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1.
Patients with osteoarthrosis suffer from disability and pain. We measured isokinetic and isometric peak torque in 20 women with gonarthrosis (GA) and in 26 healthy controls. Relationships between muscle strength, walking and stair climbing time, pain level and pain disability scores as assessed by the patients using an extensive questionnaire, radiological changes and subchondral sclerosis expressed as bone mineral density (BMD, g/cm2) of the proximal tibia were studied. Precision errors of the torque measurements in both GA patients and controls were approximately 6%. In the GA patients, isokinetic and isometric quadriceps strength was reduced by 40 and 15% (p < 0.01) respectively, and walking and stair climbing time was increased by 30% (p < 0.005). Isokinetic strength was a better predictor of pain level and pain disability scores than isometric strength and radiological stage. Walking time and stair climbing time were not associated with quadriceps strength, pain level, pain disability scores or radiological changes. Subchondral BMD was not predictive of pain. The study suggests that quadriceps strength assessed by isokinetic dynamometry in GA is a reliable measurement. Isokinetic strength was pronouncedly reduced compared to isometric strength and was a more important predictor of pain and pain disability than isometric strength. These findings should be taken into consideration when planning exercise studies and programmes in GA.  相似文献   

2.
The prevalence of lumbar disc degeneration in subjects suffering from low-back pain (n = 207; age range 10-49 years) and in age-matched asymptomatic controls (n = 216) was investigated by magnetic resonance imaging. The percentage of subjects with degenerated discs increased with age; starting from the age of 15 years, this increase was more rapid in subjects with low-back pain. Concurrently, the number of degenerated discs was higher in the pain group than in controls. Lumbar disc degeneration manifests earlier and in a greater percentage of subjects with low-back pain than in asymptomatic controls.  相似文献   

3.
Our surveys have shown lifetime prevalence of L.BP. over 30% among schoolchildren. The purpose of this study was to evaluate the relationship between back and isokinetic trunk strength, anthropometric parameters, and sports activities. One hundred and seventeen healthy children aged 10-16 years were included. All these volunteers had semi-structured interview, anthropometric and dynamic strength measurements. Lifetime prevalence of back pain was 44.5% and point prevalence was 13%. In this cross-sectional study, anthropometric and strength profiles were significantly related to age and gender. Non specific low back pain was not correlated to trunk muscle strength and/or sports activities.  相似文献   

4.
The effects of exercise for isolated lumbar extensor muscles were examined in 54 chronic low-back pain patients. Subjects were randomly assigned to a 10-week exercise program (N = 31) or a wait-list control group (N = 23). Results indicated a significant increase in isometric lumbar extension strength for the treatment group and a significant reduction in reported pain compared with the control group (P 0.05). Treated subjects reported less physical and psychosocial dysfunction whereas the control group increased in pain, and physical and psychosocial dysfunction. There were no concomitant changes in reported daily activity levels. These results show that lumbar extension exercise is beneficial for strengthening the lumbar extensors and results in decreased pain and improved perceptions of physical and psychosocial functioning in chronic back pain patients. However, these improvements were not related to changes in activities or psychological distress.  相似文献   

5.
The associations between low-back pain and occupational work loads, life-style factors, and sociodemographic factors were examined in 469 steel plant workers (436 males, 33 females), mean age (sd): 40 (12) years. Fifty-one per cent had experienced low-back pain during the preceding year. The strongest associations were found between recent low-back pain and domestic recreational activities (> or = h/wk vs 0-2 h/wk), and between recent low-back pain and work pace (too fast vs. adequate), odds ratios (95% confidence limits) being respectively 3.0 (1.5-5.8), and 2.3 (1.2-4.2). We considered a subject to have a particularly severe history of low-back pain if he or she due to low-back trouble (i) had ever been admitted to a hospital, (ii) had ever had to change work or, (iii) had had more than one week's sick-leave accumulated during the preceding year. There was a strong association between a severe low-back pain history and life-time occupational exposure to heavy and frequent lifting on the job. Forty-seven per cent of severe low-back pain events could be ascribed to heavy and frequent lifting, provided the associations were causal. We conclude that domestic recreational activities may be an important potential confounder in studies on occupational risk factors for low-back pain, and that, based on the results of this and of other studies, a case for prevention still seems to exist regarding lifting of heavy burdens in the work environment.  相似文献   

