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Purpose: Muscular deficits as part of severe osteoarthritis of the hip may persist for up to two years following total hip arthroplasty (THA). No study has evaluated the mid-term benefit of a modified enhanced-recovery-after-surgery (ERAS) concept on muscular strength of the hip in detail thus far. We (1) investigated if a modified ERAS-concept for primary THA improves the mid-term rehabilitation of muscular strength and (2) compared the clinical outcome using validated clinical scores. Methods: In a prospective, single-blinded, randomized controlled trial we compared patients receiving primary THA with a modified ERAS concept (n = 12, ERAS-group) and such receiving conventional THA (n = 12, non-ERAS) at three months and one year postoperatively. For assessment of isokinetic muscular strength, a Biodex-Dynamometer was used (peak-torque, total-work, power). The clinical outcome was evaluated by using clinical scores (Patient-Related-Outcome-Measures (PROMs), WOMAC-index (Western-Ontario-and-McMaster-Universities-Osteoarthritis-Index), HHS (Harris-Hip-Score) and EQ-5D-3L-score. Results: Three-months postoperatively, isokinetic strength (peak-torque, total-work, power) and active range of motion was significantly better in the modified ERAS group. One year postoperatively, the total work for flexion was significantly higher than in the Non-ERAS group, whilst peak-torque and power did not show significant differences. Evaluation of clinical scores revealed excellent results at both time points in both groups. However, we could not detect any significant differences between both groups in respect of the clinical outcome. Conclusion: With regard to muscular strength, this study supports the implementation of an ERAS concept for primary THA. The combination with a modified ERAS concept lead to faster rehabilitation for up to one-year postoperatively, reflected by significant higher muscular strength (peak-torque, total-work, power). Possibly, because common scores are not sensitive enough, the results are not reflected in the clinical outcome. Further larger randomized controlled trials are necessary for long-term evaluation. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively compare strength outcomes of individuals undergoing postoperative rehabilitation following quadriceps tendon (QT) autograft anterior cruciate ligament reconstruction (ACLR) with and without blood flow restriction therapy. Methods: A retrospective review of consecutive patients undergoing ACLR with QT autograft with a minimum of two quantitative postoperative isometric strength assessments via an electromechanical dynamometer (Biodex) was included. Demographics, surgical variables and strength measurement outcomes were compared between patients undergoing blood flow restriction therapy as part of postoperative rehabilitation versus those who did not. Results: Eighty‐one (81) patients met the inclusion criteria. No differences were found in demographic and surgical characteristics between those who received blood flow restriction compared with those who did not. While both groups had improvements in quadriceps peak torque and limb symmetry index (LSI; defined as peak torque of the operative limb divided by the peak torque of the nonoperative limb) over the study period, the blood flow restriction group had significantly lower mean peak torque of the operative limb at first Biodex strength measurement (95.6 vs. 111.2 Nm; p = 0.03). Additionally, the blood flow restriction group had a significantly lower mean LSI than those with no blood flow restriction at the second Biodex measurement timepoint (81% vs. 90%; p = 0.02). No other significant differences were found between the strength outcomes measured. Conclusions: Results of this study show that the 'real world' clinical implementation of blood flow restriction therapy to the postoperative rehabilitation protocol following QT autograft ACLR did not result in an increase in absolute or longitudinal changes in quadriceps strength measurements. A better understanding and standardisation of the use of blood flow restriction therapy in the rehabilitation setting is necessary to delineate the true effects of this modality on strength recovery after QT autograft ACLR. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) is used extensively for musculoskeletal conditions, but its efficacy in chronic low back pain still needs more investigation. Objective: To discuss the effectiveness of VR on selected outcomes in Chronic Non-Specific Low Back Pain (CNSLBP). Methods: Thirty-five patients with CNSLBP joined this study. Postural correction exercises using the TBed VR gaming system in addition to hamstring stretching were employed, and moist heat on the low back was applied. Pre- and post-intervention values of pain, ROM, function, and balance (overall stability index) were obtained using the numerical rating pain scale (NPRS), Oswestry Disability Index, back range of motion (BROM), and Biodex system. Satisfaction level on a 1–10 scale and the degree of commitment to the exercise sessions were assessed after the intervention. Results: The patients completed the intervention period and outcome measures sessions. Paired t-tests reported statistically significant improvements and high effect size in pain, ROM, function, and balance after the end of the treatment (p < 0.001, Cohen's d > 0.69). The level of satisfaction was 9.25 ± 0.766, and the commitment to exercise sessions was high (98.75% attendance rate). Conclusions: Applying postural correction using TBed VR gaming in addition to heat and stretching may improve pain, range of motion, function, and balance in patients with chronic low back pain. [ABSTRACT FROM AUTHOR]

Background and Objectives: Biodex System® is an advanced dynamometer used for testing various biomechanical parameters of muscles. Test outcomes allow for the identification of muscle pathology and consequently lead to a clinical diagnosis. Despite being widely used for the testing and rehabilitation of the human musculoskeletal system, no universal and acceptable protocol for wrist examination has been proposed for patients with wrist pathology. In this study, the authors aim to identify the most appropriate protocol for testing the biomechanical parameters of flexors and extensors of the wrist. Materials and Methods: A group of 20 patients with symptomatic tennis elbow and 26 healthy volunteers were examined using three different protocols: isokinetic, isometric and isotonic. Protocol order for each study participant was assigned at random with a minimum of a 24 h break between protocols. All protocol parameters were set according to data obtained from a literature review and an earlier pilot study. Following completion of each protocol, participants filled out a questionnaire-based protocol, assessing pain intensity during the exam, difficulty with exam performance and post-exam muscle fatigue. Results: The isotonic protocol showed the best patient tolerance and the highest questionnaire score. There was a significant difference (p < 0.05) between the three protocols in average pain intensity reported by study participants. All participants completed the isotonic protocol, but not all patients with symptomatic tennis elbow were able to complete the isometric and isokinetic protocols. The isotonic protocol was deemed "difficult but possible to complete" by study participants. Conclusions: The isotonic protocol is most suitable for testing the flexors and extensors of the wrist. It gives the most biomechanical data of all protocols, is well tolerated by patients and rarely causes pain during examination even in symptomatic participants. [ABSTRACT FROM AUTHOR]

Objectives: To compare the impact of core stability exercises versus Biodex balance training on postural stability and sway among patients suffering from mechanical low back pain. Methods: The study was conducted in the outpatient clinic of the Faculty of Physical Therapy, Modern University for Technology and Information, between March and June 2023. This randomized, double-blind, pre-post measurement study included forty-eight patients have been participated in this study and divided into three groups, Group A (control group) (n = 18) were given stretching as well as strengthening exercises. Group B (n = 18) were given core stability exercises plus stretching as well as strengthening exercises. Group C (n = 18) were given Biodex balance training (limit of stability, maze, and random control modes training) plus stretching as well as strengthening exercises. The Biodex Balance System were utilized to quantify dynamic balance indices at baseline and six weeks following therapy. Statistical analysis among groups for eye open firm, eye closed firm, eye open foam, and eye closed foam revealed from the Modified clinical test of sensory interaction and balance which were the main outcome indicator. Results: The Within-Group analysis revealed substantial differences regarding postural stability as well as control of postural sway for groups B and C, both prior to and following the treatment program (p value < 0.05). The between-group analysis revealed statistically substantial variations across all variables following the therapy, with Group C exhibiting further pronounced differences compared to Groups A and B (p < 0.05). Conclusion: Enhancement in all measures of dynamic balance was shown following core stability training activities and Biodex balance training, with a greater degree of improvement seen after Biodex balance training. [ABSTRACT FROM AUTHOR]

