Rupture of the anterior cruciate ligament (ACL) increases anterior-posterior (AP) laxity. The treatment aims to reduce or teach the patient to control this instability. Altered kinematics due to absent ligament function may result in knee arthrosis. This study evaluated the clinical and functional results of reconstructive surgery. Roentgen stereophotogrammetry (RSA) was used to analyse the stabilising effect of knee braces, reconstructive surgery and the kinematics of the knee with and without weight-bearing. The stability of the knees were assessed in 86 patients with ACL injuries before and/or after reconstructive surgery with the RSA technique and with the KT-1000 arthrometer The KT- 1000 (89 N) recorded smaller side to side differences than the RSA set-up without any correlation between the methods. The effect of three different braces on the AP and rotatory laxity was studied on patients with ACL injuries. The ECKO and the modified Lenox Hill reduced the instability with about one third. The SKB had no significant effect. None of the braces decreased the internal rotatory laxity but the Lenox Hill reduced the external rotatory laxity. Thirty-two patients with old ACL tears were treated with surgical reconstruction using the over the top technique (OTT) with or without augmentation. A small reduction in AP laxity was observed at the 6 month follow-up, The AP laxity was almost the same two years after as before surgery. No correlation was observed between the stability and knee function. Fifty-four patients with old unilateral anterior cruciate ligament injuries were randomised either to the over the top (OTT) or the isometric femoral tunnel position (ISO) at ACL reconstructive surgery. Seven of 24 (ISO) and 9 of 25 (OTT) had "normal" laxity two years after surgery. The patients operated with the ISO technique did not have better subjective knee function, muscle strength, functional performance or knee stability than patients operated with the OTT technique. The knee kinematics in patients with chronic unilateral ACL ruptures were examined during active extension in the supine position (13 patients) and during extension and weight-bearing (13 patients). The tibia displaced at an average 1.9 mm more anteriorly and 0.8 mm distally in the injured than in the intact knees during active extension. During extension and weightbearing the tibia was about 2 mm more posteriorly positioned than in the intact knee. The ACL rupture did not affect tibial rotations. Conclusions: The RSA recorded larger side to side differences in ACL injured and reconstructed patients than the KT-1000 arthrometer. Some knee braces are able to reduce AP laxity in ACL injured knees. No correlation was observed after surgery between knee laxity and functional scoring or tests. ACL reconstructions with isometric graft position on the femoral side did not offer any advantages compared to the over the top placement. Altered knee kinematics in the ACL injured knees were observed during knee extension with and without weight-bearing. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 6 uppsatser</p> / digitalisering@umu

The purposes of this study is to determine: (a) the relationship between the dependant variables, (b) the relationship between the Borg pain scale and the performance tests, (c) the difference in performance between involved and uninvolved extremities, and (d) the effects of the three different therapeutic exercise treatments on selected performance tests and pain free isometric strength testing. Fifty subjects with physician diagnosed anterior knee pain (AKP), completed initial performance testing and 14 subjects completed initial testing, therapy and six weeks later final performance testing. The 14 subjects were randomly assigned to one of three therapeutic exercise treatment groups. The performance tests included; pain free isometric strength tests (90, 60, 45, and 15 degrees knee flexion), stair test, timed hop, triple hop, crossover hop, Figure 8 and Borg pain scale rating for each performance test. The results indicated a significant correlation between performance tests and pain free isometric strength tests. There was no relationship indicated between the performance tests, Borg pain scale ratings. The contrast between the injured and uninjured extremities performance test values of the fifty subjects that completed the initial testing indicated no significant (p< 0.05) difference. The results of this study indicated that there was no significant difference between the therapeutic exercise treatment groups. In conclusion, the three anterior knee pain treatments had no effect on strength and performance. / School of Physical Education

