This study compared the effects of a high-intensity (HI) strength training program to a low-intensity (LI) rehabilitation program for 39 patients following total knee arthroplasty. Patients in the HI group performed high-intensity leg extension and squat exercises three times per week in addition to the standard rehabilitation, while the LI group only did the standard rehabilitation. At discharge, the HI group demonstrated greater maximal quadriceps strength compared to the LI group with no increase in pain or other complaints. The results indicate that earlier introduction of progressive high-intensity exercises can improve strength outcomes following knee replacement without impairing recovery.
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
MRI findings regarding hamstring strain injury and recovery
(6th MuscleTech Network Workshop)
14th October, Barcelona
Erik Witvrouw
Lead research and Education Sports Physiotherapist, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar / Professor Rehabilitation Science and Physiotherapy, Ghent University, Belgium
-
Isokinetic and neuromuscular evaluation as potential risk factors for hamstring injuries
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
MRI findings regarding hamstring strain injury and recovery
(6th MuscleTech Network Workshop)
14th October, Barcelona
Erik Witvrouw
Lead research and Education Sports Physiotherapist, Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar / Professor Rehabilitation Science and Physiotherapy, Ghent University, Belgium
-
Isokinetic and neuromuscular evaluation as potential risk factors for hamstring injuries
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
Hamstrings are most susceptible to injury during the early stance phase of sprinting
(13th October, Barcelona)
6th MuscleTech Network Workshop
Comparison of a strengthening programme to a proprioceptive training in impro...IOSR Journals
Abstract: Strength and proprioception are important to have a stable and functional ankle .Individuals with
ankle injuries are bound to develop a loss of either or both of these during and after the phase of
immobilization. Objectives: 1. To assess the effects of a 4 weeks strengthening programme on dynamic balance
in CAI. 2. To assess the effects of a 4 weeks proprioceptive training on dynamic balance in CAI.3. To compare
the effects of a 4 weeks strengthening programme to a proprioceptive training on dynamic balance in CAI.
Materials and methods: This was an interventional study done amongst athlete students at Deccan Education
Society college campus, Pune during November 2013 to April 2014. Total 27 college students who were known
athletes with chronic ankle instability were selected by convenient sampling. These 27 subjects were randomly
allotted, 13 to the strengthening group and 14 to the proprioceptive group. Dynamic balance was assessed
using the Functional reach test (FRT) prior to the intervention. Maximum three readings were collected and
then an average of the best two was taken while the first was considered as the trial. This was considered as the
pre intervention reading. These subjects then underwent a 4 week programme depending upon the group they
were allotted. Post intervention readings were taken of the FRT scores in the two groups and statistical analysis
was done. Results & Conclusion: Paired andUnpaired t tests were done to compare the Functional reach test
(FRT) scores pre and post in both the strengthening and proprioceptive groups and also the post training FRT
scores between the two groups. The differences in the pre and post FRT scores were found to be extremely
significant in both the groups (p value < 0.0001). However there was no significant difference between the FRT
scores post training between the two groups (p value > 0.0001). The study proves that both the strength training
as well as proprioceptive training are equally effective in improving the dynamic balance in athletes with ankle
instability. They should thus both be given to improve dynamic balance.
Keywords: Strength, Proprioceptive training, chronic ankle instability.
A Study to compare the effect of Open versus Closed kinetic chain exercises i...IOSR Journals
Abstract: Background And Purpose Of The Study: Patello-femoral arthritis is the most common type of
arthritis especially older people sometimes it is called as degenerative joint disease. Patello- femoral arthritis is
one of the common causes of physical disability in adults. It is the second most common cause of chronic
conditions. 50% of older persons after 55 years are affected. Some of the young people get arthritis from the
joint injuries. Arthritis is the leading cause of disability in our nation more than other systemic diseases like
heart diseases, cancer and diabetes. There are many therapeutic interventions for the treatment of patellofemoral
arthritis. The study is to determine whether closed kinetic chain exercise offer any advantages over
open kinetic chain exercises.
