Effects of a Short-Term Plyometric and Resistance Training Program on Fitness Performance in Boys Age 12 to 15 Years

The purpose of this study was to compare the effects of a six week training period of combined plyometric and resistance training (PRT, n = 13) or resistance training alone (RT, n = 14) on fitness performance in boys (12-15 yr). The RT group performed static stretching exercises followed by resistance training whereas the PRT group performed plyometric exercises followed by the same resistance training program. The training duration per session for both groups was 90 min. At baseline and after training all participants were tested on the vertical jump, long jump, medicine ball toss, 9.1 m sprint, pro agility shuttle run and flexibility. The PRT group made significantly (p < 0.05) greater improvements than RT in long jump (10.8 cm vs. 2.2 cm), medicine ball toss (39.1 cm vs. 17.7 cm) and pro agility shuttle run time (-0.23 sec vs. -0.02 sec) following training. These findings suggest that the addition of plyometric training to a resistance training program may be more beneficial than resistance training and static stretching for enhancing selected measures of upper and lower body power in boys.

Key points

• Youth conditioning programs which include different types of training and different loading schemes (e.g., high velocity plyometrics and resistance training) may be most effective for enhancing power performance.
• The effects of resistance training and plyometric training may be synergistic in children, with their combined effects being greater that each program performed alone.

Key words: Adolescent, strength training, power, stretch-shortening cycle     

Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial

ABSTRACT: BACKGROUND: Quadriceps femoris muscle (QFM) weakness is a feature of knee osteoarthritis (OA) and exercise programs that strengthen this muscle group can improve function, disability and pain. Traditional supervised resistance exercise is however resource intensive and dependent on good adherence which can be challenging to achieve in patients with significant knee OA. Because of the limitations of traditional exercise programs, interest has been shown in the use of neuromuscular electrical stimulation (NMES) to strengthen the QFM. We conducted a single-blind, prospective randomized controlled study to compare the effects of home-based resistance training (RT) and NMES on patients with moderate to severe knee OA. METHODS: 41 patients aged 55 to 75 years were randomised to 6 week programs of RT, NMES or a control group receiving standard care. The primary outcome was functional capacity measured using a walk test, stair climb test and chair rise test. Additional outcomes were self-reported disability, quadriceps strength and cross-sectional area. Outcomes were assessed pre- and post-intervention and at 6 weeks post-intervention (weeks 1, 8 and 14 respectively). RESULTS: There were similar, significant improvements in functional capacity for the RT and NMES groups at week 8 compared to week 1 (p<0.001) and compared to the control group (p<0.005), and the improvements were maintained at week 14 (p<0.001). Cross sectional area of the QFM increased in both training groups (NMES: +5.4%; RT: +4.3%; p=0.404). Adherence was 91% and 83% in the NMES and RT groups respectively (p=0.324). CONCLUSIONS: Home-based NMES is an acceptable alternative to exercise therapy in the management of knee OA, producing similar improvements in functional capacity. Trial registration: Current Controlled Trials ISRCTN85231954.     

Effects of Whole-Body Vibration on Resistance Training for Untrained Adults

Although resistance training (RT) combined with whole-body vibration (WBV) is becoming increasingly popular among untrained adults, the additional effects of WBV on muscle fitness are still not well understood. The aim of the present study was to evaluate the effects of WBV on muscle strength, muscle power, muscle endurance, and neuromuscular activities compared with the identical RT without WBV. Thirty-three individuals (6 males and 27 females; 22-49 years old) were randomly assigned to a training program using slow-velocity RT coupled with WBV (RT- WBV group, n = 17) or an identical exercise program without WBV (RT group, n = 16). Participants performed eight exercises per 60 min session on a vibration platform (RT-WBV group, frequency, 35 Hz; amplitude, 2 mm) twice weekly for seven weeks. To evaluate the effects of WBV, the maximal isometric and isokinetic knee extension strength, maximal isometric lumbar extension strength, countermovement-jump, and the number of sit-ups were measured before and after the trial. Significantly higher increases were observed in the maximal isometric and concentric knee extension strength (p = 0.02, p = 0.04 , respectively), and maximal isometric lumbar extension strength at 60 degrees of trunk flexion (p = 0.02) in the RT-WBV group (+36.8%, +38.4%, +26.4%, respectively) in comparison to the RT group (+16.5%, +12.8%, +14.3%, respectively). A significant difference was also observed between the RT-WBV group (+8.4%) and the RT group (+4.7%) in the countermovement jump height (p = 0.02). In conclusion, the results suggest that significant additional increases in maximal isometric and concentric knee extension and lumbar extension strength, and countermovement jump height can be achieved by incorporating WBV into a slow-velocity RT program during the initial stage of regular RT in untrained healthy adults.

