximal compound muscle action potential (Mmax), knee extensor maximal voluntary contractions (MVCs), and normalized EMG activity before and at 30 s, 3 min, and 5 min postexercise. BiFlex showed significantly lower (Δ = -18%, p = 0.03) vastus lateralis (VL) normalized EMG activity compared with the control session whereas knee extension MVC force did not show any statistical difference between the 3 conditions (p = 0.12). The TMEP·Mmax(-1) ratio measured at the VL showed a significantly higher value (Δ = +46%, p = 0.003) following BiFlex compared with the control condition at 30 s postexercise. The results suggest that the lower VL normalized EMG following BiFlex might have been due to a reduction in supraspinal motor output because spinal motoneuronal responses demonstrated substantially higher value (30 s postexercise) and peripheral excitability (compound muscle action potential) showed no change following BiFelex than control condition.

Sex comparisons of non-local muscle fatigue in human elbow flexors and knee extensors

PubMed Central

Ye, Xin; Beck, Travis W.; Wages, Nathan P.; Carr, Joshua C.

2018-01-01

Objectives: To examine non-local muscle fatigue (NLMF) in both contralateral homologous and non-related heterogonous muscles for both sexes. Methods: Ten men and nine women participated in this study. After the familiarization visit, subjects completed four separate randomly sequenced experimental visits, during which the fatiguing interventions (six sets of 30-second maximal isometric contractions) were performed on either their right elbow flexors or knee extensors. Before (Pre-) and after (Post-) the fatiguing interventions, the isometric strength and the corresponding surface electromyographic (EMG) amplitude were measured for the non-exercised left elbow flexors or knee extensors. Results: For the non-exercised elbow flexors, the isometric strength decreased for both sexes (sex combined mean±SE: Pre vs. Post=339.67±18.02 N vs. 314.41±16.37 N; p<0.001). For the non-exercised knee extensors, there is a time ´ sex interaction (p=0.025), showing a decreased isometric knee extension strength for men (Pre vs. Post =845.02±66.26 N vs. 817.39±67.64 N; p=0.019), but not for women. Conclusions: The presence of NMLF can be affected by factors such as sex and muscle being tested. Women are less likely to demonstrate NLMF in lower body muscle groups. PMID:29504584

Effects of 17-day spaceflight on knee extensor muscle function and size

NASA Technical Reports Server (NTRS)

Tesch, Per A.; Berg, Hans E.; Bring, Daniel; Evans, Harlan J.; LeBlanc, Adrian D.

2005-01-01

It is generally held that space travelers experience muscle dysfunction and atrophy during exposure to microgravity. However, observations are scarce and reports somewhat inconsistent with regard to the time course, specificity and magnitude of such changes. Hence, we examined four male astronauts (group mean approximately 43 years, 86 kg and 183 cm) before and after a 17-day spaceflight (Space Transport System-78). Knee extensor muscle function was measured during maximal bilateral voluntary isometric and iso-inertial concentric, and eccentric actions. Cross-sectional area (CSA) of the knee extensor and flexor, and gluteal muscle groups was assessed by means of magnetic resonance imaging. The decrease in strength (P<0.05) across different muscle actions after spaceflight amounted to 10%. Eight ambulatory men, examined on two occasions 20 days apart, showed unchanged (P>0.05) muscle strength. CSA of the knee extensor and gluteal muscles, each decreased (P<0.05) by 8%. Knee flexor muscle CSA showed no significant (P>0.05) change. The magnitude of these changes concord with earlier results from ground-based studies of similar duration. The results of this study, however, do contrast with the findings of no decrease in maximal voluntary ankle plantar flexor force previously reported in the same crew.

Hip and knee extensor moments predict vertical jump height in adolescent girls.

PubMed

Ford, Kevin R; Myer, Gregory D; Brent, Jensen L; Hewett, Timothy E

2009-07-01

Biomechanical factors, such as hip and knee extensor moments, related to drop jump (DJ) performance have not been investigated in adolescent girls. The purpose of this study was to determine the key independent biomechanical variables that predict overall vertical jump performance in adolescent girls. Sixteen high school adolescent girls from club-sponsored and high school-sponsored volleyball teams performed DJ at 3 different drop heights (15, 30, and 45 cm). A motion analysis system consisting of 10 digital cameras and a force platform was used to calculate vertical jump height, joint angles, and joint moments during the tasks. A multiple linear regression was used to determine the biomechanical parameters that were best predictive of vertical jump height at each box drop distance. The 2 predictor variables in all 3 models were knee and hip extensor moments. The models predicted 82.9, 81.9, and 88% of the vertical jump height variance in the 15, 30, and 45 cm trials, respectively. The results of the investigation indicate that knee and hip joint moments are the main contributors to vertical jump height during the DJ in adolescent girls. Strength and conditioning specialists attempting to improve vertical jump performance should target power and strength training to the hip and knee extensors in their athletes.

Central excitability contributes to supramaximal volitional contractions in human incomplete spinal cord injury

PubMed Central

Thompson, Christopher K; Lewek, Michael D; Jayaraman, Arun; Hornby, T George

2011-01-01

Abstract Despite greater muscle fatigue in individuals with spinal cord injury (SCI) when compared to neurologically intact subjects using neuromuscular electrical stimulation (NMES) protocols, few studies have investigated the extent of volitional fatigue in motor incomplete SCI. Using an established protocol of 20 repeated, intermittent, maximal volitional effort (MVE) contractions, we previously demonstrated that subjects with incomplete SCI unexpectedly demonstrated a 15% increase in peak knee extensor torques within the first five MVEs with minimal evidence of fatigue after 20 contraction. In the present study, we investigated potential segmental mechanisms underlying this supramaximal torque generation. Changes in twitch properties and maximum compound muscle action potentials (M-waves) were assessed prior to and following one, three and five MVEs, revealing a significant 17% increase only in maximum twitch torques after a single MVE. Despite this post-activation potentiation of the muscle, use of conventional NMES protocols to elicit repeated muscular contractions resulted in a significant decrease in evoked torque generation, suggesting limited the muscular contributions to the observed phenomenon. To evaluate potential central mechanisms underlying the augmented torques, non-linear responses to wide-pulse width (1 ms), low-intensity, variable-frequency (25–100 Hz) NMES were also tested prior to and following repeated MVEs. When variable-frequency NMES was applied following the repeated MVEs, augmented and prolonged torques were observed and accompanied by sustained quadriceps electromyographic activity often lasting >2s after stimulus termination. Such data suggest a potential contribution of elevated spinal excitability to the reserve in volitional force generation in incomplete SCI. PMID:21610138

Muscle function in aged women in response to a water-based exercises program and progressive resistance training.

PubMed

Bento, Paulo Cesar Barauce; Rodacki, André Luiz Felix

2015-11-01

The purpose of the present study was to determine the effects of a water-based exercise program on muscle function compared with regular high-intensity resistance training. Older women (n = 87) were recruited from the local community. The inclusion criteria were, to be aged 60 years or older, able to walk and able to carry out daily living activities independently. Participants were randomly assigned to one of the following groups: water-based exercises (WBG), resistance training (RTG) or control (CG). The experimental groups carried out 12 weeks of an excise program performed on water or on land. The dynamic strength, the isometric peak, and rate of torque development for the lower limbs were assessed before and after interventions. The water-based program provided a similar improvement in dynamic strength in comparison with resistance training. The isometric peak torque increased around the hip and ankle joints in the water-based group, and around the knee joint in the resistance-training group (P < 0.05). The rate of torque development increased only in the water-based group around the hip extensors muscles (P < 0.05). Water-based programs constitute an attractive alternative to promote relevant strength gains using moderate loads and fast speed movements, which were also effective to improve the capacity to generate fast torques. © 2014 Japan Geriatrics Society.

Changes in the activity of trunk and hip extensor muscles during bridge exercises with variations in unilateral knee joint angle.

PubMed

Kim, Juseung; Park, Minchul

2016-09-01

[Purpose] This study compared abdominal and hip extensor muscle activity during a bridge exercise with various knee joint angles. [Subjects and Methods] Twenty-two healthy male subjects performed a bridge exercise in which the knee joint angle was altered. While subjects performed the bridge exercise, external oblique, internal oblique, gluteus maximus, and semitendinosus muscle activity was measured using electromyography. [Results] The bilateral external and internal oblique muscle activity was significantly higher at 0° knee flexion compared to 120°, 90°, and 60°. The bilateral gluteus maximus muscle activity was significantly different at 0° of knee flexion compared to 120°, 90°, and 60°. The ipsilateral semitendinosus muscle activity was significantly increased at 90° and 60° of knee flexion compared to 120°, and significantly decreased at 0° knee flexion compared with 120°, 90°, and 60°. The contralateral semitendinosus muscle activity was significantly higher at 60° of knee flexion than at 120°, and significantly higher at 0° of knee flexion than at 120°, 90°, and 60°. [Conclusion] Bridge exercises performed with knee flexion less than 90° may be used to train the ipsilateral semitendinosus. Furthermore, bridge exercise performed with one leg may be used to train abdominal and hip extensor muscles.

Mildly disabled persons with multiple sclerosis use similar net joint power strategies as healthy controls when walking speed increases.

PubMed

Brincks, John; Christensen, Lars Ejsing; Rehnquist, Mette Voigt; Petersen, Jesper; Sørensen, Henrik; Dalgas, Ulrik

2018-01-01

To improve walking in persons with multiple sclerosis (MS), it is essential to understand the underlying mechanisms of walking. This study examined strategies in net joint power generated or absorbed by hip flexors, hip extensors, hip abductors, knee extensors, and plantar flexors in mildly disabled persons with MS and healthy controls at different walking speeds. Thirteen persons with MS and thirteen healthy controls participated and peak net joint power was calculated using 3D motion analysis. In general, no differences were found between speed-matched healthy controls and persons with MS, but the fastest walking speed was significantly higher in healthy controls (2.42 m/s vs. 1.70 m/s). The net joint power increased in hip flexors, hip extensors, hip abductors, knee extensors and plantar flexors in both groups, when walking speed increased. Significant correlations between changes in walking speed and changes in net joint power of plantar flexors, hip extensors and hip flexors existed in healthy controls and persons with MS, and in net knee extensor absorption power of persons with MS only. In contrast to previous studies, these findings suggest that mildly disabled persons with MS used similar kinetic strategies as healthy controls to increase walking speed.

Changes in Gait over a 30-min Walking Session in Obese Females.

PubMed

Singh, Bhupinder; Vo, Huy; Francis, Shelby L; Janz, Kathleen F; Yack, H John

2017-03-01

This study assessed the biomechanical gait changes in obese and normal-weight female adult subjects after a commonly recommended 30-min walking session. Hip and knee adduction and extensor moments, which are the primary modulators of frontal and sagittal plane load distribution, were hypothesized to increase in obese females after a 30-min walking period, resulting in more stress across the hip and knee joint. Ten obese (37.7 ± 4.8 yr of age, body mass index [BMI] = 36.1 ± 4.2 kg·m) and 10 normal-weight control female subjects (38.1 ± 4.5 yr of age, BMI = 22.6 ± 2.3 kg·m) walked 30 min continuously on the treadmill at their self-selected speed. V˙O2max was estimated using Ebbeling protocol. A three-dimensional pre- and posttreadmill gait analysis was conducted using infrared markers and force plates to calculate hip and knee moments. Knee extensor moments increased in both obese, pretreadmill (0.54 ± 0.28 N·m·kg) to posttreadmill (0.78 ± 0.43 N·m·kg) (P = 0.01), and control subjects, pretreadmill (0.57 ± 0.34 N·m·kg) to posttreadmill (0.80 ± 0.49 N·m·kg) (P = 0.02). Hip extensor moments decreased for both obese and control subjects. Knee adduction moments did not change in either obese or control subjects. Knee extensor and adductor moments showed good to moderate relationships with V˙O2max, but not BMI or waist circumference. Obese and normal-weight subjects experienced an increase in knee extensor moments after 30 min of walking similarly; therefore, clinicians do not need special consideration for obese individuals when recommending 30-min walking sessions. Fitness may be the important factor in judging the implications of exercise on joint mechanics and parameters of a walking program.

Effects of once weekly NMES training on knee extensors fatigue and body composition in a person with spinal cord injury.

PubMed

Gorgey, Ashraf S; Caudill, Caelb; Khalil, Refka E

2016-01-01

Single-subject case (male, 33 years of age, T6 SCI AIS A). To determine the effect of surface neuromuscular electrical stimulation (NMES) training conducted once weekly on improving fatigue resistance as well as regional and whole body composition in an individual with spinal cord injury (SCI). Laboratory setting within a SCI Center. Surface NMES resistance training (RT) of the paralyzed knee extensors was conducted once weekly for 12 weeks using ankle weights. Knee extensor fatigue index was determined by the number of repetitions (reps) achieved out of 30 reps. Total and regional body composition including percentage body fat (%BF), fat mass (FM), lean mass (LM) were conducted before the first session and one week after the last training session using whole-body dual-energy X-ray absorptiometry. The participant had a compliance rate of 83% and he was able to lift 6 and 2 lbs on the right and left legs, respectively. Right knee extensors showed greater fatigue resistance compared to the left one. Leg LM increased by 6% accompanied with decrease in arm, trunk and total body LM by -4.7%, -13%, -5%, respectively. The %BF increased by 8%, 7.3%, 15.5%, 11.5% for arm, legs, trunk and total body. Once weekly of NMES RT evokes local positive changes in leg LM without reciprocating the continuous loss in LM or gain in FM in other regions and total body. Training was effective in increasing strength as well as fatigue resistance of the trained knee extensors.

Effect of unilateral knee extensor fatigue on force and balance of the contralateral limb.

PubMed

Arora, Shruti; Budden, Shawn; Byrne, Jeannette M; Behm, David G

2015-10-01

Fatigue in one limb can decrease force production in the homologous muscle as well as other muscles of the non-fatigued limb affecting balance. The objective of the study was to examine the effect of unilateral knee extensor fatigue on the non-fatigued limb's standing balance, muscle force and activation. Sixteen healthy male subjects performed pre-fatigue balance trials, warm-up exercises, maximum voluntary isometric contractions, a knee extensors fatigue protocol, and post-fatigue balance trials. The fatigue protocol consisted of sets of 15 consecutive isometric contractions of 16 s each with 4 s recovery between repetitions, which were performed at 30% peak force for the dominant knee extensor muscles. Additional sets of contractions continued until a 50% decrease in MVIC knee extensor force was observed. Pre- and post-fatigue balance assessment consisted of transition from double to single leg standing and also single leg standing trials, which were performed bilaterally and in randomized order. The peak force and F100 were significantly decreased by 44.8% (ES = 2.54) and 39.9% (ES = 0.59), respectively, for the fatigued limb post-fatigue. There were no significant changes in the non-fatigued limb's muscle force, activation, muscle onset timing or postural stability parameters. While the lack of change in non-fatigued limb force production is in agreement with some of the previous literature in this area, the lack of effect on postural measures directly contradicts earlier work. It is hypothesized that discrepancies in the duration and the intensity of the fatigue protocol may have accounted for this discrepancy.

Muscle Strength Imbalance in the Hip Joint Caused by Fast Movements

NASA Astrophysics Data System (ADS)

Pontaga, I.

2003-07-01

Eleven male sportsmen at the age of 24.3 ± 4.5 were examined. Their hip joint flexors and extensors were tested by an "REV-9000" Technogym dynamometer system during isokinetic movements at angular velocities of 100 (low) and 200 (high) °/s. The range of hip joint movements was from 30 (in flexion) to 130° (in extension). Torque values and their ratios for hip flexors and extensors at different angular positions were obtained and compared. It is shown that, at high speeds, the flexion movement significantly raises ( p < 0.001) the torque ratios of flexors and extensors in flexion positions of the hip (50 and 60°). These ratios approximately twofold exceed their values at moderate velocities. The weakness of hip joint extensors in extreme flexion positions of the hip may cause injury of this group of muscles at fast movements.

Four Weeks of Nordic Hamstring Exercise Reduce Muscle Injury Risk Factors in Young Adults.

PubMed

Ribeiro-Alvares, João Breno; Marques, Vanessa B; Vaz, Marco A; Baroni, Bruno M

2018-05-01

Ribeiro-Alvares, JB, Marques, VB, Vaz, MA, and Baroni, BM. Four weeks of Nordic hamstring exercise reduce muscle injury risk factors in young adults. J Strength Cond Res 32(5): 1254-1262, 2018-The Nordic hamstring exercise (NHE) is a field-based exercise designed for knee-flexor eccentric strengthening, aimed at prevention of muscle strains. However, possible effects of NHE programs on other hamstring injury risk factors remain unclear. The purpose of this study was to investigate the effects of a NHE training program on multiple hamstring injury risk factors. Twenty physically active young adults were allocated into 2 equal-sized groups: control group (CG) and training group (TG). The TG was engaged in a 4-week NHE program, twice a week, 3 sets of 6-10 repetitions; while CG received no exercise intervention. The knee flexor and extensor strength were assessed through isokinetic dynamometry, the biceps femoris long head muscle architecture through ultrasound images, and the hamstring flexibility through sit-and-reach test. The results showed that CG subjects had no significant change in any outcome. TG presented higher percent changes than CG for hamstring isometric peak torque (9%; effect size [ES] = 0.27), eccentric peak torque (13%; ES = 0.60), eccentric work (18%; ES = 0.86), and functional hamstring-to-quadriceps torque ratio (13%; ES = 0.80). The NHE program led also to increased fascicle length (22%; ES = 2.77) and reduced pennation angle (-17%; ES = 1.27) in biceps femoris long head of the TG, without significant changes on muscle thickness. In conclusion, a short-term NHE training program (4 weeks; 8 training sessions) counteracts multiple hamstring injury risk factors in physically active young adults.

Explosive Strength of the Knee Extensors: The Influence of Criterion Trial Detection Methodology on Measurement Reproducibility.

PubMed

Dirnberger, Johannes; Wiesinger, Hans-Peter; Wiemer, Nicolas; Kösters, Alexander; Müller, Erich

2016-04-01

The present study was conducted to assess test-retest reproducibility of explosive strength measurements during single-joint isometric knee extension using the IsoMed 2000 dynamometer. Thirty-one physically active male subjects (mean age: 23.7 years) were measured on two occasions separated by 48-72 h. The intraclass correlation coefficient (ICC 2,1) and the coefficient of variation (CV) were calculated for (i) maximum torque (MVC), (ii) the peak rate of torque development (RTD peak ) as well as for (iii) the average rate of torque development (RTD) and the impulse taken at several predefined time intervals (0-30 to 0-300 ms); thereby explosive strength variables were derived in two conceptually different versions: on the one hand from the MVC-trial (version I), on the other hand from the trial showing the RTD peak (version II). High ICC-values (0.80-0.99) and acceptable CV-values (1.9-8.7%) could be found for MVC as well as for the RTD and the impulse taken at time intervals of ≥100 ms, regardless of whether version I or II was used. In contrast, measurements of the RTD peak as well as the RTD and the impulse taken during the very early contraction phase (i.e. RTD/impulse 0-30ms and RTD/impulse 0-50ms ) showed clearly weaker reproducibility results (ICC: 0.53-0.84; CV: 7.3-16.4%) and gave rise to considerable doubts as to clinical usefulness, especially when derived using version I. However, if there is a need to measure explosive strength for earlier time intervals in practice, it is, in view of stronger reproducibility results, recommended to concentrate on measures derived from version II, which is based on the RTD peak -trial.

Associations of knee muscle force, bone malalignment, and knee-joint laxity with osteoarthritis in elderly people.

PubMed

Nakagawa, Kazumasa; Maeda, Misako

2017-03-01

[Purpose] From the viewpoint of prevention of knee osteoarthritis, the aim of this study was to verify how muscle strength and joint laxity are related to knee osteoarthritis. [Subjects and Methods] The study subjects consisted of 90 community-dwelling elderly people aged more than 60 years (22 males, 68 females). Femorotibial angle alignment, knee joint laxity, knee extensors and flexor muscle strengths were measured in all subjects. In addition, the subjects were divided into four groups based on the presence of laxity and knee joint deformation, and the muscle strength values were compared. [Results] There was no significant difference in knee extensor muscle strength among the four groups. However, there was significant weakness of the knee flexor muscle in the group with deformation and laxity was compared with the group without deformation and laxity. [Conclusion] Decreased knee flexor muscle strengths may be involved in knee joint deformation. The importance of muscle strength balance was also considered.

Fracture of the proximal tibia after revision total knee arthroplasty with an extensor mechanism allograft.

PubMed

Klein, Gregg R; Levine, Harlan B; Sporer, Scott M; Hartzband, Mark A

2013-02-01

Extensor mechanism reconstruction with an extensor mechanism allograft (EMA) remains one of the most reliable methods for treating the extensor mechanism deficient total knee arthroplasty. We report 3 patients who were treated with an EMA who sustained a proximal tibial shaft fracture. In all 3 cases, a short tibial component was present that ended close to the level of the distal extent of the bone block. When performing an EMA, it is important to recognize that the tibial bone block creates a stress riser and revision to a long-stemmed tibial component should be strongly considered to bypass this point to minimize the risk of fracture. Copyright © 2013 Elsevier Inc. All rights reserved.

Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study.

PubMed

Łyp, Marek; Stanisławska, Iwona; Witek, Bożena; Olszewska-Żaczek, Ewelina; Czarny-Działak, Małgorzata; Kaczor, Ryszard

2018-02-13

This study deals with the use of a robot-assisted body-weight-supported treadmill training in multiple sclerosis (MS) patients with gait dysfunction. Twenty MS patients (10 men and 10 women) of the mean of 46.3 ± 8.5 years were assigned to a six-week-long training period with the use of robot-assisted treadmill training of increasing intensity of the Lokomat type. The outcome measure consisted of the difference in motion-dependent torque of lower extremity joint muscles after training compared with baseline before training. We found that the training uniformly and significantly augmented the torque of both extensors and flexors of the hip and knee joints. The muscle power in the lower limbs of SM patients was improved, leading to corrective changes of disordered walking movements, which enabled the patients to walk with less effort and less assistance of care givers. The torque augmentation could have its role in affecting the function of the lower extremity muscle groups during walking. The results of this pilot study suggest that the robot-assisted body-weight-supported treadmill training may be a potential adjunct measure in the rehabilitation paradigm of 'gait reeducation' in peripheral neuropathies.

Intrarater reliability of the Humac NORM isokinetic dynamometer for strength measurements of the knee and shoulder muscles.

PubMed

Habets, Bas; Staal, J Bart; Tijssen, Marsha; van Cingel, Robert

2018-01-10

To determine the intrarater reliability of the Humac NORM isokinetic dynamometer for concentric and eccentric strength tests of knee and shoulder muscles. 54 participants (50% female, average age 20.9 ± 3.1 years) performed concentric and eccentric strength measures of the knee extensors and flexors, and the shoulder internal and external rotators on two different Humac NORM isokinetic dynamometers, which were situated at two different centers. The knee extensors and flexors were tested concentrically at 60° and 180°/s, and eccentrically at 60° s. Concentric strength of the shoulder internal and external rotators, and eccentric strength of the external rotators were measured at 60° and 120°/s. We calculated intraclass correlation coefficients (ICCs), standard error of measurement, standard error of measurement expressed as a %, and the smallest detectable change to determine reliability and measurement error. ICCs for the knee tests ranged from 0.74 to 0.89, whereas ICC values for the shoulder tests ranged from 0.72 to 0.94. Measurement error was highest for the concentric test of the knee extensors and lowest for the concentric test of shoulder external rotators.

Electrode position markedly affects knee torque in tetanic, stimulated contractions.

PubMed

Vieira, Taian M; Potenza, Paolo; Gastaldi, Laura; Botter, Alberto

2016-02-01

The purpose of this study was to investigate how much the distance between stimulation electrodes affects the knee extension torque in tetanic, electrically elicited contractions. Current pulses of progressively larger amplitude, from 0 mA to maximally tolerated intensities, were delivered at 20 pps to the vastus medialis, rectus femoris and vastus lateralis muscles of ten, healthy male subjects. Four inter-electrode distances were tested: 32.5% (L1), 45.0% (L2), 57.5% (L3) and 70% (L4) of the distance between the patella apex and the anterior superior iliac spine. The maximal knee extension torque and the current leading to the maximal torque were measured and compared between electrode configurations. The maximal current tolerated by each participant ranged from 60 to 100 mA and did not depend on the inter-electrode distance. The maximal knee extension torque elicited did not differ between L3 and L4 (P = 0.15) but, for both conditions, knee torque was significantly greater than for L1 and L2 (P < 0.024). On average, the extension torque elicited for L3 and L4 was two to three times greater than that obtained for L1 and L2. The current leading to maximal torque was not as sensitive to inter-electrode distance. Except for L1 current intensity did not change with electrode configuration (P > 0.16). Key results presented here revealed that for a given stimulation intensity, knee extension torque increased dramatically with the distance between electrodes. The distance between electrodes seems therefore to critically affect knee torque, with potential implication for optimising exercise protocols based on electrical stimulation.

Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness.

PubMed

Schmitz, Randy J; Harrison, David; Wang, Hsin-Min; Shultz, Sandra J

2017-06-02

  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown.   To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals.   Descriptive laboratory study.   Laboratory.   Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg).   Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex.   Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R 2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R 2 Δ = 0.31, PΔ = .003).   Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population. Establishing these baseline relationships in uninjured populations may help us to better understand potential factors related to maladaptive gait patterns that predispose a person to adverse changes in the cartilage environment.

A robotic exoskeleton to treat crouch gait from cerebral palsy: Initial kinematic and neuromuscular evaluation.

PubMed

Lerner, Zachary F; Damiano, Diane L; Bulea, Thomas C

2016-08-01

A robotic exoskeleton was designed for individuals with crouch gait caused by cerebral palsy with the intent to supplement existing muscle function during walking. The aim of this study was to evaluate how powered knee extension assistance provided during stance and swing phases of the gait cycle affect knee kinematics, and knee flexor and extensor muscle activity. Muscle activity and kinematic data were collected from four individuals with crouch gait from cerebral palsy during their normal walking condition and while walking with the exoskeleton under stance, swing, and stance & swing assistance. The exoskeleton was effective in reducing crouch by an average of 13.8° in three of the four participants when assistance was provided during the stance phase; assistance during the swing phase alone was ineffective. Peak knee extensor activity was maintained for all of the conditions during the stance and swing phases. Integrated (i.e. area under the curve) knee extensor activity decreased in two of the subjects indicating a more well-modulated activation pattern. Modest increases in peak and integrated antagonist knee flexor activity were exhibited in all participants; the subject without kinematic improvement had the greatest increase. While the exoskeleton was well tolerated, additional training with a focus on reducing knee flexor activity may lead to further improvements in crouch gait reduction.

Provocative mechanical tests of the peripheral nervous system affect the joint torque-angle during passive knee motion.

PubMed

Andrade, R J; Freitas, S R; Vaz, J R; Bruno, P M; Pezarat-Correia, P

2015-06-01

This study aimed to determine the influence of the head, upper trunk, and foot position on the passive knee extension (PKE) torque-angle response. PKE tests were performed in 10 healthy subjects using an isokinetic dynamometer at 2°/s. Subjects lay in the supine position with their hips flexed to 90°. The knee angle, passive torque, surface electromyography (EMG) of the semitendinosus and quadriceps vastus medialis, and stretch discomfort were recorded in six body positions during PKE. The different maximal active positions of the cervical spine (neutral; flexion; extension), thoracic spine (neutral; flexion), and ankle (neutral; dorsiflexion) were passively combined for the tests. Visual analog scale scores and EMG were unaffected by body segment positioning. An effect of the ankle joint was verified on the peak torque and knee maximum angle when the ankle was in the dorsiflexion position (P < 0.05). Upper trunk positioning had an effect on the knee submaximal torque (P < 0.05), observed as an increase in the knee passive submaximal torque when the cervical and thoracic spines were flexed (P < 0.05). In conclusion, other apparently mechanical unrelated body segments influence torque-angle response since different positions of head, upper trunk, and foot induce dissimilar knee mechanical responses during passive extension. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Estimation of Electrically-Evoked Knee Torque from Mechanomyography Using Support Vector Regression.

PubMed

Ibitoye, Morufu Olusola; Hamzaid, Nur Azah; Abdul Wahab, Ahmad Khairi; Hasnan, Nazirah; Olatunji, Sunday Olusanya; Davis, Glen M

2016-07-19

The difficulty of real-time muscle force or joint torque estimation during neuromuscular electrical stimulation (NMES) in physical therapy and exercise science has motivated recent research interest in torque estimation from other muscle characteristics. This study investigated the accuracy of a computational intelligence technique for estimating NMES-evoked knee extension torque based on the Mechanomyographic signals (MMG) of contracting muscles that were recorded from eight healthy males. Simulation of the knee torque was modelled via Support Vector Regression (SVR) due to its good generalization ability in related fields. Inputs to the proposed model were MMG amplitude characteristics, the level of electrical stimulation or contraction intensity, and knee angle. Gaussian kernel function, as well as its optimal parameters were identified with the best performance measure and were applied as the SVR kernel function to build an effective knee torque estimation model. To train and test the model, the data were partitioned into training (70%) and testing (30%) subsets, respectively. The SVR estimation accuracy, based on the coefficient of determination (R²) between the actual and the estimated torque values was up to 94% and 89% during the training and testing cases, with root mean square errors (RMSE) of 9.48 and 12.95, respectively. The knee torque estimations obtained using SVR modelling agreed well with the experimental data from an isokinetic dynamometer. These findings support the realization of a closed-loop NMES system for functional tasks using MMG as the feedback signal source and an SVR algorithm for joint torque estimation.

Tracking control of time-varying knee exoskeleton disturbed by interaction torque.

PubMed

Li, Zhan; Ma, Wenhao; Yin, Ziguang; Guo, Hongliang

2017-11-01

Knee exoskeletons have been increasingly applied as assistive devices to help lower-extremity impaired people to make their knee joints move through providing external movement compensation. Tracking control of knee exoskeletons guided by human intentions often encounters time-varying (time-dependent) issues and the disturbance interaction torque, which may dramatically put an influence up on their dynamic behaviors. Inertial and viscous parameters of knee exoskeletons can be estimated to be time-varying due to unexpected mechanical vibrations and contact interactions. Moreover, the interaction torque produced from knee joint of wearers has an evident disturbance effect on regular motions of knee exoskeleton. All of these points can increase difficultly of accurate control of knee exoskeletons to follow desired joint angle trajectories. This paper proposes a novel control strategy for controlling knee exoskeleton with time-varying inertial and viscous coefficients disturbed by interaction torque. Such designed controller is able to make the tracking error of joint angle of knee exoskeletons exponentially converge to zero. Meanwhile, the proposed approach is robust to guarantee the tracking error bounded when the interaction torque exists. Illustrative simulation and experiment results are presented to show efficiency of the proposed controller. Additionally, comparisons with gradient dynamic (GD) approach and other methods are also presented to demonstrate efficiency and superiority of the proposed control strategy for tracking joint angle of knee exoskeleton. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Vitamin D status and physical function in older Finnish people: A one-year follow-up study.

PubMed

Salminen, Marika; Saaristo, Pilvi; Salonoja, Maritta; Vaapio, Sari; Vahlberg, Tero; Lamberg-Allardt, Christel; Aarnio, Pertti; Kivelä, Sirkka-Liisa

2015-01-01

The aim was to describe vitamin D status and its association with changes in PF during 12 months in Finnish community-dwelling elderly (≥65 years). Baseline serum 25-hydroxyvitamin D (25OHD) concentration was measured by enzymeimmunoassay, and participants (n=518) were divided according to 25OHD to three groups (I <50 nmol/l, II 50-74.9 nmol/l, and III ≥75 nmol/l). PF (maximal isometric extension strength of right and left knee, and time in five-repetition sit-to-stand test (5STS) and 10-m walking test) was measured at baseline and after 12 months. 25OHD deficiency (<50 nmol/l) was found in 20.5% of the participants. During a 12-month follow-up, differences in changes in knee extensor strength of right (p=0.044) and left (p=0.010) lower extremity and in 10-m walking test (p=.040) between the groups were significant. According to further pairwise comparisons these differences were between groups I and III (right knee, p=0.036; left knee, p=0.009; 10-m walk, p=0.044), with the exception of left knee extensor strength in which there were also significant difference between groups I and II (p=0.039). All significant differences in changes were in favour of group II or III. Significant differences in changes in knee extensor strengths maintained after adjustments for group (intervention/control), parathyroid hormone, and baseline level of knee extensor strength. Prospective analyses showed low 25OHD concentrations (<50 nmol/l) to be associated with deterioration in PF during 12 months compared with high 25OHD concentrations (≥75 nmol/l). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure.

PubMed

Taya, Masanobu; Amiya, Eisuke; Hatano, Masaru; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Tsuji, Masaki; Hosoya, Yumiko; Minatsuki, Shun; Nakayama, Atsuko; Fujiwara, Takayuki; Konishi, Yuto; Yokota, Kazuhiko; Watanabe, Masafumi; Morita, Hiroyuki; Haga, Nobuhiko; Komuro, Issei

2018-01-15

This study investigated the effectiveness and safety of interval training during in-hospital treatment of patients with advanced heart failure. Twenty-four consecutive patients with advanced symptomatic heart failure who were referred for cardiac transplant evaluation were recruited. After performing aerobic exercise for approximate intensity, high-intensity interval training (HIIT) was performed. The protocol consisted of 3 or 4 sessions of 1-min high-intensity exercise aimed at 80% of peak VO 2 or 80% heart rate reserve, followed by 4-min recovery periods of low intensity. In addition to the necessary laboratory data, hand grip strength and knee extensor strength were evaluated at the start of exercise training and both at the start and the end of HIIT. Knee extensor strength was standardized by body weight. The BNP level at the start of exercise training was 432 (812) pg/mL and it significantly decreased to 254 (400) pg/mL (p < 0.001) at the end of HIIT. Hand grip strength did not change during course. By contrast, knee extensor strength significantly increased during HIIT [4.42 ± 1.43 → 5.28 ± 1.45 N/kg, p < 0.001], whereas the improvement of knee extensor strength was not significant from the start of exercise training to the start of HIIT. In addition, the change in knee extensor strength during HIIT was significantly associated with the hemoglobin A1c level at the start of exercise (R = - 0.55; p = 0.015). HIIT has a positive impact on skeletal muscle strength among in-hospital patients with advanced heart failure.

Superior Effects of Eccentric to Concentric Knee Extensor Resistance Training on Physical Fitness, Insulin Sensitivity and Lipid Profiles of Elderly Men

PubMed Central

Chen, Trevor Chung-Ching; Tseng, Wei-Chin; Huang, Guan-Ling; Chen, Hsin-Lian; Tseng, Kuo-Wei; Nosaka, Kazunori

2017-01-01

It has been reported that eccentric training of knee extensors is effective for improving blood insulin sensitivity and lipid profiles to a greater extent than concentric training in young women. However, it is not known whether this is also the case for elderly individuals. Thus, the present study tested the hypothesis that eccentric training of the knee extensors would improve physical function and health parameters (e.g., blood lipid profiles) of older adults better than concentric training. Healthy elderly men (60–76 years) were assigned to either eccentric training or concentric training group (n = 13/group), and performed 30–60 eccentric or concentric contractions of knee extensors once a week. The intensity was progressively increased over 12 weeks from 10 to 100% of maximal concentric strength for eccentric training and from 50 to 100% for concentric training. Outcome measures were taken before and 4 days after the training period. The results showed that no sings of muscle damage were observed after any sessions. Functional physical fitness (e.g., 30-s chair stand) and maximal concentric contraction strength of the knee extensors increased greater (P ≤ 0.05) after eccentric training than concentric training. Homeostasis model assessment, oral glucose tolerance test and whole blood glycosylated hemoglobin showed improvement of insulin sensitivity only after eccentric training (P ≤ 0.05). Greater (P ≤ 0.05) decreases in fasting triacylglycerols, total, and low-density lipoprotein cholesterols were evident after eccentric training than concentric training, and high-density lipoprotein cholesterols increased only after eccentric training. These results support the hypothesis and suggest that it is better to focus on eccentric contractions in exercise medicine. PMID:28443029

Muscle mechanical advantage of human walking and running: implications for energy cost.

PubMed

Biewener, Andrew A; Farley, Claire T; Roberts, Thomas J; Temaner, Marco

2004-12-01

Muscular forces generated during locomotion depend on an animal's speed, gait, and size and underlie the energy demand to power locomotion. Changes in limb posture affect muscle forces by altering the mechanical advantage of the ground reaction force (R) and therefore the effective mechanical advantage (EMA = r/R, where r is the muscle mechanical advantage) for muscle force production. We used inverse dynamics based on force plate and kinematic recordings of humans as they walked and ran at steady speeds to examine how changes in muscle EMA affect muscle force-generating requirements at these gaits. We found a 68% decrease in knee extensor EMA when humans changed gait from a walk to a run compared with an 18% increase in hip extensor EMA and a 23% increase in ankle extensor EMA. Whereas the knee joint was extended (154-176 degrees) during much of the support phase of walking, its flexed position (134-164 degrees) during running resulted in a 5.2-fold increase in quadriceps impulse (time-integrated force during stance) needed to support body weight on the ground. This increase was associated with a 4.9-fold increase in the ground reaction force moment about the knee. In contrast, extensor impulse decreased 37% (P < 0.05) at the hip and did not change at the ankle when subjects switched from a walk to a run. We conclude that the decrease in limb mechanical advantage (mean limb extensor EMA) and increase in knee extensor impulse during running likely contribute to the higher metabolic cost of transport in running than in walking. The low mechanical advantage in running humans may also explain previous observations of a greater metabolic cost of transport for running humans compared with trotting and galloping quadrupeds of similar size.

Neuromuscular fatigue following isometric contractions with similar torque time integral.

PubMed

Rozand, V; Cattagni, T; Theurel, J; Martin, A; Lepers, R

2015-01-01

Torque time integral (TTI) is the combination of intensity and duration of a contraction. The aim of this study was to compare neuromuscular alterations following different isometric sub-maximal contractions of the knee extensor muscles but with similar TTI. Sixteen participants performed 3 sustained contractions at different intensities (25%, 50%, and 75% of Maximal Voluntary Contraction (MVC) torque) with different durations (68.5±33.4 s, 35.1±16.8 s and 24.8±12.9 s, respectively) but similar TTI value. MVC torque, maximal voluntary activation level (VAL), M-wave characteristics and potentiated doublet amplitude were assessed before and immediately after the sustained contractions. EMG activity of the vastus lateralis (VL) and -rectus femoris (RF) muscles was recorded during the sustained contractions. MVC torque reduction was similar in the 3 conditions after the exercise (-23.4±2.7%). VAL decreased significantly in a similar extent (-3.1±1.3%) after the 3 sustained contractions. Potentiated doublet amplitude was similarly reduced in the 3 conditions (-19.7±1.5%), but VL and RF M-wave amplitudes remained unchanged. EMG activity of VL and RF muscles increased in the same extent during the 3 contractions (VL: 54.5±40.4%; RF: 53.1±48.7%). These results suggest that central and peripheral alterations accounting for muscle fatigue are similar following isometric contractions with similar TTI. TTI should be considered in the exploration of muscle fatigue during sustained isometric contractions. © Georg Thieme Verlag KG Stuttgart · New York.

Tibiofemoral loss of contact area but no changes in peak pressures after meniscectomy in a Lapine in vivo quadriceps force transfer model.

PubMed

Leumann, Andre; Fortuna, Rafael; Leonard, Tim; Valderrabano, Victor; Herzog, Walter

2015-01-01

The menisci are thought to modulate load transfer and to absorb shocks in the knee joint. No study has experimentally measured the meniscal functions in the intact, in vivo joint loaded by physiologically relevant muscular contractions. Right knee joints of seven New Zealand white rabbits were loaded using isometric contractions of the quadriceps femoris muscles controlled by femoral nerve stimulation. Isometric knee extensor torques at the maximal and two submaximal force levels were performed at knee angles of 70°, 90°, 110°, and 130°. Patellofemoral and tibiofemoral contact areas and pressure distributions were measured using Fuji Presensor film inserted above and below the menisci and also with the menisci removed. Meniscectomy was associated with a decrease in tibiofemoral contact area ranging from 30 to 70% and a corresponding increase in average contact pressures. Contact areas measured below the menisci were consistently larger than those measured on top of the menisci. Contact areas in the patellofemoral joint (PFJ), and peak pressures in tibiofemoral and PFJs, were not affected by meniscectomy. Contact areas and peak pressures in all joints depended crucially on knee joint angle and quadriceps force: The more flexed the knee joint was, the larger were the contact areas and the higher were the peak pressures. In agreement with the literature, removal of the menisci was associated with significant decreases in tibiofemoral contact area and corresponding increases in average contact pressures, but surprisingly, peak pressures remained unaffected, indicating that the function of the menisci is to distribute loads across a greater contact area.

Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome.

PubMed

Alaca, Ridvan; Yilmaz, Bilge; Goktepe, A Salim; Mohur, Haydar; Kalyon, Tunc Alp

2002-11-01

To assess the effect of an isokinetic exercise program on symptoms and functions of patients with patellofemoral pain syndrome. A total of 22 consecutive patients with the complaint of anterior knee pain who met the inclusion criteria were recruited to assess the efficacy of isokinetic exercise on functional capacity, isokinetic parameters, and pain scores in patients with patellofemoral pain syndrome. A total of 37 knees were examined. Six-meter hopping, three-step hopping, and single-limb hopping course tests were performed for each patient with the measurements of the Lysholm scale and visual analog scale. Tested parameters were peak torque, total work, average power, and endurance ratios. Statistical analyses revealed that at the end of the 6-wk treatment period, functional and isokinetic parameters improved significantly, as did pain scores. There was not statistically significant correlation between different groups of parameters. The isokinetic exercise treatment program used in this study prevented the extensor power loss due to patellofemoral pain syndrome, but the improvement in the functional capacity was not correlated with the gained power.

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae.

PubMed

Yildiz, Y; Aydin, T; Sekir, U; Cetin, C; Ors, F; Alp Kalyon, T

2003-12-01

To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score. The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60 degrees /s (25-90 degrees range of flexion) and 180 degrees /s (full range). These sessions were repeated three times a week for six weeks. Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found. The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters.

A Yoga Strengthening Program Designed to Minimize the Knee Adduction Moment for Women with Knee Osteoarthritis: A Proof-Of-Principle Cohort Study

PubMed Central

2015-01-01

People with knee osteoarthritis may benefit from exercise prescriptions that minimize knee loads in the frontal plane. The primary objective of this study was to determine whether a novel 12-week strengthening program designed to minimize exposure to the knee adduction moment (KAM) could improve symptoms and knee strength in women with symptomatic knee osteoarthritis. A secondary objective was to determine whether the program could improve mobility and fitness, and decrease peak KAM during gait. The tertiary objective was to evaluate the biomechanical characteristics of this yoga program. In particular, we compared the peak KAM during gait with that during yoga postures at baseline. We also compared lower limb normalized mean electromyography (EMG) amplitudes during yoga postures between baseline and follow-up. Primary measures included self-reported pain and physical function (Knee injury and Osteoarthritis Outcome Score) and knee strength (extensor and flexor torques). Secondary measures included mobility (six-minute walk, 30-second chair stand, stair climbing), fitness (submaximal cycle ergometer test), and clinical gait analysis using motion capture synchronized with electromyography and force measurement. Also, KAM and normalized mean EMG amplitudes were collected during yoga postures. Forty-five women over age 50 with symptomatic knee osteoarthritis, consistent with the American College of Rheumatology criteria, enrolled in our 12-week (3 sessions per week) program. Data from 38 were analyzed (six drop-outs; one lost to co-intervention). Participants experienced reduced pain (mean improvement 10.1–20.1 normalized to 100; p<0.001), increased knee extensor strength (mean improvement 0.01 Nm/kg; p = 0.004), and increased flexor strength (mean improvement 0.01 Nm/kg; p = 0.001) at follow-up compared to baseline. Participants improved mobility on the six-minute walk (mean improvement 37.7 m; p<0.001) and 30-second chair stand (mean improvement 1.3; p = 0.006) at follow-up compared to baseline. Fitness and peak KAM during gait were unchanged between baseline and follow-up. Average KAM during the yoga postures were lower than that of normal gait. Normalized mean EMG amplitudes during yoga postures were up to 31.0% of maximum but did not change between baseline and follow-up. In this cohort study, the yoga-based strengthening postures that elicit low KAMs improved knee symptoms and strength in women with knee OA following a 12 week program (3 sessions per week). The program also improved mobility, but did not improve fitness or reduce peak KAM during gait. The KAM during the yoga postures were lower than that of normal gait. Overall, the proposed program may be useful in improving pain, strength, and mobility in women with knee osteoarthritis. Clinical efficacy needs to be assessed using a randomized controlled trial design. Trial Registration ClinicalTrials.gov NCT02146105 PMID:26367862

Isokinetic Strength Profile of Elite Female Handball Players.

PubMed

Xaverova, Zuzana; Dirnberger, Johannes; Lehnert, Michal; Belka, Jan; Wagner, Herbert; Orechovska, Karolina

2015-12-22

Systematic assessment of muscle strength of the lower extremities throughout the annual training cycle in athletes is crucial from a performance perspective for the optimization of the training process, as well as a health perspective with regard to injury prevention. The main aim of the present study was to determine isokinetic muscle strength of the knee flexors and extensors in female handball players at the beginning of a preparatory period and to assess whether there were any differences between players of different performance levels. The performance level was expressed by means of membership of the Women's Junior National Handball Team (JNT, n=8) or the Women's National Handball Team (NT, n=9). The isokinetic peak torque during concentric and eccentric single-joint knee flexion and extension was measured at angular velocities of 60, 180, 240°/s (concentric) and 60°/s (eccentric). The Mann-Whitney test showed no significant differences in the peak torques or ipsilateral ratios between the two groups. The bilateral force deficit (BFD) for concentric extension at 240°/s was significantly higher in the JNT compared with the NT (p=0.04; d=1.02). However, the results of individual evaluation show that the BFD was more frequent in the NT in most measurements. A high BFD was evident in the eccentric mode in both groups highlighting a need for particular strengthening. With regard to low strength ratios a prevention programme should be suggested for both observed groups of professional female handball players to reduce the risk of injury.

Is the relationship between increased knee muscle strength and improved physical function following exercise dependent on baseline physical function status?

PubMed

Hall, Michelle; Hinman, Rana S; van der Esch, Martin; van der Leeden, Marike; Kasza, Jessica; Wrigley, Tim V; Metcalf, Ben R; Dobson, Fiona; Bennell, Kim L

2017-12-08

Clinical guidelines recommend knee muscle strengthening exercises to improve physical function. However, the amount of knee muscle strength increase needed for clinically relevant improvements in physical function is unclear. Understanding how much increase in knee muscle strength is associated with improved physical function could assist clinicians in providing appropriate strength gain targets for their patients in order to optimise outcomes from exercise. The aim of this study was to investigate whether an increase in knee muscle strength is associated with improved self-reported physical function following exercise; and whether the relationship differs according to physical function status at baseline. Data from 100 participants with medial knee osteoarthritis enrolled in a 12-week randomised controlled trial comparing neuromuscular exercise to quadriceps strengthening exercise were pooled. Participants were categorised as having mild, moderate or severe physical dysfunction at baseline using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Associations between 12-week changes in physical function (dependent variable) and peak isometric knee extensor and flexor strength (independent variables) were evaluated with and without accounting for baseline physical function status and covariates using linear regression models. In covariate-adjusted models without accounting for baseline physical function, every 1-unit (Nm/kg) increase in knee extensor strength was associated with physical function improvement of 17 WOMAC units (95% confidence interval (CI) -29 to -5). When accounting for baseline severity of physical function, every 1-unit increase in knee extensor strength was associated with physical function improvement of 24 WOMAC units (95% CI -42 to -7) in participants with severe physical dysfunction. There were no associations between change in strength and change in physical function in participants with mild or moderate physical dysfunction at baseline. The association between change in knee flexor strength and change in physical function was not significant, irrespective of baseline function status. In patients with severe physical dysfunction, an increase in knee extensor strength and improved physical function were associated. ANZCTR 12610000660088 . Registered 12 August 2010.

