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Book: Isokinetics

Dvir, Zeevi

muscle testing, interpretation, and clinical applications

2004

Author's details	Zeevi Dvir
Keywords	Isometric Contraction ; Physical Therapy Techniques / methods
Language	English
Size	X, 259 S. : Ill., graph. Darst.
Edition	2. ed.
Publisher	Churchill Livingstone
Publishing place	Edinburgh u.a.
Publishing country	Great Britain
Document type	Book
Note	Includes bibliographical references and index. - Previous ed.: 1995
HBZ-ID	HT013970988
ISBN	0-443-07199-3 ; 978-0-443-07199-7
Database	Catalogue ZB MED Medicine, Health

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2004 A 5231	order for loan	Magazin

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Article: Measurement, error, information, and interpretation.

Dvir, Zeevi

Journal of exercise rehabilitation

2018 Volume 14, Issue 6, Page(s) 900–901

Language	English
Publishing date	2018-12-27
Publishing country	Korea (South)
Document type	Editorial
ZDB-ID	2756291-8
ISSN	2288-1778 ; 2288-176X
ISSN (online)	2288-1778
ISSN	2288-176X
DOI	10.12965/jer.1836596.298
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Book: Isokinetics

Dvir, Zeevi

muscle testing, interpretation and clinical applications

1995

Author's details	Zeevi Dvir
Keywords	Isometric Contraction ; Physical Therapy / methods
Language	English
Size	VIII, 199 S. : Ill., graph. Darst.
Publisher	Churchill Livingstone
Publishing place	Edinburgh u.a.
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT006580248
ISBN	0-443-04794-4 ; 978-0-443-04794-7
Database	Catalogue ZB MED Medicine, Health

In stock of ZB MED Cologne/Königswinter

Shelf mark	Loan status	Location
1995 A 3841	order for loan	Magazin

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Article: Difference, significant difference and clinically meaningful difference: The meaning of change in rehabilitation.

Dvir, Zeevi

Journal of exercise rehabilitation

2015 Volume 11, Issue 2, Page(s) 67–73

Abstract: The valid confirmation of a positive change (improvement) in a patient's health status due to intervention has been at the core of medicine and rehabilitation since their very inception as clinicians always aspired to ensure that treating their patients ... ...

Abstract	The valid confirmation of a positive change (improvement) in a patient's health status due to intervention has been at the core of medicine and rehabilitation since their very inception as clinicians always aspired to ensure that treating their patients had led to successful outcomes both in acute and chronic conditions. However what is change: either improvement or worsening (aggravation), is a complicated issue which involves clinical as well as statistical considerations. Change invariably relates to a difference in some measurable entity and almost always it relates to a time span. The confirmation of clinical change is important both for varying the treatment course (if necessary) and for the termination of treatment when the latter has reached wither its prescribed objective or a plateau. Since in the context of rehabilitation, the outcome measures (OM) are strongly linked to performance, determination of change in the latter is confounded by many factors, collectively known as the error of measurement, which render a decision regarding clinically meaningful change, highly involved. This is further complicated by the stability of the observed OM, the so-called reproducibility of the OM, and the accuracy of the measurement instrument. The higher the reproducibility the lower is the error. Moreover, in order to proclaim change, in most cases a positive one, it is necessary for the difference in outcome scores (i.e. the change) to surpass the error of measurement, in varying degree of rigor. This paper describes selected methods associated with determination of change and focuses predominantly on the difference between a simple difference in scores ('simple change'), a significant difference in scores and the so-called clinically meaningful change in scores which is considered today as the benchmark for confirmation of a real change.
Language	English
Publishing date	2015-04-30
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2756291-8
ISSN	2288-1778 ; 2288-176X
ISSN (online)	2288-1778
ISSN	2288-176X
DOI	10.12965/jer.150199
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Multiple-Joint Isokinetic Dynamometry: A Critical Review.

Dvir, Zeevi / Müller, Steffen

Journal of strength and conditioning research

2019 Volume 34, Issue 2, Page(s) 587–601

Abstract: Dvir, Z and Müller, S. Multiple-joint isokinetic dynamometry: a critical review. J Strength Cond Res 34(2): 587-601, 2020-Angular isokinetic dynamometry (AID) is widely regarded as the gold standard for dynamic muscle performance testing. Based on the ... ...

