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Motta CP, Olimpio da Silva DL, da Costa LR, Galhardo GF, Lopes AJ. Performance during the Glittre-ADL test between patients with and without post-tuberculosis bronchiectasis: A cross-sectional study. PLoS One 2023; 18:e0290850. [PMID: 37656719 PMCID: PMC10473510 DOI: 10.1371/journal.pone.0290850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/17/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Post-tuberculosis bronchiectasis (PTBB) is gaining recognition as an important chronic lung disease, representing a neglected condition with a significant burden for the individual. Recently, the Glittre-ADL test (TGlittre) has been proposed for the assessment of functional capacity, which incorporates tasks of daily living demanding the upper and lower extremities. This study used TGlittre to compare patients with PTBB to patients with non-post-tuberculosis bronchiectasis (NPTBB) and evaluate the determinants of performance during TGlittre. METHODS This is a cross-sectional study in which 32 patients with PTBB and 29 with NPTBB underwent TGlittre. In addition, they completed Short Form-36 (SF-36), handgrip strength, quadriceps muscle strength (QMS) and pulmonary function tests (PFTs). RESULTS Both PTBB and NPTBB required much more time to perform the TGlittre compared to the predicted values, although they did not differ statistically from each other [152 (124-200) vs. 145 (117-179)% predicted, p = 0.41]. Regarding the PFTs, the PTBB participants showed significantly lower values than the NPTBB participants in forced vital capacity (FVC, 60 ± 14.5 vs. 78.2 ± 22.2% predicted, p<0.001) and total lung capacity [82 (66-95) vs. 93 (82-105)% predicted, p = 0.028]. In the PTBB group, FVC (p<0.001) and QMS (p = 0.001) were the only significant independent variables to predict TGlittre time, explaining 71% of the variability in TGlittre time. In the NPTBB group, maximal expiratory pressure (p = 0.002), residual volume/TLC (p = 0.001) and QMS (p = 0.032) were the significant independent variables for predicting TGlittre time, explaining 73% of the variability in TGlittre time. CONCLUSIONS PTBB patients have lower than expected performance on TGlittre, though similar to NPTBB patients. The PTBB patients had a greater reduction in lung volume than NPTBB patients. Furthermore, the performance on TGlittre in PTBB patients is largely explained by lung volume and QMS.
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Affiliation(s)
- Cristiane Pires Motta
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
| | | | | | - Giselle Faria Galhardo
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil
- Local Development Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
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Di Giminiani R, Marinelli S, La Greca S, Di Blasio A, Angelozzi M, Cacchio A. Neuromuscular Characteristics of Unilateral and Bilateral Maximal Voluntary Isometric Contractions following ACL Reconstruction. BIOLOGY 2023; 12:1173. [PMID: 37759573 PMCID: PMC10525486 DOI: 10.3390/biology12091173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/01/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Despite the advancement of diagnostic surgical techniques in anterior cruciate ligament (ACL) reconstruction and rehabilitation protocols following ACL injury, only half of the athletes return to sports at a competitive level. A major concern is neuromechanical dysfunction, which occurs with injuries persisting in operated and non-operated legs following ACL rehabilitation. One of the criteria for a safe return to sports participation is based on the maximal voluntary isometric contraction (MVIC) performed unilaterally and a comparison between the 'healthy knee' and the 'operated knee'. The present study aimed to investigate MVIC in athletes following ACL rehabilitation during open kinetic chain exercise performed unilaterally and bilateral exercises. Twenty subjects participated in the present investigation: 10 male athletes of regional-national level (skiers, rugby, soccer, and volleyball players) who were previously operated on one knee and received a complete rehabilitation protocol (for 6-9 months) were included in the ACL group (age: 23.4 ± 2.11 years; stature: 182.0 ± 9.9 cm; body mass: 78.6 ± 9.9 kg; body mass index: 23.7 ± 1.9 kg/m2), and 10 healthy male athletes formed the control group (CG: age: 24.0 ± 3.4 years; stature: 180.3 ± 10.7 cm; body mass: 74.9 ± 13.5 kg; body mass index: 22.8 ± 2.7 kg/m2). MVICs synchronised with electromyographic (EMG) activity (recorded on the vastus lateralis, vastus medialis, and biceps femoris muscles) were performed during unilateral and bilateral exertions. The rate of force development (RFD) and co-activation index (CI) were also calculated. The differences in the MVIC and RFD between the two legs within each group were not significant (p > 0.05). Vastus lateralis EMG activity during MVIC and biceps femoris EMG activity during RFD were significantly higher in the operated leg than those in the non-operated leg when exertion was performed bilaterally (p < 0.05). The CI was higher in the operated leg than that in the non-operated leg when exertion was performed bilaterally (p < 0.05). Vice versa, vastus medialis EMG activity during RFD was significantly higher in the right leg than that in the left leg when exertion was performed bilaterally (p < 0.05) in the CG. MVICs performed bilaterally represent a reliability modality for highlighting neuromechanical asymmetries. This bilateral exercise should be included in the criteria for a safe return to sports following ACL reconstruction.
