scholarly journals Self-Managed Strength Training for Active Duty Military With a Knee Injury: A Randomized Controlled Pilot Trial

2019 ◽  
Vol 184 (7-8) ◽  
pp. e174-e183 ◽  
Author(s):  
Laura A Talbot, Col, USAFR (Ret.) ◽  
Emily Brede ◽  
Marquita N Price ◽  
Pilar d Zuber ◽  
E Jeffrey Metter
Keyword(s):  
Knee Flexion ◽  
Knee Injuries ◽  
Knee Extensor ◽  
Knee Extension ◽  
Active Duty ◽  
Group Differences ◽  
Significant Group ◽  
Active Duty Military ◽  
Significant Difference ◽  
Injured Knee

Abstract Introduction Knee injuries among active duty military are one of the most frequent musculoskeletal injuries and are often caused by exercise or intense physical activity or combat training. These injuries pose a threat to force readiness. Our objective was to assess feasibility (including recruitment and retention rates) of three self-managed strengthening strategies for knee injuries and determine if they resulted in improvements in lower extremity strength, function, pain, and activity compared to usual physical therapy (PT) in military members. Methods A pilot study using a randomized controlled trial was conducted at three outpatient military medical treatment facilities. After baseline testing, 78 active duty military members with a knee injury were randomized to 1–4 trial arms: (1) neuromuscular electrical stimulation (NMES) applied to the quadriceps muscle; (2) graduated strength walking using a weighted vest (WALK); (3) combined NMES with strength walking (COMBO); (4) usual PT alone. All groups received usual PT. The primary outcome was the rates of change in knee extensor and flexor strength over 18 weeks. Secondary outcomes explored the rates of change in functional performance, pain, and activities of daily living scale (ADLS). The primary analysis for the endpoints used repeated measures, linear mixed-effects models. This study was approved by Institutional Review Boards at all facilities. Results The randomized sample (N = 78) included 19 participants in the PT-only, 20 in the WALK, 19 in the NMES and 20 in the COMBO groups. At baseline, there were no group differences. Fifty of the participants completed the 18-week study. The completers and non-completers differed at baseline on injury mechanism, with more completers injured during sports (45% vs 29%), and more non-completers during military training (36% vs 18%). Also, they differed in uninjured knee extension (completers 28% weaker), and uninjured knee flexion (completers 22% weaker). Adherence for self-reported daily step logs showed that the WALK group was 15% below goal and COMBO group 6% below goal. The 300 PV muscle stimulator showed the NMES group completed 34% of recommended stimulation sessions and the COMBO group 30%. Knee extension strength in the injured knee found only the COMBO group having a statistically higher improvement compared to PT-only (Change over 18 weeks: 10.6 kg in COMBO; 2.1 kg in PT-only). For the injured knee flexion changes, only the COMBO showed significant difference from PT-only (Change over 18 weeks: 7.5 kg in COMBO; −0.2 kg in PT-only). Similarly, for the uninjured knee, only the COMBO showed significant difference from PT-only in knee extension (Change over 18 weeks: 14.7 Kg in COMBO; 2.7 kg in PT-only) and knee flexion (Change over 18 weeks: 6.5 kg in COMBO; −0.2 kg in PT-only). Overall pain improved during the study for all groups with no significant group differences. Similarly, function and ADLS significantly improved over 18 weeks, with no significant group differences. Conclusions Knee extensor strength improvements in the COMBO group were significantly higher compared to usual PT. Pain, functional measures, and ADLS all improved during the study with no group differences. Further research is required to confirm these findings.

The Effect of T'AI Chi Chuan Training on Balance, Kinesthetic Sense, and Strength

1997 ◽  
Vol 84 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Bert H. Jacobson ◽  
Chen Ho-Cheng ◽  
Chris Cashel ◽  
Larry Guerrero
Keyword(s):  
Glenohumeral Joint ◽  
Knee Extensor ◽  
Knee Extension ◽  
Group Differences ◽  
Control Group ◽  
Significant Group ◽  
T'ai Chi ◽  
Kinesthetic Sense ◽  
Lateral Body ◽  
T’Ai Chi

