躯干等速向心屈伸运动时屈伸肌肌力的变化:脊柱最易受损伤的角度范围

背景:目前对躯干肌肌力的研究主要集中于腰痛患者肌力变化方面,而对脊柱容易损伤的角度范围的研究不多.目的:探讨躯干等速向心屈伸动作时屈伸肌肌力变化的特征及脊柱最容易损伤的角度范围.方法:苏州大学2005/2007级研究生,健康男性14名,自愿参加测试.选用瑞士产CON-TREX人体肌力评估和训练系统,测量受试者等速向心运动时的屈伸肌肌力及脊柱角度.测试速度分别为30,60,90,120,180(°)/s,每种速度下,受试者尽自己最大力量屈伸躯干4次,组间休息5 min.主要观察:①受试者躯干运动的关节活动范围.②等速向心运动屈伸峰值力矩、屈伸肌峰值力矩比及到达峰值力矩的平均角度的变化.③等速向心运动屈伸肌总功、平均功率.结果与结论:①等速向心运动时,伸肌的峰值力矩值随角速度的增加而减少(P＜0.05),屈肌峰值力矩值未见规律性的变化;屈、伸肌的峰值力矩比随角速度的加快而增大,但差异无显著性意义(P＞0.05).②慢速等速向心运动时,不同角速度下屈、伸肌到达峰值力矩角度分布离散,30(°)/s时为-48.56°,90(°)/s时为-46.18°;快速运动时,屈、伸肌出现最大峰值力矩角度基本接近,120(°)/s时分别为-48.71°,-51.61°, 180(°)/s分别一54.86,-53.11°.⑨等速向心运动时,在不同角速度下,屈、伸肌的总功均随角速度的增加而减少,伸肌总功大于屈肌,伸肌总功的变化差异有显著性意义(P＜0.05);屈、伸肌的平均功率随角速度的增加呈线性上升,屈肌平均功率始终小于伸肌(P＜0.01).结果提示:①等速向心运动时,躯干屈伸肌群的肌力随角速度的增加而减小,躯干在慢速屈伸运动时稳定性较好.②快速等速向心运动时,突受外力打击后容易引起肌肉损伤和脊柱不稳.③等速运动时屈伸肌做功随运动速度下降而降低,但肌肉的爆发力随运动速度的增快而加大.     

健康年轻人腕关节等速肌力测试的测试者内信度和间信度

背景:越来越多研究运用等速肌力测试评估腕关节肌力,但未见有腕关节等速肌力测试的测试者内和测试者间信度报道。目的:观察健康受试者等速肌力测试腕关节屈伸肌力的峰力矩和总功的重测信度。方法:28例健康受试者随机等分为2组。第1次测试2组分别由测试者A、B在60(°)/s和180(°)/s角速度下测试。第2次测试,2组均由测试者B完成测试。结果与结论:在60(°)/s和180(°)/s下,腕关节屈肌和伸肌的峰力矩和总功的测试者内重测信度为0.65-0.95,测试者间重测信度为0.70-0.95。在低速和高速下健康受试者腕关节等速肌力测试的峰力矩和总功的重测信度为好到极好。     

女子曲棍球运动员膝关节屈伸肌群等速测试与分析

背景：等速测试系统已广泛应用来评价不同项目运动员关节肌群的力量特征。目的：测试广东省女子曲棍球运动员的膝关节进行等速向心,观察曲棍球项目运动员膝关节屈伸肌群的等速向心测试力量特征。方法：运用CON-TREX等速测试系统对广东省14名现役女子曲棍球运动员的膝关节进行等速向心测试。检测指标为相对峰力矩、关节肌群屈伸肌峰力矩比值、平均功率、总功和疲劳指数。结果与结论：在60（°/s）慢速测试时,女子曲棍球队员的两侧膝关节肌群相对峰力矩值表现为伸肌大于屈肌（P〈0.01）;左膝关节屈伸肌峰力矩比值在3种不同测试速度下的范围为66%~77%,右膝关节屈伸肌峰力矩比值为82%~88%;左膝关节伸肌平均功率值均大于屈肌（P〈0.01）;左右膝关节伸肌的总功值均大于屈肌（P〈0.01）;膝关节屈伸肌疲劳指数范围在0.24~0.48之间。膝关节伸肌的最大力量大于屈肌,屈伸肌峰力矩比值在240（°/s）快速测试时略微偏低,而右膝关节屈伸肌峰力矩比值在慢速测试时偏高,说明女子曲棍球队员左膝关节屈肌快速力量偏低,右膝关节伸肌最大力量比较低,伸肌的快速力量大于屈肌,伸肌的工作能力强于屈肌,屈伸肌的力量耐力水平比较低。     