What Strains the Anterior Cruciate Ligament During a Pivot Landing?

PubMed Central

Oh, Youkeun K.; Lipps, David B.; Ashton-Miller, James A.; Wojtys, Edward M.

2015-01-01

Background The relative contributions of an axial tibial torque and frontal plane moment to anterior cruciate ligament (ACL) strain during pivot landings are unknown. Hypothesis The peak normalized relative strain in the anteromedial (AM) bundle of the ACL is affected by the direction of the axial tibial torque but not by the direction of the frontal plane moment applied concurrently during a simulated jump landing. Study Design Controlled and descriptive laboratory studies. Methods Fifteen adult male knees with pretensioned knee muscle-tendon unit forces were loaded under a simulated pivot landing test. Compression, flexion moment, internal or external tibial torque, and knee varus or valgus moment were simultaneously applied to the distal tibia while recording the 3D knee loads and tibiofemoral kinematics. The AM-ACL relative strain was measured using a 3-mm differential variable reluctance transducer. The results were analyzed using nonparametric Wilcoxon signed–rank tests. A 3D dynamic biomechanical knee model was developed using ADAMS and validated to help interpret the experimental results. Results The mean (SD) peak AM-ACL relative strain was 192% greater (P <.001) under the internal tibial torque combined with a knee varus or valgus moment (7.0% [3.9%] and 7.0% [4.1%], respectively) than under external tibial torque with the same moments (2.4% [2.5%] and 2.4% [3.2%], respectively). The knee valgus moment augmented the AM-ACL strain due to the slope of the tibial plateau inducing mechanical coupling (ie, internal tibial rotation and knee valgus moment); this augmentation occurred before medial knee joint space opening. Conclusion An internal tibial torque combined with a knee valgus moment is the worst-case ACL loading condition. However, it is the internal tibial torque that primarily causes large ACL strain. Clinical Relevance Limiting the maximum coefficient of friction between the shoe and playing surface should limit the peak internal tibial torque that can be applied to the knee during jump landings, thereby reducing peak ACL strain and the risk for noncontact injury. PMID:22223717

One session of partial-body cryotherapy (-110 °C) improves muscle damage recovery.

PubMed

Ferreira-Junior, J B; Bottaro, M; Vieira, A; Siqueira, A F; Vieira, C A; Durigan, J L Q; Cadore, E L; Coelho, L G M; Simões, H G; Bemben, M G

2015-10-01

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at -110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

ACTN3 R577X Polymorphism and Neuromuscular Response to Resistance Training

PubMed Central

Gentil, Paulo; Pereira, Rinaldo W.; Leite, Tailce K.M.; Bottaro, Martim

2011-01-01

The R577X polymorphism at the ACTN3 gene has been associated with muscle strength, hypertrophy and athletic status. The X allele, which is associated with the absence of ACTN3 protein is supposed to impair performance of high force/velocity muscle contractions. The purpose of the present study was to investigate the association of the R577X polymorphism with the muscle response to resistance training in young men. One hundred forty one men performed two resistance training sessions per week for 11 weeks. Participants were tested for 1RM bench press, knee extensors peak torque, and knee extensors muscle thickness at baseline and after the training period. Genotyping was conducted using de DdeI restriction enzyme. Genotype distribution was 34.4% for RR, 47% for RX and 18.6% for the XX genotype. According to the results, the R577X polymorphism at the ACTN3 gene is not associated with baseline muscle strength or with the muscle strength response to resistance training. However, only carriers of the R allele showed increases in muscle thickness in response to training. Key points ACTN3 Genotype distribution in the present study was similar to others populations (34.4% for RR, 47% for RX, and 18.6% for the XX). The R577X polymorphism at the ACTN3 gene is not associated with baseline muscle strength or with the muscle strength response to resistance training. It appears that the R allele carriers respond better to muscle thickness gains in response to training. PMID:24149888

ACTN3 R577X Polymorphism and Neuromuscular Response to Resistance Training.

PubMed

Gentil, Paulo; Pereira, Rinaldo W; Leite, Tailce K M; Bottaro, Martim

2011-01-01

The R577X polymorphism at the ACTN3 gene has been associated with muscle strength, hypertrophy and athletic status. The X allele, which is associated with the absence of ACTN3 protein is supposed to impair performance of high force/velocity muscle contractions. The purpose of the present study was to investigate the association of the R577X polymorphism with the muscle response to resistance training in young men. One hundred forty one men performed two resistance training sessions per week for 11 weeks. Participants were tested for 1RM bench press, knee extensors peak torque, and knee extensors muscle thickness at baseline and after the training period. Genotyping was conducted using de DdeI restriction enzyme. Genotype distribution was 34.4% for RR, 47% for RX and 18.6% for the XX genotype. According to the results, the R577X polymorphism at the ACTN3 gene is not associated with baseline muscle strength or with the muscle strength response to resistance training. However, only carriers of the R allele showed increases in muscle thickness in response to training. Key pointsACTN3 Genotype distribution in the present study was similar to others populations (34.4% for RR, 47% for RX, and 18.6% for the XX).The R577X polymorphism at the ACTN3 gene is not associated with baseline muscle strength or with the muscle strength response to resistance training.It appears that the R allele carriers respond better to muscle thickness gains in response to training.

Posterior Tibial Slope Angle Correlates With Peak Sagittal and Frontal Plane Knee Joint Loading During Robotic Simulations of Athletic Tasks.

PubMed

Bates, Nathaniel A; Nesbitt, Rebecca J; Shearn, Jason T; Myer, Gregory D; Hewett, Timothy E

2016-07-01

Tibial slope angle is a nonmodifiable risk factor for anterior cruciate ligament (ACL) injury. However, the mechanical role of varying tibial slopes during athletic tasks has yet to be clinically quantified. To examine the influence of posterior tibial slope on knee joint loading during controlled, in vitro simulation of the knee joint articulations during athletic tasks. Descriptive laboratory study. A 6 degree of freedom robotic manipulator positionally maneuvered cadaveric knee joints from 12 unique specimens with varying tibial slopes (range, -7.7° to 7.7°) through drop vertical jump and sidestep cutting tasks that were derived from 3-dimensional in vivo motion recordings. Internal knee joint torques and forces were recorded throughout simulation and were linearly correlated with tibial slope. The mean (±SD) posterior tibial slope angle was 2.2° ± 4.3° in the lateral compartment and 2.3° ± 3.3° in the medial compartment. For simulated drop vertical jumps, lateral compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee adduction (r = 0.60-0.65), flexion (r = 0.64-0.66), lateral (r = 0.57-0.69), and external rotation torques (r = 0.47-0.72) as well as inverse correlations with peak abduction (r = -0.42 to -0.61) and internal rotation torques (r = -0.39 to -0.79). Only frontal plane torques were correlated during sidestep cutting simulations. For simulated drop vertical jumps, medial compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee flexion torque (r = 0.64-0.69) and lateral knee force (r = 0.55-0.74) as well as inverse correlations with peak external torque (r = -0.34 to -0.67) and medial knee force (r = -0.58 to -0.59). These moderate correlations were also present during simulated sidestep cutting. The investigation supported the theory that increased posterior tibial slope would lead to greater magnitude knee joint moments, specifically, internally generated knee adduction and flexion torques. The knee torques that positively correlated with increased tibial slope angle in this investigation are associated with heightened risk of ACL injury. Therefore, the present data indicated that a higher posterior tibial slope is correlated to increased knee loads that are associated with heightened risk of ACL injury. © 2016 The Author(s).

Effects of prolonged vibration to vastus intermedius muscle on force steadiness of knee extensor muscles during isometric force-matching task.

PubMed

Saito, Akira; Ando, Ryosuke; Akima, Hiroshi

2016-12-01

Afferent inputs from Ia fibers in muscle spindles are essential for the control of force and prolonged vibration has been applied to muscle-tendon units to manipulate the synaptic input from Ia afferents onto α-motor neurons. The vastus intermedius (VI) reportedly provides the highest contribution to the low-level knee extension torque among the individual synergists of quadriceps femoris (QF). The purpose of the present study was to examine the effect of prolonged vibration to the VI on force steadiness of the QF. Nine healthy men (25.1±4.3years) performed submaximal force-matching task of isometric knee extension for 15s before and after mechanical vibration to the superficial region of VI for 30min. Target forces were 2.5%, 10%, and 30% of maximal voluntary contraction (MVC), and force steadiness was determined by the coefficient of variation (CV) of force. After the prolonged VI vibration, the CV of force at 2.5%MVC was significantly increased, but CVs at 10% and 30%MVCs were not significantly changed. The present study concluded that application of prolonged vibration to the VI increased force fluctuations of the QF during a very low-level force-matching task. Copyright © 2016 Elsevier Ltd. All rights reserved.

Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study.

PubMed

Anandkumar, Sudarshan; Sudarshan, Shobhalakshmi; Nagpal, Pratima

2014-08-01

Double blind pre-test post-test control group design. To compare the isokinetic quadriceps torque, standardized stair-climbing task (SSCT) and pain during SSCT between subjects diagnosed with knee osteoarthritis pre and post kinesio tape (KT) application with and without tension. Strength of the quadriceps and torque producing capability is frequently found to be compromised in knee osteoarthritis. The efficacy of KT in improving isokinetic quadriceps torque in knee osteoarthritis is unknown, forming the basis for this study. Forty subjects were randomly allocated to either the experimental (therapeutic KT with tension) or control group (sham KT without tension) with the allocation being concealed. Pre and post test measurements of isokinetic quadriceps torque, SSCT and pain during SSCT were carried out by a blinded assessor. A large effect size with significant improvements in the peak quadriceps torque (concentric and eccentric at angular velocities of 90° per second and 120° per second), SSCT and pain were obtained in the experimental group when compared to the control group. Application of therapeutic KT is effective in improving isokinetic quadriceps torque, SSCT and reducing pain in knee osteoarthritis.

A Novel Two-Velocity Method for Elaborate Isokinetic Testing of Knee Extensors.

PubMed

Grbic, Vladimir; Djuric, Sasa; Knezevic, Olivera M; Mirkov, Dragan M; Nedeljkovic, Aleksandar; Jaric, Slobodan

2017-09-01

Single outcomes of standard isokinetic dynamometry tests do not discern between various muscle mechanical capacities. In this study, we aimed to (1) evaluate the shape and strength of the force-velocity relationship of knee extensors, as observed in isokinetic tests conducted at a wide range of angular velocities, and (2) explore the concurrent validity of a simple 2-velocity method. Thirteen physically active females were tested for both the peak and averaged knee extensor concentric force exerted at the angular velocities of 30°-240°/s recorded in the 90°-170° range of knee extension. The results revealed strong (0.960

Somatotype Variables Related to Muscle Torque and Power in Judoists

PubMed Central

Lewandowska, Joanna; Buśko, Krzysztof; Pastuszak, Anna; Boguszewska, Katarzyna

2011-01-01

The purpose of this study was to examine the relationship between somatotype, muscle torque and power output in judoists. Thirteen judoists (age 18.4±3.1 years, body height 178.6±8.2 cm, body mass 82.3±15.9 kg) volunteered to participate in this study. Somatotype was determined using the Heath-Carter method. Maximal muscle torques of elbow, shoulder, knee, hip and trunk flexors as well as extensors were measured under static conditions. Power outputs were measured in 5 maximal cycle ergometer exercise bouts, 10 s each, at increasing external loads equal to 2.5, 5.0, 7.5, 10.0 and 12.5% of body weight. The Pearson’s correlation coefficients were calculated between all parameters. The mean somatotype of judoists was: 3.5-5.9-1.8 (values for endomorphy, mesomorphy and ectomorphy, respectively). The values (mean±SD) of sum of muscle torque of ten muscle groups (TOTAL) was 3702.2±862.9 N x m. The power output ranged from 393.2±79.4 to 1077.2±275.4 W. The values of sum of muscle torque of right and left upper extremities (SUE), sum of muscle torque of right and left lower extremities (SLE), sum of muscle torque of the trunk (ST) and TOTAL were significantly correlated with the mesomorphic component (0.68, 0.80, 0.71 and 0.78, respectively). The ectomorphic component correlated significantly with values of SUE, SLE, ST and TOTAL (−0.69, −0.81, −0.71 and −0.79, respectively). Power output was also strongly correlated with both mesomorphy (positively) and ectomorphy (negatively). The results indicated that the values of mesomorphic and ectomorphic somatotype components influence muscle torque and power output, thus body build could be an important factor affecting results in judo. PMID:23487284

Assessing the therapeutic effect of 625-nm light-emitting diodes

NASA Astrophysics Data System (ADS)

Mao, Zongzhen; Xu, Guodong; Yang, Yi

2014-09-01

To evaluate the effects of red Light-Emitting Diodes on elbow extensor and flexor strength and the recovery of exercise induced fatigue, the torque values from the isokinetic dynamometer as well as biochemistry parameters were used as outcome measures. A randomized double-blind placebo-controlled crossover trial was performed with twenty male young tennis athletes. Active LED therapy (LEDT, with wavelength 625nm, 10 minutes total irradiation time, irradiated area amount to 30cm2, and 900J of total energy irradiated) or an identical placebo was delivered under double-blinded conditions to the left elbow just before exercise. The isokinetic muscle strength was measured immediately after irradiation. The blood lactate levels were sampled pre-exercise and post-exercise. The peak torque values of elbow extensor strength were significantly different between two groups. As in elbow flexor strength, the difference of peak torque was not significant. The blood lactate concentration of LEDT group post-exercise was significantly lower than those of placebo group. The results indicate that 625nm LED therapy is effective in preventing muscle fatigue as it can significantly reduce peak torque value of elbow extensors and blood lactate concentration. It has no effect on the strength of left elbow flexor or backhand performance in tennis.

Design and characterization of a torque-controllable actuator for knee assistance during sit-to-stand.

PubMed

Shepherd, Max K; Rouse, Elliott J

2016-08-01

Individuals with post-stroke hemiparesis often have difficulty standing out of a chair. One way to potentially improve sit-to-stand is to provide knee extension assistance using a powered knee exoskeleton. An exoskeleton providing unilateral, partial assistance during sit-to-stand would need to be torque-controllable. There are no knee exoskeletons on the market suitable for conducting experiments assisting stroke patients with sit-to-stand, so to enable such experiments a research device was developed. The purpose of this report is to present the design of a novel knee exoskeleton actuator that uses a fiberglass leaf spring in series to improve torque-controllability, and present a characterization of the actuator performance. The actuator is capable of the required torque and speed for sit-to-stand, has high bandwidth (25 Hz), low output impedance at low frequencies (<;0.5 Nm), and excellent torque tracking. An orthotic brace built upon this actuator will enable an in-depth study on the biomechanical effects of providing stroke subjects with knee extension assistance during sit-to-stand.

The influence of arch supports on knee torques relevant to knee osteoarthritis.

PubMed

Franz, Jason R; Dicharry, Jay; Riley, Patrick O; Jackson, Keith; Wilder, Robert P; Kerrigan, D Casey

2008-05-01

Changes in footwear and foot orthotic devices have been shown to significantly alter knee joint torques thought to be relevant to the progression if not the development of knee osteoarthritis (OA) in the medial tibiofemoral compartment. The purpose of this study was to determine if commonly prescribed arch support cushions promote a medial force bias during gait similar to medial-wedged orthotics, thereby increasing knee varus torque during both walking and running. Twenty-two healthy, physically active young adults (age, 29.2 +/- 5.1 yr) were analyzed at their self-selected walking and running speeds in control shoes with and without arch support cushions. Three-dimensional motion capture data were collected in synchrony with ground reaction force (GRF) data collected from an instrumented treadmill. Peak external knee varus torque during walking and running were calculated through a full inverse dynamic model and compared. Peak knee varus torque was statistically significantly increased by 6% (0.01 +/- 0.02 N.m.(kg.m)(-1)) in late stance during walking and by 4% (0.03 +/- 0.03 N.m.(kg.m)(-1)) during running with the addition of arch support cushions. The addition of material under the medial aspect of the foot by way of a flexible arch support promotes a medial force bias during walking and running, significantly increasing knee varus torque. These findings suggest that discretion be employed with regard to the prescription of commonly available orthotic insoles like arch support cushions.

Relation between functional mobility and dynapenia in institutionalized frail elderly.

PubMed

Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

2017-01-01

To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test.

Vascularised knee joint transplantation in man: the first two years experience.

PubMed

Kirschner, M H; Brauns, L; Gonschorek, O; Bühren, V; Hofmann, G O

2000-04-01

To describe our early experience with a new technique for restoring destroyed knee joints to give reasonable functional results. Observational clinical trial. Level-1-Trauma centre, Germany. 5 patients with large bone defects of the knee and loss of the extensor apparatus caused either by serious injury alone, or infection after serious injury. Transplantation of fresh and perfused knee joints with a vascular pedicle from multiorgan donors under immunosuppression. Ability to walk, need to remove one transplanted joint. Four patients are able to walk, the range of movement being from 50 degrees-120 degrees. The first patient additionally had to be provided with a total knee joint arthroplasty. In the third patient the graft became infected and had to be removed. She finally had an arthrodesis and bone lengthening by the Ilizarov technique. Transplantation of the knee joint may be an alternative to bone lengthening or amputation for patients with total loss of the extensor apparatus.

Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness

PubMed Central

Harrison, David; Wang, Hsin-Min; Shultz, Sandra J.

2017-01-01

Context:  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown. Objective:  To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals. Design:  Descriptive laboratory study. Setting:  Laboratory. Patients or Other Participants:  Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg). Main Outcome Measure(s):  Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex. Results:  Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R2Δ = 0.31, PΔ = .003). Conclusion:  Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population. Establishing these baseline relationships in uninjured populations may help us to better understand potential factors related to maladaptive gait patterns that predispose a person to adverse changes in the cartilage environment. PMID:28653865

Muscle function in elite master weightlifters.

PubMed

Pearson, Stephen J; Young, Archie; Macaluso, Andrea; Devito, Giuseppe; Nimmo, Myra A; Cobbold, Matthew; Harridge, Stephen D R

2002-07-01

To determine whether explosive power and isometric strength of the lower-limb muscles in elite master Olympic weightlifters declines at a similar rate to nontrained healthy controls with increasing age. 54 elite level masters weightlifters (aged 40-87), who were competitors at the World Masters Weightlifting Championships (1999), were compared with a similar number of aged-matched, healthy untrained individuals. Isometric knee extensor strength and lower-limb explosive power were tested. Extent of antagonist co-contraction during isometric knee extension was determined by EMG and power loading characteristics by using a variable inertial system. Muscle volume was estimated using anthropometry. On average, the weightlifters were able to generate 32% more peak power (P < 0.05) in the lower limbs and 32% more isometric knee extensor force (P < 0.05) than the control subjects. No significant differences in lower-leg volume were observed between the two groups. Peak power declined at a similar rate with increasing age in the weightlifters and controls (1.2 and 1.3% of a 45-yr-old's value per year), as did strength, but at a lower rate (0.6 and 0.5% per year). The inertial load at which the weightlifters achieved their maximal peak power output was greater (P < 0.05) than the controls. The torque generated at this optimal inertia was also greater in the weightlifters (P < 0.05), whereas the time taken for the weightlifters to reach their maximal peak power was on average 13% shorter (P < 0.05). No differences in antagonist co-contraction during isometric knee extension were observed between the two groups. Muscle power and isometric strength decline at a similar rate with increasing age in elite master weightlifters and healthy controls. In spite of inertial load optimization, muscle power declined in both groups at approximately twice the rate of isometric strength. Although similar rates of decline were observed, the absolute differences between the weightlifters and controls were such that an 85-yr-old weightlifter was as powerful as a 65-yr-old control subject. This would therefore represent an apparent age advantage of approximately 20 yr for the weightlifters.

The interaction between the vastus medialis and vastus intermedius and its influence on the extensor apparatus of the knee joint.

PubMed

Grob, Karl; Manestar, Mirjana; Filgueira, Luis; Kuster, Markus S; Gilbey, Helen; Ackland, Timothy

2018-03-01

Although the vastus medialis (VM) is closely associated with the vastus intermedius (VI), there is a lack of data regarding their functional relationship. The purpose of this study was to investigate the anatomical interaction between the VM and VI with regard to their origins, insertions, innervation and function within the extensor apparatus of the knee joint. Eighteen human cadaveric lower limbs were investigated using macro-dissection techniques. Six limbs were cut transversely in the middle third of the thigh. The mode of origin, insertion and nerve supply of the extensor apparatus of the knee joint were studied. The architecture of the VM and VI was examined in detail, as was their anatomical interaction and connective tissue linkage to the adjacent anatomical structures. The VM originated medially from a broad hammock-like structure. The attachment site of the VM always spanned over a long distance between: (1) patella, (2) rectus femoris tendon and (3) aponeurosis of the VI, with the insertion into the VI being the largest. VM units were inserted twice-once on the anterior and once on the posterior side of the VI. The VI consists of a complex multi-layered structure. The layers of the medial VI aponeurosis fused with the aponeuroses of the tensor vastus intermedius and vastus lateralis. Together, they form the two-layered intermediate layer of the quadriceps tendon. The VM and medial parts of the VI were innervated by the same medial division of the femoral nerve. The VM consists of multiple muscle units inserting into the entire VI. Together, they build a potential functional muscular complex. Therefore, the VM acts as an indirect extensor of the knee joint regulating and adjusting the length of the extensor apparatus throughout the entire range of motion. It is of clinical importance that, besides the VM, substantial parts of the VI directly contribute to the medial pull on the patella and help to maintain medial tracking of the patella during knee extension. The interaction between the VM and VI, with responsibility for the extension of the knee joint and influence on the patellofemoral function, leads readily to an understanding of common clinical problems found at the knee joint as it attempts to meet contradictory demands for both mobility and stability. Surgery or trauma in the anteromedial aspect of the quadriceps muscle group might alter a delicate interplay between the VM and VI. This would affect the extensor apparatus as a whole.

Neuromuscular performance of maximal voluntary explosive concentric contractions is influenced by angular acceleration.

PubMed

Hahn, D; Bakenecker, P; Zinke, F

2017-12-01

Torque production during maximal voluntary explosive contractions is considered to be a functionally more relevant neuromuscular measure than steady-state torque, but little is known about accelerated concentric contractions. This study investigated torque, muscle activity, and fascicle behavior during isometric and fast concentric contractions of quadriceps femoris. Ten participants performed maximal voluntary explosive isometric, isovelocity, and additional concentric knee extensions at angular accelerations ranging from 700 to 4000° s -2 that resulted in an angular velocity of 300° s -1 at 40° knee flexion. Concentric torque at 40° knee flexion was corrected for inertia, and the corresponding isometric torque was matched to the time when the target knee angle of 40° was reached during concentric contractions. Electromyography of quadriceps femoris and hamstrings and ultrasound of vastus lateralis were measured to determine muscle activity, fascicle length, and fascicle velocity (FV). The faster the acceleration, the more torque was produced during concentric contractions at 40° knee flexion, which was accompanied by a reduction in FV. In comparison with isometric conditions, concentric quadriceps muscle activity was increased and torque during accelerations ≥3000° s -2 equaled the time-matched isometric torque. Our results provide novel evidence that acceleration influences torque production during maximal voluntary explosive concentric contractions. This is suggested to be due to series elasticity and reduced force depression. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial.

PubMed

Dias, João Marcos; Cisneros, Lígia; Dias, Rosângela; Fritsch, Carolina; Gomes, Wellington; Pereira, Leani; Santos, Mary Luci; Ferreira, Paulo Henrique

Currently, there is poor evidence of the effect of hydrotherapy alone on patients with hip or knee osteoarthritis. The study aimed to assess the impact of hydrotherapy on pain, function, and muscle function in older women with knee osteoarthritis. A randomized controlled trial was conducted to evaluate the efficacy of hydrotherapy in women with knee osteoarthritis. Seventy-three women aged 65 and older were randomized to hydrotherapy (n=36) or a control group (n=37). The hydrotherapy group received the intervention program in a heated pool (twice per week for six weeks) and an educational protocol while the control group received an educational protocol only. Primary outcomes (before and post-treatment) were pain intensity (0-100) and function (0-100), assessed with the WOMAC questionnaire. Secondary outcomes (before and post-treatment) were knee extensor and knee flexor muscle performance (strength, power, and endurance), assessed by an isokinetic dynamometer. The magnitude of change between the groups for the outcomes was calculated using linear regression models adjusted by baseline outcome values. The hydrotherapy group had better outcomes for pain (adjusted mean difference=11 points, 95% CI: 3-18) and function (adjusted mean difference=12 points, 95% CI: 5-18). Patients receiving hydrotherapy had better performance for knee flexor and extensor strength, knee flexor power, and knee extensor endurance. Older women with knee osteoarthritis are likely to have benefits from a course of hydrotherapy exercises. Registry of clinical trials (Trial number RBR-8F57KR) - http://www.ensaiosclinicos.gov.br/rg/RBR-8f57kr/. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Age-Related Differences in Maximal and Rapid Torque Characteristics of the Hip Extensors and Dynamic Postural Balance in Healthy, Young and Old Females.

PubMed

Palmer, Ty B; Thiele, Ryan M; Thompson, Brennan J

2017-02-01

Palmer, TB, Thiele, RM, and Thompson, BJ. Age-related differences in maximal and rapid torque characteristics of the hip extensors and dynamic postural balance in healthy, young and old females. J Strength Cond Res 31(2): 480-488, 2017-The purpose of this study was to examine age-related differences in maximal and rapid torque characteristics of the hip extensor muscles and dynamic postural balance in healthy, young and older females. Eleven younger (age, 26 ± 8 years) and 11 older (age, 67 ± 8 years) females performed 2 isometric maximal voluntary contractions (MVCs) of the hip extensor muscles. Absolute and relative peak torque (PT) and rate of torque development (RTD) at early (0-50 ms) and late (0-200 ms) phases of muscle contraction were examined during each MVC. Dynamic postural balance was assessed using a commercially designed balance testing device, which provides a measurement of dynamic stability based on the overall stability index (OSI). Results indicated that absolute PT and early (RTD50) and late (RTD200) RTD variables were lower (p = 0.009-0.050), and postural OSI was higher (p = 0.011) in the old compared with the younger females; however, no differences were observed for relative PT or RTD variables (p = 0.113-0.895). A significant relationship was also observed in the older (r = -0.601; p = 0.050) but not the younger (r = -0.132; p = 0.698) females between RTD50 and OSI. The lower absolute PT and RTD and higher OSI values for the old females may contribute to the increased functional limitations often observed in older adults. The significant relationship observed in the older females between OSI and RTD50 perhaps suggests that these age-related declines in explosive strength may be an important characteristic relevant to dynamic balance scores, especially in older populations.

Comparison of different passive knee extension torque-angle assessments.

PubMed

Freitas, Sandro R; Vaz, João R; Bruno, Paula M; Valamatos, Maria J; Mil-Homens, Pedro

2013-11-01

Previous studies have used isokinetic dynamometry to assess joint torques and angles during passive extension of the knee, often without reporting upon methodological errors and reliability outcomes. In addition, the reliability of the techniques used to measure passive knee extension torque-angle and the extent to which reliability may be affected by the position of the subjects is also unclear. Therefore, we conducted an analysis of the intra- and inter-session reliability of two methods of assessing passive knee extension: (A) a 2D kinematic analysis coupled to a custom-made device that enabled the direct measurement of resistance to stretch and (B) an isokinetic dynamometer used in two testing positions (with the non-tested thigh either flexed at 45° or in the neutral position). The intra-class correlation coefficients (ICCs) of torque, the slope of the torque-angle curve, and the parameters of the mathematical model that were fit to the torque-angle data for the above conditions were measured in sixteen healthy male subjects (age: 21.4 ± 2.1 yr; BMI: 22.6 ± 3.3 kg m(-2); tibial length: 37.4 ± 3.4 cm). The results found were: (1) methods A and B led to distinctly different torque-angle responses; (2) passive torque-angle relationship and stretch tolerance were influenced by the position of the non-tested thigh; and (3) ICCs obtained for torque were higher than for the slope and for the mathematical parameters that were fit to the torque-angle curve. In conclusion, the measurement method that is used and the positioning of subjects can influence the passive knee extension torque-angle outcome.

Design, simulation and modelling of auxiliary exoskeleton to improve human gait cycle.

PubMed

Ashkani, O; Maleki, A; Jamshidi, N

2017-03-01

Exoskeleton is a walking assistance device that improves human gait cycle through providing auxiliary force and transferring physical load to the stronger muscles. This device takes the natural state of organ and follows its natural movement. Exoskeleton functions as an auxiliary device to help those with disabilities in hip and knee such as devotees, elderly farmers and agricultural machinery operators who suffer from knee complications. In this research, an exoskeleton designed with two screw jacks at knee and hip joints. To simulate extension and flexion movements of the leg joints, bearings were used at the end of hip and knee joints. The generated torque and motion angles of these joints obtained as well as the displacement curves of screw jacks in the gait cycle. Then, the human gait cycle was simulated in stance and swing phases and the obtained torque curves were compared. The results indicated that they followed the natural circle of the generated torque in joints with a little difference from each other. The maximum displacement obtained 4 and 6 cm in hip and knee joints jack respectively. The maximum torques in hip and knee joints were generated in foot contact phase. Also the minimum torques in hip and knee joints were generated in toe off and heel off phases respectively.

Effects of Lumbar Strengthening Exercise in Lower-Limb Amputees With Chronic Low Back Pain.

PubMed

Shin, Min Kyung; Yang, Hee Seung; Yang, Hea-Eun; Kim, Dae Hyun; Ahn, Bo Ram; Kwon, Hyup; Lee, Ju Hwan; Jung, Suk; Choi, Hyun Chul; Yun, Sun Keaung; Ahn, Dong Young; Sim, Woo Sob

2018-02-01

To analyze the effect of lumbar strengthening exercise in lower-limb amputees with chronic low back pain. We included in this prospective study 19 lower-limb amputees who had experienced low back pain for longer than 6 months. Participants were treated with 30-minute lumbar strengthening exercises, twice weekly, for 8 weeks. We used the visual analog scale (VAS), and Oswestry low back pain disability questionnaire, and measured parameters such as iliopsoas length, abdominal muscle strength, back extensor strength, and back extensor endurance. In addition, we assessed the isometric peak torque and total work of the trunk flexors and extensors using isokinetic dynamometer. The pre- and post-exercise measurements were compared. Compared with the baseline, abdominal muscle strength (from 4.4±0.7 to 4.8±0.6), back extensor strength (from 2.6±0.6 to 3.5±1.2), and back extensor endurance (from 22.3±10.7 to 46.8±35.1) improved significantly after 8 weeks. The VAS decreased significantly from 4.6±2.2 to 2.6±1.6 after treatment. Furthermore, the peak torque and total work of the trunk flexors and extensors increased significantly (p<0.05). Lumbar strengthening exercise in lower-limb amputees with chronic low back pain resulted in decreased pain and increased lumbar extensor strength. The lumbar strengthening exercise program is very effective for lower-limb amputees with chronic low back pain.

The influence of hip strength on lower-limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women.

PubMed

Smith, Jo Armour; Popovich, John M; Kulig, Kornelia

2014-07-01

Cross-sectional laboratory study. To compare peak lower-limb, pelvis, and trunk kinematics and interjoint and intersegmental coordination in women with strong and weak hip muscle performance. Persons with lower extremity musculoskeletal disorders often demonstrate a combination of weak hip musculature and altered kinematics during weight-bearing dynamic tasks. However, the association between hip strength and kinematics independent of pathology or pain is unclear. Peak hip extensor and abductor torques were measured in 150 healthy young women. Of these, 10 fit the criteria for the strong group and 9 for the weak group, representing those with the strongest and weakest hip musculature, respectively, of the 150 screened individuals. Kinematics of the hip, knee, pelvis, and trunk were measured during the stance phases of walking and rate-controlled hopping. Hip/knee and pelvis/trunk coordination were calculated using the vector coding technique. There were no group differences in peak hip, knee, or pelvis kinematics. Participants in the weak group demonstrated greater trunk lateral bend toward the stance limb during hopping (P = .002, effect size [d] = 1.88). In the transverse plane, those in the weak group utilized less inphase coordination between the hip and the knee during walking (P = .036, d = 1.45) and more antiphase coordination between the hip and knee during hopping (P = .03, d = 1.47). In the absence of pain or pathology, poor hip muscle performance does not affect peak hip or knee joint kinematics in young women, but is associated with significantly different lower-limb and trunk/pelvis coordination during weight-bearing dynamic tasks. J Orthop Sports Phys Ther 2014;44(7):525-531. Epub 10 May 2014. doi:10.2519/jospt.2014.5028.

A mathematical model of hiking positions in a sailing dinghy.

PubMed

Putnam, C A

1979-01-01

A mathematical model of the human body designed to calculate the resultant muscle torques required at the hip and knee joints for specific hiking techniques is presented. Data for the model were obtained from ten male subjects who adopted three basic positions: Position 1 with the knees located at the inside edge of the sidedeck, Position 2 with the knees at the middle of the sidedeck, and Position 3 with the knees at the outside edge of the sidedeck. Each resultant muscle torque was expressed as a percentage of each subject's maximum voluntary hip flexion or knee extension torque. It was found that where Positions 1 and 2 were equally effective in keeping the boat upright, Position 2 was superior to Position 1 in regard to the per cent of maximum muscle torque required. The superiority of Position 2 over Position 3 depended on the individual's relative muscle strength at the hip and knee joints. The stronger the hip flexors with respect to the knee estensors, the more desirable was Position 2 and vice versa.

The Effects of Different Passive Static Stretching Intensities on Recovery from Unaccustomed Eccentric Exercise - A Randomized Controlled Trial.

PubMed

Apostolopoulos, Nikos C; Lahart, Ian M; Plyley, Michael J; Taunton, Jack; Nevill, Alan M; Koutedakis, Yiannis; Wyon, Matthew; Metsios, George S

2018-03-12

Effects of passive static stretching intensity on recovery from unaccustomed eccentric exercise of right knee extensors was investigated in 30 recreationally active males randomly allocated into three groups: high-intensity (70-80% maximum perceived stretch), low-intensity (30-40% maximum perceived stretch), and control. Both stretching groups performed 3 sets of passive static stretching exercises of 60s each for hamstrings, hip flexors, and quadriceps, over 3 consecutive days, post-unaccustomed eccentric exercise. Muscle function (eccentric and isometric peak torque) and blood biomarkers (CK and CRP) were measured before (baseline) and after (24, 48, and 72h) unaccustomed eccentric exercise. Perceived muscle soreness scores were collected immediately (time 0), and after 24, 48, and 72h post-exercise. Statistical time x condition interactions observed only for eccentric peak torque (p=.008). Magnitude-based inference analyses revealed low-intensity stretching had most likely, very likely, or likely beneficial effects on perceived muscle soreness (48-72h and 0-72h) and eccentric peak torque (baseline-24h and baseline-72h), compared with high-intensity stretching. Compared with control, low-intensity stretching had very likely or likely beneficial effects on perceived muscle soreness (0-24h and 0-72h), eccentric peak torque (baseline-48h and baseline-72h), and isometric peak torque (baseline-72h). High-intensity stretching had likely beneficial effects on eccentric peak torque (baseline-48h), but likely harmful effects eccentric peak torque (baseline-24h) and CK (baseline-48h and baseline-72h), compared with control. Therefore, low-intensity stretching is likely to result in small-to-moderate beneficial effects on perceived muscle soreness and recovery of muscle function post-unaccustomed eccentric exercise, but not markers of muscle damage and inflammation, compared with high-intensity or no stretching.

Knee extension torque variability after exercise in ACL reconstructed knees.

PubMed

Goetschius, John; Kuenze, Christopher M; Hart, Joseph M

2015-08-01

The purpose of this study was to compare knee extension torque variability in patients with ACL reconstructed knees before and after exercise. Thirty two patients with an ACL reconstructed knee (ACL-R group) and 32 healthy controls (control group) completed measures of maximal isometric knee extension torque (90° flexion) at baseline and following a 30-min exercise protocol (post-exercise). Exercise included 30-min of repeated cycles of inclined treadmill walking and hopping tasks. Dependent variables were the coefficient of variation (CV) and raw-change in CV (ΔCV): CV = (torque standard deviation/torque mean x 100), ΔCV = (post-exercise - baseline). There was a group-by-time interaction (p = 0.03) on CV. The ACL-R group demonstrated greater CV than the control group at baseline (ACL-R = 1.07 ± 0.55, control = 0.79 ± 0.42, p = 0.03) and post-exercise (ACL-R = 1.60 ± 0.91, control = 0.94 ± 0.41, p = 0.001). ΔCV was greater (p = 0.03) in the ACL-R group (0.52 ± 0.82) than control group (0.15 ± 0.46). CV significantly increased from baseline to post-exercise (p = 0.001) in the ACL-R group, while the control group did not (p = 0.06). The ACL-R group demonstrated greater knee extension torque variability than the control group. Exercise increased torque variability more in the ACL-R group than control group. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects.

PubMed

Rice, David A; McNair, Peter J; Lewis, Gwyn N

2011-01-01

A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration. Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P < 0.001) and EMG amplitude (P ≤0.001) decreased significantly in the control group but did not change in the OA group (all P > 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P < 0.011). No between-group differences were observed for the change in hamstrings torque or EMG (all P > 0.554). γ-loop dysfunction may contribute to AMI in individuals with knee joint OA, partially explaining the marked quadriceps weakness and atrophy that is often observed in this population.

Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects

PubMed Central

2011-01-01

Introduction A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Methods Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration. Results Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P < 0.001) and EMG amplitude (P ≤0.001) decreased significantly in the control group but did not change in the OA group (all P > 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P < 0.011). No between-group differences were observed for the change in hamstrings torque or EMG (all P > 0.554). Conclusions γ-loop dysfunction may contribute to AMI in individuals with knee joint OA, partially explaining the marked quadriceps weakness and atrophy that is often observed in this population. PMID:21933392

Limb salvage after infected knee arthroplasty with bone loss and extensor mechanism deficiency using a modular segmental replacement system.

PubMed

Namdari, Surena; Milby, Andrew H; Garino, Jonathan P

2011-09-01

Multiple total knee arthroplasty revisions pose significant surgical challenges, such as bone loss and soft tissue compromise. For patients with bone loss and extensor mechanism insufficiency after total knee arthroplasty, arthrodesis is a treatment option for the avoidance of amputation. However, arthrodesis is both difficult to achieve in situations with massive bone loss and potentially undesirable due to the dramatic shortening that follows. Although intramedullary nailing for knee arthrodesis has been widely reported, this technique has traditionally relied on the achievement of bony union. We report a case of a patient with massive segmental bone loss in which a modular intercalary prosthesis was used for arthrodesis to preserve limb length without bony union. Copyright © 2011 Elsevier Inc. All rights reserved.

Estimations of relative effort during sit-to-stand increase when accounting for variations in maximum voluntary torque with joint angle and angular velocity.

PubMed

Bieryla, Kathleen A; Anderson, Dennis E; Madigan, Michael L

2009-02-01

The main purpose of this study was to compare three methods of determining relative effort during sit-to-stand (STS). Fourteen young (mean 19.6+/-SD 1.2 years old) and 17 older (61.7+/-5.5 years old) adults completed six STS trials at three speeds: slow, normal, and fast. Sagittal plane joint torques at the hip, knee, and ankle were calculated through inverse dynamics. Isometric and isokinetic maximum voluntary contractions (MVC) for the hip, knee, and ankle were collected and used for model parameters to predict the participant-specific maximum voluntary joint torque. Three different measures of relative effort were determined by normalizing STS joint torques to three different estimates of maximum voluntary torque. Relative effort at the hip, knee, and ankle were higher when accounting for variations in maximum voluntary torque with joint angle and angular velocity (hip=26.3+/-13.5%, knee=78.4+/-32.2%, ankle=27.9+/-14.1%) compared to methods which do not account for these variations (hip=23.5+/-11.7%, knee=51.7+/-15.0%, ankle=20.7+/-10.4%). At higher velocities, the difference in calculating relative effort with respect to isometric MVC or incorporating joint angle and angular velocity became more evident. Estimates of relative effort that account for the variations in maximum voluntary torque with joint angle and angular velocity may provide higher levels of accuracy compared to methods based on measurements of maximal isometric torques.

Isokinetic Strength Profile of Elite Female Handball Players

PubMed Central

Xaverova, Zuzana; Dirnberger, Johannes; Lehnert, Michal; Belka, Jan; Wagner, Herbert; Orechovska, Karolina

2015-01-01

Systematic assessment of muscle strength of the lower extremities throughout the annual training cycle in athletes is crucial from a performance perspective for the optimization of the training process, as well as a health perspective with regard to injury prevention. The main aim of the present study was to determine isokinetic muscle strength of the knee flexors and extensors in female handball players at the beginning of a preparatory period and to assess whether there were any differences between players of different performance levels. The performance level was expressed by means of membership of the Women’s Junior National Handball Team (JNT, n=8) or the Women’s National Handball Team (NT, n=9). The isokinetic peak torque during concentric and eccentric single-joint knee flexion and extension was measured at angular velocities of 60, 180, 240°/s (concentric) and 60°/s (eccentric). The Mann-Whitney test showed no significant differences in the peak torques or ipsilateral ratios between the two groups. The bilateral force deficit (BFD) for concentric extension at 240°/s was significantly higher in the JNT compared with the NT (p=0.04; d=1.02). However, the results of individual evaluation show that the BFD was more frequent in the NT in most measurements. A high BFD was evident in the eccentric mode in both groups highlighting a need for particular strengthening. With regard to low strength ratios a prevention programme should be suggested for both observed groups of professional female handball players to reduce the risk of injury. PMID:26839626

Torque Control of a Rehabilitation Teaching Robot Using Magneto-Rheological Fluid Clutches

NASA Astrophysics Data System (ADS)

Hakogi, Hokuto; Ohaba, Motoyoshi; Kuramochi, Naimu; Yano, Hidenori

A new robot that makes use of MR-fluid clutches for simulating torque is proposed to provide an appropriate device for training physical therapy students in knee-joint rehabilitation. The feeling of torque provided by the robot is expected to correspond to the torque performance obtained by physical therapy experts in a clinical setting. The torque required for knee-joint rehabilitation, which is a function of the rotational angle and the rotational angular velocity of a knee movement, is modeled using a mechanical system composed of typical spring-mass-damper elements. The robot consists of two MR-fluid clutches, two induction motors, and a feedback control system. In the torque experiments, output torque is controlled using the spring and damper coefficients separately. The values of these coefficients are determined experimentally. The experimental results show that the robot would be suitable for training physical therapy students to experience similar torque feelings as needed in a clinical situation.

Association between muscle strength and metabolic syndrome in older Korean men and women: the Korean Longitudinal Study on Health and Aging.

PubMed

Yang, Eun Joo; Lim, Soo; Lim, Jae-Young; Kim, Ki Woong; Jang, Hak Chul; Paik, Nam-Jong

2012-03-01

The objective of the study was to investigate the association between metabolic syndrome (MS) and muscle strength in community-dwelling older men and women in Korea. Korean men and women 65 years and older living in a single, typical South Korean city (n = 647) were enrolled in the Korean Longitudinal Study on Health and Aging study. The diagnosis of MS was evaluated according to the definition of the National Cholesterol Education Program Adult Treatment Panel III. Isokinetic muscle strength of the knee extensors, as determined by peak torque per body weight (newton meter per kilogram) and hand-grip strength per body weight (newton per kilogram), was measured. Participants without MS had greater leg muscle strength and grip strength per weight. The effect of MS on muscle strength was more prominent in men than in women in our study population. Only men showed a significant interaction between MS and age for muscle strength (P = .014), and the effect was greater in men aged 65 to 74 years compared with those older than 75 years (119.2 ± 31.2 vs 134.5 ± 24.3 N m/kg). Participants with MS had weaker knee extensor strength after controlling the covariates (β = -90.80, P = .003), and the interaction term (age × MS × male sex) was significant (β = 1.00, P = .017). Metabolic syndrome is associated with muscle weakness, and this relationship is particularly pronounced in men. Age can modify the impact of MS on muscle strength. Men aged 65 to 74 years with MS need a thorough assessment of muscle strength to prevent disability. Copyright © 2012 Elsevier Inc. All rights reserved.

Muscular co-contraction during walking and landing from a jump: comparison between genders and influence of activity level.

PubMed

da Fonseca, Sergio Teixeira; Vaz, Daniela Virgínia; de Aquino, Cecília Ferreira; Brício, Rachel Soares

2006-06-01

Women have higher rates of knee ligament injury than men. Co-contraction of knee muscles is proposed to be an important mechanism to protect the joint from injuries. Females have lower co-contraction levels when compared to males. Exploratory, cross-sectional design. Thirty-six men and women equally divided into four groups according to gender and activity level (sedentary and athletic) were compared in relation to vastus lateralis and biceps femoris co-contraction before heel strike during level walking and before floor contact during landing from a jump. Muscular co-contraction was assessed by surface electromyography. Correlations between co-contraction and ligament laxity, extensor and flexor work, and flexion/extension torque ratio were also analyzed. No differences between genders were found in the studied situations (p0.381). During walking, co-contraction was greater in sedentary women compared to athletic women (p=0.002). A moderate inverse correlation was found between co-contraction during walking and women extensor (r=-0.613; p=0.007) and flexor (r=-0.575; p=0.012) work. During landing from a jump, no variables correlated to co-contraction in any of the groups tested (r0.477; p0.061). Co-contraction levels were not different between genders. Results suggest that women compensate strength deficits by means of increasing activation levels, possibly to generate adequate joint stiffness to meet stabilization demands. However, this is not evident in a more stressful activity like landing from a jump. This study contributes to a better understanding of the factors related to joint protection in females, who are at a greater risk of ligament injuries.

Relation between functional mobility and dynapenia in institutionalized frail elderly

PubMed Central

Soares, Antonio Vinicius; Marcelino, Elessandra; Maia, Késsia Cristina; Borges, Noé Gomes

2017-01-01

ABSTRACT Objective To investigate the relation between functional mobility and dynapenia in institutionalized frail elderly. Methods A descriptive, correlational study involving 26 institutionalized elderly men and women, mean age 82.3±6 years. The instruments employed were the Mini Mental State Examination, the Geriatric Depression Scale, the International Physical Activity Questionnaire, the Timed Up and Go test, a handgrip dynamometer and a portable dynamometer for large muscle groups (shoulder, elbow and hip flexors, knee extensors and ankle dorsiflexors). Results Significant negative correlation between functional mobility levels assessed by the Timed Up and Go test and dynapenia was observed in all muscle groups evaluated, particularly in knee extensors (r -0.65). Conclusion A significant negative correlation between muscle strength, particularly knee extensor strength, and functional mobility was found in institutionalized elderly. Data presented indicate that the higher the muscle strength, the shorter the execution time, and this could demonstrate better performance in this functional mobility test. PMID:29091148

Can maximal and rapid isometric torque characteristics predict playing level in division I American collegiate football players?

PubMed

Thompson, Brennan J; Ryan, Eric D; Sobolewski, Eric J; Smith, Doug B; Conchola, Eric C; Akehi, Kazuma; Buckminster, Tyler

2013-03-01

The purpose of this study was to determine if maximal and rapid isometric torque characteristics could discriminate starters from nonstarters in elite Division I American collegiate football players. Sixteen starters (mean ± SD: age = 20.81 ± 1.28 years; height = 184.53 ± 6.58 cm; and mass = 108.69 ± 22.16 kg) and 15 nonstarters (20.40 ± 1.68 years; 182.27 ± 10.52 cm; and 104.60 ± 22.44 kg) performed isometric maximal voluntary contractions (MVCs) of the leg flexor and extensor muscle groups. Peak torque (PT), rate of torque development (RTD), the time to peak RTD (TTRTDpeak), contractile impulse (IMPULSE), and absolute torque values (TORQUE) at specific time intervals were calculated from a torque-time curve. The results indicated significant and nonsignificant differences between starters and nonstarters for the early rapid leg flexion torque characteristics that included RTD, IMPULSE, and TORQUE at 30 and 50 milliseconds, and TTRTDpeak. These variables also demonstrated the largest effect sizes of all the variables examined (0.71-0.82). None of the leg extensor variables, leg flexion PT, or later leg flexion rapid torque variables (≥ 100 milliseconds) were significant discriminators of playing level. These findings suggest that the early rapid leg flexion torque variables may provide an effective and sensitive muscle performance measurement in the identification of collegiate football talent. Further, coaches and practitioners may use these findings when designing training programs for collegiate football players with the intent to maximize rapid leg flexion characteristics.

