Alterations in neuromuscular function in girls with generalized joint hypermobility

BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. CONCLUSIONS: Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings

Absolute and Relative Reliability of the Timed ‘Up & Go’ Test and ‘30second Chair-Stand’ Test in Hospitalised Patients with Stroke

<div><p>Objective</p><p>The timed ‘Up & Go’ test and ‘30second Chair-Stand’ test are simple clinical outcome measures widely used to assess functional performance. The reliability of both tests in hospitalised stroke patients is unknown. The purpose was to investigate the relative and absolute reliability of both tests in patients admitted to an acute stroke unit.</p><p>Methods</p><p>Sixty-two patients (men, n = 41) attended two test sessions separated by a one hours rest. Intraclass correlation coefficients (ICC_2,1) were calculated to assess relative reliability. Absolute reliability was expressed as Standard Error of Measurement (with 95% certainty—SEM₉₅) and Smallest Real Difference (SRD) and as percentage of their respective means if heteroscedasticity was observed in Bland Altman plots (SEM₉₅% and SRD%).</p><p>Results</p><p>ICC values for interrater reliability were 0.97 and 0.99 for the timed ‘Up & Go’ test and 0.88 and 0.94 for ‘30second Chair-Stand’ test, respectively. ICC values for intrarater reliability were 0.95 and 0.96 for the timed ‘Up & Go’ test and 0.87 and 0.91 for ‘30second Chair-Stand’ test, respectively. Heteroscedasticity was observed in the timed ‘Up & Go’ test. Interrater SEM₉₅% ranged from 9.8% to 14.2% with corresponding SRD% of 13.9–20.1%. Intrarater SEM₉₅% ranged from 15.8% to 18.7% with corresponding SRD% of 22.3–26.5%. For ‘30second Chair-Stand’ test interrater SEM₉₅ ranged between 1.5 and 1.9 repetitions with corresponding SRD of 2 and 3 and intrarater SEM₉₅ ranged between 1.8 and 2.0 repetitions with corresponding SRD values of 3.</p><p>Conclusion</p><p>Excellent reliability was observed for the timed ‘Up & Go’ test and the ‘30second Chair-Stand’ test in hospitalised stroke patients. The thresholds to detect a real change in performance were 18.7% for the timed ‘Up & Go’ test and 2.0 repetitions for the ‘30second Chair-Stand’ in groups of patients and 26.5% and 3 repetitions in individual patients, respectively.</p></div

Bland Altman plot of TUG for the interrater reliability.

<p>Bland Altman plot of TUG for the interrater reliability.</p

Clinical characteristics of the participants (n = 62).

<p>Clinical characteristics of the participants (n = 62).</p

Summary of the results of TUG (n = 60) and 30s-CST (n = 61).

<p>Summary of the results of TUG (n = 60) and 30s-CST (n = 61).</p