女子曲棍球运动员膝关节屈伸肌群等速测试与分析

背景:等速测试系统已广泛应用来评价不同项目运动员关节肌群的力量特征。目的:测试广东省女子曲棍球运动员的膝关节进行等速向心,观察曲棍球项目运动员膝关节屈伸肌群的等速向心测试力量特征。方法:运用CON-TREX等速测试系统对广东省14名现役女子曲棍球运动员的膝关节进行等速向心测试。检测指标为相对峰力矩、关节肌群屈伸肌峰力矩比值、平均功率、总功和疲劳指数。结果与结论:在60(°/s)慢速测试时,女子曲棍球队员的两侧膝关节肌群相对峰力矩值表现为伸肌大于屈肌(P<0.01);左膝关节屈伸肌峰力矩比值在3种不同测试速度下的范围为66%~77%,右膝关节屈伸肌峰力矩比值为82%~88%;左膝关节伸肌平均功率值均大于屈肌(P<0.01);左右膝关节伸肌的总功值均大于屈肌(P<0.01);膝关节屈伸肌疲劳指数范围在0.24~0.48之间。膝关节伸肌的最大力量大于屈肌,屈伸肌峰力矩比值在240(°/s)快速测试时略微偏低,而右膝关节屈伸肌峰力矩比值在慢速测试时偏高,说明女子曲棍球队员左膝关节屈肌快速力量偏低,右膝关节伸肌最大力量比较低,伸肌的快速力量大于屈肌,伸肌的工作能力强于屈肌,屈伸肌的力量耐力水平比较低。     

不同运动水平大学生躯干屈伸肌群等速肌力和耐力测定

目的:等速测定不同运动水平的健康年轻人躯干屈伸肌群肌力和耐力,了解年轻人躯干肌群的肌肉功能特点.方法:①受试者为2005级首都体育学院一年级大学生120名,其中男60名,女60名.②按不同标准分为3组,普通非体育专业的大学生、普通体育教育专业的大学生、获得二级运动员的运动系大学生,每组40名,男女各20名.受试者均自愿参加测试.测试仪器: 使用Cybex6000型等动测力系统(美国).③测试方法:对健康大学生躯干屈伸肌群的肌力[测试速度为60(°)/s和120(°)/s]和耐力[测试速度为120(°)/s]等速测试.④测试指标为峰值力矩、躯干屈/伸肌群峰力矩比值、耐力比、恢复比.结果:①躯干屈伸肌的峰值力矩值变化趋势:在同一测试速度下,普通组、体教组及二级组男性躯干屈伸肌的峰值力矩值均伸肌大于屈肌;随着测试速度的增加,躯干屈伸肌的峰值力矩值有下降趋势,伸肌下降最明显;普通组的躯干屈伸肌的峰值力矩值小于体教组和二级组(P＜0.05),后二者差异无显著性(P＞0.05);女性3组屈伸肌的峰值力矩值变化同上.在 60(°)/ s和120(°)/s时的躯干屈/伸肌群峰力矩比值,男性均小于1,女性均大于1.②在同一测试速度下,3组男性及女性躯干伸肌群的耐力比和恢复比均低于屈肌群.结论:与体育教育专业和二级运动员大学生相比,非体育专业大学生存在着明显的腰背肌力下降,以及躯干屈伸肌力失衡.不同运动水平大学生伸肌群肌力和耐力弱于屈肌群.     

髌骨软化症患者膝关节等速肌力测试

目的 分析髌骨软化症患者膝关节周围肌力特征,并比较其与健康人的差异。方法 2021年3月,采用等速肌力测试与训练系统,对70例单膝发病髌骨软化症患者(观察组)和35例健康人(对照组)进行膝关节不同角速度(60°/s和180°/s)的屈、伸等速肌力测试。结果 60°/s和180°/s时,观察组患侧屈、伸肌峰力矩、峰力矩体质量比、总功均显著低于对照组(U> 1097.0,P <0.001);观察组患侧60°/s屈、伸肌和180°/s时伸肌峰力矩、峰力矩体质量比、总功均低于观察组健侧(|Z|> 2.121, P <0.05)。60°/s和180°/s时,观察组患侧屈伸肌力比值均明显大于健侧和对照组(U> 1810.0,|Z|>3.691, P <0.01)。结论 髌骨软化症患者的患膝屈、伸肌肌爆发力和耐力均减弱,膝关节肌力存在失衡现象。     

