One hundred sixty patients (mean age, 68 +/- 8 years) having primary total knee arthroplasty were assigned randomly to two rehabilitation programs: (1) clinic-based rehabilitation provided by outpatient physical therapists; or (2) home-based rehabilitation monitored by periodic telephone calls from a physical therapist. Both rehabilitation programs emphasized a common home exercise program. Before surgery, and at 12 and 52 weeks after surgery, no statistically significant differences were observed between the clinic- and the home-based groups on any of the following measures: (1) total score on the Knee Society clinical rating scale; (2) total score on the Western Ontario and McMaster Universities Osteoarthritis Index; (3) total score on the Medical Outcomes Study Short Form; (4) pain scale of the Knee Society clinical rating scale; (5) pain scale of the Western Ontario and McMaster Universities Osteoarthritis Index; (6) functional scale of the Western Ontario and McMaster Universities Osteoarthritis Index; (7) distance walked in 6 minutes; (8) number of stairs ascended and descended in 30 seconds; and (9) knee flexion range of motion, on either the per protocol or the intent-to-treat or the analyses. After primary total knee arthroplasty, patients who completed a home exercise program (home-based rehabilitation) performed similarly to patients who completed regular outpatient clinic sessions in addition to the home exercises (clinic-based rehabilitation). Additional studies need to determine which patients are likely to benefit most from clinic-based rehabilitation programs.

The relationships between isometric and isokinetic-concentric knee extensor and knee flexor strength, and quadriceps and hamstring cross-sectional area (CSA) were determined in young (n = 13, M = 24.5y) and elderly (n = 12, M = 70.7y) men. Quadriceps and hamstring CSA was determined by computed tomography. Knee extensor and flexor strength at 0 degree/s and 120 degree/s was determined on a Kin-Com isokinetic dynamometer. Compared to the young men, elderly men had significantly smaller quadriceps muscles and were weaker (22-32%) in knee flexion and knee extension at both angular velocities. Strength:CSA ratios were similar at 0 degree/s, but elderly men had decreased ratios for both extensors and flexors at 120 degree/s. Correlations of knee extensor and flexor strength with muscle CSA were significant at both velocities in elderly men, but not at either velocity for the knee flexors in young men. The decrease in isometric strength in elderly men can be accounted for by their decrease in muscle CSA, but their decrease in isokinetic-concentric strength was greater than their loss of CSA. Further study is required to determine the reason for this nonproportional loss of isokinetic-concentric strength.

SUMMARY This study investigated changes in knee extensor and flexor strength of 17 mildly involved adolescents with cerebral palsy in response to an eight‐week isokinetic strength‐training program. Peak torque and work were used as strength outcome measures. Subsequent changes in gross motor function and walking efficiency were evaluated. The significant strength gains of 21 to 25 per cent observed were similar in magnitude to those previously reported for able‐bodied individuals. A significant number of subjects showed an increase in gross motor ability. However, walking velocity and walking efficiency were unchanged. Strength gains of 15 to 17 percent were maintained for three months after the cessation of isokinetic training. RÉSUMÉ Essai d'entraînement dc force isokinétique sur lu capacité fonctionnelle et Veffwicnce dc mtirche chez les adolescents IMC Cette étude a apprécié la modification de force des fléchisseurs et exenseurs de genou chez. 17 adoelscents IMC Légèrement atteints, en réponse à un programme d'entraînement de force isokinétique duran híut semaines. La pointe du moment de couple et le travail effectué furent utilisés comme mesure de la force effectuée. Les modifications ultérieures de la fonction motrice globale et L'efficacité de la Marche furent évaluées. Des gains significatifs de force de 21 à 25 pour cent observés étaient comparables en amplitude à ceux que avaient été antérieurment rapportés chez des individus valides. Un nombre signiftctif de sujeis présentérent un gain dans L'aptitude motrice globale. Cependant, la vitesse et L'efficience de la marche demeuérent inchangées. Des gains de force de 15à 17 pour cent furent maintenus trois mois l'arrêt du programme isokinétique. ZUSAMMENFASSUNG Einfluß des isokinetischen Kraftlrainings auf Funktionsfähigkeit und Gangqualität bei Jugend Uclien mil Cerebralparese Bei 17 Jugendliehen mil Cerebralparese wurden maeh einem acht‐wöchigen isokinetischen Training die Veränderungen in der Muskelkraft e Kniestrecker und ‐beuger gemessen. Drehkaft und Aerbeit waren die Outcome‐Parameter für den Kraftzuwachs, Die daraus resultierenden Veränderungen der grobmotorischen Funktion und der Gehfähigkeit wurden bewertet. Der signifikante Kraftzuwachs von 21 bis 25 Prozent entsprach etwa den zuvor berichteten Ergcbnissen bei gesunden Personen. Eine signifikante Anzahl von Proban den zeigte cine Verbeserung der grobmotorischen Fähigkeiten. Ein Kraftzuwachs von 15 bis 17 Prozent war über drei Monate nach Beendigung des isokinetischen Trainings machweisbar. RESUMEN Efectn del entrenamiento con csfuerzo isoquinético sobre la capacidad funcional y eficiencia en la marcha en adolescentres con parálisis derebra Este estudio investiga los cambios en la fuerza de flexión y extensión de la rodilla en 17 adolescentes moderadamente afectados de parálisis cerebral, como respuesta a un programa de ocho semanas de ejercicios de esfuerzo isoquinético. Como tnedidas del resultado del esfuerzo se tomaron el trabajo y el punto maximo de toques. Sc cvaluaron los sucesivos cambios ...

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In general, bracing appears to improve performance during tasks characterized by relatively limited somatosensory input but not during tasks characterized by increased somatosenory input. The small magnitude of the improvements, coupled with their apparent lack of carry over to more difficult and functionally relevant tasks, questions the clinical benefit of the present effects of bracing.