Abstract	Dvir, Z and Müller, S. Multiple-joint isokinetic dynamometry: a critical review. J Strength Cond Res 34(2): 587-601, 2020-Angular isokinetic dynamometry (AID) is widely regarded as the gold standard for dynamic muscle performance testing. Based on the rotational movement of its actuator, AID targets "single-joint" (knee, shoulder, hip, etc.) configurations namely measurement of muscle potential while it moves the lever arm-limb assembly ostensibly around a single fixed axis. On the other hand, the application of multiple-joint isokinetic dynamometry (MID) is relatively narrow, both in research and in practice. This situation is due, possibly, to the fact that these dynamometers are generally more limited in scope namely to testing/conditioning of combined hip, knee, ankle motion (leg press), combined shoulder, elbow motion, and lifting motion patterns, despite the fact that all 3 are associated with higher functionality. However, with the emerging importance of MID, this critical review takes a fresh look at its various aspects including the terminology and classification of multiple-joint isokinetic dynamometers; the problem of scaling namely the need to adjust the range of motion and linear velocities to subjective anthropometric measures; specific technical and methodological issues that underlie the valid application of these dynamometers; available reference values; and the reproducibility of MID-based test findings. Analysis of these topics indicates that MID may validly and effectively be applied for the assessment and conditioning of specific muscle action patterns. However, there is a clear need for standardization of tests and for conditioning protocols alongside research into the use of this method in various clinical cohorts.
MeSH term(s)	Adult ; Ankle Joint/physiology ; Elbow Joint/physiology ; Female ; Humans ; Joints/physiology ; Knee Joint/physiology ; Male ; Movement ; Muscle Strength Dynamometer/standards ; Muscle, Skeletal/physiology ; Range of Motion, Articular/physiology ; Reproducibility of Results ; Shoulder/physiology
Language	English
Publishing date	2019-02-20
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1156349-7
ISSN	1533-4287 ; 1064-8011
ISSN (online)	1533-4287
ISSN	1064-8011
DOI	10.1519/JSC.0000000000002982
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Zs.A 6263: Show issues

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Article ; Online: The dynamic control ratio and its equilibrium point: A preliminary study of isokinetic fatiguing internal-external rotational effort of the shoulder joint in healthy subjects.

Suzuki, Kodai / Okada, Takashi / Takayoshi, Hakkaku / Katz-Leurer, Michal / Dvir, Zeevi

Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology

2023 Volume 70, Page(s) 102767

Abstract: The shoulder joint-related dynamic control ratio (DCR) is derived by dividing the peak eccentric moment of the external rotators (ER) by the peak concentric moment of the internal rotators (IR). However, given the inherent limitation associated with a ... ...

Abstract	The shoulder joint-related dynamic control ratio (DCR) is derived by dividing the peak eccentric moment of the external rotators (ER) by the peak concentric moment of the internal rotators (IR). However, given the inherent limitation associated with a single value DCR, an alternative approach is to calculate it at fixed angular intervals. This preliminary study aimed at exploring the variation in the DCR at a resolution of 1° and under fatiguing external and internal rotation exertions. Eighteen young men, 10 experienced and 8 without experience in overhead sporting activities completed two separate series of 45 ER eccentric and 45 IR concentric isokinetic repetitions at 120°/s. The analysis focused on repetitions 1-3 (TR1), 21-23 (TR2) and 41-43 (TR3). The relative fatigue values for both muscle groups and for both E and NE participants were 25-40% with significantly higher fatigue resistance in eccentric compared with concentric exertions. The DCR traces varied substantially linearly for most of the internal rotation range of motion while significant differences (p < 0.001) were found in their values within group between TR1, TR2 and TR3 and between experienced and non-experienced participants. An antagonistic moment equilibrium (DCR = 1) was reached in all instances and for both groups only during TR3 with a significant progressive reduction in this moment as fatigue increased. Thus, considering the DCR as an angle-based variable rather than a single value isokinetic parameter, may add new insight regarding the interplay between the rotatory muscles of the shoulder joint.
MeSH term(s)	Healthy Volunteers ; Shoulder Joint/physiology ; Muscle Fatigue ; Range of Motion, Articular ; Rotation ; Rotator Cuff/physiology ; Humans ; Adult
Language	English
Publishing date	2023-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1073161-1
ISSN	1873-5711 ; 1050-6411
ISSN (online)	1873-5711
ISSN	1050-6411
DOI	10.1016/j.jelekin.2023.102767
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Zs.A 3218: Show issues

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Article ; Online: Isokinetic Resistance Training for Ankle Plantarflexor Spasticity and Muscle Weakness in People With Multiple Sclerosis: A Proof-of-Concept Case Series.

Ventura, Lucia / Martinez, Gianluca / Aiello, Elena / Dvir, Zeevi / Deriu, Franca / Manca, Andrea

Physical therapy

2022 Volume 103, Issue 1

Abstract: Objective: To the best of the authors' knowledge, no data are available about the use of isokinetic resistance training for managing ankle plantarflexor spastic hypertonia in people with multiple sclerosis (MS). The aim of this proof-of-concept study ... ...

