1. General principles of Strengthening exercises Isokinetic Assessment and Rehabilitation
Panagiotis V. Tsaklis, PT, ATC, B.Ed, PhD
Professor
Dept. Physiotherapy – ATEI Thessaloniki / Greece
Dept Mechanical Engineering
Fibers & Polymers Lab
Massachusetts Institute of Technology

2. Strengthening exercises…
Isometrics > max / sub-max > specific angleº…
Isotonics > concentric > max 1RM / sub-max %1RM > specific ROM
> eccentric > max / sub-max > specific ROM
Isokinetics > concentric > max / sub-max > specific ROM
Plyometrics > eccentric---concentric contraction--- t~0
Functional exercises…

3. Isometric strengthening at specific angle
Note : Strengthening overflow ± 10º
from the point of application
Max or sub-max
N of Sets & Reps
Time hold / sec
Time between Reps / sec
Time between Sets / min
75 °
55 °
65 °

4. Open & Close Kinetic Chain isotonic exercises
1RM test must be perform with a controlled low angular speed,
aprox 60º/sec..and sameway when we are practicing using isotonics…
CKC
OKC

5. The relation between speed of practice and muscle fibers recruitment

6. Isokinetic Exercise
Fixed speed with a variable resistance through the predetermined ROM
accommodation of the resistance proportionally to the effort => max-load /º

7. ISOKINETIC DYNAMOMETER
THE ISOKINETIC EXERCISE
IS APPLIED
IN ALL
THE MAIN ARTICULATIONS
OF THE BODY
AND ACTIVATES
THE RELEVANT ANTAGONISTIC
MUSCLE GROUPS
IN EVERY MOOVING PATERN

8. ISOKINETIC APLLICATIONS
TEST
EXERCISE

9. ISOKINETIC TESTING DATA
Parameters analysis :
strength – time – position
Analysis of the Torque Curve

10. Ergo-physiological parameters assessing by isokinetic testing
Maximal strength (Torque) of the testing muscle groups (Peak Torque - Nm)
Fast contraction strength output (speed-force)
Dynamic relation (ratio %) between the competitive (antagonistic) muscle groups
Total work output (Total Work – Joules) & (Fatigue index), force endurance assessment index
Aveg. Power output of the testing muscles (Power - Watts)

11. Ergophysiological parameters assessing by isokinetic testing

12. Total work – avg. power & Fatigue Index

13. Results: Isokinetic endurance test Vs Wingate 30’’ test
Correlation Wigate Vs Isokinetic Median Power
Mean
Std. Deviation N
WMP 20
IMP
758.00
176.70
Correlations
Correlations
Results: Isokinetic endurance test Vs Wingate 30’’ test
Correlation Wingate Vs Isokinetic Median Power
240º/sec * 30’’ º ROM
r = .927
Mean
Std. Deviation N
WMP 20
IMP
758.00
176.70
P. Tsaklis : “Isokinetic evaluation of the knee extensors and flexors anaerobic capacity”
ISOKINETICS AND EXERCISE SCIENCE, Vol .10, No .2, 2002

14. Dynamic relation (ratio) between competitive groups

15. ?

16. Torque curve analysis 1/8’’ TAE Time to PT Time PT held
Force decay time
Delay time
Joint angle at PT
Reciprocal delay

20. Biofeedback during Isokinetic practicing

21. Combination of isokinetic exercise & EMG Biofeedback0°

22. Basic rehabilitation principles
Functional rehabilitation as…
…soon as “safely” possible…
What’s next…

24. Main goals for a joint functionality rehabilitation
Protection of the cartilage during healing process…
Retaining and enforcement of muscle activity
Retaining of the joint mobility
Supporting of the healing process using food supplements

25. The proper construction of the rehabilitation program should…
…follow the principles of…
Physiotherapy
Exercise physiology
Training science

26. Should Isokinetics be the unique choice for strengthening during rehabilitation & training

27. Isokinetic strengthening in compare and in combination with isotonics
Repeated Thigh circumference measurements
repeated maximal Isotonic effort measurements
1RM
groups
groups
“ACL rehab program using a combined isokinetic and isotonic strengthening protocol”
P. Tsaklis, J. Isokinetics & Exercise Science,Vol. 10, No.4, 2002

28. Isokinetic strengthening in compare and in combination with isotonics
J. Isokinetics & Exercise Science, 2002
Ratio Q/H
60º/sec
P. Torque Q
60º/sec
P. Torque Hams
60º/sec
Ratio Q/H
120º/sec

29. Conclusions…
Isokinetic testing is the most accurate procedure for strength evaluation and analysis of the parameters which determine the muscle power output
Isokinetic exercise is a practice method for the muscle, who secures and gets the maximal resistance in every degree of the activated ROM
Isokinetic exercise when applicates in combination with the other methods of muscle strengthening, offers the best and functional rehabilitation result

30. …I hope not get hungry yet…

31. Thank you