Trendelenburg gait describes contralateral pelvic drop during single leg stance (SLS) with occasional lateral trunk lean compensation over the stance limb. However, quantitative research on 'uncompensated Trendelenburg' gait (pelvic drop independent of lateral trunk lean) remains sparse among populations that commonly utilize this gait pattern, such as adolescent hip pathology patients. How prevalent is uncompensated Trendelenburg among various adolescent hip pathologies and how is it related to hip load, hip abduction strength, and self-reported hip pain? Gait, strength, and pain data were collected among 152 pre-operative patients clinically diagnosed with acetabular hip dysplasia, femoroacetabular impingement, Legg-Calvé-Perthes, or slipped capital femoral epiphysis (SCFE). Patients with ≥ 5.4° of dynamic pelvic drop in SLS were divided into a 'pelvic drop' group and screened to exclude those with excessive ipsilateral trunk lean. They were then compared to the 'stable pelvis' patients using a Mann-Whitney test. Dysplasia patients represented the highest proportion of the pelvic drop group (46%). The pelvic drop group showed a significant increase in self-reported hip pain (p = 0.011), maximum hip abductor moment (p = 0.002), and peak coronal power absorption at the affected hip during SLS loading response, (p < 0.001) while showing no difference in abduction strength (p = 0.381). Uncompensated Trendelenburg gait may lead to increased loading of the affected hip in adolescent hip pathology patients. Disadvantageous hip biomechanics can create increased abductor muscle demand among these pathological populations, with dysplasia patients showing the highest prevalence. Maximal abduction strength did not correlate with pelvic drop. Future work should aim to identify and quantify causal factors. Increased coronal hip power absorption during weight acceptance warrants clinical attention, as there may be a detrimental, over-reliance on passive hip structures to support load among a population that that is already predisposed to hip osteoarthritis. • Excessive pelvic drop in gait can be exhibited by adolescents with hip disorders. • Without a trunk lean compensation, this gait increases load at the affected hip. • Abnormal hip morphology may create mechanical disadvantages that cannot be overcome. • There may be an over-reliance on passive hip structures to support load. • In populations predisposed to hip osteoarthritis, clinical awareness is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Although total hip arthroplasty (THA) is expected to result in a postoperative loss of muscular strength, no study investigated the benefit of an enhanced-recovery-after-surgery (ERAS) concept on the hip muscles in detail. We evaluated if (1) an ERAS-concept for primary THA results in reduced loss of muscular strength five days and four weeks postoperative. We (2) compared the two groups regarding Patient-Related-Outcome-Measures (PROMs), WOMAC-index (Western-Ontario-and-McMaster-Universities-Osteoarthritis-Index), HHS (Harris-Hip-Score) and EQ-5d-3L-score. Methods: In a prospective, single-blinded, randomized controlled trial, we compared isokinetic muscular strength of 24 patients receiving primary THA with an enhanced recovery concept with early mobilization (n = 12, ERAS-group) and such receiving conventional THA (n = 12, non-ERAS). Isokinetic muscular strength was measured with a Biodex-Dynamometer before, as well as five days and four weeks after surgery (peak-torque, total-work, power). Furthermore, WOMAC, HHS, PROMs and EQ-5d-3L were imposed. Results: The ERAS group revealed significant higher isokinetic strength (peak-torque, total-work, power) at both time points. Both groups showed a significant pain decrease at both time points meeting very high rates of patient satisfaction resembled by good results in PROMs, WOMAC, HHS, EQ-5d. There was no significant difference in any of the scores between both groups. Conclusion: We proved a significant reduced loss of muscular strength five days and four weeks after primary THA in combination with an ERAS concept. However, the reduced loss of muscular strength is not reflected by patient's functional outcome and quality of life, showing no significant differences in WOMAC, HHS, EQ-5d-3L, PROMs and NRS. Therefore, this study supports the implementation of an ERAS concept for primary THA in terms of isokinetic strength. Further studies are needed to evaluate the development of muscular strength over a long period. [ABSTRACT FROM AUTHOR]

Background and Objectives: Biodex System® is an advanced dynamometer used for testing various biomechanical parameters of muscles. Test outcomes allow for the identification of muscle pathology and consequently lead to a clinical diagnosis. Despite being widely used for the testing and rehabilitation of the human musculoskeletal system, no universal and acceptable protocol for wrist examination has been proposed for patients with wrist pathology. In this study, the authors aim to identify the most appropriate protocol for testing the biomechanical parameters of flexors and extensors of the wrist. Materials and Methods: A group of 20 patients with symptomatic tennis elbow and 26 healthy volunteers were examined using three different protocols: isokinetic, isometric and isotonic. Protocol order for each study participant was assigned at random with a minimum of a 24 h break between protocols. All protocol parameters were set according to data obtained from a literature review and an earlier pilot study. Following completion of each protocol, participants filled out a questionnaire-based protocol, assessing pain intensity during the exam, difficulty with exam performance and post-exam muscle fatigue. Results: The isotonic protocol showed the best patient tolerance and the highest questionnaire score. There was a significant difference (p < 0.05) between the three protocols in average pain intensity reported by study participants. All participants completed the isotonic protocol, but not all patients with symptomatic tennis elbow were able to complete the isometric and isokinetic protocols. The isotonic protocol was deemed “difficult but possible to complete” by study participants. Conclusions: The isotonic protocol is most suitable for testing the flexors and extensors of the wrist. It gives the most biomechanical data of all protocols, is well tolerated by patients and rarely causes pain during examination even in symptomatic participants.

Alpine skiing is a sport and recreational physical activity which requires fine postural control to maintain balance in challenging conditions. Theoretically, balance dominates in alpine skiing, but coordinated action of the whole body of the skiers is equally important. The aim of this research was to determine the effects of experimental short-term program of intensive training of alpine skiing techniques to postural stability (on Biodex Balance System) of students. The sample is divided into an experimental (31 students, age 21.4±1.0 and body height 180.7±6.3 cm) and control group (34 students, age 20.6±0.8 and body height 180.3±6.8 cm). The results of ANCOVA within variables for the evaluation of postural stability show statistically significant effects of the applying experimental program in all applied variables at the level of significance p=.000. From the mean value results (M) it is obvious that the experimental group achieved better results compared to the identical tests applied to the control group. The results of this research show that learning to ski can improve the ability to maintain balance, especially if it is conducted under the expert supervision of a ski instructor, which can have the effect of reducing the risk of injury [ABSTRACT FROM AUTHOR]

