Skip to main content
Top
Published in: Rheumatology International 7/2008

01-05-2008 | Original Article

Isokinetic evaluation of knee extensor/flexor muscle strength in patients with hypermobility syndrome

Authors: Nilay Sahin, Akin Baskent, Hatice Ugurlu, Ender Berker

Published in: Rheumatology International | Issue 7/2008

Login to get access

Abstract

Benign joint hypermobility syndrome (BJHS) is a syndrome with musculoskeletal pain originating from the increased laxity of the joints and the ligaments. The study was to compare the isokinetic strength of knee extensor/flexor muscles of BJHS patients with healthy controls. Forty patients diagnosed as having BJHS with Brighton criteria and 45 years of age, height and weight-matched healthy controls were recruited for the study. Isokinetic testing was performed with isokinetic dynamometry of Biodex System 3Pro and measurements were recorded at knee extension/flexion pattern concentrically at 60, 180, and 240°/s angular velocities. The study group was also evaluated for functional impairment and pain by HAQ and VAS respectively. Knee extensor muscle strength was significantly lower in the patient group compared with the controls. It was hypothesized that the muscle weakness in the study group was related to lengthening of the quadriceps muscle and pain-related inactivity as well as joint instability and proprioception defect.
Literature
1.
3.
4.
go back to reference Silverman S, Constine L, Harvey W (1975) Survey of joint mobility and in vivo skin elasticity in London schoolchildren. Ann Rheum Dis 34:177–180PubMed Silverman S, Constine L, Harvey W (1975) Survey of joint mobility and in vivo skin elasticity in London schoolchildren. Ann Rheum Dis 34:177–180PubMed
5.
go back to reference Grahame R (2003) Hypermobility and hypermobility syndrome. In: Keer R, Grahame R (eds) Hypermobility syndrome. Elsevier, London, pp 1–12 Grahame R (2003) Hypermobility and hypermobility syndrome. In: Keer R, Grahame R (eds) Hypermobility syndrome. Elsevier, London, pp 1–12
6.
go back to reference Grahame R, Brid H, Child A (2000) The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome. J Rheumatol 27:1777–1779PubMed Grahame R, Brid H, Child A (2000) The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome. J Rheumatol 27:1777–1779PubMed
7.
go back to reference Maillard S, Murray KJ (2003) Hypermobility Syndrome in Children. In: Keer R, Grahame R (eds) Hypermobility syndrome. Elsevier, London, pp 41–43 Maillard S, Murray KJ (2003) Hypermobility Syndrome in Children. In: Keer R, Grahame R (eds) Hypermobility syndrome. Elsevier, London, pp 41–43
8.
go back to reference Kannus P, Beynnon B (1993) Peak torque occurrence in the range of motion during isokinetic extension and flexion of the knee. Int J Sports Med 14:422–426PubMedCrossRef Kannus P, Beynnon B (1993) Peak torque occurrence in the range of motion during isokinetic extension and flexion of the knee. Int J Sports Med 14:422–426PubMedCrossRef
9.
go back to reference Meireles SM, Oliveira LM, Andrade MS, Silva AC, Natour J (2002) Isokinetic evaluation of the knee in patients with rheumatoid arthritis. Joint Bone Spine 69:566–573PubMedCrossRef Meireles SM, Oliveira LM, Andrade MS, Silva AC, Natour J (2002) Isokinetic evaluation of the knee in patients with rheumatoid arthritis. Joint Bone Spine 69:566–573PubMedCrossRef
10.
go back to reference Baltzopoulos V, Brodie DA (1989) Isokinetic dynamometry. Applications and limitations. Sports Med 8:101–116PubMedCrossRef Baltzopoulos V, Brodie DA (1989) Isokinetic dynamometry. Applications and limitations. Sports Med 8:101–116PubMedCrossRef
11.
