Twelve Weeks of a Staged Balance and Strength Training Program Improves Muscle Strength, Proprioception, and Clinical Function in Patients with Isolated Posterior Cruciate Ligament Injuries

Ligament reconstruction is indicated in patients with an isolated posterior cruciate ligament (PCL) injury who fail conservative treatment. To eliminate the need for PCL reconstruction, an ideal rehabilitation program is important for patients with an isolated PCL injury. The purpose of this study was to investigate the improvement in functional outcome, proprioception, and muscle strength after a Both Sides Up (BOSU) ball was used in a balance combined with strength training program in patients with an isolated PCL injury. Ten patients with isolated PCL injuries were recruited to receive a 12 week training program as a study group. In the control group (post-PCL reconstruction group), ten subjects who had undergone isolated PCL reconstruction for more than 2 years were enrolled without current rehabilitation. The Lysholm score, IKDC score, proprioception (active and passive), and isokinetic muscle strength tests at 60°/s, 120°/s, and 240°/s, were used before and after training on the injured and normal knees in the study group, and in the post-PCL reconstruction group. The results were analyzed with a paired t-test to compare the change between pre-training, post-training, and the normal leg in the study group, and with an independent t-test for comparisons between the study and post-PCL reconstruction groups. Both the Lysholm and IKDC scores were significantly improved (p < 0.01) after training, and no difference was observed compared to the post-PCL reconstruction group. The active and passive proprioception was improved post-training compared to pre-training, with no difference to that in the post-PCL reconstruction group. Isokinetic knee quadriceps muscle strength was significantly greater post-training than pre-training in PCL injured knees at 60°/s, 120°/s, and 240°/s, and in hamstring muscle strength at 60°/s and 120°/s. Muscle strength in the post-training injured knee group showed no significant difference compared to that in the post-training normal leg and the post-PCL reconstruction group. The post-training improvement of muscle strength was higher in the PCL injured leg compared to the normal leg and there was no difference between the dominant and non-dominant injured leg in the study group. After 12 weeks of BOSU balance with strength training in patients with an isolated PCL injury, the functional outcome, proprioception, and isokinetic muscle strength were significantly improved, and comparable to the contralateral normal leg and the post-PCL reconstruction group. We suggest that programs combining BOSU balance and strength training should be introduced in patients with a PCL injury to promote positive clinical results.

Upper Limb Isokinetic Muscle Strength Predicts the Performance in Cross-Country Sit-Skiing

Understanding the physical fitness attributes in a sport-specific technical skill is a key to improve the action economy, and thus aerobic endurance performance. The present study was designed to investigate how upper limb muscle strength predicts double poling (DP) power performance in cross-country sit-skiing. A total of 19 female able-bodied college students (age 23.2±0.8 years, BMI 20.4±2.2) were subjected to a 30-s and 3-min DP performance tests using a sit-skiing ergometer. Isokinetic muscle strength by the angular velocity of 30 °/second, 60 °/second, and 120 °/second of the shoulder and elbow extensor/flexor were measured with an ISOMED2000 isokinetic system. A medium correlation was found between DP output power and isokinetic upper limb muscle strength (shoulder strength at all speed, r = 0.39-0.74, p < 0.1). Multiple regressions, which were employed to predict power production in the 30-s and 3-min tests, showed that shoulder extension strength at 60 °/second accounted for 34% of the variation in the 30-s test, and 40% of the variance in the 3-min test.

Internal Fixation of Lateral Trochlear Groove Osteochondritis Dissecans With Simultaneous Lateral Retinacular Lengthening in Adolescent Athletes

Background: The goals of operative treatment for the adolescent athlete with unstable osteochondritis dissecans (OCD) lesion are rigid fixation and prevention of recurrence. Purpose: To evaluate clinical and radiological outcomes of internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening. Study Design: Case series; Level of evidence, 4. Methods: Adolescent athletes who had undergone internal fixation and simultaneous lateral retinacular lengthening for an unstable OCD lesion of the lateral trochlear groove were retrospectively reviewed. Subjective assessments included the Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner activity scale, and an athletic questionnaire. Functional tests included isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance. Pre- and postoperative radiographs and magnetic resonance images were reviewed. Results: The mean ± SD age of the 17 patients included in this study was 15.9 ± 0.9 years; last clinical follow-up duration was 37.7 ± 8.1 months. At the last follow-up, the Lysholm score improved from 68.7 ± 15.3 to 93.4 ± 12.4 and the IKDC subjective score from 60.2 ± 14.7 to 88.7 ± 12.7 ( P < .001). The mean Tegner activity scale score was 9.4 ± 0.5 before injury and 8.9 ± 1.2 at the last follow-up ( P = .059). The limb symmetry indices of isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance improved at the last follow-up; the mean limb symmetry index was ≥85% in each functional test. Regarding the athletic questionnaire, 16 (94.1%) patients were satisfied with the surgery. At the last follow-up, 2 patients had higher ability after returning to sports, 11 had the same ability, and 3 had lower ability than the preinjury level. Postoperative magnetic resonance imaging at 12-month follow-up showed that the OCD lesion appeared healed in 7 (41.2%) patients and partially healed in 9 (52.9%). Conclusion: Internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening in adolescent athletes achieved satisfactory clinical and radiological outcomes. Therefore, this combined surgical technique could be considered an effective treatment for lateral trochlear groove OCD, with a high rate of return to sport.

Kinesio Taping Relieves Pain and Improves Isokinetic Not Isometric Muscle Strength in Patients with Knee Osteoarthritis—A Systematic Review and Meta-Analysis

This study investigated the effects of kinesio taping (KT) or KT plus conventional therapy on pain, muscle strength, funrefction, and range of motion in patients with knee osteoarthritis (OA). Data sources: Databases included PubMed, Ovid Medline, CINAHL, Airiti Library, EMBASE, and WOS search engines. Search terms related to KT and knee OA were combined and searched. Articles that met the inclusion criteria and were graded with a Jadad score ≥3 were included in a meta-analysis to calculate the total effect. The exclusion criteria were non-English-language articles, non-original articles, non-full-text articles, no description of the intervention, or articles with a Jadad score ≤2. Eleven articles were included in the meta-analysis. KT treatment had a significant small total effect on pain reduction (p < 0.001; n = 1509; standardized mean difference (SMD) = −0.42; 95% CI = −0.65 to −0.18) and a significant moderate total effect on isokinetic muscle strength improvement (p = 0.001; n = 447; SMD = 0.72; 95% CI = 0.28 to 1.16). No significant total effects of KT on isometric muscle strength, time to complete functional tasks, or ROM improvement were found. KT or KT plus conventional therapy has a significant effect on pain relief and isokinetic but not isometric muscle strength improvement in patients with knee OA. KT can be an effective tool for treating knee OA pain and is especially valuable for aiding in isokinetic muscle strength. (PROSPERO register ID: CRD42021252313)