6.
There is conflicting evidence regarding the efficacy of various resistance training programs for increasing strength in trained and contralateral limbs. The purposes of this investigation were to examine the effects of unilateral velocity-specific concentric isokinetic training of the extensor and flexor muscles of the elbow and knee on: 1) the carry-over effect in strength increases to velocities other than the training velocity in the trained limbs and 2) the cross-training effect at various velocities in the contralateral limbs. Twelve adult men (mean age +/- SD = 24 +/- 6 years) volunteered to train their nondominant extremities three times per week (six sets of 10 maximal repetitions) for 8 weeks at 120 degrees/sec using a Cybex II isokinetic dynamometer. The subjects were tested for increases in peak torque at 60, 120, 180, 240, and 300 degrees/sec. The training resulted in significant (p < 0.05) increases in peak torque on the trained side of the body for elbow extension and flexion as well as knee extension and flexion at all velocities tested. These findings indicated that the velocity-specific training resulted in increases in peak torque at velocities that were both greater and less than the training velocity. In addition, there was a cross-training effect, with significant (p < 0.05) increases in peak torque on the contralateral side of the body for elbow extension (all velocities except 300 degrees/sec) as well as knee extension and flexion (all velocities). These results indicate that unilateral velocity-specific concentric isokinetic training is adequate stimulus for eliciting strength gains at a wide range of velocities in both the trained and contralateral limbs.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

7.
OBJECTIVES: This study investigated how age, sex, height, body weight, self-efficacy beliefs, pain, and subjective disability predict the performance of low back pain patients on an isokinetic trunk muscle test. METHODS: One hundred and five patients participated in the study. Dependent variables were isokinetic flexion and extension strength measured as total work done at speeds 50, 100, and 150 degrees/second. RESULTS: The anthropometric measures were poor predictors, height being the only significant one. Body weight and age were of no relevance for the performance. Subjective pain and disability had negative effects on the performance of men, but not of women. Self-efficacy beliefs, i.e., the patient's belief in his or her capability to endure physical activities, was the most powerful predictor. CONCLUSION: For the purpose of validation, standardization, and interpretation of isokinetic performance in low back pain patients, these factors should be taken into account.  相似文献   

8.
Fifty-four patients with dysplastic hip and secondary degenerative arthrosis (58 hips) underwent rotational acetabular osteotomy (RAO) using a conventional anterior-posterior method or a new technique involving detachment of the greater trochanter. Pre- and postoperative hip abductor strength (HAS) and knee extensor strength (KES) were evaluated using an isokinetic dynamometer. Postoperative HAS in patients treated by detachment of the greater trochanter reached preoperative levels 16 weeks postoperatively. Comparison of the postoperative HAS based on the two different surgical approaches showed that RAO by detachment of the greater trochanter was superior to the conventional method. Pre- and postoperative HAS showed a good correlation. Postoperative improvements in HAS over presurgical values were not significant in patients with advanced-stage arthrosis and severely dysplastic hips. Preoperative HAS should serve as an index for determining whether RAO is undertaken using detachment of the greater trochanter.  相似文献   

9.
Continues a series of studies measuring the acceptance accorded to former mental patients. The procedure was to send a confederate in the guise of a job applicant to be evaluated by a worker already on the job. The 12 male workers were told either that the female applicant was an ex-mental patient or that she was an ordinary applicant, and for each condition the confederate was calm for half of the Ss and nervous for the rest. The studies show that women are more accepting of former patients than men and that men are more accepting of female than male ex-patients. Nervous applicants were rejected by workers of both sexes. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