髋关节向心性屈伸运动等速测试的重测信度

目的研究髋关节进行向心性屈伸运动等速测试的重测信度。方法 2014年9月至2015年6月,30例青年健康受试者利用同一程序和同一检测方法,间隔1周进行两次髋关节等速测试,计算两次峰力矩、峰力矩体重比、总功、相对总功和平均功率的组内相关系数(ICC)。结果髋关节以60°/s行向心性等速运动时,两侧屈肌和伸肌各项参数的ICC≥0.70 (P 0.01)。髋关节以180°/s行向心性等速运动时,两侧屈肌和右侧伸肌的各项参数ICC 0.61 (P 0.05),左侧伸肌的各项参数ICC 0.55 (P 0.05)。结论等速肌力测试测量髋关节力学特征具有良好信度,可用于临床。     

等动肌力测试10岁健康儿童肩关节屈伸肌群的发育特征

背景:肩关节是人体最灵活的关节,目前对儿童肩关节肌群发育特征的研究非常少见。目的:通过等动肌力测试分析10岁儿童肩关节屈伸肌群力量的发育特征。方法:运用Kinitech等动测力系统对59名10岁儿童双侧肩关节屈伸肌进行60,120(°)/s两种速度测试。结果与结论:①同一测试速度下同侧同名肌群男女比较,左右肩关节屈伸峰力矩、最大功率值差异均无显著性意义(P>0.05)。②左肩关节:男性屈肌在120(°)/s速度下的相对体质量峰力矩值高于女性(P<0.05),伸肌在60,120(°)/s速度下数值高于女性(P<0.01或P<0.05);男性屈肌在60(°)/s速度下的相对体质量最大功率值高于女性(P<0.05),伸肌在60,120(°)/s测试速度下的相对体质量最大功率值高于女性(P<0.05或P<0.01)。③右肩关节:男性伸肌在60,120(°)/s速度下的相对体质量峰力矩值高于女性(P<0.05);男女屈肌在60,120(°)/s速度下的相对体质量最大功率值差异均无显著性意义(P>0.05),男性伸肌在60,120(°)/s速度下的相对体质量最大功率值高于女性(P<0.01或P<0.05)。说明10岁儿童男女相比,肩关节屈伸肌群发育无明显差异;自身相比,男女儿童肩关节伸的肌群力量要好于屈肌群,屈伸比在合理范围之内。     

健康儿童膝关节屈伸工作时的生物力学规律

背景:在等速肌力测试的人群中,关于儿童的等速肌力测试研究报道较少。目的:通过对儿童膝关节屈伸肌力情况的测试,探讨儿童膝关节屈伸工作时的生物力学规律。设计、时间及地点:对比观察,于2006-10-12在河北师范大学体育学院实验室进行测试。对象:志愿受试的健康儿童选自石家庄市部分小学10岁左右的学生66名,男31名,女35名。方法:运用澳大利亚Kylingk公司生产的"Kinitech"等速肌力测试系统进行等速肌力测试,采用60,120,240(°)/s3种速度测试儿童膝关节屈伸肌力。主要观察指标:男女儿童屈伸肌峰力矩值比较和最大功率比较。结果:①3种不同测试速度中,男女儿童膝关节屈伸肌峰力矩值呈现随测试速度的增加而下降,最大功率随测试速度的增加而增加的趋势。儿童左侧峰力矩值大于右侧。③男女儿童各自屈伸肌峰力矩值均值比值F/E>0.7,并且随测试速度的增加而增大。④在60,120(°)/s的测试中,膝关节屈肌和伸肌峰力矩值性别差异无显著性意义(P>0.05),240(°)/s测试中左右侧屈肌峰力矩值性别差异具有显著性意义(P<0.01,P<0.05),男生左侧伸肌峰力矩值大于女生(P<0.05)。结论:儿童在不同的测试速度中,峰力矩及最大功率表现出的变化趋势与成人一致。提示儿童早期参加体育活动时应注意发展屈肌力量,使屈伸肌力量平衡发展。     