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae

PubMed Central

Yildiz, Y; Aydin, T; Sekir, U; Cetin, C; Ors, F; Alp, K

2003-01-01

Objectives: To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score. Methods: The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60°/s (25–90° range of flexion) and 180°/s (full range). These sessions were repeated three times a week for six weeks. Results: Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found. Conclusions: The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters. PMID:14665581

Explosive Strength of the Knee Extensors: The Influence of Criterion Trial Detection Methodology on Measurement Reproducibility

PubMed Central

Wiesinger, Hans-Peter; Wiemer, Nicolas; Kösters, Alexander; Müller, Erich

2016-01-01

Abstract The present study was conducted to assess test-retest reproducibility of explosive strength measurements during single-joint isometric knee extension using the IsoMed 2000 dynamometer. Thirty-one physically active male subjects (mean age: 23.7 years) were measured on two occasions separated by 48–72 h. The intraclass correlation coefficient (ICC 2,1) and the coefficient of variation (CV) were calculated for (i) maximum torque (MVC), (ii) the peak rate of torque development (RTDpeak) as well as for (iii) the average rate of torque development (RTD) and the impulse taken at several predefined time intervals (0–30 to 0–300 ms); thereby explosive strength variables were derived in two conceptually different versions: on the one hand from the MVC-trial (version I), on the other hand from the trial showing the RTDpeak (version II). High ICC-values (0.80–0.99) and acceptable CV-values (1.9–8.7%) could be found for MVC as well as for the RTD and the impulse taken at time intervals of ≥100 ms, regardless of whether version I or II was used. In contrast, measurements of the RTDpeak as well as the RTD and the impulse taken during the very early contraction phase (i.e. RTD/impulse0–30ms and RTD/impulse0–50ms) showed clearly weaker reproducibility results (ICC: 0.53–0.84; CV: 7.3–16.4%) and gave rise to considerable doubts as to clinical usefulness, especially when derived using version I. However, if there is a need to measure explosive strength for earlier time intervals in practice, it is, in view of stronger reproducibility results, recommended to concentrate on measures derived from version II, which is based on the RTDpeak-trial. PMID:28149337

Assessment of muscle endurance of the knee extensor muscles in adolescents with spastic cerebral palsy using a submaximal repetitions-to-fatigue protocol.

PubMed

Eken, Maaike M; Dallmeijer, Annet J; Doorenbosch, Caroline A; Dekkers, Hurnet; Becher, Jules G; Houdijk, Han

2014-10-01

To compare muscle endurance in adolescents with spastic cerebral palsy (CP) with typically developing (TD) peers using a submaximal repetitions-to-fatigue (RTF) protocol. Cross sectional. Human motion laboratory. Adolescents with spastic CP (n=16; Gross Motor Function Classification System levels I or II) and TD adolescents (n=18) within the age range of 12 to 19 years old. Not applicable. Each participant performed 3 RTF tests at different submaximal loads, ranging from 50% to 90% of their maximal voluntary knee extension torque. The relation between the number of repetitions (repetition maximum [RM]) and imposed submaximal relative (percent of maximal voluntary torque [%MVT]) and absolute (Nm/kg) torque was quantified. To compare adolescents with CP with TD adolescents, a mixed linear model was used to construct load endurance curves. Surface electromyography of quadriceps muscles was measured to assess changes in normalized amplitude and median frequency (MF) as physiological indicators of muscle fatigue. Adolescents with CP showed a larger decrease in %MVT per RM than TD adolescents (P<.05). TD adolescents showed substantial higher absolute (Nm/kg) load endurance curves than adolescents with CP (P<.001), but they did not show a difference in slope. Electromyographic normalized amplitude increased significantly (P<.05) in the quadriceps muscles in all tests for both groups. Electromyographic MF decreased significantly (P<.05) in tests with the low and medium loads. Electromyographic responses did not differ between groups, indicating that similar levels of muscle fatigue were reached. Adolescents with CP show slightly lower muscle endurance compared with TD adolescents on a submaximal RTF protocol, which is in contrast with earlier findings in a maximal voluntary fatigue protocol. Accordingly, adolescents with CP have a reduced capacity to endure activities at similar relative loads compared with TD adolescents. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Timing of intermittent torque control with wire-driven gait training robot lifting toe trajectory for trip avoidance.

PubMed

Miyake, Tamon; Kobayashi, Yo; Fujie, Masakatsu G; Sugano, Shigeki

2017-07-01

Gait training robots are useful for changing gait patterns and decreasing risk of trip. Previous research has reported that decreasing duration of the assistance or guidance of the robot is beneficial for efficient gait training. Although robotic intermittent control method for assisting joint motion has been established, the effect of the robot intervention timing on change of toe clearance is unclear. In this paper, we tested different timings of applying torque to the knee, employing the intermittent control of a gait training robot to increase toe clearance throughout the swing phase. We focused on knee flexion motion and designed a gait training robot that can apply flexion torque to the knee with a wire-driven system. We used a method of timing detecting for the robot conducting torque control based on information from the hip, knee, and ankle angles to establish a non-time dependent parameter that can be used to adapt to gait change, such as gait speed. We carried out an experiment in which the conditions were four time points: starting the swing phase, lifting the foot, maintaining knee flexion, and finishing knee flexion. The results show that applying flexion torque to the knee at the time point when people start lifting their toe is effective for increasing toe clearance in the whole swing phase.

Net joint moments and muscle activation in barbell squats without and with restricted anterior leg rotation.

PubMed

Chiu, Loren Z F; vonGaza, Gabriella L; Jean, Liane M Y

2017-01-01

Muscle utilisation in squat exercise depends on technique. The purpose of this study was to compare net joint moments (NJMs) and muscle activation during squats without and with restricted leg dorsiflexion. Experienced men (n = 5) and women (n = 4) performed full squats at 80% one repetition maximum. 3D motion analysis, force platform and (EMG) data were collected. Restricting anterior leg rotation reduced anterior leg (P = 0.001) and posterior thigh (P < 0.001) rotations, resulting in a smaller knee flexion range of motion (P < 0.001). At maximum squat depth, ankle plantar flexor (P < 0.001) and knee extensor (P < 0.001) NJM were higher in unrestricted squats. Hip extensor NJM (P = 0.14) was not different between squat types at maximum squat depth. Vastus lateralis (P > 0.05), vastus medialis (P > 0.05) and rectus femoris (P > 0.05) EMG were not different between squat types. Unrestricted squats have higher ankle plantar flexor and knee extensor NJM than previously reported from jumping and landing. However, ankle plantar flexor and knee extensor NJM are lower in restricted squats than previous studies of jumping and landing. The high NJM in unrestricted squat exercise performed through a full range of motion suggests this squat type would be more effective to stimulate adaptations in the lower extremity musculature than restricted squats.

Relationship between magnitude of applied torque in pre-swing phase and gait change for prevention of trip in elderly people.

PubMed

Miyake, Tamon; Tsukune, Mariko; Kobayashi, Yo; Sugano, Shigeki; Fujie, Masakatsu G

2016-08-01

Elderly people are at risk of tripping because of their narrow range of articular motion. To avoid tripping, gait training that improves their range of articular motion would be beneficial. In this study we propose a gait-training robot that applies a torque during the pre-swing phase to achieve this goal. We investigated the relationship between magnitude of applied torque and change in the range of knee-articular motion while walking before and after the application of this torque. We developed a wearable robot and carried out an experiment on human participants in which a motor pulls a string embedded on the robotic frame, applying torque in the pre-swing phase for a period of 20 [s]. Before and after applying torque the participant walked normally for 15 [s] without interference from the robot. We found that knee flexion angle increased after applying the torque if the torque was within the range of approximately 6-8 [Nm]. Therefore, we were able to verify that a new range of knee articular motion can be learned through application of torque.

Ankle and knee kinetics between strike patterns at common training speeds in competitive male runners.

PubMed

Kuhman, Daniel; Melcher, Daniel; Paquette, Max R

2016-01-01

The purpose of this study was to investigate the interaction of foot strike and common speeds on sagittal plane ankle and knee joint kinetics in competitive rear foot strike (RFS) runners when running with a RFS pattern and an imposed forefoot strike (FFS) pattern. Sixteen competitive habitual male RFS runners ran at two different speeds (i.e. 8 and 6 min mile(-1)) using their habitual RFS and an imposed FFS pattern. A repeated measures analysis of variance was used to assess a potential interaction between strike pattern and speed for selected ground reaction force (GRF) variables and, sagittal plane ankle and knee kinematic and kinetic variables. No foot strike and speed interaction was observed for any of the kinetic variables. Habitual RFS yielded a greater loading rate of the vertical GRF, peak ankle dorsiflexor moment, peak knee extensor moment, peak knee eccentric extensor power, peak dorsiflexion and sagittal plane knee range of motion compared to imposed FFS. Imposed FFS yielded greater maximum vertical GRF, peak ankle plantarflexor moment, peak ankle eccentric plantarflexor power and sagittal plane ankle ROM compared to habitual RFS. Consistent with previous literature, imposed FFS in habitual RFS reduces eccentric knee extensor and ankle dorsiflexor involvement but produce greater eccentric ankle plantarflexor action compared to RFS. These acute differences between strike patterns were independent of running speeds equivalent to typical easy and hard training runs in competitive male runners. Current findings along with previous literature suggest differences in lower extremity kinetics between habitual RFS and imposed FFS running are consistent among a variety of runner populations.

Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

PubMed Central

2016-01-01

Aim To investigate whether there is a sex difference in exercise induced muscle damage. Materials and Method Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage. Results Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p<0.05). There was no sex difference in isometric torque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05), and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05). Conclusion Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage. PMID:26986066

Eccentric Torque-Producing Capacity is Influenced by Muscle Length in Older Healthy Adults.

PubMed

Melo, Ruth C; Takahashi, Anielle C M; Quitério, Robison J; Salvini, Tânia F; Catai, Aparecida M

2016-01-01

Considering the importance of muscle strength to functional capacity in the elderly, the study investigated the effects of age on isokinetic performance and torque production as a function of muscle length. Eleven younger (24.2 ± 2.9 years) and 16 older men (62.7 ± 2.5 years) were subjected to concentric and eccentric isokinetic knee extension/flexion at 60 and 120° · s(-1) through a functional range of motion. The older group presented lower peak torque (in newton-meters) than the young group for both isokinetic contraction types (age effect, p < 0.001). Peak torque deficits in the older group were near 30 and 29% for concentric and eccentric contraction, respectively. Concentric peak torque was lower at 120° · s(-1) than at 60° · s(-1) for both groups (angular velocity effect, p < 0.001). Eccentric knee extension torque was the only exercise tested that showed an interaction effect between age and muscle length (p < 0.001), which suggested different torque responses to the muscle length between groups. Compared with the young group, the eccentric knee extension torque was 22-56% lower in the older group, with the deficits being lower in the shortened muscle length (22-27%) and higher (33-56%) in the stretched muscle length. In older men, the production of eccentric knee strength seems to be dependent on the muscle length. At more stretched positions, older subjects lose the capacity to generate eccentric knee extension torque. More studies are needed to assess the mechanisms involved in eccentric strength preservation with aging and its relationship with muscle length.

Reduction of Risk for Low Back Injury in Theater of Operations

DTIC Science & Technology

2015-06-01

Assessed for eligibility (n = 698) 14 Figure 4. Predicted (from regression) isometric lumbar extension strength ( torque ) mean values (adjusted by...resistance exercise to the lumbar extensors in the ranges required for strength development, torque production from the gluteals and hamstrings must be...the small lumbar muscles play only a minor role in trunk extension torque production.17 Thus, they are considered to be the weak link in trunk

Effects of fatiguing constant versus alternating intensity intermittent isometric muscle actions on maximal torque and neuromuscular responses

PubMed Central

Smith, C.M.; Housh, T.J.; Hill, E.C.; Cochrane, K.C.; Jenkins, N.D.M.; Schmidt, R.J.; Johnson, G.O.

2016-01-01

Objective: To determine the effects of constant versus alternating applications of torque during fatiguing, intermittent isometric muscle actions of the leg extensors on maximal voluntary isometric contraction (MVIC) torque and neuromuscular responses. Methods: Sixteen subjects performed two protocols, each consisting of 50 intermittent isometric muscle actions of the leg extensors with equal average load at a constant 60% MVIC or alternating 40 then 80% (40/80%) MVIC with a work-to-rest ratio of 6-s on and 2-s off. MVIC torque as well as electromyographic signals from the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) and mechanomyographic signals from the VL were recorded pretest, immediately posttest, and 5-min posttest. Results: The results indicated that there were no time-related differences between the 60% MVIC and 40/80% MVIC protocols. The MVIC torque decreased posttest (22 to 26%) and remained depressed 5-min posttest (9%). There were decreases in electromyographic frequency (14 to 19%) and mechanomyographic frequency (23 to 24%) posttest that returned to pretest levels 5-min posttest. There were no changes in electromyographic amplitude and mechanomyogrpahic amplitude. Conclusions: These findings suggested that these neuromuscular parameters did not track the fatigue-induced changes in MVIC torque after 5-min of recovery. PMID:27973384

Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction

PubMed Central

Czaplicki, Adam; Jarocka, Marta; Walawski, Jacek

2015-01-01

The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age. PMID:26646385

Contribution of knee flexor and extensor strength on sex-specific energy absorption and torsional joint stiffness during drop jumping.

PubMed

Schmitz, Randy J; Shultz, Sandra J

2010-01-01

Lower extremity injury often occurs during abrupt deceleration when attempting to change the body's direction. Although sex-specific biomechanics have been implicated in the greater risk of acute knee injury in women than in men, it is unknown if sex differences in thigh strength affect sex-specific energy absorption and torsional joint stiffness patterns. To determine sex differences in energy absorption patterns and joint stiffnesses of the lower extremity during a drop jump and to determine if these sex differences were predicted by knee extensor and flexor strength. Cross-sectional study. Laboratory environment. Recreationally active, college-aged students (41 women: age  =  22.1 ± 2.9 years, height  =  1.63 ± 0.07 m, mass  =  59.3 ± 8.0 kg; 40 men: age  =  22.4 ± 2.8 years, height  =  1.77 ± 0.1 m, mass  =  80.9 ± 14.1 kg). Participants performed knee flexor and extensor maximal voluntary isometric contractions followed by double-leg drop-jump landings. Lower extremity joint energetics (J × N(-1) × m(-1)) and torsional joint stiffnesses (Nm × N(-1) × m(-1) × degrees(-1)) were calculated for the hip, knee, and ankle during the initial landing phase. Body weight was measured in newtons and height was measured in meters. Sex comparisons were made and sex-specific regressions determined if thigh muscle strength (Nm/kg) predicted sagittal-plane landing energetics and stiffnesses. Women absorbed 69% more knee energy and had 36% less hip torsional stiffness than men. In women, greater knee extensor strength predicted greater knee energy absorption (R(2)  =  0.11, P  =  .04), and greater knee flexor strength predicted greater hip torsional stiffness (R(2)  =  0.12, P  =  .03). Sex-specific biomechanics during the deceleration phase of a drop jump revealed that women used a strategy to attempt to decrease system stiffness. Additionally, only female strength values were predictive of landing energetics and stiffnesses. These findings collectively demonstrated that the task may have been more difficult for women, resulting in a different movement strategy among those with different levels of thigh strength to safely complete the task. Future researchers should look at other predictive factors of observed sex differences.

Gouty involvement of the patella and extensor mechanism of the knee mimicking aggressive neoplasm. A case series.

PubMed

Kester, Christopher; Wallace, Matthew T; Jelinek, James; Aboulafia, Albert

2018-06-01

Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging. We present three cases of tophaceous gout mimicking aggressive neoplasms in the extensor mechanism of the knee. All cases presented as extensor tendon masses eroding into the patella, with imaging findings initially concerning for primary musculoskeletal malignancy.

Selective contribution of each hamstring muscle to anterior cruciate ligament protection and tibiofemoral joint stability in leg-extension exercise: a simulation study.

PubMed

Biscarini, Andrea; Botti, Fabio Massimo; Pettorossi, Vito Enrico

2013-09-01

A biomechanical model was developed to simulate the selective effect of the co-contraction force provided by each hamstring muscle on the shear and compressive tibiofemoral joint reaction forces, during open kinetic-chain knee-extension exercises. This model accounts for instantaneous values of knee flexion angle [Formula: see text], angular velocity and acceleration, and for changes in magnitude, orientation, and application point of external resistance. The tibiofemoral shear force (TFSF) largely determines the tensile force on anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Biceps femoris is the most effective hamstring muscle in decreasing the ACL-loading TFSF developed by quadriceps contractions for [Formula: see text]. In this range, the semimembranosus generates the dominant tibiofemoral compressive force, which enhances joint stability, opposes anterior/posterior tibial translations, and protects cruciate ligaments. The semitendinosus force provides the greatest decreasing gradient of ACL-loading TFSF for [Formula: see text], and the greatest increasing gradient of tibiofemoral compressive force for [Formula: see text]. However, semitendinosus efficacy is strongly limited by its small physiological section. Hamstring muscles behave as a unique muscle in enhancing the PCL-loading TFSF produced by quadriceps contractions for [Formula: see text]. The levels of hamstrings co-activation that suppress the ACL-loading TFSF considerably shift when the knee angular acceleration is changed while maintaining the same level of knee extensor torque by a concurrent adjustment in the magnitude of external resistance. The knowledge of the specific role and the optimal activation level of each hamstring muscle in ACL protection and tibiofemoral stability are fundamental for planning safe and effective rehabilitative knee-extension exercises.

Test-Retest Reliability of Innovated Strength Tests for Hip Muscles

PubMed Central

Meyer, Christophe; Corten, Kristoff; Wesseling, Mariska; Peers, Koen; Simon, Jean-Pierre; Jonkers, Ilse; Desloovere, Kaat

2013-01-01

The burden of hip muscles weakness and its relation to other impairments has been well documented. It is therefore a pre-requisite to have a reliable method for clinical assessment of hip muscles function allowing the design and implementation of a proper strengthening program. Motor-driven dynamometry has been widely accepted as the gold-standard for lower limb muscle strength assessment but is mainly related to the knee joint. Studies focusing on the hip joint are less exhaustive and somewhat discrepant with regard to optimal participants position, consequently influencing outcome measures. Thus, we aimed to develop a standardized test setup for the assessment of hip muscles strength, i.e. flexors/extensors and abductors/adductors, with improved participant stability and to define its psychometric characteristics. Eighteen participants performed unilateral isokinetic and isometric contractions of the hip muscles in the sagittal and coronal plane at two separate occasions. Peak torque and normalized peak torque were measured for each contraction. Relative and absolute measures of reliability were calculated using the intraclass correlation coefficient and standard error of measurement, respectively. Results from this study revealed higher levels of between-day reliability of isokinetic/isometric hip abduction/flexion peak torque compared to existing literature. The least reliable measures were found for hip extension and adduction, which could be explained by a less efficient stabilization technique. Our study additionally provided a first set of reference normalized data which can be used in future research. PMID:24260550

A Highly Backdrivable, Lightweight Knee Actuator for Investigating Gait in Stroke

PubMed Central

Sulzer, James S.; Roiz, Ronald A.; Peshkin, Michael A.; Patton, James L.

2012-01-01

Many of those who survive a stroke develop a gait disability known as stiff-knee gait (SKG). Characterized by reduced knee flexion angle during swing, people with SKG walk with poor energy efficiency and asymmetry due to the compensatory mechanisms required to clear the foot. Previous modeling studies have shown that knee flexion activity directly before the foot leaves the ground, and this should result in improved knee flexion angle during swing. The goal of this research is to physically test this hypothesis using robotic intervention. We developed a device that is capable of assisting knee flexion torque before swing but feels imperceptible (transparent) for the rest of the gait cycle. This device uses sheathed Bowden cable to control the deflection of a compliant torsional spring in a configuration known as a Series Elastic Remote Knee Actuator (SERKA). In this investigation, we describe the design and evaluation of SERKA, which includes a pilot experiment on stroke subjects. SERKA could supply a substantial torque (12 N· m) in less than 20 ms, with a maximum torque of 41 N·m. The device resisted knee flexion imperceptibly when desired, at less than 1 N·m rms torque during normal gait. With the remote location of the actuator, the user experiences a mass of only 1.2 kg on the knee. We found that the device was capable of increasing both peak knee flexion angle and velocity during gait in stroke subjects. Thus, the SERKA is a valid experimental device that selectively alters knee kinetics and kinematics in gait after stroke. PMID:22563305

Relationship between cardiopulmonary responses and isokinetic moments: the optimal angular velocity for muscular endurance

PubMed Central

Lee, Chan-Bok; Eun, Denny; Kim, Kang-Ho; Park, Jae-Wan; Jee, Yong-Seok

2017-01-01

Most protocols for testing and rehabilitation for recovery and improvement of muscular endurance have been set at 180°/sec, 240°/sec, and 300°/sec. These protocols can cause confusion to clinical providers or other researchers. This study was aimed at investigating the optimal isokinetic angular speed for measuring or developing muscular endurance after assessing the relationship between cardiopulmonary responses and isokinetic moments. This study was conducted with 31 male and female college students. Graded exercise test and body composition were measured as well as the isokinetic moments of the knee muscles at three angular speeds: 180°/sec, 240°/sec, and 300°/sec. The specific isokinetic moments of knee muscles that were measured included: peak torque (PT) and total work (TW) on extensor (e) and flexor (f) of knee joints, which were denoted as ePT180, fPT180, eTW180, fTW180, ePT240, fPT240, eTW240, fTW240, ePT300, fPT300, eTW300, and fTW300 according to the three angular speeds. Spearman correlation test was used to examine the relationship between the sum means of cardiopulmonary responses and the variables of isokinetic moments. This study confirmed that the optimal angular speed for testing or training for muscular endurance was 180°/sec, which showed a stronger relationship between cardiopulmonary responses and isokinetic moments. Therefore, this angular speed is recommended for testing and training for muscular endurance of the knee joints. PMID:28503531

Relationship between cardiopulmonary responses and isokinetic moments: the optimal angular velocity for muscular endurance.

PubMed

Lee, Chan-Bok; Eun, Denny; Kim, Kang-Ho; Park, Jae-Wan; Jee, Yong-Seok

2017-04-01

Most protocols for testing and rehabilitation for recovery and improvement of muscular endurance have been set at 180°/sec, 240°/sec, and 300°/sec. These protocols can cause confusion to clinical providers or other researchers. This study was aimed at investigating the optimal isokinetic angular speed for measuring or developing muscular endurance after assessing the relationship between cardiopulmonary responses and isokinetic moments. This study was conducted with 31 male and female college students. Graded exercise test and body composition were measured as well as the isokinetic moments of the knee muscles at three angular speeds: 180°/sec, 240°/sec, and 300°/sec. The specific isokinetic moments of knee muscles that were measured included: peak torque (PT) and total work (TW) on extensor (e) and flexor (f) of knee joints, which were denoted as ePT180, fPT180, eTW180, fTW180, ePT240, fPT240, eTW240, fTW240, ePT300, fPT300, eTW300, and fTW300 according to the three angular speeds. Spearman correlation test was used to examine the relationship between the sum means of cardiopulmonary responses and the variables of isokinetic moments. This study confirmed that the optimal angular speed for testing or training for muscular endurance was 180°/sec, which showed a stronger relationship between cardiopulmonary responses and isokinetic moments. Therefore, this angular speed is recommended for testing and training for muscular endurance of the knee joints.

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients.

PubMed

Izawa, Kazuhiro P; Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-11-27

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m²; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength ( r = -0.38, p = 0.01) and with knee extensor muscle strength ( r = -0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

A Better ARED Squat

NASA Technical Reports Server (NTRS)

Caldwell, E. E.; Newby, N. J.; Ploutz-Snyder, L.

2014-01-01

The 0-G ARED squat under loads the legs relative to the 1g ARED squat. In 1g the knee extensor/flexor muscles are primarily engaged due to the body's center of gravity is behind the knees during the motion of the squat. As body weight does not play a sufficient role 0 G, a crewmember's load exposure is limited by the load delivered by ARED through the exercise bar. Prescription loads for lowerbody resistance exercise in microgravity aim to include 1-G exercise bar load in addition to the crewmember's Earth body weight (BW); however, pressure points from the bar and the 1BW increased load at the shoulders translating to higher loads on the back have been a historical limitation for shoulders, requiring a decrease in exercise load at the start of the mission. Analogous to crewmembers, bed rest subjects report limitations of exercising with high loads on the back while performing squats on the horizontal exercise fixture (HEF), a custom exercise device that serves as an analog to 0-G ARED. Improvements for increasing loads on the HEF squat were suggested by distributing total exercise load between the hips and the bar1. The same is recommended for the 0-G ARED squat, with using current equipment on the ISS, which include the T2 running harness and T2 bungees. Quantification of this improvement has been accessed through computational modeling. The purpose of this study is to characterize joint torque during a squat with a distribution in exercise load on the ARED in 0 G. The analysis used existing models from NASA's Digital Astronaut Project. The biomechanics squat model was integrated with the ARED model and T2 bungees. The spring constant for the bungees were derived from ground testing. Forward dynamic simulation was performed for various conditions including anchor point attachments on the footplate of the ARED, bar load, hip load, and gravitational environment. The model confirms joint torques at knees is lower relative to 1G conditions primarily because the load delivery system is just with the exercise bar in 0 G. By distributing partial loads through use of the bungees to the hips joint-torque profiles were altered during a squat and provided options to enhance targeting lower-body loading in aims as for an improved countermeasure.

Muscle power is an independent determinant of pain and quality of life in knee osteoarthritis

USDA-ARS?s Scientific Manuscript database

OBJECTIVE: This study examined the relationships between leg muscle strength, power, and perceived disease severity in subjects with knee osteoarthritis (OA) in order to determine whether dynamic leg extensor muscle power would be associated with pain and quality of life in knee OA. METHODS: Baseli...

Fatigue and recovery from dynamic contractions in men and women differ for arm and leg muscles.

PubMed

Senefeld, Jonathon; Yoon, Tejin; Bement, Marie Hoeger; Hunter, Sandra K

2013-09-01

Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and MVIC electromyogram activity than women (P < 0.05). The decline in MVIC and power was greater, and force recovery was slower for the elbow flexors compared with knee extensors. The gender difference in muscle fatigue often observed during isometric tasks was diminished during fast dynamic contractions for upper and lower limb muscles. Copyright © Published 2013 by Wiley Periodicals, Inc. This article is a US Government wmusork and, as such, is in the public domain in the United States of America.

Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

NASA Astrophysics Data System (ADS)

Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

2016-11-01

Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

Eliminating impingement optimizes patellar biomechanics in high knee flexion.

PubMed

Tang, Qi-heng; Zhou, Yi-xin; Tang, Jing; Shao, Hong-yi; Wang, Guang-zhi

2010-08-01

We investigated the impact of eliminating the impingement between extensor mechanism and tibial insert on patellar tracking and patellar ligament tension in high knee flexion. Six cadaveric specimens were tested on an Oxford-type testing rig. The Genesis II knee system was implanted into each specimen knee with the traditional tibial insert and high-flex insert successively. Compared to traditional insert, the high-flex insert was characterized with a chambered anterior post and a chambered anterior lip which eliminates patella-post and patellar ligament-anterior lip impingements. The patella was tracked with an NDI Optotrak Certus system. The patellar ligament tension was measured using a NKB S-type tension transducer. There was a decrease of resultant patellar translation relative to the femur with statistically significant (P<0.05) at 90 degrees to 150 degrees of knee flexion and a decrease of patellar ligament tension with statistical significance (P<0.05) at 100 degrees, 120 degrees, 130 degrees, and 140 degrees of flexion using high-flex insert compared to traditional insert. Eliminating the impingement between extensor mechanism and implant in high knee flexion altered patellar tracking and reduced patellar ligament tension, which would facilitate high knee flexion.

Effects of Accumulating Work Shifts on Performance-Based Fatigue Using Multiple Strength Measurements in Day and Night Shift Nurses and Aides.

PubMed

Thompson, Brennan J; Stock, Matt S; Banuelas, Victoria K

2017-05-01

Objective This study aimed to examine the effects of accumulating nursing work on maximal and rapid strength characteristics in female nurses and compare these effects in day versus night shift workers. Background Nurses exhibit among the highest nonfatal injury rates of all occupations, which may be a consequence of long, cumulative work shift schedules. Fatigue may accumulate across multiple shifts and lead to performance impairments, which in turn may be linked to injury risks. Method Thirty-seven nurses and aides performed isometric strength-based performance testing of three muscle groups, including the knee extensors, knee flexors, and wrist flexors (hand grip), as well as countermovement jumps, at baseline and following exposure to three 12-hour work shifts in a four-day period. Variables included peak torque (PT) and rate of torque development (RTD) from isometric strength testing and jump height and power output. Results The rigorous work period resulted in significant decreases (-7.2% to -19.2%) in a large majority (8/9) of the isometric strength-based measurements. No differences were noted for the day versus night shift workers except for the RTD at 200 millisecond variable, for which the night shift had greater work-induced decreases than the day shift workers. No changes were observed for jump height or power output. Conclusions A compressed nursing work schedule resulted in decreases in strength-based performance abilities, being indicative of performance fatigue. Application Compressed work schedules involving long shifts lead to functional declines in nurse performance capacities that may pose risks for both the nurse and patient quality of care. Fatigue management plans are needed to monitor and regulate increased levels of fatigue.

The influence of velocity-specific resistance training on the in vivo torque-velocity relationship and the cross-sectional area of quadriceps femoris.

PubMed

Petersen, S R; Bagnall, K M; Wenger, H A; Reid, D C; Castor, W R; Quinney, H A

1989-01-01

This work was supported by Sport Canada end Hydra-Fitness Industries. In order to investigate the effects of velocity-specific resistance training, 30 healthy, male varsity athletes were assigned to either high (HVR) or low (LVR) velocity training or control (CG) groups. Subjects completed two 20-sec sets of maximal exercise at each of six hydraulic resistance stations for the lower limb. Resistances were adjusted as necessary to maintain consistent average angular velocities of approximately 1.05 and 3.14 rad/sec for the LVR and HVR groups, respectively. Subjects trained on alternate days for 6 weeks, completing either two (weeks 1 and 2) or three (weeks 3-6) circuits of the six stations each session. Peak knee extension torques were improved (p < 0.05) for the LVR group at all of seven angular velocities tested between 1.05 and 4.19 rad/sec. Improvements (p < 0.05) were also observed for the HVR group, but only at angular velocities of 2.62, 3.14, 3.66, and 4.19 rad/sec. Cross-sectional area of the quadriceps femoris muscle group obtained from serial computer tomography (CT) scans was increased (p < 0.05) for both training groups. No significant changes in either strength or cross-sectional area were observed for control subjects. These results indicate that while both of the training programs resulted in increased cross-sectional area of the knee extensors, the observed changes in strength performance are likely due to other factors which may be mediated by the different training velocities. J Orthop Sports Phys Ther 1989;10(11):456-462.

Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold.

PubMed

Skof, B; Strojnik, V

2006-03-01

The aim of this study was to determine the influence of intensive aerobic running on some muscle contractile characteristics and the dynamics of their recovery during a 2 hour period afterwards. Seven well trained runners performed a 6 km run at anaerobic threshold (V(OBLA)). Knee torque during single twitch, low and high frequency electrical stimulation (ES), maximum voluntary knee extension, and muscle activation level test of the quadriceps femoris muscles were measured before and immediately after the run, and at several time points during a 120 minute interval that followed the run. After exercise, the mean (SE) maximum twitch torque (T(TW)) and torque at ES with 20 Hz (low frequency ES; T(F20)) dropped by 14.1 (5.1)% (p<0.05) and 20.6 (7.9)% (p<0.05) respectively, while torque at stimulation with 100 Hz (high frequency ES; T(F100)), maximum isometric knee extension torque (maximum voluntary contraction torque; T(MVC)), and activation level did not change significantly. Twitch contraction time was shortened by 8 (2)% (p<0.05). Ten minutes after the run, T(TW) was 40% higher than immediately after the run and 10% (p<0.05) higher than before the run. T(F20), T(F100), and T(MVC) remained lower for 60 minutes (p<0.05) than before the run. A 6 km continuous run at V(OBLA) caused peripheral fatigue by impairing excitation-contraction coupling. Twitch torque recovered very quickly. However, the process of torque restoration at maximum isometric knee extension torque and at high and low frequency ES took much longer.

Efficacy of massage on muscle soreness, perceived recovery, physiological restoration and physical performance in male bodybuilders.

PubMed

Kargarfard, Mehdi; Lam, Eddie T C; Shariat, Ardalan; Shaw, Ina; Shaw, Brandon S; Tamrin, Shamsul B M

2016-01-01

It is believed that sport massage after intensive exercise might improve power and perceptual recovery in athletes. However, few studies have been done in this area. This study aimed to examine the effect of massage on the performance of bodybuilders. Thirty experienced male bodybuilders were randomly assigned to either a massage group (n = 15) or a control group (n = 15). Both groups performed five repetition sets at 75-77% of 1RM of knee extensor and flexor muscle groups. The massage group then received a 30-min massage after the exercise protocol while the control group maintained their normal passive recovery. Criteria under investigation included: plasma creatine kinase (CK) level, agility test, vertical jump test, isometric torque test, and perception of soreness. All variables were measured over 6 time periods: baseline, immediately after the DOMS inducing protocol, right after the massage, and 24, 48, and 72 h after the massage. Both groups showed significant (P < .001) decreases in jumping, agility performance, and isometric torque, but significant (P < .001) increases in CK and muscle soreness levels. The massage group in general demonstrated a better recovery rate. As such, a post-exercise massage session can improve the exercise performance and recovery rate in male bodybuilders after intensive exercise.

Do oarsmen have asymmetries in the strength of their back and leg muscles?

PubMed

Parkin, S; Nowicky, A V; Rutherford, O M; McGregor, A H

2001-07-01

The aim of this study was to establish whether asymmetry of the strength of the leg and trunk musculature is more prominent in rowers than in controls. Nineteen oarsmen and 20 male controls matched for age, height and body mass performed a series of isokinetic and isometric strength tests on an isokinetic dynamometer. These strength tests focused on the trunk and leg muscles. Comparisons of strength were made between and within groups for right and left symmetry patterns, hamstring: quadriceps ratios, and trunk flexor and extensor ratios. The results revealed no left and right asymmetries in either the knee extensor or flexor strength parameters (including both isometric and isokinetic measures). Knee extensor strength was significantly greater in the rowing population, but knee flexor strength was similar between the two groups. No difference was seen between the groups for the hamstring: quadriceps strength ratio. In the rowing population, stroke side had no influence on leg strength. No differences were observed in the isometric strength of the trunk flexors and extensors between groups, although EMG activity was significantly higher in the rowing population. Patterns of asymmetry of muscle activity were observed between the left and right erector spinae muscles during extension, which was significantly related to rowing side (P < 0.01). These observations could be related to the high incidence of low back pain in oarsmen.

Genetic polymorphisms to predict gains in maximal O2 uptake and knee peak torque after a high intensity training program in humans.

PubMed

Yoo, Jinho; Kim, Bo-Hyung; Kim, Soo-Hwan; Kim, Yangseok; Yim, Sung-Vin

2016-05-01

The study aimed to identify single nucleotide polymorphisms (SNPs) that significantly influenced the level of improvement of two kinds of training responses, including maximal O2 uptake (V'O2max) and knee peak torque of healthy adults participating in the high intensity training (HIT) program. The study also aimed to use these SNPs to develop prediction models for individual training responses. 79 Healthy volunteers participated in the HIT program. A genome-wide association study, based on 2,391,739 SNPs, was performed to identify SNPs that were significantly associated with gains in V'O2max and knee peak torque, following 9 weeks of the HIT program. To predict two training responses, two independent SNPs sets were determined using linear regression and iterative binary logistic regression analysis. False discovery rate analysis and permutation tests were performed to avoid false-positive findings. To predict gains in V'O2max, 7 SNPs were identified. These SNPs accounted for 26.0 % of the variance in the increment of V'O2max, and discriminated the subjects into three subgroups, non-responders, medium responders, and high responders, with prediction accuracy of 86.1 %. For the knee peak torque, 6 SNPs were identified, and accounted for 27.5 % of the variance in the increment of knee peak torque. The prediction accuracy discriminating the subjects into the three subgroups was estimated as 77.2 %. Novel SNPs found in this study could explain, and predict inter-individual variability in gains of V'O2max, and knee peak torque. Furthermore, with these genetic markers, a methodology suggested in this study provides a sound approach for the personalized training program.

ACL deficient potential copers and non-copers reveal different isokinetic quadriceps strength profiles in the early stage after injury

PubMed Central

Eitzen, I; Eitzen, TJ; Holm, I; Snyder-Mackler, L; Risberg, MA

2011-01-01

Background Isokinetic muscle strength tests using the peak torque value is the most frequently included quadriceps muscle strength measurement for anterior cruciate ligament (ACL) injured subjects. Aims The purpose of this study was to investigate quadriceps muscle performance during the whole isokinetic curve in ACL deficient subjects classified as potential copers or non-copers, and investigate whether these curve profiles were associated with single-leg hop performance. We hypothesized that quadriceps muscle torque at other knee flexion angles than peak torque would give more information about quadriceps muscle strength deficits. Furthermore, we hypothesized that there would be significant torque differences between potential copers and non-copers, and a significant relationship between angle specific torque values and single-leg hop performance. Study Design Cross-sectional study; Level of evidence, 2 Methods Seventy-six individuals with a complete unilateral ACL rupture within the last 3 months were included. The subjects were classified into potential copers and non-copers according to the criteria from Fitzgerald et al12. Isokinetic quadriceps muscle tests were performed at 60°/sec (Biodex 6000). Mean torque values were calculated for peak torque as well as for specific knee flexion angles. The one-leg hop and the 6 meter timed hop tests were included and symmetry indices were used. Results The peak torque value did not identify the largest quadriceps muscle strength deficit. Rather, these were established at knee flexion angles of less than 40°. There were significant differences in angle specific torque values between potential copers and non-copers (p<0.05). Moderate to strong associations were disclosed between angle specific torque values and single-leg hop performance, but only for non-copers (r≥0.32– 0.58). Conclusions Angle specific quadriceps muscle torque values of less than 40° of knee flexion provide more information on the quadriceps strength deficits after ACL injury compared to the commonly used peak torque values. PMID:20110458

Relationships Between Knee Extension Moments During Weighted and Unweighted Gait and Strength Measures That Predict Knee Moments After ACL Reconstruction.

PubMed

Hartigan, Erin; Aucoin, Jennifer; Carlson, Rita; Klieber-Kusak, Melanie; Murray, Thomas; Shaw, Bernadette; Lawrence, Michael

Weighted gait increases internal knee extension moment impulses (KEMI) in the anterior cruciate ligament-reconstructed (ACLR) limb; however, limb differences persist. (1) KEMI during normal gait will influence KEMI during weighted gait and (2) peak knee extension (PKE) torque and time to reach PKE torque will predict KEMI during gait tasks. Descriptive laboratory study. Twenty-four women and 14 men completed 3 gait tasks (unweighted, vest, sled) and strength testing after discharge from rehabilitation and clearance to return to sports. KEMI were calculated during the first 25% of stance. PKE torque and time to reach PKE torque were obtained using a dynamometer. Data on the ACLR limb and symmetry indices (SIs) were analyzed for each sex. Women presented with asymmetrical PKE torques and KEMI across tasks. There were three correlations noted for KEMI: between the walk and vest, walk and sled, and vest and sled tasks. Slower time to PKE torque predicted limb asymmetries across tasks and KEMI in the ACLR limb during the sled task. Men presented with asymmetrical PKE torques and KEMI during the sled task. There was a correlation noted for KEMI between walk and vest tasks only. During the sled task, ACLR limb time to PKE torque predicted KEMI in the ACLR limb and PKE torque SI predicted KEMI SI. Women use asymmetrical KEMI profiles during all gait tasks, and those with worse KEMI during walking have worse KEMI during weighted gait. Men have asymmetrical KEMI when sled towing, and these KEMIs do not correlate with KEMI during walking or vest tasks. PKE torque deficits persist when attempting to return to sports. Only men use gains in PKE torque to improve KEMI profiles. Although quicker PKE torque generation will increase KEMI in women, normalization of KEMI profiles will not occur by increasing rate of force development only. Gait retraining is recommended to correct asymmetrical KEMI profiles used across gait tasks in women.

Relationships of muscle strength and bone mineral density in ambulatory children with cerebral palsy.

PubMed

Chen, C-L; Lin, K-C; Wu, C-Y; Ke, J-Y; Wang, C-J; Chen, C-Y

2012-02-01

This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p < 0.05). Children with level I had greater knee flexor strength and GMFM-66 scores than those with level II (p < 0.001). However, the knee extensor strength and distal femur and lumbar aBMD did not differ between two groups. Regression analysis revealed the weight and knee extensor strength, but not GMFM-66 scores, were related positively to the distal femur and lumbar aBMD (adjusted r (2) = 0.56-0.65, p < 0.001). These results suggest the muscle strength, especially antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.

Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients.

PubMed

Rantalainen, T; Valtonen, A; Sipilä, S; Pöyhönen, T; Heinonen, A

2012-03-01

It is currently unknown whether knee replacement-associated bone loss is modified by rehabilitation programs. Thus, a sample of 45 (18 men and 25 women) persons with unilateral knee replacement were recruited; age 66 years (sd 6), height 169 cm (sd 8), body mass 83 kg (sd 15), time since operation 10 months (sd 4) to explore the associations between maximal torque/power in knee extension/flexion and femoral mid-shaft bone traits (Cortical cross-sectional area (CoA, mm(2)), cortical volumetric bone mineral density (CoD, mg/mm(3)) and bone bending strength index (SSI, mm(3))). Bone traits were calculated from a single computed tomography slice from the femoral mid-shaft. Pain in the operated knee was assessed with the WOMAC questionnaire. Stepwise regression models were built for the operated leg bone traits, with knee extension and flexion torque and power, age, height, body mass, pain score and time since operation as independent variables. CoA was 2.3% (P=0.015), CoD 1.2% (P<0.001) and SSI 1.6% (P=0.235) lower in the operated compared to non-operated leg. The overall proportions of the variation explained by the regression models were 50%, 29% and 55% for CoA, CoD and SSI, respectively. Body mass explained 12% of Coa, 11% of CoD and 11% of SSI (P≤0.003). Maximal knee flexion torque explained 38% of Coa, 7% of CoD and 44% of SSI (p≤0.047). For CoD time since operation also became a significant predictor (11%, P=0.045). Knee flexion torque of the operated leg was positively associated with bone strength in the operated leg. Thus, successful rehabilitation may diminish bone loss in the operated leg. Copyright © 2011 Elsevier B.V. All rights reserved.

Contribution of Knee Flexor and Extensor Strength on Sex-Specific Energy Absorption and Torsional Joint Stiffness During Drop Jumping

PubMed Central

Schmitz, Randy J.; Shultz, Sandra J.

2010-01-01

Abstract Context: Lower extremity injury often occurs during abrupt deceleration when attempting to change the body's direction. Although sex-specific biomechanics have been implicated in the greater risk of acute knee injury in women than in men, it is unknown if sex differences in thigh strength affect sex-specific energy absorption and torsional joint stiffness patterns. Objective: To determine sex differences in energy absorption patterns and joint stiffnesses of the lower extremity during a drop jump and to determine if these sex differences were predicted by knee extensor and flexor strength. Design: Cross-sectional study. Setting: Laboratory environment. Patients or Other Participants: Recreationally active, college-aged students (41 women: age  =  22.1 ± 2.9 years, height  =  1.63 ± 0.07 m, mass  =  59.3 ± 8.0 kg; 40 men: age  =  22.4 ± 2.8 years, height  =  1.77 ± 0.1 m, mass  =  80.9 ± 14.1 kg). Intervention(s): Participants performed knee flexor and extensor maximal voluntary isometric contractions followed by double-leg drop-jump landings. Main Outcome Measure(s): Lower extremity joint energetics (J × N−1 × m−1) and torsional joint stiffnesses (Nm × N−1 × m−1 × degrees−1) were calculated for the hip, knee, and ankle during the initial landing phase. Body weight was measured in newtons and height was measured in meters. Sex comparisons were made and sex-specific regressions determined if thigh muscle strength (Nm/kg) predicted sagittal-plane landing energetics and stiffnesses. Results: Women absorbed 69% more knee energy and had 36% less hip torsional stiffness than men. In women, greater knee extensor strength predicted greater knee energy absorption (R2  =  0.11, P  =  .04), and greater knee flexor strength predicted greater hip torsional stiffness (R2  =  0.12, P  =  .03). Conclusions: Sex-specific biomechanics during the deceleration phase of a drop jump revealed that women used a strategy to attempt to decrease system stiffness. Additionally, only female strength values were predictive of landing energetics and stiffnesses. These findings collectively demonstrated that the task may have been more difficult for women, resulting in a different movement strategy among those with different levels of thigh strength to safely complete the task. Future researchers should look at other predictive factors of observed sex differences. PMID:20831388

Neuromuscular Impairments Contributing to Persistently Poor and Declining Lower-Extremity Mobility Among Older Adults: New Findings Informing Geriatric Rehabilitation.

PubMed

Ward, Rachel E; Beauchamp, Marla K; Latham, Nancy K; Leveille, Suzanne G; Percac-Lima, Sanja; Kurlinski, Laura; Ni, Pengsheng; Goldstein, Richard; Jette, Alan M; Bean, Jonathan F

2016-08-01

To identify neuromuscular impairments most predictive of unfavorable mobility outcomes in late life. Longitudinal cohort study. Research clinic. Community-dwelling primary care patients aged ≥65 years (N=391) with self-reported mobility modifications, randomly selected from a research registry. Not applicable. Categories of decline in and persistently poor mobility across baseline, 1 and 2 years of follow-up in the Lower-Extremity Function scales of the Late-Life Function and Disability Instrument. The following categories of impairment were assessed as potential predictors of mobility change: strength (leg strength), speed of movement (leg velocity, reaction time, rapid leg coordination), range of motion (ROM) (knee flexion/knee extension/ankle ROM), asymmetry (asymmetry of leg strength and knee flexion/extension ROM measures), and trunk stability (trunk extensor endurance, kyphosis). The largest effect sizes were found for baseline weaker leg strength (odds ratio [95% confidence interval]: 3.45 [1.72-6.95]), trunk extensor endurance (2.98 [1.56-5.70]), and slower leg velocity (2.35 [1.21-4.58]) predicting a greater likelihood of persistently poor function over 2 years. Baseline weaker leg strength, trunk extensor endurance, and restricted knee flexion motion also predicted a greater likelihood of decline in function (1.72 [1.10-2.70], 1.83 [1.13-2.95], and 2.03 [1.24-3.35], respectively). Older adults exhibiting poor mobility may be prime candidates for rehabilitation focused on improving these impairments. These findings lay the groundwork for developing interventions aimed at optimizing rehabilitative care and disability prevention, and highlight the importance of both well-recognized (leg strength) and novel impairments (leg velocity, trunk extensor muscle endurance). Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

PubMed

Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

2015-02-15

During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. Copyright © 2015 the American Physiological Society.

Does insulin-like growth factor 1 genotype influence muscle power response to strength training in older men and women?