Background: Whole-body vibration (WBV) has been proposed as a viable alternative, or adjuvant to exercise for power development in athletes. More recently individualized frequency (I-Freq) has been introduced with the notion that individuals may elicit a greater reflex response to different levels (Hz) of vibration. Purpose: The aim of the study was to evaluate acute WBV as a feasible intervention to increase power in trained cyclists. Additionally, to evaluate the efficacy of utilizing I-Freq as an alternative to 30Hz, a common frequency seen in the literature. Methods: Twelve highly-trained, competitive male cyclists (age= 29.9 yrs ± SD 10.0; body height=175.4 cm ± SD 7.8; body mass= 77.3 kg ± SD 13.9) free of musculoskeletal injury or pathology participated in the study. The Wingate test for anaerobic power was administered on three occasions following a control of no vibration, 30 Hz, and I-freq. Measures of peak power (PP), average power (AP) and rate of fatigue were recorded and compared to the vibratory conditions using separate RM-ANOVA’s. Results: PP, AP, and rate of fatigue were not significantly impacted by 30 Hz and I-Freq vibration interventions (p > 0.05). Conclusion: Acute WBV using the parameters of the present study may not have been practical to elicit an increase in power as potential changes in the highly trained population may have been muted as a function of training status. / School of Physical Education, Sport, and Exercise Science

The purpose of this investigation was to examine the effects of 20 years of distance running training on the morphological and functional characteristics of skeletal muscle. Sixty men (current age = 49.2 ± 2.4 yr.) were first studied between 1966-1974 when they were all highly trained. Based on their training regimens in the interim between testing, subjects were described as highly trained (HI), fitness trained (FIT) or untrained (UT). Gastrocnemius muscle biopsy samples revealed an increase (p<0.05) in the proportion of type I fibers of the FIT (52.9 ± 5.3 vs. 61.9 ± 5.2%) and UT (56.3 ± 2.9 vs. 65.4 ± 3.8%) groups, while the HI group, who was initially characterized by a high percentage (>70%) of type I muscle fibers, was unchanged. Among the elite distance runners who had continued high volume, high intensity running, succinate dehydrogenase (SDH) activity and type I and type II muscle fiber areas were similar between evaluations. In 1993, the HI group had higher (p<0.05) SDH and citrate synthase (CS) activities compared with the FIT and UT groups, whereas phosphorylase activity did not differ. Capillary density and capillary-to-fiber ratio were also greater (p<0.05) in the HI group compared with the other two groups. Isokinetic plantar flexion strength at 60°/s and 180°/s and cross-sectional area (CT scans) of the lower leg (gastrocnemius and soleus) were similar among groups. These data suggest that aging may have a significant effect upon the distribution of muscle fibers and may be dependent upon fiber composition as a young adult. In addition, sustained endurance training appears to maintain the oxidative characteristics of the skeletal muscle, but does not provide an advantage in absolute calf muscle strength compared with individuals who train considerably less or not at all. / School of Physical Education

Aerobic exercise (AE) may interfere with muscle adaptations induced by resistance exercise (RE). Three experimental campaigns were conducted to explore the influence of AE on molecular, functional and muscular adaptations to acute and chronic RE. Twenty-nine men performed unilateral knee extensor RE preceded by AE (AE+RE). The contralateral leg did RE only. First, the influence of acute AE on muscle molecular responses to RE performed 6 h later was studied. Subsequently, this exercise regimen was implemented over 5 weeks training. The relationships between acute and chronic outcomes were examined and molecular responses to acute exercise were assessed in untrained and trained muscle. Finally, acute and chronic responses to AE+RE, interspersed by only 15 min recovery, were investigated.Phosphorylation of mTOR and p70S6K was greater after AE+RE than after RE. In parallel, myostatin was suppressed for a longer time after AE+RE. These results suggest that AE+RE enhance skeletal muscle anabolic environment more than RE alone (Paper I). After 5 weeks training, improvements in muscle strength and power were similar across legs. However, AE+RE prompted a greater increase in muscle size than RE, suggesting that AE potentiates the hypertrophic stimulus to RE training without altering muscle function progress (Paper II). Consistent with changes in whole-muscle size, AE+RE showed greater anabolic molecular responses than RE. As chronic training blunted this effect, it appears that AE offers a synergistic hypertrophic stimulus to RE only during short-term training (Paper III). Although putative regulators of hypertrophy such as p70S6K, myostatin and PGC-1a4 were examined, no molecular marker correlated with changes in muscle size, strength or power induced by training. Hence, this study challenges the concept that single molecular markers are viable predictors of training-induced muscle adaptations (Paper III–IV). When recovery time between exercise bouts was reduced to 15 min, AE+RE still produced a more substantial increase in muscle size than RE. However, progression of concentric strength was blunted. Thus, while restored muscle function between exercise bouts is a prerequisite for achieving maximal gains in strength and power, incomplete recovery appears not to compromise muscle hypertrophy (Paper V).Collectively, the results suggest that outcomes of AE+RE are impacted by chronic training and time allowed for recovery between exercise modes. Yet, the current study offers no support to the view that AE interferes with muscle hypertrophy induced by RE.

