RELIABILITY OF THE ISOMETRIC DYNAMOMETER IN CONTROL, PARAPLEGIC, AND AMPUTEE INDIVIDUALS

Upper extremity blood-flow restriction training applied during walking in an adult with a rare form of spina bifida: a case report

INTRODUCTION

Adults with spina bifida have impaired mobility and often rely on assistive devices like crutches for walking, which exert high torque demands on the upper extremities. Blood flow restriction training (BFRT) may improve strength and gait measures by increasing intensity of training when applied during walking for individuals with limited walking tolerance. However, no studies have investigated the application of BFRT to the upper extremities for individuals who rely on crutches for walking.

CASE DESCRIPTION

This case describes a 29-year-old female with diastematomyelia, a rare form of spina bifida, who had lower extremity weakness and reduced gait capacity requiring crutches. The patient underwent 8 weeks of bilateral upper extremity BFRT during walking. The BFRT program consisted of 4 bouts of walking per session, each lasting 3 minutes with 35-50% limb occlusion pressure. Outcomes measured at baseline and 8 weeks included the 10 Meter Walk Test (10MWT), Timed Up and Go (TUG), 5 Times Sit-Stand Test (5×STS), hand-held dynamometry of 8 upper extremity muscles, and a BFRT satisfaction questionnaire.

OUTCOMES

After 8 weeks, she demonstrated improvements on the 10MWT (0.15 m/s, 23%), TUG (-3.4s, 20%), 5×STS (-3.4 s, -22%), and upper extremity strength improvements ranged from 8-79% (2.8-6.7 kg). There were no adverse events related to the intervention and satisfaction was high.

DISCUSSION

Bilateral upper extremity BFRT was safely applied during walking in an adult with spina bifida. The improvements in strength and functional mobility warrant future study among individuals who rely on upper extremity strength for ambulation.

Factors, mechanisms and improvement methods of muscle strength loss

Muscle strength is a crucial aspect of muscle function, essential for maintaining normal physical activity and quality of life. The global aging population coupled with the increasing prevalence of muscle disorders and strength loss, poses a remarkable public health challenge. Understanding the mechanisms behind muscle strength decline is vital for improving public health outcomes. This review discusses recent research advancements on muscle strength loss from various perspectives, including factors contributing to muscle strength decline, the signaling pathways involved in the deterioration of muscle function, and the methods for assessing muscle strength. The final section explores the influence of exercise stimulation and nutrition on muscle strength.

Reliability of belt-stabilized handheld or isokinetic dynamometer-based isometric knee-extensor strength-testing when seated with the toes of the contralateral nonexamined side off the floor

[Purpose] To determine the intra-rater and inter-devices reliability of isometric knee-extensor muscle-strength-measurement. [Participants and Methods] The participants were 77 university students (50 males; 27 females) who underwent isometric knee-extension muscle-strength measurement twice with a belt-stabilized handheld dynamometer and isokinetic dynamometer. The intra-rater and inter-devices reliability was ascertained from measurements that were performed with the participant seated on the edge of the bed, the toes of the contralateral nonexamined side off the floor, and the trunk supported by the upper limb. [Results] In the overall, male, and female cohorts, the 95% confidence intervals of intra-rater reliabilities (1,1) in the belt-stabilized handheld and isokinetic dynamometers were 0.96-0.98, 0.92-0.97, and 0.81-0.96, 0.82-0.92, 0.73-0.90, and 0.78-0.95, respectively, and the inter-device 95% confidence intervals were 0.52-0.77, 0.28-0.69, and -0.03 to 0.63, respectively. Compared to the belt-stabilized handheld dynamometer group, the isokinetic dynamometer group had higher knee-extension muscle strength. [Conclusion] The intra-rater reliability was rated good-to-excellent and moderate-to-excellent for the belt-stabilized handheld and isokinetic dynamometers, respectively. The inter-devices reliability was poor, and isometric knee-extension muscle strength in the isokinetic dynamometer group was higher than that in the belt-stabilized handheld dynamometer group.

ORTHOSTATIC SUPPORT IN PARAPLEGIC AND AMPUTEE PATIENTS: A CONTROLLED TRIAL

Introduction

Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients.

Objective

The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group.

Methods

The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group.

Results

Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients.

Conclusion

The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.