Gael Guilhem, Christophe Cornu, Arnaud Guével
Context: Resistance exercise training commonly is performed against a constant external ioad (isotonic) or at a constant velocity (isokinetic). Researchers comparing the effectiveness of isotonic and isokinetic resistance-training protocols need to equalize the mechanical stimulus (work and velocity) applied.
Objective: To examine whiether the standardization protocol could be adjusted and applied to an eccentric training program.
Design: Controlled laboratory study.
Setting: Controlled research laboratory. Patients or Other Participants: Twenty-one sport science male students (age = 20.6±1.5 years, height = 178.0 ±4.0 cm, mass = 74.5 ±9.1 kg).
Intervention(s): Participants performed 9 weeks of isotonic (n = 11 ) or isokinetic (n = 10) eccentric training of knee extensors that was designed so they would perform the same amount of angular work at the same mean angular velocity.
Main Outcome Measure(s): Angular work and angular velocity.
Results: The isotonic and isokinetic groups performed the same total amount of work (-185.2 ±6.5 kJ and -184.4 ±8.6 kJ, respectively) at the same angular velocity (21 ± 17s and 22°/s, respectively) with the same number of repetitions (8.0 and 8.0, respectively). Bland-Altman analysis showed that work (bias = 2.4%) and angular velocity (bias = 0.2%) were equalized over 9 weeks between the modes of training.
Conclusions: The procedure developed allows angular work and velocity to be standardized over 9 weeks of isotonic and isokinetic eccentric training of the knee extensors. This method could be useful in future studies in which researchers compare neuromuscular adaptations induced by each type of training mode with respect to rehabilitating patients after musculoskeletal injury.
Key Words: resistance exercise, muscle strength, knee extensors.
Burks, R., Daniel, D., & Losse, G. (1984).
This study was undertaken to examine the immediate effect of continuous passive motion (CPM) on anterior cruciate ligament (ACL) reconstruction stability. Ca daver knees were tested with a knee arthrometer with the anterior cruciate intact and then with the anterior cruciate sectioned. One of three anterior cruciate re constructions was then performed and stability was restored to the knee and it was again tested with the knee arthrometer. Stability was defined as being within 2 mm of the intact measurement. The three operations selected were the Marshall-Maclntosh "over-the-top," (OTT) a patellar bone-patellar tendon-tubercle bone (BTB) graft, and a semitendinosis reconstruction. The specimens were placed on a CPM device in a cooler at 38 degree F and put through a range of motion of 20 to 70 degree at 10 cycles per minute for 3 days. A success was less than a 2 mm increase in the post-CPM measurement compared to pre-CPM. All three bone-tendon-bone op erations failed. The semitendinosis operation was suc cessful in only three out of eight specimens. The OTT operation was successful in eight out of nine speci mens. The possible reasons for success and failure are discussed.Because of the potential problems with failure of an ACL with CPM it is suggested that the particular tech nique being used for an anterior cruciate reconstruction be tested prior to it being used with CPM clinically.
Βρείτε το άρθρο:
The effect of continuous passive motion on anterior cruciate ligament reconstruction stability. American Journal of Sports Medicine, 12(4), 323-327. doi: http://dx.doi.org/10.1177/036354658401200414
Kirschner, P. P.
There is still a controversial discussion in literature about the use of motor driven splints in knee surgery--as the principle of continuous passive motion, CPM. For this reason it seemed useful for an evaluation to look through the papers which were published since 1990. It was obvious, that negative results were published often before this year, but this papers are still quoted standard works. In medical data bases subito-doc.de, medscape.com, medica.de and zbmed.de 230 papers were found by search CPM, continuous passive motion and arthromot. Coincidentally there was a search for authors who were already quoted in other papers. 36 papers concerning CPM after knee surgery were utilized. The role of CPM regarding the range of motion, swelling, duration of hospital stay, use of analgesics, costs, postoperative manipulations, wound healing and thrombo embolic complications was evaluated. Although the results of this partial retrospective, partial prospective, sometimes randomized or double blinded studies are in contradiction, there can only be found a trend to better results. New clinical studies for evidence based guidelines in the handling of continuous passive motion after knee surgery are necessary.
Βρείτε το πλήρες άρθρο:
Kirschner, P. P. (2004). [CPM--continuous passive motion: Treatment of injured or operated knee-joints using passive movement. A meta-analysis of current literature]. Der Unfallchirurg, 107(4), 328-340.
Retrieved from http://search.proquest.com/docview/71867567?accountid=36196;
Lenssen Ton AF, van Steyn, Mike JA, Crijns, Yvonne HF, Waltje Eddie MH, Roox, George M et al.
BMC Musculoskeletal Disorders9 (2008): 60-60.
Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty. Although research suggests that Continuous Passive Motion (CPM) should be implemented in the first rehabilitation phase after surgery, there is substantial debate about the duration of each session and the total period of CPM application. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we investigated the effectiveness of prolonged CPM use in the home situation as an adjunct to standardised PT. Efficacy was assessed in terms of faster improvements in range of motion (RoM) and functional recovery, measured at the end of the active treatment period, 17 days after surgery. Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were randomised over two treatment groups. The experimental group received CPM + PT for 17 consecutive days after surgery, whereas the usual care group received the same treatment during the in-hospital phase (i.e. about four days), followed by PT alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after surgery, both groups received standardised PT. The primary focus of rehabilitation was functional recovery (e.g. ambulation) and regaining RoM in the knee. Results Prolonged use of CPM slightly improved short-term RoM in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-standard PT programme. Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessments. Conclusion Although results indicate that prolonged CPM use might have a small short-term effect on RoM, routine use of prolonged CPM in patients with limited RoM at hospital discharge should be reconsidered, since neither long-term effects nor transfer to better functional performance was detected.
Βρείτε το πλήρες άρθρο:
"Lenssen, T. A. F., van Steyn, M.,J.A., Crijns, Y. H. F., Waltje, E. M. H., Roox, G. M., Geesink, R. J. T., . . . De Bie, R.,A. (2008). Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty. BMC Musculoskeletal Disorders, 9, 60-60. doi: http://dx.doi.org/10.1186/1471-2474-9-60 "
Kenneth McLeod, Sara Morley, Andrew Matsushima
J. Biomedical Science and Engineering, 2012, 5, 194-201 JBiSE
doi:10.4236/jbise.2012.54025 Published Online April 2012 (http://www.SciRP.org/journal/jbise/)
Muscle imbalances are a well accepted cause of mus-culo-skeletal pain, yet clinicians lack a simple, non- invasive, and reproducible means to assess muscle effort during activities of daily living. To address this issue, we have been developing vibromyography (VMG) as a means to quantitatively assess muscle mechanical effort such that accurate muscle effort ratios can be determined in the clinic. In this study, VMG was used to characterize muscle imbalances in older adults with low-level knee pain while they per-formed step-up and step-down activities. In addition to determining whether VMG can identify the im-balances previously reported in individuals with knee pain, we address the question of whether these knee muscle imbalances were a likely cause of knee pain, or whether the imbalances represented a coping re-sponse for pre-existing knee pain. A population (N = 30) of 35 - 85 year old men and women with a total of 42 painful knees were assessed. Robust multiple step- wise regression analysis identified weak hip abductor muscle effort relative to hamstring muscle effort as the best predictor of knee pain (p = 0.00006), with weak vastus lateralis effort in eccentric contraction, relative to concentric contraction, being the second best predictor (p = 0.0003). Muscle imbalances were able to account for 40% of the variation in reported pain, and the observed pattern of increasing knee pain with increasing quadriceps strength during con-centric contraction leads us to infer that the observed muscle imbalances are not the result of a protective action by the individual, but rather are a principle cause of the knee pain.
Keywords: Vibromyography; Knee Pain; Muscle Balance; Osteoarthritis
Περισσότερα (αρχείο .pdf)
2008 Ιούνιος 12-14 Πάτρα
1ο Συνέδριο Αρθροσκόπησης
Γ. Μώρος (1), Δ. Ντουραντώνης (2)
(1) Φυσικοθεραπευτής, Νοσηλευτής, Εργαστηριακός Συνεργάτης Τμ. Φυσικοθεραπείας Α.Τ.Ε.Ι Πάτρας
(2) Ιατρός, Φυσικοθεραπευτής, Εργαστηριακός Συνεργάτης Τμ. Φυσικοθεραπείας Α.Τ.Ε.Ι Πάτρας
Σκοπός: Σκοπός της παρούσας μελέτης είναι η προσπάθεια αξιολόγησης των μυϊκών ελλειμμάτων και των εκτεινόντων και των καμπτήρων του γόνατος σε ασθενείς που υποβλήθηκαν σε αρθροσκοπική συνδεσμοπλαστική ΠΧΣ.
1998 ΣΕΠΤΕΜΒΡΙΟΣ 04-06
6ο Συμπόσιο Φυσιατρικής & Φυσικοθεραπείας,"Χρόνιες Παθήσεις Ι" Αργοστόλι ΚΕΦΑΛΟΝΙΑΣ
ΓΕΩΡΓΙΟΣ Ι. ΜΩΡΟΣ
Η σπουδαιότητα του CYBEX NORM 770, στην λειτουργική αποκατάσταση της δύσκαμπτης άρθρωσης του γόνατος
Υλικό – Μέθοδος
22 ασθενείς με μετεγχειρητική δυσκαμψία γόνατος εκ των οποίων 15 άνδρες και 7 γυναίκες ηλικίας: από 12 ετών έως 60 ετών. Μέσος όρος ηλικίας: 31 έτη. Το εύρος της κίνησής τους κυμαινόταν από 0 – 0 – 10 έως 0 – 0 – 65 μοίρες και όλοι είχαν χειρουργηθεί. Όλοι δε προσήλθαν και υποβλήθηκαν στη διαδικασία κινητοποίησης με το Cybex Norm cpm 770, μετεγχειρητικά 2 12 μήνες αργότερα και μάλιστα όταν το πρόγραμμα κινητοποίησης το οποίο είχαν ακολουθήσει μέχρι τότε είχε αποτύχει.
ΣΥΝΔΕΣΜΙΚΕΣ ΚΑΚΩΣΕΙΣ ΠΟΔΟΚΝΗΜΙΚΗΣ (Π.Δ.Κ.)
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