The Effect of Isokinetic Strengthening Training

Comparison of the Functional Recovery and Cytokines Changes Between Isokinetic and Isotonic Training in Patients With Acute Stroke, After Total Hip Replacement or After Total Knee Replacement

Our participants will include 40 patients within one month of stroke, 43 patients who received total hip replacement or total knee replacement two to four weeks before. The participants will be randomly assigned to isokinetic, isotonic or isometric training groups. Outcome measures including isometric peak torque of hip/knee at 90 degree of flexion, peak torque of hip/knee at angular velocity of 60 degree/s and 120 degree/s, Short Form 36 (SF-36), the Timed Up and Go test, the Oxford Hip/knee Score, the plasma concentration of hsCRP, and the level of substance P in saliva will be collected at the beginning and 4 weeks after the training program. Statistical significant differences will be determined between the improvement of outcome measures of the isokinetic and the isotonic training groups.

Study Overview

• Status: Recruiting
• Conditions: Stroke; Arthroplasty, Replacement, Knee; Resistance Training; Arthroplasty, Replacement, Hip
• Intervention / Treatment: Device: Isokinetic strengthening exercise; Device: Isotonic strengthening exercise; Behavioral: isometric strengthening exercise

Detailed Description

Our participants will include 40 patients within one month of stroke, 43 patients who received total hip replacement or total knee replacement two to four weeks before. The participants will be randomly assigned to isokinetic, isotonic or isometric training groups. Outcome measures including isometric peak torque of hip/knee at 90 degree of flexion, peak torque of hip/knee at angular velocity of 60 degree/s and 120 degree/s, Short Form 36 (SF-36), the Timed Up and Go test, the Oxford Hip/knee Score, the plasma concentration of hsCRP, and the level of substance P in saliva will be collected at the beginning and 4 weeks after the training program. Statistical significant differences will be determined between the

• Study Type: Interventional
• Enrollment (Estimated): 126
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Yuan-Yang Cheng, MD, PhD; Phone Number: 3500 +886-4-23592525; Email: rifampin@gmail.com

Study Locations

• Taiwan
  • Taichung City, Taiwan, 40705
    • Recruiting
    • Department of Physical Medicine and Rehabilitation
    • Contact: Yuan-Yang Cheng, MD, PhD; Phone Number: 3533 +886423592525; Email: rifampin@gmail.com
    • Principal Investigator: Yuan-Yang Cheng, MD, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 36 years to 66 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• within one month of acute stroke
• receive total hip/knee replacement within two to four weeks before

Exclusion Criteria:

• cannot perform from sitting to standing
• Body Mass Index > 30
• Lower limbs fracture history
• Diabetic polyneuropathy
• Cardiopulmonary diseases that impede exercise prescription
• Impaired cognitive function
• Infectious disease during the study period that may cause cytokine changes

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Isokinetic training; Ten times, three sets of isokinetic strengthening exercise using 30 degree/sec and 120 degree/sec	Device: Isokinetic strengthening exercise; Isokinetic strengthening exercise provides muscle training throughout the range of motion of a joint at a pre-set constant speed of angular velocity. It can be performed in an eccentric or concentric way in a controlled manner, and is evidenced to be an effective and safe training method in patients with anterior cruciate ligament reconstruction, burn injury, ankle instability, osteoarthritic knee, and chronic stroke in the past literatures.
Active Comparator: Isotonic training; Ten times, three sets of isotonic strengthening exercise using consistent resistance of 60% of 1-repetition maximum of hip or knee	Device: Isotonic strengthening exercise; Isotonic strengthening exercise keeps the tension remained unchanged during the muscle's length changing. As the muscle's force changes via the length-tension relationship during a contraction, an isotonic contraction will keep force constant while velocity changes. There are two types of isotonic contractions: (1) concentric and (2) eccentric. In a concentric contraction, the muscle tension rises to meet the resistance, then remains the same as the muscle shortens. In eccentric, the muscle lengthens due to the resistance being greater than the force the muscle is producing.
Placebo Comparator: isometric training; home exercise education on isometric quadriceps strengthening on the day of out-patient appointment	Behavioral: isometric strengthening exercise; home exercise education on isometric quadriceps strengthening on the day of out-patient appointment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak torque	Isometric peak torque of hip/knee at 90 degree of flexion, peak torque of hip/knee at angular velocity of 60 degree/s and 120 degree/s	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Timed Up and Go test	stand up from a chair, walk for 3 meters and go back and sit down	4 weeks
Short Form 36 (SF-36) questionnaire	Use the 36-item, patient-reported questionnaire to survey the self-perceived health status	4 weeks
Oxford Hip/Knee Score	symptoms score during daily activities	4 weeks
The plasma concentration of hsCRP, and the level of substance P in saliva	check by drawing blood and test	4 weeks

Collaborators and Investigators

• Sponsor: Taichung Veterans General Hospital
• Investigators: Principal Investigator: Yuan-Yang Cheng, MD, PhD, Department of Physical Medicine and Rehabilitation

Publications and helpful links

General Publications

• Cheng YY, Liu CC, Lin SY, Lee CH, Chang ST, Wang SP. Comparison of the Therapeutic Effects Between Isokinetic and Isotonic Strength Training in Patients After Total Knee Replacement: A Prospective, Randomized Controlled Trial. Orthop J Sports Med. 2022 Jun 21;10(6):23259671221105852. doi: 10.1177/23259671221105852. eCollection 2022 Jun.

Study record dates

Study Major Dates

• Study Start: January 1, 2013
• Primary Completion (Estimated): December 1, 2024
• Study Completion (Estimated): December 1, 2024

Study Registration Dates

• First Submitted: October 18, 2016
• First Submitted That Met QC Criteria: October 18, 2016
• First Posted (Estimated): October 19, 2016

Study Record Updates

• Last Update Posted (Estimated): November 14, 2023
• Last Update Submitted That Met QC Criteria: November 12, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: CF12251

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO