Circulating levels of dickkopf-1, osteoprotegerin and sclerostin are higher in old compared with young men and women and positively associated with whole-body bone mineral density in older adults.

Bone mineral density declines with increasing older age. We examined the levels of circulating factors known to regulate bone metabolism in healthy young and older adults. The circulating levels of dickkopf-1, osteocalcin, osteoprotegerin and sclerostin were positively associated with whole-body bone mineral density (WBMD) in older adults, despite the average WBMD being lower and circulating dickkopf-1, osteoprotegerin and sclerostin being higher in old than young. INTRODUCTION: This study aims to investigate the relationship between whole-body bone mineral density (WBMD) and levels of circulating factors with known roles in bone remodelling during 'healthy' ageing. METHODS: WBMD and fasting plasma concentrations of dickkopf-1, fibroblast growth factor-23, osteocalcin, osteoprotegerin, osteopontin and sclerostin were measured in 272 older subjects (69 to 81 years; 52% female) and 171 younger subjects (18-30 years; 53% female). RESULTS: WBMD was lower in old than young. Circulating osteocalcin was lower in old compared with young, while dickkopf-1, osteoprotegerin and sclerostin were higher in old compared with young. These circulating factors were each positively associated with WBMD in the older adults and the relationships remained after adjustment for covariates (r values ranging from 0.174 to 0.254, all p < 0.01). In multivariate regression, the body mass index, circulating sclerostin and whole-body lean mass together accounted for 13.8% of the variation with WBMD in the older adults. In young adults, dickkopf-1 and body mass index together accounted for 7.7% of variation in WBMD. CONCLUSION: Circulating levels of dickkopf-1, osteocalcin, osteoprotegerin and sclerostin are positively associated with WBMD in community-dwelling older adults, despite the average WBMD being lower and circulating dickkopf-1, osteoprotegerin and sclerostin being higher in old than young.

Diagnostic measures for sarcopenia and bone mineral density.

SUMMARY: Currently used diagnostic measures for sarcopenia utilize different measures of muscle mass, muscle strength, and physical performance. These diagnostic measures associate differently to bone mineral density (BMD), as an example of muscle-related clinical outcome. These differences should be taken into account when studying sarcopenia. INTRODUCTION: Diagnostic measures for sarcopenia utilize different measures of muscle mass, muscle strength, and physical performance. To understand differences between these measures, we determined the association with respect to whole body BMD, as an example of muscle-related clinical outcome. METHODS: In the European cross-sectional study MYOAGE, 178 young (18-30 years) and 274 healthy old participants (69-81 years) were recruited. Body composition and BMD were evaluated using dual-energy X-ray densitometry. Diagnostic measures for sarcopenia were composed of lean mass as percentage of body mass, appendicular lean mass (ALM) as percentage of body mass, ALM divided by height squared (ALM/height(2)), knee extension torque, grip strength, walking speed, and Timed Up and Go test (TUG). Linear regression models were stratified for sex and age and adjusted for age and country, and body composition in separate models. RESULTS: Lean mass and ALM/height(2) were positively associated with BMD (P < 0.001). Significance remained in all sex and age subgroups after further adjustment for fat mass, except in old women. Lean mass percentage and ALM percentage were inversely associated with BMD in old women (P < 0.001). These inverse associations disappeared after adjustment for body mass. Knee extension torque and handgrip strength were positively associated with BMD in all subgroups (P < 0.01), except in old women. Walking speed and TUG were not related to BMD. CONCLUSIONS: The associations between diagnostic measures of sarcopenia and BMD as an example of muscle-related outcome vary widely. Differences between diagnostic measures should be taken into account when studying sarcopenia.

Low back muscle fatigue during Sørensen endurance test in patients with chronic low back pain: relationship between electromyographic spectral compression and anthropometric characteristics.