go back to reference van der Esch M, Steultjens M, Knol DL, Dinant H, Dekker J (2006) Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum 55:953–959PubMedCrossRef van der Esch M, Steultjens M, Knol DL, Dinant H, Dekker J (2006) Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum 55:953–959PubMedCrossRef
12.
go back to reference Hsieh LF, Guu CS, Liou HJ, Kung HC (1992) Isokinetic and isometric testing of knee musculature in young female patients with patellofemoral pain syndrome. J Formos Med Assoc 91:199–205PubMed Hsieh LF, Guu CS, Liou HJ, Kung HC (1992) Isokinetic and isometric testing of knee musculature in young female patients with patellofemoral pain syndrome. J Formos Med Assoc 91:199–205PubMed
13.
go back to reference Borman P, Celiker R, Hascelik Z (1999) Muscle performance in fibromyalgia syndrome. Rheumatol Int 19:27–30PubMedCrossRef Borman P, Celiker R, Hascelik Z (1999) Muscle performance in fibromyalgia syndrome. Rheumatol Int 19:27–30PubMedCrossRef
14.
go back to reference Maqeut D, Croisier JL, Renard C, Crielaard JM (2002) Muscle performance in patients with fibromyalgia. Joint Bone Spine 69:293–299CrossRef Maqeut D, Croisier JL, Renard C, Crielaard JM (2002) Muscle performance in patients with fibromyalgia. Joint Bone Spine 69:293–299CrossRef
15.
go back to reference Perrin DH (1993) Isokinetic exercise and assessment. Human Kinetics Publishers, Champaign (IL), pp 6–37 Perrin DH (1993) Isokinetic exercise and assessment. Human Kinetics Publishers, Champaign (IL), pp 6–37
16.
go back to reference Wilk KE (1995) Isokinetic testing and exercise for the knee. In: Mangine RE (ed) Physical therapy of the knee. Churchill Livingstone, New York, pp 263–288 Wilk KE (1995) Isokinetic testing and exercise for the knee. In: Mangine RE (ed) Physical therapy of the knee. Churchill Livingstone, New York, pp 263–288
17.
go back to reference Baltzopoulos V (1995) Muscular and tibiofemoral joint forces during isokinetic concentric knee extension. Clin Biomech 10:208–214CrossRef Baltzopoulos V (1995) Muscular and tibiofemoral joint forces during isokinetic concentric knee extension. Clin Biomech 10:208–214CrossRef
18.
go back to reference Bowsher D (1998) Acute and chronic pain and assessment. In: Wells PE, Frampton V, Bowsher D (eds) Pain management and physical therapy. Appletion and Lange, Norwalk, pp 8–11 Bowsher D (1998) Acute and chronic pain and assessment. In: Wells PE, Frampton V, Bowsher D (eds) Pain management and physical therapy. Appletion and Lange, Norwalk, pp 8–11
19.
go back to reference Frank JM, Moll MH, Hort JF (1982) A comparison of three ways of measuring of pain. Rheum Rehab 21:211–217CrossRef Frank JM, Moll MH, Hort JF (1982) A comparison of three ways of measuring of pain. Rheum Rehab 21:211–217CrossRef
20.
go back to reference Fries JF, Spitz P, Kraines R (1980) Measurment of patient outcome in arthritis. Arthritis Rheum 23:137–145PubMedCrossRef Fries JF, Spitz P, Kraines R (1980) Measurment of patient outcome in arthritis. Arthritis Rheum 23:137–145PubMedCrossRef
21.
go back to reference Kucukdeveci A, Sahin H, Ataman S (2004) Issues ın cross-cultural validity: exampla from the adaptation, reliability, and validity testing of a Turkish version of the Stanford health assessment questionnaire. Arthritis Rheum 51:14–19PubMedCrossRef Kucukdeveci A, Sahin H, Ataman S (2004) Issues ın cross-cultural validity: exampla from the adaptation, reliability, and validity testing of a Turkish version of the Stanford health assessment questionnaire. Arthritis Rheum 51:14–19PubMedCrossRef
22.
go back to reference Hall C, Brody LT (1999) Impairment of muscle performance. In: Hall CM, Brody LT (eds) Therapeutic exercise moving toward function. Williams and Wilkins, Philadelphia, pp 59–60 Hall C, Brody LT (1999) Impairment of muscle performance. In: Hall CM, Brody LT (eds) Therapeutic exercise moving toward function. Williams and Wilkins, Philadelphia, pp 59–60
