Acute Effects of Open Kinetic Chain Exercise Versus Those of Closed Kinetic Chain Exercise on Quadriceps Muscle Thickness in Healthy Adults

Evaluation of ultrasonographic cartilage and muscle thickness in female rheumatoid arthritis patients with knee pain

BackgroundThis study aimed to show the effect of ultrasonographic muscle and cartilage thickness measurements on knee pain in RA patients.MethodsIn this cross-sectional and single-blind study, female patients aged 30-50 years old, diagnosed with RA, and in remission or low disease activity for at least 6 months were included. They were divided into two groups: with and without knee pain. Knee cartilage thickness measurements from 3 compartments, Quadriceps and Hamstring muscle thickness measurements were performed by ultrasound by a physician blinded to the patients' pain conditions.ResultsOf the 130 patients included in the study; the number of comorbidities in the group with knee pain(n = 61) and glucocorticoid use in the group without knee pain(n = 69) were significantly higher. No significant difference was detected in all cartilage and muscle thickness measurements in the groups with and without knee pain. The average cartilage thickness was found to be significantly lower in patients using glucocorticoids. A low level, positive and significant correlation was detected between cartilage thickness in the medial condyle and age and body mass index(BMI); and between cartilage thickness in the lateral condyle and BMI.ConclusionThere is significant loss of muscle and cartilage thickness in RA patients, even if it is not directly compatible with the pain condition. Being able to evaluate these losses with ultrasound in the follow-up and treatment of the disease is a great power in the hands of the physician.

Effect of closed-chain isometric plyometric training combined with palonosetron on postoperative knee function in patients after total knee arthroplasty

Background

Functional training after total knee arthroplasty (TKA) is of great significance for the recovery of knee function. However, the utility of applying an effective training modality, closed-chain isokinetic plyometric training, on top of the drug palonosetron, which is used to prevent nausea and vomiting, is unclear.

Objective

To investigate the effect of closed-chain isokinetic plyometric training combined with palonosetron-on-postoperative-knee-function in patients with TKA, aiming to provide an effective rehabilitation program for patients with TKA.

Methods

The results of the intervention were compared in 47 TKA patients who received closed-chain isokinetic plyometric training combined with palonosetron with 47 TKA patients who received conventional plyometric training combined with palonosetron. Knee function was evaluated using the Hospital for Specialty Surgery Knee (HSS), quadriceps muscle strength was assessed using real-time isometric plyometric testing with the BIODEX-sYs-tem 4-type system, walking ability was evaluated using the Timed Up-and-Go Test (TUGT), and proprioception was determined using the Biodex System 4-type multi-joint isometric system.

Results

After-the intervention,-the-HSS scores-of-the-experimental-group-were-higher-than-those-of-the-control-group-(P < 0.05); the peak moment values of the quadriceps (PT), the total quadriceps work values (STW), and the average power of the quadriceps (AP) were higher than those of the control group (P < 0.05); and the values of the reproduced deviation of the knee joint active joint angle and the TUGT time were lower than those of the control group (P < 0.05).

Conclusion

Closed-chain isokinetic plyometric training combined with palonosetron can strengthen their muscle strength and improve proprioception, which effectively promotes the recovery of postoperative knee function and walking ability in TKA patients.

Effects of functional strength training on pain, function, and lower extremity biomechanics in patients with patellofemoral pain syndrome: a randomized clinical trial

BACKGROUND

Patellofemoral pain syndrome (PFPS) is a common disorder affecting the lower extremity. This study aimed to compare the effects of functional strength training (FST) and standard strength training (SST) in PFPS patients.

METHODS

Forty college students (aged 18-30 years) with PFPS and no exercise habits were randomized into FST group (n = 20) and SST group (n = 20). FST group underwent six weeks of lower extremity training focused on functional adaptations, whereas SST group focus on lower extremity strength training. Function (Kujala Patellofemoral Scale, KPS), pain (visual analog scale, VAS), peak joint angles of hip, knee, and ankle, along with muscle activation (step-down test) of Vastus medialis, Vastus lateralis, Biceps femoris, Semitendinosus, Gluteus maximus, and Gluteus medius were assessed at baseline and after intervention.

RESULTS

FST outperformed SST in pain reduction (p = 0.026) and function (p = 0.006) post-intervention. The FST group also showed increased hip flexion (p < 0.001), gluteus maximus activation (p < 0.001), and reduced knee valgus (p = 0.032), while SST group exhibited greater knee flexion (p = 0.008), and higher activation of the lateral femoral (p < 0.001) and semitendinosus (p < 0.001).

CONCLUSION

Interventions focused on functional adaptations result in differential kinematic and muscle activation changes that may result in greater improvements in pain and knee function than lower limb muscle strengthening alone.