This study assessed low back muscle fatigue during Sørensen back endurance test in chronic low back pain (CLBP) patients and healthy controls, and investigated relationship between the erector spinae muscle fatigability and subject's anthropometric characteristics. Four groups (n = 10 per group) of middle-aged (47-52-year-old) subjects participated: 1) female CLBP patients, 2) healthy female subjects, 3) male CLBP patients and 4) healthy male subjects. Subjects performed Sørensen back endurance test until exhaustion, while electromyographic (EMG) power spectrum median frequency compression over time (MF slope) as indicator of the erector spinae muscle fatigability, and endurance time were recorded. The endurance time was shorter (p < 0.05) in male CLBP patients compared to the healthy male and female subjects. No significant gender differences in endurance time were found in CLBP patients and in healthy subjects. EMG power spectrum MF slope did not differ significantly in CLBP patients and in healthy subjects. However, MF slope was higher (p < 0.05) in healthy male than in female subjects. Body mass and BMI correlated moderately positively with MF slope (r = 0.40-0.67) in all measured groups. We conclude that male CLBP patients had lower back extensor muscle isometric endurance compared to the healthy subjects of both genders, whereas no gender differences in isometric endurance were found in CLBP patients and in healthy subjects. Healthy male subjects had greater lumbar erector spinae muscle fatigability compared to the healthy female subjects. Subjects with higher body mass and body mass index fatigued faster during Sørensen back endurance test.

Shoulder muscle strength and fatigability in patients with frozen shoulder syndrome: the effect of 4-week individualized rehabilitation.

The effect of 4-week individualized rehabilitation on shoulder muscle strength and fatigability was evaluated in 10 patients with frozen shoulder syndrome (FSS) in comparison of 10 age- and gender-matched healthy control subjects. Isometric maximal voluntary contraction (MVC) force of the shoulder flexors was measured by hand-held dynamometer. Isometric endurance of the shoulder muscles was characterized by endurance time and net impulse (NI) assessed during weight (30% MVC) holding in hand until exhaustion. Fatigability of deltoideus, infraspinatus and trapezius muscles during isometric endurance test was assessed by electromyogram (EMG) power spectrum median frequency (MF) slope per minute. Rehabilitation in patients with FSS consisted of exercise therapy in swimming pool and gymnasium, electrical therapy and massage. Before rehabilitation, patients with FSS had less (p < 0.05) isometric MVC force and NI during endurance test compared to the control. MF slope in patients with FSS for involved extremity was higher (p <0.05) for the deltoideus muscle and less for the infraspinatus muscle before rehabilitation compared to the controls. Shoulder pain was decreased (p < 0.05) and isometric MVC force and NI in endurance test in patients for involved extremity were increased after rehabilitation. No significant changes in endurance time and MF slope for infraspinatus and trapezius muscles in patients for involved extremity were observed after rehabilitation, whereas MF slope for deltoideus muscle was increased. It was concluded that in patients with FSS, 4-week rehabilitation decreased shoulder pain and improved MVC force of the shoulder flexors and isometric working capacity of these muscles during endurance test.

Changes in soleus motoneuron pool reflex excitability and surface EMG parameters during fatiguing low- vs. high-intensity isometric contractions.

The fatigue-related changes in soleus motoneuron pool reflex excitability and surface electromyography (EMG) parameters, and maximal voluntary contraction (MVC) force of the plantarflexor (PF) muscles during repeatedly sustained low- (30% MVC) vs. high-intensity (70% MVC) isometric contractions were evaluated Twelve young men with mean (+/- SE) age of 22.4 +/- 0.3 years participated in two fatigue tasks on separate days with at least 1-week interval. The fatigue task consisted of three sustained isometric contractions of PF muscles at a target force level until exhaustion separated with 2-min pause between contractions. M-wave (muscle compound action potential) amplitude (M(max)), Hoffmann reflex maximal amplitude (H(max)) to M-wave amplitude ratio (H(max)/M(max)), and root mean square amplitude (RMS) and median frequency (MF) of EMG power spectrum were recorded from the soleus muscle. The M(max) remained constant immediately post-fatigue and during recovery for low- and high-intensity fatigue tasks, whereas H(max)/M(max) was significantly (p < 0.05) reduced only after high-intensity fatigue task. The increase in RMS and decrease in MF during isometric contractions, and reduction in MVC force immediately after the exercise was greater (p < 0.05) for low-intensity fatigue task. We conclude that low-intensity isometric contractions, repeatedly sustained to fatigue, resulted in a marked increase in the EMG amplitude and spectral compression without a significant post-fatigue reflex inhibition of soleus motoneuron pool. High-intensity contractions, however, resulted in post-fatigue reflex inhibition of soleus motoneuron pool and less pronounced EMG spectral compression during fatiguing contractions. A failure of neuromuscular transmission-propagation was not evident after repetitive fatiguing isometric contractions.