Introduction: Ankle instability is a common injury in athletes, affecting the quality of life, functional limitation, as well as static and dynamic balance. The aim of the study was to compare the efficacy of virtual reality and Biodex balance training in the treatment of ankle instability in adolescent athletes. Material and methods: Ninety football players were enrolled in this study after the assessment of their eligibility. Their age ranged from 12 to 16 years. They were randomly allocated to three groups of equal numbers. Group 1 received a guideline protocol, group 2 received the same guideline protocol in addition to Wii Sport Training, and group 3 received the same guideline protocol in addition to Biodex balance training. All groups received treatment protocols three times a week for 3 months. Outcome measures included the stability indices (overall stability, anteroposterior stability, and mediolateral) measured by the Biodex Balance System as well as ankle instability measured by the Cumberland Ankle Instability Tool. Measurements were collected at the baseline and after 3 months of treatment. Results: Post-treatment findings revealed a statistically significant decrease in the overall, anteroposterior, and mediolateral stability indices, as well as significant increase in Cumberland Ankle Instability outcomes of all groups (p < 0.05). On the other hand, there were no statistically significant differences between the virtual reality and Biodex balance training groups. Conclusions: Virtual reality training has a significant effect which appears to be similar to the Biodex balance training in adolescent athletes with chronic ankle instability. [ABSTRACT FROM AUTHOR]

Aim. Patellar Tendinopathy is a pathology with implications both in sports activity and the dynamics of everyday life. There are many treatment possibilities described in the specialized literature, but there is no exact guideline regarding the optimal management for this pathology. Because of that, it is important both for the therapist and to identify modern treatment possibilities that are adapted to the particularities of the subject and symptomatology. With this paper we want to present the progression and course of the recovery program from classic to modern approach, but also the 's outcome when two modern ways of treatment complete each other for treating s having Patellar Tendinopathy. The recovery program took place over a period of 24 sessions with a frequency of 3 days/week. During the recovery sessions we used classic physical exercises, the Biodex System 4 pro dynamometer and the ESWT device from Zimmer. The recovery program was staged, in the first phase we used classic physical exercises in combination with the isokinetic dynamometer to have optimal load on the knee. Later, we introduced the ESWT sessions into the recovery plan, which had an effect right from the first session, modulating the pain and by the 3rd session of ESWT the pain was eliminated. Conclusions. Computerized dynamometry and extracorporeal shockwave therapy have proven to be an effective combination in the management of Patellar Tendinopathy and are of real help both for the purpose of evaluating the functional status and in positively influencing it until the complete elimination of pain. [ABSTRACT FROM AUTHOR]

The reliability of isokinetic peak torque (PT) has been reported mostly using a short-term (<~10 day) inter-trial testing time frame. However, many studies and programs utilize a long-term (several weeks to months) inter-trial testing period. Additionally, the methods by which the PT value is selected and reported from a multiple rep testing scheme have not been well investigated for both reliability and PT absolute performance comparisons. The purpose of this study was to investigate the long-term reliability of isokinetic and isometric PT of the leg extensors with an emphasis on the differences among several PT score selection methods. Thirteen men and women (age = 19.5 years) underwent two testing trials separated by 28.8 (±1.8) days. Testing included maximal voluntary contractions of three sets of three reps for two isokinetic contraction conditions of 60 (Isok60) and 240 (Isok240) deg/s velocities, and three sets of one rep of isometric contractions for the leg extensors. The PT score was derived from seven different methods (see text for descriptions). Reliability as assessed from intraclass correlation coefficients (ICCs) varied widely across contraction conditions and PT score selection parameters. The Isok60 velocity overall had lower reliability (ICCs = 0.48–0.81) than Isok240 (0.77–0.87) across the conditions whereas the isometric PT variables showed moderate reliability (0.71–0.73). Overall the set 1 PT score selection parameters were generally lower (p ≤ 0.05) than those that involved sets two and three. Systematic error (p ≤ 0.05) was shown for 6 out of the 17 PT selection variables. On a subjective interpretation basis, when taking everything into account the best overall combination of time/trial efficiency, reliability, best/highest PT score parameter, and reduced risk of systematic bias appears to be the PT variable that uses the average of the highest two reps of the first two sets of three reps—i.e., averaging the highest two values of the six total reps from the first two sets. [ABSTRACT FROM AUTHOR]

Purpose: Total knee arthroplasty (TKA) combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate isokinetic knee muscle strength after cemented TKA in combination with an enhanced recovery after surgery (ERAS) compared to a conventional setup. Methods: In the single blinded prospective randomized study, 52 patients underwent navigated primary cemented TKA within an ERAS (n = 30) or a conventional setup (n = 22). Preoperatively, five days and four weeks after surgery isokinetic knee muscle strength with BIODEX-type measuring device (peak torque in Nm, work in Joules and power in Watt) and subjective patient-related outcome measures (PROMs) were investigated. Results: The ERAS group showed significantly better outcomes in knee flexion at 180°/s (peak torque (Nm) p = 0.047, work (J) p = 0.040 and power (W) p = 0.016) 5 days postoperatively. The isokinetic measuring at knee extension 60°/s and 180°/s demonstrated no significant difference. The PROMs showed that patients were satisfied with the postoperative results in both groups. After 4 weeks, there was no longer a significant difference in isokinetic measuring at knee extension and flexion between the ERAS and conventional group. Conclusions: TKA with the concept of ERAS improves excellent isokinetic outcome and patient satisfaction. The isokinetic muscle strength measurement can help patients and surgeons to modify expectations and improve patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. Objective: To examine the test−retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. Methods: Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. Results: The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CVTE) values were 6.6–19.5%. Change in the mean expressed as a percent varied from −3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs. Conclusion: Test−retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults. Methods: Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated. Results: When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior–posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group. Conclusion: Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Objective: Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception exercises in patients with knee osteoarthritis. Design: A single-center randomized trial with three parallel arms. Setting: A tertiary health care facility in Turkey. Participants: Female patients with knee osteoarthritis aged 40–70 years. Interventions: Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups. Main measures: Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score). Results: Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance – Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor. Conclusions: Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample. [ABSTRACT FROM AUTHOR]

Background: Handheld dynamometry (HHD) is a practical alternative to traditional testing of lower extremity strength. However, its reliability and validity across different populations and settings are not clear. Hypothesis: We hypothesize that HHD is a valid and reliable device to assess lower extremity strength in a population of older adults. Study Design: Cross-sectional/cohort. Level of Evidence: Level 3. Methods: This study included 258 older adults (≥65 years). Isometric knee extension and flexion force were measured by 1 examiner, using an HHD (n = 222), including 3 repetitions to calculate within-day intrarater reliability. These measurements were repeated by the examiner in a subgroup (n = 23) to analyze intrarater reliability over a test-retest period of on average 8 weeks. In addition, HHD force measures were performed by a second examiner (n = 29) to analyze interrater reliability. In another subgroup (n = 77), isometric knee extension and flexion torque were measured by 1 examiner using both the HHD and Biodex System 4 to assess relative validity. Results: HHD and Biodex measurements were highly correlated and showed excellent concurrent validity. HHD systematically overestimated torque as compared with Biodex by 8 N·m on average. Same-day intrarater intraclass correlation coefficients (ICCs) ranged from 0.97 to 0.98. Interrater reliability ICCs ranged from 0.83 to 0.95. Conclusion: HHD represents a reliable and valid alternative to Biodex to rank individuals on leg strength, or to assess within-person changes in leg strength over time, because of the high validity and reliability. The HHD is less suited for absolute strength assessment because of significant systematic overestimations. Clinical Relevance: Clinicians are encouraged to use HHD to rank older adults on leg strength, or to assess within-person changes in leg strength over time, but not to compare readings with cut-offs or normative values. [ABSTRACT FROM AUTHOR]