10.
11.
Pain drawings were obtained from a group of 651 patients who had chronic low-back pain. Pain drawings were rated in four grades according to the degree of organic and nonorganic pain. Experienced and inexperienced evaluators were used. The reliability was excellent with an interevaluator reliability between 73% and 78%. A correlation between pain drawings and Waddell's nonorganic physical signs demonstrated that a large proportion of patients with high Waddell scores had nonorganic pain drawings. No significant differences were noted in the distribution of Waddell scores and pain drawings based on patient gender or payment status (i.e., medicolegal or workers' compensation). Pain drawings afford an important adjunct in the physician's assessment of chronic low-back pain.  相似文献   

12.
PURPOSE: To determine whether isokinetic training can improve the strength of the hemiparetic knee musculature, functional mobility, and physical activity and to evaluate its effect on spasticity in long-term stroke survivors. DESIGN: Nonrandomized self-controlled trial. SUBJECTS: A volunteer sample of 15 community-dwelling stroke survivors of at least 6 months. INTERVENTION: A 6-week (3 days/week, 40 minutes/day) program consisting of warm-up, stretches, reciprocal knee extension and flexion isokinetic strengthening, and cool-down for the paretic limb. MAIN OUTCOME MEASURES: Peak isokinetic hamstring and quadriceps torque, quadriceps spasticity, gait velocity, timed Up and Go, timed stair climb, and the Human Activity Profile (HAP) scores were recorded at baseline, after training, and 4 weeks after training cessation (follow-up). RESULTS: Paretic muscle strength improved after training (p < .05) while tone remained consistent (p > .87). Gait velocity increased after training (p < .05) and at follow-up (p < .05). Changes in stair climbing and timed Up and Go were not significant (p > .37; p > .91), although subjects perceived gains in their physical abilities at follow-up (p < .01). CONCLUSIONS: Gains in strength and gait velocity without concomitant increases in muscle tone are possible after a short-term strengthening program for stroke survivors. The psychological benefit associated with physical activity is significant.  相似文献   

13.
Studied the effect of the previous job applicant upon ratings of test results for the following applicant. 2 informational aspects of the previous job applicant were varied: overall level of information favorability, and order of information within the previous job applicant. Interviewers were life insurance agency managers who through classroom instruction had been trained in the interpretation of test results. Results indicate that 55% of the criterion variance was accounted for by the test results while the favorability of the previous job applicant accounted for 4%. Thus, although the quality of the previous job applicant had a statistically significant effect on the evaluation of valid test results, its effect on the employment decision was negligible. By implication, the results also points to the necessity of building models on additional criteria than statistical significance. (25 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

14.
An experiment was conducted to examine the role that maximal lifting power has in predicting maximum acceptable weight of lift (MAWL) for a frequency of one lift per 8 h. The secondary aim of the study was to compare the ability of power to predict MAWL to previously used measures of capacity including two measures of isometric strength, five measures of isokinetic strength, and isoinertial capacity on an incremental lifting test. Twenty-five male subjects volunteered to participate in the experiment. The isometric tests involved maximum voluntary contractions for composite lifting strength at vertical heights of 15 and 75 cm. Peak isokinetic strength was measured at velocities of 0.1, 0.2, 0.4, 0.6 and 0.8 m s-1 using a modified CYBEX II isokinetic dynamometer. Isoinertial lifting capacity was measured on the X-factor incremental lifting machine and peak power was measured on the incremental lifting machine by having subjects lift a 25 kg load as quickly as possible. The results indicate that peak isoinertial power is significantly correlated with MAWL, and this correlation was higher than any of the correlations between the other predictor variables and MAWL. The relationships between the isokinetic strength measures and MAWL were stronger than the relationships between the isometric measures and MAWL. Overall, the results suggest that tests used to predict MAWL should be dynamic rather than static.  相似文献   