The purpose of this study was to assess the effect of T'ai Chi Chuan training on lateral stability, kinesthetic sense, and strength of voluntary knee extension. Subjects consisted of 24 naive volunteers (12 men and 12 women) between the ages of 20 and 45 years. Pre- and 12-week posttests included lateral body stability, kinesthetic sense in the glenohumeral joint for 30°, 45°, and 60°, and strength of knee extension. After pretest data collection, 12 subjects performed T'ai Chi Chuan three times per week for 12 weeks, learning 108 forms of T'ai Chi Chuan. A 2 × 2 analysis of variance was used to estimate significance of group differences on all of the dependent variables. Significant group differences were found in lateral body stability, kinesthetic sense at 60°, and strength of the dominant knee extensor. No significant differences between the T'ai Chi and the control group were found for kinesthetic sense at 30° and 45° rotation of the glenohumeral joint. Film analysis indicated that the two lesser angles were not as common in the T'ai Chi training as the greater angle (60°) and thus may be less practiced. It appears that T'ai Chi Chuan presents a low-stress method to enhance stability, selected kinesthetic sense, and strength of knee extension.

scholarly journals PO-166 Neuromuscular Fatigue after maximal Concentric and Eccentric Contractions of Knee Extensor

2018 ◽  
Vol 1 (4) ◽  
Author(s):  
Shenpeng Xu ◽  
Ying Wang ◽  
Wan Chen
Keyword(s):  
Electrical Stimulation ◽  
Knee Flexion ◽  
Low Frequency ◽  
Knee Extensor ◽  
Knee Extension ◽  
Neuromuscular Fatigue ◽  
Peripheral Fatigue ◽  
Concentric Exercise ◽  
Significant Difference ◽  
Low Frequency Fatigue

Objective The aim of this study was to investigate after different maximal contractions concentric and eccentric would cause different neuromuscular fatigue of knee extensor.  Methods Ten healthy young men(21≤age≤24) who were not adapted by electrical stimulation were the subjects.The subjects were asked to arrive at the laboratory in three weeks at the same time of every week to avoid the effects of biological rhythms.Each subject performed three group maximal contractions on the ISOMED2000 isokinetic muscle tester according to the requirements.The subjects performed the same neuromuscular function test before and after exercise.The centripetal motion scheme:3*30,M1(knee flexion)-CON,M2(knee extension)-CON.angular velocity is 60 °,interval 30s in each group.Centrifugal motion scheme:3*30,M1(knee flexion)-ECC,M2(knee extension)-ECC.angular velocity is 60 °,interval 30s in each group.  Results The decrease rate of peak torque after concentric exercise was 55.93±13.20%, which was significantly higher than that after centrifugal exercise (20.06 ±11.06%, P < 0.01)The total work of the concentric movement was 8737.20±1543.43J, which was significantly smaller than that of the centrifugal exercise group (14312.20±2978.31J, P < 0. 01).The decline rate of MVC in concentric exercise was 24.89 ±10.54 and that in centrifugal exercise was 19.32±9.90,there was no significant difference between the two groups. Double Twitch induced a very significant decrease in PT-SSR RFD-SSN RHD-SS (P<0.01).There was no significant difference in VA decline rate.PAP decreased from 142.82±14.55% to 125.23±11.36 after concentric exercise, and after eccentric exercise PAP decreased from 141.1215.72% to 126.02 ±10.45.  Conclusions The neuromuscular fatigue caused by two kinds of exercise. Peripheral fatigue accounted for 39.19% after concentric exercise and 23.59% after centrifugal exercise,but there was little difference in the degree of central fatigue.All of them showed low frequency fatigue, and the low frequency fatigue after centrifugal exercise was more obvious. Key World:Neuromuscular fatigue; Electrical stimulation; High-frequency fatigue; Low-frequency fatigue; PAP.

A comparative study of the acute effects of knee brace vs. kinesiotape on selected isokinetic strength variables of the knee muscles

2021 ◽  
pp. 1-6
Author(s):  
Ali Kerim Yilmaz ◽  
Mehmet Vural ◽  
Mustafa Özdal ◽  
Menderes Kabadayi
Keyword(s):  
Knee Injuries ◽  
Knee Extension ◽  
Acute Effects ◽  
Post Injury ◽  
Kinesio Tape ◽  
Knee Strength ◽  
Significant Difference ◽  
S Peak ◽  
Male Subjects ◽  
Methods Of Treatment

BACKGROUND: Different methods of treatment for preventing knee injuries, enhancing knee strength and minimising post-injury risks have been explored. Among these methods, Kinesio tape (KT) and knee braces (KB) are commonly used. OBJECTIVE : To investigate the acute effects of KT and KB on isokinetic knee strength parameters. METHODS: A total of 15 healthy sedentary male subjects voluntarily participated in the study. Concentric isokinetic knee extension (EX) and flexion (FLX) strength were measured at three sessions: 1. Baseline 2. with KT (’KT’) 3. with KB (’KB’). Tests were performed at 60, 180 and 240∘/s. Peak moment (PM), Hamstring/Quadriceps ratio (HQR), and joint angle at peak moment (JAPM) were measured. RESULTS: ‘KT’ and ‘KB’ were associated with increase in PMEX, PMFLX, HQR at 60 and 240∘/s (p< 0.05) and increased JAPMEX. No significant difference was observed at 180∘/s (p> 0.05). CONCLUSION: In healthy individuals, ‘I’ shape KT and KB positively affect EX and FLX strengths and HQR, especially at low angular velocity.