Objective: To evaluate isokinetic dynamometer reliability for isometric assessment of plantar flexor (PF) strength., Design: Cross-sectional., Setting: Testing by the same physiotherapist twice during a first session (repeatability) and once during a second session (reproducibility)., Participants: Twenty-two healthy subjects (44 ankles, 11 men/11 women)., Main Outcome Measures: Isometric PF peak torque, with and without body mass normalization, at 0° and +20° of plantar flexion. Measurement reliability was evaluated using intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC)., Results: Without normalization, measurement repeatability was excellent at 0° of plantar flexion (ICC, 0.94; SEM, 6.6%; MDC, 18.4%) compared with good repeatability at +20° (ICC, 0.85; SEM, 11.1%; MDC 30.6%). Measurement repeatability following normalization was good at 0° (ICC, 0.88; SEM, 5.2%; MDC, 14.4%) and +20° (ICC, 0.79; SEM, 10.2%; MDC, 28.1%). While reproducibility was good at 0° with normalization (ICC, 0.84; SEM, 5.9%; MDC, 16.3%) or excellent without (ICC 0.92; SEM 7.5%; MDC, 20.8%), it was moderate at +20° with normalization (ICC 0.71; SEM 11.3%; MDC, 31.3%) or good without (ICC 0.78; SEM 13.0%; MDC, 36.1%)., Conclusion: The reliability of PF maximal isometric strength is good/excellent at 0° of plantar flexion but moderate/good at +20°., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

BACKGROUND: Handball is a strenuous contact sport placing emphasis on running, jumping, throwing, hitting, blocking, and pushing. Various technical and tactical skills are required for this dynamic sport, namely speed, agility, balance, power, strength, and coordination. Hence, the aim of the present study was to assess the changes in the physical fitness components with 8 weeks of plyometric training and core training given to the handball players and to compare the effect of both training methods on the handball players. METHODS: Sixty players were randomly selected to participate in the study. The players were divided into three groups, namely Group A (plyometric), Group B (core), and Group C (control) (n = 20 each). The speed was assessed with 40 m dash sprint, agility by Illinois agility test, and lower limb power by isokinetic dynamometer (BIODEX). The experimental group underwent their respective trainings, and the control underwent conventional training. The posttraining results were recorded after 8 weeks of training. RESULTS: There was a significant difference within the groups, but there was no significant difference between the three groups. CONCLUSION: Both training methods were equally beneficial for the improvement in sprinting speed, Illinois agility test, and lower limb power.

Abstract Background Children with cerebral palsy have impairments of postural control during static and dynamic activities. Improving postural control is one of the primary objectives of rehabilitation for children with cerebral palsy. Therefore, the objective of this study was to study the effect of functional electric stimulation on postural control in children with hemiplegic cerebral palsy. A randomized controlled study was conducted on 30 children with hemiplegic cerebral palsy (18 boys and 12 girls) between the ages of 8 and 12 years. The children were distributed in two equal groups. The experimental group received functional electrical stimulation (pulse width 300 μs, frequency 33 Hz, 2 h/day, 3 days/week, / 3 consecutive months) in addition to the traditional physical therapy program. While the control group received the traditional physiotherapy program only for the same duration. The outcomes included postural stability indices that were measured at baseline and following 3 months of intervention using the Biodex balance system. Results A significant improvement was found in the postural stability indices of children in both groups, comparing their mean values before and after treatment. Furthermore, the results revealed a greater improvement in the postural stability of the experimental group (P < 0.001). Conclusion Functional electrical stimulation may be a useful tool to enhance the postural stability of children with hemiplegic cerebral palsy. Clinical trial registration This study was registered in the ClinicalTrial.gov PRS (NCT04269798). https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009LHP&selectaction=Edit&uid=U0003GAI&ts=4&cx=74k74l

Abstract Background Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI). Methods This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device. Results Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior–posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior–posterior stability (p = 0.001), medial–lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p

Abstract Purpose Although total hip arthroplasty (THA) is expected to result in a postoperative loss of muscular strength, no study investigated the benefit of an enhanced‐recovery‐after‐surgery (ERAS) concept on the hip muscles in detail. We evaluated if (1) an ERAS‐concept for primary THA results in reduced loss of muscular strength five days and four weeks postoperative. We (2) compared the two groups regarding Patient‐Related‐Outcome‐Measures (PROMs), WOMAC‐index (Western‐Ontario‐and‐McMaster‐Universities‐Osteoarthritis‐Index), HHS (Harris‐Hip‐Score) and EQ‐5d‐3L‐score. Methods In a prospective, single‐blinded, randomized controlled trial, we compared isokinetic muscular strength of 24 patients receiving primary THA with an enhanced recovery concept with early mobilization (n = 12, ERAS‐group) and such receiving conventional THA (n = 12, non‐ERAS). Isokinetic muscular strength was measured with a Biodex‐Dynamometer before, as well as five days and four weeks after surgery (peak‐torque, total‐work, power). Furthermore, WOMAC, HHS, PROMs and EQ‐5d‐3L were imposed. Results The ERAS group revealed significant higher isokinetic strength (peak‐torque, total‐work, power) at both time points. Both groups showed a significant pain decrease at both time points meeting very high rates of patient satisfaction resembled by good results in PROMs, WOMAC, HHS, EQ‐5d. There was no significant difference in any of the scores between both groups. Conclusion We proved a significant reduced loss of muscular strength five days and four weeks after primary THA in combination with an ERAS concept. However, the reduced loss of muscular strength is not reflected by patient’s functional outcome and quality of life, showing no significant differences in WOMAC, HHS, EQ‐5d‐3L, PROMs and NRS. Therefore, this study supports the implementation of an ERAS concept for primary THA in terms of isokinetic strength. Further studies are needed to evaluate the development of muscular strength over a long period.

Abstract Purpose Total knee arthroplasty (TKA) combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate isokinetic knee muscle strength after cemented TKA in combination with an enhanced recovery after surgery (ERAS) compared to a conventional setup. Methods In the single blinded prospective randomized study, 52 patients underwent navigated primary cemented TKA within an ERAS (n = 30) or a conventional setup (n = 22). Preoperatively, five days and four weeks after surgery isokinetic knee muscle strength with BIODEX‐type measuring device (peak torque in Nm, work in Joules and power in Watt) and subjective patient‐related outcome measures (PROMs) were investigated. Results The ERAS group showed significantly better outcomes in knee flexion at 180°/s (peak torque (Nm) p = 0.047, work (J) p = 0.040 and power (W) p = 0.016) 5 days postoperatively. The isokinetic measuring at knee extension 60°/s and 180°/s demonstrated no significant difference. The PROMs showed that patients were satisfied with the postoperative results in both groups. After 4 weeks, there was no longer a significant difference in isokinetic measuring at knee extension and flexion between the ERAS and conventional group. Conclusions TKA with the concept of ERAS improves excellent isokinetic outcome and patient satisfaction. The isokinetic muscle strength measurement can help patients and surgeons to modify expectations and improve patient satisfaction.

