Reliability of isokinetic strength and aerobic power testing for patients with chronic heart failure

PURPOSE: The objective of this study was to assess the reliability of testing skeletal muscle strength and peak aerobic power in a clinical population of patients with chronic heart failure (CHF).

METHODS: Thirty-three patients with CHF (New York Heart Association (NYHA) Functional Class 2.3 ± 0.5; left ventricular ejection fraction 27% ± 7%; age 65 ± 9 years; 28:5 male-female ratio) underwent two identical series of tests (T1 and T2), 1 week apart, for strength and endurance of the muscle groups responsible for knee extension/flexion and elbow extension/flexion. The patients also underwent two graded exercise tests on a bicycle ergometer to measure peak oxygen consumption (VO_2peak). Three months later, 18 of the patients underwent a third test (T3) for each of the measures. Means were compared using MANOVA with repeated measures for strength and endurance, and ANOVA with repeated measures for VO_2peak.

RESULTS: Combining data for all four movement patterns, the expression of strength increased from T1 to T2 by 12% ± 25% (P < .001; intraclass correlation coefficient [ICC] = 0.89). Correspondingly, endurance increased by 13% ± 23% (P = .004; ICC = 0.87). Peak oxygen consumption was not significantly different (16.2 ± 0.8 and 16.1 ± 0.8 mL·kg^-1·min^-1 for T1 and T2, respectively;P = .686; ICC = 0.91). There were no significant differences between T2 and T3 for strength (2% ± 17%;P = .736; ICC = 0.92) or muscle endurance (-1% ± 15%;P = .812; ICC = 0.96), but VO_2peak decreased from 16.7 ± 1.2 to 14.9 ± 0.9 mL·kg^-1·min^-1 (-10% ± 18%;P = .021; ICC = 0.89).

CONCLUSIONS: These data suggest that in a population of patients with CHF, a familiarization trial for skeletal muscle strength testing is necessary. Although familiarization is not required for assessing oxygen consumption as a single measurement, VO_2peak declined markedly in the 3-month period for which these patients were followed. Internal consistency within patients was high for the second and third strength trials and the first and second tests of VO_2peak.

Effects of prolonged running performed at the intensity corresponding to the onset of blood lactate accumulation, on maximum isokinetic strength in active non-athletic individuals

OBJETIVO: O objetivo deste estudo foi analisar os efeitos da corrida contínua prolongada realizada na intensidade correspondente ao início do acúmulo do lactato no sangue (OBLA) sobre o torque máximo dos extensores do joelho analisado em diferentes tipos de contração e velocidade de movimento em indivíduos ativos. MÉTODO: Oito indivíduos do gênero masculino (23,4 ± 2,1 anos; 75,8 ± 8,7 kg; 171,1 ± 4,5 cm) participaram deste estudo. Primeiramente, os sujeitos realizaram um teste incremental até a exaustão voluntária para determinar a velocidade correspondente ao OBLA. Posteriormente, os sujeitos retornaram ao laboratório em duas ocasiões, separadas por pelo menos sete dias, para realizar 5 contrações isocinéticas máximas para os extensores do joelho em duas velocidades angulares (60 e 180º.s-1) sob as condições excêntrica (PTE) e concêntrica (PTC). Uma sessão foi realizada após um período de aquecimento padronizado (5 min a 50%VO2max). A outra sessão foi realizada após uma corrida contínua no OBLA até a exaustão voluntária. Essas sessões foram executadas em ordem randômica. RESULTADOS: Houve redução significante do PTC somente a 60º.s-1 (259,0 ± 46,4 e 244,0 ± 41,4 N.m). Entretanto, a redução do PTE foi significante a 60º.s-1 (337,3 ± 43,2 e 321,7 ± 60,0 N.m) e 180º.s-1 (346,1 ± 38,0 e 319,7 ± 43,6 N.m). As reduções relativas da força após o exercício de corrida foram significantemente diferentes entre os tipos de contração somente a 180º.s-1. CONCLUSÃO: Podemos concluir que, em indivíduos ativos, a redução no torque máximo após uma corrida contínua prolongada no OBLA pode ser dependente do tipo de contração e da velocidade angular.