Acceptance and Feasibility of Seated Elliptical Pedaling to Replace Sedentary Behavior in Older Adults

2020 ◽  
Vol 28 (6) ◽  
pp. 844-853
Author(s):  
Nicholas L. Lerma ◽  
Chi C. Cho ◽  
Ann M. Swartz ◽  
Hotaka Maeda ◽  
Young Cho ◽  
...  
Keyword(s):  
Older Adults ◽  
Light Intensity ◽  
Health Outcomes ◽  
Sedentary Behavior ◽  
Activity Monitor ◽  
Group Differences ◽  
Significant Group ◽  
Significant Difference ◽  
The Impact

The purpose of this study was to explore the feasibility and acceptability of a seated pedaling device to reduce sedentary behavior (SB) in the homes of older adults. Methods: Each participant (N = 20) was outfitted with an activity monitor and seated pedaling device in the home for 7 days and randomly assigned to one of four light-intensity pedaling groups (15, 30, 45, and 60 min/day). Results: There was 100% adherence in all groups and significant group differences in the minutes pedaled per day (p < .001), with no significant difference in the total pedaling days completed (p = .241). The 15-, 30-, 45-, and 60-min groups experienced a 4.0%, 5.4%, 10.6%, and 11.3% reduction in SB on the days pedaled, respectively. Conclusion: Clinically relevant reductions in SB time were achievable in this 1-week trial. Long-term adherence and the impact of replacing SB with seated light activities on geriatric-relevant health outcomes should be investigated.

scholarly journals Criterion-Related Validity of Knee Joint-Position-Sense Measurement Using Image Capture and Isokinetic Dynamometry

2015 ◽  
Vol 24 (1) ◽  
Author(s):  
Nicola Relph ◽  
Lee Herrington
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Cost Effective ◽  
Absolute Error ◽  
Knee Extension ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Image Capture ◽  
Significant Difference

Context: Clinicians require portable, valid, and cost-effective methods to monitor knee joint-position-sense (JPS) ability. Objective: To examine the criterion-related validity of image-capture JPS measures against an isokinetic-dynamometer (IKD) procedure. Design: Random crossover design providing a comparison of knee JPS measures from image capture and IKD procedures. Participants: 10 healthy participants, 5 female, age 28.0 ± 13.29 y, mass 60.3 ± 9.02 kg, height 1.65 ± 0.07 m, and 5 male, 29.6 ± 10.74 y, mass 73.6 ± 5.86 kg, height 1.75 ± 0.07 m. Main Outcome Measures: The dependent variables were absolute error scores (AES) provided by 2 knee directions (flexion and extension). The independent variables were the method (image capture and IKD). Results: There was no significant difference between clinical and IKD AED into knee-extension data (P = .263, r = 0.55). There was a significant difference between clinical and IKD AES into knee-flexion data (P = .016, r =.70). Conclusions: Analysis of photographic images to assess JPS measurements using knee flexion is valid against IKD techniques. However, photo-analysis measurements provided a lower error score using knee-extension data and thus may provide an optimal environment to produce maximal knee JPS acuity. Therefore, clinicians do not need expensive equipment to collect representative JPS ability.

Quadriceps weakness in a family with nemaline myopathy: influence of knee angle

2003 ◽  
Vol 105 (5) ◽  
pp. 585-589 ◽  
Author(s):  
Karin GERRITS ◽  
Inge GOMMANS ◽  
Baziel VAN ENGELEN ◽  
Arnold DE HAAN
Keyword(s):  
Muscle Weakness ◽  
Knee Flexion ◽  
Knee Extensor ◽  
Nemaline Myopathy ◽  
Knee Extension ◽  
Neuromuscular Disorder ◽  
Quadriceps Weakness ◽  
Normal Strength ◽  
Torque Angle

Nemaline myopathy is a congenital neuromuscular disorder, which primarily affects the thin filaments. Clinically the most important feature is muscle weakness; however, this weakness is poorly understood. The present investigation aimed to determine the torque angle relationship of the knee extensor muscles during in vivo muscle contractions in a family with a novel phenotype of nemaline myopathy. The results of this study show that quadriceps weakness occurs predominantly at higher knee flexion angles, but relatively normal strength was found at angles closer to full knee extension. When the relative torque angle relationships were considered, torque loss at smaller than optimum knee flexion angle was greater in the patients compared with the controls. In addition, the optimum angle for maximal quadriceps torque production was shifted towards smaller knee flexion angles in the patients. This suggests that a weakness specifically at higher knee flexion angles probably occurs as a result of adaptations consequently to the disease. Furthermore, it is important to assess muscle function at different joint positions to allow adequate interpretation of muscle weakness.

scholarly journals Contextual Information Modulates Pupil Size in Autistic and Non-Autistic Children.

