Validity of maximal isometric knee extension strength measurements obtained with a belt-stabilized hand-held dynamometer method in healthy adults

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e1562
Author(s):  
N. Ushiyama ◽  
Y. Kurobe ◽  
K. Momose
2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Adam Weaver ◽  
Dylan Roman ◽  
Maua Mosha ◽  
Nicholas Giampetruzzi

Background: The standard of care in ACL reconstruction (ACLR) typically involves standardized strength testing at 6 months or later to assess a patient’s readiness to return to play (RTP) using isokinetic and isometric testing, and functional strength testing. Recent literature suggests that isokinetic knee extension strength should demonstrate 89% limb symmetry index (LSI) or greater prior to returning to sport. However, there is little known on the effects of strength testing early in the rehabilitation process and the relationship to strength test performance at time of RTP. Purpose: The purpose of this study was to examine how early post-operative strength test performance impacts isokinetic strength outcomes at RTP testing in adolescents. Methods: The retrospective cohort study included patients undergoing primary ACLR between 12 and 18 years of age, early post-operative strength measures, and isokinetic dynamometer strength at RTP from July 2017 and April 2019. Data was dichotomized into desired outcomes at 3 months: >70% isometric knee extension LSI, > 20 repetitions on anterior stepdown test (AST), > 90% LSI Y Balance. At RTP testing, isokinetic knee extension strength data was categorized into >89% LSI at 3 speeds (300, 180, 60°/sec). Chi square testing and odds ratio statistics were used to examine association and its magnitude. Results: 63 patients met inclusion criteria (38 females; 15.37±1.66 years old). >70% LSI isometric knee extension strength at 3 months showed a significant association (Table 2) and demonstrated the strongest odds of having >89% LSI on isokinetic strength tests at all 3 speeds at RTP with 180°/sec being the highest (OR=14.5; 95% CI=4.25,49.43; p= <0.001). Performance on AST showed a significant association (χ2 (1, n=63) = 17.00, p <0.001), and highest odds at 180°/sec (OR=4.61; 95% CI = 1.59, 13.39, p=<0.001) and 60°/sec (OR= 3.07; 95% CI = 1.10, 8.63, p= 0.04). Combination of performance on isometric strength tests and AST showed a significant association to isokinetic strength at all three speeds, but less predictive then isometrics in isolation. (Table 2). There was no significant relationship between YBR LSI at 3 months and isokinetic strength at 6 months. Conclusion: Standardized strength testing early in rehabilitation can help identify patients that will successfully complete RTP testing. Our results suggest that isometric knee extension strength and timed anterior stepdown test provide meaningful clinical information early in the rehabilitation process. This data also suggests that the use of YBAL for predicting isokinetic strength performance is limited. [Table: see text][Table: see text]


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nikola Rommersbach ◽  
Rainer Wirth ◽  
Gero Lueg ◽  
Christiane Klimek ◽  
Mirja Schnatmann ◽  
...  

Abstract Background We assessed the quantitative changes in muscle mass and strength during 2 weeks of hospitalization in immobile and mobile acutely ill hospitalized older adults. Methods Forty-one patients (82.4 ± 6.6 years, 73.0% females) participated in this prospective longitudinal observational study. Mobility status was defined according to walking ability as described in the Barthel-Index. Functional status, including handgrip strength and isometric knee-extension strength, and mid-thigh magnetic resonance imaging (MRI) measurements of cross-sectional area (CSA) were conducted on admission and at discharge. Results Twenty-two participants (54%) were immobile and 19 (46%) mobile. In all, 54.0 and 12.0% were at risk of malnutrition and malnourished, respectively. The median time between baseline and follow-up for MRI scans were 13 days in mobile and immobile participants (P = 0.072). Mid-thigh muscle and subcutaneous fat CSA significantly decreased by 3.9cm2 (5.0%, P = 0.002) and 5.3cm2 (5.7%, P = 0.036) during hospitalization whereas intermuscular fat remained unchanged in immobile subjects. No significant changes were observed in mobile patients. In a regression analysis, mobility was the major independent risk factor for changes in mid-thigh muscle CSA as a percentage of initial muscle area (P = 0.022) whereas other variables such as age (P = 0.584), BMI (P = 0.879), nutritional status (P = 0.835) and inflammation (P = 0.291) were not associated with muscle mass changes. There was a significant decrease in isometric knee extension strength (P = 0.002) and no change in handgrip strength (P = 0.167) in immobile patients whereas both parameters increased significantly over time in mobile patients (P = 0.048 and P = 0.012, respectively). Conclusions Two weeks of disease-related immobilization result in a significant loss of thigh muscle mass and muscle strength in older patients with impaired mobility. Concomitantly, there was a significant reduction of subcutaneous adipose tissue in immobile older hospitalized patients whereas no changes were observed in intermuscular fat among these patients. These data highlight the importance of mobility support in maintaining muscle mass and function in older hospitalized patients.


2009 ◽  
Vol 24 (5) ◽  
pp. 693-696
Author(s):  
Hiroshi YAMASAKI ◽  
Toshifumi SOGAWA ◽  
Yasushi HIRAGA ◽  
Kunihiro KATAYAMA ◽  
Koji SHIGESHIMA ◽  
...  

2018 ◽  
Vol 55 (4) ◽  
pp. 624-631
Author(s):  
Mika Tada ◽  
Yoshitsugu Omori ◽  
Takuma Mogamiya ◽  
Shotaro Sasaki ◽  
Hironobu Katata ◽  
...  

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Karl Henrikson ◽  
Sanjib Adhikary ◽  
Gregory Pace ◽  
Wai Liu ◽  
Paul Juliano ◽  
...  

Category: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.


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