Method: The patients are randomly selected based on inclusion and exclusion criteria and divided into two
groups. Group A and Group B. Group A is trained with closed kinetic chain exercise and Group B is trained
with open kinetic chain exercises for a period of 12 weeks. the pre and post treatment readings of VAS and
KUJALA scale are taken in both groups for statistical analysis.
Results: The results showed reduction in pain and improvement in functional activity in both Group A and
Group B, significant improvement has been noted in Group A after 12 weeks of training.
Conclusion: This study shows that there was significant improvement in functional ability and reduction of pain
as a result of both open and closed kinetic chain exercises program. There are only few significant differences
between closed kinetic chain exercises (GROUP-A) and open kineticchain exercises (GROUP-B). It reviles that
closed kinetic chain exercises are more effective in the treatment of patello-femoral arthritis than the
(GROUP-B) open kinetic chain exercises
Ricard Pruna / Dani Medina
Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
-
Which is our Return To Play criteria?
Mark Sherry
Manager of Sports Rehabilitation at the University of Wisconsin Sports Medicine Center, Physical Therapist, Madison, Wisconsin, USA.
-
Return to Play Guidelines Following Acute Hamstring Strain
(6th MuscleTech Network Workshop)
14th October, Barcelona
Anthony Shield - is nmi a risk factor for hamstring strain injury MuscleTech Network
Anthony Shield
Senior lecturer, School of Exercise and Nutrition Science Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia.
-
Is neuromuscular inhibition a risk factor for hamstring strain?
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
Is Postexercise muscle soreness a valid indicator of muscular adaptations?Fernando Farias
DELAYED ONSET MUSCLE SORE- NESS (DOMS) IS A COMMON SIDE EFFECT OF PHYSICAL ACTIVITY, PARTICULARLY OF A VIGOROUS NATURE. MANY EXERCISERS WHO REGULARLY PERFORM RESISTANCE TRAINING CONSIDER DOMS TO BE ONE OF THE BEST INDICATORS OF TRAINING EFFECTIVENESS, WITH SOME RELYING UPON THIS SOURCE AS A PRIMARY GAUGE. THIS ARTICLE DISCUSSES THE RELEVANCE OF USING DOMS TO ASSESS WORKOUT QUALITY.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
Bryan Heiderscheit
Professor, Department of Orthopedics and Rehabilitation, Department of Biomedical Engineering, Director, UW Runners' Clinic, Director, Badger Athletic Performance Research, Co-director, UW Neuromuscular Biomechanics Lab, University of Wisconsin-Madison, Madison, WI, USA.
-
Hamstrings are most susceptible to injury during the early stance phase of sprinting
(13th October, Barcelona)
6th MuscleTech Network Workshop
Comparison of a strengthening programme to a proprioceptive training in impro...IOSR Journals
Abstract: Strength and proprioception are important to have a stable and functional ankle .Individuals with
ankle injuries are bound to develop a loss of either or both of these during and after the phase of
immobilization. Objectives: 1. To assess the effects of a 4 weeks strengthening programme on dynamic balance
in CAI. 2. To assess the effects of a 4 weeks proprioceptive training on dynamic balance in CAI.3. To compare
the effects of a 4 weeks strengthening programme to a proprioceptive training on dynamic balance in CAI.