Isokinetic Strength and Endurance in Proximal and Distal Muscles in Patients With Peripheral Artery Disease

Background: The objective of this study was to analyze the muscle strength and endurance of the proximal and distal lower-extremity muscles in peripheral artery disease (PAD) patients. Methods: Twenty patients with bilateral PAD with symptoms of intermittent claudication and nine control subjects without PAD were included in the study, comprising 40 and 18 legs, respectively. All subjects performed an isokinetic muscle test to evaluate the muscle strength and endurance of the proximal (knee extension and knee flexion movements) and distal (plantar flexion and dorsiflexion movements) muscle groups in the lower extremity. Results: Compared with the control group, the PAD group presented lower muscle strength in knee flexion (-14.0%), dorsiflexion (-26.0%), and plantar flexion (-21.2%) movements (P < 0.05) but similar strength in knee extension movements (P > 0.05). The PAD patients presented a 13.5% lower knee flexion/extension strength ratio compared with the control subjects (P < 0.05), as well as lower muscle endurance in dorsiflexion (-28.1%) and plantar flexion (-17.0%) movements (P < 0.05). The muscle endurance in knee flexion and knee extension movements was similar between PAD patients and the control subjects (P > 0.05). Conclusion: PAD patients present lower proximal and distal muscle strength and lower distal muscle endurance than control patients. Therefore, interventions to improve muscle strength and endurance should be prescribed for PAD patients.

The effect of a weighted-vest strength and balance training program on obstructed walking in postmenopausal women

SUMMARY Background: Age related declines in lower extremity strength have been associated with impaired mobility and changes in gait patterns, which increase the likelihood of falls. Since community dwelling adults encounter a wide range of locomotor challenges including uneven and obstmcted walking surfaces, we examined the effect of a strength 11 and balance exercise program on obstructed walking in postmenopausal women. Objectives: This study examined the effect of a weighted-vest strength and balance exercise program on adaptations of the stance leg during obstacle walking in postmenopausal women. Methods: Eighteen women aged 44-62 years who had not engaged in regular resistance training for the past year were recruited from the St. Catharines community to participate in this study. Eleven women volunteered for an aerobic (walking), strength, and balance training program 3 times per week for 12 weeks while 7 women volunteered as controls. Measurements included: force platform dynamic balance measure of the center of pressure (COP) and ground reaction forces (GRFs) in the stance leg while going over obstacles of different heights (0,5, 10,25 and 30 cm); and isokinetic strength measures of knee and ankle extension and flexion. Results: Of the 18 women, who began the trial, 16 completed it. The EX group showed a significant increase of 40% in ankle plantar flexion strength (P < 0.05). However, no improvements in measures of COP or GRFs were observed for either group. Failure to detect any changes in measures of dynamic balance may be due to small sample size. Conclusions: Postmenopausal women experience significant improvements in ankle strength with 12 weeks of a weighted-vest balance and strength training program, however, these changes do not seem to be associated with any improvement in measures of dynamic balance.

The effect of a segmental, localized lower limb cooling protocol on muscular strength and balance

The human neuromuscular system is susceptible to changes within the thermal environment. Cold extrinsic temperatures can significantly reduce muscle and nervous system function and communication, which can have consequences for motor performance. A repeated measures design protocol exposed participants to a 12°C cold water immersion (CWI) up to the ankle, knee, and hip to determine the effect that reduced skin and muscle temperature had on balance and strength task execution. Although a linear reduction in the ability to perform balance tasks was seen from the control condition through to the hip CWI, results from the study indicated a significant reduction in dynamic balance (Star Excursion Balance Test reach distance) performance from only the hip CWI (P<0.05). This reduced performance could have been due to an increase in joint stiffness, increased agonist-antagonist co-contraction, and/or reduced isokinetic muscular strength. Reduced physical performance due to cold temperature could negatively impact outdoor recreational athletics.

