• Document: ISOKINETIC TESTING AND DATA INTERPRETATION
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ISOKINETIC TESTING AND DATA INTERPRETATION PRINCIPLES OF ISOKINETIC The principle behind Isokinetic exercise and testing is that the lever arm moves at a preset fixed speed allowing for accommodating resistance to the effort the subject applies. This mean that the resistance encountered by the subject is equal to their effort. The set lever arm speed allows the dynamometer to measure the torque output by the patient through out the range of motion (ROM). This is unlike manual muscle testing which is a static test, and Isotonic testing which measures strength at the strongest portion of the ROM and is also effected by speed of movement. Isokinetic resistance will accommodate to pain, fatigue, changes in length tension curve and biomechanical leverage of the muscle allowing for safe efficient exercise and testing. Because of the accommodating resistance the muscle is loaded throughout the ROM, the patient’s resistance is then equal to the effort they apply, regardless of the length tension curve which varies with Isotonic loading or pain. Therefore, making it a safer and more efficient form of exercise than Isotonics, which maximally loads the muscle at it’s weakest points. Also, when the patient begins to fatigue and they are unable to continue with the exercise they are still loaded maximally with the isotonic resistance, unlike Isokinetic resistance which will accommodate to this variable. Much like the ROM carry-over effect seen with Isometric exercise, there is a 30º ROM carry over with Isokinetic exercise. The carry over is 15º on each side of the end ROM exercised. This will allow for strengthening of the muscle within the non-exercised ROM. (Davies A.T. Sports Health Care Perspective 1995 Vol 1:4) There is also a 30º/sec physiological overflow between the speeds. This is important with exercise training, as each speed does not have to be exercised. For example, if you start an exercise at 60º/sec, you do not have to exercise at 90º/sec as the overflow will compensate for this. The variety of speeds and physiologic overflow has a distinct advantage over Isotonics, which are usually performed at 60deg/sec. (Davies as above) Speed Factor Velocity Spectrum (degrees/second) Slow Medium Fast 2-180 180-240 300-500 The one principle of Isokinetics which is important to remember for clinical applications and testing is that torque production varies with speed. The lower the preset speed the more torque can be produced concentrically, Increasing the preset speed concentric torque production will decrease. More motor units can be recruited at lower speeds than at higher speeds allowing more torque production. The converse is true eccentrically, the higher the preset speed the more torque will be produced, this is due to the nature of eccentric muscle physiology. Compressive and translational forces across a joint will vary with speed also. Faster speeds have less compressive forces than slower speeds. This is important to remember clinically, as it will apply to treating specific pathologies. For example, patellofemoral pathologies should be started out at higher speeds to reduce the compressive forces across the joint which in turn will protect the joint surface and will be more comfortable to the patient. On the other hand, a shoulder with multidirectional instability should be started out with lower speeds to use the compressive forces to stabilize the shoulder in the glenoid fossa. Translational forces across a joint also vary with speed. The knee joint experiences anterior translation of the tibia with slower speeds. This is due to the force vectors created by the quadriceps, and the biomechanics of the knee joint. Slower speeds should be avoided or used with care when rehabilitating an ACL deficient or post surgical patient. The opposite is true with the shoulder, the faster the speeds the more translational movements. This is also due to the biomechanics of the joint and the force vectors created by the musculature. The use of speeds are also important with curve analysis, as deficits will be more pronounced at the slower speeds. This is due to the fact that the muscle has enough time to recruit motor units 1 and generate torque allowing compressive and translational forces which may elicit pain, or in the case of an ACL deficient patient translation of the tibia, which will alter the biomechanics of the joint. This is apparent as a dip in the torque curve. At higher speeds there will be more artifact spiking. This is due to the lever arm decelerating into the end stop causing a spike in the torque curve at the end ROM. This may appear as a peak torque value, and can be eliminated, as you will see later, by windowing the data. Isokinetic Training Effects Since the subject essentially needs to "catch" the machine to develop resistance, isokinetic exercise helps to develop some of the follo

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