Materials and methods: This was an interventional study done amongst athlete students at Deccan Education
Society college campus, Pune during November 2013 to April 2014. Total 27 college students who were known
athletes with chronic ankle instability were selected by convenient sampling. These 27 subjects were randomly
allotted, 13 to the strengthening group and 14 to the proprioceptive group. Dynamic balance was assessed
using the Functional reach test (FRT) prior to the intervention. Maximum three readings were collected and
then an average of the best two was taken while the first was considered as the trial. This was considered as the
pre intervention reading. These subjects then underwent a 4 week programme depending upon the group they
were allotted. Post intervention readings were taken of the FRT scores in the two groups and statistical analysis
was done. Results & Conclusion: Paired andUnpaired t tests were done to compare the Functional reach test
(FRT) scores pre and post in both the strengthening and proprioceptive groups and also the post training FRT
scores between the two groups. The differences in the pre and post FRT scores were found to be extremely
significant in both the groups (p value < 0.0001). However there was no significant difference between the FRT
scores post training between the two groups (p value > 0.0001). The study proves that both the strength training
as well as proprioceptive training are equally effective in improving the dynamic balance in athletes with ankle
instability. They should thus both be given to improve dynamic balance.
Keywords: Strength, Proprioceptive training, chronic ankle instability.
A Study to compare the effect of Open versus Closed kinetic chain exercises i...IOSR Journals
Abstract: Background And Purpose Of The Study: Patello-femoral arthritis is the most common type of
arthritis especially older people sometimes it is called as degenerative joint disease. Patello- femoral arthritis is
one of the common causes of physical disability in adults. It is the second most common cause of chronic
conditions. 50% of older persons after 55 years are affected. Some of the young people get arthritis from the
joint injuries. Arthritis is the leading cause of disability in our nation more than other systemic diseases like
heart diseases, cancer and diabetes. There are many therapeutic interventions for the treatment of patellofemoral
arthritis. The study is to determine whether closed kinetic chain exercise offer any advantages over
open kinetic chain exercises.
Method: The patients are randomly selected based on inclusion and exclusion criteria and divided into two
groups. Group A and Group B. Group A is trained with closed kinetic chain exercise and Group B is trained
with open kinetic chain exercises for a period of 12 weeks. the pre and post treatment readings of VAS and
KUJALA scale are taken in both groups for statistical analysis.
Results: The results showed reduction in pain and improvement in functional activity in both Group A and
Group B, significant improvement has been noted in Group A after 12 weeks of training.
Conclusion: This study shows that there was significant improvement in functional ability and reduction of pain
as a result of both open and closed kinetic chain exercises program. There are only few significant differences
between closed kinetic chain exercises (GROUP-A) and open kineticchain exercises (GROUP-B). It reviles that
closed kinetic chain exercises are more effective in the treatment of patello-femoral arthritis than the
(GROUP-B) open kinetic chain exercises
Ricard Pruna / Dani Medina
Senior Researcher and Sports Medicine Specialist at the Medical Services Futbol Club Barcelona
-
Which is our Return To Play criteria?
Mark Sherry
Manager of Sports Rehabilitation at the University of Wisconsin Sports Medicine Center, Physical Therapist, Madison, Wisconsin, USA.
-
Return to Play Guidelines Following Acute Hamstring Strain
(6th MuscleTech Network Workshop)
14th October, Barcelona
Anthony Shield - is nmi a risk factor for hamstring strain injury MuscleTech Network
Anthony Shield
Senior lecturer, School of Exercise and Nutrition Science Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia.
-
Is neuromuscular inhibition a risk factor for hamstring strain?
Fabrizio Tencone
Isokinetic Medical Group, Torino, Italy – Head Juventus Football Club Medical Department, Italy.
-
From injury to return to sport: 25 years of experience in Italian football
(6th MuscleTech Network Workshop)
14th October, Barcelona
Is Postexercise muscle soreness a valid indicator of muscular adaptations?Fernando Farias
DELAYED ONSET MUSCLE SORE- NESS (DOMS) IS A COMMON SIDE EFFECT OF PHYSICAL ACTIVITY, PARTICULARLY OF A VIGOROUS NATURE. MANY EXERCISERS WHO REGULARLY PERFORM RESISTANCE TRAINING CONSIDER DOMS TO BE ONE OF THE BEST INDICATORS OF TRAINING EFFECTIVENESS, WITH SOME RELYING UPON THIS SOURCE AS A PRIMARY GAUGE. THIS ARTICLE DISCUSSES THE RELEVANCE OF USING DOMS TO ASSESS WORKOUT QUALITY.
