Isokinetic Knee Strengthening Impact on Physical and Functional Performance, Pain Tolerance, and Quality of Life in Overweight/Obese Women with Patellofemoral Pain Syndrome.

Background/Objectives: Patellofemoral syndrome is a common osteoarticular condition that affects many individuals. Various treatment options are available, with a significant emphasis on targeted muscle-strengthening exercises. The purpose of this study was to investigate the effect of isokinetic muscle strengthening on muscle strength, joint range of motion, quality of life, physical performance, and pain tolerance in overweight/obese women with patellofemoral syndrome. Methods: Twenty-four overweight or obese women with patellofemoral syndrome participated in the study during September and October 2023 in a private medical facility for physical medicine and functional rehabilitation. They were randomly assigned to one of two groups for six weeks of isokinetic muscle strengthening. The first group (ISO.G) followed a rehabilitation program combined with isokinetic muscle strengthening. A second group (PCM.G) followed a rehabilitation program that includes an isokinetic protocol in passive compensation movement. The extensors' peak torque was measured before and after training. Results: The flexors' peak torque, stair climbing test, 10 m walk, chair lift, monopodal support, goniometric knee flexion test, heel-buttock distance measurement, pain, and quality of life scores improved significantly in both groups. The ISO.G, on the other hand, benefited from a significant increase in quadriceps muscle strength revealed by the extensors' peak torque. Conclusions: For the treatment of patellofemoral syndrome, isokinetic muscle strengthening in concentric mode appears to have a significant advantage over the classic rehabilitation program with isokinetic passive compensation, particularly in muscle strength gain, in addition to the improvement of joint range of motion, quality of life, physical performance, and pain tolerance. Isokinetic training may be recommended as a beneficial approach for the rehabilitative treatment of patellofemoral pain syndrome in overweight/obese women.

Developing normative values and predictive models for the 6-minute walk test across diverse adolescent developmental stages.

The six-minute walking test (6MWT) is commonly used to measure functional capacity in field settings, primarily through the distance covered. This study aims to establish reference curves for the six-minute walking distance (6MWD) and peak heart rate (PHR) and develop a predictive equation for cardiovascular capacity in Tunisian children and adolescents. A total of 1501 participants (706 boys and 795 girls), aged 10-18 years, were recruited from schools in Tunisia. The Lambda (L), Mu (M), and Sigma (S) methods (LMS method) were employed to develop smoothed percentile curves for 6MWD and PHR. Multivariate linear regression was utilized to formulate a prediction equation for 6MWD. Smoothed percentiles (3rd, 10th, 25th, 50th, 75th, 90th, and 97th) for 6MWD and PHR were presented with age. All variables showed a strong positive correlation (p < 0.001) with a six-minute walking distance (r ranged from 0.227 to 0.558 for girls and from 0.309 to 0.610 for boys), except resting heart rate, which showed a strong negative correlation (girls: r = -0.136; boys: r = -0.201; p < 0.001). Additionally, PHR showed a weak correlation (p > 0.05). The prediction equations, based on age as the primary variable, were established for both genders. For boys: 6MWD = 66.181 + 38.142 × Age (years) (R2 = 0.372; Standard Error of Estimate (SEE) = 122.13), and for girls: 6MWD = 105.535 + 28.390 × Age (years) (R2 = 0.312; SEE = 103.66). The study provides normative values and predictive equations for 6MWD and PHR in Tunisian children and adolescents. These findings offer essential tools for identifying, monitoring, and interpreting cardiovascular functional deficits in clinical and research settings.

Is isokinetic shoulder strength a determinant of serve ball velocity in tennis?

The tennis serve is closely related to the quality of the tennis match. However, the isokinetic parameters associated with the tennis serve are still unclear. The aim of this study was to investigate the relationships between ball velocity and isokinetic shoulder strength in tennis serve and to determine isokinetic strength parameters that can predict tennis serve velocity. A total of 13 elite male athletes (16.8 ± 1.5 years) voluntarily participated in the study. The athletes' shoulder internal-external rotation, extension-flexion and abduction-adduction strengths were measured with 5-5-15 repetitions at 60°/s, 180°/s, 240°/s angular velocities. Later, the athletes' 1st, 2nd, and average serve ball speeds were determined using a handheld radar gun. Significant correlations were found between ball speed and isokinetic tennis serve strength (r = 0.556-0.819; p < 0.05). The correlations between ball speed and isokinetic strength performance were higher at 180°/s and 240°/s angular velocities. Extension (240°/s; r = 0.819), flexion (180°/s; r = 0.755), abduction (240°/s; r = 0.733), adduction (240°/s; r = 0.684) and internal rotation (180°/s; r = 0.803) were highly correlated with ball velocity. These findings suggest that strength training to increase the ball speed of the tennis serve should be performed fast at high angular velocities and planning should focus on the strength of extension, flexion, abduction, adduction and internal rotation.