TRIAL REGISTRATION

chictr.org.cn. NO: ChiCTR2400087664. Date 01/08/2024.

Immediate Effect of Compression Contrast Therapy on Quadriceps Femoris Muscles' Regeneration in MMA Fighters

Objectives: This study aimed to evaluate the immediate effect of Game Ready (GR) heat-cold compression contrast therapy (HCCT) on changes in the biomechanical parameters of the quadriceps femoris muscles and tissue perfusion. Methods: Fifteen male MMA fighters were subjected to HCCT on the dominant leg's thigh and control sham therapy on the other. The experimental intervention used a pressure cuff with the following parameters: time-20 min; pressure-25-75 mmHg; and temp.-3-45°C, changing every 2 min. For the control group, the temp. of sham therapy was 15-36 °C, and pressure was 15-25 mmHg, changing every 2 min. Measurements were taken on the head of the rectus femoris muscle (RF) 5 min before therapy, 5 min after, and 1 h after therapy in the same order in all participants: microcirculatory response (PU), muscle tension (MT), stiffness (S), flexibility (E), tissue temperature (°C), and pressure pain threshold (PPT). Results: The analysis revealed significant differences between the HCCT and sham therapy groups and the measurement time (rest vs. post 5 min and post 1 h) for PU, MT, E, and °C (p < 0.00001) (a significant effect of time was found) in response to GR therapy. No significant differences were found for the PPT. Conclusions: The results of this study prove that GR HCCT evokes changes in the biomechanical parameters of the RF muscles and perfusion in professional MMA fighters.

Exercise selection plays an important role in inducing non-uniform acute responses on elbow flexors muscle thickness

The muscle thickness (MT) acutely increases in response to the redirection of blood flow during exercise, with this muscle swelling being a proxy to quantify the degree of muscle stimuli and involvement in an exercise. The present study aims to compare the MT acute variations between the biceps brachii (BB) and brachialis (BRA) muscles in two different unilateral exercises, the dumbbell curl (DC) and dumbbell row (DR). Sixteen well-trained young males performed a 10-repetition maximum (10RM) load test and retest for each exercise. Four sets were performed with the 10RM load for each exercise until the concentric failure. The BB and BRA muscles MT were measured pre and post-intervention with a B-mode ultrasound images. The main finding of this study was that, when DC is performed, the BB presented greater MT changes (18.67% ± 6.23) compared to BRA (12.27% ± 6.20) (p = 0.025), and compared to BB when performed in DR (12.23% ± 6.03) (p = 0.024). It was also found that BB greatest increase from BRA was not observed in DR and the BRA results were similar in both exercises. These results indicate that the structural acute responses can be muscle-specific among the elbow flexors muscles for the single-joint exercise and also exercise-specific. Therefore, either one of these two exercises can be chosen to stimulate BRA, but it would be interesting to use DC to offer greater stimuli for BB.

Acute effects of resistance exercise on the muscle architecture and tissue organization of the maximal isometrically contracted and uncontracted gastrocnemius medialis muscle

This study aimed to investigate the acute effects of resistance exercise on muscle architecture and tissue organization at rest and during isometric maximum voluntary contraction (iMVC) of the gastrocnemius medialis muscle. In 16 healthy adults (25 ± 3 y), ultrasound scans were captured before (pre), immediately after (post), and 15 min after (post_15) single-leg calf raises during rest and iMVCs. Measurements included muscle thickness (MT), pennation angle (PA), and fascicle length (FL). Spatial frequency analysis (SFA) assessed tissue organization (e.g. peak spatial frequency radius (PSFR), quality factor (Q6)). MT increased significantly from pre to post (+5.7%) and post_15 (+5.6%) at rest. During iMVC, MT and FL increased significantly from pre to post (MT: +8.1%, FL: +14.9%) and post_15 (MT: +5.2%, FL: +10.5%), while PA decreased significantly from pre to post_15 (-10.2%). PSFR and Q6 decreased significantly from pre to post (-7.0-8.2%) and increased from post to post_15 (+10.3-10.6%) at rest, with no significant changes during iMVC. Resistance exercise led to altered muscle architecture for more than 15 min, while SFA parameters reverted to baseline within 15 min. Thus, SFA potentially enables early differentiation of potential physiological alterations in muscle micro-morphology.

Clinical effects of walking exercise program for older adults applied with an exercise assist robot (Bot Fit): A randomized controlled trial

BACKGROUND

Interval walking exercise (IWE) consists of repeated walking for 3 min with high intensity, followed by 3 min of walking with low intensity. A wearable robot is an exoskeleton system that is worn on the body and helps the body move.

RESEARCH QUESTION

The purpose of this study is to verify the effects of performing IWE using Bot Fit (Samsung Electronics, Korea) on older adults.