PubMed

Sood, Suchi; Hanson, Erik D; Delmonico, Matthew J; Kostek, Matthew C; Hand, Brian D; Roth, Stephen M; Hurley, Ben F

2012-02-01

The CA-repeat polymorphism in the insulin-like growth factor 1 (IGF1) gene promoter region has been associated with strength and circulating IGF-I protein levels. The purpose of the study was to determine if the IGF1 CA-repeat polymorphism influences muscle power at baseline and in response to ST in older adults. Knee extensor peak power (PP) was measured at 50, 60, and 70% of 1-RM strength before and after 10 weeks of unilateral knee extensor ST in older adults, aged 50-85 years, to determine the changes in absolute and relative PP with ST. Subjects (N = 114) were genotyped for the IGF1 CA-repeat polymorphism and grouped as homozygous for the 192 allele, heterozygous, or non-carriers of the 192 allele. The 192 homozygotes had significantly lower baseline PP at 50, 60, and 70% of 1-RM strength than the non-carriers when age, sex, and baseline fat-free mass were covaried (all P < 0.05). This same relationship was observed when the highest PP within these ranges was compared (e.g., 317.6 ± 13.5 for 192 homozygotes and 380.2 ± 16.3 for non-carriers of the 192 allele, P < 0.05). Both absolute and relative PP increased significantly with ST in all genotype groups as expected, but there were no significant relationships among IGF1 genotypes and any of the PP changes. Despite a significant relationship between IGF1 genotype and knee extensor peak power at baseline, IGF1 genotype does not appear to influence changes in knee extensor peak power with ST.

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients

PubMed Central

Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-01-01

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01) and with knee extensor muscle strength (r = −0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation. PMID:29186880

Relationship between isometric shoulder strength and arms-only swimming power among male collegiate swimmers: study of valid clinical assessment methods.

PubMed

Awatani, Takenori; Morikita, Ikuhiro; Mori, Seigo; Shinohara, Junji; Tatsumi, Yasutaka

2018-04-01

[Purpose] The purpose of the present study was to confirm the relationships between shoulder strength (extensor strength and internal rotator strength) of the abducted position and swimming power during arm-only swimming. [Subjects and Methods] Fourteen healthy male collegiate swimmers participated in the study. Main measures were shoulder strength (strength using torque that was calculated from the upper extremity length and the isometric force of the abducted position) and swimming power. [Results] Internal rotation torque of the dominant side in the abducted external rotated position (r=0.85) was significantly correlated with maximum swimming power. The rate of bilateral difference in extension torque in the maximum abducted position (r=-0.728) was significantly correlated with the swimming velocity-to-swimming power ratio. [Conclusion] The results of this study suggest that internal rotator strength measurement in the abducted external rotated position and extensor strength measurement in the maximum abducted position are valid assessment methods for swimmers.

Effects of 8 weeks of vibration training at different frequencies (1 or 15 Hz) in senior sportsmen on torque and force development and of 1 year of training on muscle fibers.

PubMed

Kern, H; Kovarik, J; Franz, C; Vogelauer, M; Löfler, S; Sarabon, N; Grim-Stieger, M; Biral, D; Adami, N; Carraro, U; Zampieri, S; Hofer, Ch

2010-02-01

To examine the effects of 8 weeks of vibration training at different frequencies (1 and 15 Hz) on maximal isometric torque and force development in senior sportsmen, and of 1 year of heavy-resistance and vibration trainings on muscle fibers. Seven healthy senior sportsmen (mean age: 69.0 +/- 5.4 years) performed an 8 weeks of strength training of knee extensors. Vibrations were applied vertically to the axis of movement during training. One leg of each subject was trained at a frequency of 1 Hz, while the other leg was trained at 15 Hz. Measures of isometric peak torque (at knee-angles of 60, 90 and 120 degrees ) and force development were recorded before and after training. Four sportsmen continued a year-long heavy-resistance training adding every second week a session of vibration training. After training, muscle biopsies were harvested from their quadriceps muscles and used for structural analyses. Morphometry of muscle fibers was performed by light microscopy. Immunohistochemistry using anti-MHCemb and anti-N-CAM antibodies was performed to measure potential muscle damage. Data from muscle morphometry were compared to that of a series of vastus lateralis biopsies harvested from 12 young sportsmen and four healthy elderly. Our results showed a significant increase in isometric peak torque at both 1 and 15 Hz vibration frequency in all three measured angles of the knee. There was no significant difference between the two frequencies, but we could find a higher increase in percentage of maximum power after the 1 Hz training. The results of force development showed a slight increase at the 1 Hz training in measured time frames from 0 to 50 and 200 ms, without statistical significance. A trend to significance was found at the 1 Hz training at the time window up to 200 ms. The 15 Hz training showed no significant changes of force development. Muscle biopsies show that the muscles of these well trained senior sportsmen contain muscle fibers which are 35% larger than those of sedentary elderly and, unexpectedly, 10% larger than those of young sportsmen. Despite 1 year of heavy resistance and vibration training, no evidence of muscle damage or denervation/reinnervation could be observed by light microscopy analyses, ATPase histochemistry and immunohistochemistry using anti-N-CAM or anti-MHC-emb antibodies. Integration of vibration to conventional strength training in elderly sportsmen induces similar improvement of isometric peak torque and force development independently from the vibration frequency after 8 weeks of training, and long-term results in the surprising evidence of hypertrophic muscle fibers larger than those of young active sportsmen. The observation that the vibration training with low frequency is safe opens the possibility to test these rehabilitation procedures in sedentary elderly.

A New Training for Older Adults Using Combined Neuromuscular Electrical Stimulation and Volitional Contraction: A Pilot Study.

PubMed

Takano, Yoshio; Matsuse, Hiroo; Tsukada, Yuuya; Omoto, Masayuki; Hashida, Ryuki; Shiba, Naoto

2016-01-01

The hybrid training system (HTS) resists the motion of a volitionally contracting agonist muscle using force generated by its electrically stimulated antagonist. We have developed a new training method using the principle of HTS. This study was designed to evaluate the effect of HTS with electrical stimulation on muscle strength and physical function by comparing it against training without electrical stimulation in older adults. 16 subjects were randomly divided into two groups: the squat and single leg lift training (control, CTR) group, and the CTR with HTS training group. Some electrical stimulation was applied to the quadriceps and hamstring muscles in the HTS group. The subjects performed training for 25 min per session 3 times a week for 12 weeks. At points before and after the research maximal isokinetic torque, knee-flexors (KFT) and knee-extensors (KET), a one-leg standing test (OLT), a functional reach test (FRT), a 10-meter maximal gait time (10MGT) and Timed up & go test (TUG) were conducted. None of the subjects had any injuries during the study period. TUG significantly improved after the training period in both the HTS group (7.15 sec to 6.01 sec P = 0.01) and in the CTR.

Design of patient-specific gait modifications for knee osteoarthritis rehabilitation.

PubMed

Fregly, Benjamin J; Reinbolt, Jeffrey A; Rooney, Kelly L; Mitchell, Kim H; Chmielewski, Terese L

2007-09-01

Abstract-Gait modification is a nonsurgical approach for reducing the external knee adduction torque in patients with knee osteoarthritis (OA). The magnitude of the first adduction torque peak in particular is strongly associated with knee OA progression. While toeing out has been shown to reduce the second peak, no clinically realistic gait modifications have been identified that effectively reduce both peaks simultaneously. This study predicts novel patient-specific gait modifications that achieve this goal without changing the foot path. The modified gait motion was designed for a single patient with knee OA using dynamic optimization of a patient-specific, full-body gait model. The cost function minimized the knee adduction torque subject to constraints limiting how much the new gait motion could deviate from the patient's normal gait motion. The optimizations predicted a "medial-thrust" gait pattern that reduced the first adduction torque peak between 32% and 54% and the second peak between 34% and 56%. The new motion involved three synergistic kinematic changes: slightly decreased pelvis obliquity, slightly increased leg flexion, and slightly increased pelvis axial rotation. After gait retraining, the patient achieved adduction torque reductions of 39% to 50% in the first peak and 37% to 55% in the second one. These reductions are comparable to those reported after high tibial osteotomy surgery. The associated kinematic changes were consistent with the predictions except for pelvis obliquity, which showed little change. This study demonstrates that it is feasible to design novel patient-specific gait modifications with potential clinical benefit using dynamic optimization of patient-specific, full-body gait models. Further investigation is needed to assess the extent to which similar gait modifications may be effective for other patients with knee OA.

Ground reaction forces and knee mechanics in the weight acceptance phase of a dance leap take-off and landing.

PubMed

Kulig, Kornelia; Fietzer, Abbigail L; Popovich, John M

2011-01-01

Aesthetic constraints allow dancers fewer technique modifications than other athletes to negotiate the demands of leaping. We examined vertical ground reaction force and knee mechanics during a saut de chat performed by healthy dancers. It was hypothesized that vertical ground reaction force during landing would exceed that of take-off, resulting in greater knee extensor moments and greater knee angular stiffness. Twelve dancers (six males, six females; age 18.9 ± 1.2 years, mass 59.2 ± 9.5 kg, height 1.68 ± 0.08 m, dance training 8.9 ± 5.1 years) with no history of low back pain or lower extremity pathology participated in the study. Saut de chat data were captured using an eight-camera Vicon system and AMTI force platforms. Peak ground reaction force was 26% greater during the landing phase, but did not result in increased peak knee extensor moments. Taking into account the 67% greater knee angular displacement during landing, this resulted in less knee angular stiffness during landing. In conclusion, landing was accomplished with less knee angular stiffness despite the greater peak ground reaction force. A link between decreased joint angular stiffness and increased soft tissue injury risk has been proposed elsewhere; therefore, landing from a saut de chat may be more injurious to the knee soft tissue than take-off.

The influence of caffeine ingestion on strength and power performance in female team-sport players.

PubMed

Ali, Ajmol; O'Donnell, Jemma; Foskett, Andrew; Rutherfurd-Markwick, Kay

2016-01-01

The aim of this study was to examine the influence of caffeine supplementation on knee flexor and knee extensor strength before, during and after intermittent running exercise in female team-sport players taking oral contraceptive steroids (OCS). Ten healthy females (24 ± 4 years; 59.7 ± 3.5 kg; undertaking 2-6 training sessions per week) taking low-dose monophasic oral contraceptives of the same hormonal composition took part in a randomised, double-blind, placebo-controlled crossover-design trial. Sixty minutes following the ingestion of a capsule containing 6 mg∙kg -1 body mass anhydrous caffeine or artificial sweetener (placebo), participants completed a 90-min intermittent treadmill-running protocol. Isometric strength performance and eccentric and concentric strength and power of the knee flexors and knee extensors (using isokinetic dynamometer), as well as countermovement jump (CMJ), was measured before, during and after the exercise protocol, as well as ~12 h post-exercise. Blood samples were taken before, during and post-exercise to measure glucose, insulin and free fatty acids (FFA). Caffeine supplementation significantly increased eccentric strength of the knee flexors ( P  < 0.05) and eccentric power of both the knee flexors ( P  < 0.05) and extensors ( P  < 0.05). However, there was no effect on isometric or concentric parameters, or CMJ performance. FFA was elevated with caffeine supplementation over time ( P  < 0.05) while levels of glucose and insulin were not affected by caffeine intake. Caffeine supplementation increased eccentric strength and power in female team-sport players taking OCS both during an intermittent running protocol and the following morning.

Modelling the joint torques and loadings during squatting at the Smith machine.

PubMed

Biscarini, Andrea; Benvenuti, Paolo; Botti, Fabio; Mastrandrea, Francesco; Zanuso, Silvano

2011-03-01

An analytical biomechanical model was developed to establish the relevant properties of the Smith squat exercise, and the main differences from the free barbell squat. The Smith squat may be largely patterned to modulate the distributions of muscle activities and joint loadings. For a given value of the included knee angle (θ(knee)), bending the trunk forward, moving the feet forward in front of the knees, and displacing the weight distribution towards the forefoot emphasizes hip and lumbosacral torques, while also reducing knee torque and compressive tibiofemoral and patellofemoral forces (and vice versa). The tibiofemoral shear force φ(t) displays more complex trends that strongly depend on θ(knee). Notably, for 180° ≥ θ(knee) ≥ 130°, φ(t) and cruciate ligament strain forces can be suppressed by selecting proper pairs of ankle and hip angles. Loading of the posterior cruciate ligament increases (decreases) in the range 180° ≥ θ(knee) ≥ 150° (θ(knee) ≤ 130°) with knee extension, bending the trunk forward, and moving the feet forward in front of the knees. In the range 150° > θ(knee) > 130°, the behaviour changes depending on the foot weight distribution. The conditions for the development of anterior cruciate ligament strain forces are explained. This work enables careful use of the Smith squat in strengthening and rehabilitation programmes.

Comparison of joint kinetics during free weight and flywheel resistance exercise.

PubMed

Chiu, Loren Z F; Salem, George J

2006-08-01

The most common modality for resistance exercise is free weight resistance. Alternative methods of providing external resistance have been investigated, in particular for use in microgravity environments such as space flight. One alternative modality is flywheel inertial resistance, which generates resistance as a function of the mass, distribution of mass, and angular acceleration of the flywheel. The purpose of this investigation was to characterize net joint kinetics of multijoint exercises performed with a flywheel inertial resistance device in comparison to free weights. Eleven trained men and women performed the front squat, lunge, and push press on separate days with free weight or flywheel resistance, while instrumented for biomechanical analysis. Front squats performed with flywheel resistance required greater contribution of the hip and ankle, and less contribution of the knee, compared to free weight. Push presses performed with flywheel resistance had similar impulse requirements at the knee compared to free weight, but greater impulse requirement at the hip and ankle. As used in this investigation, flywheel inertial resistance increases the demand on the hip extensors and ankle plantarflexors and decreases the mechanical demand on the knee extensors for lower extremity exercises such as the front squat and lunge. Exercises involving dynamic lower and upper extremity actions, such as the push press, may benefit from flywheel inertial resistance, due to the increased mechanical demand on the knee extensors.

Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

PubMed Central

Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

2014-01-01

Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral perfusion capacities that could elicit higher levels of peripheral cardiorepiratory stimulus during exercise. PMID:24838811

Design of a lightweight, tethered, torque-controlled knee exoskeleton.

PubMed

Witte, Kirby Ann; Fatschel, Andreas M; Collins, Steven H

2017-07-01

Lower-limb exoskeletons show promise for improving gait rehabilitation for those with chronic gait abnormalities due to injury, stroke or other illness. We designed and built a tethered knee exoskeleton with a strong lightweight frame and comfortable, four-point contact with the leg. The device is structurally compliant in select directions, instrumented to measure joint angle and applied torque, and is lightweight (0.76 kg). The exoskeleton is actuated by two off-board motors. Closed loop torque control is achieved using classical proportional feedback control with damping injection in conjunction with iterative learning. We tested torque measurement accuracy and found root mean squared (RMS) error of 0.8 Nm with a max load of 62.2 Nm. Bandwidth was measured to be phase limited at 45 Hz when tested on a rigid test stand and 23 Hz when tested on a person's leg. During bandwidth tests peak extension torques were measured up to 50 Nm. Torque tracking was tested during walking on a treadmill at 1.25 m/s with peak flexion torques of 30 Nm. RMS torque tracking error averaged over a hundred steps was 0.91 Nm. We intend to use this knee exoskeleton to investigate robotic assistance strategies to improve gait rehabilitation and enhance human athletic ability.

Movement Strategies among Groups of Chronic Ankle Instability, Coper, and Control.

PubMed

Son, S Jun; Kim, Hyunsoo; Seeley, Matthew K; Hopkins, J Ty

2017-08-01

Comprehensive evaluation of movement strategies during functional movement is a difficult undertaking. Because of this challenge, studied movements have been oversimplified. Furthermore, evaluating movement strategies at only a discrete time point(s) provide limited insight into how movement strategies may change or adapt in chronic ankle instability (CAI) patients. This study aimed to identify abnormal movement strategies in individuals with a history of ankle sprain injury during a sports maneuver compared with healthy controls. Sixty-six participants, consisting of 22 CAI patients, 22 ankle sprain copers, and 22 healthy controls, participated in this study. Functional profiles of lower extremity kinematics, kinetics, and EMG activation from initial contact (0% of stance) to toe-off (100% of stance) were collected and analyzed during a jump landing/cutting task using a functional data analysis approach. Compared with copers, CAI patients displayed landing positions of less plantarflexion, less inversion, more knee flexion, more hip flexion, and less hip abduction during the first 25% of stance. However, restricted dorsiflexion angle was observed in both CAI patients and copers relative to controls during the midlanding to mid-side-cutting phase when the ankle and knee reached its peak range of motion (e.g., dorsiflexion and knee flexion). Reduced EMG activation of tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius may be due to altered kinematics that reduce muscular demands on the involved muscles. CAI patients displayed altered movement strategies, perhaps in an attempt to avoid perceived positions of risk. Although sagittal joint positions seemed to increase the external torque on the knee and hip extensors, frontal joint positions appeared to reduce the muscular demands on evertor and hip abductor muscles.

Greater glucose uptake heterogeneity in knee muscles of old compared to young men during isometric contractions detected by [18F]-FDG PET/CT

PubMed Central

Rudroff, Thorsten; Kindred, John H.; Benson, John-Michael; Tracy, Brian L.; Kalliokoski, Kari K.

2014-01-01

We used positron emission tomography/computed tomography (PET/CT) and [18F]-FDG to test the hypothesis that glucose uptake (GU) heterogeneity in skeletal muscles as a measure of heterogeneity in muscle activity is greater in old than young men when they perform isometric contractions. Six young (26 ± 6 years) and six old (77 ± 6 years) men performed two types of submaximal isometric contractions that required either force or position control. [18F]-FDG was injected during the task and PET/CT scans were performed immediately after the task. Within-muscle heterogeneity of knee muscles was determined by calculating the coefficient of variation (CV) of GU in PET image voxels within the muscles of interest. The average GU heterogeneity (mean ± SD) for knee extensors and flexors was greater for the old (35.3 ± 3.3%) than the young (28.6 ± 2.4%) (P = 0.006). Muscle volume of the knee extensors were greater for the young compared to the old men (1016 ± 163 vs. 598 ± 70 cm3, P = 0.004). In a multiple regression model, knee extensor muscle volume was a predictor (partial r = −0.87; P = 0.001) of GU heterogeneity for old men (R2 = 0.78; P < 0.001), and MVC force predicted GU heterogeneity for young men (partial r = −0.95, P < 0.001). The findings demonstrate that GU is more spatially variable for old than young men and especially so for old men who exhibit greater muscle atrophy. PMID:24904432

Evidence of compensatory joint kinetics during stair ascent and descent in Parkinson's disease.

PubMed

Conway, Zachary J; Silburn, Peter A; Blackmore, Tim; Cole, Michael H

2017-02-01

Stair ambulation is a challenging activity of daily life that requires larger joint moments than walking. Stabilisation of the body and prevention of lower limb collapse during this task depends upon adequately-sized hip, knee and ankle extensor moments. However, people with Parkinson's disease (PD) often present with strength deficits that may impair their capacity to control the lower limbs and ultimately increase their falls risk. To investigate hip, knee and ankle joint moments during stair ascent and descent and determine the contribution of these joints to the body's support in people with PD. Twelve PD patients and twelve age-matched controls performed stair ascent and descent trials. Data from an instrumented staircase and a three-dimensional motion analysis system were used to derive sagittal hip, knee and ankle moments. Support moment impulses were calculated by summing all extensor moment impulses and the relative contribution of each joint was calculated. Linear mixed model analyses indicated that PD patients walked slower and had a reduced cadence relative to controls. Although support moment impulses were typically not different between groups during stair ascent or descent, a reduced contribution by the ankle joint required an increased knee joint contribution for the PD patients. Despite having poorer knee extensor strength, people with PD rely more heavily on these muscles during stair walking. This adaptation could possibly be driven by the somewhat restricted mobility of this joint, which may provide these individuals with an increased sense of stability during these tasks. Copyright © 2016 Elsevier B.V. All rights reserved.

IS PAIN IN ONE KNEE ASSOCIATED WITH ISOMETRIC MUSCLE STRENGTH IN THE CONTRALATERAL LIMB? - DATA FROM THE OSTEOARTHRITIS INITIATIVE (OAI)

PubMed Central

Steidle, E.; Wirth, W.; Glass, N.; Ruhdorfer, A.; Cotofana, S.; Eckstein, F.; Segal, N. A.

2014-01-01

Objective Knee pain and muscle weakness confer risk for knee osteoarthritis incidence and progression. The purpose of this study was to determine whether unilateral knee pain influences contralateral thigh muscle strength. Design Of 4796 Osteoarthritis Initiative participants, 224 (mean±SD age 63.9±8.9 years) cases could be matched to a control. Cases were defined as having unilateral knee pain (numerical rating scale (NRS)≥4/10; ≥infrequent pain) and one pain-free knee (NRS 0–1; ≤infrequent pain; WOMAC≤1). Controls were defined as having bilaterally pain-free knees (NRS 0–1; ≤infrequent pain; WOMAC≤1). Maximal isometric muscle strength [N] was compared between limbs in participants with unilateral pain (cases), and between pain-free limbs of cases and controls. Results Knee extensor/flexor strength in pain-free limbs of cases was lower than in bilaterally pain-free controls (−5.5%/–8.4%; p=0.043/p=0.022). Within cases, maximum extensor/flexor strength was significantly lower in the painful than in the pain-free limb (−6.4%/4.1%; p<0.0001/p=0.015). Conclusions These results suggest that strength in limbs without knee pain is associated with the pain status of the contralateral knee. The strength difference between unilateral pain-free cases and matched bilateral pain-free controls was similar to that between limbs in persons with unilateral knee pain. Lower strength due to contralateral knee pain might be centrally mediated. PMID:25768069

Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy.

PubMed

Gomes, Aline A; Ackermann, Marko; Ferreira, Jean P; Orselli, Maria Isabel V; Sacco, Isabel C N

2017-11-09

Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neural and muscular impairments due to diabetes and neuropathy. In this study, the lower limb's muscle force distribution during gait was estimated and compared in diabetic patients with and without polyneuropathy. Thirty individuals were evaluated in a cross-sectional study, equally divided among controls (CG) and diabetic patients with (DNG) and without (DG) polyneuropathy. The acquired ground reaction forces and kinematic data were used as input variables for a scaled musculoskeletal model in the OpenSim software. The maximum isometric force of the ankle extensors and flexors was reduced in the model of DNG by 30% and 20%, respectively. The muscle force was calculated using static optimization, and peak forces were compared among groups (flexors and extensors of hip, knee, and ankle; ankle evertors; and hip abductors) using MANOVAs, followed by univariate ANOVAs and Newman-Keuls post-hoc tests (p < 0.05). From the middle to late stance phase, DG showed a lower soleus muscle peak force compared to the CG (p=0.024) and the DNG showed lower forces in the gastrocnemius medialis compared to the DG (p=0.037). At the terminal swing phase, the semitendinosus and semimembranosus peak forces showed lower values in the DG compared to the CG and DNG. At the late stance, the DNG showed a higher peak force in the biceps short head, semimembranosus, and semitendinosus compared to the CG and DG. Peak forces of ankle (flexors, extensors, and evertors), knee (flexors and extensors), and hip abductors distinguished DNG from DG, and both of those from CG. Both diabetic groups showed alterations in the force production of the ankle extensors with reductions in the forces of soleus (DG) and gastrocnemius medialis (DNG) seen in both diabetic groups, but only DNG showed an increase in the hamstrings (knee flexor) at push-off. A therapeutic approach focused on preserving the functionality of the knee muscles is a promising strategy, even if the ankle dorsiflexors and plantarflexors are included in the resistance training.

Experiment K-7-33: Functional Neuromuscular Adaptation to Spaceflight

NASA Technical Reports Server (NTRS)

Edgerton, V. R.; Bodine-Fowler, S.; Hodgson, J. A.; Roy, R. R.; Kozlovskaya, I. B.

1994-01-01

The following data were collected from two Rhesus monkeys (782 and 2483) that were flown aboard a 14-day biosatellite mission (COSMOS 2044). The proposed study was designed to determine the effects of the absence of weight support on flexor and extensor muscles of the hindlimb. These effects were assessed morphologically and biochemically from muscle biopsies taken from a slow extensor, the soleus; a fast extensor, the medial gastrocnemius; and a fast flexor, the tibialis anterior. A second objective of this study was to determine the relative importance of activity (as determined by intramuscular electromyography, and force (as determined by joint torque) on the adaptation of muscle.

Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton

PubMed Central

Zhang, Dingguo; Ren, Yong; Gui, Kai; Jia, Jie; Xu, Wendong

2017-01-01

Functional electrical stimulation (FES) and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee) that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings) were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG) was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton). Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization. PMID:29311798

Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton.

PubMed

Zhang, Dingguo; Ren, Yong; Gui, Kai; Jia, Jie; Xu, Wendong

2017-01-01

Functional electrical stimulation (FES) and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee) that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings) were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG) was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton). Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization.

Activation of biceps femoris long head reduces tibiofemoral anterior shear force and tibial internal rotation torque in healthy subjects

PubMed Central

Azmi, Nur Liyana; Ding, Ziyun; Xu, Rui

2018-01-01

The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases. PMID:29304102

Measurement of Resistive Plantar Flexion Torque of the Ankle during Passive Stretch in Healthy Subjects and Patients with Poststroke Hemiplegia.

PubMed

Mizuno, Shiho; Sonoda, Shigeru; Takeda, Kotaro; Maeshima, Shinichiro

2016-04-01

Quantification of increased muscle tone for patients with spasticity has been performed to date using various devices to replace the manual scales, such as the modified Ashworth scale or the Tardieu scale. We developed a device that could measure resistive plantar flexion (PF) torque of the ankle during passive dorsiflexion (DF) as an indicator of muscle tone of ankle plantar flexors. The primary objective was to explore the test-retest intrarater reliability of a custom-built device. Participants were 11 healthy subjects (7 men, 4 women; mean age 47.0 years) and 22 patients with poststroke hemiplegia (11 hemorrhagic, 11 ischemic; 14 men, 8 women; mean age 57.2 years). The device was affixed to the ankle. Subjects were seated with knees either flexed or extended. The ankle was passively dorsiflexed from 20° of PF to more than 10° of DF at 5°/second (slow stretch) or 90°/second (fast stretch). Angle and torque were measured twice during the stretches. The intraclass correlation coefficients (ICCs) of torque at 10° of DF (T10) in the 4 conditions-slow and fast stretches with knee flexed or extended-were calculated. The T10 ICCs of the 4 conditions were .95-.99 in both groups. The healthy subjects showed significantly higher T10 of knee extension than of knee flexion during slow and fast stretches. The patients showed increased velocity-dependent torque during fast stretches. Excellent reliability was observed. The device is suitable for measuring resistive PF torque during passive stretch in a flexed knee condition. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Activation of biceps femoris long head reduces tibiofemoral anterior shear force and tibial internal rotation torque in healthy subjects.

PubMed

Azmi, Nur Liyana; Ding, Ziyun; Xu, Rui; Bull, Anthony M J

2018-01-01

The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases.

Do peak torque angles of muscles change following anterior cruciate ligament reconstruction using hamstring or patellar tendon graft?

PubMed

Yosmaoğlu, Hayri Baran; Baltacı, Gül; Sönmezer, Emel; Özer, Hamza; Doğan, Deha

2017-12-01

This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle. The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer. Angle of peak knee flexion torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the hamstring tendon group. Angle of peak knee extension torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the patellar tendon group. There were no statistically significant differences in the flexion and extension peak torque angles between the operated and nonoperated knees at 60°/second in both groups. The angle of peak torque at relatively high angular velocities is affected after ACL reconstruction in patients with hamstring or patellar tendon grafts. The graft donor site directly influences this parameter. This finding may be important for clinicians in terms of preventing re-injury.

Joint torques and joint reaction forces during squatting with a forward or backward inclined Smith machine.

PubMed

Biscarini, Andrea; Botti, Fabio M; Pettorossi, Vito E

2013-02-01

We developed a biomechanical model to determine the joint torques and loadings during squatting with a backward/forward-inclined Smith machine. The Smith squat allows a large variety of body positioning (trunk tilt, foot placement, combinations of joint angles) and easy control of weight distribution between forefoot and heel. These distinctive aspects of the exercise can be managed concurrently with the equipment inclination selected to unload specific joint structures while activating specific muscle groups. A backward (forward) equipment inclination decreases (increases) knee torque, and compressive tibiofemoral and patellofemoral forces, while enhances (depresses) hip and lumbosacral torques. For small knee flexion angles, the strain-force on the posterior cruciate ligament increases (decreases) with a backward (forward) equipment inclination, whereas for large knee flexion angles, this behavior is reversed. In the 0 to 60 degree range of knee flexion angles, loads on both cruciate ligaments may be simultaneously suppressed by a 30 degree backward equipment inclination and selecting, for each value of the knee angle, specific pairs of ankle and hip angles. The anterior cruciate ligament is safely maintained unloaded by squatting with backward equipment inclination and uniform/forward foot weight distribution. The conditions for the development of anterior cruciate ligament strain forces are clearly explained.

Does trampoline or hard surface jumping influence lower extremity alignment?

PubMed

Akasaka, Kiyokazu; Tamura, Akihiro; Katsuta, Aoi; Sagawa, Ayako; Otsudo, Takahiro; Okubo, Yu; Sawada, Yutaka; Hall, Toby

2017-12-01

[Purpose] To determine whether repetitive trampoline or hard surface jumping affects lower extremity alignment on jump landing. [Subjects and Methods] Twenty healthy females participated in this study. All subjects performed a drop vertical jump before and after repeated maximum effort trampoline or hard surface jumping. A three-dimensional motion analysis system and two force plates were used to record lower extremity angles, moments, and vertical ground reaction force during drop vertical jumps. [Results] Knee extensor moment after trampoline jumping was greater than that after hard surface jumping. There were no significant differences between trials in vertical ground reaction force and lower extremity joint angles following each form of exercise. Repeated jumping on a trampoline increased peak vertical ground reaction force, hip extensor, knee extensor moments, and hip adduction angle, while decreasing hip flexion angle during drop vertical jumps. In contrast, repeated jumping on a hard surface increased peak vertical ground reaction force, ankle dorsiflexion angle, and hip extensor moment during drop vertical jumps. [Conclusion] Repeated jumping on the trampoline compared to jumping on a hard surface has different effects on lower limb kinetics and kinematics. Knowledge of these effects may be useful in designing exercise programs for different clinical presentations.

Does trampoline or hard surface jumping influence lower extremity alignment?

PubMed Central

Akasaka, Kiyokazu; Tamura, Akihiro; Katsuta, Aoi; Sagawa, Ayako; Otsudo, Takahiro; Okubo, Yu; Sawada, Yutaka; Hall, Toby

2017-01-01

[Purpose] To determine whether repetitive trampoline or hard surface jumping affects lower extremity alignment on jump landing. [Subjects and Methods] Twenty healthy females participated in this study. All subjects performed a drop vertical jump before and after repeated maximum effort trampoline or hard surface jumping. A three-dimensional motion analysis system and two force plates were used to record lower extremity angles, moments, and vertical ground reaction force during drop vertical jumps. [Results] Knee extensor moment after trampoline jumping was greater than that after hard surface jumping. There were no significant differences between trials in vertical ground reaction force and lower extremity joint angles following each form of exercise. Repeated jumping on a trampoline increased peak vertical ground reaction force, hip extensor, knee extensor moments, and hip adduction angle, while decreasing hip flexion angle during drop vertical jumps. In contrast, repeated jumping on a hard surface increased peak vertical ground reaction force, ankle dorsiflexion angle, and hip extensor moment during drop vertical jumps. [Conclusion] Repeated jumping on the trampoline compared to jumping on a hard surface has different effects on lower limb kinetics and kinematics. Knowledge of these effects may be useful in designing exercise programs for different clinical presentations. PMID:29643592

Discharge behavior of motor units in knee extensors during the initial stage of constant-force isometric contraction at low force level.

PubMed

Kamo, Mifuyu

2002-03-01

To elucidate the strategy of the activity of motor units (MUs) to maintain a constant-force isometric contraction, I examined the behavior of MUs in knee extensor muscles [(vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF)] during a sustained contraction at 5% of maximal voluntary contraction for 5 min. In all cases, the spike interval exhibited an elongating trend, and two discharge patterns were observed, continuous discharge and decruitment. In continuous-discharge MUs, the trend slope was steep immediately after the onset of constant force (steep phase), and then became gentle (gentle phase). Decruitments were observed frequently during each phase, and additional MU recruitment was observed throughout the contraction. The mean value of recruitment threshold force did not differ among the extensors. The mean spike interval at the onset of constant-force isometric contractions was shorter in RF than in VL. However, there were no differences in the duration and extent of the elongating trend, decruitment time and recruitment time among the extensors. The electromyogram of the antagonist biceps femoris muscle revealed no compensatory change for extensor activity. These results indicated that at a low force level, the strategy employed by the central nervous system to maintain constant force appears to involve cooperation among elongating trends in the spike interval, decruitment following elongation, and additional MU recruitment in synergistic muscles.

Gait perturbation response in chronic anterior cruciate ligament deficiency and repair.

PubMed

Ferber, Reed; Osternig, Louis R; Woollacott, Marjorie H; Wasielewski, Noah J; Lee, Ji Hang

2003-02-01

To determine how chronic anterior cruciate ligament deficient and surgically repaired subjects react to unexpected forward perturbations during gait as compared to healthy controls. Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and three months following reconstructive surgery, and 10 uninjured controls. The ability of an anterior cruciate ligament injured individual to react and maintain equilibrium during gait perturbations is critical for the prevention of reinjury. No studies have investigated how these individuals respond to unexpected perturbations during normal gait. An unexpected forward perturbation was induced upon heel strike using a force plate capable of translational movement. Prior to surgery, the anterior cruciate ligament subjects exhibited a greater knee extensor moment in response to the perturbation compared to healthy controls. Following surgery, the anterior cruciate ligament injured subjects exhibited a static knee position and a sustained knee extensor moment throughout stance in response to the perturbation as compared to controls. These data suggest that chronic anterior cruciate ligament deficient subjects rely heavily on knee extensor musculature to prevent collapse in response to an unexpected perturbation. This same reactive response was more pronounced 3 months following surgery. The results suggest that, prior to and following surgery, chronic anterior cruciate ligament injured subjects respond differently than healthy controls to an unexpected perturbation during gait. Anterior cruciate ligament injured or repaired subjects do not reduce or avoid vigorous contraction of the quadriceps muscles when responding to gait perturbations.

Physical performance measures that predict faller status in community-dwelling older adults.

PubMed

Macrae, P G; Lacourse, M; Moldavon, R

1992-01-01

Falls are a leading cause of fatal and nonfatal injuries among the elderly. Accurate determination of risk factors associated with falls in older adults is necessary, not only for individual patient management, but also for the development of fall prevention programs. The purpose of this study was to evaluate the effectiveness of clinical measures, such as the one-legged stance test (OLST), sit-to-stand test (STST), manual muscle tests (MMT), and response speed in predicting faller status in community-dwelling older adults (N = 94, age 60-89 years). The variables assessed were single-leg standing (as measured by OLST), STST, and MMT of 12 different muscle groups (hip flexors, hip abductors, hip adductors, knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors, shoulder flexors, shoulder abductors, elbow flexors, elbow extensors, and finger flexors), and speed of response (as measured by a visual hand reaction and movement time task). Of the 94 older adults assessed, 28 (29.7%) reported at least one fall within the previous year. The discriminant analysis revealed that there were six variables that significantly discriminated between fallers and nonfallers. These variables included MMT of the ankle dorsiflexors, knee flexors, hip abductors, and knee extensors, as well as time on the OLST and the STST. The results indicate that simple clinical measures of musculoskeletal function can discriminate fallers from nonfallers in community-dwelling older adults. J Orthop Sports Phys Ther 1992;16(3):123-128.

Evaluation of peripheral muscle strength of patients undergoing elective cardiac surgery: a longitudinal study

PubMed Central

Santos, Kelli Maria Souza; de Cerqueira Neto, Manoel Luiz; Carvalho, Vitor Oliveira; de Santana Filho, Valter Joviniano; da Silva Junior, Walderi Monteiro; Araújo Filho, Amaro Afrânio; Cerqueira, Telma Cristina Fontes; Cacau, Lucas de Assis Pereira

2014-01-01

Introduction Peripheral muscle strength has been little explored in the literature in the context of cardiac rehabilitation. Objective To evaluate the peripheral muscle strength of patients undergoing elective cardiac surgery. Methods This was a longitudinal observational study. The peripheral muscle strength was measured using isometric dynamometry lower limb (knee extensors and flexors) at three different times: preoperatively (M1), the day of discharge (M2) and hospital discharge (M3). Participants received physiotherapy pre and postoperatively during the days of hospitalization during the morning and afternoon. Results Twenty-two patients were evaluated. The values of peripheral muscle strength of knee extensors preoperative found were about 50% lower than those predicted for the healthy population. When comparing muscle strength prior (M1), with the remaining evaluation, found himself in a fall of 29% for the movement of knee extension and 25% for knee flexion in M2 and a decrease of 10% movement for knee extension and 13% for knee flexion in M3 when comparing with M1. Conclusion The values of peripheral muscle strength prior of the study patients were lower than predicted for the healthy population of the same age. After the surgical event this reduction is even more remarkable, being reestablished until the time of discharge, to values close to baseline. PMID:25372909

Evaluation of peripheral muscle strength of patients undergoing elective cardiac surgery: a longitudinal study.

PubMed

Santos, Kelli Maria Souza; Cerqueira Neto, Manoel Luiz de; Carvalho, Vitor Oliveira; Santana Filho, Valter Joviniano de; Silva Junior, Walderi Monteiro da; Araújo Filho, Amaro Afrânio; Cerqueira, Telma Cristina Fontes; Cacau, Lucas de Assis Pereira

2014-01-01

Peripheral muscle strength has been little explored in the literature in the context of cardiac rehabilitation. To evaluate the peripheral muscle strength of patients undergoing elective cardiac surgery. This was a longitudinal observational study. The peripheral muscle strength was measured using isometric dynamometry lower limb (knee extensors and flexors) at three different times: preoperatively (M1), the day of discharge (M2) and hospital discharge (M3). Participants received physiotherapy pre and postoperatively during the days of hospitalization during the morning and afternoon. Twenty-two patients were evaluated. The values of peripheral muscle strength of knee extensors preoperative found were about 50% lower than those predicted for the healthy population. When comparing muscle strength prior (M1), with the remaining evaluation, found himself in a fall of 29% for the movement of knee extension and 25% for knee flexion in M2 and a decrease of 10% movement for knee extension and 13% for knee flexion in M3 when comparing with M1. The values of peripheral muscle strength prior of the study patients were lower than predicted for the healthy population of the same age. After the surgical event this reduction is even more remarkable, being reestablished until the time of discharge, to values close to baseline.

Resveratrol Enhances Exercise-Induced Cellular and Functional Adaptations of Skeletal Muscle in Older Men and Women.

PubMed

Alway, Stephen E; McCrory, Jean L; Kearcher, Kalen; Vickers, Austen; Frear, Benjamin; Gilleland, Diana L; Bonner, Daniel E; Thomas, James M; Donley, David A; Lively, Mathew W; Mohamed, Junaith S

2017-11-09

Older men (n = 12) and women (n = 18) 65-80 years of age completed 12 weeks of exercise and took either a placebo or resveratrol (RSV) (500 mg/d) to test the hypothesis that RSV treatment combined with exercise would increase mitochondrial density, muscle fatigue resistance, and cardiovascular function more than exercise alone. Contrary to our hypothesis, aerobic and resistance exercise coupled with RSV treatment did not reduce cardiovascular risk further than exercise alone. However, exercise added to RSV treatment improved the indices of mitochondrial density, and muscle fatigue resistance more than placebo and exercise treatments. In addition, subjects that were treated with RSV had an increase in knee extensor muscle peak torque (8%), average peak torque (14%), and power (14%) after training, whereas exercise did not increase these parameters in the placebo-treated older subjects. Furthermore, exercise combined with RSV significantly improved mean fiber area and total myonuclei by 45.3% and 20%, respectively, in muscle fibers from the vastus lateralis of older subjects. Together, these data indicate a novel anabolic role of RSV in exercise-induced adaptations of older persons and this suggests that RSV combined with exercise might provide a better approach for reversing sarcopenia than exercise alone. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Influence of Skeletal Muscle Carnosine Content on Fatigue during Repeated Resistance Exercise in Recreationally Active Women

PubMed Central

Varanoske, Alyssa N.; Hoffman, Jay R.; Church, David D.; Baker, Kayla M.; Dodd, Sarah J.; Coker, Nicholas A.; Oliveira, Leonardo P.; Dawson, Virgil L.; Stout, Jeffrey R.

2017-01-01

Carnosine is a naturally occurring intramuscular dipeptide that is thought to attenuate fatigue during high-intensity exercise. Carnosine content is influenced by various factors, including gender and diet. Despite research reporting that carnosine content is lower in women compared to men and lower in vegetarians compared to omnivores, no investigations have examined carnosine content in women based on dietary protein intake and its effect on muscle fatigue. Twenty recreationally active women were assigned to either a high (HI; n = 5), moderate (MOD; n = 10), or low (LO; n = 5) group based upon intramuscular carnosine content of the vastus lateralis. Each participant underwent two unilateral maximal voluntary isometric contractions (MVIC) of the knee extensors separated by an isokinetic exercise protocol consisting of five sets of 50 repeated maximal unilateral contractions. Magnitude-based inferences were used to analyze group differences. Percent decline in rate of force development and peak torque (PT) during the MVICs and changes in PT and mean torque during the muscle-fatiguing protocol were lower in HI compared to both MOD and LO. Additionally, absolute and relative dietary protein intake were greater in HI compared to MOD or LO. Results indicated that greater intramuscular carnosine content was reflective of greater dietary protein intake and that individuals with higher carnosine content displayed a greater attenuation of fatigue compared to those with lower carnosine. PMID:28880219

Influence of Skeletal Muscle Carnosine Content on Fatigue during Repeated Resistance Exercise in Recreationally Active Women.

PubMed

Varanoske, Alyssa N; Hoffman, Jay R; Church, David D; Wang, Ran; Baker, Kayla M; Dodd, Sarah J; Coker, Nicholas A; Oliveira, Leonardo P; Dawson, Virgil L; Fukuda, David H; Stout, Jeffrey R

2017-09-07

Carnosine is a naturally occurring intramuscular dipeptide that is thought to attenuate fatigue during high-intensity exercise. Carnosine content is influenced by various factors, including gender and diet. Despite research reporting that carnosine content is lower in women compared to men and lower in vegetarians compared to omnivores, no investigations have examined carnosine content in women based on dietary protein intake and its effect on muscle fatigue. Twenty recreationally active women were assigned to either a high (HI; n = 5), moderate (MOD; n = 10), or low (LO; n = 5) group based upon intramuscular carnosine content of the vastus lateralis. Each participant underwent two unilateral maximal voluntary isometric contractions (MVIC) of the knee extensors separated by an isokinetic exercise protocol consisting of five sets of 50 repeated maximal unilateral contractions. Magnitude-based inferences were used to analyze group differences. Percent decline in rate of force development and peak torque (PT) during the MVICs and changes in PT and mean torque during the muscle-fatiguing protocol were lower in HI compared to both MOD and LO. Additionally, absolute and relative dietary protein intake were greater in HI compared to MOD or LO. Results indicated that greater intramuscular carnosine content was reflective of greater dietary protein intake and that individuals with higher carnosine content displayed a greater attenuation of fatigue compared to those with lower carnosine.

Comparison between the effects of 4 different electrical stimulation current waveforms on isometric knee extension torque and perceived discomfort in healthy women.

PubMed

Dantas, Lucas Ogura; Vieira, Amilton; Siqueira, Aristides Leite; Salvini, Tania Fatima; Durigan, João Luiz Quagliotti

2015-01-01

We studied the effects of different neuromuscular electrical stimulation (NMES) currents, 2 kHz-frequency alternating currents (KACs, Russian and Aussie) and 2 pulsed currents (PCs), on isometric knee extension torque and discomfort level, both in isolation and combined, with maximum voluntary contraction (MVC). Twenty-one women (age 21.6 ± 2.5 years) were studied. We evaluated torque evoked by NMES or NMES combined with maximum voluntary contraction of the quadriceps muscle of healthy women. Discomfort level was measured using a visual analog pain scale. Despite comparable levels of discomfort, evoked torque was lower for Russian current compared with the other modalities (Russian 50.8%, Aussie 71.7%, PC500 76.9%, and PC200 70.1%; P < 0.001). There was no advantage in combining NMES with MVC compared with isolated NMES. The Aussie and PC approaches proved superior to Russian current for inducing isometric knee extension torque. This information is important in guiding decision making with regard to NMES protocols for muscle strengthening. © 2014 Wiley Periodicals, Inc.

Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults.

PubMed

Anderson, Dennis E; Madigan, Michael L

2014-03-21

Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly <100%, and were higher than for other measures examined. Older adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of Knee Joint Angle and Contraction Intensity on Hamstrings Coactivation.

PubMed

Wu, Rui; Delahunt, Eamonn; Ditroilo, Massimiliano; Lowery, Madeleine M; DE Vito, Giuseppe

2017-08-01

This study investigated the effect of knee joint angle and contraction intensity on the coactivation of the hamstring muscles (when acting as antagonists to the quadriceps) in young and older individuals of both sexes. A total of 25 young (24 ± 2.6 yr) and 26 older (70 ± 2.5 yr) healthy men and women participated. Maximal voluntary isometric contraction of the knee extensors and flexors was assessed at two knee joint angles (90° and 60°, 0° = full extension). At each angle, participants performed submaximal contractions of the knee extensors (20%, 50%, and 80% maximal voluntary isometric contraction), whereas surface EMG was simultaneously acquired from the vastus lateralis and biceps femoris muscles to assess the level (EMG root-mean-square) of agonist activation and antagonist coactivation. Subcutaneous adipose tissue in the areas corresponding to surface EMG electrode placements was measured via ultrasonography. The contractions performed at 90° knee flexion demonstrated higher levels of antagonist coactivation (all P < 0.01) and agonist activation (all P < 0.01) as a function of contraction intensity compared with the 60° knee flexion. Furthermore, after controlling for subcutaneous adipose tissue, older participants exhibited a higher level of antagonist coactivation at 60° knee flexion compared with young participants (P < 0.05). The results of the present study suggest that 1) the antagonist coactivation is dependent on knee joint angle and contraction intensity and 2) subcutaneous adipose tissue may affect the measured coactivation level likely because of a cross-talk effect. Antagonist coactivation may play a protective role in stabilizing the knee joint and maintaining constant motor output.

Weightlifting performance is related to kinematic and kinetic patterns of the hip and knee joints.

PubMed

Kipp, Kristof; Redden, Josh; Sabick, Michelle B; Harris, Chad

2012-07-01

The purpose of this study was to investigate the correlations between biomechanical outcome measures and weightlifting performance. Joint kinematics and kinetics of the hip, knee, and ankle were calculated while 10 subjects performed a clean at 85% of 1 repetition maximum (1RM). Kinematic and kinetic time-series patterns were extracted with principal components analysis. Discrete scores for each time-series pattern were calculated and used to determine how each pattern was related to body mass-normalized 1RM. Two hip kinematic and 2 knee kinetic patterns were significantly correlated with relative 1RM. The kinematic patterns captured hip and trunk motions during the first pull and hip joint motion during the movement transition between the first and second pulls. The first kinetic pattern captured a peak in the knee extension moment during the second pull. The second kinetic pattern captured a spatiotemporal shift in the timing and amplitude of the peak knee extension moment. The kinematic results suggest that greater lift mass was associated with steady trunk position during the first pull and less hip extension motion during the second-knee bend transition. Further, the kinetic results suggest that greater lift mass was associated with a smaller knee extensor moments during the first pull, but greater knee extension moments during the second pull, and an earlier temporal transition between knee flexion-extension moments at the beginning of the second pull. Collectively, these results highlight the importance of controlled trunk and hip motions during the first pull and rapid employment of the knee extensor muscles during the second pull in relation to weightlifting performance.