Abstract	Objective: To the best of the authors' knowledge, no data are available about the use of isokinetic resistance training for managing ankle plantarflexor spastic hypertonia in people with multiple sclerosis (MS). The aim of this proof-of-concept study was to explore the feasibility and effects of concentric contractions on spasticity-related resistance to passive motion, strength, and mobility in people with MS and ankle plantarflexor spasticity. Methods: In this pretest/posttest case series, 5 people with MS (mean age = 53.6 [SD = 8.8] years; median Expanded Disability Status Scale score = 5; Modified Ashworth Scale range = 1-4) received 6 weeks of isokinetic resistance training of the spastic plantarflexors. Before and after the intervention, the following outcomes were assessed: average peak torque during passive robotic mobilization, isometric strength, surface electromyography (sEMG) from the spastic muscles, time to complete the 10-m Walk Test, and the Timed "Up & Go" Test. The standardized effect size was used to test pretest and posttest effects at the individual level. Group-level analyses were also performed. Results: Following the training, the average peak torque recorded from the plantarflexors during passive motion at a velocity of 150 degrees per second was found to be decreased by at least 1 SD in all participants but 1, with a significant reduction at the group level of 23.8%. Conversely, no changes in sEMG activity were detected. Group-level analyses revealed that the maximal strength of the trained plantarflexors increased significantly (31.4%). Fast walking speed increased and time to complete the Timed "Up & Go" Test decreased in 4 participants, although not significantly at the group level. Conclusion: Isokinetic resistance training proved safe and feasible in people who had MS and ankle plantarflexor spasticity. The observed reductions in resistance to passive motion from the spastic plantarflexors in the absence of sEMG changes might suggest a mechanical rather than a neural effect of the training. Impact: Based on these preliminary findings, isokinetic resistance training does not exacerbate hypertonia in people with MS and ankle plantarflexor spasticity and could be safely used to manage muscle weakness in this population.
MeSH term(s)	Humans ; Middle Aged ; Muscle Spasticity ; Ankle ; Multiple Sclerosis/complications ; Resistance Training ; Ankle Joint ; Muscle Weakness ; Paresis ; Muscle Hypertonia ; Muscle, Skeletal
Language	English
Publishing date	2022-10-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	415886-6
ISSN	1538-6724 ; 0031-9023
ISSN (online)	1538-6724
ISSN	0031-9023
DOI	10.1093/ptj/pzac146
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Article ; Online: The application of the Neurac technique vs. manual therapy in patients during the acute phase of subacromial impingement syndrome: A randomized single-blinded controlled trial.

Kim, Soo-Yong / Dvir, Zeevi / Oh, Jae-Seop

Journal of back and musculoskeletal rehabilitation

2019 Volume 33, Issue 4, Page(s) 645–653

Abstract: Backgroud: Although the effect of exercise in patients during the subacute and/or chronic subacromial impingement syndrome has been reported, only a few studies have examined the effect of pain free exercise in the acute phase of this disorder.: ... ...

Abstract	Backgroud: Although the effect of exercise in patients during the subacute and/or chronic subacromial impingement syndrome has been reported, only a few studies have examined the effect of pain free exercise in the acute phase of this disorder. Objective: To compare the effect of training using the Neurac technique which combines body segments suspension and vibration vs. manual therapy, on various relevant outcome parameters in patients with acute subacromial impingement syndrome (PASIS). Method: Twenty-six patients underwent a 4 week intervention program. Using random assignment, half of the patients were treated using the Neurac device while the other half was treated using manual therapy. The outcome parameters consisted of shoulder pain, shoulder function, range of motion (ROM) and the isokinetic strength of the external and internal rotators at 60 and 180∘/s. Results: Following either modes of interventions, the pain, function, and ROM improved significantly compared to pre-intervention levels in both groups. Time-by-group interaction was observed for the rotational strength which increased significantly and exclusively in the Neurac group. Conclusions: Given its positive effect on shoulder pain, function, ROM and the isokinetic strength of the external and internal rotators, we recommend the application of the Neurac technique in PASIS.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations/methods ; Physical Therapy Modalities ; Range of Motion, Articular/physiology ; Shoulder/physiopathology ; Shoulder Impingement Syndrome/physiopathology ; Shoulder Impingement Syndrome/therapy ; Shoulder Pain/physiopathology ; Single-Blind Method ; Treatment Outcome ; Vibration/therapeutic use
Language	English
Publishing date	2019-10-08
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	1184721-9
ISSN	1878-6324 ; 1053-8127
ISSN (online)	1878-6324
ISSN	1053-8127
DOI	10.3233/BMR-170884
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Zs.A 4580: Show issues

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Article ; Online: Wrist flexion and extension strength in patients with work-related chronic elbow pain: the isokinetic effort factor and its implications.