Nikos Malliaropoulos - Rehabilitation of hamstring injuries MuscleTech Network
Nikos Malliaropoulos
Director of the Athletics National Sports Medicine Centre Thessaloniki Greece. Consultant SEM Physician Barts and The London Clinical Senior Lecturer QMUL CSEM.
-
The rehabilitation of Hamstring injuries - Can we be more injury specific?
(6th MuscleTech Network Workshop)
14th October, Barcelona
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Postexercise Cold Water Immersion Benefits Are Not Greater than the Placebo E...Fernando Farias
A CWI placebo is also as effective as
CWI itself in the recovery of muscle strength over 48 h.
This can likely be attributed to improved subjective ratings
of pain and readiness for exercise, suggesting that the hy-
pothesized physiological benefits surrounding CWI may
be at least partly placebo related.
An experimental study on scapulothoracic and glenohumeral kinematics followin...pharmaindexing
Aim
This study aimed to find out the effect of rotator cuff fatigue on humeral head migration during dynamic shoulder external rotation activity (combination of flexion, abduction, external rotation) in tennis players.
Objectives
The purpose for physiotherapist in sports performance enhancement assessment of shoulder kinematics provides a reliable tool for studying kinematics during arm elevation.
To understand the importance of external rotation strengthening on clearing superior glenohumeral joint migration for tennis professionals.
Materials and Methods
A total of 20 men of tennis players without shoulder disorders were recruited in the study. The study was conducted in the Tamilnadu tennis association (TNTA) and Gandhi nagar tennis club (GNC adayar). Pre and post tests were performed.
Results
The data was analyzed using SPSS. The experimental group (who received external rotator fatigue protocol) showed significance with (p=0.001) value when compared with the control group. Also, the post-test mean value of the experimental group showed a significant improvement after the protocol.
Conclusion
External rotators stretching and strengthening protocol showed significant improvement in functional status of glenohumeral joint than conventional traditional coaching program alone on tennis professionals.
An experimental study on scapulothoracic and glenohumeral kinematics followin...
Marivo_SIF_2016[1094]
1. 1Student at School of Physiotherapy - University of Eastern Piedmont, Novara, Italy.
2Laboratory of Ergonomics and Musculoskeletal Disorders Assessment, Istituti Clinici Scientifici Maugeri SpA SB - IRCCS, Veruno (NO), Italy.
3Student at School of Physiotherapy, University of Eastern Piedmont, Fossano (CN), Italy
4Unit of Rehabilitation and Functional Recovery, Casa di Cura La Residenza, Rodello (CN), Italy
Background and Objective
The full recovery of strength and function after total knee arthroplasty (TKA) is uncommon,1,2 and patients are frequently
exposed to future disability. Despite these known impairments and activity limitations, there is a lack of established
standards for prescribing exercise paradigms.3 However, there is preliminary evidence that early, progressive high-intensity
rehabilitation can lead to better outcomes.4
Aim of this study was to analyze the safety and effects of a three-weeks, high-load (HI) strength training compared to
controls who underwent a low-intensity (LI) rehabilitation program.
Material and Methods
A total of 39 inpatients with primary unilateral TKA were
recruited in two rehabilitation institutes, and randomized to
the HI (N=18) or LI (N=21) group. A sample size of 18
subject per group was needed. Both groups received a
comprehensive low-intensity treatment aimed to improve
strength, ROM, gait, and function. In addition, the HI group
included two high-intensity strength exercises (leg extension
and squat) three times a week.5
Patients were assessed by means of maximal quadriceps
strength in open and closed kinetic chain. The two groups
were compared by a two-ways ANOVA. Any complaint
(increase of pain/swelling or decreased of walking
endurance/knee ROM) was also recorded. Safety was
assessed with the percentage of dropout, defined as the ratio
between the number of patients who withdrew from
treatment and the number of patient enrolled in the same
group.