23.
go back to reference Kannus P (1994) Isokinetic evaluation of muscular performance: implications for muscle testing and rehabilitation. Int J Sports Med 15:11–18 Kannus P (1994) Isokinetic evaluation of muscular performance: implications for muscle testing and rehabilitation. Int J Sports Med 15:11–18
24.
go back to reference Siqueira CM, Pelegrini FR, Fontana MF, Greve JM (2002) Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes. Rev Hosp Clin Fac Med Sao Paulo 57:19–24PubMed Siqueira CM, Pelegrini FR, Fontana MF, Greve JM (2002) Isokinetic dynamometry of knee flexors and extensors: comparative study among non-athletes, jumper athletes and runner athletes. Rev Hosp Clin Fac Med Sao Paulo 57:19–24PubMed
25.
go back to reference Iossifidou AN, Baltzopoulos V (2000) Peak power assessment in isokinetic dynamometry. Eur J Appl Physiol 82:158–160PubMedCrossRef Iossifidou AN, Baltzopoulos V (2000) Peak power assessment in isokinetic dynamometry. Eur J Appl Physiol 82:158–160PubMedCrossRef
26.
go back to reference Osternig LR (1986) Isokinetic dynamometry: implications for muscle testing and rehabilitation. Exerc Sport Sci Rev 14:45–80PubMedCrossRef Osternig LR (1986) Isokinetic dynamometry: implications for muscle testing and rehabilitation. Exerc Sport Sci Rev 14:45–80PubMedCrossRef
27.
go back to reference Gross MT, McGrain P, Demilio N, Plyler L (1989) Relationship between multiple predictor variables and normal knee torque production. Phys Ther 69:54–62PubMed Gross MT, McGrain P, Demilio N, Plyler L (1989) Relationship between multiple predictor variables and normal knee torque production. Phys Ther 69:54–62PubMed
28.
go back to reference Borges O (1989) Isometric and isokinetic knee extension and flexion torque in men and women aged 20–70. Scand J Rehabil Med 21:45–53PubMed Borges O (1989) Isometric and isokinetic knee extension and flexion torque in men and women aged 20–70. Scand J Rehabil Med 21:45–53PubMed
29.
go back to reference Pincivero DM, Lephart SM, Karunakara RG (1997) Relation between open and closed kinematic chain assessment of knee strength and functional performance. Clin J Sport Med 7:11–16PubMedCrossRef Pincivero DM, Lephart SM, Karunakara RG (1997) Relation between open and closed kinematic chain assessment of knee strength and functional performance. Clin J Sport Med 7:11–16PubMedCrossRef
30.
go back to reference Jacoby SM (2001) Isokinetics in rehabilitation. In: Prentice WE, Voigth ML (eds) Techniques in musculoskeletal rehabilitation. McGraw-Hill Medical Publishing Division, New York, pp 154–160 Jacoby SM (2001) Isokinetics in rehabilitation. In: Prentice WE, Voigth ML (eds) Techniques in musculoskeletal rehabilitation. McGraw-Hill Medical Publishing Division, New York, pp 154–160
31.
go back to reference Fossier E, Christel P, Djian P, Darman Z, Witvoet J (1993) Principles and value of isokinetic evaluation in ruptures of the anterior cruciate ligament. Rev Chir Orthop Reparatrice Appar Mot 79:615–624PubMed Fossier E, Christel P, Djian P, Darman Z, Witvoet J (1993) Principles and value of isokinetic evaluation in ruptures of the anterior cruciate ligament. Rev Chir Orthop Reparatrice Appar Mot 79:615–624PubMed
32.
go back to reference Bohannon RW, Gibson DF, Larkin P (1986) Effect of resisted knee flexion on knee extension torque. Phys Ther 66:1239–1241PubMed Bohannon RW, Gibson DF, Larkin P (1986) Effect of resisted knee flexion on knee extension torque. Phys Ther 66:1239–1241PubMed
33.