Key points

• A randomized controlled trial was conducted to investigate the effects of slow velocity resistance training combined with whole-body vibration on maximal muscle strength, power, muscle endurance, and neuromuscular activities in healthy untrained individuals.
• Resistance training program for lower extremities and trunk muscles were performed twice weekly for 7 weeks.
• A 7 weeks slow velocity resistance training program with whole-body vibration significantly increased maximal isometric knee extension and lumbar extension strength and power in healthy untrained individuals.

Key words: Vibration, novice, adults, exercise, strength, power     

Effect of Home-Based Well-Rounded Exercise in Community-Dwelling Older Adults

The purpose of this study was to assess the efficacy of a home-based well-rounded exercise program (WREP) in older adults. Forty sedentary community-dwelling older adults were randomly assigned to an exercise group (n = 23; aged 62-80 yr, average: 69.2 ± 5.2; 12 men and 11 women) or a control group (n = 17; aged 63-85 yr, average: 70.1 ± 6.6; 5 men and 12 women). The exercise group performed a 12-wk WREP which included aerobic exercise (walking) on about 3 days·wk^-1 for 37 min·day^-1; elastic band-based resistance exercises for the major muscle groups on about 3 days·wk^-1 for 26 min; and flexibility exercises (stretching) on about 4 days·wk^-1 for 19 min·day^-1. General physical characteristics, functional strength (Arm Curl [AC], Chair Stand [CS]), dynamic balance and agility (Up & Go [UG]), flexibility (Back Scratch [BS], Sit & Reach [SR]), and endurance (12-min walk [12-MW]) were measured. Following the 12-wk home-based WREP, improvements were observed in AC, CS, UG, BS, SR and 12-MW for the exercise group but not for the control group. These results suggest that the home-based WREP can improve overall fitness in older adults.

Key Points

• Walking, elastic band exercise and stretching were prescribed as a Well-Rounded Exercise Program for older adults.
• By combining aerobic, resistance and flexibility exercises, a Well-Rounded Exercise Program was effective for improving endurance, functional strength, dynamic balance and agility, and flexibility.
• Community-based exercise classes motivated older adults to perform home-based exercises.

Key words: Physical fitness, aerobic exercise, resistance exercise, flexibility exercise, adherence     

The Effect of Instability Training on Knee Joint Proprioception and Core Strength

Although there are many studies demonstrating increased trunk activation under unstable conditions, it is not known whether this increased activation would translate into meaningful trunk strength with a prolonged training program. Additionally, while balance-training programs have been shown to improve stability, their effect on specific joint proprioception is not clear. Thus the objective of this study was to examine training adaptations associated with a 10-week instability-training program. Participants were tested pre- and post-training for trunk extension and flexion strength and knee proprioception. Forty-three participants participated in either a 10-week (3 days per week) instability-training program using Swiss balls and body weight as resistance or a control group (n = 17). The trained group increased (p < 0. 05) trunk extension peak torque/body weight (23.6%) and total work output (20.1%) from pre- to post-training while the control group decreased by 6.8% and 6.7% respectively. The exercise group increased their trunk flexion peak torque/body weight ratios by 18.1% while the control group decreased by 0.4%. Knee proprioception (combined right and left joint repositioning) improved 44.7% from pre- to post-training (p = 0.0006) and persisted (21.5%) for 9 months post-training. In addition there was a side interaction with the position sense of the right knee at 9 months showing 32.1% (p = 0.03) less deviation from the reference angle than the right knee during pre-testing. An instability-training program using Swiss balls with body weight as resistance can provide prolonged improvements in joint proprioception and core strength in previously untrained individuals performing this novel training stress which would contribute to general health.