2021 ◽  
Author(s):  
Chiara Tortelli ◽  
Antonella Pomè ◽  
Marco Turi ◽  
Roberta Igliozzi ◽  
David Charles Burr ◽  
...  
Keyword(s):  
Comparison Group ◽  
Contextual Information ◽  
Self Report ◽  
Group Differences ◽  
Clinical Samples ◽  
Clinical Group ◽  
The Sun ◽  
Autistic Children ◽  
Significant Group ◽  
Significant Difference

Abstract Background. Recent Bayesian models suggest that perception is more “data-driven” and less dependent on contextual information in autistic individuals than others. However, experimental tests of this hypothesis have given mixed results, possibly due to the lack of objectivity of the self-report methods typically employed. Here we introduce an objective no-report paradigm based on pupillometry to assess the processing of contextual information in autistic children and a comparison clinical group.Methods. After validating (in a group of neurotypical adults) a child-friendly pupillometric paradigm, in which we embedded test images within an animation movie that participants watched passively, we compared pupillary response to images of the sun and meaningless control images in children with autism versus age- and IQ-matched children presenting developmental disorders unrelated to the autistic spectrum. Results. Both clinical groups showed stronger pupillary constriction for the sun images compared with control images, like the neurotypical adults. There was no detectable difference between autistic children and the comparison group (in spite of a significant difference in pupillary light responses, enhanced in the autistic group). Limitations: Having found no statistically significant differences between groups, we cannot exclude that group differences existed but were too small to be detected – a critique that applies to most negative findings. Additional limitations concern the heterogeneous composition of the comparison group and the types of stimuli tested, which only allowed for studying the effect of context on relatively complex perceptual processes. Conclusions: Our report introduces an objective technique for studying perception in clinical samples and children. The lack of statistically significant group differences in our tests suggests that autistic children and the comparison group do not show large differences in perception of these stimuli. This opens the way to further studies testing contextual processing at other levels of perception.

scholarly journals Does the Early and Late Rate of Torque Development, Change in Relation to the Quadriceps Angle?

2019 ◽  
Vol 7 (3S) ◽  
pp. 1
Author(s):  
Ajlan Saç
Keyword(s):  
Lower Extremity ◽  
Knee Injuries ◽  
Knee Extensor ◽  
Myoelectrical Activity ◽  
Rate Of Torque Development ◽  
Q Angle ◽  
Extensor Muscles ◽  
Significant Difference ◽  
Torque Development ◽  
Knee Extensor Muscles

The rate of torque development (RTD), which determines the force that can be developed in the early phase of muscle contraction (0-200 ms), is very important in terms of tracking explosive strength improvement and preventing knee injuries. The purpose of this study was to investigate the relationship of quadriceps angle which affects the structural alignment of the lower extremity with early (0-100 ms) and late (100-200 ms) rate of torque development of the knee extensor muscles and myoelectrical activity. The study was carried out with 38 well-trained male basketball players (mean age: 22.3±2.5 years). The participants were divided into two groups with normal (<11°) and abnormal (>10°) values. RTD was measured in concentric/concentric mode at 60, 120 and 180°/s angular velocities in an isokinetic dynamometer. Surface electromyography (sEMG) was used to determine the myoelectrical activity. When RTD0-100 and RTD100-200 were examined, statistically significant difference was observed at 60 and 120°/s (p<0.05). However, no difference was observed at 180°/s. In addition, sEMG data did not have a statistically significant difference between groups. Negative correlation was found between all RTD at 60, 10 and 180°/s with Q angle (180°/s RTD0-100 r= -0.34, 180°/s RTD100-200 r= -0.35, 120°/s RTD0-100 r= -0.40, 120°/s RTD100-200 r= -0.48, 60°/s RTD0-100 r= -0.55, 60°/s RTD100-200 r= -0.59; p<0.05). There was a negative correlation between the structural differences of the lower extremity and the early and late rate of torque development of the knee extensor muscles. Considering the structural variables, it is thought that it is important to improve the rate of torque development with appropriate resistance training in athletes with variables such as abnormal Q angle, and thus knee injuries can be prevented through athletic development.