15.
OBJECTIVE: To determine whether female college athletes had increased muscle strength and bone mass in comparison with age-matched nonathletic female subjects and, if so, whether participation in weight-bearing versus non-weight-bearing exercise made a difference. MATERIAL AND METHODS: We performed a comparative statistical analysis of the bone mineral density (BMD) of the total body, lumbar spine, and femoral neck, maximal oxygen uptake (VO2max), muscle strength, and level of physical activity in 21 runners, 22 swimmers, and 20 control subjects. The study participants were female college students, 18 to 24 years old, who had had more than 8 normal menstrual cycles during the past year. RESULTS: Statistical analyses showed significantly higher VO2max in the two athletic study groups than in the control subjects (P < 0.0001). No significant difference in BMD was noted among the three groups. Total body BMD (r = 0.30; P = 0.02) and femoral neck BMD (r = 0.39; P = 0.002) were positively correlated with weight-bearing activity but not with non-weight-bearing activity. VO2Max (an index of physical fitness) was positively correlated with femoral neck BMD (r = 0.33; P = 0.009) and trochanteric BMD (r = 0.29; P = 0.021). Shoulder muscle strength (determined by isokinetic dynamometry) was positively correlated with total body BMD (r = 0.34; P = 0.007) and lumbar spine BMD (r = 0.28; P = 0.028). Swimmers had higher muscle strength in the back and upper extremities than did runners and control subjects. Hip girdle muscle strength was not significantly different among the three groups. Total body BMD had a positive correlation with percentage of body fat and height. Lumbar spine BMD was higher in subjects who had previously used oral contraceptives. The athletes had a lower percentage of body fat, were less likely to have used oral contraceptives, and had fewer years of normal menses than did the control subjects. CONCLUSION: Our study shows that (1) total body BMD and femoral neck BMD were significantly higher in the study group that performed weight-bearing exercises than in control subjects, (2) swimming exercise had no effect on BMD, and (3) although swimming is not a bone-building exercise, it can significantly improve shoulder, back, and grip muscle strength.  相似文献   

16.
The thigh and lower leg of six patients with prior polio were examined using magnetic resonance imaging (MRI), and the strength of their weak foot dorsiflexors was measured isokinetically. Spinecho images of the lower extremities were visually evaluated on a semi-quantitative four-point scale, and T1 and T2 relaxation times of the lower leg anterior compartment were analysed. There were prominent MRI signs of randomly distributed muscle degeneration. The high signal intensity changes in the affected muscles on T1-weighted images and T1 and T2 values indicated replacement of muscle fibres with fat and the accumulation of tissue water, respectively. MRI findings were compared with isokinetic strength in foot dorsiflexor muscles. Foot dorsiflexor peak torque values at 30 deg/s ranged from 6 to 29 Nm. There was no significant correlation between MRI visual scoring, T1 and T2 relaxation times and peak torque values at 30 deg/s. However, the most severe MRI changes with visual scoring and T2 relaxation times were observed in the patients with the most pronounced muscle weakness.  相似文献   