go back to reference Aagaard P, Simonsen EB, Magnusson SP, Larsson B, Dyhre-Poulsen P (1998) A new concept for isokinetic hamstring: quadriceps muscle strength ratio. Am J Sports Med 26:231–237PubMed Aagaard P, Simonsen EB, Magnusson SP, Larsson B, Dyhre-Poulsen P (1998) A new concept for isokinetic hamstring: quadriceps muscle strength ratio. Am J Sports Med 26:231–237PubMed
34.
go back to reference Lesmes GR, Costill DL, Coyle EF, Fink WJ (1978) Muscle strength and power changes during maximal isokinetic training. Med Sci Sports 10:266–269PubMed Lesmes GR, Costill DL, Coyle EF, Fink WJ (1978) Muscle strength and power changes during maximal isokinetic training. Med Sci Sports 10:266–269PubMed
35.
go back to reference Soderman K, Alfredson H, Pietila T, Werner S (2001) Risk factors for leg injuries in female soccer players: a prospective investigation during one out-door season. Knee Surg Sports Traumatol Arthrosc 9:313–321PubMedCrossRef Soderman K, Alfredson H, Pietila T, Werner S (2001) Risk factors for leg injuries in female soccer players: a prospective investigation during one out-door season. Knee Surg Sports Traumatol Arthrosc 9:313–321PubMedCrossRef
36.
go back to reference Roberts D, Ageberg E, Andersson G, Friden T (2007) Clinical measurments of proprioception, muscle strength and laxity in relation to function in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc 15:9–16PubMedCrossRef Roberts D, Ageberg E, Andersson G, Friden T (2007) Clinical measurments of proprioception, muscle strength and laxity in relation to function in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc 15:9–16PubMedCrossRef
37.
go back to reference Ferrell WR, Tennant N, Sturrock RD, Ashton L, Creed G, Brydson G, Rafferty D (2004) Amelioration of symptoms by enhancement of proprioception in patients with joint hypermobility syndrome. Arthritis Rheum 50:3323–3328PubMedCrossRef Ferrell WR, Tennant N, Sturrock RD, Ashton L, Creed G, Brydson G, Rafferty D (2004) Amelioration of symptoms by enhancement of proprioception in patients with joint hypermobility syndrome. Arthritis Rheum 50:3323–3328PubMedCrossRef
38.
go back to reference Hall GM, Ferrel WR, Sturrock RD (1995) The effect of the hypermobility syndrome on knee joint proprioception. Br J Rheumatol 34:121–125PubMedCrossRef Hall GM, Ferrel WR, Sturrock RD (1995) The effect of the hypermobility syndrome on knee joint proprioception. Br J Rheumatol 34:121–125PubMedCrossRef
39.
go back to reference Bowerman SJ, Smith DR, Carlson M, King GA (2006) A comprasion of factors influencing ACL injury in male and female athletes and non-athletes. Phys Ther Sport 7:144–152CrossRef Bowerman SJ, Smith DR, Carlson M, King GA (2006) A comprasion of factors influencing ACL injury in male and female athletes and non-athletes. Phys Ther Sport 7:144–152CrossRef
40.
go back to reference Wilkerson GB, Pinerola JJ, Caturano RW (1997) Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. J Orthop Sports Phys Ther 26:78–86PubMed Wilkerson GB, Pinerola JJ, Caturano RW (1997) Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. J Orthop Sports Phys Ther 26:78–86PubMed
41.
go back to reference Kupper JC, Loitz-Ramage B, Corr DT, Hart DA, Ronsky JL (2007) Measuring knee joint laxity: A review of applicable models and the need for new approaches to minimize variability. Clin Biomech (Bristol, Avon) 22:1–13CrossRef Kupper JC, Loitz-Ramage B, Corr DT, Hart DA, Ronsky JL (2007) Measuring knee joint laxity: A review of applicable models and the need for new approaches to minimize variability. Clin Biomech (Bristol, Avon) 22:1–13CrossRef
42.
go back to reference Shirakura K, Kato K, Udagawa E (1992) Characteristics of the isokinetic performance of patients with injured cruciate ligaments. Am J Sports Med 20:754–760PubMedCrossRef Shirakura K, Kato K, Udagawa E (1992) Characteristics of the isokinetic performance of patients with injured cruciate ligaments. Am J Sports Med 20:754–760PubMedCrossRef
43.
go back to reference Keays SL, Bullock-Saxton JE, Newcombe P, Keays AC (2003) The relationship between knee strenght and functional stability before and after anterior cruciate ligament reconstruction. J Orthop Res 21:231–237PubMedCrossRef Keays SL, Bullock-Saxton JE, Newcombe P, Keays AC (2003) The relationship between knee strenght and functional stability before and after anterior cruciate ligament reconstruction. J Orthop Res 21:231–237PubMedCrossRef
44.
go back to reference Goradia VK, Grana WA, Pearson SE (2006) Factors associated with decreased muscle strength after anterior cruciate ligament reconstruction with hamstring tendon grafts. Arthroscopy 22:80PubMed Goradia VK, Grana WA, Pearson SE (2006) Factors associated with decreased muscle strength after anterior cruciate ligament reconstruction with hamstring tendon grafts. Arthroscopy 22:80PubMed
45.
46.
go back to reference Nijs J, Meeus M, De Meirleir K (2006) Chronic musculoskeletal pain in chronic fatigue syndrome: recent developments and therapeutic implications. Man Ther 11:187–191PubMedCrossRef Nijs J, Meeus M, De Meirleir K (2006) Chronic musculoskeletal pain in chronic fatigue syndrome: recent developments and therapeutic implications. Man Ther 11:187–191PubMedCrossRef
47.
go back to reference Afzali L, Kuwabara F, Zachazewski J, Browne P, Robinson B (1992) A new method for the determination of the characteristic shape of an isokinetic quadriceps femoris muscle torque curve. Phys Ther 72:585–592 discussion 593–595PubMed Afzali L, Kuwabara F, Zachazewski J, Browne P, Robinson B (1992) A new method for the determination of the characteristic shape of an isokinetic quadriceps femoris muscle torque curve. Phys Ther 72:585–592 discussion 593–595PubMed
48.
go back to reference Scudder GN (1980) Torque curves produced at the knee during isometric and isokinetic exercise. Arch Phys Med Rehabil 61:68–73PubMed Scudder GN (1980) Torque curves produced at the knee during isometric and isokinetic exercise. Arch Phys Med Rehabil 61:68–73PubMed
49.
go back to reference Kellis E, Baltzopoulos V (1997) The effects of antagonist moment on the resultant knee joint moment during isokinetic testing of the knee extensors. Eur J Appl Physiol Occup Physiol 76:253–259PubMedCrossRef Kellis E, Baltzopoulos V (1997) The effects of antagonist moment on the resultant knee joint moment during isokinetic testing of the knee extensors. Eur J Appl Physiol Occup Physiol 76:253–259PubMedCrossRef
50.
go back to reference Grace TG, Sweetser ER, Nelson MA, Ydens LR, Skipper BJ (1984) Isokinetic muscle imbalance and knee-joint injuries. A prospective blind study. J Bone Joint Surg Am 66:734–740PubMed Grace TG, Sweetser ER, Nelson MA, Ydens LR, Skipper BJ (1984) Isokinetic muscle imbalance and knee-joint injuries. A prospective blind study. J Bone Joint Surg Am 66:734–740PubMed
51.
go back to reference Barton LM, Bird HA (1996) Improving pain by the stabilization of hyperlax joints. J Orthop Rheumatol 9:46–51 Barton LM, Bird HA (1996) Improving pain by the stabilization of hyperlax joints. J Orthop Rheumatol 9:46–51
Metadata
Title
Isokinetic evaluation of knee extensor/flexor muscle strength in patients with hypermobility syndrome
Authors
Nilay Sahin
Akin Baskent
Hatice Ugurlu
Ender Berker
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 7/2008
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-007-0493-4

Other articles of this Issue 7/2008

Rheumatology International 7/2008 Go to the issue