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Affiliation(s)
- Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (S.L.G.)
| | - Stefano Marinelli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (S.L.G.)
| | - Stefano La Greca
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (S.L.G.)
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, ‘G. D’Annunzio’ University of Chieti-Pescara, 66013 Chieti, Italy;
| | - Massimo Angelozzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.A.); (A.C.)
| | - Angelo Cacchio
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.A.); (A.C.)
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Garcia D, de Sousa Neto IV, de Souza Monteiro Y, Magalhães DP, Ferreira GML, Grisa R, Prestes J, Rosa BV, Abrahin O, Martins TM, Vidal SE, de Moura Andrade R, Celes RS, Rolnick N, da Cunha Nascimento D. Reliability and Validity of a Portable Traction Dynamometer in Knee-Strength Extension Tests: An Isometric Strength Assessment in Recreationally Active Men. Healthcare (Basel) 2023; 11:healthcare11101466. [PMID: 37239753 DOI: 10.3390/healthcare11101466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND the study determined the validity and reliability of measurements obtained using the portable traction dynamometer (PTD) (E-Lastic, E-Sports Solutions, Brazil) and the reproducibility between evaluators (precision) in the evaluation of the isometric muscle strength of the knee extensors of healthy male adults, compared to measurements obtained with the "gold standard" computerized dynamometer (CD) (Biodex System 3, Nova York, NY, USA). METHODS we evaluated sixteen recreationally active men (29.50 ± 7.26 years). The test-retest reliability of both equipment to determine quadriceps strength, agreement analysis, and the minimal important difference were verified. RESULTS excellent test-retest interrater reliability was observed for absolute and relative measurements, with a low absolute error for both sets of equipment and excellent validity of the PTD against the CD, as verified by linear regression and Pearson's correlation coefficient. CONCLUSIONS PTD is a valid and reliable instrument for assessing the isometric strength of knee extensors, with results similar to the isometric CD "gold standard".
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Affiliation(s)
- Danielle Garcia
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
- Department of Physical Education, UniProjeção University Center, Brasília 72115145, Brazil
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo 14040900, Brazil
| | - Yuri de Souza Monteiro
- Department of Physical Education, UniProjeção University Center, Brasília 72115145, Brazil
| | | | | | - Roberto Grisa
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
| | - Jonato Prestes
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
| | - Bruno Viana Rosa
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
| | - Odilon Abrahin
- Laboratory of Resistance Exercise and Health, University of the State of Pará, Belém 66050540, Brazil
| | - Tatiane Meire Martins
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
| | - Samuel Estevam Vidal
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
| | | | - Rodrigo Souza Celes
- Department of Physical Education, Catholic University of Brasilia (UCB), Brasília 71966900, Brazil
- Faculty of Physical Education, University of Brasilia, Brasilia 70910900, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York, NY 10468, USA
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Tang MM, Nuss CA, Fogarty N, Baxter JR. Plantar flexor deficits following Achilles tendon rupture: A novel small animal dynamometer and detailed instructions. J Biomech 2022; 145:111393. [PMID: 36442431 PMCID: PMC9813868 DOI: 10.1016/j.jbiomech.2022.111393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/28/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
Plantar flexor functional deficits measured using joint dynamometry are associated with poor outcomes in patients following Achilles tendon rupture. In this study, we developed a small animal dynamometer to quantify functional deficits in a rat Achilles tendon rupture model. Like our reported plantar flexor deficits in patients recovering from Achilles tendon ruptures, we found in our small animal model functional deficits across the ankle range of motion, resulting in an average 34% less positive work being done compared to the uninjured contralateral limb. These functional deficits are similar to 38% less plantar flexor work done by patients who were treated non-surgically in our prior research. Further, these torque deficits were greater in plantar flexion than dorsiflexion, which agree with clinical complaints of limited function during tasks like jumping and hiking. These findings serve as compelling evidence that our Sprague Dawley rat model of an Achilles tendon rupture recapitulates the functional deficits we observed in patients treated nonsurgically. We provide thorough documentation for other groups to build their own dynamometers, which can be modified to meet unique experimental criteria.