Effects of Step Length, Age, and Fall History on Hip and Knee Kinetics and Knee Co-contraction during the Maximum Step Length Test

PubMed Central

Schulz, Brian W.; Jongprasithporn, Manutchanok; Hart-Hughes, Stephanie J.; Bulat, Tatjana

2017-01-01

Background Maximum step length is a brief clinical test involving stepping out and back as far as possible with the arms folded across the chest. This test has been shown to predict fall risk, but the biomechanics of this test are not fully understood. Knee and hip kinetics (moments and powers) are greater for longer steps and for younger subjects, but younger subjects also step farther. Methods To separate effects of step length, age, and fall history on joint kinetics; 14 healthy younger, 14 older non-fallers, and 11 older fallers (27(5), 72(5), 75(6) years respectively) all stepped to the same relative target distances of 20-80% of their height. Knee and hip kinetics and knee co-contraction were calculated. Findings Hip and knee kinetics and knee co-contraction all increased with step length, but older non-fallers and fallers utilized greater stepping hip and less stepping knee extensor kinetics. Fallers had greater stepping knee co-contraction than non-fallers. Stance knee co-contraction of non-fallers was similar to young for shorter steps and similar to fallers for longer steps. Interpretation Age had minimal effects and fall history had no effects on joint kinetics of steps to similar distances. Effects of age and fall history on knee co-contraction may contribute to age-related kinetic differences and shorter maximal step lengths of older non-fallers and fallers, but step length correlated with every variable tested. Thus, declines in maximum step length could indicate declines in hip and knee extensor kinetics and impaired performance on similar tasks like recovering from a trip. PMID:23978310

The Relationship between Vitamin D and Muscle Size and Strength in Patients on Hemodialysis

PubMed Central

Gordon, Patricia L.; Sakkas, Giorgos K.; Doyle, Julie W.; Shubert, Tiffany; Johansen, Kirsten L.

2007-01-01

OBJECTIVE Vitamin D has various actions in skeletal muscle. The purpose of this study was to compare lower limb muscle size and strength in hemodialysis (HD) patients being treated with 1,25-dihydroxyvitamin D (calcitriol) or a 1,25-dihydroxyvitamin D analog (paricalcitol) to HD patients who were receiving none. DESIGN This was a retrospective cross-sectional study. SETTING Outpatient hemodialysis centers. PATIENTS HD patients receiving calcitriol or paricalcitol (active vitamin D) for control of secondary hyperparathyroidism (VitD, n = 49) were compared to HD patients who were not (n = 30). MAIN OUTCOME MEASURES Cross-sectional areas (CSA) of thigh and tibialis anterior muscles by magnetic resonance imaging (MRI), and three measures of strength; three-repetition maximum (3RM) for knee extension (isotonic), peak torque of knee extensors (isokinetic), and maximal voluntary contraction (MVC) of the ankle dorsiflexor muscles (isometric). RESULTS There were no differences in age, weight, dialysis vintage, or intact parathyroid hormone levels between the groups, although serum albumin was higher in the VitD group (p <0.05). Patients in the VitD group had larger thigh muscle CSA (p < 0.05) and were stronger across all strength measures (p< 0.05) after controlling for age and gender (ANCOVA). When all analyses were subsequently adjusted for serum albumin concentration, only the difference in 3RM knee extension strength lost significance. There were no significant differences in any measurements between patients who received calcitriol or paricalcitol. CONCLUSION Treatment with active vitamin D was associated with greater muscle size and strength in this cohort of HD patients. PMID:17971312

Muscular strength profile in Tunisian male national judo team.

PubMed

Ghrairi, Mourad; Hammouda, Omar; Malliaropoulos, Nikos

2014-04-01

it is well established that muscle strength is a determinant factor in judo. However, little data are available for African athletes. Therefore, the aim of this study was to provide reference data of the muscular strength profile (MSP) for an African team, Tunisian judo team. the study was conducted among ten international judo athletes from Tunisia. To determine their MSP, we used an isokinetic dynamometer to assess Hamstrings, Quadriceps of both knees and external, internal rotators of both shoulders. The angular velocities of the assessments were; 90, 180, 240°/s for the knees and 60, 120°/s for the shoulders. MSP was determined based on two parameters; the maximum peak torque (PT) of each muscle and the ratio agonistic/antagonistic muscles (R). The knee extensors and flexors in the "supporting leg" had higher PT than in the "attacking leg"; respectively, 245N.m versus 237 (p<0.05) and 147 N.m versus 145 (p>0.05). R was normal for both legs. Furthermore, both rotators of the dominant shoulder had higher PT; 84 N.m versus 71 for the internal rotators (p<0.05) and 34,7 N.m versus 29,0 for the lateral rotators (p<0.05). Inversely, R was higher in the non-dominant side; 45% versus 35, p<0.05). the MSP of the selected elites Tunisian judo athletes was characterized by 3 major features; a strength of the quadriceps in the standing leg significantly higher than in the attacking leg, a normal muscular balance Hamstrings/quadriceps in both legs and a strength of the shoulder' rotators higher in the dominant side.

Lower-extremity isokinetic strength profiling in professional rugby league and rugby union.

PubMed

Brown, Scott R; Brughelli, Matt; Griffiths, Peter C; Cronin, John B

2014-03-01

While several studies have documented isokinetic knee strength in junior and senior rugby league players, investigations of isokinetic knee and hip strength in professional rugby union players are limited. The purpose of this study was to provide lower-extremity strength profiles and compare isokinetic knee and hip strength of professional rugby league and rugby union players. 32 professional rugby league and 25 professional rugby union players. Cross-sectional analysis. Isokinetic dynamometry was used to evaluate peak torque and strength ratios of the dominant and nondominant legs during seated knee-extension/ flexion and supine hip-extension/flexion actions at 60°/s. Forwards from both codes were taller and heavier and had a higher body-mass index than the backs of each code. Rugby union forwards produced significantly (P < .05) greater peak torque during knee flexion in the dominant and nondominant legs (ES = 1.81 and 2.02) compared with rugby league forwards. Rugby league backs produced significantly greater hip-extension peak torque in the dominant and nondominant legs (ES = 0.83 and 0.77) compared with rugby union backs. There were no significant differences in hamstring-to-quadriceps ratios between code, position, or leg. Rugby union forwards and backs produced significantly greater knee-flexion-to-hip-extension ratios in the dominant and nondominant legs (ES = 1.49-2.26) than rugby union players. It seems that the joint torque profiles of players from rugby league and union codes differ, which may be attributed to the different demands of each code.

The effects of low-repetition and light-load power training on bone mineral density in postmenopausal women with sarcopenia: a pilot study.

PubMed

Hamaguchi, Kanako; Kurihara, Toshiyuki; Fujimoto, Masahiro; Iemitsu, Motoyuki; Sato, Koji; Hamaoka, Takafumi; Sanada, Kiyoshi

2017-05-02

Age-related reduction in bone mineral density (BMD) is generally accelerated in women after menopause, and could be even more pronounced in individuals with sarcopenia. Light-load power training with a low number of repetitions would increase BMD, significantly reducing bone loss in individuals at risk of osteoporosis. This study investigated the effects of low-repetition, light-load power training on BMD in Japanese postmenopausal women with sarcopenia. The training group (n = 7) followed a progressive power training protocol that increased the load with a weighted vest, for two sessions per week, over the course of 6 weeks. The training exercise comprised five kinds of exercises (squats, front lunges, side lunges, calf raises, and toe raises), and each exercise contained eight sets of three repetitions with a 15-s rest between each set. The control group (n = 8) did not undergo any training intervention. We measured BMD, muscle strength, and anthropometric data. Within-group changes in pelvis BMD and knee extensor strength were significantly greater in the training group than the control group (p = 0.029 and 0.030 for pelvis BMD and knee extensor strength, respectively). After low-repetition, light-load power training, we noted improvements in pelvis BMD (1.6%) and knee extensor strength (15.5%). No significant within- or between-group differences were observed for anthropometric data or forearm BMD. Six weeks of low-repetition, light-load power training improved pelvis BMD and knee extensor strength in postmenopausal women with sarcopenia. Since this training program does not require high-load exercise and is therefore easily implementable as daily exercise, it could be an effective form of exercise for sedentary adults at risk for osteoporosis who are fearful of heavy loads and/or training that could cause fatigue. This trial was registered with the University Hospital Medical Information Network on 31 October 2016 ( UMIN000024651 ).

Effect of knee flexion angle on ground reaction forces, knee moments and muscle co-contraction during an impact-like deceleration landing: implications for the non-contact mechanism of ACL injury.

PubMed

Podraza, Jeffery T; White, Scott C

2010-08-01

Investigating landing kinetics and neuromuscular control strategies during rapid deceleration movements is a prerequisite to understanding the non-contact mechanism of ACL injury. The purpose of this study was to quantify the effect of knee flexion angle on ground reaction forces, net knee joint moments, muscle co-contraction and lower extremity muscles during an impact-like, deceleration task. Ground reaction forces and knee joint moments were determined from video and force plate records of 10 healthy male subjects performing rapid deceleration single leg landings from a 10.5 cm height with different degrees of knee flexion at landing. Muscle co-contraction was based on muscle moments calculated from an EMG-to-moment processing model. Ground reaction forces and co-contraction indices decreased while knee extensor moments increased significantly with increased degrees of knee flexion at landing (all p<0.005). Higher ground reaction forces when landing in an extended knee position suggests they are a contributing factor in non-contact ACL injuries. Increased knee extensor moments and less co-contraction with flexed knee landings suggest that quadriceps overload may not be the primary cause of non-contact ACL injuries. The results bring into question the counterbalancing role of the hamstrings during dynamic movements. The soleus may be a valuable synergist stabilizing the tibia against anterior translation at landing. Movement strategies that lessen the propagation of reaction forces up the kinetic chain may help prevent non-contact ACL injuries. The relative interaction of all involved thigh and lower leg muscles, not just the quadriceps and hamstrings should be considered when interpreting non-contact ACL injury mechanisms. Copyright 2010 Elsevier B.V. All rights reserved.

Different knee joint loading patterns in ACL deficient copers and non-copers during walking.

PubMed

Alkjær, Tine; Henriksen, Marius; Simonsen, Erik B

2011-04-01

Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces is unresolved. Thus, the aim of the present study was to investigate how different walking patterns observed between copers, non-copers, and controls affect the knee compression and shear forces during walking. Three-dimensional gait analyses were performed in copers (n = 9), non-copers (n = 10), and control subjects (n =19). The net knee joint moment, knee joint reaction forces, and the sagittal knee joint angle were input parameters to a biomechanical model that assessed the knee compression and shear forces. The results showed that the non-copers walked with significantly reduced knee compression and shear forces than the controls. The overall knee compression force pattern was similar between the copers and controls, although this variable was significantly increased at heel strike in the copers compared to both non-copers and controls. The peak shear force was significantly dependent on the peak knee extensor moment. This covariance was significantly different between groups meaning that at a given knee extensor moment the shear force was significantly reduced in the copers compared to controls. The different knee joint loading patterns observed between non-copers and copers reflected the different walking strategies adopted by these groups, which may have implications for the knee joint stability. The strategy adopted by the copers may resemble an effective way to stabilize the knee joint during walking after an ACL rupture and that the knee kinematics may play a key role for this strategy. It is clinically relevant to investigate if gait retraining would enable non-copers to walk as copers and thereby improve their knee joint stability.

The Motor and the Brake of the Trailing Leg in Human Walking: Leg Force Control Through Ankle Modulation and Knee Covariance

PubMed Central

Toney, Megan E.; Chang, Young-Hui

2016-01-01

Human walking is a complex task, and we lack a complete understanding of how the neuromuscular system organizes its numerous muscles and joints to achieve consistent and efficient walking mechanics. Focused control of select influential task-level variables may simplify the higher-level control of steady state walking and reduce demand on the neuromuscular system. As trailing leg power generation and force application can affect the mechanical efficiency of step-to-step transitions, we investigated how joint torques are organized to control leg force and leg power during human walking. We tested whether timing of trailing leg force control corresponded with timing of peak leg power generation. We also applied a modified uncontrolled manifold analysis to test whether individual or coordinated joint torque strategies most contributed to leg force control. We found that leg force magnitude was adjusted from step-to-step to maintain consistent leg power generation. Leg force modulation was primarily determined by adjustments in the timing of peak ankle plantar-flexion torque, while knee torque was simultaneously covaried to dampen the effect of ankle torque on leg force. We propose a coordinated joint torque control strategy in which the trailing leg ankle acts as a motor to drive leg power production while trailing leg knee torque acts as a brake to refine leg power production. PMID:27334888

Performance Evaluation of a Lower Limb Exoskeleton for Stair Ascent and Descent with Paraplegia*

PubMed Central

Farris, Ryan J.; Quintero, Hugo A.; Goldfarb, Michael

2013-01-01

This paper describes the application of a powered lower limb exoskeleton to aid paraplegic individuals in stair ascent and descent. A brief description of the exoskeleton hardware is provided along with an explanation of the control methodology implemented to allow stair ascent and descent. Tests were performed with a paraplegic individual (T10 complete injury level) and data is presented from multiple trials, including the hip and knee joint torque and power required to perform this functionality. Joint torque and power requirements are summarized, including peak hip and knee joint torque requirements of 0.75 Nm/kg and 0.87 Nm/kg, respectively, and peak hip and knee joint power requirements of approximately 0.65 W/kg and 0.85 W/kg, respectively. PMID:23366287

Acute effects of static stretching on passive stiffness of the hamstring muscles calculated using different mathematical models.

PubMed

Nordez, Antoine; Cornu, Christophe; McNair, Peter

2006-08-01

The aim of this study was to assess the effects of static stretching on hamstring passive stiffness calculated using different data reduction methods. Subjects performed a maximal range of motion test, five cyclic stretching repetitions and a static stretching intervention that involved five 30-s static stretches. A computerised dynamometer allowed the measurement of torque and range of motion during passive knee extension. Stiffness was then calculated as the slope of the torque-angle relationship fitted using a second-order polynomial, a fourth-order polynomial, and an exponential model. The second-order polynomial and exponential models allowed the calculation of stiffness indices normalized to knee angle and passive torque, respectively. Prior to static stretching, stiffness levels were significantly different across the models. After stretching, while knee maximal joint range of motion increased, stiffness was shown to decrease. Stiffness decreased more at the extended knee joint angle, and the magnitude of change depended upon the model used. After stretching, the stiffness indices also varied according to the model used to fit data. Thus, the stiffness index normalized to knee angle was found to decrease whereas the stiffness index normalized to passive torque increased after static stretching. Stretching has significant effects on stiffness, but the findings highlight the need to carefully assess the effect of different models when analyzing such data.

Different fatigue-resistant leg muscles and EMG response during whole-body vibration.

PubMed

Simsek, Deniz

2017-12-01

The purpose of this study was to determine the effects of static whole-body vibration (WBV) on the Electromyograhic (EMG) responses of leg muscles, which are fatigue-resistant in different manner. The study population was divided into two groups according to the values obtained by the Fatigue Index [Group I: Less Fatigue Resistant (LFR), n=11; Group II: More Fatigue Resistant (MFR), n=11]. The repeated electromyographic (EMG) activities of four leg muscles were analyzed the following determinants: (1) frequency (30 Hz, 35 Hz and 40 Hz); (2) stance position (static squat position); (3) amplitude (2 mm and 4 mm) and (4) knee flexion angle (120°), (5) vertical vibration platform. Vibration data were analyzed using Minitab 16 (Minitab Ltd, State College, PA, USA). The significance level was set at p<.05. The study results showed that static WBV stimuli given at different frequencies and amplitudes resulted in a significant increase (p<.05) in compared, the LFR group showed significantly (1) higher rates of quadriceps femoris and hamstring muscle fatigue (p<.05), (2) higher levels of knee extensor and flexor torque (p<.05) and (3) higher percentage increases in EMG activation at higher frequencies (max at 40 Hz) and amplitudes (4 mm) (p<.05). The present study can be used for the optimal prescription of vibration exercise and can serve to guide the development of training programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Performance determinants of fixed gear cycling during criteriums.

PubMed

Babault, Nicolas; Poisson, Maxime; Cimadoro, Guiseppe; Cometti, Carole; Païzis, Christos

2018-06-17

Nowadays, fixed gear competitions on outdoor circuits such as criteriums are regularly organized worldwide. To date, no study has investigated this alternative form of cycling. The purpose of the present study was to examine fixed gear performance indexes and to characterize physiological determinants of fixed gear cyclists. This study was carried out in two parts. Part 1 (n = 36) examined correlations between performance indexes obtained during a real fixed gear criterium (time trial, fastest laps, averaged lap time during races, fatigue indexes) and during a sprint track time trial. Part 2 (n = 9) examined correlations between the recorded performance indexes and some aerobic and anaerobic performance outputs (VO 2max , maximal aerobic power, knee extensor and knee flexor maximal voluntary torque, vertical jump height and performance during a modified Wingate test). Results from Part 1 indicated significant correlations between fixed gear final performance (i.e. average lap time during the finals) and single lap time (time trial, fastest lap during races and sprint track time trial). In addition, results from Part 2 revealed significant correlations between fixed gear performance and aerobic indicators (VO 2max and maximal aerobic power). However, no significant relationship was obtained between fixed gear cycling and anaerobic qualities such as strength. Similarly to traditional cycling disciplines, we concluded that fixed gear cycling is mainly limited by aerobic capacity, particularly criteriums final performance. However, specific skills including technical competency should be considered.

Muscular activity during dynamic squats in patients with ACL reconstruction.

PubMed

Ceaglio, Sebastian; Alberto, Federico; Catalfamo, Paola Andrea; Braidot, Ariel Andres

2010-01-01

One of the most frequent injuries in subjects who practice sport is the rupture of the anterior cruciate ligament (ACL). Appropriate reconstruction and rehabilitation are key issues in full recovery of patients and their return to previous activities. This paper presents a new method to estimate muscle strength during a dynamic exercise from kinematic and electromyographic (EMG) data. Recovery of patients with ACL rupture and reconstruction was evaluated 4 and 6 months after surgery by assessing the differences in knee extensor and flexor muscle activity between the unimpaired and injured limbs. The results show that squat EMGs from the extensor muscles of the knee from the injured and unimpaired limb could help assess rehabilitation outputs in patients who had undergone an ACL reconstructive surgery.

Analysis of Muscle Force-Velocity Parameter Changes in Elderly Women Resulting from Physical Activity--In Continuous Examinations

ERIC Educational Resources Information Center

Skrzek, Anna; Stefanska, Malgorzata

2012-01-01

The aim of the paper was to evaluate changes in muscle force-velocity parameters (F-v) in elderly women subjected to physical exercise. The examinations encompassed 20 women, aged 62-71, who were students at the University of the Third Age in Wroclaw. The evaluation of flexors and extensors of the knee joint, as well as flexors and extensors of…

The relationship between EMG activity and extensor moment generation in the erector spinae muscles during bending and lifting activities.

PubMed

Dolan, P; Adams, M A

1993-01-01

The relationship between EMG activity and extensor moment generation in the erector spinae muscles was investigated under isometric and concentric conditions. The full-wave rectified and averaged EMG signal was recorded from skin-surface electrodes located over the belly of the erector spinae at the levels of T10 and L3, and compared with measurements of extensor moment. The effects of muscle length and contraction velocity were studied by measuring the overall curvature (theta) and rate of change of curvature (d theta/dt) of the lumbar spine in the sagittal plane, using the '3-Space Isotrak' system. Isometric contractions were investigated with the subjects pulling up on a load cell attached to the floor. Hand height was varied to produce different amounts of lumbar flexion, as indicated by changes in lumbar curvature. The extensor moment was found to be linearly related to EMG activity, and the 'gradient' and 'intercept' of the relationship were themselves dependent upon the lumbar curvature at the time of testing. Concentric contractions were investigated with the subjects extending from a seated toe-touching position, at various speeds, while the torque exerted on the arm of a Cybex dynamometer was continuously measured. Under these conditions the EMG signal (E) was higher than the isometric signal (E0) associated with the same torque. E and E0 were related as follows: E0 = E/(1 + A d theta/dt), where A = 0.0014 exp (0.045P) and P = percentage lumbar flexion. This equation was used to correct the EMG data for the effect of contraction velocity. The corrected data were then used, in conjunction with the results of the isometric calibrations, to calculate the extensor moment generated by the erector spinae muscles during bending and lifting activities. The extensor moment can itself be used to calculate the compressive force acting on the lumbar spine.

Biomechanical Evaluation of Knee Joint Laxities and Graft Forces After Anterior Cruciate Ligament Reconstruction by Anteromedial Portal, Outside-In, and Transtibial Techniques

PubMed Central

Sim, Jae Ang; Gadikota, Hemanth R.; Li, Jing-Sheng; Li, Guoan; Gill, Thomas J.

2013-01-01

Background Recently, anatomic anterior cruciate ligament (ACL) reconstruction is emphasized to improve joint laxity and to potentially avert initiation of cartilage degeneration. There is a paucity of information on the efficacy of ACL reconstructions by currently practiced tunnel creation techniques in restoring normal joint laxity. Study Design Controlled laboratory study. Hypothesis Anterior cruciate ligament reconstruction by the anteromedial (AM) portal technique, outside-in (OI) technique, and modified transtibial (TT) technique can equally restore the normal knee joint laxity and ACL forces. Methods Eight fresh-frozen human cadaveric knee specimens were tested using a robotic testing system under an anterior tibial load (134 N) at 0°, 30°, 60°, and 90° of flexion and combined torques (10-N·m valgus and 5-N·m internal tibial torques) at 0° and 30° of flexion. Knee joint kinematics, ACL, and ACL graft forces were measured in each knee specimen under 5 different conditions (ACL-intact knee, ACL-deficient knee, ACL-reconstructed knee by AM portal technique, ACL-reconstructed knee by OI technique, and ACL-reconstructed knee by TT technique). Results Under anterior tibial load, no significant difference was observed between the 3 reconstructions in terms of restoring anterior tibial translation (P > .05). However, none of the 3 ACL reconstruction techniques could completely restore the normal anterior tibial translations (P <.05). Under combined tibial torques, both AM portal and OI techniques closely restored the normal knee anterior tibial translation (P > .05) at 0° of flexion but could not do so at 30° of flexion (P <.05). The ACL reconstruction by the TT technique was unable to restore normal anterior tibial translations at both 0° and 30° of flexion under combined tibial torques (P <.05). Forces experienced by the ACL grafts in the 3 reconstruction techniques were lower than those experienced by normal ACL under both the loading conditions. Conclusion Anterior cruciate ligament reconstructions by AM portal, OI, and modified TT techniques are biomechanically comparable with each other in restoring normal knee joint laxity and in situ ACL forces. Clinical Relevance Anterior cruciate ligament reconstructions by AM portal, OI, and modified TT techniques result in similar knee joint laxities. Technical perils and pearls should be carefully considered before choosing a tunnel creating technique. PMID:21908717

The effect of open kinetic chain knee extensor resistance training at different training loads on anterior knee laxity in the uninjured.

PubMed

Barcellona, Massimo G; Morrissey, Matthew C

2016-04-01

The commonly used open kinetic chain knee extensor (OKCKE) exercise loads the sagittal restraints to knee anterior tibial translation. To investigate the effect of different loads of OKCKE resistance training on anterior knee laxity (AKL) in the uninjured knee. non-clinical trial. Randomization into one of three supervised training groups occurred with training 3 times per week for 12 weeks. Subjects in the LOW and HIGH groups performed OKCKE resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Subjects in the isokinetic training group (ISOK) performed isokinetic OKCKE resistance training using 2 sets of 20 maximal efforts. AKL was measured using the KT2000 arthrometer with concurrent measurement of lateral hamstrings muscle activity at baseline, 6 weeks and 12 weeks. Twenty six subjects participated (LOW n = 9, HIGH n = 10, ISOK n = 7). The main finding from this study is that a 12-week OKCKE resistance training programme at loads of 20 sets of 2RM, leads to an increase in manual maximal AKL. OKCKE resistance training at high loads (20 sets of 2RM) increases AKL while low load OKCKE resistance training (2 sets of 20RM) and isokinetic OKCKE resistance training at 2 sets of 20RM does not. Copyright © 2015 Elsevier Ltd. All rights reserved.

Muscle oxygenation of vastus lateralis and medialis muscles during alternating and pulsed current electrical stimulation.

PubMed

Aldayel, Abdulaziz; Muthalib, Makii; Jubeau, Marc; McGuigan, Michael; Nosaka, Kazunori

2011-05-01

This study compared between alternating and pulsed current electrical muscle stimulation (EMS) for muscle oxygenation and blood volume during isometric contractions. Nine healthy men (23-48 years) received alternating current EMS (2500 Hz) modulated at 75 Hz on the knee extensors of one leg, and pulsed current EMS (75 Hz) for the other leg separated by 2 weeks in a randomised, counter-balanced order. Pulse duration (400 μs), on-off ratio (5-15 s) and other stimulation parameters were matched between conditions and 30 isometric contractions were induced at the knee joint angle of 100° (0° full extension). Changes in tissue oxygenation index (∆TOI) and total hemoglobin volume (∆tHb) of vastus lateralis and medialis muscles over 30 contractions were assessed by a near-infrared spectroscopy, and were compared between conditions by a two-way repeated measures ANOVA. Peak torque produced during EMS increased over 30 contractions in response to the increase in the stimulation intensity for pulsed current, but not for the alternating current EMS. The torque during each isometric contraction was less stable in alternating than pulsed current EMS. The changes in ∆TOI amplitude during relaxation phases and ∆tHb amplitude were not significantly different between conditions. However, the decreases in ∆TOI amplitude during contraction phases from baseline were significantly (P < 0.05) greater for the pulsed current than alternating current from the 18th contraction (-15.6 ± 2.3 vs. -8.9 ± 1.8%) to 30th contraction (-10.7 ± 1.8 vs. -4.8 ± 1.5%). These results suggest that the muscles were less activated in the alternating current EMS when compared with the pulsed current EMS.

Chain-loaded variable resistance warm-up improves free-weight maximal back squat performance.

PubMed

Mina, Minas A; Blazevich, Anthony J; Giakas, Giannis; Seitz, Laurent B; Kay, Anthony D

2016-11-01

The acute influence of chain-loaded variable resistance exercise on subsequent free-weight one-repetition maximum (1-RM) back squat performance was examined in 16 recreationally active men. The participants performed either a free-weight resistance (FWR) or chain-loaded resistance (CLR) back squat warm-up at 85% 1-RM on two separate occasions. After a 5-min rest, the participants attempted a free-weight 1-RM back squat; if successful, subsequent 5% load additions were made until participants failed to complete the lift. During the 1-RM trials, 3D knee joint kinematics and knee extensor and flexor electromyograms (EMG) were recorded simultaneously. Significantly greater 1-RM (6.2 ± 5.0%; p < .01) and mean eccentric knee extensor EMG (32.2 ± 6.7%; p < .01) were found after the CLR warm-up compared to the FWR condition. However, no difference (p > .05) was found in concentric EMG, eccentric or concentric knee angular velocity, or peak knee flexion angle. Performing a CLR warm-up enhanced subsequent free-weight 1-RM performance without changes in knee flexion angle or eccentric and concentric knee angular velocities; thus a real 1-RM increase was achieved as the mechanics of the lift were not altered. These results are indicative of a potentiating effect of CLR in a warm-up, which may benefit athletes in tasks where high-level strength is required.

Effects of Two Football Stud Types on Knee and Ankle Kinetics of Single-Leg Land-Cut and 180° Cut Movements on Infilled Synthetic Turf.

PubMed

Bennett, Hunter J; Brock, Elizabeth; Brosnan, James T; Sorochan, John C; Zhang, Songning

2015-10-01

Higher ACL injury rates have been recorded in cleats with higher torsional resistance in American football, which warrants better understanding of shoe/stud-dependent joint kinetics. The purpose of this study was to determine differences in knee and ankle kinetics during single-leg land cuts and 180° cuts on synthetic infilled turf while wearing 3 types of shoes. Fourteen recreational football players performed single-leg land cuts and 180° cuts in nonstudded running shoes (RS) and in football shoes with natural (NTS) and synthetic turf studs (STS). Knee and ankle kinetic variables were analyzed with a 3 × 2 (shoe × movement) repeated-measures ANOVA (P < .05). A significant shoe-by-movement interaction was found in loading response peak knee adduction moments, with NTS producing smaller moments compared with both STS and RS only in 180° cuts. Reduced peak negative plantar flexor powers were also found in NTS compared with STS. The single-leg land cut produced greater loading response and push-off peak knee extensor moments, as well as peak negative and positive extensor and plantar flexor powers, but smaller loading peak knee adduction moments and push-off peak ankle eversion moments than 180° cuts. Overall, the STS and 180° cuts resulted in greater frontal plane knee loading and should be monitored for possible increased ACL injury risks.

Effect of muscle length on strength and dexterity after stroke.

PubMed

Ada, L; Canning, C; Dwyer, T

2000-02-01

The effect of muscle length on strength and dexterity after stroke was investigated. The aim was to determine if poor function at a particular muscle length could be attributed solely to differential weakness at this joint angle or whether an additional problem of differential dexterity exists. This descriptive research study measured elbow flexor and extensor strength as well as dexterity at three elbow joint angles: 30 degrees , 60 degrees and 90 degrees flexion. Dexterity was measured independently of strength. Fifteen (seven female, eight male) chronic stroke patients (mean age 67 years) who could actively flex and extend their affected elbow participated. Ten neurologically normal control subjects (mean age 67 years) acted as controls. Strength was measured as peak elbow flexor and extensor torque at three angles; and dexterity was measured as coherence for slow and fast tracking also at three angles. Dexterity was not affected by muscle length but strength was and this finding was the same for both stroke and controls. While the magnitude of the torque-angle curves was not significantly different between stroke and controls, the shape of torque-angle curves was altered after stroke so that both the elbow flexors (p < 0.05) and extensors (p < 0.05) tested weaker in the testing position where they were shortest. Since there was no differential loss of dexterity, it appears that differential loss of strength, especially in the shortened range, may explain the clinical observation of poorer function at one muscle length than another after stroke. Specific training to strengthen the muscles in these ranges is therefore of clinical importance for rehabilitation.

The influences of sex and posture on joint energetics during drop landings.

PubMed

Norcross, M F; Shultz, S J; Weinhold, P S; Lewek, M D; Padua, D A; Blackburn, J T

2015-04-01

Previous observations suggest that females utilize a more erect initial landing posture than males with sex differences in landing posture possibly related to sex-specific energy absorption (EA) strategies. However, sex-specific EA strategies have only been observed when accompanied by sex differences in initial landing posture. This study (a) investigated the potential existence of sex-specific EA strategies; and (b) determined the influences of sex and initial landing posture on the biomechanical determinants of EA. The landing biomechanics of 80 subjects were recorded during drop landings in Preferred, Flexed, and Erect conditions. No sex differences in joint EA were identified after controlling for initial landing posture. Males and females exhibited greater ankle EA during Erect vs Flexed landings with this increase driven by 12% greater ankle velocity, but no change in ankle extensor moment. No differences in hip and knee EA were observed between conditions. However, to achieve similar knee EA, subjects used 7% greater mean knee extensor moment but 9% less knee angular velocity during Flexed landings. The results suggest that sex-specific EA strategies do not exist, and that the magnitude of knee joint EA can be maintained by modulating the relative contributions of joint moment and angular velocity to EA. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Correlation between the knee adduction torque and medial contact force for a variety of gait patterns.

PubMed

Zhao, Dong; Banks, Scott A; Mitchell, Kim H; D'Lima, Darryl D; Colwell, Clifford W; Fregly, Benjamin J

2007-06-01

The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. This study uses in vivo data collected from a single subject with an instrumented knee implant to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe-out) with simultaneous collection of instrumented implant, video motion, and ground reaction data. For each trial, the knee adduction torque was measured externally while the total axial force applied to the tibial insert was measured internally. Based on data collected from the same subject performing treadmill gait under fluoroscopic motion analysis, a regression equation was developed to calculate medial contact force from the implant load cell measurements. Correlation analyses were performed for the stance phase and entire gait cycle to quantify the relationship between the knee adduction torque and both the medial contact force and the medial to total contact force ratio. When the entire gait cycle was analyzed, R(2) for medial contact force was 0.77 when all gait trials were analyzed together and between 0.69 and 0.93 when each gait trial was analyzed separately (p < 0.001 in all cases). For medial to total force ratio, R(2) was 0.69 for all trials together and between 0.54 and 0.90 for each trial separately (p < 0.001 in all cases). When only the stance phase was analyzed, R(2) values were slightly lower. These results support the hypothesis that the knee adduction torque is highly correlated with medial compartment contact force and medial to total force ratio during gait. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

RELATIONSHIP BETWEEN ISOMETRIC THIGH MUSCLE STRENGTH AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES (MCIDS) IN KNEE FUNCTION IN OSTEOARTHRITIS – DATA FROM THE OSTEOARTHRITIS INITIATIVE

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2014-01-01

Objective To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower limb function. Methods Isometric knee extensor and flexor strength of 4553 Osteoarthritis Initiative participants (2651 women/1902 men) was related to Western Ontario McMasters Universities (WOMAC) physical function scores by linear regression. Further, groups of Male and female participant strata with minimal clinically important differences (MCIDs) in WOMAC function scores (6/68) were compared across the full range of observed values, and to participants without functional deficits (WOMAC=0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Results Per regression equations, a 3.7% reduction in extensor and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and a 3.6%/4.8% reduction in men. For strength divided by body weight, reductions were 5.2%/6.7% in women and 5.8%/6.7% in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest non-linear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Conclusion Reductions of approximately 4% in isometric muscle strength and of 6% in strength/weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower limb function. PMID:25303012

Polypropylene mesh augmentation for complete quadriceps rupture after total knee arthroplasty.

PubMed

Nodzo, Scott R; Rachala, Sridhar R

2016-01-01

Polypropylene mesh has previously been shown to be an effective treatment for failed patellar tendon repairs after total knee arthroplasty (TKA), but there have been few reports of this synthetic mesh used in complete quadriceps rupture after TKA. We retrospectively reviewed seven consecutive cases in six patients with complete quadriceps tears after TKA who had their quadriceps tendon repaired with suture and polypropylene mesh augmentation. All but two patients had previously failed primary suture repair. Patient outcomes were evaluated using the Knee Society Score. Standardized anterior-posterior (AP), lateral and merchant radiographs were evaluated preoperatively and at final follow-up. Seven knees in six patients were evaluated with a mean follow-up of 34±10 (range 24 to 49months) months. There were only four clinical successes defined as an extensor lag less than 30°. Of the functioning knees at final follow-up (n=5) the overall extensor lag in this group did significantly improve from 50±13° to 20±15° (range 5 to 40°) (p=.01). Mean postoperative flexion at final follow-up was 115±8°. Mean Knee Society Score for function improved from 20±30 to 45±54 (p=.03) as did the mean Knee Society Score for pain (44±18 vs. 74±78, p=.02). Polypropylene mesh offered limited postoperative functional results when used as an augment to the multiply operated knee that sustains a complete quadriceps rupture after TKA, but did allow for significant improvement in postoperative pain outcomes. IV. Copyright © 2015 Elsevier B.V. All rights reserved.

Alpha-actinin-3 (ACTN3) R577X polymorphism influences knee extensor peak power response to strength training in older men and women.

PubMed

Delmonico, Matthew J; Kostek, Matthew C; Doldo, Neil A; Hand, Brian D; Walsh, Sean; Conway, Joan M; Carignan, Craig R; Roth, Stephen M; Hurley, Ben F

2007-02-01

The alpha-actinin-3 (ACTN3) R577X polymorphism has been associated with muscle power performance in cross-sectional studies. We examined baseline knee extensor concentric peak power (PP) and PP change with approximately 10 weeks of unilateral knee extensor strength training (ST) using air-powered resistance machines in 71 older men (65 [standard deviation = 8] years) and 86 older women (64 [standard deviation = 9] years). At baseline in women, the XX genotype group had an absolute (same resistance) PP that was higher than the RR (p =.005) and RX genotype groups (p =.02). The women XX group also had a relative (70% of one-repetition maximum [1-RM]) PP that was higher than that in the RR (p =.002) and RX groups (p =.008). No differences in baseline absolute or relative PP were observed between ACTN3 genotype groups in men. In men, absolute PP change with ST in the RR (n = 16) group approached a significantly higher value than in the XX group (n = 9; p =.07). In women, relative PP change with ST in the RR group (n = 16) was higher than in the XX group (n = 17; p =.02). The results indicate that the ACTN3 R577X polymorphism influences the response of quadriceps muscle power to ST in older adults.

The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

PubMed Central

Aue Sobol, Nanna; Andersen, Lars L.; Kiel, Peter; Løfholm, Peter; Magnusson, S. Peter; Krogsgaard, Michael R.

2014-01-01

Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94%) of the noninjured leg, decreasing to 64% (95% CI 60–69%) 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P = 0.020). Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity. PMID:24877078

Stance controlled knee flexion improves stimulation driven walking after spinal cord injury

PubMed Central

2013-01-01

Background Functional neuromuscular stimulation (FNS) restores walking function after paralysis from spinal cord injury via electrical activation of muscles in a coordinated fashion. Combining FNS with a controllable orthosis to create a hybrid neuroprosthesis (HNP) has the potential to extend walking distance and time by mechanically locking the knee joint during stance to allow knee extensor muscle to rest with stimulation turned off. Recent efforts have focused on creating advanced HNPs which couple joint motion (e.g., hip and knee or knee and ankle) to improve joint coordination during swing phase while maintaining a stiff-leg during stance phase. Methods The goal of this study was to investigate the effects of incorporating stance controlled knee flexion during loading response and pre-swing phases on restored gait. Knee control in the HNP was achieved by a specially designed variable impedance knee mechanism (VIKM). One subject with a T7 level spinal cord injury was enrolled and served as his own control in examining two techniques to restore level over-ground walking: FNS-only (which retained a stiff knee during stance) and VIKM-HNP (which allowed controlled knee motion during stance). The stimulation pattern driving the walking motion remained the same for both techniques; the only difference was that knee extensor stimulation was constant during stance with FNS-only and modulated together with the VIKM to control knee motion during stance with VIKM-HNP. Results Stance phase knee angle was more natural during VIKM-HNP gait while knee hyperextension persisted during stiff-legged FNS-only walking. During loading response phase, vertical ground reaction force was less impulsive and instantaneous gait speed was increased with VIKM-HNP, suggesting that knee flexion assisted in weight transfer to the leading limb. Enhanced knee flexion during pre-swing phase also aided flexion during swing, especially when response to stimulation was compromised. Conclusions These results show the potential advantages of incorporating stance controlled knee flexion into a hybrid neuroprosthesis for walking. The addition of such control to FNS driven walking could also enable non-level walking tasks such as uneven terrain, slope navigation and stair descent where controlled knee flexion during weight bearing is critical. PMID:23826711

Reliability and validity of the Performance Recorder 1 for measuring isometric knee flexor and extensor strength.

PubMed

Neil, Sarah E; Myring, Alec; Peeters, Mon Jef; Pirie, Ian; Jacobs, Rachel; Hunt, Michael A; Garland, S Jayne; Campbell, Kristin L

2013-11-01

Muscular strength is a key parameter of rehabilitation programs and a strong predictor of functional capacity. Traditional methods to measure strength, such as manual muscle testing (MMT) and hand-held dynamometry (HHD), are limited by the strength and experience of the tester. The Performance Recorder 1 (PR1) is a strength assessment tool attached to resistance training equipment and may be a time- and cost-effective tool to measure strength in clinical practice that overcomes some limitations of MMT and HHD. However, reliability and validity of the PR1 have not been reported. Test-retest and inter-rater reliability was assessed using the PR1 in healthy adults (n  =  15) during isometric knee flexion and extension. Criterion-related validity was assessed through comparison of values obtained from the PR1 and Biodex® isokinetic dynamometer. Test-retest reliability was excellent for peak knee flexion (intra-class correlation coefficient [ICC] of 0.96, 95% CI: 0.85, 0.99) and knee extension (ICC  =  0.96, 95% CI: 0.87, 0.99). Inter-rater reliability was also excellent for peak knee flexion (ICC  =  0.95, 95% CI: 0.85, 0.99) and peak knee extension (ICC  =  0.97, 95% CI: 0.91, 0.99). Validity was moderate for peak knee flexion (ICC  =  0.75, 95% CI: 0.38, 0.92) but poor for peak knee extension (ICC  =  0.37, 95% CI: 0, 0.73). The PR1 provides a reliable measure of isometric knee flexor and extensor strength in healthy adults that could be used in the clinical setting, but absolute values may not be comparable to strength assessment by gold-standard measures.

THIGH MUSCLE CROSS-SECTIONAL AREAS AND STRENGTH IN KNEES WITH EARLY VS KNEES WITHOUT RADIOGRAPHIC KNEE OSTEOARTHRITIS: A BETWEEN-KNEE, WITHIN-PERSON COMPARISON

PubMed Central

Ruhdorfer, AS; Dannhauer, T; Wirth, W; Cotofana, S; Roemer, F; Nevitt, M; Eckstein, F

2014-01-01

Objective To compare cross-sectional and longitudinal side-differences in thigh muscle anatomical cross-sectional areas (ACSAs), muscle strength, and specific strength (strength/ACSA), between knees with early radiographic change vs. knees without radiographic knee osteoarthritis (RKOA), in the same person. Design 55 (of 4796) Osteoarthritis Initiative participants fulfilled the inclusion criteria of early RKOA in one limb (definite tibiofemoral osteophytes; no radiographic joint space narrowing [JSN]) vs. no RKOA (no osteophyte; no JSN) in the contralateral limb. ACSAs of the thigh muscles and quadriceps heads were determined using axial MRIs at 33%/30% femoral length (distal to proximal). Isometric extensor and flexor muscle strength were measured (Good Strength Chair). Baseline quadriceps ACSA and extensor (specific) strength represented the primary analytic focus, and two-year changes of quadriceps ACSAs the secondary focus. Results No statistically significant side-differences in quadriceps (or other thigh muscle) ACSAs, muscle strength, or specific strength were observed between early RKOA vs. contralateral limbs without RKOA (p≥0.44), neither in men nor in women. The two-year reduction in quadriceps ACSA in limbs with early RKOA was −0.9±6% (mean ± standard deviation) vs. −0.5±6% in limbs without RKOA (statistical difference p=0.85). Conclusion Our results do not provide evidence that early unilateral radiographic changes, i.e. presence of osteophytes, are associated with cross-sectional or longitudinal differences in quadriceps muscle status compared with contralateral knees without RKOA. At the stage of early unilateral RKOA there thus appears to be no clinical need for countervailing a potential dys-balance in quadriceps ACSAs and strength between both knees. PMID:25278072

Annual Progress Report, Fiscal Year 1981.

DTIC Science & Technology

1981-09-30

Ticlopidine Hydrochloride - A Clinical Trial in Patients with Transient Cerebral or Monocular Ischemic Attacks ............... 138 Work Unit No. 81/57...Hand Injuries .................................... 180 Work Unit No. 80/06 (FY8O,C) Evaluation of Antagonistic Knee Flexors and Extensors During Prone...Preventable Training Injury : Accepted for publication in Military Medicine(C). Smith WR, Lee SH, Vichick DA: Evaluation of Antagonistic Knee Flexors and

[Initial results with the Munich knee simulator].

PubMed

Frey, M; Riener, R; Burgkart, R; Pröll, T

2002-01-01

In orthopaedics more than 50 different clinical knee joint evaluation tests exist that have to be trained in orthopaedic education. Often it is not possible to obtain sufficient practical training in a clinical environment. The training can be improved by Virtual Reality technology. In the frame of the Munich Knee Joint Simulation project an artificial leg with anatomical properties is attached by a force-torque sensor to an industrial robot. The recorded forces and torques are the input for a simple biomechanical model of the human knee joint. The robot is controlled in such way that the user gets the feeling he moves a real leg. The leg is embedded in a realistic environment with a couch and a patient on it.

Muscular strength profile in Tunisian male national judo team

PubMed Central

Ghrairi, Mourad; Hammouda, Omar; Malliaropoulos, Nikos

2014-01-01

Summary Background: it is well established that muscle strength is a determinant factor in judo. However, little data are available for African athletes. Therefore, the aim of this study was to provide reference data of the muscular strength profile (MSP) for an African team, Tunisian judo team. Methods: the study was conducted among ten international judo athletes from Tunisia. To determine their MSP, we used an isokinetic dynamometer to assess Hamstrings, Quadriceps of both knees and external, internal rotators of both shoulders. The angular velocities of the assessments were; 90, 180, 240°/s for the knees and 60, 120°/s for the shoulders. Results: MSP was determined based on two parameters; the maximum peak torque (PT) of each muscle and the ratio agonistic/antagonistic muscles (R). The knee extensors and flexors in the “supporting leg” had higher PT than in the “attacking leg”; respectively, 245N.m versus 237 (p<0.05) and 147 N.m versus 145 (p>0.05). R was normal for both legs. Furthermore, both rotators of the dominant shoulder had higher PT; 84 N.m versus 71 for the internal rotators (p<0.05) and 34,7 N.m versus 29,0 for the lateral rotators (p<0.05). Inversely, R was higher in the non-dominant side; 45% versus 35, p<0.05). Conclusion: the MSP of the selected elites Tunisian judo athletes was characterized by 3 major features; a strength of the quadriceps in the standing leg significantly higher than in the attacking leg, a normal muscular balance Hamstrings/quadriceps in both legs and a strength of the shoulder’ rotators higher in the dominant side. PMID:25332926

Physical Examination of the Knee: Meniscus, Cartilage, and Patellofemoral Conditions.

PubMed

Bronstein, Robert D; Schaffer, Joseph C

2017-05-01

The knee is one of the most commonly injured joints in the body. Its superficial anatomy enables diagnosis of the injury through a thorough history and physical examination. Examination techniques for the knee described decades ago are still useful, as are more recently developed tests. Proper use of these techniques requires understanding of the anatomy and biomechanical principles of the knee as well as the pathophysiology of the injuries, including tears to the menisci and extensor mechanism, patellofemoral conditions, and osteochondritis dissecans. Nevertheless, the clinical validity and accuracy of the diagnostic tests vary. Advanced imaging studies may be useful adjuncts.

Volume and fat infiltration of spino-pelvic musculature in adults with spinal deformity

PubMed Central

Moal, Bertrand; Bronsard, Nicolas; Raya, José G; Vital, Jean Marc; Schwab, Frank; Skalli, Wafa; Lafage, Virginie

2015-01-01

AIM: To investigate fat infiltration and volume of spino-pelvic muscles in adults spinal deformity (ASD) with magnetic resonance imaging (MRI) and 3D reconstructions. METHODS: Nineteen female ASD patients (mean age 60 ± 13) were included prospectively and consecutively and had T1-weighted Turbo Spin Echo sequence MRIs with Dixon method from the proximal tibia up to T12 vertebra. The Dixon method permitted to evaluate the proportion of fat inside each muscle (fat-water ratio). In order to investigate the accuracy of the Dixon method for estimating fat vs water, the same MRI acquisition was performed on phantoms of four vials composed of different proportion of fat vs water. With Muscl’X software, 3D reconstructions of 17 muscles or group of muscles were obtained identifying the muscle’s contour on a limited number of axial images [Deformation of parametric specific objects (DPSO) Method]. Musclar volume (Vmuscle), infiltrated fat volume (Vfat) and percentage of fat infiltration [Pfat, calculated as follow: Pfat = 100 × (Vfat/Vmuscle)] were characterized by extensor or flexor function respectively for the spine, hip and knee and theirs relationship with demographic data were investigated. RESULTS: Phantom acquisition demonstrated a non linear relation between Dixon fat-water ratio and the real fat-water ratio. In order to correct the Dixon fat-water ratio, the non linear relation was approximated with a polynomial function of degree three using the phantom acquisition. On average, Pfat was 13.3% ± 5.3%. Muscles from the spinal extensor group had a Pfat significantly greater than the other muscles groups, and the largest variability (Pfat = 31.9% ± 13.8%, P < 0.001). Muscles from the hip extensor group ranked 2nd in terms of Pfat (14% ± 8%), and were significantly greater than those of the knee extensor (P = 0.030). Muscles from the knee extensor group demonstrated the least Pfat (12% ± 8%). They were also the only group with a significant correlation between Vmuscle and Pfat (r = -0.741, P < 0.001), however this correlation was lacking in the other groups. No correlation was found between the Vmuscle total and age or body mass index. Except for the spine flexors, Pfat was correlated with age. Vmuscle and Vfat distributions demonstrated that muscular degeneration impacted the spinal extensors most. CONCLUSION: Mechanisms of fat infiltration are not similar among the muscle groups. Degeneration impacted the spinal and hip extensors most, key muscles of the sagittal alignment. PMID:26495250

Torque and mechanomyogram relationships during electrically-evoked isometric quadriceps contractions in persons with spinal cord injury.