Key points

• Although traditional free weight resistance exercises have been recommended as most beneficial for improving strength and power in athletes (Behm et al., 2010b), an IT program using Swiss balls and body weight as a resistance may provide an alternative starting point for the sedentary untrained population.
• As it is well documented that force or strength is decreased when unbalanced (Behm et al., 2010b) and balance-training programs improve balance (Behm and Kean 2006), this type of instability RT program can provide significant adaptations to improve trunk strength especially with the untrained.
• This type of training should also be incorporated into a new program as the improvements in joint proprioception may help protect from joint injuries over a protracted period.
• The finding that improved joint proprioception persists for months after training should be emphasized to those individuals whose training is regularly or inconsistently interrupted.

Key words: Instability resistance training, stability, back, abdominals     

Electromyographic Comparison of Five Lower-Limb Muscles between Single- and Multi-Joint Exercises among Trained Men

Resistance-training exercises can be classified as either single- or multi-joint exercises and differences in surface electromyography (EMG) amplitude between the two training methods may identify which muscles can benefit from either training modality. This study aimed to compare the surface EMG amplitude of five hip- and knee extensors during one multi-joint (leg press) and two single-joint exercises (knee extension and kickback). Fifteen resistance-trained men completed one familiarization session to determine their unilateral six repetitions maximum (6RM) in the three exercises. During the following experimental session, EMG amplitudes of the vastus lateralis, vastus medialis, rectus femoris, gluteus maximus and biceps femoris of the left leg were measured while performing three repetitions on their respective 6RM loads. The multi-joint exercise leg press produced higher EMG amplitude of the vastus lateralis (ES = 0.92, p = 0.003) than the single-joint exercise knee extension, whereas the rectus femoris demonstrated higher EMG amplitude during the knee extension (ES = 0.93, p = 0.005). The biceps femoris EMG amplitude was higher during the single-joint exercise kickback compared to the leg press (ES = 2.27, p < 0.001), while no significant differences in gluteus maximus (ES = 0.08, p = 0.898) or vastus medialis (ES = 0.056, p = 0.025 were observed between exercises. The difference in EMG amplitude between single- and multi-joint exercises appears to vary depending on the specific exercises and the muscle groups tested. Leg press is a viable and time-efficient option for targeting several hip- and knee extensors during resistance training of the lower limbs, but the single-joint exercises may be preferable for targeting the rectus femoris and biceps femoris.Key points

• The differences in EMG amplitudes between single- and multi-joint exercises appears to vary depending on the specific exercises and the muscle groups tested.
• Leg press may be a time efficient approach for targeting the gluteus maximus, vastus lateralis and vastus medialis either more or equally as effectively as a combination of kickback and knee extension.
• Knee extension and kickback may be preferable options for targeting the biceps femoris and rectus femoris specifically.

Key words: Muscle activity, leg press, knee extension, kickback, EMG, strength     

Analysis of effectiveness of therapeutic exercise for knee osteoarthritis and possible factors affecting outcome

Background

There are numerous reports and evidences to suggest that exercise therapy is effective for knee osteoarthritis (knee OA). However, there is a lack of sufficient research concerning the factors influencing its application and effectiveness. The purposes of this study were to evaluate effects of the mode of treatment delivery on the improvement of symptoms in knee OA, and to analyze potential risk factors affecting improvement after exercise therapies.

Methods

The 209 women applicants diagnosed with knee OA were randomly allocated into either a group performing group exercise in a class or a group performing home exercise. The 90 min exercise program was performed under the guidance of physiotherapists as a group exercise therapy. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) of the subjects of both groups before and after intervention was compared to examine the effect of exercise therapy. In addition, body mass index, knee range of motion (ROM), the femorotibial angle from radiographs, OA severity from Kellgren–Lawrence grade, and meniscus abnormality and subchondral bone marrow lesions from MRI findings were statistically analyzed as factors that may affect exercise therapy.

Results

A significantly greater improvement in WOMAC was observed in the subjects of group exercise (81 subjects) as compared with the subjects of home exercise (122 subjects). There was a significantly high proportion of subjects with knee flexion contracture among the subjects participating in group exercise that showed only minor symptom improvement (p < 0.05). In addition, exercise therapy proved to be highly effective for subjects with limited quadriceps muscle strength (p < 0.05).