Serum albumin and muscle measures in a cohort of healthy young and old participants.

Consensus on clinically valid diagnostic criteria for sarcopenia requires a systematical assessment of the association of its candidate measures of muscle mass, muscle strength, and physical performance on one side and muscle-related clinical parameters on the other side. In this study, we systematically assessed associations between serum albumin as a muscle-related parameter and muscle measures in 172 healthy young (aged 18-30 years) and 271 old participants (aged 69-81 year) from the European MYOAGE study. Muscle measures included relative muscle mass, i.e., total- and appendicular lean mass (ALM) percentage, absolute muscle mass, i.e., ALM/height(2) and total lean mass in kilograms, handgrip strength, and walking speed. Muscle measures were standardized and analyzed in multivariate linear regression models, stratified by age. Adjustment models included age, body composition, C-reactive protein and lifestyle factors. In young participants, serum albumin was positively associated with lean mass percentage (p = 0.007) and with ALM percentage (p = 0.001). In old participants, serum albumin was not associated with any of the muscle measures. In conclusion, the association between serum albumin and muscle measures was only found in healthy young participants and the strongest for measures of relative muscle mass.

Knee extension strength and vertical jumping performance in nordic combined athletes.

BACKGROUND: The purpose of this study was to measure knee extension strength and vertical jumping performance characteristics in nordic combined athletes. METHODS: Unilateral knee extension isometric maximal force (MF) and rate of force development (RFD) were measured by a special dynamometer, and unilateral isokinetic peak torque (PT) at angular velocities of 60 and 180 deg/sec by a Cybex II dynamometer. Maximal squat (SJ) and counter-movement jumps (CMJ) were performed on force platform. Nine nordic combined athletes as the experimental group and 12 untrained male university students as the control group participated. RESULTS: Nordic combined athletes had a greater (p<0.05) absolute and relative (body mass-related) values of knee extension isometric MF and isokinetic PT, isometric RFD as well as jumping height in SJ and CMJ, than controls. The jumping height in CMJ was greater (p<0.05) compared with SJ only in nordic combined athletes. Jumping height in SJ and CMJ correlated significantly (p<0.05) with knee extension isometric RFD (r=0.62-0.83) and isokinetic PT at angular velocity of 60 deg/sec (r=0.70-0.82) in nordic combined athletes and untrained men. No significant correlation was obtained between unilateral knee extension isometric MF and isokinetic PT or vertical jumping height. CONCLUSIONS: The present study demonstrated a markedly higher voluntary maximal and explosive force-generating capacity of the extensor muscles of lower extremities in nordic combined athletes compared with untrained men, which indicates the adaptation to specific explosive type of strength training.

Age-related differences in knee extension rate of isometric force development and vertical jumping performance in women.

AIM: The purpose of this study was to compare knee extension rate of isometric force development and vertical jumping performance characteristics in young, middle-aged and elderly women. METHODS: Unilateral knee extension maximal rate of isometric force development (RFD) was measured by a dynamometer. Maximal squat (SJ) and counter-movement jumps (CMJ) were performed on a force platform. Twelve young (21- to 24-year-old), 12 middle-aged (50- to 58-year-old) and 13 elderly (70- to 76-year-old) women participated. RESULTS: Young women had greater (p<0.05) maximal isometric RFD as compared to older groups. No significant differences in maximal isometric RFD between middle-aged and elderly women have been found. The jumping height in SJ and CMJ was greater in young women as compared to older groups, and in middle-aged women greater as compared to elderly women. Absolute and body mass-related values of CMJ height was greater as compared to SJ height only in young women. Young women had greater jumping height relative to body mass in SJ and CMJ than the other groups. CONCLUSION: The ability to develop isometric force of the knee extensor muscles rapidly did not differ significantly in middle-aged and elderly women. Middle-aged and elderly women had a reduced ability to use the potentiating effect of stretch-shortening cycle to vertical jumping performance during CMJ.

Improvement in Parkinson's disease patients achieved by coordination dynamics therapy.

