The Effect of Isokinetic Strengthening Training

Study Overview
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Brief Summary
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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.

Detailed Description
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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

Official Title
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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

Conditions
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Resistance Training, Stroke, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee

Intervention / Treatment
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* Device: Isokinetic strengthening exercise
* Device: Isotonic strengthening exercise
* Behavioral: isometric strengthening exercise


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Isokinetic training<br>Ten times, three sets of isokinetic strengthening exercise using 30 degree/sec and 120 degree/sec | Device: Isokinetic strengthening exercise<br>* 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.<br>|
| Active Comparator: Isotonic training<br>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<br>* 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.<br>|
| Placebo Comparator: isometric training<br>home exercise education on isometric quadriceps strengthening on the day of out-patient appointment | Behavioral: isometric strengthening exercise<br>* home exercise education on isometric quadriceps strengthening on the day of out-patient appointment<br>|

What is the study measuring?
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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 |