Purpose: The aim of the performed tests and static measurements was to determine the torque and to determine the activity curve for individual muscle heads during the flexion-extension movement in the elbow joint. Methods: Both heads of the biceps branchial muscle and the triceps muscle of the arm – long head and lateral head – were examined. Static measurements were carried out for four selected positions of the upper limb. For each pose, a measurement series consisting of five attempts of ten seconds of effort was performed. Isometric contraction was performed as 100% of the maximum voluntary MVC contraction. Dynamic measurements were carried out when working in isokinetic conditions. In both stages, an EMG and a Biodex isokinetic dynamometer were used. Results: During the analyses, it was assumed that the average value of the torque is equal to the approximate value of the torque of a given head under static conditions. The value of the torque of the biceps brachial muscle, long head was 48.04 Nm and for the short head – 45.82 Nm. For the triceps muscle of the long head, this value was 52.52 Nm and for the lateral head – 38.06 Nm. On the basis of dynamic measurements, four activation curves were determined for each of the heads during the 7-second task. For the curves, the sum value of muscle activity in a given period of time was calculated as the area under the curve. Conclusions: Both parts of the series of articles present a series of experimental studies conducted in order to determine the parameters for one patient, for whom a personalized numerical model of the upper limb was ultimately created. Static measurements were carried out to determine the maximum values of the moments of forces. Dynamic measurements allowed for the determination of activity curves during the movement of the upper limb. [ABSTRACT FROM AUTHOR]

Introduction: Balance and postural performance measures are quite variable. These measures can be influenced by chronic musculoskeletal problems. In the literature, contradicting results are given regarding the effects of postural stability indices and limits of stability measures in subjects having chronic low back pain. Additionally, the available work on this topic is still scarce.Aim: The aims of this study were to compare differences in limits of stability and postural indices among participants having chronic mechanical low back pain (LBP) and a matched healthy group.Materials and Methods: This is a cross-sectional comparative study in which the LBP group consisted of 60 participants while the healthy control group comprised 30 subjects. The severity of pain was measured using the Visual Analogue Scale (VAS). Postural stability indices (overall, anteroposterior and mediolateral) and limits of postural stability (directional control and time) were measured using the Biodex balance device.Results: Both groups were similar regarding baseline characteristics (p>0.05). The overall and anteroposterior stability indices demonstrated statistically significant differences in favour of the healthy subjects (p2.8). Additionally, limits of stability measures indicated a statistically significant difference (p0.9).Conclusions: Chronic low back pain adversely affects postural stability indices and limits of stability.

The reliability of isokinetic peak torque (PT) has been reported mostly using a short-term (p ≤ 0.05) than those that involved sets two and three. Systematic error (p ≤ 0.05) was shown for 6 out of the 17 PT selection variables. On a subjective interpretation basis, when taking everything into account the best overall combination of time/trial efficiency, reliability, best/highest PT score parameter, and reduced risk of systematic bias appears to be the PT variable that uses the average of the highest two reps of the first two sets of three reps—i.e., averaging the highest two values of the six total reps from the first two sets.

Introduction Ankle instability is a common injury in athletes, affecting the quality of life, functional limitation, as well as static and dynamic balance. The aim of the study was to compare the efficacy of virtual reality and Biodex balance training in the treatment of ankle instability in adolescent athletes. Material and methods Ninety football players were enrolled in this study after the assessment of their eligibility. Their age ranged from 12 to 16 years. They were randomly allocated to three groups of equal numbers. Group 1 received a guideline protocol, group 2 received the same guideline protocol in addition to Wii Sport Training, and group 3 received the same guideline protocol in addition to Biodex balance training. All groups received treatment protocols three times a week for 3 months. Outcome measures included the stability indices (overall stability, anteroposterior stability, and mediolateral) measured by the Biodex Balance System as well as ankle instability measured by the Cumberland Ankle Instability Tool. Measurements were collected at the baseline and after 3 months of treatment. Results Post-treatment findings revealed a statistically significant decrease in the overall, anteroposterior, and mediolateral stability indices, as well as significant increase in Cumberland Ankle Instability outcomes of all groups (p < 0.05). On the other hand, there were no statistically significant differences between the virtual reality and Biodex balance training groups. Conclusions Virtual reality training has a significant effect which appears to be similar to the Biodex balance training in adolescent athletes with chronic ankle instability.

Background: The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. Objective: To examine the test−retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. Methods: Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. Results: The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CVTE) values were 6.6–19.5%. Change in the mean expressed as a percent varied from −3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs. Conclusion: Test−retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings.

In spite of the increasing number of balance assessment studies, the relationship between painful upper extremity and balance disorders is not yet fully understood. The objective of this paper was to determine if balance was affected by painful should er syndromes. A total of 40 adults aged between 20-60, 20 with painful shoulder syndrome (study group) and 20 with healthy shoulders (control group). Stability tests and the risk of fall were evaluated with the help of a Biodex Balance device, the range of motion was evaluated with the help of a universal goniometer, and the intensity of pain was measured with the help of vis ual analog scale (VAS) in both groups. While the overall stability index, one of the subgroups of the stability test, differed between the groups (p< 0.05), no difference was observed in the fall risk scores (p=0.05). Stability test scores showed a positiv e significant correlation with the pain intensity, according to the VAS: pain during night (r2=0.452, p=0.045) and pain while doing any activity (r2=0.764, p=0.000). Individuals with painful shoulders may have a stability disorder. In addition to classical measurement methods in individuals with shoulder pain, emphasis should be placed on balance assessment and shoulder evaluations may be required in adults with atypic al balance disorders. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of vitamin D and exercise on balance, fall risk and quality of life (QoL) in postmenopausal women. Methods: In this prospective, randomised, controlled, single‐blind study postmenopausal women aged 50‐70 years were included. Participants with <25nmol/L 25(OH) vitamin D were randomised to three groups: group‐I (vitamin D replacement) (n = 21), group‐II (core and balance exercises) (n = 18), and group‐III (vitamin D replacement plus core and balance exercises) (n = 20). The participants with >75nmol/L 25(OH) vitamin D (group‐IV) (n = 40) were designated as control group and received the core and balance exercises. The participants were evaluated before and after 8 weeks with Berg balance test and Biodex balance system (postural stability and fall risk tests) for balance and Nottingham Health Profile (NHP) for QoL. Results: Group IV had better baseline BBT, NHP pain, NHP emotional reactions, NHP social isolation subdomain and total score. After treatment, all groups showed significant improvement in balance (except group I, mediolateral stability index) and QoL (except group II). There was no significant difference between groups (I, II and III) after intervention. Conclusion: Vitamin D replacement therapy has positive effects on balance and QoL. Core strengthening and balance exercises are essential for better balance and fall prevention in postmenopausal women. Any superior effect of vitamin D or exercise on each other was not determined. [ABSTRACT FROM AUTHOR]