Eight patients in whom Parkinson's disease had set on 5 to 10 years earlier underwent low intensity coordination dynamics therapy with on average 4 hours per week for 2.5 months. The ongoing pharmaco-therapy and the conventional fitness training for 1 to 2 hours per week were not changed. With the coordination dynamics therapy the functioning of the central nervous system (CNS) of the Parkinson's disease patients improved by 35%, as quantified by coordination dynamics measurements. Following 3 months of no coordination dynamics therapy, but further ongoing pharmaco-therapy and fitness training the CNS functioning worsened again by 21%. It is concluded that pharmaco-therapy and conventional fitness training alone cannot prevent the worsening of the CNS functioning in progressing Parkinson's disease, but additional coordination dynamics therapy can.

Coordination dynamics in Parkinson's disease patients and healthy subjects quantified by the coordination dynamics recording method and sEMG.

Coordination dynamics were measured in Parkinson's disease patients to quantify central nervous system (CNS) dysfunction. The low-load coordination dynamics in the patients were impaired by 56% for forward and 44% for backward moving in comparison to a control group of similar age. Exercising at higher load was only partly possible. When the disease preferentially affected one side of the body, the coordination dynamics were worse for the affected side. A dexterity test showed that coordination of hand and arm movements could be improved in the short-term memory when exercising on the special coordination dynamics recording and therapy device. Simultaneously taken surface EMG (sEMG) showed that the motor pattern was impaired in the Parkinson's disease patients. sEMG recordings showed further that the fast fatigable muscle fibre activation was impaired. FF-type muscle fibres were already activated for low load in one and not at all in another muscle. In conclusion, coordination between motoneuron firings and between arm and leg movements were found to be impaired in Parkinson's disease patients.

Back extensor muscle fatigability in chronic low back pain patients and controls: Relationship between electromyogram power spectrum changes and body mass index.

Back extensor muscle fatigability and its relationship to body mass index (BMI) was measured in 12 chronic nonspecific low back pain (CNLBP) patients (7 women and 5 men) and 12 healthy age-and gender-matched controls. Subjects performed Sørensen back isometric endurance test until exhaustion while EMG spectral mean power frequency (MPF) over the lumbar erector spinae muscle and endurance time were recorded. The CNLBP patients had significantly shorter endurance time than healthy controls. Spectral MPF significantly declined as time of isometric contraction progressed. Relative decrease of the MPF per minute (MPF slope) for left and right side, and pooled MPF slope was significantly higher in CNLBP patients compared with controls. In CNLBP patients the isometric endurance time correlated significantly negatively with BMI (r=-0.71). In controls BMI correlated significantly positively with MPF slopes of left (r=0.68) and right (r=0.57) side, and pooled MPF slope (r=0.62).

Diagnostic criteria for sarcopenia and physical performance.

Relative and absolute muscle mass and muscle strength are used as diagnostic criteria for sarcopenia. We aimed to assess which diagnostic criteria are most associated with physical performance in 180 young (18-30 years) and 281 healthy old participants (69-81 years) of the European study MYOAGE. Diagnostic criteria included relative muscle mass (total or appendicular lean mass (ALM) as percentage of body mass), absolute muscle mass (ALM/height squared and total lean mass), knee extension torque, and handgrip strength. Physical performance comprised walking speed, Timed Up and Go test (TUG), and in a subgroup physical fitness. Diagnostic criteria for sarcopenia and physical performance were standardized, and the associations were analyzed using linear regression models stratified by age category, with adjustments for age, gender, and country. In old participants, relative muscle mass was associated with faster walking speed, faster TUG, and higher physical fitness (all p < 0.001). Absolute muscle mass was not associated with physical performance. Knee extension torque and handgrip strength were associated with faster walking speed (both p ≤ 0.003). Knee extension torque was associated with TUG (p = 0.001). Knee extension torque and handgrip strength were not associated with physical fitness. In young participants, there were no significant associations between diagnostic criteria for sarcopenia and physical performance, except for a positive association between relative muscle mass and physical fitness (p < 0.001). Relative muscle mass, defined as lean mass or ALM percentage, was most associated with physical performance. Absolute muscle mass including ALM/height squared was not associated with physical performance. This should be accounted for when defining sarcopenia.

Associations between muscle strength, spirometric pulmonary function and mobility in healthy older adults.