Hip muscles strength and activation in older fallers and non-fallers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Free-running circadian rhythms of muscle strength, reaction time, and body temperature in totally blind people

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The relationship between knee strength and functional stability before and after anterior cruciate ligament reconstruction

Functional stability of the knee is dependent on an intact ligamentous system and the timely and efficient contraction of supporting musculature. The aim of this study was to assess the relationship between muscle strength and functional stability in 31 patients pre- and post-operatively, following a unilateral anterior cruciate ligament rupture. All subjects underwent reconstructive surgery using semitendonosis and gracilis tendons. Isokinetic strength assessment of quadriceps and hamstring muscles was performed at a rate of movement of 60% and 120degrees/s. Functional stability was determined by performance during five functional stability tests that included the shuttle run, side step, carioca, single and triple hop tests. Pearson's correlation coefficient statistics were applied to pre-operative and post-operative data respectively. These analyses demonstrated a significant positive correlation between quadriceps strength indices at both testing speeds and the two hop tests pre-operatively (p's < 0.007) and between quadriceps strength indices at both speeds and all five functional tests post-operatively (p's < 0.01). Assessed using Steiger's formula, there was a significant increase in the correlation between quadriceps strength indices and three functional tests post-operatively compared to pre-operatively (p < 0.05). No significant correlation between hamstring strength indices and functional scores existed pre- or post-operatively. This study has shown a significant correlation exists between quadriceps strength indices and functional stability both before and after surgery, this relationship does not reach significance between hamstring strength indices and functional stability. (C) 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

Static and dynamic shoulder stabilizer adaptations in javelin throwers: A preliminary study

BACKGROUND: Adaptations to Internal (IR) and external (ER) rotator shoulder muscles improving overhead throwing kinematics could lead to muscular strength imbalances and be considered an intrinsic risk factor for shoulder injury, as well as modified shoulder range of motion (RoM). OBJECTIVE: To establish profiles of internal and external rotation RoM and isokinetic IR and ER strength in adolescent- and national-level javelin throwers. METHODS: Fourteen healthy subjects were included in this preliminary cross-sectional study, 7 javelin throwers (JTG) and 7 nonathletes (CG). Passive internal and external rotation RoM were measured at 90 degrees of shoulder abduction. Isokinetic strength of dominant and non-dominant IR and ER was evaluated during concentric (60, 120 and 240 degrees/s) and eccentric (60 degrees/s) contractions by Con-Trex (R) dynamometer with the subject in a seated position with 45 degrees of shoulder abduction in the scapular plane. RESULTS: We reported significantly lower internal rotation and significantly higher external rotation RoM in JTG than in CG. Concentric and eccentric IR and ER strength were significantly higher for the dominant shoulder side in JTG (P < 0.05), without significant differences in ER/IR ratios. CONCLUSIONS: The main finding of this preliminary study confirmed static and dynamic shoulder stabilizer adaptations due to javelin throw practice in a population of adolescent- and national-level javelin throwers.

Treinamento de força unilateral: efeitos sobre a taxa de desenvolvimento de força do membro contralateral

The aim of this study was to analyze the effects of unilateral isokinetic strength training at high speed (180°.s-1) of the dominant leg on the rate of force development (RFD) of the contralateral limb. The study included 18 male individuals, apparently healthy, with an average of 23 years, and without regular practice of physical activities. The subjects were divided randomly into two groups: control group (GC) and isokinetic group (GISOC). Assessments were made of the values of peak isometric torque (PT isom) and RFD of both lower limbs in the pre-training. So, the GISOC underwent an isokinetic strength training with high speed (180°.s-1) for 6 weeks, with the dominant leg only and then reassessed. It was found that there was no significant improvement in value of PT isom (p> 0.05), and the RFD for the dominant limb had a significant improvement (p< 0.05) compared to the pre-training and that there was no transfer of values to the contralateral side (p> 0.05). It can be concluded that the isokinetic training at high speed was not enough for significant cross education

Comparação de diferentes tipos de exercício na composição corporal e força em jovens desportistas do sexo feminino