小学生膝关节屈伸肌力的等速测试

背景:以往对小学生下肢力量发育的评估,主要局限于立定跳远和纵跳摸高等身体素质的测量,缺乏对其肌肉功能的定量性研究.目的:通过小学生膝关节屈伸肌力发展现状进行测试分析,正确认识小学生关节肌肉力量发育特征.方法:运用"Kinitech "等速肌力测试系统对随机抽取石家庄市年龄为9～12 岁的54 名健康小学生(男25 例、女29 例)膝关节屈伸肌群进行60,120,240 (°)/s 三种速度测试.结果与结论:小学生膝关节屈、伸肌群峰力矩均呈现随测试速度增加而下降的现象;男、女生左侧屈肌群在60,120 (°)/s 时及右侧屈肌群在60 (°)/s 时,峰力矩低于伸肌群峰力矩(P < 0.01 或P < 0.05).同一测试速度下,在测试速度为240 (°)/s 时,男生左侧屈、伸肌群及右侧屈肌群峰力矩明显高于女生(P < 0.01 或P < 0.05).     

Effects of posture and lower limb muscle strength on the results of the Star Excursion Balance Test

[Purpose] This study aimed to clarify the relationship between the distance measurements in the Star Excursion Balance Test and participants’ posture and lower limb muscle strength. [Participants and Methods] Nine healthy male college students participated in this study. Star Excursion Balance Test distance was measured in both lower limbs by performing anterior, posterolateral, and posteromedial trials; measuring the maximum reach; and performing three-dimensional motion analysis to determine the posture at maximum reach. Isokinetic muscle strength for knee flexion/extension, hip flexion/extension, and hip adduction/abduction were measured using an isokinetic machine. [Results] The hip extension strength, reach side ankle dorsiflexion angles, stance side knee flexion, reach side knee flexion, and knee flexion strength were selected as significant explanatory variables in the anterior direction. For the posteromedial direction, hip adduction and hip extension strength, reach side hip flexion angle, and stance side hip flexion angle were selected. For the posterolateral direction, reach side knee flexion angle and stance side ankle dorsiflexion, knee flexion strength and reach side hip flexion angle were selected. [Conclusion] The related factors differed between the dominant and non-dominant legs even in the same reach direction.     

Test-retest reliability of isokinetic muscle strength of the lower extremities in patients with stroke

OBJECTIVE: To i the test-retest reliability of isokinetic strength measurements of 3 muscle groups of the lower extremities in stroke patients. DESIGN: Isokineth tests of bilateral hip flexors, knee extensors, and ankle plantarflexors at 2 angular velocities, performed during 2 sessions scheduled 1 week apart for each subject. SETTING: Outpatilitation clinic of a local hospital in Taiwan. PARTICIPANTS: Nts with mild spastic hemiparesis secondary to stroke and with poststroke onset time of at least 6 months. All subjects could communicate and voluntarily move the affected lower extremity. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The maximal peak torque, total work, and average power of the 3 muscle groups on the affected side examined during each test were quantified by using the normalization and the deficit methods. The normalization method divides the measured strength value by the patient's body weight, whereas the deficit method divides the difference between the strengths of the unaffected and affected extremities by the strength of the unaffected extremity. RESULTS: The normalized strength measures for muscles on the affected side showed good to excellent test-retest reliability (intraclass correlation coefficient [ICC] range,.62-.94; P<.05), whereas the deficit strength measures did not always show good reliability (ICC range,.13-.91). The knee extensors and ankle plantarflexors, but not the hip flexors, on the affected side showed better test-retest reliability of isokinetic strength generated at faster velocity (ICC range,.73-.94) than that generated at slower velocity (ICC range,.62-.88). The normalized peak torque (ICC range,.76-.94) and total work (ICC range,.83-.91) were more reliable than the normalized average power (ICC range,.62-.90) for all 3 muscle groups on the affected side. CONCLUSIONS: Quantitative assessment of muscle strength of the affected lower extremity in patients with mild spastic hemiparesis secondary to stroke is feasible using isokinetic testing. However, the test-retest reliability of isokinetic strength measures is affected by the quantifying method, testing velocity, and strength measures.     

