Ayodele Teslim Onigbinde

Hand and leg dominance: Do they really affect limb muscle strength?

The aim of this study was to compare the strength of selected muscle groups in 32 right- and 32 left-limb dominant subjects. Using standard procedures, we measured the isometric strength of hand grip, elbow flexion, knee extension and knee flexion. Each subjects hand grip strength ratio (GSR) was calculated. The results revealed that our right- and left-limb dominant subjects were comparable in age, weight, height and body adiposity. However, the left-limb dominant subjects exhibited stronger left-hand grip and left knee extensor strength than their right-limb dominant counterparts. Similarly, the right-limb dominant subjects exhibited greater right elbow flexor muscle strength than their left-limb dominant counterparts. The GSR for the right- and left-limb dominant subjects was similar. We recommend that separate grip strength, knee extensor and elbow flexor norms be established for right- and left-limb dominant subjects.

An assessment of knowledge and opinion of Nigerian physiotherapists on application of iontophoresis in the management of selected skin disorders and arthritis

It is becoming increasingly important to improve knowledge of physiotherapists about iontophoresis since it involves topical medications. There is need to ascertain that physiotherapists have adequate knowledge of the procedure. The primary aim of this study was to determine the opinion and knowledge level of Nigerian physiotherapists about iontophoresis. One hundred and twenty-three (123) physiotherapists were purposively selected. A structured self-administered questionnaire was used for this study. The data were analyzed using descriptive statistics. The result showed that 40 (33.3%) physiotherapists were using iontophoresis as a treatment technique for skin ulcer, hyperhidrosis, and arthritis. Sixty-six (53.7%) of all the respondents chose galvanic (interrupted galvanic) current as the mode used for applying iontophoresis, 43 (35.0%) chose wrongly, faradic current as the current mode while 14 (11.3%) are ignorant of the correct current mode. The result showed variations in electrode placement for stimulation among physiotherapists- nerve root (12.2%), myotome (10.6%), trigger or acupuncture points (22.0%) while 12.2% indicated that they had no idea of appropriate electrodes placement. There was no significant difference in the mean percentage difference in the number of respondent who were correct in the type of current format being utilized for iontophoresis procedure and those who were wrong. Also, there was no significant difference in the mean percentage difference in the number of respondent who uses different methods of electrode placement. Most physiotherapists (62.6%) chose 1-15 minutes as the duration of application for iontophoresis while 31.7% chose their parameters based on patients tolerance, experience and patients condition. It was concluded that few physiotherapists in Nigeria have adequate knowledge about iontophoresis and very few are using iontophoresis as a treatment option.

Inter-limb effects of isometric quadriceps strengthening on untrained contra-lateral homologous muscle of patients with knee osteoarthritis.

PURPOSE The primary objective of this study was to establish if there would be inter-limb crossing of strength from trained quadriceps muscles of unaffected limb to the untrained homologous group of muscles in subjects with knee osteoarthritis. METHODS Twenty-one patients with knee osteoarthritis were recruited for the study. The affected knee was not trained while the unaffected quadriceps group of muscles was trained for 6 weeks using isometric contraction exercises. The patients sat on a quadricep bench with knee flexed to 90° as starting position. An ankle strap was used to fasten the required weight for isometric training at the lower one-third of the unaffected limb. Each patient extended the unaffected knee until the leg was fully straightened, maintaining quadriceps isometric contraction for 3 to 5 seconds; and then slowly returned to the starting position; 12 repetitions and 3 sets were performed thrice a week for 6 weeks. The peak isometric quadricep strengths of both limbs were quantified with spring balance at baseline and after 6 weeks. During quantification, all the patients were verbally motivated to achieve maximum voluntary contraction at extension. The data were analyzed using descriptive statistics of mean, standard deviation and percentages. Parametric inferential statistics of dependent t-test (paired) was used to compare the pre and post values obtained. RESULTS The peak isometric quadriceps strength of the affected limb with knee osteoarthritis without training at baseline was 132.67 ± 42.26 N while at the 6th week it was 159.30 ± 49.33 N showing a significant increase of 20% (p = 0.001). For the trained unaffected knee, at onset and at 6th week, the peak isometric quadricep strengths were 158.83 ± 43.28 N and 192.00 ± 47.31 N respectively. There was significant increase of 21% in the quadriceps muscle strength of the unaffected knee after training (p = 0.001). However, there was no significant difference in the increments observed between the peak isometric quadriceps strengths of both limbs (p = 0.06). CONCLUSION We concluded that there was cross training effect on the contralateral quadriceps muscle when only the ipsilateral (unaffected) homologous muscle was strengthened.