PubMed

Ibitoye, Morufu Olusola; Hamzaid, Nur Azah; Hasnan, Nazirah; Abdul Wahab, Ahmad Khairi; Islam, Md Anamul; Kean, Victor S P; Davis, Glen M

2016-08-01

The interaction between muscle contractions and joint loading produces torques necessary for movements during activities of daily living. However, during neuromuscular electrical stimulation (NMES)-evoked contractions in persons with spinal cord injury (SCI), a simple and reliable proxy of torque at the muscle level has been minimally investigated. Thus, the purpose of this study was to investigate the relationships between muscle mechanomyographic (MMG) characteristics and NMES-evoked isometric quadriceps torques in persons with motor complete SCI. Six SCI participants with lesion levels below C4 [(mean (SD) age, 39.2 (7.9) year; stature, 1.71 (0.05) m; and body mass, 69.3 (12.9) kg)] performed randomly ordered NMES-evoked isometric leg muscle contractions at 30°, 60° and 90° knee flexion angles on an isokinetic dynamometer. MMG signals were detected by an accelerometer-based vibromyographic sensor placed over the belly of rectus femoris muscle. The relationship between MMG root mean square (MMG-RMS) and NMES-evoked torque revealed a very high association (R(2)=0.91 at 30°; R(2)=0.98 at 60°; and R(2)=0.97 at 90° knee angles; P<0.001). MMG peak-to-peak (MMG-PTP) and stimulation intensity were less well related (R(2)=0.63 at 30°; R(2)=0.67 at 60°; and R(2)=0.45 at 90° knee angles), although were still significantly associated (P≤0.006). Test-retest interclass correlation coefficients (ICC) for the dependent variables ranged from 0.82 to 0.97 for NMES-evoked torque, between 0.65 and 0.79 for MMG-RMS, and from 0.67 to 0.73 for MMG-PTP. Their standard error of measurements (SEM) ranged between 10.1% and 31.6% (of mean values) for torque, MMG-RMS and MMG-PTP. The MMG peak frequency (MMG-PF) of 30Hz approximated the stimulation frequency, indicating NMES-evoked motor unit firing rate. The results demonstrated knee angle differences in the MMG-RMS versus NMES-isometric torque relationship, but a similar torque related pattern for MMG-PF. These findings suggested that MMG was well associated with torque production, reliably tracking the motor unit recruitment pattern during NMES-evoked muscle contractions. The strong positive relationship between MMG signal and NMES-evoked torque production suggested that the MMG might be deployed as a direct proxy for muscle torque or fatigue measurement during leg exercise and functional movements in the SCI population. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Myofibrillar and collagen protein synthesis in human skeletal muscle in young men after maximal shortening and lengthening contractions.

PubMed

Moore, Daniel R; Phillips, Stuart M; Babraj, John A; Smith, Kenneth; Rennie, Michael J

2005-06-01

We aimed to determine whether there were differences in the extent and time course of skeletal muscle myofibrillar protein synthesis (MPS) and muscle collagen protein synthesis (CPS) in human skeletal muscle in an 8.5-h period after bouts of maximal muscle shortening (SC; average peak torque = 225 +/- 7 N.m, means +/- SE) or lengthening contractions (LC; average peak torque = 299 +/- 18 N.m) with equivalent work performed in each mode. Eight healthy young men (21.9 +/- 0.6 yr, body mass index 24.9 +/- 1.3 kg/m2) performed 6 sets of 10 maximal unilateral LC of the knee extensors on an isokinetic dynamometer. With the contralateral leg, they then performed 6 sets of maximal unilateral SC with work matched to the total work performed during LC (10.9 +/- 0.7 vs. 10.9 +/- 0.8 kJ, P = 0.83). After exercise, the participants consumed small intermittent meals to provide 0.1 g.kg(-1).h(-1) of protein and carbohydrate. Prior exercise elevated MPS above rest in both conditions, but there was a more rapid rise after LC (P < 0.01). The increases (P < 0.001) in CPS above rest were identical for both SC and LC and likely represent a remodeling of the myofibrillar basement membrane. Therefore, a more rapid rise in MPS after maximal LC could translate into greater protein accretion and muscle hypertrophy during chronic resistance training utilizing maximal LC.

Relationship between muscle mass and physical performance: is it the same in older adults with weak muscle strength?

PubMed

Kim, Kyoung-Eun; Jang, Soong-Nang; Lim, Soo; Park, Young Joo; Paik, Nam-Jong; Kim, Ki Woong; Jang, Hak Chul; Lim, Jae-Young

2012-11-01

the relationship between muscle mass and physical performance has not been consistent among studies. to clarify the relationship between muscle mass and physical performance in older adults with weak muscle strength. cross-sectional analysis using the baseline data of 542 older men and women from the Korean Longitudinal Study on Health and Aging. dual X-ray absorptiometry, isokinetic dynamometer and the Short Physical Performance Battery (SPPB) were performed. Two muscle mass parameters, appendicular skeletal mass divided by weight (ASM/Wt) and by height squared (ASM/Ht(2)), were measured. We divided the participants into a lower-quartile (L25) group and an upper-three-quartiles (H75) group based on the knee-extensor peak torque. Correlation analysis and logistic regression models were used to assess the association between muscle mass and low physical performance, defined as SPPB scores <9, after controlling for confounders. in the L25 group, no correlation between mass and SPPB was detected, whereas the correlation between peak torque and SPPB was significant and higher than that in the H75 group. Results from the logistic models also showed no association between muscle mass and SPPB in the L25 group, whereas muscle mass was associated with SPPB in the H75 group. muscle mass was not associated with physical performance in weak older adults. Measures of muscle strength may be of greater clinical importance in weak older adults than is muscle mass per se.

Definition and evaluation of testing scenarios for knee wear simulation under conditions of highly demanding daily activities.

PubMed

Schwiesau, Jens; Schilling, Carolin; Kaddick, Christian; Utzschneider, Sandra; Jansson, Volkmar; Fritz, Bernhard; Blömer, Wilhelm; Grupp, Thomas M

2013-05-01

The objective of our study was the definition of testing scenarios for knee wear simulation under various highly demanding daily activities of patients after total knee arthroplasty. This was mainly based on a review of published data on knee kinematics and kinetics followed by the evaluation of the accuracy and precision of a new experimental setup. We combined tibio-femoral load and kinematic data reported in the literature to develop deep squatting loading profiles for simulator input. A servo-hydraulic knee wear simulator was customised with a capability of a maximum flexion of 120°, a tibio-femoral load of 5000N, an anterior-posterior (AP) shear force of ±1000N and an internal-external (IE) rotational torque of ±50Nm to simulate highly demanding patient activities. During the evaluation of the newly configurated simulator the ability of the test machine to apply the required load and torque profiles and the flexion kinematics in a precise manner was examined by nominal-actual profile comparisons monitored periodically during subsequent knee wear simulation. For the flexion kinematics under displacement control a delayed actuator response of approximately 0.05s was inevitable due to the inertia of masses in movement of the coupled knee wear stations 1-3 during all applied activities. The axial load and IE torque is applied in an effective manner without substantial deviations between nominal and actual load and torque profiles. During the first third of the motion cycle a marked deviation between nominal and actual AP shear load profiles has to be noticed but without any expected measurable effect on the latter wear simulation due to the fact that the load values are well within the peak magnitude of the nominal load amplitude. In conclusion the described testing method will be an important tool to have more realistic knee wear simulations based on load conditions of the knee joint during activities of daily living. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Assessment of the in-season changes in mechanical and neuromuscular characteristics in professional soccer players.

PubMed

García-García, Oscar; Serrano-Gómez, Virginia; Hernández-Mendo, Antonio; Tapia-Flores, Antonio

2016-06-01

The aim of this study was to monitor in-season changes in the mechanical and neuromuscular characteristics of knee extensor and flexor muscles in professional soccer players. Twenty-one professional soccer players (soccer group, or SG) and sixteen non-soccer playing males (non-soccer group, or NSG) were assessed by tensiomyography on two occasions: just after the start of the competitive season and 10 weeks later. During this time the soccer players' training sessions were built mainly on speed and strength drills. Mixed-design factorial analysis of variance was conducted and effect sizes were calculated. There was a significant interaction between time (assessment points) x group (SG vs. NSG) x muscle for contraction time (Tc), maximum radial muscle displacement (Dm), and delay time (Td). In the case of the knee extensors, after 10 weeks, there was a 17.7%-22.7% decrease in Tc, an 8.7%-9.9% decrease in Td, and a 12.2%-14.2% decrease in Dm knee extensor in the SG (P<0.01), with a large effect size. In the case of the knee flexors, by contrast, there was an 11.9% increase in Td and a 24.5% increase in Dm (P<0.01), with a moderate to large effect size. The findings confirm that mechanical and neuromuscular characteristics change over time and also vary according to the characteristics of the athlete (SG vs. NSG) and the muscle analyzed. In conclusion, soccer coaches could use Tc, Td, and Dm data to individualize work load and intensity and control the effects of neuromuscular training throughout the season using a portable, non-invasive technique that, unlike stress tests, does not cause fatigue and therefore does not interfere with training periodization.

Core strength and lower extremity alignment during single leg squats.

PubMed

Willson, John D; Ireland, Mary Lloyd; Davis, Irene

2006-05-01

Muscles of the trunk, hip, and knee influence the orientation of the lower extremity during weight bearing activities. The purpose of this study was threefold: first, to compare the orientation of the lower extremity during a single leg (SL) squat among male and female athletes; second, to compare the strength of muscle groups in the trunk, hips, and knees between these individuals; and third, to evaluate the association between trunk, hip, and knee strength and the orientation of the knee joint during this activity. Twenty-four male and 22 female athletes participated in this study. Peak isometric torque was determined for the following muscle actions: trunk flexion, extension, and lateral flexion, hip abduction and external rotation, and knee flexion and extension. The frontal plane projection angle (FPPA) of the knee during a 45 degrees SL squat was determined using photo editing software. Males and females moved in opposite directions during the SL squat test (F(1,42) = 5.05, P = 0.03). Females typically moved toward more extreme FPPA during SL squats (P = 0.056), while males tended to move toward more neutral alignment (P = 0.066). Females also generated less torque in all muscle groups, with the exception of trunk extension. The projection angle of the knee during the SL squat test was most closely associated with hip external rotation strength. Using instruments suitable for a clinical setting, females were found to have greater FPPA and generally decreased trunk, hip, and knee isometric torque. Hip external rotation strength was most closely associated with the frontal plane projection angle.

Balance and Muscle Strength in Elderly Women Who Dance Samba

PubMed Central

Serra, Marcos Maurício; Alonso, Angelica Castilho; Peterson, Mark; Mochizuki, Luis; Greve, Júlia Maria D'Andréa; Garcez-Leme, Luiz Eugênio

2016-01-01

Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group—elderly participants of the carnival parades in the “Wing of Baianas”, and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength. PMID:27906984

Balance and Muscle Strength in Elderly Women Who Dance Samba.

PubMed

Serra, Marcos Maurício; Alonso, Angelica Castilho; Peterson, Mark; Mochizuki, Luis; Greve, Júlia Maria D'Andréa; Garcez-Leme, Luiz Eugênio

2016-01-01

Considering the growth of the aging population, and the increasing risk for falls and related morbidity, it is vital to seek efficient, comprehensive, and culturally relevant prevention programs for elderly people to reduce risks for falls. The aim of the present study was to evaluate the postural balance and muscle strength among women participating in the "Wing of Baianas" in the carnival parades. One hundred and ten women, with an average age of 67.4±5.9 years, were divided into two groups: Baianas group-elderly participants of the carnival parades in the "Wing of Baianas", and a Control group of women who do not dance samba. Assessments included a physical activity questionnaire, isokinetic muscle strength testing for the knee extensors and flexors, and a postural balance assessment completed on a force platform. There were no differences between groups, for postural balance outcomes, during the eyes open condition; however, with eyes closed, there was a significant effect between groups (Baianas vs Control) in all variables. The Baianas group showed less medio-lateral displacement (p < 0.04); and anteroposterior displacement (p < 0.007); larger amplitudes of medio-lateral displacement (p < 0.001); and anteroposterior displacement (p < 0.001); increased mean velocity (p < 0.01); and elliptical area (p < 0.01) There were no differences in the isokinetic peak torque corrected by body weight, total work and flexor/extensor ratio. Participation in the Wing of Baianas is associated with better balance with closed eyes, but there were no differences between dancers and non-dancers for muscle strength.

Estimations of One Repetition Maximum and Isometric Peak Torque in Knee Extension Based on the Relationship Between Force and Velocity.

PubMed

Sugiura, Yoshito; Hatanaka, Yasuhiko; Arai, Tomoaki; Sakurai, Hiroaki; Kanada, Yoshikiyo

2016-04-01

We aimed to investigate whether a linear regression formula based on the relationship between joint torque and angular velocity measured using a high-speed video camera and image measurement software is effective for estimating 1 repetition maximum (1RM) and isometric peak torque in knee extension. Subjects comprised 20 healthy men (mean ± SD; age, 27.4 ± 4.9 years; height, 170.3 ± 4.4 cm; and body weight, 66.1 ± 10.9 kg). The exercise load ranged from 40% to 150% 1RM. Peak angular velocity (PAV) and peak torque were used to estimate 1RM and isometric peak torque. To elucidate the relationship between force and velocity in knee extension, the relationship between the relative proportion of 1RM (% 1RM) and PAV was examined using simple regression analysis. The concordance rate between the estimated value and actual measurement of 1RM and isometric peak torque was examined using intraclass correlation coefficients (ICCs). Reliability of the regression line of PAV and % 1RM was 0.95. The concordance rate between the actual measurement and estimated value of 1RM resulted in an ICC(2,1) of 0.93 and that of isometric peak torque had an ICC(2,1) of 0.87 and 0.86 for 6 and 3 levels of load, respectively. Our method for estimating 1RM was effective for decreasing the measurement time and reducing patients' burden. Additionally, isometric peak torque can be estimated using 3 levels of load, as we obtained the same results as those reported previously. We plan to expand the range of subjects and examine the generalizability of our results.

EFFECT OF AXIAL TIBIAL TORQUE DIRECTION ON ACL RELATIVE STRAIN AND STRAIN RATE IN AN IN VITRO SIMULATED PIVOT LANDING

PubMed Central

Oh, Youkeun K.; Kreinbrink, Jennifer L.; Wojtys, Edward M.; Ashton-Miller, James A.

2011-01-01

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment and internal or external tibial torque) was applied to the distal tibia while recording the 3-D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3mm DVRT. In this repeated measures experiment, the Wilcoxon Signed-Rank test was used to test the null hypotheses with p<0.05 considered significant. The mean (± SD) peak AM-ACL relative strains were 5.4±3.7 % and 3.1±2.8 % under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4±160.1 %/sec and 179.4±109.9 %/sec, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70% and 42% greater under internal than external tibial torque, respectively (p=0.023, p=0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. PMID:22025178

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction.

PubMed

Orishimo, Karl F; Kremenic, Ian J; Mullaney, Michael J; McHugh, Malachy P; Nicholas, Stephen J

2010-11-01

When a patient performs a clinically normal hop test based on distance, it cannot be assumed that the biomechanics are similar between limbs. The objective was to compare takeoff and landing biomechanics between legs in patients who have undergone anterior cruciate ligament reconstruction. Kinematics and ground reaction forces were recorded as 13 patients performed the single-leg hop on each leg. Distance hopped, joint range of motion, peak joint kinetics and the peak total extensor moment were compared between legs during both takeoff and landing. Average hop distance ratio (involved/noninvolved) was 93 ± 4%. Compared to the noninvolved side, knee motion during takeoff on the involved side was significantly reduced (P = 0.008). Peak moments and powers on the involved side were lower at the knee and higher at the ankle and hip compared with the noninvolved side (Side by Joint P = 0.011; P = 0.003, respectively). The peak total extensor moment was not different between legs (P = 0.305) despite a decrease in knee moment and increases in ankle and hip moments (Side by Joint P = 0.015). During landing, knee motion was reduced (P = 0.043), and peak power absorbed was decreased at the knee and hip and increased at the ankle on the involved side compared to the noninvolved side (P = 0.003). The compensations by other joints may indicate protective adaptations to avoid overloading the reconstructed knee.

The effect of a knee ankle foot orthosis incorporating an active knee mechanism on gait of a person with poliomyelitis.

PubMed

Arazpour, Mokhtar; Chitsazan, Ahmad; Bani, Monireh Ahmadi; Rouhi, Gholamreza; Ghomshe, Farhad Tabatabai; Hutchins, Stephen W

2013-10-01

The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase. Lower limb kinematic and kinetic data plus data for temporospatial parameters were acquired from three test walks using each orthosis. Walking speed, step length, and vertical and horizontal displacement of the pelvis decreased when walking with the powered stance control knee ankle foot orthosis compared to the knee ankle foot orthosis. When using the powered stance control knee ankle foot orthosis, the knee flexion achieved during swing and also the overall pattern of walking more closely matched that of normal human walking. The reduced walking speed may have caused the smaller compensatory motions detected when the powered stance control knee ankle foot orthosis was used. The new powered SCKAFO facilitated controlled knee flexion and extension during ambulation for a volunteer poliomyelitis person.

Investigation of the Effects of High-Intensity, Intermittent Exercise and Unanticipation on Trunk and Lower Limb Biomechanics During a Side-Cutting Maneuver Using Statistical Parametric Mapping.

PubMed

Whyte, Enda F; Richter, Chris; OʼConnor, Siobhan; Moran, Kieran A

2018-06-01

Whyte, EF, Richter, C, O'Connor, S, and Moran, KA. Investigation of the effects of high-intensity, intermittent exercise and unanticipation on trunk and lower limb biomechanics during a side-cutting maneuver using statistical parametric mapping. J Strength Cond Res 32(6): 1583-1593, 2018-Anterior cruciate ligament (ACL) injuries frequently occur during side-cutting maneuvers when fatigued or reacting to the sporting environment. Trunk and hip biomechanics are proposed to influence ACL loading during these activities. However, the effects of fatigue and unanticipation on the biomechanics of the kinetic chain may be limited by traditional discrete point analysis. We recruited 28 male, varsity, Gaelic footballers (21.7 ± 2.2 years; 178.7 ± 14.6 m; 81.8 ± 11.4 kg) to perform anticipated and unanticipated side-cutting maneuvers before and after a high-intensity, intermittent exercise protocol (HIIP). Statistical parametric mapping (repeated-measures analysis of varience) identified differences in phases of trunk and stance leg biomechanics during weight acceptance. Unanticipation resulted in less trunk flexion (p < 0.001) and greater side flexion away from the direction of cut (p < 0.001). This led to smaller (internal) knee flexor and greater (internal) knee extensor (p = 0.002-0.007), hip adductor (p = 0.005), and hip external rotator (p = 0.007) moments. The HIIP resulted in increased trunk flexion (p < 0.001) and side flexion away from the direction of cut (p = 0.038), resulting in smaller (internal) knee extensor moments (p = 0.006). One interaction effect was noted demonstrating greater hip extensor moments in the unanticipated condition post-HIIP (p = 0.025). Results demonstrate that unanticipation resulted in trunk kinematics considered an ACL injury risk factor. A subsequent increase in frontal and transverse plane hip loading and sagittal plane knee loading was observed, which may increase ACL strain. Conversely, HIIP-induced trunk kinematic alterations resulted in reduced sagittal plane knee and subsequent ACL loading. Therefore, adequate hip and knee control is important during unanticipated side-cutting maneuvers.

History-dependent force, angular velocity and muscular endurance in ACTN3 genotypes.

PubMed

Broos, Siacia; Van Leemputte, Marc; Deldicque, Louise; Thomis, Martine A

2015-08-01

This study aimed at determining the influence of the ACTN3 R577X polymorphism on muscle strength and muscle endurance in non-athletic young men. 266 healthy young men were included in this study. Each subject performed maximal isometric, concentric and eccentric contractions of the knee extensor muscles on an isokinetic dynamometer. Force depression, force enhancement and the fatigue index were derived from these data. In addition, handgrip strength, squat jump (SJ) and counter movement jump (CMJ) height were obtained. Our group included 83 RR (31 %), 131 RX (49 %) and 52 XX (20 %) individuals. The muscle bone cross-sectional area of the thigh was 5 % higher in RR compared to XX individuals (P = 0.033). RR genotypes showed 6 % higher handgrip strength compared to the XX group (P = 0.047). They also jumped 5 % higher in both the SJ and CMJ tests (P = 0.029; P = 0.031). No differences were found in force depression, force enhancement, isometric or eccentric strength. The relative concentric knee torque at 200°/s and at 300°/s was 7 and 8 % higher in RR compared to XX genotypes, respectively (P = 0.049; P = 0.048). Also, the fatigue index was found to be 4 % lower in XX genotypes (P = 0.037). Our findings are in agreement with the higher prevalence of the RR genotype in power-oriented activities. The better fatigue index of XX genotypes may be beneficial in endurance-type activities.

Squatting Exercises in Older Adults: Kinematic and Kinetic Comparisons

PubMed Central

FLANAGAN, SEAN; SALEM, GEORGE J.; WANG, MAN-YING; SANKER, SERENA E.; GREENDALE, GAIL A.

2012-01-01

Purpose Squatting activities may be used, within exercise programs, to preserve physical function in older adults. This study characterized the lower-extremity peak joint angles, peak moments, powers, work, impulse, and muscle recruitment patterns (electromyographic; EMG) associated with two types of squatting activities in elders. Methods Twenty-two healthy, older adults (ages 70–85) performed three trials each of: 1) a squat to a self-selected depth (normal squat; SQ) and 2) a squat onto a chair with a standardized height of 43.8 cm (chair squat; CSQ). Descending and ascending phase joint kinematics and kinetics were obtained using a motion analysis system and inverse dynamics techniques. Results were averaged across the three trials. A 2 × 2 (activity × phase) ANOVA with repeated measures was used to examine the biomechanical differences among the two activities and phases. EMG temporal characteristics were qualitatively examined. Results CSQ generated greater hip flexion angles, peak moments, power, and work, whereas SQ generated greater knee and ankle flexion angles, peak moments, power, and work. SQ generated a greater knee extensor impulse, a greater plantar flexor impulse and a greater total support impulse. The EMG temporal patterns were consistent with the kinetic data. Conclusions The results suggest that, with older adults, CSQ places greater demand on the hip extensors, whereas SQ places greater demand on the knee extensors and ankle plantar flexors. Clinicians may use these discriminate findings to more effectively target specific lower-extremity muscle groups when prescribing exercise for older adults. PMID:12673148

Effects of Wearing a Compression Garment During Night Sleep on Recovery From High-Intensity Eccentric-Concentric Quadriceps Muscle Fatigue.

PubMed

Shimokochi, Yohei; Kuwano, Satoshi; Yamaguchi, Taichi; Abutani, Hiroyuki; Shima, Norihiro

2017-10-01

This study aimed to investigate the effects of wearing a compression garment (CG) during night sleep on muscle fatigue recovery after high-intensity eccentric and concentric knee extensor exercises. Seventeen male college students participated in 2 experimental sessions under CG and non-CG (NCG) wearing conditions. Before night sleep under CG or NCG wearing conditions, the subjects performed a fatiguing protocol consisting of 10 sets of 10 repetitions of maximal isokinetic eccentric and concentric knee extensor contractions, with 30-second rest intervals between the sets. Immediately before and after and 24 hours after the fatiguing protocol, maximum voluntary isometric contraction (MVIC) force for knee extensor muscles was measured; surface electromyographic data from the vastus medialis and rectus femoris were also measured. A 2-way repeated-measure analysis of variance followed by Bonferroni pairwise comparisons were used to analyze the differences in each variable. Paired-sample t-tests were used to analyze the mean differences between the conditions at the same time points for each variable. The MVIC 24 hours after the fatiguing protocol was approximately 10% greater in the CG than in the NCG condition (p = 0.033). Changes in the electromyographic variables over time did not significantly differ between the conditions. Thus, it was concluded that wearing a CG during night sleep may promote localized muscle fatigue recovery but does not influence neurological factors after the fatiguing exercise.

Measurement of the end-to-end distances between the femoral and tibial insertion sites of the anterior cruciate ligament during knee flexion and with rotational torque.

PubMed

Wang, Joon Ho; Kato, Yuki; Ingham, Sheila J M; Maeyama, Akira; Linde-Rosen, Monica; Smolinski, Patrick; Fu, Freddie H

2012-10-01

The aim of this study was to determine the end-to-end distance changes in anterior cruciate ligament (ACL) fibers during flexion/extension and internal/external rotation of the knee. The positional relation between the femur and tibia of 10 knees was digitized on a robotic system during flexion/extension and with an internal/external rotational torque (5 Nm). The ACL insertion site data, acquired by 3-dimensional scanning, were superimposed on the positional data. The end-to-end distances of 5 representative points on the femoral and tibial insertion sites of the ACL were calculated. The end-to-end distances of all representative points except the most anterior points were longest at full extension and shortest at 90°. The distances of the anteromedial (AM) and posterolateral (PL) bundles were 37.2 ± 2.1 mm and 27.5 ± 2.8 mm, respectively, at full extension and 34.7 ± 2.4 mm and 20.7 ± 2.3 mm, respectively, at 90°. Only 4 knees had an isometric point, which was 1 of the 3 anterior points. Under an internal torque, both bundles became longer with statistical meaning at all flexion angles (P = .005). The end-to-end distances of all points became longest with internal torque at full extension and shortest with an external torque at 90°. Only 4 of 10 specimens had an isometric point at a variable anterior point. The end-to-end distances of the AM and PL bundles were longer in extension and shorter in flexion. The nonisometric tendency of the ACL and the end-to-end distance change during knee flexion/extension and internal/external rotation should be considered during ACL reconstruction to avoid overconstraint of the graft. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The influence of athletic status on maximal and rapid isometric torque characteristics and postural balance performance in Division I female soccer athletes and non-athlete controls.

PubMed

Palmer, Ty B; Hawkey, Matt J; Thiele, Ryan M; Conchola, Eric C; Adams, Bailey M; Akehi, Kazuma; Smith, Doug B; Thompson, Brennan J

2015-07-01

The purpose of this study was to examine the effectiveness of maximal and rapid isometric torque characteristics of the hip extensor muscles and postural balance performance to discriminate between female collegiate soccer athletes and non-athlete controls. Ten athletes (mean ± SE: age = 19·20 ± 0·36 year; mass = 62·23 ± 3·12 kg; height = 162·43 ± 1·70 cm) and 10 non-athletes (age = 20·30 ± 0·40 year; mass = 69·64 ± 3·20 kg; height = 163·22 ± 2·10 cm) performed two isometric maximal voluntary contractions (MVCs) of the hip extensor muscles. Peak torque (PT) and absolute and relative rate of torque development (RTD) at early (0-50 ms) and late (100-200 ms) phases of muscle contraction were examined during each MVC. Postural balance was assessed using a commercially designed balance testing device, which provides a measurement of static stability based on sway index (SI). Results indicated that absolute and relative RTD at 0-50 ms (RTD50 and RTD50norm) were greater (P = 0·007 and 0·026), and postural SI was lower (P = 0·022) in the athletes compared with the non-athletes. However, no differences (P = 0·375-0·709) were observed for PT nor absolute and relative RTD at 100-200 ms (RTD100-200 and RTD100-200norm). Significant relationships were also observed between RTD50 and RTD50norm and SI (r = -0·559 and -0·521; P = 0·010 and 0·019). These findings suggest that early rapid torque characteristics of the hip extensor muscles and postural balance performance may be sensitive and effective measures for discriminating between college-aged athletes and non-athletes. Coaches and practitioners may use these findings as performance evaluation tools to help in identifying athletes with both superior early rapid torque and balance performance abilities, which may possibly be an indicator of overall athletic potential. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

A wearable robotic orthosis with a spring-assist actuator.

PubMed

Seungmin Jung; Chankyu Kim; Jisu Park; Dongyoub Yu; Jaehwan Park; Junho Choi

2016-08-01

This paper introduces a wearable robotic orthosis with spring-assist actuators, which is designed to assist people who have difficulty in walking. The spring-assist actuator consists of an electrical motor and a spring, which are attached to a rotational axis in parallel to each other. The spring-assist actuator is developed based on the analysis on the stiffness of the knee and hip joints during walking. "COWALK-Mobile," which is a wearable robotic orthosis, is developed using the spring-assist actuators to reduce the required motor torque during walking. The COWALK-Mobile has active hip and knee joints and passive ankle joints to provide assistive torque to the wearer. The required joint torque is generated by the spring as well as the electrical motor, which results in a decrease of maximum required torque for the motor. In order to evaluate the performance of the spring-assist actuator, experiments are carried out. The experiments show that the spring-assist actuators reduced the required motor torque during walking.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments.

PubMed

Pasternak, Braulio; Sousa Neto, Manoel Damião de; Dionísio, Valdeci Carlos; Pécora, Jesus Djalma; Silva, Ricardo Gariba

2012-02-01

This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

PubMed Central

PASTERNAK-JÚNIOR, Braulio; de SOUSA NETO, Manoel Damião; DIONÍSIO, Valdeci Carlos; PÉCORA, Jesus Djalma; SILVA, Ricardo Gariba

2012-01-01

Objective This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques. PMID:22437679

Knee and Ankle Joint Angles Influence the Plantarflexion Torque of the Gastrocnemius.

PubMed

Landin, Dennis; Thompson, Melissa; Reid, Meghan

2015-08-01

The gastrocnemius (GA) is the lone bi-articular muscle of the leg, crossing both the knee and ankle. As with any bi-articular muscle, both joints affect its length/tension curve. The role of the GA as a plantarflexor is firmly established; however, no current research has investigated how changes in knee and ankle joint positions on its ability to generate a plantarflexion (PF) torque. This paper reports on the PF force generated by the GA at specific knee and ankle joint combinations. The right GA of 26 participants was electrically stimulated via surface electrodes following a standardized protocol at 24 knee and ankle joint combinations. Three stimulations were applied at each of the 24 positions. Data were recorded on three dependent measures: the passive moment, which was the PF moment created by the tissue without stimulation, the maximum moment, which was the highest PF moment during the stimulation and included the passive moment, and the stimulated moment, which reflected the PF moment during stimulation minus the passive moment. A straight knee and dorsiflexed ankle create the position in which the GA generates the greatest PF moment, but it is also the position of greatest length. This finding is in contrast to conclusions from previous research with bi-articular muscles, which has consistently shown that the greatest length is not a muscle's optimal length. The full ranges of motion for the knee and ankle apparently do not elongate the GA beyond its optimal length for producing a PF moment. Clinicians commonly evaluate GA status with the patient seated and the foot subject to gravity. The present results indicate that manual testing of the GA in isolation should be performed, whenever possible, with the knee extended and the ankle dorsiflexed to potentially elicit the maximum PF torque from the GA.

Analysis of lower limb work-energy patterns in world-class race walkers.

PubMed

Hanley, Brian; Bissas, Athanassios

2017-05-01

The aim of this study was to analyse lower limb work patterns in world-class race walkers. Seventeen male and female athletes race walked at competitive pace. Ground reaction forces (1000 Hz) and high-speed videos (100 Hz) were recorded and normalised joint moments, work and power, stride length, stride frequency and speed estimated. The hip flexors and extensors were the main generators of energy (24.5 J (±6.9) and 40.3 J (±8.3), respectively), with the ankle plantarflexors (16.3 J (±4.3)) contributing to the energy generated during late stance. The knee generated little energy but performed considerable negative work during swing (-49.1 J (±8.7)); the energy absorbed by the knee extensors was associated with smaller changes in velocity during stance (r = .783, P < .001), as was the energy generated by the hip flexors (r = -.689, P = .002). The knee flexors did most negative work (-38.6 J (±5.8)) and the frequent injuries to the hamstrings are probably due to this considerable negative work. Coaches should note the important contributions of the hip and ankle muscles to energy generation and the need to develop knee flexor strength in reducing the risk of injury.

Fatigue affects peak joint torque angle in hamstrings but not in quadriceps.

PubMed

Coratella, Giuseppe; Bellin, Giuseppe; Beato, Marco; Schena, Federico

2015-01-01

Primary aim of this study was to investigate peak joint torque angle (i.e. the angle of peak torque) changes recorded during an isokinetic test before and after a fatiguing soccer match simulation. Secondarily we want to investigate functional Hecc:Qconc and conventional Hconc:Qconc ratio changes due to fatigue. Before and after a standardised soccer match simulation, twenty-two healthy male amateur soccer players performed maximal isokinetic strength tests both for hamstrings and for quadriceps muscles at 1.05 rad · s(‒1), 3.14 rad · s(‒1) and 5.24 rad · s(‒1). Peak joint torque angle, peak torque and both functional Hecc:Qconc and conventional Hconc:Qconc ratios were examined. Both dominant and non-dominant limbs were tested. Peak joint torque angle significantly increased only in knee flexors. Both eccentric and concentric contractions resulted in such increment, which occurred in both limbs. No changes were found in quadriceps peak joint torque angle. Participants experienced a significant decrease in torque both in hamstrings and in quadriceps. Functional Hecc:Qconc ratio was lower only in dominant limb at higher velocities, while Hconc:Qconc did not change. This study showed after specific fatiguing task changes in hamstrings only torque/angle relationship. Hamstrings injury risk could depend on altered torque when knee is close to extension, coupled with a greater peak torque decrement compared to quadriceps. These results suggest the use eccentric based training to prevent hamstrings shift towards shorter length.

[Patella fractures in knee arthroplasty].

PubMed

Roth, A; Ghanem, M; Fakler, J

2016-05-01

Periprosthetic patella fractures occur both with and without retropatellar joint replacement. A non-operative treatment yields satisfactory results with low morbidity. It can be applied in minimally displaced fractures that have an intact retropatellar component and an intact extensor mechanism, combined with an initial immobilization. The surgical treatment is associated with relatively poor results and with high complication rates. There was only minor improvement of functional results, no matter which surgical technique was used. Surgical intervention is still required in fractures with a loosening of the patellar component, considerable dislocations of fragments, and damage to or rupture of the extensor mechanism. In particular, type II fractures require repair of the extensor mechanism and the fracture or patellectomy. Type III fractures require a revision or resection of the patella, a patelloplasty or total patellectomy. In addition, early or late reconstruction using allograft to restore the extensor mechanism can be taken in consideration.

Gait and balance of transfemoral amputees using passive mechanical and microprocessor-controlled prosthetic knees.

PubMed

Kaufman, K R; Levine, J A; Brey, R H; Iverson, B K; McCrady, S K; Padgett, D J; Joyner, M J

2007-10-01

Microprocessor-controlled knee joints appeared on the market a decade ago. These joints are more sophisticated and more expensive than mechanical ones. The literature is contradictory regarding changes in gait and balance when using these sophisticated devices. This study employed a crossover design to assess the comparative performance of a passive mechanical knee prosthesis compared to a microprocessor-controlled knee joint in 15 subjects with an above-knee amputation. Objective measurements of gait and balance were obtained. Subjects demonstrated significantly improved gait characteristics after receiving the microprocessor-controlled prosthetic knee joint (p<0.01). Improvements in gait were a transition from a hyperextended knee to a flexed knee during loading response which resulted in a change from an internal knee flexor moment to a knee extensor moment. The participants' balance also improved (p<0.01). All conditions of the Sensory Organization Test (SOT) demonstrated improvements in equilibrium score. The composite score also increased. Transfemoral amputees using a microprocessor-controlled knee have significant improvements in gait and balance.

Relationship between isometric thigh muscle strength and minimum clinically important differences in knee function in osteoarthritis: data from the osteoarthritis initiative.

PubMed

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2015-04-01

To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower leg function. Isometric knee extensor and flexor strength of 4,553 Osteoarthritis Initiative participants (2,651 women and 1,902 men) was related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scores by linear regression. Further, groups of male and female participant strata with minimum clinically important differences (MCIDs) in WOMAC function scores (6 of 68 units) were compared across the full range of observed values and to participants without functional deficits (WOMAC score 0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Per regression equations, a 3.7% reduction in extensor strength and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and, respectively, a 3.6% and 4.8% reduction in men. For strength divided by body weight, reductions were 5.2% and 6.7%, respectively, in women and 5.8% and 6.7%, respectively, in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest nonlinear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Reductions of approximately 4% in isometric muscle strength and of 6% in strength per body weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower leg function. Copyright © 2015 by the American College of Rheumatology.

Joint Moment-Angle Properties of the Hip Extensors in Subjects With and Without Patellofemoral Pain.

PubMed

Kindel, Curtis; Challis, John

2018-04-01

Strength deficits of hip extension in individuals with patellofemoral syndrome are commonly reported in literature. No literature to date has examined these deficits with variable positions of the knee and hip; altering knee angle alters the length and therefore potentially the force produced by the biarticular muscles. Beyond strength, neuromuscular control can also be assessed through the analysis of isometric joint moment steadiness. Subjects consisted of a group of individuals with patellofemoral syndrome (n = 9), and a group of age- and size-matched controls with no symptoms (n = 9). Maximum isometric joint moments for hip extension were measured at 4 points within the joint's range of motion, at 2 different knee positions (0° and 90°) for each group. The joint moment signals were analyzed by computing signal Coefficient of Variation (CV). The results indicate that no significant differences were found between the groups of subjects for the hip extension moments when the knee was extended. However, there was a significant difference between the groups for the joint moments of hip extension with the knee flexed at all 4 hip positions. Results also showed hip extension CV values to be significantly higher in the patellofemoral group compared with the control group, indicating greater signal noise and therefore poorer neuromuscular control of the hip extensor musculature. This study demonstrated that individuals with patellofemoral syndrome have reduced hip extension strength and reduced neuromuscular control with the knee flexed compared with a control group. These results have implications for the etiology of patellofemoral syndrome and its rehabilitation.

Zapateado technique as an injury risk in Mexican folkloric and Spanish dance: an analysis of execution, ground reaction force, and muscle strength.

PubMed

Echegoyen, Soledad; Aoyama, Takeshi; Rodríguez, Cristina

2013-06-01

Zapateado is a repetitive percussive footwork in dance. This percussive movement, and the differences in technique, may be risk factors for injury. A survey on zapateado dance students found a rate of 1.5 injuries/1,000 exposures. Knee injuries are more frequent than in Spanish dancers than folkloric dancers. The aim of this research was to study the relationship between technique and ground reaction force between zapateado on Spanish and Mexican folkloric dancers. Ten female dance students (age 22.4 ± 4 yrs), six Spanish dancers and four Mexican folkloric dancers, were considered. Each student performed zapateado with a flat foot, wearing high-heeled shoes during 5 seconds on a force platform. Videotapes were taken on a lateral plane, and knee and hip angles in each movement phase were measured with Dartfish software. Additionally, knee and ankle flexor and extensor strength was measured with a dynamometer. Ground reaction forces were lower for Spanish dancers than Mexican folkloric dancers. Spanish dancers had less knee flexion when the foot contacted to the ground than did Mexican folkloric dancers. On Spanish dancers, the working leg had more motion in relation to hip and knee angles than was seen in folkloric dancers. The ankle extensors were stronger on folkloric dancers, and there were no differences for the other muscle groups. Knee flexion at foot contact and muscle strength imbalance could be risk factors for injuries. It is suggested that the technique in Spanish dance in Mexico be reviewed, although more studies are required to define more risk factors.

The influence of knee alignment on lower extremity kinetics during squats.

PubMed

Slater, Lindsay V; Hart, Joseph M

2016-12-01

The squat is an assessment of lower extremity alignment during movement, however there is little information regarding altered joint kinetics during poorly performed squats. The purpose of this study was to examine changes in joint kinetics and power from altered knee alignment during a squat. Thirty participants completed squats while displacing the knee medially, anteriorly, and with neutral alignment (control). Sagittal and frontal plane torques at the ankle, knee, and hip were altered in the descending and ascending phase of the squat in both the medial and anterior malaligned squat compared to the control squat. Ankle and trunk power increased and hip power decreased in the medial malaligned squat compared to the control squat. Ankle, knee, and trunk power increased and hip power decreased in the anterior malaligned squat compared to the control squat. Changes in joint torques and power during malaligned squats suggest that altered knee alignment increases ankle and trunk involvement to execute the movement. Increased anterior knee excursion during squatting may also lead to persistent altered loading of the ankle and knee. Sports medicine professionals using the squat for quadriceps strengthening must consider knee alignment to reduce ankle and trunk involvement during the movement. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Anterolateral Capsule of the Knee Behaves Like a Sheet of Fibrous Tissue.

PubMed

Guenther, Daniel; Rahnemai-Azar, Amir A; Bell, Kevin M; Irarrázaval, Sebastián; Fu, Freddie H; Musahl, Volker; Debski, Richard E

2017-03-01

The function of the anterolateral capsule of the knee has not been clearly defined. However, the contribution of this region of the capsule to knee stability in comparison with other anterolateral structures can be determined by the relative force that each structure carries during loading of the knee. Purpose/Hypothesis: The purpose of this study was to determine the forces in the anterolateral structures of the intact and anterior cruciate ligament (ACL)-deficient knee in response to an anterior tibial load and internal tibial torque. It was hypothesized that the anterolateral capsule would not function like a traditional ligament (ie, transmitting forces only along its longitudinal axis). Controlled laboratory study. Loads (134-N anterior tibial load and 7-N·m internal tibial torque) were applied continuously during flexion to 7 fresh-frozen cadaveric knees in the intact and ACL-deficient state using a robotic testing system. The lateral collateral ligament (LCL) and the anterolateral capsule were separated from the surrounding tissue and from each other. This was done by performing 3 vertical incisions: lateral to the LCL, medial to the LCL, and lateral to the Gerdy tubercle. Attachments of the LCL and anterolateral capsule were detached from the underlying tissue (ie, meniscus), leaving the insertions and origins intact. The force distribution in the anterolateral capsule, ACL, and LCL was then determined at 30°, 60°, and 90° of knee flexion using the principle of superposition. In the intact knee, the force in the ACL in response to an anterior tibial load was greater than that in the other structures ( P < .001). However, in response to an internal tibial torque, no significant differences were found between the ACL, LCL, and forces transmitted between each region of the anterolateral capsule after capsule separation. The anterolateral capsule experienced smaller forces (~50% less) compared with the other structures ( P = .048). For the ACL-deficient knee in response to an anterior tibial load, the force transmitted between each region of the anterolateral capsule was 434% greater than was the force in the anterolateral capsule ( P < .001) and 54% greater than the force in the LCL ( P = .036) at 30° of flexion. In response to an internal tibial torque at 30°, 60°, or 90° of knee flexion, no significant differences were found between the force transmitted between each region of the anterolateral capsule and the LCL. The force in the anterolateral capsule was significantly smaller than that in the other structures at all knee flexion angles for both loading conditions ( P = .004 for anterior tibial load and P = .04 for internal tibial torque). The anterolateral capsule carries negligible forces in the longitudinal direction, and the forces transmitted between regions of the capsule were similar to the forces carried by the other structures at the knee, suggesting that it does not function as a traditional ligament. Thus, the anterolateral capsule should be considered a sheet of tissue. Surgical repair techniques for the anterolateral capsule should restore the ability of the tissue to transmit forces between adjacent regions of the capsule rather than along its longitudinal axis.

Effect of Exercise-Induced Enhancement of the Leg-Extensor Muscle-Tendon Unit Capacities on Ambulatory Mechanics and Knee Osteoarthritis Markers in the Elderly

PubMed Central

Karamanidis, Kiros; Oberländer, Kai Daniel; Niehoff, Anja; Epro, Gaspar; Brüggemann, Gert-Peter

2014-01-01

Objective Leg-extensor muscle weakness could be a key component in knee joint degeneration in the elderly because it may result in altered muscular control during locomotion influencing the mechanical environment within the joint. This work aimed to examine whether an exercise-induced enhancement of the triceps surae (TS) and quadriceps femoris (QF) muscle-tendon unit (MTU) capacities would affect mechanical and biological markers for knee osteoarthritis in the elderly. Methods Twelve older women completed a 14-week TS and QF MTU exercise intervention, which had already been established as increasing muscle strength and tendon stiffness. Locomotion mechanics and serum cartilage oligomeric matrix protein (COMP) levels were examined during incline walking. MTU mechanical properties were assessed using simultaneously ultrasonography and dynamometry. Results Post exercise intervention, the elderly had higher TS and QF contractile strength and tendon-aponeurosis stiffness. Regarding the incline gait task, the subjects demonstrated a lower external knee adduction moment and lower knee adduction angular impulse during the stance phase post-intervention. Furthermore, post-intervention compared to pre-intervention, the elderly showed lower external hip adduction moment, but revealed higher plantarflexion pushoff moment. The changes in the external knee adduction moment were significantly correlated with the improvement in ankle pushoff function. Serum COMP concentration increased in response to the 0.5-h incline walking exercise with no differences in the magnitude of increment between pre- and post-intervention. Conclusions This work emphasizes the important role played by the ankle pushoff function in knee joint mechanical loading during locomotion, and may justify the inclusion of the TS MTU in prevention programs aiming to positively influence specific mechanical markers for knee osteoarthritis in the elderly. However, the study was unable to show that COMP is amenable to change in the elderly following a 14-week exercise intervention and, therefore, the physiological benefit of improved muscle function for knee cartilage requires further investigation. PMID:24905024

Effect of exercise-induced enhancement of the leg-extensor muscle-tendon unit capacities on ambulatory mechanics and knee osteoarthritis markers in the elderly.

PubMed

Karamanidis, Kiros; Oberländer, Kai Daniel; Niehoff, Anja; Epro, Gaspar; Brüggemann, Gert-Peter

2014-01-01

Leg-extensor muscle weakness could be a key component in knee joint degeneration in the elderly because it may result in altered muscular control during locomotion influencing the mechanical environment within the joint. This work aimed to examine whether an exercise-induced enhancement of the triceps surae (TS) and quadriceps femoris (QF) muscle-tendon unit (MTU) capacities would affect mechanical and biological markers for knee osteoarthritis in the elderly. Twelve older women completed a 14-week TS and QF MTU exercise intervention, which had already been established as increasing muscle strength and tendon stiffness. Locomotion mechanics and serum cartilage oligomeric matrix protein (COMP) levels were examined during incline walking. MTU mechanical properties were assessed using simultaneously ultrasonography and dynamometry. Post exercise intervention, the elderly had higher TS and QF contractile strength and tendon-aponeurosis stiffness. Regarding the incline gait task, the subjects demonstrated a lower external knee adduction moment and lower knee adduction angular impulse during the stance phase post-intervention. Furthermore, post-intervention compared to pre-intervention, the elderly showed lower external hip adduction moment, but revealed higher plantarflexion pushoff moment. The changes in the external knee adduction moment were significantly correlated with the improvement in ankle pushoff function. Serum COMP concentration increased in response to the 0.5-h incline walking exercise with no differences in the magnitude of increment between pre- and post-intervention. This work emphasizes the important role played by the ankle pushoff function in knee joint mechanical loading during locomotion, and may justify the inclusion of the TS MTU in prevention programs aiming to positively influence specific mechanical markers for knee osteoarthritis in the elderly. However, the study was unable to show that COMP is amenable to change in the elderly following a 14-week exercise intervention and, therefore, the physiological benefit of improved muscle function for knee cartilage requires further investigation.