O estudo pretende comparar o efeito de diferentes tipos de exercício físico na composição corporal e força em jovens desportistas do sexo feminino. A amostra foi constituída por vinte e seis desportistas femininas com idades compreendidas entre os 16 e 21 anos. Previamente ao início do estudo foram sujeitas ao 1º momento de avaliação, e após vinte e quatro semanas realizaram o segundo e ultimo momento de avaliação. Os parâmetros avaliados foram a composição corporal através da técnica de absorciometria radiológica de dupla energia; a força isocinética, nomeadamente os momentos de força (peak-torques) e rácios nos músculos extensores e flexores do joelho; a potência muscular nos membros inferiores através dos saltos verticais Squat jump e Countermovement jump. Posteriormente foram separadas em quatro grupos, grupo natação e exercício vibratório (NAT EV; n= 6), grupo natação (NAT; n=6), grupo futsal (FUTS; n= 6) e o grupo de controlo (CONT; n= 8). O grupo (NAT/EV), participou num programa de exercício vibratório (EV), três sessões por semana complementar ao treino de natação. O grupo de (NAT) cumpriu o plano de treino correspondente à disciplina, o grupo de (FUTS) cumpriu o treino referente à respetiva modalidade, o grupo controlo (CONT) realizou somente os exercícios físicos inerentes às aulas de educação física na escola. Resultados: Nas comparações inter grupos, verificou-se no grupo FUTS um aumento de 0,1 (g/m2) ± 0,0 nos valores da DMO-PE, quando comparado com o grupo de CONT, nas comparações intra grupo o grupo de NAT EV registou um acréscimo de 0,1 (g/m2) ± 0,1 nos valores da DMO-TC. Em conclusão, os resultados obtidos sugerem que a modalidade de FUTS promoveu mais alterações na composição corporal, nomeadamente na DMO-PE, no entanto dados conseguidos pelo grupo de NAT EV sugerem que o exercício vibratório poderá influenciar positivamente o incremento da DMO; ABSTRACT: The objective of this study was to compare the effect of different types of exercise on body composition and strength in young female athletes. The sample consisted of twenty-six female athletes aged between 16 and 21. Before the study there was a 1st evaluation point, after twenty-four weeks there was the 2nd and final evaluation. We evaluated body composition through x-ray absorptiometry technique of dual energy, isokinetic strength, including the peak-torques and ratios in the extensor and flexor muscles of the knee; the muscle power in the lower limbs was evaluatated through the vertical jumps Squat jump and countermovement jump. During the study they were separated into four groups, swimming exercise group and vibration (NAT EV; n = 6), swimming group (NAT; n= 6), footsal group (FUTS; n= 6) and control group (CONT; n= 8). The NAT/EV group, participated in a vibrating exercise program (EV), complementary to swimming training, with three sessions per week. The NAT group fulfilled the corresponding swimming workout plan, FUTS group fulfilled the training related to futsal, the CONT group only performed the usual exercises in physical education classes at school. Results: In intergroup comparisons, there was an increase in FUTS group of 0.1 (g / m2) ± 0.0 in the values of MBD-PE, when compared with the CONT group comparisons in intra-group group NAT EV increased by 0.1 (g / m2) ± 0.1 in BMD-TC values. In conclusion, the results suggest that FUTS group promoted more changes in body composition, particularly in BMD-PE, but data obtained by NAT EV group suggest that vibration exercise can positively influence the increase in BMD.

Efeitos do suster-relaxar na cinemática tridimensional, função neuromuscular e sintomatologia álgica de um atleta de crossfit com dor lombar

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

The Biodex Isokinetic Dynamometer for knee strength assessment in children : advantages and limitations

Objective: To critically appraise the Biodex System 4 isokinetic dynamometer for strength assessment of children. Methods: Appraisal was based on experiences from two independent laboratories involving testing of 213 children. Issues were recorded and the manufacturer was consulted regarding appropriate solutions. Results: The dynamometer had insufficient height adjustment for alignment of the knee for some children, requiring the construction of padding to better fit the child within the dynamometer. Potential for entrapment of the non-testing leg was evident in the passive and eccentric modes and a leg bracket restraint was constructed. Automated gravity correction did not operate when protocols were linked or data was exported to an external device. Conclusions: Limitations were noted, some of which were applicable to knee strength testing in general and others which were specific to use with children. However, most of these obstacles could be overcome, making the Biodex System 4 suitable for assessment of knee strength in children.