Marivo Simone1, PTs; Vercelli Stefano2, PhD PT; Sartorio Francesco2, MSc PT;
Morra Valentina3 PTs, Piano Leonardo4 OMPT
Results
At discharge, the HI group had greater maximal quadriceps
strength (Table 1) in both the leg extension (p<0.05) and
squat (p<0.01) compared to the control group (Figure 1). The
high-intensity exercises were well tolerated, and no subject
withdrew from treatment.
References
1-Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005;157-165.
2-Silva M, Shepherd EF, Jackson WO, Pratt JA, McClung CD, Schmalzried TP. Knee strength after total knee arthroplasty. J Arthroplasty. 2003;18:605-611.
3-Pozzi F, Snyder-Mackler L, Zeni J. Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med. 2013;49(6):877-92.
4-Bade MJ, Stevens-Lapsley JE. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther 2011;41:932-41.
5-American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports
Exerc. 2009;41(3):687-708. doi: 10.1249/MSS.0b013e3181915670.
FEASIBILITY, SAFETY, AND EFFECTS OF EARLY HIGH-INTENSITY
STRENGTH EXERCISES FOLLOWING TOTAL KNEE REPLACEMENT:
A RANDOMIZED CONTROLLED TRIAL
Discussion
Results indicate that the addition of high-intensity
exercises initiated early in the course of recovery after
TKA led to superior strength outcomes, without leading to
increase of pain, swelling or decrease of knee
performances in this group of patients.
The key difference between the 2 programs was the level
of intensity chosen for resistive strength training, and it is
likely that treatment intensity was the primary driver of the
differences in outcomes between groups. Safety of HI
exercises was demonstrated by the absence of difference
in dropout ratio or symptoms’ intensity between groups.
Conclusions
Introducing progressive submaximal exercise after TKA
leads to increased muscular strength with no impairments
that may slow down the recovery process or lengthen the
time of hospitalization. The implementation of more
intense interventions should be considered.
Figure 1. Comparison of strength tests between groups over time
(Tukey box plots). On the left is shown the maximal strength in the leg
extension test, expressed in kilograms; on the right, the maximum
number of repetitions executed in the squat test (the minimum height
recorded for each patient during the squat test at admission was
maintained at discharge). Abbreviations: HI, high-intensity group; LI,
low-intensity group; LE_t0, Leg Extension at admission; LE_t1, Leg
Extension at discharge; Squat_t0, Squat test at admission; Squat_t1,
Squat test at discharge; *, statistical significance at p<0.05; **,
statistical significance at p<0.01. Boxes are the first and third
quartiles, the band inside the box is the mean, the whiskers represent
the lowest value still within 1.5 IQR of the lower quartile, and the
highest value still within 1.5 IQR of the upper quartile.
Table 1. Abbreviations: HI, high-intensity rehabilitation group; LI, low-
intensity rehabilitation group; SD, standard deviation; T0, first day
assessment; T1, last day assessment, Leg extension, maximal
strength in open kinetics chain on leg extension machine expressed in
KG; Squat, maximal strength in closed kinetic chain expressed in lower
height maximum repetition in squat exercise.
Leg extension
T0 T1
Group Mean (SD) p25 p75 Mean (SD) p25 p75
HI 5,1 (3,25) 2,3 6,3 11,6 (4,3) 8,2 14,3
LI 3,27 (3,26) 1,3 4,6 7,02 (4,89) 3,5 9
Squat
T0 T1
Group Mean (SD) p25 p75 Mean (SD) p25 p75
HI 11,25 (3,71) 8,5 13 30 (10,68) 21 40
LI 11,52 (6,87) 6 14 22,38 (10,85) 12 30