A Biomechanical Investigation of A Single-Limb Squat: Implications for Lower Extremity Rehabilitation Exercise

PubMed Central

Richards, Jim; Thewlis, Dominic; Selfe, James; Cunningham, Andrew; Hayes, Colin

2008-01-01

Context: Single-limb squats on a decline angle have been suggested as a rehabilitative intervention to target the knee extensors. Investigators, however, have presented very little empirical research in which they have documented the biomechanics of these exercises or have determined the optimum angle of decline used. Objective: To determine the involvement of the gastrocnemius and rectus femoris muscles and the external ankle and knee joint moments at 60° of knee flexion while performing a single-limb squat at different decline angles. Design: Participants acted as their own controls in a repeated-measures design. Patients or Other Participants: We recruited 10 participants who had no pain, injury, or neurologic disorder. Intervention(s): Participants performed single-limb squats at different decline angles. Main Outcome Measure(s): Angle-specific knee and ankle moments were calculated at 60° of knee flexion. Angle-specific electromyography (EMG) activity was calculated at 60° of knee flexion. Integrated EMG also was calculated to determine the level of muscle activity over the entire squat. Results: An increase was seen in the knee moments (P < .05) and integrated EMG in the rectus femoris (P < .001) as the decline angle increased. A decrease was seen in the ankle moments as the decline angle increased (P  =  .001), but EMG activity in the gastrocnemius increased between 16° and 24° (P  =  .018). Conclusions: As the decline angle increased, the knee extensor moment and EMG activity increased. As the decline angle increased, the ankle plantar-flexor moments decreased; however, an increase in the EMG activity was seen with the 24° decline angle compared with the 16° decline angle. This indicates that decline squats at an angle greater than 16° may not reduce passive calf tension, as was suggested previously, and may provide no mechanical advantage for the knee. PMID:18833310

Progressive Changes in Walking Kinematics and Kinetics After Anterior Cruciate Ligament Injury and Reconstruction: A Review and Meta-Analysis.

PubMed

Slater, Lindsay V; Hart, Joseph M; Kelly, Adam R; Kuenze, Christopher M

2017-09-01

  Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described.   To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR.   We searched PubMed and Web of Science from 1970 through 2013.   We selected only articles that provided peak kinematic and kinetic values during walking in individuals with ACLD or ACLR and comparison with a healthy control group or the contralateral uninjured limb.   A total of 27 of 511 identified studies were included. Weighted means, pooled standard deviations, and 95% confidence intervals were calculated for the healthy control, ACLD, and ACLR groups at each reported time since surgery. The magnitude of between-groups (ACLR versus ACLD, control, or contralateral limb) differences at each time point was evaluated using Cohen d effect sizes and associated 95% confidence intervals. Peak knee-flexion angle (Cohen d = -0.41) and external knee-extensor moment (Cohen d = -0.68) were smaller in the ACLD than in the healthy control group. Peak knee-flexion angle (Cohen d range = -0.78 to -1.23) and external knee-extensor moment (Cohen d range = -1.39 to -2.16) were smaller in the ACLR group from 10 to 40 months after ACLR. Reductions in external knee-adduction moment (Cohen d range = -0.50 to -1.23) were present from 9 to 42 months after ACLR.   Reductions in peak knee-flexion angle, external knee-flexion moment, and external knee-adduction moment were present in the ACLD and ACLR groups. This movement profile during the loading phase of gait has been linked to knee-cartilage degeneration and may contribute to the development of osteoarthritis after ACLR.

Characteristics and preliminary observations of the influence of electromyostimulation on the size and function of human skeletal muscle during 30 days of simulated microgravity

NASA Technical Reports Server (NTRS)

Duvoisin, Marc R.; Convertino, Victor A.; Buchanan, Paul; Gollnick, Philip A.; Dudley, Gary A.

1989-01-01

The effect of transcutaneous electromyostimulation (EMS) on the development of atrophy and the loss of strength in lower limb musculature in humans exposed to microgravity was determined in three subjects who received EMS twice daily in a 3-d on/1-d off cycle on their dominant leg during 30 days of bedrest. The output waveform from the stimulator was sequenced to the knee extensors, knee flexors, ankle extensors, and ankle flexors, and caused three isometric contractions of each muscle group per minute. It was found that, in the dominant leg, EMS acted to attenuate the changes caused by bedrest, such as reductions in the leg volume, muscle compartment size, cross-sectional area of slow- and fast-twitch fibers, strength, and aerobic enzyme activities, and an increase in leg compliance.

Do patients with diabetic neuropathy use a higher proportion of their maximum strength when walking?

PubMed

Brown, Steven J; Handsaker, Joseph C; Bowling, Frank L; Maganaris, Costantinos N; Boulton, Andrew J M; Reeves, Neil D

2014-11-28

Diabetic patients have an altered gait strategy during walking and are known to be at high risk of falling, especially when diabetic peripheral neuropathy is present. This study investigated alterations to lower limb joint torques during walking and related these torques to maximum strength in an attempt to elucidate why diabetic patients are more likely to fall. 20 diabetic patients with moderate/severe peripheral neuropathy (DPN), 33 diabetic patients without peripheral neuropathy (DM), and 27 non-diabetic controls (Ctrl) underwent gait analysis using a motion analysis system and force plates to measure kinetic parameters. Lower limb peak joint torques and joint work done (energy expenditure) were calculated during walking. The ratio of peak joint torques and individual maximum joint strengths (measured on a dynamometer) was then calculated for 59 of the 80 participants to yield the ‘operating strength’ for those participants. During walking DM and DPN patients showed significantly reduced peak torques at the ankle and knee. Maximum joint strengths at the knee were significantly less in both DM and DPN groups than Ctrls, and for the DPN group at the ankle. Operating strengths were significantly higher at the ankle in the DPN group compared to the Ctrls. These findings show that diabetic patients walk with reduced lower limb joint torques; however due to a decrement in their maximum ability at the ankle and knee, their operating strengths are higher. This allows less reserve strength if responding to a perturbation in balance, potentially increasing their risk of falling.

Runners with Patellofemoral Pain Exhibit Greater Peak Patella Cartilage Stress Compared to Pain-Free Runners.

PubMed

Liao, Tzu-Chieh; Keyak, Joyce H; Powers, Christopher M

2018-02-27

The purpose of this study is to determine whether recreational runners with patellofemoral pain (PFP) exhibit greater peak patella cartilage stress compared to pain-free runners. A secondary purpose was to determine the kinematic and/or kinetic predictors of peak patella cartilage stress during running. Twenty-two female recreational runners participated (12 with PFP and 10 pain-free controls). Patella cartilage stress profiles were quantified using subject-specific finite element models simulating the maximum knee flexion angle during stance phase of running. Input parameters to the finite element model included subject-specific patellofemoral joint geometry, quadriceps muscle forces, and lower extremity kinematics in the frontal and transverse planes. Tibiofemoral joint kinematics and kinetics were quantified to determine the best predictor of stress using stepwise regression analysis. Compared to the pain-free runners, those with PFP exhibited greater peak hydrostatic pressure (PFP vs. control, 21.2 ± 5.6 MPa vs. 16.5 ± 4.6 MPa) and maximum shear stress (11.3 ± 4.6 MPa vs. 8.7 ± 2.3 MPa). Knee external rotation was the best predictor of peak hydrostatic pressure and peak maximum shear stress (38% and 25% of variances, respectively) followed by the knee extensor moment (21% and 25% of variances, respectively). Runners with PFP exhibit greater peak patella cartilage stress during running compared to pain-free individuals. The combination of knee external rotation and a high knee extensor moment best predicted elevated peak stress during running.

[Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis].

PubMed

Chen, Yoa; Yu, Yong; He, Cheng-qi

2015-11-01

To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis (OA). Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque (Nm) and Max torque/weight (Nm/ kg). Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Poor proprioception (high JMDT) was negatively correlated with muscle strength (P<0.05). There was no significant correlation between knee proprioception (high JMDT) and joint pain (WOMAC pain score), and between knee proprioception (high JMDT) and joint stiffness (WOMAC stiffness score). Poor proprioception (high JMDT) was correlated with limitation in functional ability (WOMAC physical function score r=0.659, P<0.05). WOMAC score was correlated with poor muscle strength (quadriceps muscle strength r = -0.511, P<0.05, hamstring muscle strength r = -0.408, P<0.05). The multiple stepwise regression model showed that high JMDT C standard partial regression coefficient (B) = 0.385, P<0.50 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Patients with poor proprioception is associated with poor muscle strength and limitation in functional ability. Patients with symptomatic OA of knees commonly endure with moderate to considerable dysfunction, which is associated with poor proprioception (high JMDT) and high VAS-scale score.

Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing.

PubMed

Oh, Youkeun K; Kreinbrink, Jennifer L; Wojtys, Edward M; Ashton-Miller, James A

2012-04-01

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring, and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment, and internal or external tibial torque) was applied to the distal tibia while recording the 3D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3 mm DVRT. In this repeated measures experiment, the Wilcoxon signed-rank test was used to test the null hypotheses with p < 0.05 considered significant. The mean (±SD) peak AM-ACL relative strains were 5.4 ± 3.7% and 3.1 ± 2.8% under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4 ± 160.1%/s and 179.4 ± 109.9%/s, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70 and 42% greater under internal than under external tibial torque, respectively (p = 0.023, p = 0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. Copyright © 2011 Orthopaedic Research Society.

Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease.

PubMed

Dowman, Leona; McDonald, Christine F; Hill, Catherine J; Lee, Annemarie; Barker, Kathryn; Boote, Claire; Glaspole, Ian; Goh, Nicole; Southcott, Annemarie; Burge, Angela; Ndongo, Rebecca; Martin, Alicia; Holland, Anne E

2016-09-01

To evaluate the inter-rater and intra-rater reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease (ILD). Test retest reliability of hand-held dynamometry for elbow flexor and knee extensor strength between two independent raters and two testing sessions. Physiotherapy department within a tertiary hospital. Thirty participants with ILD of varying aetiology were included. Twenty participants completed the inter-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean (SD) age 73 (10) years, 11 male) and 21 participants completed the intra-rater reliability protocol (10 idiopathic pulmonary fibrosis, mean age 71 (10) years, 11 male). Mean muscle strength (kg). Agreement between the two raters and testing sessions was analyzed using Bland-Altman plots and reliability was estimated using intraclass correlation coefficients (ICC). For elbow flexor strength there was a mean difference between raters of -0.6kg (limits of agreement (LOA) -5.6 to 4.4kg) and within raters of -0.3kg (LOA -2.8 to 2.3kg). The ICCs were 0.95 and 0.98, respectively. For knee extensor strength there was a mean difference between raters of -1.5kg (LOA -6.9 to 3.9kg) and within raters of -0.7kg (LOA -3.9 to 2.4kg). The ICCs were 0.95 and 0.97, respectively. Hand-held dynamometry is reliable in measuring elbow flexor and knee extensor strength in people with ILD. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Periodization effects during short-term resistance training with equated exercise variables in females.

PubMed

Pelzer, Thiemo; Ullrich, Boris; Pfeiffer, Mark

2017-03-01

During resistance training, volume and load can be altered either gradually (traditional periodization: TP) or with frequent changes between subsequent sessions (daily undulating periodization: DUP). We hypothesized that the periodization model employed would not impact upon training-induced adaptations when exercise variables are equated. Nineteen females (22.0 years, moderate resistance training experience of 27.9 months) performed 6 weeks of knee extensor training with 3 weekly sessions exercising one leg using TP and the contralateral leg using DUP. Training load varied between 40, 60, and 80% of one repetition maximum (1RM). Volume, range of motion, and time under tension were equated for each leg with a biofeedback software. Dynamometry, surface EMG and ultrasonography were used to determine temporal changes of knee extensor maximum voluntary strength (MVC), neural drive of the M. quadriceps femoris (QF) and vastus lateralis (VL) and rectus femoris (RF) muscle architecture. Significant (P < 0.05) gains for isometric (TP 15%, DUP 13%) and isokinetic-concentric (TP 8%, DUP 10%) MVC and knee extensor 1RM (TP 18%, DUP 24%) occurred post training. VL and RF-muscle thickness showed significant (P < 0.05) increases ranging from 12 to 20% for TP and from 13 to 19% for DUP. Furthermore, significant (P < 0.05) increases in VL-pennation angle and VL-fascicle length occurred in both legs while QF EMG remained unchanged. No significant temporal differences were found between both models, displaying similar small to large effect sizes. Periodization is no adaptation trigger during short-term resistance training with equated exercise variables.

Low-frequency electric muscle stimulation combined with physical therapy after total hip arthroplasty for hip osteoarthritis in elderly patients: a randomized controlled trial.

PubMed

Gremeaux, Vincent; Renault, Julien; Pardon, Laurent; Deley, Gaelle; Lepers, Romuald; Casillas, Jean-Marie

2008-12-01

To assess the effects of low-frequency electric muscle stimulation associated with usual physiotherapy on functional outcome after total hip arthroplasty (THA) for hip osteoarthritis (OA) in elderly subjects. Randomized controlled trial; pre- and posttreatment measurements. Hospital rehabilitation department. Subjects (N=29) referred to the rehabilitation department after THA for hip OA. The intervention group (n=16; 78+/-8 y) received simultaneous low-frequency electric muscle stimulation of bilateral quadriceps and calf muscles (highest tolerated intensity, 1h session, 5 d/wk, for 5 weeks) associated with conventional physical therapy including resistance training. The control group (n=13; 76+/-10 y) received conventional physical therapy alone (25 sessions). Maximal isometric strength of knee extensors, FIM instrument, before and after; a six-minute walk test and a 200 m fast walk test, after; length of stay (LOS). Low-frequency electric muscle stimulation was well tolerated. It resulted in a greater improvement in strength of knee extensors on the operated side (77% vs 23%; P<.01), leading to a better balance of muscle strength between the operated and nonoperated limb. The low-frequency electric muscle stimulation group also showed a greater improvement in FIM scores, though improvements in the walk tests were similar for the 2 groups, as was LOS. Low-frequency electric muscle stimulation is a safe, well-tolerated therapy after THA for hip OA. It improves knee extensor strength, which is one of the factors leading to greater functional independence after THA.

RELIABILITY AND VALIDITY OF A MODIFIED ISOMETRIC DYNAMOMETER IN THE ASSESSMENT OF MUSCULAR PERFORMANCE IN INDIVIDUALS WITH ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

PubMed Central

de Vasconcelos, Rodrigo Antunes; Bevilaqua-Grossi, Débora; Shimano, Antonio Carlos; Paccola, Cleber Jansen; Salvini, Tânia Fátima; Prado, Christiane Lanatovits; Junior, Wilson A. Mello

2015-01-01

Objectives: The aim of this study was to evaluate the reliability and validity of a modified isometric dynamometer (MID) in performance deficits of the knee extensor and flexor muscles in normal individuals and in those with ACL reconstructions. Methods: Sixty male subjects were invited to participate of the study, being divided into three groups with 20 subjects each: control group (GC), group of individuals with ACL reconstruction with patellar tendon graft (GTP, and group of individuals with ACL reconstruction with hamstrings graft (GTF). All individuals performed isometric tests in the MID, muscular strength deficits collected were subsequently compared to the tests performed on the Biodex System 3 operating in the isometric and isokinetic mode at speeds of 60°/s and 180o/s. Intraclass ICC correlation calculations were done in order to assess MID reliability, specificity, sensitivity and Kappa's consistency coefficient calculations, respectively, for assessing the MID's validity in detecting muscular deficits and intra- and intergroup comparisons when performing the four strength tests using the ANOVA method. Results: The modified isometric dynamometer (MID) showed excellent reliability and good validity in the assessment of the performance of the knee extensor and flexor muscles groups. In the comparison between groups, the GTP showed significantly greater deficits as compared to the GTF and GC groups. Conclusion: Isometric dynamometers connected to mechanotherapy equipments could be an alternative option to collect data concerning performance deficits of the extensor and flexor muscles groups of the knee in subjects with ACL reconstruction. PMID:27004175

Effects of step length and step frequency on lower-limb muscle function in human gait.

PubMed

Lim, Yoong Ping; Lin, Yi-Chung; Pandy, Marcus G

2017-05-24

The aim of this study was to quantify the effects of step length and step frequency on lower-limb muscle function in walking. Three-dimensional gait data were used in conjunction with musculoskeletal modeling techniques to evaluate muscle function over a range of walking speeds using prescribed combinations of step length and step frequency. The body was modeled as a 10-segment, 21-degree-of-freedom skeleton actuated by 54 muscle-tendon units. Lower-limb muscle forces were calculated using inverse dynamics and static optimization. We found that five muscles - GMAX, GMED, VAS, GAS, and SOL - dominated vertical support and forward progression independent of changes made to either step length or step frequency, and that, overall, changes in step length had a greater influence on lower-limb joint motion, net joint moments and muscle function than step frequency. Peak forces developed by the uniarticular hip and knee extensors, as well as the normalized fiber lengths at which these muscles developed their peak forces, correlated more closely with changes in step length than step frequency. Increasing step length resulted in larger contributions from the hip and knee extensors and smaller contributions from gravitational forces (limb posture) to vertical support. These results provide insight into why older people with weak hip and knee extensors walk more slowly by reducing step length rather than step frequency and also help to identify the key muscle groups that ought to be targeted in exercise programs designed to improve gait biomechanics in older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of type 1 diabetes and diabetic polyneuropathy on muscle strength and fatigability.

PubMed

Orlando, Giorgio; Balducci, Stefano; Bazzucchi, Ilenia; Pugliese, Giuseppe; Sacchetti, Massimo

2017-06-01

Although it is widely accepted that diabetic polyneuropathy (DPN) is linked to a marked decline in neuromuscular performance, information on the possible impact of type 1 diabetes (T1D) on muscle strength and fatigue remains unclear. The purpose of this study was to investigate the effects of T1D and DPN on strength and fatigability in knee extensor muscles. Thirty-one T1D patients (T1D), 22 T1D patients with DPN (DPN) and 23 matched healthy control participants (C) were enrolled. Maximal voluntary contraction (MVC) and endurance time at an intensity level of 50% of the MVC were assessed at the knee extensor muscles with an isometric dynamometer. Clinical characteristics of diabetic patients were assessed by considering a wide range of vascular and neurological parameters. DPN group had lower knee extensor muscles strength than T1D (-19%) and the C group (-37.5%). T1D group was 22% weaker when compared to the C group. Lower body muscle fatigability of DPN group was 22 and 45.5% higher than T1D and C group, respectively. T1D group possessed a higher fatigability (29.4%) compared to C group. A correlation was found between motor and sensory nerve conduction velocity and muscle strength and fatigability. Patients with T1D are characterised by both a higher fatigability and a lower muscle strength, which are aggravated by DPN. Our data suggest that factors other than nervous damage play a role in the pathogenesis of such defect.

Contralateral structural femoral autograft use in treatment of an open periarticular knee fracture to perform knee arthrodesis.

PubMed

Mack, Andrew W; Helgeson, Melvin D; Tis, John E

2008-09-01

Combat-related blast injuries often cause devastating extremity trauma. We report a case of a 21-year-old male service member who sustained massive bilateral lower extremity trauma secondary to a blast injury. His orthopaedic injuries included a near traumatic disarticulation of the right knee and a left open type IIIB periarticular knee fracture with traumatic patellectomy, loss of the extensor mechanism, and segmental loss of the distal 11 cm of his femur. Definitive treatment of his injuries included a contralateral structural cortical femoral autograft which was implanted into the left knee segmental defect to facilitate knee fusion with an intramedullary knee fusion nail and a right transfemoral amputation. Radiographic evidence of solid fusion was obtained 8 months postoperatively. Currently, the patient is a community ambulator with the aid of his right lower extremity prosthetic limb and cane.

[On evaluating the robot-based experimental system for biomechanical experiment of human knee].

PubMed

Deng, Guoyong; Tian, Lianfang; Bai, Bo; Sun, Hui

2010-02-01

This is a report on how we use the hybrid force-displacement control method to load the human knee and analyze the effect and value of our robot experimental system through the biomechanical experiments of total meniscal resection of human knee. The whole robot control system can load continuously on the specimens, thus overcoming the shortcomings of the traditional loading methods which can only load discretely. In the meantime, by using the robot-based testing system, the force (torque) of the specimens and the spatial position under the force can be measured in real-time, which overcomes the shortcomings caused by the separation of force (torque) measurement from displacement measurement and so greatly improves the measurement accuracy.

Maximum voluntary joint torque as a function of joint angle and angular velocity: model development and application to the lower limb.

PubMed

Anderson, Dennis E; Madigan, Michael L; Nussbaum, Maury A

2007-01-01

Measurements of human strength can be important during analyses of physical activities. Such measurements have often taken the form of the maximum voluntary torque at a single joint angle and angular velocity. However, the available strength varies substantially with joint position and velocity. When examining dynamic activities, strength measurements should account for these variations. A model is presented of maximum voluntary joint torque as a function of joint angle and angular velocity. The model is based on well-known physiological relationships between muscle force and length and between muscle force and velocity and was tested by fitting it to maximum voluntary joint torque data from six different exertions in the lower limb. Isometric, concentric and eccentric maximum voluntary contractions were collected during hip extension, hip flexion, knee extension, knee flexion, ankle plantar flexion and dorsiflexion. Model parameters are reported for each of these exertion directions by gender and age group. This model provides an efficient method by which strength variations with joint angle and angular velocity may be incorporated into comparisons between joint torques calculated by inverse dynamics and the maximum available joint torques.

The trivector approach for minimally invasive total knee arthroplasty: a technical note.

PubMed

Benazzo, Francesco; Rossi, Stefano Marco Paolo

2012-09-01

One of the main criticisms of minimally invasive approaches in total knee arthroplasty has been their poor adaptability in cases of major deformity or stiffness of the knee joint. When they are used in such cases, excessive soft-tissue tension is needed to provide appropriate joint exposure. Here, we describe the "mini trivector approach," which has become our standard approach for total knee replacement because it permits us to enlarge the indication for minimally or less invasive total knee replacement to many knees where quad sparing, a subvastus approach, or a mini quad or mini midvastus snip may not be sufficient to achieve correct exposure. It consists of a limited double snip of the VMO and the quadriceps tendon that reduces tension on the extensor mechanism and allows easier verticalization of the patella as well as good joint exposure.

Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study

PubMed Central

Kanzaki, Noriyuki; Ono, Yoshiko; Shibata, Hiroshi; Moritani, Toshio

2015-01-01

Background The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain. Methods A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years) with knee pain. Subjects were randomly assigned to one of the two supplements containing 1) 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, and 5 μg of vitamin D per day (GCQID group, n=50) or 2) a placebo (placebo group, n=50). Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions. Results In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030) and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038) were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren–Lawrence (K–L) grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, P<0.05) was significantly greater in the GCQID group than in the placebo group in subjects with K–L grade I. No adverse effect of treatment was identified in the safety assessment. Conclusion In subjects with knee pain, GCQID supplementation was effective for relieving knee pain and improving locomotor functions. PMID:26604721

Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study.

PubMed

Kanzaki, Noriyuki; Ono, Yoshiko; Shibata, Hiroshi; Moritani, Toshio

2015-01-01

The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain. A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years) with knee pain. Subjects were randomly assigned to one of the two supplements containing 1) 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, and 5 μg of vitamin D per day (GCQID group, n=50) or 2) a placebo (placebo group, n=50). Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions. In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030) and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038) were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren-Lawrence (K-L) grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, P<0.05) was significantly greater in the GCQID group than in the placebo group in subjects with K-L grade I. No adverse effect of treatment was identified in the safety assessment. In subjects with knee pain, GCQID supplementation was effective for relieving knee pain and improving locomotor functions.

Changes in Indirect Markers of Muscle Damage and Tendons After Daily Drop Jumping Exercise with Rapid Load Increase

PubMed Central

Paleckis, Vidas; Mickevičius, Mantas; Snieckus, Audrius; Streckis, Vytautas; Pääsuke, Mati; Rutkauskas, Saulius; Steponavičiūtė, Rasa; Skurvydas, Albertas; Kamandulis, Sigitas

2015-01-01

The aim of this study was to assess changes in indirect markers of muscle damage and type I collagen degradation, as well as, patellar and Achilles tendon morphological differences during nine daily drop-jumps sessions with constant load alternated with rapid increases in load to test the hypothesis that frequent drop-jump training results in negative muscular and tendon adaptation. Young men (n = 9) performed daily drop jump workouts with progression every 3 days in terms of number of jumps, platform height and squat amplitude. Voluntary and electrically evoked knee extensor torque, muscle soreness, blood plasma creatine kinase (CK) activity and carboxyterminal cross-linked telopeptide (ICTP), patellar and Achilles tendon thickness and cross-sectional area (CSA) were assessed at different time points during the training period and again on days 1, 3, 10 and 17 after the training. The findings were as follows: (1) steady decline in maximal muscle strength with major recovery within 24 hours after the first six daily training sessions; (2) larger decline in electrically induced muscle torque and prolonged recovery during last three training sessions; (3) increase in patellar and Achilles tendons CSA without change in thickness towards the end of training period; (4) increase in jump height but not in muscle strength after whole training period. Our findings suggest that frequent drop-jump sessions with constant load alternated with rapid increases in load do not induce severe muscle damage or major changes in tendons, nonetheless, this type of loading is not advisable for muscle strength improvement. Key points Frequent drop jump training induces activation mode dependent muscle torque depression late in the training period. No significant changes in the thickness of patellar and Achilles tendons are observed during frequent training, while CSA increases towards the end of training period. Longitudinal effect for jump height but not for muscle strength is evident after the whole training period. PMID:26664280

Torque of the shank rotating muscles in patients with knee joint injuries.

PubMed

Hrycyna, Mariusz; Zieliński, Jacek

2011-01-01

The aim of the study was to evaluate the torque of the shank rotating muscles in patients with reconstructed anterior cruciate ligament (ACL) and rehabilitation accomplished in comparison with a control group. The study was carried out on the group of 187 males. For the purpose of the study a prototype testing device for the shank rotating muscles' torque under static conditions was used. The study was based on the measurement of maximal torque at selected angles (-30°, 0°, 45°) of the shank rotation as well as on the angle (30°, 60°, 90°) of flexion of the knee joint. The results obtained in the group with reconstructed anterior cruciate ligament (ACL) and rehabilitation accomplished were comparable to those the control group and mostly of no statistical significance. Lack of significant differences between the values of shank rotating muscles' torque achieved in an injured limb compared to an uninjured one may testify to an effective rehabilitation process. The results of the research can serve as a diagnostic tool for the rehabilitation process development.

Isokinetic strength assessment offers limited predictive validity for detecting risk of future hamstring strain in sport: a systematic review and meta-analysis.

PubMed

Green, Brady; Bourne, Matthew N; Pizzari, Tania

2018-03-01

To examine the value of isokinetic strength assessment for predicting risk of hamstring strain injury, and to direct future research into hamstring strain injuries. Systematic review. Database searches for Medline, CINAHL, Embase, AMED, AUSPORT, SPORTDiscus, PEDro and Cochrane Library from inception to April 2017. Manual reference checks, ahead-of-press and citation tracking. Prospective studies evaluating isokinetic hamstrings, quadriceps and hip extensor strength testing as a risk factor for occurrence of hamstring muscle strain. Independent search result screening. Risk of bias assessment by independent reviewers using Quality in Prognosis Studies tool. Best evidence synthesis and meta-analyses of standardised mean difference (SMD). Twelve studies were included, capturing 508 hamstring strain injuries in 2912 athletes. Isokinetic knee flexor, knee extensor and hip extensor outputs were examined at angular velocities ranging 30-300°/s, concentric or eccentric, and relative (Nm/kg) or absolute (Nm) measures. Strength ratios ranged between 30°/s and 300°/s. Meta-analyses revealed a small, significant predictive effect for absolute (SMD=-0.16, P=0.04, 95% CI -0.31 to -0.01) and relative (SMD=-0.17, P=0.03, 95% CI -0.33 to -0.014) eccentric knee flexor strength (60°/s). No other testing speed or strength ratio showed statistical association. Best evidence synthesis found over half of all variables had moderate or strong evidence for no association with future hamstring injury. Despite an isolated finding for eccentric knee flexor strength at slow speeds, the role and application of isokinetic assessment for predicting hamstring strain risk should be reconsidered, particularly given costs and specialised training required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Analysis of the Response Speed of Musculature of the Knee in Professional Male and Female Volleyball Players

PubMed Central

Rodríguez-Ruiz, D.; Diez-Vega, I.; Rodríguez-Matoso, D.; Fernandez-del-Valle, M.; Sagastume, R.; Molina, J. J.

2014-01-01

The aim of this study was to evaluate the normalized response speed (Vrn) of the knee musculature (flexor and extensor) in high competitive level volleyball players using tensiomyography (TMG) and to analyze the muscular response of the vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), and biceps femoris (BF) in accordance with the specific position they play in their teams. One hundred and sixty-six players (83 women and 83 men) were evaluated. They belonged to eight teams in the Spanish women's superleague and eight in the Spanish men's superleague. The use of Vrn allows avoiding possible sample imbalances due to anatomical and functional differences and demands. We found differences between Vrn in each of the muscles responsible for extension (VM, RF, and VL) and flexion (BF) regardless of the sex. Normalized response speed differences seem to be larger in setters, liberos and outside players compared to middle blockers and larger in males when compared to females. These results of Vrn might respond to the differences in the physical and technical demands of each specific position, showing an improved balance response of the knee extensor and flexor musculature in male professional volleyball players. PMID:25003109

NOT ALL SINGLE LEG SQUATS ARE EQUAL: A BIOMECHANICAL COMPARISON OF THREE VARIATIONS.

PubMed

Khuu, Anne; Foch, Eric; Lewis, Cara L

2016-04-01

The single leg squat (SLS) is a functional task used by practitioners to evaluate and treat multiple pathologies of the lower extremity. Variations of the SLS may have different neuromuscular and biomechanical demands. The effect of altering the non-stance leg position during the SLS on trunk, pelvic, and lower extremity mechanics has not been reported. The purpose of this study was to compare trunk, pelvic, hip, knee, and ankle kinematics and hip, knee, and ankle kinetics of three variations of the SLS using different non-stance leg positions: SLS-Front, SLS-Middle, and SLS-Back. Sixteen healthy women performed the three SLS tasks while data were collected using a motion capture system and force plates. Joint mechanics in the sagittal, frontal, and transverse planes were compared for the SLS tasks using a separate repeated-measures analysis of variance (ANOVA) for each variable at two analysis points: peak knee flexion (PKF) and 60 ° of knee flexion (60KF). Different non-stance leg positions during the SLS resulted in distinct movement patterns and moments at the trunk, pelvis, and lower extremity. At PKF, SLS-Back exhibited the greatest kinematic differences (p < 0.05) from SLS-Front and SLS-Middle with greater ipsilateral trunk flexion, pelvic anterior tilt and drop, hip flexion and adduction, and external rotation as well as less knee flexion and abduction. SLS-Back also showed the greatest kinetic differences (p < 0.05) from SLS-Front and SLS-Middle with greater hip external rotator moment and knee extensor moment as well as less hip extensor moment and knee adductor moment at PKF. At 60KF, the findings were similar except at the knee. The mechanics of the trunk, pelvis, and lower extremity during the SLS were affected by the position of the non-stance leg in healthy females. Practitioners can use these findings to distinguish between SLS variations and to select the appropriate SLS for assessment and rehabilitation. 3.

Elastic Bands in Combination With Free Weights in Strength Training: Neuromuscular Effects.

PubMed

Andersen, Vidar; Fimland, Marius S; Kolnes, Maria K; Saeterbakken, Atle H

2015-10-01

This study compared the effects of a variable vs. a constant lower limb resistance training program on muscle strength, muscle activation, and ballistic muscle performance at different knee angles. Thirty-two females were randomized to a constant resistance training free-weight group (FWG) or a variable resistance training group using free weights in combination with elastic bands (EBG). Two variations of the squat exercise (back squat and split) were performed 2 days per week for 10 weeks. Knee extensor maximal voluntary isometric contraction (MVC) and countermovement jump were assessed at knee angles of 60, 90, and 120° before and after the intervention. During the MVCs, muscle activation of the superficial knee extensor muscles was measured using surface electromyography. The FWG increased their MVCs at 60 and 90° (24 and 15%, respectively), whereas the EBG only increased significantly at 60° (15%). The FWG increased their jump height significantly at all angles (12-16%), whereas the EBG only improved significantly at 60 and 90° (15 and 10%, respectively). Both groups improved their 6-repetition maximum free-weight squat performance (EBG: 25% and FWG: 23%). There were no significant changes in muscle activation. In conclusion, constant and variable resistance training provided similar increases in dynamic and isometric strength, and ballistic muscle performance, albeit most consistently for the group training only with free weights.

Mechanical and biomechanical analysis of a linear piston design for angular-velocity-based orthotic control.

PubMed

Lemaire, Edward D; Samadi, Reza; Goudreau, Louis; Kofman, Jonathan

2013-01-01

A linear piston hydraulic angular-velocity-based control knee joint was designed for people with knee-extensor weakness to engage knee-flexion resistance when knee-flexion angular velocity reaches a preset threshold, such as during a stumble, but to otherwise allow free knee motion. During mechanical testing at the lowest angular-velocity threshold, the device engaged within 2 degrees knee flexion and resisted moment loads of over 150 Nm. The device completed 400,000 loading cycles without mechanical failure or wear that would affect function. Gait patterns of nondisabled participants were similar to normal at walking speeds that produced below-threshold knee angular velocities. Fast walking speeds, employed purposely to attain the angular-velocity threshold and cause knee-flexion resistance, reduced maximum knee flexion by approximately 25 degrees but did not lead to unsafe gait patterns in foot ground clearance during swing. In knee collapse tests, the device successfully engaged knee-flexion resistance and stopped knee flexion with peak knee moments of up to 235.6 Nm. The outcomes from this study support the potential for the linear piston hydraulic knee joint in knee and knee-ankle-foot orthoses for people with lower-limb weakness.

Growth trend of the quadriceps femoris muscle in junior Olympic weight lifters: an 18-month follow-up survey.

PubMed

Kanehisa, Hiroaki; Funato, Kazuo; Kuno, Shinya; Fukunaga, Tetsuo; Katsuta, Shigeru

2003-05-01

Isometric torque and the cross-sectional area (CSA) of the quadriceps femoris muscle (QF) were measured twice at an interval of 18 months in seven junior Olympic weight lifters (aged 15.5-17.1 years at the start of the study) to investigate the growth trend of this muscle group in junior athletes specializing in strength and power events. The CSAs of the QF and its four constituent muscles were determined at 30% (proximal to the knee), 50%, and 70% of femur length (Fl) using a magnetic resonance imaging method. Only at 30%Fl were significant increases found in the CSAs of the QF and all constituent muscles, except for the rectus femoris. At this level, the CSA of the vastus medialis relative to the QF decreased significantly, suggesting a predominant hypertrophy in the vastus intermedius and vastus lateralis muscles. Isometric torque during knee extension increased significantly compared, to the CSA for the QF measured at the three levels. Thus, the present results indicate that, at least at high school age, the QF for junior Olympic weight lifters is characterized by a preferential hypertrophy at the level proximal to the knee joint, with an increase in knee extension torque relative to the CSA.

Knee extension isometric torque production differences based on verbal motivation given to introverted and extroverted female children.

PubMed

McWhorter, J Wesley; Landers, Merrill; Young, Daniel; Puentedura, E Louie; Hickman, Robbin A; Brooksby, Candi; Liveratti, Marc; Taylor, Lisa

2011-08-01

To date, little research has been conducted to test the efficacy of different forms of motivation based on a female child's personality type. The purpose of this study was to evaluate the ability of female children to perform a maximal knee extension isometric torque test with varying forms of motivation, based on the child's personality type (introvert vs. extrovert). The subjects were asked to perform a maximal isometric knee extension test under three different conditions: 1) with no verbal motivation, 2) with verbal motivation from the evaluator only, and 3) with verbal motivation from a group of their peers and the evaluator combined. A 2×3 mixed ANOVA was significant for an interaction (F 2,62=17.530; p<0.0005). Post hoc testing for the introverted group showed that scores without verbal motivation were significantly higher than with verbal motivation from the evaluator or the evaluator plus the peers. The extroverted group revealed that scores with verbal motivation from the evaluator or the evaluator plus the peers were significantly higher than without verbal motivation. Results suggest that verbal motivation has a varying effect on isometric knee extension torque production in female children with different personality types. Extroverted girls perform better with motivation, whereas introverted girls perform better without motivation from others.

Two-stage knee arthrodesis with a modular intramedullary nail due to septic failure of revision total knee arthroplasty with extensor mechanism deficiency.

PubMed

Friedrich, Max J; Schmolders, Jan; Wimmer, Matthias D; Strauss, Andreas C; Ploeger, Milena M; Wirtz, Dieter C; Gravius, Sascha; Randau, Thomas M

2017-10-01

Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery. Thirty seven patients with PJI treated within a two-stage exchange and reimplantation of an arthrodesis nail between 2008 and 2014 were included. Systemic and local risk factors were graded preoperatively according to McPherson et al. All patients were treated according to a structured treatment algorithm. Clinical and functional evaluation was performed using the Oxford Knee Score and the Visual Analogue Scale. Thirty two of 37 patients (86.5%) were graded as free of infection. Five patients (13.5%) had recurrent infection after arthrodesis with the need of revision surgery. Mean leg-length discrepancy was 2.2cm. The mean VAS for pain was three, the mean Oxford Knee Score was 38±9. Total implant survival at a 74month follow-up was 74.3% (95% CI: 45.4 to 91.1%), as determined by Kaplan-Meier survival curves. Local McPherson Score, as well as number of revisions was found to be of significant influence to the survival rate. Septic failure of revision knee arthroplasty can be effectively treated with two-stage arthrodesis using a modular intramedullary nail, providing a stable and painless limb with satisfactory functional results and acceptable infection eradication rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Quadriceps Muscle Fatigue on Stiff-Knee Gait in Patients with Hemiparesis

PubMed Central

Boudarham, Julien; Roche, Nicolas; Pradon, Didier; Delouf, Eric; Bensmail, Djamel; Zory, Raphael

2014-01-01

The relationship between neuromuscular fatigue and locomotion has never been investigated in hemiparetic patients despite the fact that, in the clinical context, patients report to be more spastic or stiffer after walking a long distance or after a rehabilitation session. The aim of this study was to evaluate the effects of quadriceps muscle fatigue on the biomechanical gait parameters of patients with a stiff-knee gait (SKG). Thirteen patients and eleven healthy controls performed one gait analysis before a protocol of isokinetic quadriceps fatigue and two after (immediately after and after 10 minutes of rest). Spatiotemporal parameters, sagittal knee and hip kinematics, rectus femoris (RF) and vastus lateralis (VL) kinematics and electromyographic (EMG) activity were analyzed. The results showed that quadriceps muscle weakness, produced by repetitive concentric contractions of the knee extensors, induced an improvement of spatiotemporal parameters for patients and healthy subjects. For the patient group, the increase in gait velocity and step length was associated with i) an increase of sagittal hip and knee flexion during the swing phase, ii) an increase of the maximal normalized length of the RF and VL and of the maximal VL lengthening velocity during the pre-swing and swing phases, and iii) a decrease in EMG activity of the RF muscle during the initial pre-swing phase and during the latter 2/3 of the initial swing phase. These results suggest that quadriceps fatigue did not alter the gait of patients with hemiparesis walking with a SKG and that neuromuscular fatigue may play the same functional role as an anti-spastic treatment such as botulinum toxin-A injection. Strength training of knee extensors, although commonly performed in rehabilitation, does not seem to be a priority to improve gait of these patients. PMID:24718087

Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations

PubMed Central

Schilaty, Nathan D.; Bates, Nathaniel A.; Nagelli, Christopher; Krych, Aaron J.; Hewett, Timothy E.

2018-01-01

Background: Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature. Purpose/Hypothesis: The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar external loads are applied during a simulated drop vertical jump landing task. It was hypothesized that female limbs would demonstrate significant differences in knee abduction moment that predispose females to ACL injury when compared with males. Study Design: Controlled laboratory study. Methods: Motion analysis data of 67 athletes who performed a drop vertical jump were collected. The kinematic and kinetic data were used to categorize tertiles of relative risk, and these values were input into a cadaveric impact simulator to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test. Results: Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee abduction moment (KAM) demonstrated significant differences in females as compared with males (F 1,136 = 4.398, P = .038). When normalized to height and weight, this difference between males and females increased in significance (F 1,136 = 7.155, P = .008). Compared with males, females exhibited a 10.3-N·m increased knee abduction torque at 66 milliseconds postimpact and a 22.3-N·m increased abduction torque at 100 milliseconds postimpact. For loading condition, the condition of “maximum ACL strain” demonstrated a maximum difference of 54.3-N·m increased abduction torque and 74.5-N·m increased abduction torque at 66 milliseconds postimpact. Conclusion: Under the tested conditions, increased external loads led to increased medial knee translation force, knee abduction moment, and external knee moment. Females exhibited greater forces and moments at the knee, especially at KAM, when loaded in similar conditions. As these KAM loads are associated with increased load and strain on the ACL, the sex-based differences observed in the present study may account for a portion of the underlying mechanics that predispose females to ACL injury as compared with males in a controlled simulated athletic task. Clinical Relevance: KAM increases strain to the ACL under clinically representative loading. Additionally, this work establishes the biomechanical characteristics of knee loading between sexes. PMID:29568787

Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations.

PubMed

Schilaty, Nathan D; Bates, Nathaniel A; Nagelli, Christopher; Krych, Aaron J; Hewett, Timothy E

2018-03-01

Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature. The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar external loads are applied during a simulated drop vertical jump landing task. It was hypothesized that female limbs would demonstrate significant differences in knee abduction moment that predispose females to ACL injury when compared with males. Controlled laboratory study. Motion analysis data of 67 athletes who performed a drop vertical jump were collected. The kinematic and kinetic data were used to categorize tertiles of relative risk, and these values were input into a cadaveric impact simulator to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test. Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee abduction moment (KAM) demonstrated significant differences in females as compared with males ( F 1,136 = 4.398, P = .038). When normalized to height and weight, this difference between males and females increased in significance ( F 1,136 = 7.155, P = .008). Compared with males, females exhibited a 10.3-N·m increased knee abduction torque at 66 milliseconds postimpact and a 22.3-N·m increased abduction torque at 100 milliseconds postimpact. For loading condition, the condition of "maximum ACL strain" demonstrated a maximum difference of 54.3-N·m increased abduction torque and 74.5-N·m increased abduction torque at 66 milliseconds postimpact. Under the tested conditions, increased external loads led to increased medial knee translation force, knee abduction moment, and external knee moment. Females exhibited greater forces and moments at the knee, especially at KAM, when loaded in similar conditions. As these KAM loads are associated with increased load and strain on the ACL, the sex-based differences observed in the present study may account for a portion of the underlying mechanics that predispose females to ACL injury as compared with males in a controlled simulated athletic task. KAM increases strain to the ACL under clinically representative loading. Additionally, this work establishes the biomechanical characteristics of knee loading between sexes.

Computational problems in autoregressive moving average (ARMA) models

NASA Technical Reports Server (NTRS)

Agarwal, G. C.; Goodarzi, S. M.; Oneill, W. D.; Gottlieb, G. L.

1981-01-01

The choice of the sampling interval and the selection of the order of the model in time series analysis are considered. Band limited (up to 15 Hz) random torque perturbations are applied to the human ankle joint. The applied torque input, the angular rotation output, and the electromyographic activity using surface electrodes from the extensor and flexor muscles of the ankle joint are recorded. Autoregressive moving average models are developed. A parameter constraining technique is applied to develop more reliable models. The asymptotic behavior of the system must be taken into account during parameter optimization to develop predictive models.

The Influence of Task Complexity on Knee Joint Kinetics Following ACL Reconstruction

PubMed Central

Schroeder, Megan J.; Krishnan, Chandramouli; Dhaher, Yasin Y.

2015-01-01

Background Previous research indicates that subjects with anterior cruciate ligament reconstruction exhibit abnormal knee joint movement patterns during functional activities like walking. While the sagittal plane mechanics have been studied extensively, less is known about the secondary planes, specifically with regard to more demanding tasks. This study explored the influence of task complexity on functional joint mechanics in the context of graft-specific surgeries. Methods In 25 participants (10 hamstring tendon graft, 6 patellar tendon graft, 9 matched controls), three-dimensional joint torques were calculated using a standard inverse dynamics approach during level walking and stair descent. The stair descent task was separated into two functionally different sub-tasks—step-to-floor and step-to-step. The differences in external knee moment profiles were compared between groups; paired differences between the reconstructed and non-reconstructed knees were also assessed. Findings The reconstructed knees, irrespective of graft type, typically exhibited significantly lower peak knee flexion moments compared to control knees during stair descent, with the differences more pronounced in the step-to-step task. Frontal plane adduction torque deficits were graft-specific and limited to the hamstring tendon knees during the step-to-step task. Internal rotation torque deficits were also primarily limited to the hamstring tendon graft group during stair descent. Collectively, these results suggest that task complexity was a primary driver of differences in joint mechanics between anterior cruciate ligament reconstructed individuals and controls, and such differences were more pronounced in individuals with hamstring tendon grafts. Interpretation The mechanical environment experienced in the cartilage during repetitive, cyclical tasks such as walking and other activities of daily living has been argued to contribute to the development of degenerative changes to the joint and ultimately osteoarthritis. Given the task-specific and graft-specific differences in joint mechanics detected in this study, care should be taken during the rehabilitation process to mitigate these changes. PMID:26101055

Knee Proprioception and Strength and Landing Kinematics During a Single-Leg Stop-Jump Task

PubMed Central

Nagai, Takashi; Sell, Timothy C; House, Anthony J; Abt, John P; Lephart, Scott M

2013-01-01

Context The importance of the sensorimotor system in maintaining a stable knee joint has been recognized. As individual entities, knee-joint proprioception, landing kinematics, and knee muscles play important roles in functional joint stability. Preventing knee injuries during dynamic tasks requires accurate proprioceptive information and adequate muscular strength. Few investigators have evaluated the relationship between knee proprioception and strength and landing kinematics. Objective To examine the relationship between knee proprioception and strength and landing kinematics. Design Cross-sectional study. Setting University research laboratory. Patients or Other Participants Fifty physically active men (age = 26.4 ± 5.8 years, height = 176.5 ± 8.0 cm, mass = 79.8 ± 16.6 kg). Intervention(s) Three tests were performed. Knee conscious proprioception was evaluated via threshold to detect passive motion (TTDPM). Knee strength was evaluated with a dynamometer. A 3-dimensional biomechanical analysis of a single-legged stop-jump task was used to calculate initial contact (IC) knee-flexion angle and knee-flexion excursion. Main Outcome Measure(s) The TTDPM toward knee flexion and extension, peak knee flexion and extension torque, and IC knee-flexion angle and knee flexion excursion. Linear correlation and stepwise multiple linear regression analyses were used to evaluate the relationships of both proprioception and strength against landing kinematics. The α level was set a priori at .05. Results Enhanced TTDPM and greater knee strength were positively correlated with greater IC knee-flexion angle (r range = 0.281–0.479, P range = .001–.048). The regression analysis revealed that 27.4% of the variance in IC knee-flexion angle could be accounted for by knee-flexion peak torque and TTDPM toward flexion (P = .001). Conclusions The current research highlighted the relationship between knee proprioception and strength and landing kinematics. Individuals with enhanced proprioception and muscular strength had better control of IC knee-flexion angle during a dynamic task. PMID:23672323

Effects of elevated H+ and Pi on the contractile mechanics of skeletal muscle fibres from young and old men: implications for muscle fatigue in humans.