STRENGTH AND FATIGUE MEASUREMENTS OF THE HIP FLEXOR AND HIP EXTENSOR MUSCLES: TEST-RETEST RELIABILITY AND LIMB DOMINANCE EFFECT

Background:Standardized testing of hip muscle strength and fatigue in the sagittal plane is important for assessing, treating and preventing a number of trunk and lower extremity pathologies. Furthermore, individuals displaying asymmetries of muscle strength between limbs are more likely to sustain an injury.Purpose:To evaluate the test-retest reliability of isometric strength and isokinetic fatigue measurements of the hip flexor and hip extensor muscles, and to examine whether there is a significant limb dominance effect on strength, fatigue and flexor-extensor ratios.Study design:Cross-sectional study.Methods:To evaluate reliability, 30 healthy individuals (33.2 + /- 13.1 years) were included. On a separate occasion, 24 healthy individuals (29.0 + /- 10.3 years) participated to assess between-limb differences. Reliability was established using intraclass correlation coefficients (ICCs), standard error of measurements (SEM) and minimal detectable change (MDC). Isometric strength (best peak torque of three maximal contractions; Nm/kg), isokinetic fatigue (total work of 20 consecutive maximal concentric flexor-extensor contractions at 120 °/s; Joule/kg), and flexor-extensor ratios, were recorded using a Biodex dynamometer.Results:Reliability was good-to-excellent (ICCs>0.83) and measurement errors were acceptable (SEM<13.6% and MDC%<37.8%). No significant between-limb differences in strength, fatigue and flexor-extensor ratios were detected.Conclusions:Isometric strength and isokinetic fatigue of the hip flexor and hip extensor muscles can be reliably assessed in healthy individuals using the Biodex dynamometer. Limb dominance did not significantly affect strength, fatigue or flexor-extensor ratios.Level of Evidence:2b     

等速离心肌力训练治疗膝关节骨关节炎的研究

运动Ｃｙｂｅｘ－６０００型等还肌力测试和训练系统对２０例膝关节骨关节炎患者进行 量等速离心肌力训练，观察训练对患膝肌力、疼痛及下肢功能的影响。结果表明：经过４周的训练，患膝 伸肌群各项测试指标均有不同程度提高，疼痛明显缓解，下肢功能显著改善。说明亚极量等速离心训练对膝关节骨关节炎２的近期疗效是明显的。     

等速肌力测试训练系统在学龄期痉挛型脑性瘫痪患者中的应用

目的:研究等速肌力测试训练系统在学龄期痉挛型脑性瘫痪患者康复治疗中的应用。方法:将30例学龄期痉挛型脑瘫患者随机分为2组各15例,对照组使用常规康复治疗手段,观察组在对照组基础上增加髋关节屈伸肌群的等速肌力训练。治疗前后用起立-行走计时测试(TUGT),BERG平衡量表(BBS)评定,同时采用Isomed2000等速肌力测试及训练系统测定双侧屈髋峰力矩(PTF)、伸髋峰力矩(PTE)、双侧屈伸髋峰力矩体重比(PT/BW)。结果:30°/S角速度双侧峰力矩比较:治疗3个月后,观察组左右侧下肢PTF、PTE、PTF/BW及PTE/BW均较治疗前及对照组明显提高(均P0.05),对照组左右侧下肢PTE、PTF/BW及PTE/BW均较治疗前明显提高(均P0.05),PTF治疗前后比较差异无统计学意义。60°/S角速度双侧峰力矩比较:治疗后,观察组左右侧下肢PTF、PTE、PTF/BW及PTE/BW均较治疗前及对照组明显提高(均P0.05),对照组治疗前后比较均差异无统计学意义。治疗后,2组TUGT评分均较治疗前明显下降(均P0.05),且观察组明显低于对照组(P0.05);2组BBS评分治疗前后虽然均有提高,但差异无统计学意义。结论:等速肌力测试训练系统作为康复治疗中有效的肌力训练的手段,能够在痉挛型脑瘫患者上使用,值得临床推广。     

The Effects of Isokinetic Eccentric Resistance Exercise for the Hip Joint on Functional Gait of Stroke Patients

[Purpose] The purpose of this study was to determine the effects of resistance exercise strengthening the hip flexor and extensor muscles on functional gait of stroke patients. [Subjects and Methods] Twenty patients were randomized into two groups. Both groups performed conventional physical therapy for six weeks. The experimental group also performed isokinetic eccentric resistance exercises for the hip flexor and extensor muscles. The hip muscle strength, stair up and down time, TUG time(timed up and go test), and 10 m gait velocity were measured at the baseline, and after 3 weeks, and 6 weeks of treatment. [Results] The experimental showed significant improvements compared to the baseline in hip muscle strength, stair up and down time, TUG time and 10 m gait velocity after 3 and 6 weeks of treatment. After 3 and 6 weeks of treatment, there were gains in hip muscle strength and 10 m gait velocity. The control group showed no significant increase in hip muscle strength, stair up and down time, TUG time or 10 m gait velocity. [Conclusion] We consider that conventional physical therapy contributes to the improvement of functional gait of stroke patients. However, it is more desirable to perform isokinetic eccentric resistance exercises for hip flexor and extensor muscles combined with conventional physical therapy for the improvement of hip muscle strength, stair up and down time, TUG time and 10 m gait velocity.Key words: Functional gait, Isokinetic exercise, Stroke patients     