Chaler, Joaquim / Torra, Mercè / Pujol, Eduard / Maiques, Anna / Anasetti, Federica / Garreta, Roser / Dvir, Zeevi

Journal of shoulder and elbow surgery

2021 Volume 30, Issue 11, Page(s) 2587–2595

Abstract: Background: The validity of isokinetic strength findings relating to forearm muscles in patients with chronic elbow pain and/or epicondylitis is not well established. Furthermore, given the nature of this disorder, ensuring maximal effort in performing ... ...

Abstract	Background: The validity of isokinetic strength findings relating to forearm muscles in patients with chronic elbow pain and/or epicondylitis is not well established. Furthermore, given the nature of this disorder, ensuring maximal effort in performing the tests is an essential prerequisite. The isokinetic-based DEC parameter (defined as the difference between high- and low-velocity eccentric-to-concentric ratios of a given muscle) has been shown to efficiently detect maximal effort. The purpose of this study was therefore to assess the validity of isokinetic strength tests in patients with chronic elbow pain and/or epicondylitis. Methods: A cohort consisting of 44 male patients with chronic elbow pain (average evolution time, 262 ± 193.04 days) was recruited. The wrist extensor and flexor concentric and eccentric isokinetic strength of the involved and uninvolved sides was measured. The involved-uninvolved and flexor-extensor (F/E) ratios, as well as the DEC (eccentric-concentric difference), were computed based on peak moment values. Work disability and relapse within the first year were registered. In maximal performers, associations between deficits, F/E ratios, work disability, and symptom relapse were explored applying multiple comparisons. Results: Of the patients, 68.2% met the maximal-effort criteria, with the involved-side muscles being significantly weaker than their uninvolved-side counterparts in most cases. Although the mean deficit in this group was not associated with either work disability or relapse, patients with a relapse of symptoms within the first year had a significantly higher F/E ratio than those without relapse. Conclusion: In patients presenting with chronic elbow pain who perform at the maximal level of effort, high wrist F/E strength ratios may predict symptom relapse.
MeSH term(s)	Elbow ; Elbow Joint ; Humans ; Male ; Muscle, Skeletal ; Pain ; Range of Motion, Articular ; Wrist
Language	English
Publishing date	2021-07-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1170782-3
ISSN	1532-6500 ; 1058-2746
ISSN (online)	1532-6500
ISSN	1058-2746
DOI	10.1016/j.jse.2021.06.005
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Zs.A 3973: Show issues

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Article ; Online: The association between specific temporomandibular disorders and cervicogenic headache.

Greenbaum, Tzvika / Dvir, Zeevi / Emodi-Perlman, Alona / Reiter, Shoshana / Rubin, Pessia / Winocur, Ephraim

Musculoskeletal science & practice

2021 Volume 52, Page(s) 102321

Abstract: Background and aims: Upper neck signs, symptoms and hypomobility have been shown to present with a higher prevalence in patients with temporomandibular disorders (TMDs). However, there is currently no evidence of an association between specific TMDs and ...

Abstract	Background and aims: Upper neck signs, symptoms and hypomobility have been shown to present with a higher prevalence in patients with temporomandibular disorders (TMDs). However, there is currently no evidence of an association between specific TMDs and cervicogenic headache (CGH). Therefore, the aim of this study was to evaluate the odds ratio and the relative risk of CGH in patients with specific TMDs. Method: 116 participants, including 74 patients with TMD (pain-related/intraarticular/mixed TMD) and 42 healthy controls took part in this study. The TMD diagnosis was made by senior faculty members of the Dental School according to the Diagnostic Criteria for TMD, while the cervical diagnosis was made by a qualified senior physical therapist. The analysis comprised the evaluation of the odds ratio of CGH among patients with TMD and the relative risk (RR) for CGH during 14-24 months of follow-up. Results: Significantly higher odds ratios of cervicogenic headache were found among pain-related and mixed TMD (12.17 and 10.76, respectively) versus healthy controls. During the 14-24 months of follow-up, there was no significant difference of relative risk for CGH among patients with TMD versus healthy controls. Summary and conclusions: The results support a clear clinical association between painful TMD (pain-related and mixed TMD) and cervicogenic headache.
MeSH term(s)	Humans ; Neck ; Neck Pain/diagnosis ; Odds Ratio ; Post-Traumatic Headache/diagnosis ; Post-Traumatic Headache/epidemiology ; Temporomandibular Joint Disorders/epidemiology
Language	English
Publishing date	2021-01-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2888772-4
ISSN	2468-7812
ISSN (online)	2468-7812
DOI	10.1016/j.msksp.2021.102321
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