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Affiliation(s)
- My M Tang
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Courtney A Nuss
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Natalie Fogarty
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Josh R Baxter
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
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Šarabon N, Kozinc Ž, Perman M. Establishing Reference Values for Isometric Knee Extension and Flexion Strength. Front Physiol 2021; 12:767941. [PMID: 34721087 PMCID: PMC8554160 DOI: 10.3389/fphys.2021.767941] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/24/2021] [Indexed: 01/23/2023] Open
Abstract
Single-joint isometric and isokinetic knee strength assessment plays an important role in strength and conditioning, physical therapy, and rehabilitation. The literature, however, lacks absolute reference values. We systematically reviewed the available studies that assessed isometric knee strength. Two scientific databases (PubMed and PEDro) were searched for the papers that are published from the inception of the field to the end of 2019. We included studies that involved participants of both genders and different age groups, regardless of the study design, that involved isometric knee extension and/or flexion measurement. The extracted data were converted to body-mass-normalized values. Moreover, the data were grouped according to the knee angle condition (extended, mid-range, and flexed). A meta-analysis was performed on 13,893 participants from 411 studies. In adult healthy males, the pooled 95% confidence intervals (CI) for knee extension were 1.34–2.23Nm/kg for extended knee angle, 2.92–3.45Nm/kg for mid-range knee angle, and 2.50–3.06Nm/kg for flexed knee angle, while the CIs for flexion were 0.85–1.20, 1.15–1.62, and 0.96–1.54Nm/kg, respectively. Adult females consistently showed lower strength than adult male subgroups (e.g., the CIs for knee extension were 1.01–1.50, 2.08–2.74, and 2.04–2.71Nm/kg for extended, mid-range, and flexed knee angle condition). Older adults consistently showed lower values than adults (e.g., pooled CIs for mid-range knee angle were 1.74–2.16Nm/kg (male) and 1.40–1.64Nm/kg (female) for extension, and 0.69–0.89Nm/kg (male) and 0.46–0.81Nm/kg (female) for flexion). Reliable normative for athletes could not be calculated due to limited number of studies for individual sports.
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Affiliation(s)
- Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia.,Human Health Department, InnoRenew CoE, Izola, Slovenia.,Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Ljubljana, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Mihael Perman
- Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Koper, Slovenia.,Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
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Local Muscle Endurance and Strength Had Strong Relationship with CrossFit ® Open 2020 in Amateur Athletes. Sports (Basel) 2021; 9:sports9070098. [PMID: 34357932 PMCID: PMC8309786 DOI: 10.3390/sports9070098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/21/2022] Open
Abstract
This study analyzed the relationship between anthropometric measures, cardiorespiratory capacity, strength, power, and local muscle endurance with performance in the CrossFit® Open 2020. For this, 17 volunteers (6 women) (29.0 ± 7.2 years) completed, on separate weeks, tests for body composition (dual-energy X-ray absorptiometry), maximal oxygen consumption (2 km row test), muscle strength (one repetition maximum (1 RM) back and front squat, isometric peak torque), muscle power (1 RM snatch and clean and jerk) and muscle endurance (Tibana test), which were compared with performance during the CrossFit® Open 2020. Specific tests of localized muscular endurance and muscle strength had the strongest relationship with performance in the CrossFit® Open 2020. On the other hand, the percentage of fat and cardiorespiratory capacity were not significantly correlated with CrossFit® Open 2020 workout performance. Coaches and practitioners should therefore utilize these findings to assess physical fitness and organize the distribution of the training session based on less developed physical needs, in order to ensure an appropriate physiological adaptation for a given competition.