Conclusions

When prescribing exercise therapy for knee OA, evaluation of a subject’s ROM and muscle strength is important in deciding whether to commence exercise therapy and what type of exercise therapy to apply; it is also important in predicting the effect of exercise therapy.     

Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study

OBJECTIVE: This preliminary study sought to determine whether using 1500/1200mg of glucosamine hydrochloride and chondroitin sulfate (GH/CS) is effective, both separately and combined with exercise, compared to a placebo plus exercise program in improving physical function, pain, strength, balance, and mobility in older adults with knee osteoarthritis (OA). METHODS: This double-blind, placebo-controlled, randomized clinical trial lasted 12 months. Participants included 89 older adults (age>/=50 years) with knee OA randomized to either GH/CS or placebo group. Phase I was a 6-month trial comparing the effects of assignment to either GH/CS or placebo. Phase II added 6 months of exercise for both groups. The primary outcome measure was Western Ontario and McMaster University Osteoarthritis Index (WOMAC) function, and secondary outcome measures included WOMAC pain, 6-min walk, balance, and knee strength. RESULTS: Of the 89 randomized participants, 72 (81%) completed the study. The median pill compliance was 94% and 95% in Phase I, and, in Phase II, 97% and 91% for the GH/CS and placebo groups, respectively. Median exercise compliance during Phase II was 77% for the GH/CS group and 78% for the placebo group. WOMAC function and pain did not differ significantly between the groups at 6- or 12-month follow-up. There were also no significant differences between the groups in 6-min walk or knee strength; however, balance was better in the placebo group with approximately a 10% difference compared to the GH/CS group. CONCLUSIONS: The GH/CS group was not superior to the placebo group in function, pain, or mobility after both phases of the intervention (pill only and pill plus exercise).     

Osteoarthritis action alliance consensus opinion-best practice features of anterior cruciate ligament and lower limb injury prevention programs

AIM To identify best practice features of an anterior cruciate ligament(ACL) and lower limb injury prevention programs(IPPs) to reduce osteoarthritis(OA).METHODS This consensus statement started with us performing a systematic literature search for all relevant articles from 1960 through January 2017 in PubM ed, Web of Science and CINAHL. The search strategy combined the Medical Subject Heading(Me SH) and keywords for terms:(1) ACL OR "knee injury" OR "anterior cruciate ligament";(2) "prevention and control" OR "risk reduction" OR "injury prevention" OR "neuromuscular training"; and(3) meta-analysis OR "systematic review" OR "cohort study" OR randomized. We found 166 different titles. The abstracts were reviewed for pertinent papers. The papers were reviewed by at least two authors and consensus of best practice for IPP to prevent OA was obtained by conference calls and e-mail discussions. All authors participated in the discussion.RESULTS The best practice features of an IPP have the following six components:(1) lower extremity and core strengthening;(2) plyometrics;(3) continual feedback to athletes regarding proper technique;(4) sufficient dosage;(5) minimal-to-no additional equipment; and(6) balance training to help prevent injuries. Exercises focused on preventing ankle sprains, hamstring injuries and lateral trunk movements are important. Plyometric exercises should focus on correcting knee valgus movement.Exercises should focus on optimizing the hamstring to quadriceps strength ratio. In order for IPP to be successful, there should be increased education and verbal feedback along with increased athletic compliance. Additional equipment is not necessary. Balance training alone does not significantly reduce injuries, but is beneficial with other exercises. Not enough evidence to recommend stretching and agility exercises, with no ill effects identified. Therefore, we suggest making these optional features.CONCLUSION Best practice features for ACL and lower limb IPPs to help prevent OA contain six key components along with two optional.     

