Sabriye Ercan

An evaluation of the lower extremity muscle strength of patients with chronic venous insufficiency

Objective In this study, the aim was to evaluate the lower extremity muscle strength in patients with chronic venous insufficiency using an isokinetic dynamometer. Methods The study comprised a group of 36 lower extremities of 23 patients diagnosed with chronic venous insufficiency and a control group of 40 lower extremities of 20 patients who did not have chronic venous insufficiency. In the diagnosis and evaluation of chronic venous insufficiency, photoplethysmography was used to evaluate the venous return circulation time. Visual Analog Scale scoring was applied to define the level of pain of the patients. Muscle strength measurements were made in all the lower extremities by using an isokinetic dynamometer. Results A statistically significant difference was detected between the groups in terms of the muscle strength parameters in the ankle plantar flexion, and knee flexor and extensor muscles. However, no statistically significant difference was found between the groups in the ankle dorsiflexion muscle strength parameters. A significant difference was determined in the ratio of ankle dorsiflexion/plantar flexion muscle strength between the mild, moderate and severe venous insufficiency groups. A statistically considerable negative correlation was found between the Visual Analog Scale scores and the photoplethysmography results. According to the Visual Analog Scale results, as the degree of venous insufficiency increased, so did the level of pain. Conclusion Impaired lower extremity muscle strength was observed in chronic venous insufficiency patients. Although the current study was consistent with literature in respect of impaired calf muscle strength, this finding was also seen in the thigh muscles. Furthermore, we concluded that if venous insufficiency becomes more severe, impaired calf muscle strength becomes more evident.

Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency

Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly (p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.

Qualifications of Safe Return to Play Criteria

Anterior cruciate ligament (ACL) injury has various negative implications for thigh muscle function, including reduction of muscle strength and instability of torque. Conservative treatment and / or surgical procedures may be preferred by considering patient’s age, activity level, additional injury and the patient’s expectations. Aim of ACL surgery in athletes is to allow a safe return to preoperative activity level. Literatures have shown different criterias about returning to sports. Some of these criterias are time after surgery, negative Lachman and Pivot shift tests, range of motion, extension/flexion muscle strength of the knee, functional knee tests and lower limb symmetry indexes. Although these criteria provide, second-injury risks are high within 2 years of primary ACL reconstruction. The risk of re-injury rates for the ACL vary between 0 and 19% for the ipsilateral side and between 7 and 24% for the uninjured contralateral knee. The purpose of this study was to investigate value of knee function between the return to normal knee function following ACL reconstruction (ipsilateral and uninjured contralateral side) and the healthy knees, and present recommendation for reduce the risk of rerupture. Totally 14 healthy male and 15 male patients who had unilateral ACL reconstruction, followed knee rehabilitation programme regularly and returned to normal knee function following after minimum 8th month the operation participated in the study. We applied Tegner activity level, Lysholm knee score, operated, intact and healthy knee range of motion, one leg hop test, flamingo balance test, isokinetic muscle strength test and proprioception test in the study. No statistically significant differences were found in the demographic data, activity level, and knee score between groups (p>0,05). The test that assesses passive joint position sense at 30˚ showed statistically significant differences between operated and intact non-operated knee (p<0,05). This data was better at operated knee. There were statistically significant differences in functional tests, isokinetic hamstring muscle test at operated knee and proprioception test between patients and control groups (p<0,05). Arthrogenic muscle inhibition occurs bilaterally after unilateral ACL ruptures. Thus, normal lower limb symmetry determined by tests. On the other hand; muscle strength, motor coordination, proprioception and knee function may be insufficient compared to healthy control groups. For this reason, we should consider that it is important to improve bilateral lower extremity functions at ACL rehabilitation program. Datas of operated and non-operated knee and control group Operated side Non-operated side Control group Flexion ROM (˚) 130 131,67 130,5 Extension ROM (˚) 1,27 0 0 Flamingo balance test EV 1,53 1,33 2,5 One leg hop test (cm) 108,22 123 142,67 Prop active 30˚ AEV 5,73 5,8 1,45 Prop active 45˚ AEV 5,27 6,13 2,18 Prop active 75˚ AEV 5,27 4,2 2,3 Prop passive 30˚ AEV 2,27 6,13 1,79 Prop passive 45˚ AEV 4,33 3,8 1,33 Prop passive 75˚ AEV 3,07 3,6 1,51 Extension PT (Nm) 168,9 193,2 179,07 Extension PT/BW (%) 222,27 253,87 250,93 Extension IPT (Nm) 99,21 112,8 108,57 Extension TWD (Nm) 1437,29 1575,4 1526,86 Flexion PT (Nm) 91,87 100,6 111 Flexion PT/BW (%) 118,13 129,47 157,5 Flexion IPT (Nm) 61,86 68,27 72,14 Flexion TWD (Nm) 797,93 818,67 885,86 ROM: Range of motions, cm:centimeter, EV: Error value, Prop: Proprioception, AEV: Absolute error value, PT: Peak torque, PT/BW: Peak torque/body weight, IPT: Initial peak torque, TWD: Total work done, Nm: Newtonmeter

The Effect of Applying Rigid Taping to Quadriceps Muscles on Knee Extension Strength and Jumping Distance

Objectives: The scientific literature is insufficient to support the use of elastic or rigid taping for the prevention or treatment of musculoskeletal injury or performance enhancement. The aim of this study was to analyze the effects of applying rigid taping on the knee extension strength and lower limb function in healthy subjects. Methods: Twenty eight healthy volunteers (age: 20.9 ± 1.1 years) were randomly assigned to two groups of 14 subjects each: Placebo/sham tape and rigid tape (Rigid tape application over the same muscles). All individuals were assessed for single and double leg hops and peak isometric and concentric isokinetic torque before and after interventions. Results: There were no statistically significant differences in jumping distances, isometric peak torque, isokinetic peak torque and total work done between groups. Conclusion: Application of rigid tape to quadriceps muscles did not significantly change lower limb functions, jump distance and knee extensor peak torque in healthy sedentary subjects.