Background: Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI). Methods: This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device. Results: Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior–posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior–posterior stability (p = 0.001), medial–lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p < 0.05). Conclusions: According to the results, there were significant differences between the mean pain scores, static and dynamic balance, and the rate of fall between the women with knee osteoarthritis with and without the KI index. Therefore, patients with knee osteoarthritis, which also has an index of KI, are more susceptible to falls, and proper strategies are required to reduce the level of KI in these patients. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 atypical symptoms in older persons include falls, confusion, dizziness, and unusual weariness. Falls and their consequences are among the most prevalent causes of disability among older adults, significantly lowering quality of life and resulting in the loss of independence as well as impaired psychosocial functioning. The study purpose was to examine the impact of the SARS-CoV-2 infectious disease on balance in community-dwelling older adults. Methods: Sixty-four older adults aged ≥ 60 years from both sexes, 31 treated for SARS-CoV-2 infection and 33 matched normal controls participated in the study. The Biodex Stability System (BSS) and Berg Balance Scale (BBS) were used for evaluation of balance and fall risk. The correlation between the Biodex overall stability index and the Berg Balance Scale score was investigated. Results: When compared to controls, the SARS-CoV-2 group had significantly higher values of the Biodex overall stability index (OSI) (p = 0.011), anterior–posterior stability index (APSI) (p = 0.013), mediolateral stability index (MLSI) (p = 0.018), and fall risk index (FRI) (p = 0.008), as well as statistically lower scores on the Berg balance scale (p = 0.003). A moderate negative correlation was found between the two assessment tools in the SARS-CoV-2 group. Conclusion: Balance impairment and an increased risk of falling are among the outcomes of SARS-CoV-2 in community-dwelling older adults.

Background and Objectives: Following an injury, upper-body strength and proprioception training is typically suggested. To our understanding, no prior research has looked into the impact of balance training on upper-body strength and stability. So, this study investigated the effects of Biodex balance training on enhancing the dynamic stability, strength, and function of the upper quarter (UQ) in recreational weightlifters. Materials and Methods: Fifty male weightlifters were randomly assigned into two groups. The experimental group received an upper-extremity Biodex balance training program three times/week for eight weeks, while the control group underwent a regular weightlifting training routine. Pre- and post-test scores of the upper-quarter dynamic stability, strength, and function were measured for both groups using the shoulder active repositioning accuracy test, two-minute push-up test, and the upper-quarter Y-balance test (UQ-YBT) and one-arm hop test, respectively. Results: Post-test values were significantly greater for the normalized UQ-YBT test than pre-test values in both groups (p < 0.05). Post-test values of the experimental group were significantly greater than the control group (p < 0.05). Regarding the shoulder active repositioning accuracy test and the time of the one-arm hop test, post-test values were significantly lower than pre-test values for both groups (p < 0.05), and post-test values of the experimental group were significantly lower than those of the control group (p < 0.05). The post-test value of the two-minute push-up test of each group was significantly higher than the pre-test value (p < 0.05), without any significant difference between both groups (p > 0.05). Conclusions: Adding upper-body Biodex balance training to a regular weightlifting training routine was effective in enhancing the upper quarter′s dynamic stability and function.

Balance can be defined as keeping the center of gravity of the body within the surface of the support and has crucial role in sport. However, there are insufficient knowledge regarding balance field testing. The main aim of this study was to determine association between Biodex laboratory balance test and Y balance field test. The participants in this study were 12 students (6 males, 6 females) of Faculty of Kinesiology in Split, Croatia. The set of variables included anthropometric measures (body height, body weight, body mass index), two laboratory balance tests conducted on Biodex (Postural stability test, Limits of stability test) and field balance test (Y balance test). The correlations between observed variables were calculated by Pearson's product moment correlation. No significant correlations were found between Y balance test and both Postural stability test (r=-0.06 and 0.02 respectively for left and right leg) and Limits of stability test (r=-0.06 and 0.02). The results of this study indicate that Y balance test is not a precise measure of balance ability in well-trained individuals. Authors hypothesize that Y balance test performance is greatly influenced by lower extremity strength and mobility. There is an obvious need for the construction and validation of new field tests to assess the level of balance in amateur and professional athletes. [ABSTRACT FROM AUTHOR]

Purpose. The aims of the study were to determine the relationship between the shoulder muscles strength and the athletic performance of high-level swimmers and to detect the strength variables that had the biggest impact on high performance in sports swimming. Methods. The study involved 39 high qualified swimmers (12 females and 27 males). To determine the strength variables, shoulder flexion and extension were carried out in isokinetic conditions. A biodex S4 dynamometer was used. The following protocols were applied: (1) 3 repetitions, 60°/s; (2) 20 repetitions, 180°/s. the r-Pearson correlation analysis or the rho-Spearman correlation analysis were used. The family-wise error was checked. Results. The level of strength had a greater influence on the swimming performance in males (25 of the 68 obtained variables) than in females (18 of the 68 variables). The strength variables that had the biggest impact on high performance in sports swimming were peak torque (r: 0.39--0.633), total work (r: 0.408--0.692), average power (r: 0.44--0.739), and average peak torque (r: 0.456--0.72). Conclusions. Regardless of the respondents' gender or the analysed shoulder movement, the following variables were repeated: peak torque, total work, average power, and average peak torque. Unfortunately, the results were not statistically significant. Only acceleration time of the left shoulder in the arm flexion movement in males was significant. Despite this, once the muscular groups are similar for the listed strength variables, the swimmer's capability to produce force out of water seems to help them perform better in the water. [ABSTRACT FROM AUTHOR]

BACKGROUND: Isokinetic evaluation is considered the gold standard in muscle strength measurement due to its sensitivity, intra-dynamometer reproducibility and usefulness in the injury prevention screening and follow up of subjects with musculoskeletal pathologies, neurological disease or after surgical operation. However, can one switch among different isokinetic dynamometers for the purpose of knee muscles evaluation? OBJECTIVES: To comprehensively evaluate the compatibility of the isokinetic short concentric and eccentric strength evaluation protocol and of the fatigability resistance evaluation between three different isokinetic devices. METHODS: Eighteen recreationally active men underwent three isokinetic knee testing sessions on three different isokinetic devices with 7–10 days of rest between each session. Relative (Pearson's r product-moment correlation coefficient – PCC) and absolute (standard error of measurement – SEM, Cohen effect sizes (d) and probabilistic inferences – MBI) parameters of reproducibility were determined to assess the inter-dynamometer agreement. RESULTS: For the short concentric and eccentric strength evaluation protocol, the extensors in concentric mode and the flexors in eccentric mode can be compared (eventually with transposition formulas provided) between Biodex, Con-Trex and Cybex (almost all PCC ⩾ 0.80). The DCR could be compared between Con-Trex and Cybex and between Biodex and Cybex pairs (eventually with transposition formula provided). For the fatigability resistance evaluation protocol, the total sum can be compared for extensors (eventually with transposition formulas provided) for PM for all dynamometer pairs considered and, in the case of MW, only for Biodex and Con-Trex (PCC ⩾ 0.80). CONCLUSIONS: Only some of the parameters derived either from the short concentric and eccentric strength evaluation protocol or the fatigability resistance evaluation protocol may be interchangeable providing transposition formulas are applied. Otherwise, isokinetic findings are largely system-dependent save some specific instances. [ABSTRACT FROM AUTHOR]

Purpose: Visually-impaired individuals encounter difficulties in balance control and quality of life, and experience more instability, compared to healthy people. Thus, the present study aimed to evaluate the effects of vestibular exercises training program on postural control, risk of falling, and quality of life in individuals with visual impairment. Methods: This was a quasi-experimental study with a pretest-posttest and a control group design. In total, 24 men with visual impairment were randomly divided into the control and experimental groups. The experimental group performed a 4-week vestibular exercise program for 3 weekly sessions of 50 minutes. The Biodex Balance System, Timed Up and Go (TUG) test, and 36-Item Short Form Survey (SF-36) were respectively used to evaluate the postural control, risk of falling, and quality of life of the study samples, before and after the exercise intervention. Univariate analysis and Paired Samples t-test were used to determine the differences between the two groups. Results: The present study results suggested that vestibular exercises improved balance and quality of life, and decrease the risk of falling in visually-impaired people; there was a significant difference between pretest and posttest values in the experimental group. However, no significant difference was observed in the control group in the mentioned variables. The Univariate analysis results revealed that the experimental group obtained higher scores on balance, risk of falling, and quality of life, compared to the control group. Conclusion: Vestibular exercises significantly improved postural control and quality of life, and decreased the risk of falling in the studied samples. It is recommended that these exercises be included in the rehabilitation programs for visually-impaired individuals.