Passive Muscle Stiffness of Biceps Femoris is Acutely Reduced after Eccentric Knee Flexion

Eccentric hamstring exercises reportedly prevent hamstring strain injury in the biceps femoris long head (BFlh). However, information on the favorable adaptive responses in the BFlh to eccentric hamstring exercises is limited. We aimed to examine the acute effect of maximal isokinetic eccentric knee flexion on passive BFlh stiffness as a potential risk factor for the hamstring strain injury using ultrasound shear wave elastography. Ten young participants randomly performed both tasks involving five consecutive repetitions of isokinetic concentric and eccentric knee flexion with maximal effort on different legs. Passive BFlh shear modulus was taken before and 30, 60, 90, and 120 s after each task. Passive BFlh shear modulus was significantly reduced at all time points after eccentric knee flexion, whereas there was no significant change in passive BFlh shear modulus after the concentric task. The present findings indicate that passive BFlh stiffness would reduce specifically after low-volume, slow-velocity eccentric knee flexion exercise. The findings may help provide practitioners with a basis to develop more effective exercise programs for preventing HSI. Key points

• Passive muscle stiffness of the biceps femoris long head (BFlh) was directly assessed using ultrasound shear wave elastography.
• Passive BFlh stiffness was reduced after five consecutive repetitions of eccentric knee flexion, but not concentric contractions.
• The present findings may provide practitioners with a basis to develop more effective exercise programs for preventing HSI.

Key words: Eccentric hamstring exercises, isokinetic knee flexion, ultrasound shear wave elastography, shear modulus     

Effects of weekly and fortnightly therapeutic exercise on physical function and health-related quality of life in individuals with hip osteoarthritis

BackgroundMost previous studies on the effects of therapeutic exercise on osteoarthritis (OA) of the hip joint included participants with knee OA or postoperative participants. Moreover, although some systematic reviews recommend therapeutic exercise for hip OA, a consensus on the effective interventional frequency has not been reached. This study aimed to investigate the effects of therapeutic exercise performed at different frequencies on physical function and health-related quality of life in participants with hip OA.MethodsIndividuals diagnosed with hip OA (36 women, age 42–79 years; 19 in 2009 and 17 in 2010) were recruited from the cooperating medical institutions. They were divided into two groups depending on the frequency of therapeutic exercise: fortnightly in 2009 (fortnightly group) and weekly in 2010 (weekly group). Participants in each group performed the same land-based and aquatic exercises on the same day for a total of ten sessions. Muscle strength of the lower extremity, “timed up and go” (TUG), time of one-leg standing with open eyes (TOLS), Harris Hip Score, and scores of the Medical Outcomes Survey Short Form-36 questionnaire, were measured before and after interventions.ResultsThe fortnightly group had no significant changes in lower-extremity muscle strength following intervention, but the strength of all muscles in the weekly group improved significantly after intervention. Further, in both groups, TUG and TOLS of the worse side of the hip joint significantly improved after interventions.ConclusionsWeekly exercise improves muscle strength of the lower extremity and may therefore be an effective interventional technique for managing hip OA. In addition, in persons with hip OA, therapeutic exercise consisting of both land- and water-based exercises markedly improved physical function.     

Effects of a Combined Aerobic and Strength Training Program in Youth Patients with Acute Lymphoblastic Leukemia

Cure rates of youth with Acute Lymphoblastic Leukemia (ALL) have increased in the past decades, but survivor’s quality of life and physical fitness has become a growing concern. Although previous reports showed that resistance training is feasible and effective, we hypothesized that a more intense exercise program would also be feasible, but more beneficial than low- to moderate-intensity training programs. We aimed to examine the effects of an exercise program combining high-intensity resistance exercises and moderate-intensity aerobic exercises in young patients undergoing treatment for ALL. A quasi-experimental study was conducted. The patients (n = 6; 5-16 years of age) underwent a 12-week intra-hospital training program involving high-intensity strength exercises and aerobic exercise at 70% of the peak oxygen consumption. At baseline and after 12 weeks, we assessed sub-maximal strength (10 repetition-maximum), quality of life and possible adverse effects. A significant improvement was observed in the sub maximal strength for bench press (71%), lat pull down (50%), leg press (73%) and leg extension (64%) as a result of the training (p < 0.01). The parents’ evaluations of their children’s quality of life revealed an improvement in fatigue and general quality of life, but the children’s self-reported quality of life was not changed. No adverse effects occurred. A 12-week in-hospital training program including high-intensity resistance exercises promotes marked strength improvements in patients during the maintenance phase of the treatment for Acute Lymphoblastic Leukemia without side-effects. Parents’ evaluations of their children revealed an improvement in the quality of life.