Concentric Isokinetic Strengthening Program's Impact on Knee Biomechanical Parameters, Physical Performance and Quality of Life in Overweight/Obese Women with Chronic Meniscal Lesions.

Meniscal injuries are one of the most common intra-articular knee injuries. Different treatments are presented depending on the symptoms and duration of meniscus tears, such as arthroscopic partial meniscectomy, physiotherapy, or even pharmacological treatment. The purpose was to investigate the effect of a concentric isokinetic knee muscle strengthening program on strength, joint range of motion, physical performance, quality of life and pain tolerance in overweight/obese women with chronic meniscal lesions. Twenty-four overweight/obese women were randomized into two groups. A control group (CG) performed a usual rehabilitation program plus isokinetic muscle strengthening (IMS) in the continuous passive motion mode and measured with an isokinetic dynamometer. An experimental group (EG) performed the same program in combination with IMS in the isokinetic active mode. The peak torque of the knee extensors (PTE) and flexors (PTF), sit-to-stand test, stair climb test, joint amplitude, heel-to-buttock distance, Thessaly test, KOOS questionnaire of pain and quality of life were measured pre- and post-protocol. After the intervention, the sit-stand number for both groups was significantly higher (p < 0.001) and the time to climb stairs was significantly reduced for the EG (p < 0.001). A significant improvement in joint range of motion, life quality (p < 0.001), relief in knee pain (p < 0.001) and in the post-program evaluation at the EG (p < 0.05) was noted. There was no significant difference in PTE and PTF between groups at 60°/s and 180°/s. The IMS in the active mode could be an effective therapeutic modality in managing middle-aged patients suffering from a degenerative meniscal tear.

Influence of muscle volume on jumping performance in healthy male and female youth and young adults.

BACKGROUND: Sex differences that appear throughout puberty have a substantial impact on the training process. It remains unclear what effect these sex differences should have on how training programs are planned and performed and what objectives should be established for boys and girls of different ages. This study aimed to investigate the relationship between vertical jump performance and muscle volume based on age and sex. METHODS: One hundred eighty healthy males (n = 90) and females (n = 90) performed three different types of vertical jumps (VJ): squat jump (SJ), counter movement jump (CMJ), and counter movement jump with arms (CMJ with arms). We used the anthropometric method to measure muscle volume. RESULTS: Muscle volume differed across age groups. There were significant effects of age, sex, and their interaction on the SJ, CMJ, and CMJ with arms heights. From the age of 14-15, males exhibited better performances than females, and large effect sizes became apparent in the SJ (d = 1.09, P = 0.04), CMJ (d = 2.18; P = 0.001) and CMJ with arms (d = 1.94; P = 0.004). For the 20-22-year-old age group, there was a significant difference in VJ performance between males and females. Extremely large effect sizes became apparent in the SJ (d = 4.44; P = 0.001), CMJ (d = 4.12; P = 0.001) and CMJ with arms (d = 5.16; P = 0.001). When performances were normalized to the lower limb length, these differences persisted. After normalization to muscle volume, males exhibited better performance when compared to females. This difference persisted only for the 20-22-year-old group on the SJ (p = 0.005), CMJ (p = 0.022) and CMJ with arms (p = 0.016). Among male participants, muscle volume was significantly correlated with SJ (r = 0.70; p < 0.01), CMJ (r = 0.70; p < 0.01) and CMJ with arms (r = 0.55; p < 0.01). CONCLUSIONS: The results indicate that muscle volume may be one of the major determining factors in sex differences in vertical jumping performance.

Comparison of the Physical, Physiological, and Psychological Responses of the High-Intensity Interval (HIIT) and Small-Sided Games (SSG) Training Programs in Young Elite Soccer Players.

