Skip to main content
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2003 Dec;37(6):475–479. doi: 10.1136/bjsm.37.6.475

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae

Y Yildiz 1, T Aydin 1, U Sekir 1, C Cetin 1, F Ors 1, K Alp 1
PMCID: PMC1724705  PMID: 14665581

Abstract

Objectives: To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score.

Methods: The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60°/s (25–90° range of flexion) and 180°/s (full range). These sessions were repeated three times a week for six weeks.

Results: Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found.

Conclusions: The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters.

Full Text

The Full Text of this article is available as a PDF (247.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alaca Ridvan, Yilmaz Bilge, Goktepe A. Salim, Mohur Haydar, Kalyon Tunc Alp. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002 Nov;81(11):807–813. doi: 10.1097/00002060-200211000-00002. [DOI] [PubMed] [Google Scholar]
  2. Arroll B., Ellis-Pegler E., Edwards A., Sutcliffe G. Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy. Am J Sports Med. 1997 Mar-Apr;25(2):207–212. doi: 10.1177/036354659702500212. [DOI] [PubMed] [Google Scholar]
  3. Aydin Taner, Yildiz Yavuz, Yildiz Cemil, Atesalp Sabri, Kalyon Tunç Alp. Proprioception of the ankle: a comparison between female teenaged gymnasts and controls. Foot Ankle Int. 2002 Feb;23(2):123–129. doi: 10.1177/107110070202300208. [DOI] [PubMed] [Google Scholar]
  4. Baier M., Hopf T. Ankle orthoses effect on single-limb standing balance in athletes with functional ankle instability. Arch Phys Med Rehabil. 1998 Aug;79(8):939–944. doi: 10.1016/s0003-9993(98)90091-0. [DOI] [PubMed] [Google Scholar]
  5. Bohannon R. W., Larkin P. A., Cook A. C., Gear J., Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984 Jul;64(7):1067–1070. doi: 10.1093/ptj/64.7.1067. [DOI] [PubMed] [Google Scholar]
  6. Boucher J. P., King M. A., Lefebvre R., Pépin A. Quadriceps femoris muscle activity in patellofemoral pain syndrome. Am J Sports Med. 1992 Sep-Oct;20(5):527–532. doi: 10.1177/036354659202000507. [DOI] [PubMed] [Google Scholar]
  7. Douris P. C. The effect of isokinetic exercise on the relationship between blood lactate and muscle fatigue. J Orthop Sports Phys Ther. 1993 Jan;17(1):31–35. doi: 10.2519/jospt.1993.17.1.31. [DOI] [PubMed] [Google Scholar]
  8. Fulkerson John P. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med. 2002 May-Jun;30(3):447–456. doi: 10.1177/03635465020300032501. [DOI] [PubMed] [Google Scholar]
  9. Grelsamer R. P., Klein J. R. The biomechanics of the patellofemoral joint. J Orthop Sports Phys Ther. 1998 Nov;28(5):286–298. doi: 10.2519/jospt.1998.28.5.286. [DOI] [PubMed] [Google Scholar]
  10. Holmes S. W., Jr, Clancy W. G., Jr Clinical classification of patellofemoral pain and dysfunction. J Orthop Sports Phys Ther. 1998 Nov;28(5):299–306. doi: 10.2519/jospt.1998.28.5.299. [DOI] [PubMed] [Google Scholar]
  11. Irrgang J. J., Pezzullo D. Rehabilitation following surgical procedures to address articular cartilage lesions in the knee. J Orthop Sports Phys Ther. 1998 Oct;28(4):232–240. doi: 10.2519/jospt.1998.28.4.232. [DOI] [PubMed] [Google Scholar]
  12. Kannus P., Aho H., Järvinen M., Niittymäki S. Computerized recording of visits to an outpatient sports clinic. Am J Sports Med. 1987 Jan-Feb;15(1):79–85. doi: 10.1177/036354658701500112. [DOI] [PubMed] [Google Scholar]
  13. Kaufman K. R., An K. N., Litchy W. J., Morrey B. F., Chao E. Y. Dynamic joint forces during knee isokinetic exercise. Am J Sports Med. 1991 May-Jun;19(3):305–316. doi: 10.1177/036354659101900317. [DOI] [PubMed] [Google Scholar]
  14. Lephart S. M., Pincivero D. M., Giraldo J. L., Fu F. H. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med. 1997 Jan-Feb;25(1):130–137. doi: 10.1177/036354659702500126. [DOI] [PubMed] [Google Scholar]
  15. MacIntyre D. L., Robertson D. G. Quadriceps muscle activity in women runners with and without patellofemoral pain syndrome. Arch Phys Med Rehabil. 1992 Jan;73(1):10–14. [PubMed] [Google Scholar]
  16. Mangine R. E., Eifert-Mangine M., Burch D., Becker B. L., Farag L. Postoperative management of the patellofemoral patient. J Orthop Sports Phys Ther. 1998 Nov;28(5):323–335. doi: 10.2519/jospt.1998.28.5.323. [DOI] [PubMed] [Google Scholar]