Key points

• Patients with ALL present low muscle strength and poor quality of life.
• High-intensity resistance exercises combined with moderate-intensity aerobic exercise improved muscle strength and quality of life during the maintenance phase of ALL treatment.
• The exercise training program seemed to be tolerable and safe in ALL patients.

Key words: Acute lymphoblastic leukemia, child, strength training, pediatrics, quality of life     

Effectiveness of diclofenac versus acetaminophen in primary care patients with knee osteoarthritis: [NTR1485], DIPA-Trial: design of a randomized clinical trial

Background

The prevalence of knee osteoarthritis(OA) in East Asia is as common for men and even higher for women than that reported in the Caucasian population. Since both population aging and economic growth have taken place at a much faster pace in Asian countries, such as South Korea, one would expect knee OA to become a major public health problem. However, few studies have examined the influence of knee OA on the quality of life (QoL) and physical function in Asia. The aim of this cross-sectional study is to investigate the influence of knee osteoarthritis (OA) on the quality of life (QoL), function and lower extremity physical performance and the gender difference in its influence in elderly community residents in Korea.

Methods

Participants were from the population-based Hallym Aging Study (HAS). The mean age of the 504 study subjects was 70.2 years and 274 (54%) were women. Demographic information was obtained by questionnaire, and radiographic evaluations consisted of weight-bearing semi-flexed knee radiographs. Self-reported QoL and function were assessed using Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Short Form 12-item (SF-12). Performance-based lower extremity function was assessed using the tests consisting of standing balance, usual walk and chair stands. The odds ratios(ORs) for belonging to the worst quartile of WOMAC and physical performance test were calculated by logistic regression analysis in radiographic knee OA compared to non-OA after adjustment of confounders. Scores for SF-12 items were analyzed using general linear models and means adjusted for age, BMI and OA severity were compared.

Results

Subjects with radiographic knee OA had significantly increased OR for belonging to the worst WOMAC quartile(for pain, 2.13,95% confidence interval[CI], 1.33-3.40, for stiffness, 2.94,95% CI,1.78-4.86, and for function, 2.97, 95% CI,1.83-4.81) and significantly worse SF-12 scores compared to non-OA after adjustment of age, BMI and sex. Women had worse WOMAC and SF-12 scores compared to men, regardless of the presence of radiographic knee OA after adjustment of age, BMI and OA severity. OA subjects had significantly worse performance score for usual walk and chair stands compared to non-OA subjects, but the ORs were no more significant after adjustment of sex.

Conclusions

Knee OA negatively affects the QoL and physical function in both genders, but women are more adversely affected than men.     

A Multi-Station Proprioceptive Exercise Program in Patients with Bilateral Knee Osteoarthrosis: Functional Capacity,Pain and Sensoriomotor Function. A Randomized Controlled Trial

We investigated the effects of a multi-station proprioceptive exercise program on functional capacity, perceived knee pain, and sensoriomotor function. Twenty-two patients (aged 41-75 years) with grade 2-3 bilateral knee osteoarthrosis were randomly assigned to two groups: treatment (TR; n = 12) and non-treatment (NONTR; n = 10). TR performed 11 different balance/coordination and proprioception exercises, twice a week for 6 weeks. Functional capacity and perceived knee pain during rest and physical activity was measured. Also knee position sense, kinaesthesia, postural control, isometric and isokinetic knee strength (at 60, 120 and 180°·s^-1) measures were taken at baseline and after 6 weeks of training. There was no significant difference in any of the tested variables between TR and NONTR before the intervention period. In TR perceived knee pain during daily activities and functional tests was lessened following the exercise program (p < 0.05). Perceived knee pain was also lower in TR vs. NONTR after training (p < 0.05). The time for rising from a chair, stair climbing and descending improved in TR (p < 0.05) and these values were faster compared with NONTR after training (p < 0.05). Joint position sense (degrees) for active and passive tests and for weight bearing tests improved in TR (p < 0.05) and the values were lower compared with NONTR after training (p < 0.05). Postural control (‘eyes closed’) also improved for single leg and tandem tests in TR (p < 0.01) and these values were higher compared with NONTR after training. The isometric quadriceps strength of TR improved (p < 0.05) but the values were not significantly different compared with NONTR after training. There was no change in isokinetic strength for TR and NONTR after the training period. The results suggest that using a multi-station proprioceptive exercise program it is possible to improve postural control, functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis.