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Romero-Franco N, Jiménez-Reyes P, Fernández-Domínguez JC. Concurrent Validity and Reliability of a Low-Cost Dynamometer to Assess Maximal Isometric Strength in Neck Movements. J Manipulative Physiol Ther 2021; 44:229-235. [PMID: 33461749 DOI: 10.1016/j.jmpt.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/18/2020] [Accepted: 08/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate the concurrent validity and reliability of a low-cost digital dynamometer to assess maximal isometric strength in neck movements. METHODS Twelve recreationally active participants (6 women, 6 men; age: 24.1 ± 3.4 years; height: 1.71 ± 0.06 m; weight: 64.6 ± 11.7 kg) performed neck flexion, extension, and lateral flexion, and maximal isometric strength was simultaneously measured using an isokinetic dynamometer (gold standard) and a digital dynamometer to evaluate the concurrent validity of the latter. One week later, all the participants repeated 3 trials of each neck movement (3 minutes apart) registered only with the digital dynamometer. The first and second trial were guided by tester 1 and the third trial was guided by tester 2. RESULTS The concurrent validity of the digital dynamometer showed a nearly perfect correlation between both devices (r > 0.986, P < .001), with Bland-Altman plots showing absolute agreement. Intertester and intratester reliability were nearly perfect for all neck movements (intraclass correlation coefficient > 0.86). CONCLUSION The low-cost digital dynamometer showed valid and reliable measurements of maximal isometric strength in neck movements.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain..
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Hirano M, Katoh M, Gomi M, Arai S. Validity and reliability of isometric knee extension muscle strength measurements using a belt-stabilized hand-held dynamometer: a comparison with the measurement using an isokinetic dynamometer in a sitting posture. J Phys Ther Sci 2020; 32:120-124. [PMID: 32158074 PMCID: PMC7032982 DOI: 10.1589/jpts.32.120] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/04/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine the validity and reliability of isometric knee
extension muscle strength measurements using a belt-stabilized hand-held dynamometer
compared to that using an isokinetic dynamometer with the participant in a sitting
posture. [Participants and Methods] Forty-two university students participated. The
isometric knee extension muscle strength was measured using a hand-held dynamometer and an
isokinetic dynamometer. For both measurements, the participants were in the similar
sitting posture. The sitting posture maintained trunk stability, with the hands on the
bed, and the non-measurement-side toe touching the floor or table. The intra-class
correlation coefficient and the relevance were verified. [Results] Intra-rater correlation
coefficient (1, 1) of the two measurements was ≥0.75. A significant difference was found
in the measurement value between males and females. No significant difference was found
between the measurements value of the two devices. A significant positive correlation was
found in the measurement value of two devices in the male participants. [Conclusion] When
compared to the standard method of isometric knee extension muscle strength measurements
using an isokinetic dynamometer with the participant in the sitting posture, measurements
using the belt-stabilized hand-held dynamometer were considered valid and highly reliable
in the male participants.
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Affiliation(s)
- Masahiro Hirano
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Munenori Katoh
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Masahiro Gomi
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Saori Arai
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
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Beach A, Regazzola G, Neri T, Verheul R, Parker D. The effect of knee prosthesis design on tibiofemoral biomechanics during extension tasks following total knee arthroplasty. Knee 2019; 26:1010-1019. [PMID: 31402095 DOI: 10.1016/j.knee.2019.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 07/05/2019] [Accepted: 07/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Determine whether the tibiofemoral motion and electromyographic activity of the knee differs in patients with a medial pivot implant, compared to those with cruciate-retaining and posterior-stabilised designs, during knee extension after Total Knee Arthroplasty (TKA). METHODS An observational study was conducted on a cohort of patients that had undergone TKA for a minimum of 12 months prior. Three matched groups (n = 18) were categorised based on implant type: medial-pivot (MP), posterior-stabilised (PS) and cruciate-retaining (CR). Kinematics, with motion analysis (Vicon, USA) and surface electromyography (Delsys, USA) were assessed during step-ascent and walking tasks. RESULTS All groups displayed a similar amount of knee extension in both tasks. They also paradoxically produced an average mean internal rotation movement during knee extension in both the step-ascent and walking tasks. The only significant difference was found in the step-ascent task, in which the MP group produced a larger absolute amount of rotation than the CR implant group (P = 0.007), but neither group differed from the PS implant group. The groups did not differ in rotation during the walking task (P > 0.05). The MP group displayed significantly (P < 0.01) greater knee extensor activation during the step-ascent than the PS group. CONCLUSION The MP design was only significantly different to another implant design for the step-ascent task. Patients with either knee implant types were not strictly limited to producing the traditional "screw-home" mechanism, defined by external rotation during extension. Furthermore, comparison with the non-implant contralateral limb suggested that rotation is not necessarily dictated by implant design.