  17. Mariani P. P., Caruso I. An electromyographic investigation of subluxation of the patella. J Bone Joint Surg Br. 1979 May;61-B(2):169–171. doi: 10.1302/0301-620X.61B2.438268. [DOI] [PubMed] [Google Scholar]
  18. Milgrom C., Finestone A., Eldad A., Shlamkovitch N. Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits. J Bone Joint Surg Am. 1991 Aug;73(7):1041–1043. [PubMed] [Google Scholar]
  19. Mirzabeigi E., Jordan C., Gronley J. K., Rockowitz N. L., Perry J. Isolation of the vastus medialis oblique muscle during exercise. Am J Sports Med. 1999 Jan-Feb;27(1):50–53. doi: 10.1177/03635465990270011601. [DOI] [PubMed] [Google Scholar]
  20. Møller B. N., Krebs B., Tidemand-Dal C., Aaris K. Isometric contractions in the patellofemoral pain syndrome. An electromyographic study. Arch Orthop Trauma Surg. 1986;105(1):24–27. doi: 10.1007/BF00625655. [DOI] [PubMed] [Google Scholar]
  21. Mühlbauer R., Lukasz T. S., Faber T. S., Stammberger T., Eckstein F. Comparison of knee joint cartilage thickness in triathletes and physically inactive volunteers based on magnetic resonance imaging and three-dimensional analysis. Am J Sports Med. 2000 Jul-Aug;28(4):541–546. doi: 10.1177/03635465000280041601. [DOI] [PubMed] [Google Scholar]
  22. Nissen C. W., Cullen M. C., Hewett T. E., Noyes F. R. Physical and arthroscopic examination techniques of the patellofemoral joint. J Orthop Sports Phys Ther. 1998 Nov;28(5):277–285. doi: 10.2519/jospt.1998.28.5.277. [DOI] [PubMed] [Google Scholar]
  23. Owings Tammy M., Grabiner Mark D. Motor control of the vastus medialis oblique and vastus lateralis muscles is disrupted during eccentric contractions in subjects with patellofemoral pain. Am J Sports Med. 2002 Jul-Aug;30(4):483–487. doi: 10.1177/03635465020300040601. [DOI] [PubMed] [Google Scholar]
  24. Powers C. M., Landel R., Perry J. Timing and intensity of vastus muscle activity during functional activities in subjects with and without patellofemoral pain. Phys Ther. 1996 Sep;76(9):946–967. doi: 10.1093/ptj/76.9.946. [DOI] [PubMed] [Google Scholar]
  25. Powers C. M., Perry J., Hsu A., Hislop H. J. Are patellofemoral pain and quadriceps femoris muscle torque associated with locomotor function? Phys Ther. 1997 Oct;77(10):1063–1078. doi: 10.1093/ptj/77.10.1063. [DOI] [PubMed] [Google Scholar]
  26. Powers C. M. Rehabilitation of patellofemoral joint disorders: a critical review. J Orthop Sports Phys Ther. 1998 Nov;28(5):345–354. doi: 10.2519/jospt.1998.28.5.345. [DOI] [PubMed] [Google Scholar]
  27. Rozzi S. L., Lephart S. M., Sterner R., Kuligowski L. Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther. 1999 Aug;29(8):478–486. doi: 10.2519/jospt.1999.29.8.478. [DOI] [PubMed] [Google Scholar]
  28. Sanchis-Alfonso V., Rosello-Sastre E., Martinez-Sanjuan V. Pathogenesis of anterior knee pain syndrome and functional patellofemoral instability in the active young. Am J Knee Surg. 1999 Winter;12(1):29–40. [PubMed] [Google Scholar]
  29. Sanchis-Alfonso V., Roselló-Sastre E. Immunohistochemical analysis for neural markers of the lateral retinaculum in patients with isolated symptomatic patellofemoral malalignment. A neuroanatomic basis for anterior knee pain in the active young patient. Am J Sports Med. 2000 Sep-Oct;28(5):725–731. doi: 10.1177/03635465000280051801. [DOI] [PubMed] [Google Scholar]
  30. Souza D. R., Gross M. T. Comparison of vastus medialis obliquus: vastus lateralis muscle integrated electromyographic ratios between healthy subjects and patients with patellofemoral pain. Phys Ther. 1991 Apr;71(4):310–320. doi: 10.1093/ptj/71.4.310. [DOI] [PubMed] [Google Scholar]
  31. Steinkamp L. A., Dillingham M. F., Markel M. D., Hill J. A., Kaufman K. R. Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med. 1993 May-Jun;21(3):438–444. doi: 10.1177/036354659302100319. [DOI] [PubMed] [Google Scholar]
  32. Stiene H. A., Brosky T., Reinking M. F., Nyland J., Mason M. B. A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1996 Sep;24(3):136–141. doi: 10.2519/jospt.1996.24.3.136. [DOI] [PubMed] [Google Scholar]
  33. Wild J. J., Jr, Franklin T. D., Woods G. W. Patellar pain and quadriceps rehabilitation. An EMG study. Am J Sports Med. 1982 Jan-Feb;10(1):12–15. doi: 10.1177/036354658201000103. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES