Distribution of Knee Isokinetic Angle-specific Moments and Ratios
Condition: Musculoskeletal Diseases
MeSH terms: Musculoskeletal Diseases
Study type: Interventional

Summary: 
      The quantification of the strength-producing capacity of the knee joint muscles by isokinetic
      measurement is one of the most widely used tools for monitoring and deciding whether to
      return to sport after ACL reconstruction. However, the isokinetic evaluation performed in
      current practice does not exploit all the measures offered by this exploration technique,
      which can lead to errors in analysis and interpretation of the results and underestimate its
      ability to predict a return to sport under optimal conditions. Recently, more complete
      analysis models than those currently in use and integrating the moment-angle relationship
      have thus proposed the use of functional ratios sweeping the whole amplitude of the knee
      joint. Baumgart proposed an analysis of the variation of isokinetic force moments at each
      angle after ligamentoplasty. This approach seems to be the future of isokinetic performance
      analyses, but for the moment this has only been used in pathological populations and on small
      numbers of patients (less than 40). There are therefore no reference values in healthy
      subjects.
    

Detailed description: 
      Rupture of the anterior cruciate ligament is a common sports trauma injury, frequently
      leading to a surgical intervention. However, despite the extensive scientific literature on
      the subject, return to sports at a lower level is common, sometimes to the point of giving up
      pivoting sports. Current rehabilitation strategies and the means used tend to limit their
      effectiveness, as do the batteries of tests for returning to sport .

      One of the most widely used assessments for monitoring and decision-making on return to sport
      after ACL reconstruction is the quantification of the strength production capacity of the
      knee joint muscles by isokinetic measurement. However, the isokinetic evaluation carried out
      in current practice does not exploit all the measures offered by this exploration technique,
      which can lead to errors in the analysis and interpretation of the results . This discrepancy
      between the possibilities offered by this tool and its current exploitation may underestimate
      its capacity to predict a return to sport under optimal conditions .

      In clinical practice, the analysis is reduced to the consideration of two indices: the peak
      torques of the extensor and flexor muscles of the knee, which are compared between the two
      legs (right and left sides), and the ratio between the torque peak of the flexor muscles and
      that of the extensor muscles, this ratio being considered as a control of joint balance. More
      comprehensive analysis models than those currently in use and integrating the moment-angle
      relationship have thus proposed the use of functional ratios sweeping the knee's joint range
      of motion. Baumgart has proposed an analysis of the variation of isokinetic force moments at
      each angle after ligamentoplasty . This approach seems to be the future of isokinetic
      performance analyses, but has so far only been used in pathological populations and on small
      numbers of patients (less than 40). There are therefore no reference values in healthy
      subjects. The search for reference values for the torque of the muscles of the knee over the
      entire angular range of motion represents an important line of research to improve the
      objective evaluation of the neuromuscular performance of the knee and the return to sport of
      patients, particularly following ACL reconstruction.
    

Intervention name(s): Evaluation of the strength of knee flexors and extensors
Intervention type(s): Other
Intervention description(s): Each participant will benefit from a clinical evaluation and an evaluation of the strength of knee flexors and extensors using an isokinetic dynamometer after a 10-minute warm up.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: knee isokinetic angle