METHODS

The experimental group (EG; n = 10) performed the IWE program with Bot Fit, and the control group (CG; n = 12) performed the IWE program without Bot Fit, three times a week for six weeks. Both groups were evaluated for spatio-temporal parameters, pelvic movement, function, muscle power, and waist-to-hip ratio (WHR) at before, after three weeks and after six weeks of exercise.

RESULTS

There was a significant difference between the two groups in the pelvic tilt range after six weeks of exercise (P < 0.05). The pelvic rotation range showed a significant difference after six weeks of exercise in the EG (P < 0.01). During the stance phase, rectus abdominis (RA) muscle power and its contraction ratio significantly increased after six weeks of exercise in the EG (P < 0.05). The WHR was significantly lower after six weeks of exercise in EG than in the CG (P < 0.05).

SIGNIFICANCE

Bot Fit maximizes the normal walking effect, promotes correct posture and physical activity to prevent falls, improves quality of life (QOL). It has shown clinical effects and has been used for successful aging of older adults.

Effects of weight-bearing dance aerobics on lower limb muscle morphology, strength and functional fitness in older women

Objective

To investigate the effects of 12-week weight-bearing dance aerobics (WBDA) on muscle morphology, strength and functional fitness in older women.

Methods

This controlled study recruited 37 female participants (66.31y ± 3.83) and divided them into intervention and control groups according to willingness. The intervention group received 90-min WBDA thrice a week for 12 weeks, while the control group maintained normal activities. The groups were then compared by measuring muscle thickness, fiber length and pennation angle by ultrasound, muscle strength using an isokinetic multi-joint module and functional fitness, such as 2-min step test, 30-s chair stand, chair sit-and-reach, TUG and single-legged closed-eyed standing test. The morphology, strength, and functional fitness were compared using ANCOVA or Mann-Whitney U test to study the effects of 12 weeks WBDA.

Results

Among all recruited participants, 33 completed all tests. After 12 weeks, the thickness of the vastus intermedius (F = 17.85, P < 0.01) and quadriceps (F = 15.62, P < 0.01) was significantly increased in the intervention group compared to the control group, along with a significant increase in the torque/weight of the knee flexor muscles (F = 4.47, P = 0.04). Similarly, the intervention group revealed a significant improvement in the single-legged closed-eyed standing test (z = -2.16, P = 0.03) compared to the control group.

Conclusion

The study concluded that compared to the non-exercising control group, 12-week WBDA was shown to thicken vastus intermedius, increase muscle strength, and improve physical function in older women. In addition, this study provides a reference exercise program for older women.

Effect of lower limb resistance exercise with abdominal draw-in on stroke survivors: A pilot study

BACKGROUND

Evidence-based guidelines are needed to inform rehabilitation practice including the effect of non-paralytic lower limb resistance exercise with abdominal drawing-in technique (ADIM) on recovery of trunk control, balance and daily living after stroke survivors.

OBJECTIVE

The purpose of this study was to compare the effects of trunk control strengthening performed in non-paralytic lower limb resistance exercise with ADIM on trunk control, balance, daily living in stroke survivors.

METHODS

The 24 participants with stroke were randomly divided into three groups: lower limb resistance exercise group (LRAG; n = 8), lower limb exercise group (LAG; n = 8), and control group (CG; n = 8). The training sessions were conducted three times a week for four weeks. Outcome measures included the Korean version Trunk Impairment Scale (K-TIS), Postural Assessment Scale of Stroke (PASS), Modified Functional Reach Test (mFRT), Berg Balance Scale (BBS), Foot print and Modified Barthel's Index (MBI).

RESULTS

The results showed that the LRAG had a significant effect on the K-TIS, PASS, mFRT, Foot print and MBI than the LAG and CG (p < 0.05). The BBS results showed a significant difference the CG (p < 0.05).

CONCLUSION

This study showed that repeated non-paralytic lower limb resistance exercises with ADIM can be used clinically as a training method for general physiotherapy in patients with reduced postural control, balance and daily living.

Effects of Visual-Motor Illusion via Image Videos Showing Increased Exercise Intensity on the Tibial Anterior during Sit-to-Stand Movement: A Study of Healthy Participants

Visual-motor illusion (VMI) elicits kinesthetic sensation from visual stimulation. We have previously performed ankle motion VMI with resistance applied to the ankle joint on the paralyzed side (power-VMI (P-VMI)) and ankle motion VMI without resistance (standard-VMI (S-VMI)) to activate the tibialis anterior (TA) muscle in stroke-paralyzed patients and compared sit-to-stand (STS) durations, but these studies did not measure TA activity during the STS movement. The purpose of this study was to evaluate the effects of different intensities of visual stimuli presented during VMI on TA and STS movement. Healthy right-footed adults (n = 18) observed two different VMI videos of ankle dorsiflexion, including S-VMI and P-VMI, with an observation time of 2 min each. STS movement was evaluated before and after watching each video. Each participant performed both S-VMI and P-VMI interventions on the same day. Only P-VMI enhanced the integrated electromyogram of the TA, increased the angular velocities of the trunk forward inclination and the ankle dorsiflexion, and shortened the STS duration. Our results indicate that P-VMI facilitates the activation of TA during STS, and we believe that we have clarified the intervention mechanism of VMI.

