Standardized voluntary force measurement in a lower extremity rehabilitation robot

BACKGROUND: Isometric force measurements in the lower extremity are widely used in rehabilitation of subjects with neurological movement disorders (NMD) because walking ability has been shown to be related to muscle strength. Therefore muscle strength measurements can be used to monitor and control the effects of training programs. A new method to assess isometric muscle force was implemented in the driven gait orthosis (DGO) Lokomat. To evaluate the capabilities of this new measurement method, inter- and intra-rater reliability were assessed. METHODS: Reliability was assessed in subjects with and without NMD. Subjects were tested twice on the same day by two different therapists to test inter-rater reliability and on two separate days by the same therapist to test intra-rater reliability. RESULTS: Results showed fair to good reliability for the new measurement method to assess isometric muscle force of lower extremities. In subjects without NMD, intraclass correlation coefficients (ICC) for inter-rater reliability ranged from 0.72 to 0.97 and intra-rater reliability from 0.71 to 0.90. In subjects with NMD, ICC ranged from 0.66 to 0.97 for inter-rater and from 0.50 to 0.96 for intra-rater reliability. CONCLUSION: Inter- and intra- rater reliability of an assessment method for measuring maximal voluntary isometric muscle force of lower extremities was demonstrated. We suggest that this method is a valuable tool for documentation and controlling of the rehabilitation process in patients using a DGO

The effect of warm-up intensity on range of motion and anaerobic performance

Although there is a paucity of scientific support for the benefits of warm-up, athletes commonly warm up prior to activity with the intention of improving performance and reducing the incidence of injuries. The purpose of this study was to examine the role of warm-up intensity on both range of motion (ROM) and anaerobic performance. Nine males (age = 21.7 +/- 1.6 years, height = 1.77 +/- 0.04 m, weight = 80.2 +/- 6.8 kg, and VO2max = 60.4 +/- 5.4 ml/kg/min) completed four trials. Each trial consisted of hip, knee, and ankle ROM evaluation using an electronic inclinometer and an anaerobic capacity test on the treadmill (time to fatigue at 13 km/hr and 20% grade). Subjects underwent no warm-up or a warm-up of 15 minutes running at 60, 70 or 80% VO2max followed by a series of lower limb stretches. Intensity of warm-up had little effect on ROM, since ankle dorsiflexion and hip extension significantly increased in all warm-up conditions, hip flexion significantly increased only after the 80% VO2max warm-up, and knee flexion did not change after any warm-up. Heart rate and body temperature were significantly increased (p < 0.05) prior to anaerobic performance for each of the warm-up conditions, but anaerobic performance improved significantly only after warm-up at 60% VO2max (10%) and 70% VO2max (13%). A 15-minute warm-up at an intensity of 60-70% VO2max is therefore recommended to improve ROM and enhance subsequent anaerobic performance