PubMed

Sundberg, Christopher W; Hunter, Sandra K; Trappe, Scott W; Smith, Carolyn S; Fitts, Robert H

2018-05-28

The mechanisms for the loss in muscle power and increased fatigability with ageing are unresolved. We show that the contractile mechanics of fibres from the vastus lateralis of old men were well-preserved compared to young men, but the selective loss of fast myosin heavy chain (MHC) II muscle was strongly associated with age-related decrements in whole-muscle strength and power. We reveal that the combination of acidosis (H + ) and inorganic phosphate (P i ) is an important mediator of muscle fatigue in humans by inhibiting the low- to high-force state of the cross-bridge cycle and peak power, but the depressive effects of these ions on cross-bridge function were similar in fibres from young and old men. These findings suggest the age-related loss in muscle power is due primarily to the atrophy of fast fibres, but the age-related increased fatigability cannot be explained by an increased sensitivity of the cross-bridge to H + and P i . The purpose of this study was to identify the mechanisms for the loss in muscle power and increased fatigability with ageing by integrating measures of whole-muscle function with single fibre contractile mechanics. After adjusting for the 22% smaller muscle mass in old (73-89 yrs, n = 6) compared with young men (20-29 yrs, n = 6), isometric torque and power output of the knee extensors were, respectively, 38% and 53% lower with age. Fatigability was ∼2.5-fold greater with age and strongly associated with the reductions in the electrically-evoked contractile properties. To test whether cross-bridge mechanisms could explain age-related decrements in knee extensor function, we exposed myofibres (n = 254) from the vastus lateralis to conditions mimicking quiescent muscle and fatiguing levels of H + (pH 6.2) and P i (30 mM). The fatigue-mimicking condition caused marked reductions in force, shortening velocity, and power and inhibited the low- to high-force state of the cross-bridge cycle, confirming non-human studies that these ions act synergistically to impair cross-bridge function. Other than severe age-related atrophy of fast fibres (-55%), contractile function and the depressive effects of the fatigue-mimicking condition did not differ in fibres from young and old men. The selective loss of fast MHC II muscle was strongly associated with the age-related decrease in isometric torque (r = 0.785) and power (r = 0.861). These data suggest that the age-related loss in muscle strength and power is due primarily to the atrophy of fast fibres, but that the age-related increased fatigability cannot be explained by an increased sensitivity of the cross-bridge to H + and P i . This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation.

PubMed

Kostka, Joanna; Czernicki, Jan; Pruszyńska, Magdalena; Miller, Elżbieta

The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program. Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (F ext , F flex ) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test. The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both F flex kg -1 and F ext kg -1 had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for F ext kg -1 and, interestingly, even more prominent for F flex kg -1 . MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Reduced servo-control of fatigued human finger extensor and flexor muscles.

PubMed Central

Hagbarth, K E; Bongiovanni, L G; Nordin, M

1995-01-01

1. In healthy human subjects holding the index finger semi-extended at the metacarpophalangeal joint against a moderate load, electromyographic (EMG) activity was recorded from the finger extensor and flexor muscles during different stages of muscle fatigue. The aim was to study the effect of muscle fatigue on the level of background EMG activity and on the reflex responses to torque pulses causing sudden extensor unloadings. Paired comparisons were made between the averaged EMG and finger deflection responses under two conditions: (1) at a stage of fatigue (following a sustained co-contraction) when great effort was required to maintain the finger position, and (2) under non-fatigue conditions while the subject tried to produce similar background EMG levels to those in the corresponding fatigue trials. 2. Both the unloading reflex in the extensor and the concurrent stretch reflex in the flexor were significantly less pronounced and had a longer latency in the fatigue trials. Consequently, the finger deflections had a larger amplitude and were arrested later in the fatigue trials. 3. It is concluded that--with avoidance of 'automatic gain compensation', i.e. reflex modifications attributable to differences in background EMG levels--the servo-like action of the unloading and stretch reflexes is reduced in fatigued finger extensor and flexor muscles. PMID:7562624

Hip joint torques during the golf swing of young and senior healthy males.

PubMed

Foxworth, Judy L; Millar, Audrey L; Long, Benjamin L; Way, Michael; Vellucci, Matthew W; Vogler, Joshua D

2013-09-01

Descriptive, laboratory study. To compare the 3-D hip torques during a golf swing between young and senior healthy male amateur golfers. The secondary purpose was to compare the 3-D hip joint torques between the trail leg and lead leg. The generation of hip torques from the hip musculature is an important aspect of the golf swing. Golf is a very popular activity, and estimates of hip torques during the golf swing have not been reported. Twenty healthy male golfers were divided into a young group (mean ± SD age, 25.1 ± 3.1 years) and a senior group (age, 56.9 ± 4.7 years). All subjects completed 10 golf swings using their personal driver. A motion capture system and force plates were used to obtain kinematic and kinetic data. Inverse dynamic analyses were used to calculate 3-D hip joint torques of the trail and lead limbs. Two-way analyses of covariance (group by leg), with club-head velocity as a covariate, were used to compare peak hip torques between groups and limbs. Trail-limb hip external rotator torque was significantly greater in the younger group compared to the senior group, and greater in the trail leg versus the lead leg. When adjusting for club-head velocity, young and senior healthy male amateur golfers generated comparable hip torques during a golf swing, with the exception of the trail-limb hip external rotator torque. The largest hip torque found was the trail-limb hip extensor torque.

Quadriceps femoris spasticity in children with cerebral palsy: measurement with the pendulum test and relationship with gait abnormalities.

PubMed

Szopa, Andrzej; Domagalska-Szopa, Małgorzata; Kidoń, Zenon; Syczewska, Małgorzata

2014-12-16

Development of a reliable and objective test of spasticity is important for assessment and treatment of children with cerebral palsy. The pendulum test has been reported to yield reliable measurements of spasticity and to be sensitive to variations in spasticity in these children. However, the relationship between the pendulum test scores and other objective measures of spasticity has not been studied. The present study aimed to assess the effectiveness of an accelerometer-based pendulum test as a measurement of spasticity in CP, and to explore the correlation between the measurements of this test and the global index of deviation from normal gait in in children with cerebral palsy. We studied thirty-six children with cerebral palsy, including 18 with spastic hemiplegia and 18 with spastic diplegia, and a group of 18 typically-developing children. Knee extensor spasticity was assessed bilaterally using the accelerometer-based pendulum test and three-dimensional gait analysis. The Gillette Gait Index was calculated from the results of the gait analysis. The data from the accelerometer-based pendulum test could be used to distinguish between able-bodied children and children with cerebral palsy. Additionally, two of the measurements, first swing excursion and relaxation index, could be used to differentiate the degree of knee extensor spasticity in the children with cerebral palsy. Only a few moderate correlations were found between the Gillette Gait Index and the pendulum test data. This study demonstrates that the pendulum test can be used to discriminate between typically developing children and children with CP, as well as between various degrees of spasticity, such as spastic hemiplegia and spastic diplegia, in the knee extensor muscle of children with CP. Deviations from normal gait in children with CP were not correlated with the results of the pendulum test.

Dehydration reduces left ventricular filling at rest and during exercise independent of twist mechanics.

PubMed

Stöhr, Eric J; González-Alonso, José; Pearson, James; Low, David A; Ali, Leena; Barker, Horace; Shave, Rob

2011-09-01

The purpose of this study was to determine whether the reduction in stroke volume (SV), previously shown to occur with dehydration and increases in internal body temperatures during prolonged exercise, is caused by a reduction in left ventricular (LV) function, as indicated by LV volumes, strain, and twist ("LV mechanics"). Eight healthy men [age: 20 ± 2, maximal oxygen uptake (VO₂max): 58 ± 7 ml·kg⁻¹·min⁻¹] completed two, 1-h bouts of cycling in the heat (35°C, 50% peak power) without fluid replacement, resulting in 2% and 3.5% dehydration, respectively. Conventional and two-dimensional speckle-tracking echocardiography was used to determine LV volumes, strain, and twist at rest and during one-legged knee-extensor exercise at baseline, both levels of dehydration, and following rehydration. Progressive dehydration caused a significant reduction in end-diastolic volume (EDV) and SV at rest and during one-legged knee-extensor exercise (rest: Δ-33 ± 14 and Δ-21 ± 14 ml, respectively; exercise: Δ-30 ± 10 and Δ-22 ± 9 ml, respectively, during 3.5% dehydration). In contrast to the marked decline in EDV and SV, systolic and diastolic LV mechanics were either maintained or even enhanced with dehydration at rest and during knee-extensor exercise. We conclude that dehydration-induced reductions in SV at rest and during exercise are the result of reduced LV filling, as reflected by the decline in EDV. The concomitant maintenance of LV mechanics suggests that the decrease in LV filling, and consequently ejection, is likely caused by the reduction in blood volume and/or diminished filling time rather than impaired LV function.

Modulation of Isometric Quadriceps Strength in Soccer Players With Transcranial Direct Current Stimulation: A Crossover Study.

PubMed

Vargas, Valentine Z; Baptista, Abrahão F; Pereira, Guilherme O C; Pochini, Alberto C; Ejnisman, Benno; Santos, Marcelo B; João, Silvia M A; Hazime, Fuad A

2018-05-01

Vargas, VZ, Baptista, AF, Pereira, GOC, Pochini, AC, Ejnisman, B, Santos, MB, João, SMA, and Hazime, FA. Modulation of isometric quadriceps strength in soccer players with transcranial direct current stimulation: a crossover study. J Strength Cond Res 32(5): 1336-1341, 2018-The aim of this study was to evaluate the effect of transcranial direct current stimulation (tDCS) on the maximum isometric muscle contraction (MVIC) of the knee extensors in soccer players at the preprofessional level. Twenty female soccer players aged 15-17 years (mean = 16.1; SD = 0.9) with 5.2 ± 2.6 years of training were randomly divided into 2 groups to receive either active or sham tDCS in a single session (2 mA; 0.057 mA·cm). The MVIC of the knee extensors was evaluated in both lower limbs by manual dynamometry in 5 sets of contractions divided into 4 blocks: (a) prestimulation, (b) during tDCS, (c) 30 minutes after tDCS, and (d) 60 minutes after tDCS. After an interval of 7 days, the groups were evaluated again, and the type of initial stimulation was inverted between participants. The MVIC of the knee extensors increased significantly during active tDCS (dominant limb (DL) = 0.4; IC = 0.1-0.8 N·Kg), 30 minutes after active tDCS (DL = 0.9; IC 0.4-1.4 N·Kg), and 60 minutes after active tDCS (DL = 1.0; IC 0.3-1.6 N·Kg) but not for sham tDCS. Our conclusion was that tDCS temporarily increases isometric quadriceps strength in adolescent female soccer players, which may be useful for both strength training and rehabilitation.

Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults.

PubMed

Correa, Cleiton S; Cunha, Giovani; Marques, Nise; Oliveira-Reischak, Ãlvaro; Pinto, Ronei

2016-07-01

Previous studies presented different results regarding the maintenance time of muscular adaptations after strength training and the ability to resume the gains on muscular performance after resumption of the training programme. This study aimed to verify the effect of strength training on knee extensors and elbow flexor muscle strength, rectus femoris muscle volume and functional performance in older female adults after 12 weeks of strength training, 1 year of detraining and followed by 12 weeks of retraining. Twelve sedentary older women performed 12 weeks of strength training, 1 year of detraining and 12 weeks of retraining. The strength training was performed twice a week, and the assessment was made four times: at the baseline, after the strength training, after the detraining and after the retraining. The knee extensor and elbow flexor strength, rectus femoris muscle volume and functional task were assessed. Strength of knee extensor and elbow flexor muscles, rectus femoris muscle volume and 30-s sit-to-stand increased from baseline to post-training (respectively, 40%, 70%, 38% and 46%), decreased after detraining (respectively, -36%, -64%, -35% and -43%) and increased again these parameters after retraining (35%, 68%, 36% and 42%). Strength training induces gains on strength and hypertrophy, also increased the performance on functional tasks after the strength training. The stoppage of the strength caused strength loss and reduction of functional performance. The resumption of the strength training promoted the same gains of muscular performance in older female adults. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

The effects of low and moderate doses of caffeine supplementation on upper and lower body maximal voluntary concentric and eccentric muscle force.

PubMed

Tallis, Jason; Yavuz, Harley C M

2018-03-01

Despite the growing quantity of literature exploring the effect of caffeine on muscular strength, there is a dearth of data that directly explores differences in erogenicity between upper and lower body musculature and the dose-response effect. The present study sought to investigate the effects of low and moderate doses of caffeine on the maximal voluntary strength of the elbow flexors and knee extensors. Ten nonspecifically strength-trained, recreationally active participants (aged 21 ± 0.3 years) completed the study. Using a randomised, counterbalanced, and double-blind approach, isokinetic concentric and eccentric strength was measured at 60 and 180°/s following administration of a placebo, 3 mg·kg -1 body mass caffeine, and 6 mg·kg -1 body mass caffeine. There was no effect of caffeine on the maximal voluntary concentric and eccentric strength of the elbow flexors, or the eccentric strength of the knee extensors. Both 3 and 6 mg·kg -1 body mass caffeine caused a significant increase in peak concentric force of the knee extensors at 180°/s. No difference was apparent between the 2 concentrations. Only 6 mg·kg -1 body mass caused an increase in peak concentric force during repeated contractions. The results infer that the effective caffeine concentration to evoke improved muscle performance may be related to muscle mass and contraction type. The present work indicates that a relatively low dose of caffeine treatment may be effective for improving lower body muscular strength, but may have little benefit for the strength of major muscular groups of the upper body.

The neuromuscular fatigue induced by repeated scrums generates instability that can be limited by appropriate recovery.

PubMed

Morel, B; Hautier, C A

2017-02-01

The aim of this study was to evaluate the influence of the fatigue on the machine scrum pushing sagittal forces during repeated scrums and to determine the origin of the knee extensor fatigue. Twelve elite U23 rugby union front row players performed six 6-s scrums every 30 s against a dynamic scrum machine with passive or active recovery. The peak, average, and the standard deviation of the force were measured. A neuromuscular testing procedure of the knee extensors was carried out before and immediately after the repeated scrum protocol including maximal voluntary force, evoked force, and voluntary activation. The average and peak forces did not decrease after six scrums with passive recovery. The standard deviation of the force increased by 70.2 ± 42.7% (P < 0.001). Maximal voluntary/evoked force and voluntary activation decreased (respectively 25.1 ± 7.0%, 14.6 ± 5.5%, and 24 ± 9.9%; P < 0.001). The standard deviation of the force did not increase with active recovery and was associated with lower decrease of maximal voluntary/evoked force and voluntary activation (respectively 12.8 ± 7.9%, 4.9 ± 6.5%, and 7.6 ± 4.1%; all P < 0.01). As a conclusion repeated scrummaging induced an increased machine scrum pushing instability associated with central and peripheral fatigue of the knee extensors. Active recovery seems to limit all these manifestations of fatigue. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Contractile function and motor unit firing rates of the human hamstrings.

PubMed

Kirk, Eric A; Rice, Charles L

2017-01-01

Neuromuscular properties of the lower limb in health, aging, and disease are well described for major lower limb muscles comprising the quadriceps, triceps surae, and dorsiflexors, with the notable exception of the posterior thigh (hamstrings). The purpose of this study was to further characterize major muscles of the lower limb by comprehensively exploring contractile properties in relation to spinal motor neuron output expressed as motor unit firing rates (MUFRs) in the hamstrings of 11 (26.5 ± 3.8) young men. Maximal isometric voluntary contraction (MVC), voluntary activation, stimulated contractile properties including a force-frequency relationship, and MUFRs from submaximal to maximal voluntary contractile intensities were assessed in the hamstrings. Strength and MUFRs were assessed at two presumably different muscle lengths by varying the knee joint angles (90° and 160°). Knee flexion MVCs were 60-70% greater in the extended position (160°). The frequency required to elicit 50% of maximum tetanic torque was 16-17 Hz. Mean MUFRs at 25-50% MVC were 9-31% less in the biceps femoris compared with the semimembranosus-semitendinosus group. Knee joint angle (muscle length) influenced MUFRs such that mean MUFRs were greater in the shortened (90°) position at 50% and 100% MVC. Compared with previous reports, mean maximal MUFRs in the hamstrings are greater than those in the quadriceps and triceps surae and somewhat less than those in the tibialis anterior. Mean maximal MUFRs in the hamstrings are influenced by changes in knee joint angle, with lower firing rates in the biceps femoris compared with the semimembranosus-semitendinosus muscle group. We studied motor unit firing rates (MUFRs) at various voluntary contraction intensities in the hamstrings, one of the only major lower limb muscles to have MUFRs affected by muscle length changes. Within the hamstrings muscle-specific differences have greater impact on MUFRs than length changes, with the biceps femoris having reduced neural drive compared with the semimembranosus-semimembranosus. Comparing our results to other lower limb muscles, flexors have inherently higher firing rate compared with extensors. Copyright © 2017 the American Physiological Society.

Contractile function and motor unit firing rates of the human hamstrings

PubMed Central

Kirk, Eric A.

2016-01-01

Neuromuscular properties of the lower limb in health, aging, and disease are well described for major lower limb muscles comprising the quadriceps, triceps surae, and dorsiflexors, with the notable exception of the posterior thigh (hamstrings). The purpose of this study was to further characterize major muscles of the lower limb by comprehensively exploring contractile properties in relation to spinal motor neuron output expressed as motor unit firing rates (MUFRs) in the hamstrings of 11 (26.5 ± 3.8) young men. Maximal isometric voluntary contraction (MVC), voluntary activation, stimulated contractile properties including a force-frequency relationship, and MUFRs from submaximal to maximal voluntary contractile intensities were assessed in the hamstrings. Strength and MUFRs were assessed at two presumably different muscle lengths by varying the knee joint angles (90° and 160°). Knee flexion MVCs were 60–70% greater in the extended position (160°). The frequency required to elicit 50% of maximum tetanic torque was 16–17 Hz. Mean MUFRs at 25–50% MVC were 9–31% less in the biceps femoris compared with the semimembranosus-semitendinosus group. Knee joint angle (muscle length) influenced MUFRs such that mean MUFRs were greater in the shortened (90°) position at 50% and 100% MVC. Compared with previous reports, mean maximal MUFRs in the hamstrings are greater than those in the quadriceps and triceps surae and somewhat less than those in the tibialis anterior. Mean maximal MUFRs in the hamstrings are influenced by changes in knee joint angle, with lower firing rates in the biceps femoris compared with the semimembranosus-semitendinosus muscle group. NEW & NOTEWORTHY We studied motor unit firing rates (MUFRs) at various voluntary contraction intensities in the hamstrings, one of the only major lower limb muscles to have MUFRs affected by muscle length changes. Within the hamstrings muscle-specific differences have greater impact on MUFRs than length changes, with the biceps femoris having reduced neural drive compared with the semimembranosus-semimembranosus. Comparing our results to other lower limb muscles, flexors have inherently higher firing rate compared with extensors. PMID:27784806

Eccentric activation and muscle damage: biomechanical and physiological considerations during downhill running.

PubMed Central

Eston, R G; Mickleborough, J; Baltzopoulos, V

1995-01-01

An eccentric muscle activation is the controlled lengthening of the muscle under tension. Functionally, most leg muscles work eccentrically for some part of a normal gait cycle, to support the weight of the body against gravity and to absorb shock. During downhill running the role of eccentric work of the 'anti-gravity' muscles--knee extensors, muscles of the anterior and posterior tibial compartments and hip extensors--is accentuated. The purpose of this paper is to review the relationship between eccentric muscle activation and muscle damage, particularly as it relates to running, and specifically, downhill running. PMID:7551767

Whole-body vibration training induces hypertrophy of the human patellar tendon.

PubMed

Rieder, F; Wiesinger, H-P; Kösters, A; Müller, E; Seynnes, O R

2016-08-01

Animal studies suggest that regular exposure to whole-body vibration (WBV) induces an anabolic response in bone and tendon. However, the effects of this type of intervention on human tendon properties and its influence on the muscle-tendon unit function have never been investigated. The aim of this study was to investigate the effect of WBV training on the patellar tendon mechanical, material and morphological properties, the quadriceps muscle architecture and the knee extension torque-angle relationship. Fifty-five subjects were randomized into either a vibration, an active control, or an inactive control group. The active control subjects performed isometric squats on a vibration platform without vibration. Muscle and tendon properties were measured using ultrasonography and dynamometry. Vibration training induced an increase in proximal (6.3%) and mean (3.8%) tendon cross-sectional area, without any appreciable change in tendon stiffness and modulus or in muscle architectural parameters. Isometric torque at a knee angle of 90° increased in active controls (6.7%) only and the torque-angle relation remained globally unchanged in all groups. The present protocol did not appreciably alter knee extension torque production or the musculo-tendinous parameters underpinning this function. Nonetheless, this study shows for the first time that WBV elicits tendon hypertrophy in humans. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Spatial Orientation in Flight

DTIC Science & Technology

1986-12-01

on posture, exerted through tonic activation of so-called " antigravity " muscles such as hip and knee extensors. These vestibular reflexes, of course... antigravity houses, which are built in such a way that the visually apparent vertical is quite different from the true 112 %IN.. Figure 43. Conditioned

Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.

PubMed

Valtonen, Anu; Pöyhönen, Tapani; Sipilä, Sarianna; Heinonen, Ari

2010-06-01

To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. Randomized controlled trial. Research laboratory and hospital rehabilitation pool. Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial. Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24). Mobility limitation assessed by walking speed and stair ascending time, and self-reported physical functional difficulty, pain, and stiffness assessed by Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire. Knee extensor power and knee flexor power assessed isokinetically, and thigh muscle cross-sectional area (CSA) by computed tomography. Compared with the change in the control group, habitual walking speed increased by 9% (P=.005) and stair ascending time decreased by 15% (P=.006) in the aquatic training group. There was no significant difference between the groups in the WOMAC scores. The training increased knee extensor power by 32% (P<.001) in the operated and 10% (P=.001) in the nonoperated leg, and knee flexor power by 48% (P=.003) in the operated and 8% (P=.002) in the nonoperated leg compared with controls. The mean increase in thigh muscle CSA of the operated leg was 3% (P=.018) and that of the nonoperated leg 2% (P=.019) after training compared with controls. Progressive aquatic resistance training had favorable effects on mobility limitation by increasing walking speed and decreasing stair ascending time. In addition, training increased lower limb muscle power and muscle CSA. Resistance training in water is a feasible mode of rehabilitation that has wide-ranging positive effects on patients after knee replacement surgery. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Altered biomechanical strategies and medio-lateral control of the knee represent incomplete recovery of individuals with injury during single leg hop.

PubMed

Roos, Paulien E; Button, Kate; Sparkes, Valerie; van Deursen, Robert W M

2014-02-07

Anterior cruciate ligament (ACL) injury can result in failure to return to pre-injury activity levels and future osteoarthritis predisposition. Single leg hop is used in late rehabilitation to evaluate recovery and inform treatment but biomechanical understanding of this activity is insufficient. This study investigated single leg hop for distance aiming to evaluate if ACL patients had recovered: (1) landing strategies and (2) medio-lateral knee control. We hypothesized that patients with reconstructive surgery (ACLR) would have more similar landing strategies and knee control to healthy controls than patients treated conservatively (ACLD). 16 ACLD and 23 ACLR subjects were compared to 20 healthy controls (CONT). Kinematic and ground reaction force data were collected while subjects hopped their maximum distance. The main output parameters were hop distance, peak knee flexor angles and extensor moments and Fluency (a measure introduced to represent medio-lateral knee control). Statistical differences between ACL and control groups were analyzed using a general linear model univariate analysis, with COM velocity prior to landing as covariate. Hop distance was the smallest for ACLD and largest for CONT (p<0.001; ACLD 57.1±14.1; ACLR 75.1±17.8; CONT 77.7±14.07% height). ACLR used a similar kinematic strategy to CONT, but had a reduced peak knee extensor moment (p<0.001; ACLD 0.32±0.14; ACLR 0.31±0.16; CONT 0.42±0.13 BW.height). Fluency was reduced in both ACLD and ACLR (p=0.006; ACLD 0.13±0.34; ACLR 0.14±0.34; CONT 0.17±0.41s). Clinical practice uses hopping distance to evaluate ACL patients' recovery. This study demonstrated that aspects such as movement strategies and knee control need to be evaluated. © 2013 Published by Elsevier Ltd.

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity.

PubMed

Ekelem, Andrew; Goldfarb, Michael

2018-01-01

Spasticity is a common comorbidity associated with spinal cord injury (SCI). Robotic exoskeletons have recently emerged to facilitate legged mobility in people with motor complete SCI. Involuntary muscle activity attributed to spasticity, however, can prevent such individuals from using an exoskeleton. Specifically, although most exoskeleton technologies can accommodate low to moderate spasticity, the presence of moderate to severe spasticity can significantly impair gait kinematics when using an exoskeleton. In an effort to potentially enable individuals with moderate to severe spasticity to use exoskeletons more effectively, this study investigates the use of common peroneal stimulation in conjunction with exoskeleton gait assistance. The electrical stimulation is timed with the exoskeleton swing phase, and is intended to acutely suppress extensor spasticity through recruitment of the flexion withdrawal reflex (i.e., while the stimulation is activated) to enable improved exoskeletal walking. In order to examine the potential efficacy of this approach, two SCI subjects with severe extensor spasticity (i.e., modified Ashworth ratings of three to four) walked in an exoskeleton with and without supplemental stimulation while knee and hip motion was measured during swing phase. Stimulation was alternated on and off every ten steps to eliminate transient therapeutic effects, enabling the acute effects of stimulation to be isolated. These experiments indicated that common peroneal stimulation on average increased peak hip flexion during the swing phase of walking by 21.1° (236%) and peak knee flexion by 14.4° (56%). Additionally, use of the stimulation decreased the swing phase RMS motor current by 228 mA (15%) at the hip motors and 734 mA (38%) at the knee motors, indicating improved kinematics were achieved with reduced effort from the exoskeleton. Walking with the exoskeleton did not have a significant effect on modified Ashworth scores, indicating the common peroneal stimulation has only acute effects on suppressing extensor tone and aiding flexion. This preliminary data indicates that such supplemental stimulation may be used to improve the quality of movement provided by exoskeletons for persons with severe extensor spasticity in the lower limb.

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity

PubMed Central

Ekelem, Andrew; Goldfarb, Michael

2018-01-01

Spasticity is a common comorbidity associated with spinal cord injury (SCI). Robotic exoskeletons have recently emerged to facilitate legged mobility in people with motor complete SCI. Involuntary muscle activity attributed to spasticity, however, can prevent such individuals from using an exoskeleton. Specifically, although most exoskeleton technologies can accommodate low to moderate spasticity, the presence of moderate to severe spasticity can significantly impair gait kinematics when using an exoskeleton. In an effort to potentially enable individuals with moderate to severe spasticity to use exoskeletons more effectively, this study investigates the use of common peroneal stimulation in conjunction with exoskeleton gait assistance. The electrical stimulation is timed with the exoskeleton swing phase, and is intended to acutely suppress extensor spasticity through recruitment of the flexion withdrawal reflex (i.e., while the stimulation is activated) to enable improved exoskeletal walking. In order to examine the potential efficacy of this approach, two SCI subjects with severe extensor spasticity (i.e., modified Ashworth ratings of three to four) walked in an exoskeleton with and without supplemental stimulation while knee and hip motion was measured during swing phase. Stimulation was alternated on and off every ten steps to eliminate transient therapeutic effects, enabling the acute effects of stimulation to be isolated. These experiments indicated that common peroneal stimulation on average increased peak hip flexion during the swing phase of walking by 21.1° (236%) and peak knee flexion by 14.4° (56%). Additionally, use of the stimulation decreased the swing phase RMS motor current by 228 mA (15%) at the hip motors and 734 mA (38%) at the knee motors, indicating improved kinematics were achieved with reduced effort from the exoskeleton. Walking with the exoskeleton did not have a significant effect on modified Ashworth scores, indicating the common peroneal stimulation has only acute effects on suppressing extensor tone and aiding flexion. This preliminary data indicates that such supplemental stimulation may be used to improve the quality of movement provided by exoskeletons for persons with severe extensor spasticity in the lower limb. PMID:29910710

Skinfold thickness affects the isometric knee extension torque evoked by Neuromuscular Electrical Stimulation.

PubMed

Medeiros, Flávia V A; Vieira, Amilton; Carregaro, Rodrigo L; Bottaro, Martim; Maffiuletti, Nicola A; Durigan, João L Q

2015-01-01

Subcutaneous adipose tissue may influence the transmission of electrical stimuli through to the skin, thus affecting both evoked torque and comfort perception associated with neuromuscular electrical stimulation (NMES). This could seriously affect the effectiveness of NMES for either rehabilitation or sports purposes. To investigate the effects of skinfold thickness (SFT) on maximal NMES current intensity, NMES-evoked torque, and NMES-induced discomfort. First, we compared NMES current intensity, NMES-induced discomfort, and NMES-evoked torque between two subgroups of subjects with thicker (n=10; 20.7 mm) vs. thinner (n=10; 29.4 mm) SFT. Second, we correlated SFT to NMES current intensity, NMES-induced discomfort, and NMES-evoked knee extension torque in 20 healthy women. The NMES-evoked torque was normalized to the maximal voluntary contraction (MVC) torque. The discomfort induced by NMES was assessed with a visual analog scale (VAS). NMES-evoked torque was 27.5% lower in subjects with thicker SFT (p=0.01) while maximal current intensity was 24.2% lower in subjects with thinner SFT (p=0.01). A positive correlation was found between current intensity and SFT (r=0.540, p=0.017). A negative correlation was found between NMES-evoked torque and SFT (r=-0.563, p=0.012). No significant correlation was observed between discomfort scores and SFT (rs=0.15, p=0.53). These results suggest that the amount of subcutaneous adipose tissue (as reflected by skinfold thickness) affected NMES current intensity and NMES-evoked torque, but had no effect on discomfort perception. Our findings may help physical therapists to better understand the impact of SFT on NMES and to design more rational stimulation strategies.

Long-term interventions effects of robotic training on patients after anterior cruciate ligament reconstruction.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Ye, Miao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-08-01

[Purpose] The aim of this study was to examine the long-term interventions effects of robot-assisted therapy rehabilitation on functional activity levels after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 8 patients (6 males and 2 females) who received anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy lasting for one month. The Timed Up-and-Go test, 10-Meter Walk test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and extensor strength of isokinetic movement of the knee joint were evaluated before and after the intervention. [Results] The average value of the of vastus medialis EMG, Functional Reach Test, and the maximum and average extensor strength of the knee joint isokinetic movement increased significantly, and the time of the 10-Meter Walk test decreased significantly. [Conclusion] These results suggest that walking ability and muscle strength can be improved by robotic walking training as a long-term intervention.

Long-term interventions effects of robotic training on patients after anterior cruciate ligament reconstruction

PubMed Central

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Zhou, Yue; Gu, Rui; Ye, Miao; Ge, Meng; Xu, Yanfeng; Liu, Jianfeng

2016-01-01

[Purpose] The aim of this study was to examine the long-term interventions effects of robot-assisted therapy rehabilitation on functional activity levels after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 8 patients (6 males and 2 females) who received anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy lasting for one month. The Timed Up-and-Go test, 10-Meter Walk test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and extensor strength of isokinetic movement of the knee joint were evaluated before and after the intervention. [Results] The average value of the of vastus medialis EMG, Functional Reach Test, and the maximum and average extensor strength of the knee joint isokinetic movement increased significantly, and the time of the 10-Meter Walk test decreased significantly. [Conclusion] These results suggest that walking ability and muscle strength can be improved by robotic walking training as a long-term intervention. PMID:27630396

Muscle strength and fatigue in newly diagnosed patients with myasthenia gravis.

PubMed

Vinge, Lotte; Andersen, Henning

2016-10-01

Dynamometry is increasingly used as an objective measurement of muscle strength in neurological diseases. No study has applied dynamometry in untreated newly diagnosed patients with myasthenia gravis (MG). Isometric muscle strength at the shoulder, knee, and ankle was determined in 21 MG patients before and after initial anti-myasthenic treatment. Isometric strength was compared with MG evaluation scales. Muscle strength was reduced for knee extensors and shoulder abductors but normal for ankle extensors. Isometric muscle strength did not correlate significantly with manual muscle testing (MG Composite). Dynamometry revealed improved muscle strength of up to 50% (median 17%; range -1.8-49.8) despite no change in the MG Composite score. Dynamometry appears to be a more sensitive method of identifying changes in limb strength than MG evaluation scales. This supports the use of dynamometry in MG patients, especially for evaluation of the effect of anti-myasthenic treatment. Muscle Nerve 54: 709-714, 2016. © 2016 Wiley Periodicals, Inc.

Longitudinal sensitivity to change of MRI-based muscle cross-sectional area versus isometric strength analysis in osteoarthritic knees with and without structural progression: pilot data from the Osteoarthritis Initiative.

PubMed

Dannhauer, Torben; Sattler, Martina; Wirth, Wolfgang; Hunter, David J; Kwoh, C Kent; Eckstein, Felix

2014-08-01

Biomechanical measurement of muscle strength represents established technology in evaluating limb function. Yet, analysis of longitudinal change suffers from relatively large between-measurement variability. Here, we determine the sensitivity to change of magnetic resonance imaging (MRI)-based measurement of thigh muscle anatomical cross sectional areas (ACSAs) versus isometric strength in limbs with and without structural progressive knee osteoarthritis (KOA), with focus on the quadriceps. Of 625 "Osteoarthritis Initiative" participants with radiographic KOA, 20 had MRI cartilage and radiographic joint space width loss in the right knee isometric muscle strength measurement and axial T1-weighted spin-echo acquisitions of the thigh. Muscle ACSAs were determined from manual segmentation at 33% femoral length (distal to proximal). In progressor knees, the reduction in quadriceps ACSA between baseline and 2-year follow-up was -2.8 ± 7.9 % (standardized response mean [SRM] = -0.35), and it was -1.8 ± 6.8% (SRM = -0.26) in matched, non-progressive KOA controls. The decline in extensor strength was more variable than that in ACSAs, both in progressors (-3.9 ± 20%; SRM = -0.20) and in non-progressive controls (-4.5 ± 28%; SRM = -0.16). MRI-based analysis of quadriceps muscles ACSAs appears to be more sensitive to longitudinal change than isometric extensor strength and is suggestive of greater loss in limbs with structurally progressive KOA than in non-progressive controls.

High-threshold motor unit firing reflects force recovery following a bout of damaging eccentric exercise.

PubMed

Macgregor, Lewis J; Hunter, Angus M

2018-01-01

Exercise-induced muscle damage (EIMD) is associated with impaired muscle function and reduced neuromuscular recruitment. However, motor unit firing behaviour throughout the recovery period is unclear. EIMD impairment of maximal voluntary force (MVC) will, in part, be caused by reduced high-threshold motor unit firing, which will subsequently increase to recover MVC. Fourteen healthy active males completed a bout of eccentric exercise on the knee extensors, with measurements of MVC, rate of torque development and surface electromyography performed pre-exercise and 2, 3, 7 and 14 days post-exercise, on both damaged and control limb. EIMD was associated with decreased MVC (235.2 ± 49.3 Nm vs. 161.3 ± 52.5 Nm; p <0.001) and rate of torque development (495.7 ± 136.9 Nm.s-1 vs. 163.4 ± 163.7 Nm.s-1; p <0.001) 48h post-exercise. Mean motor unit firing rate was reduced (16.4 ± 2.2 Hz vs. 12.6 ± 1.7 Hz; p <0.01) in high-threshold motor units only, 48h post-exercise, and common drive was elevated (0.36 ± 0.027 vs. 0.56 ± 0.032; p< 0.001) 48h post-exercise. The firing rate of high-threshold motor units was reduced in parallel with impaired muscle function, whilst early recruited motor units remained unaltered. Common drive of motor units increased in offset to the firing rate impairment. These alterations correlated with the recovery of force decrement, but not of pain elevation. This study provides fresh insight into the central mechanisms associated with EIMD recovery, relative to muscle function. These findings may in turn lead to development of novel management and preventative procedures.

The efficacy of periodised resistance training on neuromuscular adaptation in older adults.

PubMed

Conlon, Jenny A; Newton, Robert U; Tufano, James J; Peñailillo, Luis E; Banyard, Harry G; Hopper, Amanda J; Ridge, Ashley J; Haff, G Gregory

2017-06-01

This study compared the effect of periodised versus non-periodised (NP) resistance training on neuromuscular adaptions in older adults. Forty-one apparently healthy untrained older adults (female = 21, male = 20; 70.9 ± 5.1 years; 166.3 ± 8.2 cm; 72.9 ± 13.4 kg) were recruited and randomly stratified to an NP, block periodised (BP), or daily undulating periodised (DUP) training group. Outcome measures were assessed at baseline and following a 22-week resistance training intervention (3 day week -1 ), including: muscle cross-sectional area (CSA), vertical jump performance, isometric and isokinetic peak torque, isometric rate of force development (RFD), and muscle activation. Thirty-three participants satisfied all study requirements and were included in analyses (female = 17, male = 16; 71.3 ± 5.4 years; 166.3 ± 8.5 cm; 72.5 ± 13.7 kg). Block periodisation, DUP, and NP resistance training induced statistically significant improvements in muscle CSA, vertical jump peak velocity, peak power and jump height, and peak isometric and isokinetic torque of the knee extensors at 60 and 180° s -1 , with no between-group differences. Muscle activity and absolute RFD measures were statistically unchanged following resistance training across the entire cohort. Periodised resistance training, specifically BP and DUP, and NP resistance training are equally effective for promoting increases in muscular hypertrophy, strength, and power among untrained older adults. Consequently, periodisation strategies are not essential for optimising neuromuscular adaptations during the initial stages of resistance training in the aging population.

A systems-based investigation into vitamin D and skeletal muscle repair, regeneration, and hypertrophy.

PubMed

Owens, Daniel J; Sharples, Adam P; Polydorou, Ioanna; Alwan, Nura; Donovan, Timothy; Tang, Jonathan; Fraser, William D; Cooper, Robert G; Morton, James P; Stewart, Claire; Close, Graeme L

2015-12-15

Skeletal muscle is a direct target for vitamin D. Observational studies suggest that low 25[OH]D correlates with functional recovery of skeletal muscle following eccentric contractions in humans and crush injury in rats. However, a definitive association is yet to be established. To address this gap in knowledge in relation to damage repair, a randomised, placebo-controlled trial was performed in 20 males with insufficient concentrations of serum 25(OH)D (45 ± 25 nmol/l). Prior to and following 6 wk of supplemental vitamin D3 (4,000 IU/day) or placebo (50 mg of cellulose), participants performed 20 × 10 damaging eccentric contractions of the knee extensors, with peak torque measured over the following 7 days of recovery. Parallel experimentation using isolated human skeletal muscle-derived myoblast cells from biopsies of 14 males with low serum 25(OH)D (37 ± 11 nmol/l) were subjected to mechanical wound injury, which enabled corresponding in vitro studies of muscle repair, regeneration, and hypertrophy in the presence and absence of 10 or 100 nmol 1α,25(OH)2D3. Supplemental vitamin D3 increased serum 25(OH)D and improved recovery of peak torque at 48 h and 7 days postexercise. In vitro, 10 nmol 1α,25(OH)2D3 improved muscle cell migration dynamics and resulted in improved myotube fusion/differentiation at the biochemical, morphological, and molecular level together with increased myotube hypertrophy at 7 and 10 days postdamage. Together, these preliminary data are the first to characterize a role for vitamin D in human skeletal muscle regeneration and suggest that maintaining serum 25(OH)D may be beneficial for enhancing reparative processes and potentially for facilitating subsequent hypertrophy. Copyright © 2015 the American Physiological Society.

Vastus lateralis surface and single motor unit EMG following submaximal shortening and lengthening contractions.

PubMed

Altenburg, Teatske M; de Ruiter, Cornelis J; Verdijk, Peter W L; van Mechelen, Willem; de Haan, Arnold

2008-12-01

A single shortening contraction reduces the force capacity of muscle fibers, whereas force capacity is enhanced following lengthening. However, how motor unit recruitment and discharge rate (muscle activation) are adapted to such changes in force capacity during submaximal contractions remains unknown. Additionally, there is limited evidence for force enhancement in larger muscles. We therefore investigated lengthening- and shortening-induced changes in activation of the knee extensors. We hypothesized that when the same submaximal torque had to be generated following shortening, muscle activation had to be increased, whereas a lower activation would suffice to produce the same torque following lengthening. Muscle activation following shortening and lengthening (20 degrees at 10 degrees /s) was determined using rectified surface electromyography (rsEMG) in a 1st session (at 10% and 50% maximal voluntary contraction (MVC)) and additionally with EMG of 42 vastus lateralis motor units recorded in a 2nd session (at 4%-47%MVC). rsEMG and motor unit discharge rates following shortening and lengthening were normalized to isometric reference contractions. As expected, normalized rsEMG (1.15 +/- 0.19) and discharge rate (1.11 +/- 0.09) were higher following shortening (p < 0.05). Following lengthening, normalized rsEMG (0.91 +/- 0.10) was, as expected, lower than 1.0 (p < 0.05), but normalized discharge rate (0.99 +/- 0.08) was not (p > 0.05). Thus, muscle activation was increased to compensate for a reduced force capacity following shortening by increasing the discharge rate of the active motor units (rate coding). In contrast, following lengthening, rsEMG decreased while the discharge rates of active motor units remained similar, suggesting that derecruitment of units might have occurred.

Fish-oil supplementation enhances the effects of strength training in elderly women.

PubMed

Rodacki, Cintia L N; Rodacki, André L F; Pereira, Gleber; Naliwaiko, Katya; Coelho, Isabela; Pequito, Daniele; Fernandes, Luiz Cléudio

2012-02-01

Muscle force and functional capacity generally decrease with aging in the older population, although this effect can be reversed, attenuated, or both through strength training. Fish oil (FO), which is rich in n-3 (omega-3) PUFAs, has been shown to play a role in the plasma membrane and cell function of muscles, which may enhance the benefits of training. The effect of strength training and FO supplementation on the neuromuscular system of the elderly has not been investigated. The objective was to investigate the chronic effect of FO supplementation and strength training on the neuromuscular system (muscle strength and functional capacity) of older women. Forty-five women (aged 64 ± 1.4 y) were randomly assigned to 3 groups. One group performed strength training only (ST group) for 90 d, whereas the others performed the same strength-training program and received FO supplementation (2 g/d) for 90 d (ST90 group) or for 150 d (ST150 group; supplemented 60 d before training). Muscle strength and functional capacity were assessed before and after the training period. No differences in the pretraining period were found between groups for any of the variables. The peak torque and rate of torque development for all muscles (knee flexor and extensor, plantar and dorsiflexor) increased from pre- to posttraining in all groups. However, the effect was greater in the ST90 and ST150 groups than in the ST group. The activation level and electromechanical delay of the muscles changed from pre- to posttraining only for the ST90 and ST150 groups. Chair-rising performance in the FO groups was higher than in the ST group. Strength training increased muscle strength in elderly women. The inclusion of FO supplementation caused greater improvements in muscle strength and functional capacity.

High-threshold motor unit firing reflects force recovery following a bout of damaging eccentric exercise

PubMed Central

Macgregor, Lewis J.

2018-01-01

Exercise-induced muscle damage (EIMD) is associated with impaired muscle function and reduced neuromuscular recruitment. However, motor unit firing behaviour throughout the recovery period is unclear. EIMD impairment of maximal voluntary force (MVC) will, in part, be caused by reduced high-threshold motor unit firing, which will subsequently increase to recover MVC. Fourteen healthy active males completed a bout of eccentric exercise on the knee extensors, with measurements of MVC, rate of torque development and surface electromyography performed pre-exercise and 2, 3, 7 and 14 days post-exercise, on both damaged and control limb. EIMD was associated with decreased MVC (235.2 ± 49.3 Nm vs. 161.3 ± 52.5 Nm; p <0.001) and rate of torque development (495.7 ± 136.9 Nm.s-1 vs. 163.4 ± 163.7 Nm.s-1; p <0.001) 48h post-exercise. Mean motor unit firing rate was reduced (16.4 ± 2.2 Hz vs. 12.6 ± 1.7 Hz; p <0.01) in high-threshold motor units only, 48h post-exercise, and common drive was elevated (0.36 ± 0.027 vs. 0.56 ± 0.032; p< 0.001) 48h post-exercise. The firing rate of high-threshold motor units was reduced in parallel with impaired muscle function, whilst early recruited motor units remained unaltered. Common drive of motor units increased in offset to the firing rate impairment. These alterations correlated with the recovery of force decrement, but not of pain elevation. This study provides fresh insight into the central mechanisms associated with EIMD recovery, relative to muscle function. These findings may in turn lead to development of novel management and preventative procedures. PMID:29630622

Load compensating reactions to perturbations at wrist joint in normal man

NASA Technical Reports Server (NTRS)

Jaeger, R. J.; Agarwell, G. C.; Gottlieb, G. L.

1981-01-01

The electromyographic responses to step torque loads were studied in flexors and extensors at the human wrist. Based on temporal bursting patterns and functional behavior, the response was divided into four temporal components. Two early components, the myotatic (30-60 ms) late myotatic (60-120 ms) appears to be reflex response. The third postmyotatic component (120-200 ms) appear to be a triggered reaction, preceeding the fourth, stabilizing component (200-400 ms). A comparison of response at the wrist with similar data at the ankle provides the basis for a generalized classification of the response in various muscles to torque step perturbations.

Robot-assisted gait training in multiple sclerosis: a pilot randomized trial.

PubMed

Beer, S; Aschbacher, B; Manoglou, D; Gamper, E; Kool, J; Kesselring, J

2008-03-01

To evaluate feasibility and perform an explanatory analysis of the efficacy of robot-assisted gait training (RAGT) in MS patients with severe walking disabilities (Expanded Disability Status Scale [EDSS] 6.0-7.5) in a pilot trial. Prospective, randomized, controlled clinical trial comparing RAGT with conventional walking training (CWT) in a group of stable MS patients (n = 35) during an inpatient rehabilitation stay, 15 sessions over three weeks. All patients participated additionally in a multimodal rehabilitation program. The primary outcome measure was walking velocity and secondary measures were 6-min-walking distance, stride length and knee-extensor strength. All tests were performed by an external blinded assessor at baseline after three weeks and at follow-up after six months. Additionally, Extended Barthel Index (EBI) at entry and discharge was assessed (not blinded), and acceptance/convenience of RAGT rated by patients (Visual Analogue Scale [VAS]) was recorded. Nineteen patients were randomly allocated to RAGT and 16 patients to CWT. Groups were comparable at baseline. There were 5 drop-outs (2 related directly to treatment) in the RAGT group and 1 in the CWT group, leaving 14 RAGT patients and 15 CWT patients for final analysis. Acceptance and convenience of RAGT as rated by patients were high. Effect sizes were moderate to large, although not significant, for walking velocity (0.700, 95% CI -0.089 to 1.489), walking distance (0.401, 95% CI - 0.370 to 1.172) and knee-extensor strength (right: 1.105, 95% CI 0.278 to 1.932, left 0.650, 95% CI -0.135 to 1.436) favouring RAGT. Prepost within-group analysis revealed an increase of walking velocity, walking distance and knee-extensor strength in the RAGT group, whereas in CWT group only walking velocity was improved. In both groups outcome values returned to baseline at follow-up after six months (n = 23). Robot-assisted gait training is feasible and may be an effective therapeutic option in MS patients with severe walking disabilities. Effect size calculation and prepost analysis suggest a higher benefit on walking velocity and knee-extensor strength by RAGT compared to CWT. Due to several limitations, however, our results should be regarded as preliminary. Post hoc power calculation showed that two groups of 106 patients are needed to demonstrate a significant moderate effect size of 0.4 after three weeks of RAGT. Thus, further studies with a larger number of patients are needed to investigate the impact of this new treatment option in MS patients.

The effect of high intensity exercise and anticipation on trunk and lower limb biomechanics during a crossover cutting manoeuvre.

PubMed

Whyte, Enda F; Richter, Chris; O'connor, Siobhan; Moran, Kieran A

2018-04-01

We investigated the effects of high intensity, intermittent exercise (HIIP) and anticipation on trunk, pelvic and lower limb biomechanics during a crossover cutting manoeuvre. Twenty-eight male, varsity athletes performed crossover cutting manoeuvres in anticipated and unanticipated conditions pre- and post-HIIP. Kinematic and kinetic variables were captured using a motion analysis system. Statistical parametric mapping (repeated-measures ANOVA) was used to identify differences in biomechanical patterns. Results demonstrated that both unanticipation and fatigue (HIIP) altered the biomechanics of the crossover cutting manoeuvre, whereas no interactions effects were observed. Unanticipation resulted in less trunk and pelvic side flexion in the direction of cut (d = 0.70 - 0.79). This led to increased hip abductor and external rotator moments and increased knee extensor and valgus moments with small effects (d = 0.24-0.42), potentially increasing ACL strain. The HIIP resulted in trivial to small effects only with a decrease in internal knee rotator and extensor moment and decreased knee power absorption (d = 0.35), reducing potential ACL strain. The effect of trunk and hip control exercises in unanticipated conditions on the crossover cutting manoeuvre should be investigated with a view to refining ACL injury prevention programmes.