The purpose of this study was to examine the effects of two different repetition maximum (RM) loads and training patterns on acute neuromuscular responses. Twenty one resistance-trained males performed 4 protocols of dynamic constant external resistance exercise, involving elbow flexors, that manipulated either load (5RM, 10RM) or training pattern (TP). For TP the subjects completed 4 sets of exercise with 3 min rest between exercise performing each set to fatigue which produced a decrease in the number of repetitions with each subsequent set (DTP); the second testing pattern involved performing the same number of sets and repetitions to the DTP but in a reverse order so that the repetitions ascend with each subsequent set (ATP). Volume load (VL) was equated for both patterns but the set in which the greatest VL was achieved occurred at different times in the workout, either in the 1st (DTP) or 4th (ATP) set of the exercise. Both TPs were conducted with a 5RM and 10RM load. Fatigue was assessed by changes in maximum voluntary isometric contraction (MVIC), motor unit activation (MUA), muscle twitch characteristics (peak twitch [PT], time to peak twitch [TPT], and 1/2 relaxation time [1/2 RT]). All protocols produced significant changes pre to post fatigue (p A).05) for MVIC, MUA, PT, 1/2RT, and TPT. 5RM/ATP, 10RM/DTP, and 1 ORM/ATP protocols produced significant changes in MUA. PT was found to be significantly different across loads. The results indicate that central fatigue is independent of load and pattern whereas peripheral fatigue appears to be dependent on load.

The overall aim of this thesis was to investigate postural balance, physical activity, physical capacity and their associations in young people (16-20 years) with intellectual disability (ID), mild to moderate. The aim was also to study the reliability and concurrent validity of postural balance tests. To evaluate postural balance, one assessor used five common postural balance tests and one new test. The tests were performed twice for 89 young people with ID (one to twelve days apart). Intraclass correlation coefficients greater than 0.80 were achieved for four of the common balance tests: Extended Timed Up and Go Test (ETUGT), Modified Forward Reach Test (MFRT), One-Leg Stance Test (OLS), and a Force Platform Test (FPT). The smallest real difference ranged from 12% to 40%; less than 20% is considered to be low. For the six balance tests, the concurrent validity varied between none to low. Falls are more common for young people with ID compared to young people without ID. One reason could be impaired postural balance. The postural balance for young people with ID has not been thoroughly investigated. Therefore, five balance tests and three muscle strength tests were used to compare young people with ID with an age-matched control group without ID (n=255). The young people with ID had significantly lower scores on most of the postural balance tests and muscle strength tests of the trunk and lower limbs. Muscle strength, height, and body mass index had no strong association with postural balance. The results also illustrated that young people with ID did not rely more on vision for their balance ability compared to peers without ID. It seems that postural balance is impaired for young people with ID when evaluated with common tests. An everyday situation is to react to unexpected balance disturbances to avoid falls by using different postural responses. Since young people with ID seem to fall more often than peers without ID, it is valuable to investigate if those postural responses are different between the groups. Therefore, young people with and without ID (n=99) were exposed to six backward surface translations and several postural muscle responses were evaluated: muscle synergies and strategies, muscle onset latency, time-to-peak amplitude, and adaptation. The responses of the investigated muscles – the gastrocnemius, the biceps femoris, and the erector spinae L4 level – were measured using electromyography. The results showed that there were no differences between the two groups with respect to synergies or strategies, muscle onset latency, and time-to-peak amplitude. An overall pattern was seen, that young people with ID adapted their muscle response slower in all three muscles than peers without ID, but this pattern was not statistically significant. Studies have shown that people with ID have impaired postural balance, a lower level of physical activity, and lower aerobic capacity compared to people without ID. The association is however not investigated. Therefore, postural balance (postural sway indirectly measured with the subjects standing on a force platform), physical activity (measured with a pedometer), and aerobic capacity (measured with a sub-maximal ergometer cycle test) were used to assess young people with and without ID (n=106). To investigate the subjects’ view of their own health, the subjects completed an adapted questionnaire that addressed their perceived health. The analysis showed no significant associations between postural balance, level of physical activity, and aerobic capacity. The subjects in the ID group, both men and women, had significantly lower aerobic capacity compared to subjects without ID. The answers from the health questionnaire did not correspond to the measured outcomes from the physical tests for young people with ID. In conclusion, ETUGT and MFRT can be used to evaluate change in postural balance over time in young people with mild to moderate ID. The low concurrent validity suggests that the postural balance tests probably challenge various subsystems. Young people with ID have impaired postural balance and perform lower on muscle strength tests than age-matched controls. Postural muscle responses after external perturbations seem to be similar for young people with and without ID, but the ability to adapt muscle responses after repeated perturbations appears to be slower for young people with ID. The studies in the thesis also indicate that young people with ID have reduced level of physical activity and lower aerobic capacity. The lack of association between the different physical functions indicates that they should be evaluated and exercised separately. Young persons with ID might have more difficulty realising the health advantage of being physically active, as they do not seem to make this connection. Because of this, it is important that parents/guardians, school staff, physiotherapists, and others encourage them to participate in physical activity.