Determination of the Effects of a Series of Ten Whole-Body Cryostimulation Sessions on Physiological Responses to Exercise and Skin Temperature Behavior following Exercise in Elite Athletes

The present study investigated the effects of a series of 10 whole-body cryostimulation (WBC) sessions (3 min; -110 °C) on physiological and thermal responses to a submaximal exercise test in 17 elite athletes. Participants performed an exercise test twice at similar levels of intensity before and after a series of ten WBC sessions. Before and during the test, each participant's oxygen uptake (VO2), heart rate (HR), internal temperature (Ti), and skin temperature in selected areas of the skin were measured, and the mean arterial pressure (MAP), physiological strain index (PSI), and mean skin temperature (Tsk) were calculated. The results show that during exercise, increases in Ti and the PSI were significantly lower after the WBC sessions, and although there were no significant changes in HR or the MAP, the Tsk was significantly higher. Following exercise, an increase in skin temperature asymmetry over the lower-body muscles was detected. A series of WBC sessions induced a tendency toward a decrease in temperature asymmetry over the thigh muscles. In conclusion, a series of ten WBC sessions does not induce significant modifications in physiological variables but does influence the PSI and Ti during exercise. Moreover, a series of ten WBC sessions influences the distribution of skin temperature and the magnitude of temperature asymmetries in the early phase of recovery.

Effects and Adaptation of Visual-Motor Illusion Using Different Visual Stimuli on Improving Ankle Joint Paralysis of Stroke Survivors—A Randomized Crossover Controlled Trial

Visual-motor illusion (VMI) is an intervention to induce kinesthetic sensation from visual stimuli. We aimed to compare the effects of VMI of different visual stimuli on the paralyzed side ankle joint of stroke hemiplegic patients (hemiplegic patients) and to clarify their indication. We applied two types of VMI images of ankle dorsiflexion: ankle dorsiflexion without resistance (standard VMI (S-VMI)) and maximum effort dorsiflexion with resistance (power VMI (P-VMI)). Twenty-two hemiplegic patients were divided into two groups: Group A, which received S-VMI first and P-VMI one week later (n = 11), and Group B, which received P-VMI first and S-VMI one week later (n = 11). Immediate effects were evaluated. Outcomes were the dorsiflexion angle and angular velocity, degree of sense of agency (SoA), and sense of ownership. Patient’s characteristics of cognitive flexibility were assessed using the Trail making test-B (TMT-B). Fugl-Meyer assessment and the Composite-Spasticity-Scale were also assessed. P-VMI was significantly higher than S-VMI in SoA and dorsiflexion angular velocity. Additionally, the degree of improvement in dorsiflexion function with P-VMI was related to TMT-B and degree of muscle tone. Therefore, P-VMI improves ankle function in hemiplegic patients more than S-VMI but should be performed with cognitive flexibility and degree of muscle tone in mind.

Reliability and Validity of an Ultrasound-Based Protocol for Measurement of Quadriceps Muscle Thickness in Children

Introduction and aims: Accurate determination of skeletal muscle size is of great importance in multiple settings including resistance exercise, aging, disease, and disuse. Ultrasound (US) measurement of muscle thickness (MT) is a method of relatively high availability and low cost. The present study aims to evaluate a multisite ultrasonographic protocol for measurement of MT with respect to reproducibility and correlation to gold-standard measurements of muscle volume (MV) with magnetic resonance imaging (MRI) in children.

Material and methods: 15 children completed the study (11 ± 1 year, 41 ± 8 kg, 137 ± 35 cm). Following 20 min supine rest, two investigators performed US MT measurements of all four heads of the m. quadriceps femoris, at pre-determined sites. Subsequently, MRI scanning was performed and MV was estimated by manual contouring of individual muscle heads.

Results: Ultrasound measurement of MT had an intra-rater reliability of ICC = 0.985–0.998 (CI 95% = 0.972–0.998) and inter-rater reliability of ICC = 0.868–0.964 (CI 95% = 0.637–0.983). The US examinations took less than 15 min, per investigator. Muscle thickness of all individual quadriceps muscles correlated significantly with their corresponding MV as measured by MRI (overall r = 0.789, p < 0.001).

Conclusion: The results of this study indicate that US measurement of MT using a multisite protocol is a competitive alternative to MRI scanning, especially with respect to availability and time consumption. Therefore, US MT could allow for wider clinical and scientific implementation.