Key Points

• It is possible to improve postural control, functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis with a pure proprioceptive/ balance exercise program used in the present study.
• The exercise regime used in the present study was as effective as previous studies, but of much shorter duration and utilized unsophisticated, inexpensive equipment which is available in most physiotherapy departments.
• Therefore, the incorporation of this exercise program into clinical practice is readily feasible.

Key Words: Osteoarthrosis, proprioception, balance, perceived knee pain, function     

A pilot study of post-total knee replacement gait rehabilitation using lower limbs robot-assisted training system

The aim of this study was to explore the application value of the lower limbs robot-assisted training system for post-total knee replacement (TKR) gait rehabilitation. A total of 60 patients with osteoarthritis of the knee were equally randomized into the traditional and robot-assisted rehabilitation training groups within 1 week after TKR. All patients received 2-week training. Scores of hospital for special surgery (HSS), knee kinesthesia grades, knee proprioception grades, functional ambulation (FAC) scores, Berg balance scores, 10-m sitting–standing time, and 6-min walking distances were compared between the groups. The HSS score, Berg score, 10-m sitting–standing time, and 6-min walking distance of the robot-assisted training group were significantly higher than the control group (P < 0.05). Its knee kinesthesia grade, knee proprioception grade, and FAC score were better than the control group but not significantly (P > 0.05). Lower limbs robot-assisted rehabilitation training improves post-TKR patients’ knee proprioception and stability more effectively compared with the traditional method. It improves patients’ gait and symptoms, increases their walking speed, and prolongs their walking distances, which benefit their return to family and society.     

High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial

The aim of this randomized controlled study was to compare the effects of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) on pain relief and functional improvement in patients with knee osteoarthritis (KOA). A total of 53 male patients participated in this study, with a mean (SD) age of 54.6 (8.49) years. Patients were randomly assigned into three groups and treated with HILT and exercise (HILT?+?EX), LLLT and exercise (LLLT?+?EX), and placebo laser plus exercise (PL?+?EX) in groups 1, 2, and 3, respectively. The outcomes measured were pain level measured by visual analog scale (VAS) and knee function measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Statistical analyses were performed to compare the differences between baseline and posttreatment measurements. The level of statistical significance was set as P?<?0.05. The result showed that HILT and LLLT combined with exercise were effective treatment modalities in decreasing the VAS and WOMAC scores after 6 weeks of treatment. HILT combined with exercises was more effective than LLLT combined with exercises, and both treatment modalities were better than exercises alone in the treatment of patients with KOA.     

Efficacy of a target-matching foot-stepping exercise on proprioception and function in patients with knee osteoarthritis

STUDY DESIGN: A randomized clinical trial design. OBJECTIVE: To investigate the efficacy of high, repetitive, target-matching foot-stepping exercise (TMFSE) performed in a sitting position on proprioception, functional score, and walking velocity for patients with knee osteoarthritis (OA). BACKGROUND: Researchers have suggested that exercises to address knee OA should include proprioceptive training. However, most patients cannot tolerate conventional proprioceptive training performed in a standing position. METHODS AND MEASURES: Forty-nine subjects (mean age +/- SD, 63.3 +/- 8.1) with knee OA were randomly assigned to the exercise or no intervention groups. The exercise group practiced TMFSE in sitting, 3 sessions weekly for 6 weeks. All subjects underwent assessments of knee reposition error, functional incapacity score, and walking velocity prior to and after intervention. RESULTS: The TMFSE significantly improved reposition error from a mean +/- SD of 3.0 degrees +/- 1.6 degrees to 1.5 degrees +/- 0.6 degree, walking velocity on ground level from 44.1 +/- 2.9 to 38.6 +/- 2.5 sec for 60 meters, time to complete a stairs task from 34.2 +/- 2.1 to 26.5 +/- 2.3 seconds, time to complete a figure-of-eight from 51.3 +/- 6.7 to 29.1 +/- 3.6 seconds, and score on a functional incapacity scale from 12.0 +/- 3.1 to 4.9 +/- 1.7, in subjects with knee OA after 6-week intervention (P <.0125). In contrast, the control group showed no change in any of the measured tests. CONCLUSION: TMFSE in sitting appears to be an option for exercise in patients with mild to moderate knee OA. This may be an especially attractive option for patients who may have pain with weight-bearing exercises. A longitudinal study with a larger sample size is needed to confirm the potential use of TMFSE for patients with knee OA.     