Cancer patients’ reported illness and treatment related concerns, perception of availability and use of available information: The influence of socio-demographics

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6077-6077
Author(s):  
P. Jean-Pierre ◽  
J. A. Roscoe ◽  
G. R. Morrow ◽  
M. Hofman ◽  
K. Fiscella ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Treatment Plan ◽  
Illness Perception ◽  
Diagnosis And Treatment ◽  
Group Differences ◽  
Significant Group ◽  
Additional Information ◽  
Significant Difference ◽  
Logistic Regressions ◽  
And Gender

6077 Backgrounds: Studies that examine the roles of socio-demographics in illness perception and healthcare communication among cancer patients are relatively absent. Methods: This sample included 973 (904 whites, 69 non-whites) patients undergoing treatment for cancer at 20 geographically separate sites. Concerns over understanding the diagnosis and treatment plan were assessed on a 5-point-scale (“1=no concern” to “5=a great deal of concern”). Patients were also asked if: a) whether or not information was available to them, b) if yes, did they used it or not, and c) would more information have been helpful. χ2-analyses and ANCOVAs, were conducted to examine group differences in education, occupation, and concern over understanding the diagnosis and treatment plan. Logistic regressions were conducted to assess the independent association of race to patients’ beliefs that additional information would have been helpful. Results: χ2 analyses showed no significant difference between whites and non-whites in education and occupation (Ps > .05). Subsequent ANCOVAs showed significant group differences in concerns over understanding the diagnosis (F(1, 967) = 9.13, p = 0.003) and treatment plan (F(1, 967) = 7.95, p = 0.01), after adjusting for education, occupation, age, and gender. Additionally, χ2 showed significant group differences in beliefs that more information would have been helpful (p < .05). More non-whites (70.3%) than whites (53.1%) indicated that additional information would have been helpful to understanding the diagnosis. Similarly, more non-whites (69.4%) than whites (53.4%) indicated that additional information would have been helpful to understanding the treatment plan. Subsequent logistic regressions confirmed that race independently predicted patients’ indications that more information would have been helpful to understanding the diagnosis (OR = 1.96, 95%CI = 1.12, 3.42) and treatment plan (OR = 1.84, 95%CI = 1.05, 3.22). Conclusion: The findings underscore the need for oncology professionals to consider and integrate information about socio-demographics in their intervention and communication with racial/ethnic minority patients. Supported by NHI PHS-grant U10-CA37420 No significant financial relationships to disclose.

Relationship of The Knee Extensor Strength But Not The Quadriceps Femoris Muscularity With Sprint Performance in Sprinters: A Reexamination and Extension

2021 ◽  
Author(s):  
Miyuki Hori ◽  
Tadashi Suga ◽  
Masafumi Terada ◽  
Takahiro Tanaka ◽  
Yuki Kusagawa ◽  
...  
Keyword(s):  
Knee Extensor ◽  
Knee Extension ◽  
Quadriceps Femoris ◽  
Sprint Performance ◽  
Sprint Time ◽  
Knee Extensor Strength ◽  
Significant Difference ◽  
The Absolute ◽  
Relationship Of ◽  
The Relationship

Abstract Purpose: This study examined the relationships of the knee extensor strength and quadriceps femoris size with sprint performance in sprinters. Methods: Fifty-eight male sprinters and 40 body size-matched male non-sprinters participated in this study. The knee extensor isometric and isokinetic strengths were measured using a dynamometer. The isokinetic strength measurements were performed with slow and fast velocities at 60°/s and 180°/s, respectively. The quadriceps femoris muscle volume (MV) was measured using magnetic resonance imaging. The relative values of the knee extensor strengths and quadriceps femoris MV were normalized to body mass.Results: The absolute and relative values of the two velocity isokinetic strengths, but not of isometric strength, of the knee extension were significantly higher in sprinters than in non-sprinters (both Ps < 0.05). Such a significant difference was also observed for the relative quadriceps femoris MV (P = 0.018). In sprinters, there were significant correlations between all three knee extensor strengths and quadriceps femoris MV (r = 0.421 to 0.531, all Ps £ 0.001). The absolute and relative strengths of the fast-velocity isokinetic knee extension correlated with personal best 100-m sprint time (r = -0.477 and -0.409, respectively, both Ps £ 0.001). By contrast, no significant correlations were observed between absolute and relative quadriceps femoris MVs and personal best 100-m sprint time. Conclusions: These findings suggest that despite the presence of the relationship between muscle strength and size, the knee extensor strength may be related to superior sprint performance in sprinters independently of the quadriceps femoris muscularity.

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