No description available.

Muscle strength is assumed to be closely related with BMD, the so called determinant of bone strength, however, new methods for bone strength measurement are arising. The purpose of this study was to determine the relationship between bone mineral density (BMD), muscle strength and natural frequency of the radius in the dominant and non-dominant arm in healthy and osteopenic individuals aged between 50-70 years. Sixty sedentary male (thirty healthy and thirty osteopenic) participated this study. Bone mineral density assessment was performed by dual x-ray absorbtiometry (DEXA) and quantitative computed tomography (QCT), whereas muscle strength was measured by an isokinetic dynamometer quantitatively. Natural frequency of the radius was determined by a dual channel frequency analyzer. Differences between BMD, muscle strength and natural frequency in healthy and osteopenic participants according to dominancy were examined by Analysis of Variance (ANOVA). Pearson Product Correlation Coefficient test was conducted to determine the magnitude of the correlation between cortical, trabecular and average BMD, muscle strength and natural frequency. Results demonstrated a statistically significant difference between BMD, natural frequency and muscle strength in the dominant arm of both groups. There was also a significant difference in the non-dominant arm in terms of BMD, natural frequency and muscle strength, except in total work in the non-dominant arms. Moreover, there was a moderate positive correlation between BMD measured by DEXA and natural frequency in the dominant arm (r = ,59 / p &lt / .001) and non-dominant arm (r = 0,64 / p &lt / 0.001), whereas the muscle strength was correlated to BMD with a low positive correlation in terms of peak torque in extension (r = ,36 / p = ,005), peak torque in flexion (r = ,31 / p = ,016), total work in extension (r = ,28 / p = ,030) and total work in flexion (r = ,27 / p = ,041) in the dominant arms. The correlation between muscle strength and BMD was not significant in the non-dominant arm. The highest correlation between natural frequency and bone geometry parameters was observed in cortical thickness (r = ,82 / p = ,02). A statistically significant positive correlation (r = ,81 / p = ,04) was also observed between average BMD measured by QCT and by DEXA. In summary, according to the findings of this study, it can be concluded that vibration analysis is a precise method in predicting bone strength that depends highly on its size, shape and the distribution of its trabecular and cortical components.

TThis thesis looks at the development of a Hand and Wrist Strength Gauge. The gauge was developed by the author at the Flinders Medical Centre Occupational Therapy Department in 1997. / thesis (MApSc(OccupationalTherapy))--University of South Australia, 2003.