Taner Aydin

Shoulder proprioception: a comparison between the shoulder joint in healthy and surgically repaired shoulders.

Abstract Proprioceptive mechanisms appear to play a role in stabilizing the glenohumeral joint and may serve as a means for interplay between the static stabilizers and the dynamic muscle restraints. The aim of this study was to investigate proprioception of the joint in healthy and surgically repaired shoulders. Shoulder proprioception was measured in 44 subjects who were assigned to two experimental groups: group 1, healthy subjects (n = 24); and group 2, patients who have undergone surgical reconstruction (n = 20). Joint position sense was measured with a Cybex NORM isokinetic dynamometer. The results revealed no significant differences in proprioception between the dominant and nondominant shoulders in group 1. No significant mean differences were revealed between the surgical and contralateral shoulder in group 2 under any test condition. These results imply that arm dominance in healthy individuals does not influence the proprioceptive sensibility and that reconstructive surgery appears to restore some of these proprioception characteristics.

Repair of neglected Achilles tendon ruptures: procedures and functional results

Surgical repair of neglected Achilles tendon ruptures presents the challenge of restoring the function of the Achilles tendon complex while repairing the large defect that is created by the delay in appropriate treatment. We present our preferred technique for delayed repair and the results of six patients who were available for complete follow-up evaluation. The combined surgical technique includes: V-to-Y gastrocnemius recession or advancement, excision of the fibroadipose defect, end-to-end anastomosis, gastrocnemius aponeurotic flap to reinforce the anastomosis. Each of six patients were interviewed and examined clinically and by Cybex II isokinetic strength testing. All six patients have been able to return to their pre-injury activities. Cybex II isokinetic strength testing demonstrated peak torque deficiencies in plantar flexion ranging from 2.5%–22% as compared with the unaffected limb. The overall results of the technique described indicate that very satisfactory functioning of a neglected Achilles tendon rupture can be obtained.

Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome.

Hazneci B, Yildiz Y, Sekir U, Aydin T, Kalyon TA: Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil 2005;84:521–527. Objective:The objective of this study was to demonstrate the impairment of knee joint position sense in individuals with patellofemoral pain syndrome and investigate the effects of isokinetic exercise on knee joint position sense and muscle strength. Design:A total of 24 male patients complaining of anterior knee pain caused by overexertion and 24 male healthy individuals without symptoms were included for this investigation. Isokinetic exercise protocol was carried out at angular velocities of 60 degrees/sec and 180 degrees/sec. These sessions were repeated three times per week and lasted for 6 wks. At the beginning and after 6 wks of knee passive joint position sense, quadriceps and hamstring muscle strength and pain assessments were performed. Results:After the isokinetic exercise, flexion peak torque (P < 0.05), extension peak torque (P < 0.01), flexion total work (P < 0.001), extension total work (P < 0.001), passive reproduction of knee joint position sense for 40 degrees of flexion (P < 0.05) and 50 degrees of extension (P < 0.01), and pain score (P < 0.001) improved significantly in the patellofemoral pain syndrome group. Conclusion:Isokinetic exercises have positive effects on passive position sense of knee joints, increasing the muscular strength and work capacity. These findings show that using the present isokinetic exercise in rehabilitation protocols of patients with patellofemoral pain syndrome not only improves the knee joint stabilization but also the proprioceptive acuity.

Shoulder terminal range eccentric antagonist/concentric agonist strength ratios in overhead athletes

Objective: The agonist–antagonist strength relationship for shoulder external rotation and internal rotation was formerly described by the relatively more functional ratios of eccentric external rotator to concentric internal rotator moments, and eccentric internal rotator to concentric external rotator moments for the entire range of motion. The aim of this study was to provide descriptive data for terminal range eccentric antagonist/concentric agonist rotator cuff strength in overhead athletes.

Proprioception of the ankle: a comparison between female teenaged gymnasts and controls.

Proprioceptive mechanisms appear to play a role in stabilizing the joints and may serve as a means for interplay between static stabilizers and dynamic muscular restraints. The purpose of our study was to investigate whether or not gymnastic training has any effect on the balance and on proprioception in an ankle, as seen in gymnasts and in nongymnasts. We evaluated the proprioceptive ability of the ankle using four different tests (a one-leg-standing test, a single-limb-hopping test, an active angle-reproduction test, and a passive angle-reproduction test). Proprioception of the ankle was measured in 40 subjects who were assigned to two experimental groups. Group 1 (n: 20) were healthy control subjects, and group 2 (n: 20) were teenaged female gymnasts. The sense of position of a joint was actively measured using a Cybex NORMTM isokinetic dynamometer and measured passively with a proprioception-testing device. A Mann-Whitney U test was used to compare mean values of the gymnasts to the controls. Results revealed statistically significant differences (p<0.05) between two groups. We found no statistically significant differences between the dominant and nondominant ankle in volunteers or in gymnasts, in all tests. The results of this study suggest that gymnastic training has a positive influence on sense of position of the ankle joint and on balance, in addition to increasing muscle tone.

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae

Objectives: To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score. Methods: The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60°/s (25–90° range of flexion) and 180°/s (full range). These sessions were repeated three times a week for six weeks. Results: Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found. Conclusions: The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters.

Isokinetic Muscle Performance in Major Depressive Disorder: Alterations by Antidepressant Therapy

The aims of this study were (i) to examine whether patients with major depressive disorder (MDD) differ from healthy control subjects with respect to isokinetic muscle performance (IMP) as measured by a dynamometer; (ii) to investigate the effect of subchronic treatment on the IMP in depressed patients. Thirty-eight patients with MDD, and 41 sex-and age-matched healthy controls participated in this study. The severity of depression and anxiety levels were evaluated by the Hamilton Depression and Anxiety Scales. Quadriceps and hamstring IMPs were determined by using an isokinetic dynamometer before and after subchronic antidepressant treatment. The patients had lower IMP levels than healthy controls. After treatment for three months with selective serotonin reuptake inhibitors, the IMP levels increased significantly. These findings suggest that (i) MDD may be characterized by reduced IMP levels; and (ii) treatment with antidepressants may increase the IMP levels, as a state marker for depression. It was concluded that (i) isokinetic muscle performance may be used as a state marker for monitoring antidepressant drug effects on MDD; (ii) isokinetic exercise increasing IMP may be used in the treatment of depression.