The aim of this study was to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretch techniques on dynamic standing balance performances using Biodex Balance System (BBS). Seven wrestlers from the Turkish National Team between the ages of 18 and 25 were tested before and immediately after PNF stretching interventions. The stretching protocol involved a 5-min warm-up at at at 70 rpm with 1-kp resistance on a stationary cycle ergometer followed by four PNF stretching exercises to stretch the leg extensor muscles of the dominant and nondominant limbs according to the procedures of a previous study. Balance was measured in two conditions; dominant and nondominant limbs over a period of 20s and Medial–lateral stability index (MLSI), Anterior–posterior stability index (APSI) and an Overall stability index (OSI) were recorded before and after PNF interventions. One way repeated-measures analysis of variance (ANOVA) was used to analyze the differences between pretest and posttest BBS values. There were no significant balance index differences after the PNF interventions for dominant leg (p>0.05). However, a significant increase was found in MLSI values for non-dominant leg. Even though the PNF stretching intervention reduced MLSI dynamic balance performance for the non-dominant leg in our findings, other BBS index scores showed that dynamic balance performance was not affected by the acute bout of PNF stretching.

Purpose: This work aimed to define the impact of the introduction of power and speed dry-land training in female swimmers aged 15-16 on the rise of time results at a distance of 200 m and on the increase of the strength level of the muscle groups in the elbow joint. Method: The investigations were conducted on a group of 28 junior female swimmers: group 1 (aged 13-14) with speed and endurance training based on "water" exercises; group 2 (aged 15-16) with extra power and speed dry-land training. The following parameters were analyzed: time results, the moments of muscle forces in the elbow joint at the extension and flexion movements in isokinetic conditions and the ratio of the values of moments of muscle forces of flexors in relation to extensors. Results: Statistically significant differences between groups were found for the following parameters: the time results from swimming 200 m with (p < 0.001) and without using lower limbs (p = 0.031), the ratio of the moments of muscle forces of flexors to extensors (p < 0.05). Conclusions: The results of the correlation analysis show that the higher the moments of muscle forces of flexors and extensors of the elbow joint, the shorter the time obtained in swimming 200 m in the freestyle stroke. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) stretch techniques on dynamic standing balance performances using Biodex Balance System (BBS). Seven wrestlers from the Turkish National Team between the ages of 18 and 25 were tested before and immediately after PNF stretching interventions. The stretching protocol involved a 5-min warm-up at at at 70 rpm with 1-kp resistance on a stationary cycle ergometer followed by four PNF stretching exercises to stretch the leg extensor muscles of the dominant and nondominant limbs according to the procedures of a previous study. Balance was measured in two conditions; dominant and nondominant limbs over a period of 20s and Medial–lateral stability index (MLSI), Anterior–posterior stability index (APSI) and an Overall stability index (OSI) were recorded before and after PNF interventions. One way repeated-measures analysis of variance (ANOVA) was used to analyze the differences between pretest and posttest BBS values. There were no significant balance index differences after the PNF interventions for dominant leg (p>0.05). However, a significant increase was found in MLSI values for non-dominant leg. Even though the PNF stretching intervention reduced MLSI dynamic balance performance for the non-dominant leg in our findings, other BBS index scores showed that dynamic balance performance was not affected by the acute bout of PNF stretching.

Background: Balance is an indispensable part of daily activities and is considered important in examining the performance of athletes especially in basketball. Despite the advantages of neck proprioceptive neuromuscular facilitation (PNF) training on neck proprioception, it has remained understudied. Neck proprioception is very important for performance in exercise. Therefore, the aim of this study was to evaluate the effect of neck PNF training on neck proprioception on postural stability and limit of stability in elite female basketball players. Methods: In this study, 30 female basketball players with at least three years of basketball activity were randomly assigned into two groups: experimental group (neck PNF training) and control group. The experimental group participated in 4-week neck PNF training sessions (12 sessions per week). On the other hand, the control group performed only daily routine exercises. Limit of stability and postural stability index of the participants were determined by the Biodex balance test before and after the exercise program. Independent t-test (between the two groups) and paired t-test (in each group) were applied using the SPSS-18 software to analyze the obtained data, with a significance level of p

The objective of the current research was to compare the impact of balance and stabilizing trainings on balance indices in patients with nonspecific chronic low back pain. In this randomized, controlled, single-blinded clinical trial, 20 people suffering from nonspecific chronic low back pain were randomly assigned to two groups of balance and stabilizing trainings. Trainings of both groups were performed for 6 weeks and four sessions per week. The overall, lateral, and anterior-posterior stability indices, pain, and disability were measured using Biodex balance system, visual analog scale, and Oswestry scale, before and after treatment, respectively. Paired t-test and independent t-test were used for analyzing the data. In the balance group, the pain severity was changed from 6.33 ± 1.63 to 4.33 ± 2.6 (P = 0.005) and dynamic anterior-posterior stability index in the standing position on left leg with closing eyes was changed from 5.56 ± 2.25 to 3.45 ± 1. 57 (P = 0.03). In the stabilizing group, pain severity was changed from 4. 16 ± 1.47 to 1.33 ± 0.81 (P = 0.0001) and disability index was changed from 17.33 ± 5.60 to 5.33 ± 3.93 (P = 0.01). Reduction in pain and disability in the stabilizing group and increase in two balance indices were significant in the balance training group compared to those in other group (P < 0.05). Research findings revealed that the impact of stabilizing trainings was significant in reducing pain and disability compared to that in balance trainings.

Critical moments during gymnastic exercises are those related to landing and suppressing overloads, transmitted through lower limbs. A swimmer’s lower limbs provide a good body position in the water and maintain the balance. Both in sports authors postulate reaching bilateral, steady development of the athlete’s body. The main aim was identification and a comparative analysis of the hip, knee and ankle joints flexors and extensors strength, of highly qualified gymnasts and swimmers. Ten healthy subjects participated in the investigation. Five gymnasts (22.2 ±7.3 y.o., 169.4 ±3.91 cm, 64.4 ±3.78 kg) and five swimmers (20.5 ±1.3 y.o., 186.2 ±1.64 cm, 78.4 ±2.61 kg) were highly qualified Polish athletes. Strength measurements were made on Biodex S4 isokinetic dynamometer. Subjects performed hip extension/flexion in lying position, knee extension/flexion and ankle plantar/dorsi flexion. Strength parameters of the lower limbs differentiate gymnasts and swimmers. Lower limb’s strength parameters can be used during training, control, selection or prevention. To achieve a high sport level, swimmers must demonstrate higher strength parameters of lower limbs than gymnasts. The value of work in the maximum repetition (MRW) should be thoroughly analyzed. Highly qualified gymnasts and swimmers should take into account the harmonious, bilateral strength development of the lower limbs.