The Effect of Structured Exercise Intervention on Intensity and Volume of Total Physical Activity

This study aimed to investigate the effects of a 12-week structured exercise intervention on total physical activity and its subcategories. Twenty-three overweight or obese middle aged men with impaired glucose regulation were randomized into a 12-week Nordic walking group, a power-type resistance training group, and a non-exercise control group. Physical activity was measured with questionnaires before the intervention (1–4 weeks) and during the intervention (1–12 weeks) and was expressed in metabolic equivalents of task. No significant change in the volume of total physical activity between or within the groups was observed (p > 0.050). The volume of total leisure-time physical activity (structured exercises + non-structured leisure-time physical activity) increased significantly in the Nordic walking group (p < 0.050) but not in the resistance training group (p > 0.050) compared to the control group. In both exercise groups increase in the weekly volume of total leisure-time physical activity was inversely associated with the volume of non-leisure-time physical activities. In conclusion, structured exercise intervention did not increase the volume of total physical activity. Albeit, endurance training can increase the volume of high intensity physical activities, however it is associated with compensatory decrease in lower intensity physical activities. To achieve effective personalized exercise program, individuality in compensatory behavior should be recognised.

Key Points

• Structured NW or RT training does not increase the volume of total physical activity.
• NW intervention can increase the volume of higher intensity activities.
• The increased in volume of LTPA induced by the structured NW and RT interventions was associated with the decreased volume of NLTPA.

Key words: Nordic walking, resistance training, energy expenditure, thermogenesis, glucose intolerance     

Extent of tibiofemoral osteoarthritis before knee arthroplasty: multicenter data from the osteoarthritis initiative

Background  

Knee arthroplasty traditionally is recommended for persons with substantial disability and disabling pain attributable to moderate or severe osteoarthritis (OA). Pain and functional status after arthroplasty may be influenced by the extent of knee OA before surgery and recent evidence suggests persons with less severe knee OA before undergoing TKA have greater pain levels and worse function than persons with more severe knee OA.     

Effect of Rest Interval Length on the Volume Completed During Upper Body Resistance Exercise

The purpose of the current study was to compare the workout volume (sets x resistance x repetitions per set) completed during two upper body resistance exercise sessions that incorporated 1 minute versus 3 minute rest intervals between sets and exercises. Twelve trained men completed two experimental sessions that consisted of 5 upper body exercises (i.e. barbell bench press, incline barbell bench press, pec deck flye, barbell lying triceps extension, triceps pushdown) performed for three sets with an 8-RM load. The two experimental sessions differed only in the length of the rest interval between sets and exercises; one session with a 1-minute and the other session with a 3-minute rest interval. The results demonstrated that for each exercise, significantly greater workout volume was completed when resting 3 minutes between sets and exercises (p < 0.05). These results indicate that during a resistance exercise session, if sufficient time is available, resting 3 minutes between sets and exercises allows greater workout volume for the upper body exercises examined.

Key points

• The length of the rest interval between sets is an important variable when designing a resistance exercise program and may vary depending on the characteristic being emphasized (i.e. maximal strength, hypertrophy, localized muscular endurance, power).
• Although acknowledged, this variable is rarely monitored precisely in field settings.
• Previous studies that examined rest interval lengths from 1 to 5 minutes between sets for single exercises demonstrated significant differences in repetition performance and the exercise volume completed.
• There is a need for further research to compare the workout volume (sets x resistance x repetitions per set) completed over an entire resistance exercise session with different rest intervals between sets.
• The results of the current study indicate that during a resistance exercise session, if sufficient time is available, resting 3 minutes between sets and exercises allows greater workout volume for the upper body exercises examined.

Key words: Recovery, fatigue, strength, muscle endurance, weight training, strength training