跳跃项目训练对青少年膝关节屈伸肌肉力量的影响

背景:等速测试系统作为一种评价人体肌肉功能水平的研究方法和手段,在研究中得到了越来越广泛的应用.但运用等速肌力测试研究运动训练对青少年肌群发展影响的报道很少.目的:通过等速肌力测试,对长期进行跳高、跳远系统训练的青少年和同年龄的无训练者两类人群膝关节肌肉力量及其特征进行对比分析.设计、时间及地点:对比观察实验,于2008-10/12在河北省体育科学研究所实验室进行.对象:随机抽取河北师范大学附属中学不参加训练的志愿者20名作为普通组,抽取石家庄市体校进行跳高、跳远训练的志愿者20名作为训练组,参试者均为男性.方法:采用Cybex-6000等速测试系统,按照测试要求对参试者膝关节进行测试,测试顺序为先向心后离心.测试速度为慢速60(°)/s、中速120(°)/s、快速240(°)/s.主要观察指标:膝关节屈、伸肌群的相对峰力矩.结果:纳入实验对象40名,均进入结果分析.与普通组比较,训练组两侧膝关节60,120,240(°)/s屈、伸肌向心、离心收缩时峰力矩较高,差异有显著性意义(P＜0.01),训练组左、右两膝在3个速度上的屈肌与伸肌峰力矩比值均低于普通组.结论:跳跃项目训练对青少年膝关节屈伸肌肉力量的增长有良好的促进作用,但在青少年膝关节屈伸肌力协调发展上有所不足,造成屈伸肌比值下降,这也可能是训练方法不当所造成的.     

膝骨关节炎患者股四头肌功能水平及髋关节步态运动学特征分析

目的:观察中老年膝骨关节炎(KOA)患者股四头肌功能水平及步行过程中髋关节的运动学特征。方法:选取18例KOA患者为KOA组,8例无KOA者为对照组,2组的年龄、身高、体重和身体质量指数(BMI值)相匹配。2组受试者均进行等速肌力测试、无线表面肌电测试及步态测试,测试及比较2组股四头肌峰力矩(PT值)、股内侧肌(VM)、股外侧肌(VL)和股直肌(RF)的积分肌电值(iEMG)、均方根值(RMS)、平均功率频率(MPF)及峰值髋内收、外展角度等和步行中髋关节的运动学特征,将股四头肌肌力与髋关节运动学特征进行相关性分析。结果:KOA组股四头肌等长和等速运动时PT值较对照组显著下降(P<0.01),VL在60°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.05),RF在180°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.01),步行时峰值髋关节内收及外展角度显著低于对照组(P<0.05),股四头肌肌力与髋关节运动学特征无相关。结论:KOA组较对照组股四头肌肌力显著降低,活动时神经支配效率显著下降,且步行过程中峰值髋内收、外展角度显著减少,股四...     

Sequential isokinetic and manual muscle testing in patients with neuromuscular disease. A pilot study

The purposes of this study were to compare the value of isokinetic testing and manual muscle testing (MMT) in longitudinal measurements of muscle strength in patients with neuromuscular disease and to identify any consistent pattern demonstrated by the isokinetic testing of patients with specific diagnoses. We measured knee extensor muscle strength at periodic intervals in patients, using MMT and isokinetic testing at angular limb velocities of 30 and 180 degrees/sec. An isokinetic fatigability test also was conducted. The results indicated that in patients who were graded 9 to 10 (ie, within normal limits) by MMT methods, sequential isokinetic strength tests revealed improvement not indicated by MMT. In patients, however, having weakness detectable by MMT and whose course was deteriorating, isokinetic testing did not seem to add clinically significant information for long-term management. Some patients with myotonia demonstrated an increase in peak torque during the fatigability test; this response was unique among the diagnoses we tested. Isokinetic testing may provide, in some patients with neuromuscular disease, valuable information when used in conjunction with MMT for sequential monitoring of strength. Continued research is needed to investigate the value of isokinetic testing in the diagnosis and management of patients with neuromuscular disease.