Critical moments during gymnastic exercises are those related to landing and suppressing overloads, transmitted through lower limbs. A swimmer's lower limbs provide a good body position in the water and maintain the balance. Both in sports authors postulate reaching bilateral, steady development of the athlete's body. The main aim was identification and a comparative analysis of the hip, knee and ankle joints flexors and extensors strength, of highly qualified gymnasts and swimmers. Ten healthy subjects participated in the investigation. Five gymnasts (22.2 ±7.3 y.o., 169.4 ±3.91 cm, 64.4 ±3.78 kg) and five swimmers (20.5 ±1.3 y.o., 186.2 ±1.64 cm, 78.4 ±2.61 kg) were highly qualified Polish athletes. Strength measurements were made on Biodex S4 isokinetic dynamometer. Subjects performed hip extension/flexion in lying position, knee extension/flexion and ankle plantar/dorsi flexion. Strength parameters of the lower limbs differentiate gymnasts and swimmers. Lower limb's strength parameters can be used during training, control, selection or prevention. To achieve a high sport level, swimmers must demonstrate higher strength parameters of lower limbs than gymnasts. The value of work in the maximum repetition (MRW) should be thoroughly analyzed. Highly qualified gymnasts and swimmers should take into account the harmonious, bilateral strength development of the lower limbs. [ABSTRACT FROM AUTHOR]

Abstract Isometric force- or torque-time parameters are commonly reported in the research literature. The processing methods of the electronic dynamometer-derived signal may influence the outcome measures. This study determined the influence of filtering and sample rate (SR) on isometric torque-time parameters and provides specific signal processing recommendations for future studies. Twenty-three subjects performed 49 isometric maximum voluntary contractions (MVCs) of the knee extensors on an isokinetic dynamometer. Outcome measures included peak torque (PT), and rate of torque development at peak (RTDPEAK), 50 (RTD50) and 200 (RTD200) ms for seven filter conditions including low-pass filter cutoffs at 5, 10, 20, 50, 100 and 150 Hz and a notch filter at 100 and 200 Hz. Comparisons were also made across four SR conditions at 100, 500, 1000 and 2000 Hz. The RTDPEAK variable was markedly changed (−5.4 to −37.9%) for all filter frequencies compared to the 150 Hz condition and the RTD50 variable was altered for all frequencies between 50 and 5 Hz. No differences were found for RTD200. For SR, compared to the 2000 Hz condition, differences were revealed for the 100 Hz condition for the RTDPEAK and RTD50 variables. The filtering or SR did not alter PT across any of the conditions. The filter and SR applied to the signal was capable of distorting the MVC signal and skewing the torque–time parameters, specifically for the early and maximum RTD variables of the MVC curve (RTD50 and RTDPEAK). For traditional isokinetic dynamometers, a low-pass filter cutoff of 150 Hz and a SR of at least 1000 Hz is recommended when assessing early isometric force- or torque-time MVC parameters. [ABSTRACT FROM AUTHOR]

The objective of the study was to determine whether a relationship exists between the two common methods for assessing postural stability in athletes: the time-to-stabilisation (TTS) via force-plate and the Biodex Balance System (BBS). The conditions under which these measurements assess dynamic postural control may not provide sufficient feedback to practitioners. Fourty-four amateur soccer players with no history of musculoskeletal disorders volunteered for the study. Pearson correlation was used to compare the anterior-- posterior (AP), medio-lateral (ML), and the overall stability indexes measured by BBS, with the corresponding parameters of TTS assessed via force plate. There was no significant correlation between any parameters of dynamic stability measured by force-plate and the stability indexes. However, there was a significant correlation between the resulting vectors and the AP component of TTS for each jump protocol. Furthermore, forward drop landing exhibited shortest TTS in AP direction, while lateral drop landing resulted in longer ML TTS relative to both forward jumps (p < 0.001). These results demonstrate that the TTS and BBS stability indexes should be used as distinct measures of dynamic postural stability. TTS protocols may be modified to target a specific training conditions or athletic population. [ABSTRACT FROM AUTHOR]

The objective of the current research was to compare the impact of balance and stabilizing trainings on balance indices in patients with nonspecific chronic low back pain. In this randomized, controlled, single-blinded clinical trial, 20 people suffering from nonspecific chronic low back pain were randomly assigned to two groups of balance and stabilizing trainings. Trainings of both groups were performed for 6 weeks and four sessions per week. The overall, lateral, and anterior-posterior stability indices, pain, and disability were measured using Biodex balance system, visual analog scale, and Oswestry scale, before and after treatment, respectively. Paired t-test and independent t-test were used for analyzing the data. In the balance group, the pain severity was changed from 6.33 ± 1.63 to 4.33 ± 2.6 (P = 0.005) and dynamic anterior-posterior stability index in the standing position on left leg with closing eyes was changed from 5.56 ± 2.25 to 3.45 ± 1. 57 (P = 0.03). In the stabilizing group, pain severity was changed from 4. 16 ± 1.47 to 1.33 ± 0.81 (P = 0.0001) and disability index was changed from 17.33 ± 5.60 to 5.33 ± 3.93 (P = 0.01). Reduction in pain and disability in the stabilizing group and increase in two balance indices were significant in the balance training group compared to those in other group (P < 0.05). Research findings revealed that the impact of stabilizing trainings was significant in reducing pain and disability compared to that in balance trainings. [ABSTRACT FROM AUTHOR]

Background: Coverage of soft tissue defects at the lower extremity may necessitate microsurgical tissue transfer, such as by fasciocutaneous anterolateral thigh (ALT) or myocutaneous musculus latissimus dorsi (MLD) flaps. Hitherto, these two flaps have not been compared systematically in terms of patient satisfaction and functional outcome. The purpose of this study was to compare patients’ satisfaction and functional outcome following ALT vs. MLD transfer. Methods: Thirty-six patients were divided into an ALT group (n=22, mean age: 42.0 years) and a MLD group (n=14, mean age: 55.5 years). Both groups were compared concerning isokinetic analysis (Biodex System III), circumference measurement, flap volume, scar size, complication rates, patients’ satisfaction, and functional outcome (SF-36 questionnaire, Foot and Ankle Outcome Score (FAOS)), hospital stay and duration of surgery.Results: Isokinetic force measurements showed a higher mean maximum force for dorsiflexion in the MLD group at an angular velocity of 60°/sec. (ALT 17.5±7.9 Nm, MLD 18.5±16.3 Nm; p0.05) in quality of life and functional outcome. Average hospital stay and duration of operation showed no differences between groups.Conclusion: In the present study, no significant differences in quality of life and functional outcome were found between ALT and MLD group. Only in isokinetic force measurement isolated significant differences with advantages of MLD group were detected. The current study provides additional information concerning ALT and MLD flaps and may support decision-making in selecting the appropriate free flap.