Pathological obstruction in lungs leads to severe decreases in muscle strength and mobility in patients suffering from chronic obstructive pulmonary disease. The purpose of this study was to investigate the interdependency between muscle strength, spirometric pulmonary functions and mobility outcomes in healthy older men and women, where skeletal muscle and pulmonary function decline without interference of overt disease. A total of 135 69- to 81-year-old participants were recruited into the cross-sectional study, which was performed as a part of European study MyoAge. Full, partial and no mediation models were constructed to assess the interdependency between muscle strength (handgrip strength, knee extension torque, lower extremity muscle power), spirometric pulmonary function (FVC, FEV1 and FEF50) and mobility (6-min walk and Timed Up and Go tests). The models were adjusted for age, sex, total fat mass, body height and site of enrolment. Partial mediation models, indicating both direct and pulmonary function mediated associations between muscle strength and mobility, fitted best to the data. Greater handgrip strength was significantly associated with higher FVC, FEV1 and FEF50 (p < 0.05). Greater muscle power was significantly associated with better performance in mobility tests. Results suggest that decline in mobility with aging may be caused by decreases in both muscle strength and power but also mediated through decreases in spirometric pulmonary function. Future longitudinal studies are warranted to better understand how loss of function and mass of the respiratory muscles will affect pulmonary function among older people and how these changes are linked to mobility decline.

Shoulder muscle function in frozen shoulder syndrome patients following manipulation under anesthesia: a 6-month follow-up study.

INTRODUCTION: The present study evaluates changes in shoulder muscle function in patients with frozen shoulder syndrome (FSS) following manipulation under general anesthesia (MUA). PATIENTS AND METHODS: Fifteen FSS patients with mean (±SD) age of 53.6±9.7 years were included in this study. Isometric endurance of the shoulder muscles was characterized by time and net impulse (NI), which were assessed with the patient holding a weight in the hand until exhaustion. Fatigability of the deltoid and trapezius muscles during isometric endurance test was assessed by electromyogram power spectrum median frequency (MF) slope per minute. Patients were also screened for daytime pain. Data were collected before MUA, and at 1 and 6 months postoperatively. RESULTS: Six months postoperatively, the MF slope for the trapezius and deltoid muscles of the involved and uninvolved shoulders did not differ (P>0.05), whereas NI remained lower and endurance time was longer (P<0.05). Shoulder pain was reduced as compared to preoperative levels (on visual analog scale) 1 and 6 months postoperatively (P<0.05). DISCUSSION: In patients with FSS, the fastest improvements in shoulder muscle NI, fatigability and pain take place in the first month after MUA; 6 months after MUA, however, NI and endurance time remained impaired for the involved shoulder. Physiotherapy should pay more attention to muscle function recovery. LEVEL OF EVIDENCE: Level III, prospective follow-up study.

Twitch contraction properties of plantar flexor muscles in pre- and post-pubertal boys and men.

This study compared electrically evoked twitch contraction characteristics of the plantar flexor muscles in pre-pubertal (11-year-old) and post-pubertal (16-year old) boys, and young (19- to 23-year-old) men. The posterior tibial nerve was stimulated by supramaximal square-wave pulses of 1 ms duration at rest and after brief (5 s) isometric maximal voluntary contraction (MVC) of the plantar flexor muscles, i.e. during postactivation potentiation. Men had higher MVC force than boys and post-pubertal boys higher than prepubertal boys. Pre-pubertal boys had lower peak twitch forces (P(t)) at rest and when potentiated compared with post-pubertal boys and men, whereas no significant differences were found between post-pubertal boys and men. Pre-pubertal boys had higher ratios of P(t) at rest and potentiated P(t) to MVC force than post-pubertal boys and men. No age-related differences were obtained in post-activation potentiation, rest and potentiated twitch contraction and half-relaxation time, and MVC force relative to body mass. The main findings of the study were that puberty is characterized by increased muscle force-generating capacity with no change in twitch potentiation and time-course characteristics, and that twitch force-generating capacity develops in an adult-like pattern after puberty.

Neuromuscular fatigue during repeated exhaustive submaximal static contractions of knee extensor muscles in endurance-trained, power-trained and untrained men.