17.
Hemodynamic, cardiac, and hormonal responses to lower-body negative pressure (LBNP) were examined in 24 healthy men to test the hypothesis that responsiveness of reflex control of blood pressure during orthostatic challenge is associated with interactions between strength and aerobic power. Subjects underwent treadmill tests to determine peak oxygen uptake (VO2max) and isokinetic dynamometer tests to determine knee extensor strength. Based on predetermined criteria, subjects were classified into one of four fitness profiles of six subjects each, matched for age, height, and body mass: (a) low strength/average aerobic fitness, (b) low strength/high aerobic fitness, (c) high strength/average aerobic fitness, and (d) high strength/high aerobic fitness. Following 90 min of 0.11 rad (6 degrees) head-down tilt (HDT), each subject underwent graded LBNP to -6.7 kPa or presyncope, with maximal duration 15 min, while hemodynamic, cardiac, and hormonal responses were measured. All groups exhibited typical hemodynamic, hormonal, and fluid shift responses during LBNP, with no intergroup differences between high and low strength characteristics. Subjects with high aerobic power exhibited greater (P < 0.05) stroke volume and lower (P < 0.05) heart rate, vascular peripheral resistance, and mean arterial pressure during rest, HDT, and LBNP. Seven subjects, distributed among the four fitness profiles, became presyncopal. These subjects showed greatest reduction in mean arterial pressure during LBNP, had greater elevations in vasopressin, and lesser increases in heart rate and peripheral resistance. Neither VO2max nor leg strength were associated with fall in arterial pressure or with syncopal episodes. We conclude that interactions between aerobic and strength fitness characteristics do not influence responses to LBNP challenge.  相似文献   

18.
The afferent pathways of discogenic low-back pain have not been fully investigated. We hypothesised that this pain was transmitted mainly by sympathetic afferent fibres in the L2 nerve root, and in 33 patients we used selective local anaesthesia of this nerve. Low-back pain disappeared or significantly decreased in all patients after the injection. Needle insertion provoked pain which radiated to the low back in 23 patients and the area of skin hypoalgesia produced included the area of pre-existing pain in all but one. None of the nine patients with related sciatica had relief of that component of their symptoms. Our findings show that the main afferent pathways of pain from the lower intervertebral discs are through the L2 spinal nerve root, presumably via sympathetic afferents from the sinuvertebral nerves. Discogenic low-back pain should be regarded as a visceral pain in respect of its neural pathways. Infiltration of the L2 nerve is a useful diagnostic test and also has some therapeutic value.  相似文献   

19.
One hundred seventy-six consecutive patients with chronic low-back pain and no history of previous lumbar surgery were studied to test the clinical criteria of Fairbank et al. and Helbig and Lee for zygapophysial joint pain. All patients underwent a history, examination, and a series of zygapophysial joint injections or blocks of the medial branches of the dorsal ramus with lignocaine. Those patients responding to the first series of blocks were given confirmatory blocks using bupivacaine. None of the clinical features tested was found to be associated with response to the confirmatory block. The Fairbank et al. and Helbig and Lee criteria were shown to be unreliable in distinguishing pain of zygapophysial joint origin from pain of other origins.  相似文献   

20.
Lower extremity strength and fat-free mass were examined in 58 postmenopausal women aged 60-72 yr. Subjects were studied before and after an 11-mo control period (n = 16) or before and after an 11-mo weight-bearing exercise training program designed to generate relatively high ground reaction forces (n = 42). Twenty-two of the exercisers initiated hormone replacement therapy (HRT) at the outset of exercise and continued HRT for 11 mo. Hip extension and abduction strength were assessed using a hand-held dynamometer. Force production during knee extension and flexion was evaluated on an isokinetic dynamometer at 60, 90, and 180 degrees/s. Simultaneous knee and hip extension strength was also assessed on a leg press machine. Total body and lower extremity fat-free mass were determined using dual-energy x-ray absorptiometry. There were no significant changes in muscle strength or body composition in control subjects. Both exercise groups had significant increases in fat-free mass and in all strength measures. Fat-free mass increased from 38.8 +/- 4.3 to 39.7 +/- 4.3 kg in the exercise group and from 37.7 +/- 3.9 to 38.9 +/- 4.6 kg in the exercise-plus-HRT group. The average relative increase in strength was 16.2 +/- 11.0% in the exercise group and 17.0 +/- 13.0% in the exercise-plus-HRT group. Women receiving HRT did not have a gain in fat-free mass or in strength over and above that demonstrated by the women not on HRT. Our results provide evidence that HRT does not augment the increases in muscle mass or strength that occur in response to weight-bearing exercise in older women.  相似文献   

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