We investigated the effects of high-intensity interval (HIIT) and small-sided games (SSG) training programs on physiological and psychological responses in young soccer players. Twenty-four male soccer players (age 16.7 ± 0.9 years) were divided into two groups (HIIT and SSG) and completed a 6-week training programs consisting of two training sessions a week. HIIT consisted of intermittent runs lasting 15 s at the 110% maximum aerobic speed followed by a passive recovery lasting 15 s; SSG was instead structured in a 4 versus 4 players games on a playing field of 25 × 35 m. The muscular power of the lower body was assessed before and after each training session using the 5-jump test to leg length, and two incremental field tests (VAMEVAL test and modified agility t-test). Our results show that HIIT and SSG have similar beneficial effects on the variables connected to the soccer-specific performance and the endurance with little influence on neuromuscular performances. Psychological responses were assessed using the "physical activity enjoyment scale", the Hooper index and the POMS variables. Results showed that SSG offers greater perceived enjoyment than what can be achieved with HIIT. In conclusion, SSG can be considered an effective, more motivating, and fun soccer-specific training that brings about physiological responses and neuromuscular adjustments in young soccer players.

Isokinetic strengthening and neuromuscular electrical stimulation protocol impact on physical performances, functional status and quality of life in knee osteoarthritis overweight/obese women.

BACKGROUND: Knee muscle weakness associated with overweight/obesity can lead to impairment of vital daily function in knee osteoarthritis patients. This study investigated the effect of a knee eccentric isokinetic muscle strength (IMS) training program combined with neuromuscular electrical stimulation (NMES) on muscle strength and flexibility, joint ROM, functional status, physical performance, and quality of life in knee osteoarthritis overweight/obese women. METHODS: Thirty-six women were randomized into three groups, two experimental groups (EG) and a control group following a classic rehabilitation program. During 6 weeks of two sessions/week, one of the two EGs performed an IMS program (ISO.G); the other underwent combined IMS and NMES training (ISO + NMES.G). All patients were evaluated with clinical examination, isokinetic test at 60°/s and 240°/s speeds, physical performance tests related to activities of daily living, and Knee injury and Osteoarthritis Outcome Score (KOOS) quality of life questionnaire, before and after the intervention. RESULTS: In the 10-m walk, chair stand, stair climb and monopodal stance tests, muscle flexibility and quality of life scores showed significant improvement for ISO.G (P = 0.000) and ISO + NMES.G (P = 0.000). Concentric strength at 240°/s was improved in ISO + NMES.G (P = 0.000) unlike the muscle strength at 60°/s (quadriceps, P = 0.104; hamstrings, P = 0.171), force asymmetry (P = 0.481) and post-intervention joint ROM (P = 0.309). CONCLUSIONS: The combination of IMS and NMES shows significant superiority over the usual rehabilitation program for the majority of the parameters measured for optimal management of knee osteoarthritis.

Somatosensory-related limitations for bimanual coordination after stroke.

BACKGROUND: Bimanual coordinated movements may be impaired after stroke, so an assessment of causes is necessary to optimize rehabilitation strategies. OBJECTIVE: We assessed the role of afference-based sources of coordination, including phase entrainment and error correction based on visual and somatosensory feedback. METHODS: In all, 10 persons with unilateral chronic stroke and 8 age-matched controls participated in a kinesthetic tracking protocol, in which the hemiparetic upper limb was passively driven by the machine. The task consisted of matching the trajectory of the driven limb as accurately as possible with the freely moving limb in 2 conditions: eyes closed and eyes open. We analyzed the continuous relative phase (CRP), the mean absolute difference between positions (ADP) between the positions of the 2 limbs, and the jerk of the matching limb. RESULTS: Coordination instability (CRP standard deviation) and mean ADP were significantly higher for patients with eyes closed, compared with patients with eyes open, controls with eyes closed, and controls with eyes open. Moreover, the jerk was higher for the nonparetic limb of patients than for the control group. Thus, the nonparetic limb did not produce optimally smooth movements even as the motor-driven paretic limb did. CONCLUSION: Besides deficits caused by interhemispheric competition and motor execution of the paretic limb, somatosensory feedback is a limiting factor in bimanual coordination after stroke. The findings have clinical implications pertaining to the design and individualization of efficient bimanual movement therapy.