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Affiliation(s)
- Aaron Beach
- Sydney Orthopaedic Research Institute, Sydney, Australia.
| | | | - Thomas Neri
- Sydney Orthopaedic Research Institute, Sydney, Australia
| | | | - David Parker
- Sydney Orthopaedic Research Institute, Sydney, Australia
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Bui KL, Mathur S, Dechman G, Maltais F, Camp P, Saey D. Fixed Handheld Dynamometry Provides Reliable and Valid Values for Quadriceps Isometric Strength in People With Chronic Obstructive Pulmonary Disease: A Multicenter Study. Phys Ther 2019; 99:1255-1267. [PMID: 30939198 DOI: 10.1093/ptj/pzz059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/09/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Quadriceps weakness is associated with poor clinical outcomes in chronic obstructive pulmonary disease (COPD). However, quadriceps isometric strength assessment has not been routinely adopted in clinical practice because of the lack of homogeneity in the devices and protocols and the lack of reliability studies. OBJECTIVE The objectives of this study were to determine the test-retest reliability and the criterion validity of a commercially available handheld dynamometer for evaluating the quadriceps isometric maximal voluntary contraction (iMVCquad) using a standardized protocol and to investigate the relationship between iMVCquad and functional capacity in people with COPD. DESIGN This was a prospective, observational, multicenter trial. METHODS Participants with mild to severe COPD from 4 Canadian sites were tested on 2 separate days. Five iMVCquad measurements were obtained following a standardized procedure with a fixed handheld dynamometer (iMVCquad-HHD), and then 5 iMVCquad measurements were obtained with a computerized dynamometer (iMVCquad-CD; the gold standard). Functional capacity was assessed with the Short Physical Performance Battery. Intraclass correlation coefficients, standard errors of measurement, Bland-Altman plots, and Spearman correlation coefficients were used for analyses. RESULTS Sixty-five participants (mean age = 69 years [SD = 8]; forced expiratory volume in 1 second = 48% of predicted value [SD = 21]) completed the study. The mean iMVCquad-HHD values on visits 1 and 2 were 102.7 (SD = 51.6) and 105.6 (SD = 58.8) N·m, respectively; the standard error of measurement was 11.4 N·m. The between-visits intraclass correlation coefficient for iMVCquad-HHD was 0.95 (95% confidence interval = 0.92-0.97), with a mean bias of 2.0 (Bland-Altman plot). There was a strong correlation between iMVCquad-HHD and iMVCquad-CD (Spearman correlation coefficient = 0.86). There was no correlation between iMVCquad-HHD and Short Physical Performance Battery total score. LIMITATIONS Participants had stable COPD with few comorbidities and were more physically active than the general population of people with COPD; results might not be applicable to patients with acute exacerbations of the disease or more comorbidities. Assessment order between handheld and computerized dynamometers has not been randomized, but analyses did not highlight any systematic bias or learning effect. CONCLUSIONS Quadriceps strength assessment can be implemented in a reliable and valid way in people with COPD using a fixed handheld dynamometer and standardized procedure. This protocol should be established in clinical practice to facilitate the assessment of muscle strength in people with COPD.
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Affiliation(s)
- Kim-Ly Bui
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Gail Dechman
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - François Maltais
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval
| | - Pat Camp
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada; and Department of Physical Therapy, University of British Columbia
| | - Didier Saey
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 Chemin Ste-Foy, Quebec City, Quebec, Canada, G1V 4G5
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Suzuki Y, Kamide N, Kitai Y, Ando M, Sato H, Yoshitaka S, Sakamoto M. Absolute reliability of measurements of muscle strength and physical performance measures in older people with high functional capacities. Eur Geriatr Med 2019; 10:733-740. [DOI: 10.1007/s41999-019-00218-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/28/2019] [Indexed: 01/12/2023]
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