Isokinetic Dynamometer (Part I)
Objectives:
By the end of this lecture the student will be able to:
1. Define isokinetic dynamometer.
2. Discuss the components of isokinetic dynamometer.
3. Discuss Modes of operation in the Isokinetic Dynamometer.
4. Identify Contraindications to isokinetic testing and training.
5. Discuss Advantages and disadvantages of isokinetic dynamometer
Isokinetic dynamometer
Isokinetic is a Latin word means "same movement". Isokinetic movement
is the dynamic movement at a preset controlled velocity.
The early dynamometers were known as passive systems, i.e. they were
only capable of measuring the torque or force generated during the
concentric and isometric contractions.
Active systems are more recent, and although they can still operate
passively, they are now able to measure eccentric muscle contraction.
Isokinetic Testing and Training Equipment
Isokinetic dynamometers (rate-limiting devices that control the velocity
of motion) provide accommodating resistance during dynamic exercises
of the extremities or trunk.
The equipment supplies resistance proportional to the force generated by
the person using the machine.
The preset rate (degrees per second) cannot be exceeded no matter how
vigorously the person pushes against the force arm. Therefore, the muscle
contracts to its fullest capacity at all points in the ROM.
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Components of isokinetic dynamometer:
1 3
4
2
20
5
19 6
18 8
17 7
16
15
14
9
10
12
13 11
1. Headrest Adjust Lock Knob 12. Positive-Lock Casters (all four wheels)
2. Cervical Headrest 13. Footrest Adjust Lock Knob
3. Scapula Roll 14. Foot rest
4. Back Attachment Support Arm 15. Docking Clamp with Lock Knob
5. Scapula Roll Adjustment Knob 16. Femur Strap
6. Torso Straps with Clavicle Pads 17. Pelvic Strap
7. Goniometer 18. Connecting Hub
8. Lower Extremity Compression Device 19. Connecting Hub Lock Knob
9. Sacral pad 20. Lumbar Pad
10. Seat Tilt Lever. 21. Torso Strap Buckles
11.Height Foot Pedal 22. Ex/Flex Mounting Bars (inset)
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Modes of operation in the Isokinetic Dynamometer:
Modern machines are capable of testing and exercising muscles in a wide range
of exercise modes: passive, isometric, and isotonic and isokinetic.
Passive mode
When operating in the passive mode, the velocity remains constant and no
voluntary force is required by the patient to initiate the movement.
Uses:
1. To familiarize the patient with the machine.
2. The motion obtained in this mode is similar to that obtained using
continuous passive motion (CPM) machine to maintain postoperative
range of movement.
3. It is useful mode to begin motor relearning, as required after an ACL
surgery.
Isometric mode
During isometric exercise, the muscle contracts without shortening or
lengthening. As the force of contraction increases, there is an increase in the
tension generated by the muscle, but there is no change in the muscle length and
there is no visible joint movement. Isometric exercise is also called static
exercise. The isometric mode on the dynamometer allows the physiotherapist to
program a series of isometric hold angles throughout the available range of
motion.
Isokinetic mode:
The concept of isokinetic exercise involves training or testing muscle strength
under conditions of constant angular velocity. The isokinetic dynamometer can
be programmed to fix the speed of movement of the exercising range of
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movement. In this mode the angular velocity of the lever arm will remain
constant unlike during isotonic test, where it is variable and controlled by the
patient. The external load applied to the moving segment remains consistent
with the maximum capacity of the muscle throughout the range of either
eccentric or concentric contraction.
Isotonic mode:
The term "isotonic" (iso = same, tonic = tension) is somewhat of a misnomer,
and is therefore best regarded only as a "working definition" because muscle
tension never remains constant throughout range.
During the isotonic mode on the dynamometer, the patient selects the exercise
velocity and thus it may vary across the range. The muscle tension may also
vary through the available joint range and will be weakest at the extremes of
range and greatest in mid range.
Contraindications to isokinetic and training:
Absolute
Non united fractures to limb
Epilepsy
Cardiac insufficiency (unless monitored)
Severe peripheral vascular disease
Aneurysms
Anticoagulants
Recent (< 3 months previous) X-ray/chemo therapy
Long term steroid use (> 3 months)
Acute (< 7 days) muscle/ligament tear.
Pregnancy.
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Any neurological condition (e.g. stroke, Parkinson's disease) unless
closely monitored
Skin problems .
Severe osteoporosis
Malignancy (in area to be tested)
Relative:
Pain
Limited range of motion (severe)
Soft tissue healing
Bone healing
Effusions
Osteoporosis
Anemia
Rheumatoid arthritis.
Recent surgery.
Advantages of isokinetic dynamometer
1. The dynamometer is capable of providing objective and
quantitative strength data in static (isometric) and dynamic muscle
contractions.
2. It measure muscle force, moment, work, power.
3. Isokinetic equipment can provide maximum resistance at all points
in the ROM as a muscle contracts.
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4. Both high- and low-velocity training can be done safely and
effectively. The equipment accommodates for a painful arc of
motion.
5. As a patient fatigues, exercise can still continue.
6. Isolated strengthening of muscle groups is possible to correct
strength deficits in specific muscle groups.
7. External stabilization keeps the patient and moving segment well
aligned.
8. Concentric and eccentric contractions of the same muscle group
can be performed repeatedly, or reciprocal exercise of opposite
muscle groups can be performed, allowing one muscle group to
rest while its antagonist contracts.
9. Computer-based visual or auditory cues provide feedback to the
patient so sub-maximal to maximal work can be carried out more
consistently.
Disadvantages of isokinetic dynamometer
1. The equipment is large and expensive
2. Setup time and assistance from personnel are necessary if a patient is
to exercise multiple muscle groups
3. The equipment cannot be incorporated into a home exercise program
4. Most units allow only open-chain (non-weight-bearing) movement
patterns, which do not simulate lower extremity functions and some
upper extremity functions.
5. Although functional movements typically occur in combined patterns
and at many different velocities, most exercises are performed in a
single plane and at a constant velocity.
6. Although the range of concentric training velocities (up to 500
degrees/sec) is comparable to some lower extremity limb speeds
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during functional activities, even the upper limits of this range cannot
begin to approximate the rapid limb speeds that are necessary during
many sports related motions, such as throwing. In addition, the
eccentric velocities available only begin to approach medium-range
speeds, far slower than the velocity of movement associated with
quick changes of direction and deceleration.