The neural and muscular changes during fatigue produced in repeated submaximal static contractions of knee extensors were measured. Three groups of differently adapted male subjects (power-trained, endurance-trained and untrained, 15 in each) performed the exercise that consisted of 10 trials of submaximal static contractions at the level of 40% of maximal voluntary contraction (MVC) force till exhaustion with the inter-trial rest intervals of 1 min. MVC force, reaction time and patellar reflex time components before and after the fatiguing exercise and following 5, 10 and 15 min of recovery were recorded. Endurance-trained athletes had a significantly longer holding times for all the 10 trials compared with power-trained athletes and untrained subjects. However, no significant differences in static endurance between power-trained athletes and untrained subjects were noted. The fatigue test significantly prolonged the time between onset of electrical and mechanical activity (electromechanical delay) in voluntary and reflex contractions. The electromechanical delay in voluntary contraction condition for power-trained and untrained subjects and in reflex condition for endurance-trained subjects had not recovered 15 min after cessation of exercise. No significant changes in the central component of visual reaction time (premotor time of MVC) and latency of patellar reflex were noted after fatiguing static exercise. It is concluded, that in this type of exercise the fatigue development may be largely owing to muscle contractile failure.

Twitch contractile properties of plantar flexor muscles in power and endurance trained athletes.

This study compared twitch contractile properties of plantar flexor muscles among three groups of 12 subjects each: endurance and power trained athletes and untrained subjects. The posterior tibial nerve was stimulated by supramaximal square wave pulses of 1-ms duration. Power trained athletes had higher twitch maximal force, maximal rates of force development and relaxation and also maximal voluntary contraction (MVC) force. The trained subjects had a smaller twitch maximal force: MVC force ratio and shorter twitch contraction and half-relaxation times than the untrained subjects with no significant differences between the two groups. Thus, the short time for evoked twitches in the athletes compared to the untrained subjects would seem unrelated to the type of training. It is concluded that power training induces a more evident increase of muscle force-generating capacity and speed of contraction and relaxation than endurance training.

Age-related differences in twitch contractile properties of plantarflexor muscles in women.

This study compared maximal voluntary isometric strength and electrically evoked twitch characteristics of the plantarflexor muscles among the groups of women of the 3rd (n=14), 4th (n=13), 5th (n=11), 6th (n=12) and 8th (n=13) decade. A significant decrease (P < 0.05-0.001) has been found in isometric maximal voluntary contraction (MVC) force from the 5th decade and in twitch maximal force from the 6th decade. The 3rd decade group produced 72% greater MVC force and 43% greater twitch maximal force than the 8th decade group (P < 0.001). A prolongation (P < 0.01) in twitch contraction time was observed from the 5th decade. Twitch contraction time in the 3rd decade group was 16% shorter (P < 0.001) compared with the 8th decade group (P < 0.01). Twitch half-relaxation time did not differ significantly (P > 0.05) among the groups. A decrease (P < 0. 05-0.001) has been found in twitch maximal rate of force development from the 5th decade and in twitch maximal rate of relaxation from the 6th decade. The 3rd decade group produced 63% greater (P < 0. 001) twitch maximal rate of force development than the 8th decade group. It was concluded that in women a marked age-related reduction in maximal voluntary force-generating capacity of the plantarflexor muscles and speed of contraction of the electrically evoked twitch takes place after 40 years of age, while reduction in maximal force-generating capacity and speed of relaxation of the twitch occurs after 50 years of age.

Isokinetic torque deficit of the knee extensor muscles after arthroscopic partial meniscectomy.

Isokinetic torque deficit of the knee extensor muscles in the operated leg was measured in 21 male patients (mean age 26.4 +/- 1.9 years) who had undergone arthroscopic partial medial meniscectomy. The isokinetic torque testing was performed 1, 3, and 6 months postoperatively using the Cybex II dynamometer according to standard technique. Isokinetic knee extension peak torque (PT) at angular velocities of 60 degrees and 180 degrees/s was determined in both legs, and the proportional PT deficit in the operated leg was compared with that in the nonoperated leg. A significant (P<0.001) isokinetic PT deficit in the operated leg in testing with angular velocity of 60 degrees and 80 degrees/s was observed at 1 month (28.6% and 31.0%, respectively) and 3 months (19.8% and 15.8%, respectively) postoperatively. At 6 months postoperatively a significant (P<0.001) isokinetic PT deficit (18.2%) of the knee extensor muscles in the operated leg was observed only in testing with angular velocity of 60 degrees/s; no significant differences (P>0.05) in isokinetic PT between the operated and nonoperated leg in testing with angular velocity of 180 degrees/s was found 6 months postoperatively. Thus in patients with arthroscopic partial meniscectomy the postoperative recovery of isokinetic strength of the knee extensor muscles in the injured leg is closely related to testing velocity, while it is more delayed at low than intermediate angular velocities.