The purpose of this study was to determine whether imbalance of the internal and external rotator musculature of the shoulder were etiological factors implicated in impingement syndrome. Shoulder ...torque measurements were obtained from 15 asymptomatic volunteers and 30 patients with chronic impingement syndrome, 15 of whom were evaluated after arthroscopic anterior acromioplasty. Isokinetic strength was assessed using the Biodex system in a modified position (in the plane of the scapula and in 45 degrees abduction) with test speeds of 60 degrees and 180 degrees per second. Internal and external rotator strength values and ratios were calculated for both peak torque and average power. Shoulder rotational strength values and the internal rotator/external rotator ratio were significantly higher in the dominant and nondominant control group shoulders than in the involved and uninvolved impingement shoulders for operated on and nonoperated on patients. These data demonstrate that primary change in the normal internal rotator/external rotator ratio of the shoulder is an etiological factor implicated in impingement syndrome not modified by anterior acromioplasty.
Isokinetic shoulder rotational strength was evaluated in four groups of subjects as follows: 12 nonathletes, 12 runners, 15 tennis players, and 12 baseball players for a total of 51 subjects. The ...tests were performed in the seated 45 degrees abducted test position in the scapular plane at 60, 180, and 300 degrees.s-1 for both shoulders. Peak torque and mean power values were gathered, and from these values the internal/external rotation ratios were calculated. Intergroup comparison showed a progression of the ratio related to the sports discipline. The nonathletes and runners had ratios close to those reported for nonathletes (1.3 to 1.5). The tennis players had ratios close to 1.5, whereas the baseball players had ratios from 1.6 to 2.2. The comparison between dominant and nondominant side showed no significant differences in the tennis players and higher values for the dominant side in the nonathletes and runners under certain conditions (180 degrees.s-1 for the nonathletes and 300 degrees.s-1 for the runners). Regarding the baseball players, the ratio was systematically higher for the dominant side. These results raise questions about the influence of sports discipline on the internal/external rotator muscle ratio and indicate the need to establish normative values based on the characteristics of the population under study.
In the course of bronchoalveolar lavages performed in 115 immunocompromised patients in order to investigate the occurrences of pneumonitis, Pneumocystis carinii pneumonia was diagnosed by ...demonstration of cysts in bronchoalveolar lavage specimens from 11 patients. The cellular phenomena associated with P. carinii infection at the level of the alveolar space were evaluated. Differential cell counts on bronchoalveolar lavage preparations stained by the May-Grünwald-Giemsa method were performed in immunocompromised patients and in ten nonimmunocompromised patients without any respiratory disease. A decrease in the alveolar macrophage count associated with an increase in the polymorphonuclear neutrophil count and the presence of plasma cells and/or immunoblasts was highly suggestive of P. carinii pneumonia. These cellular changes in bronchoalveolar lavage specimens are discussed in relation to the pathologic features usually described in P. carinii pneumonia.
Quantification of the differential cell count and total number of cells recovered from the lower respiratory tract by bronchoalveolar lavage is a valuable technique for the diagnostic study of ...interstitial lung diseases. To examine the effect on the cell counts of different methods of processing the lavage fluid, two comparisons were performed. First, two methods of differential cell counting were compared using 28 fluids. One count was performed in a Malassez hemocytometer after incubation of the living cells with neutral red for five minutes at room temperature; large cells and some small cells that had incorporated neutral red were identified as macrophages. Another count was performed on cytocentrifuge preparations made using the Shandon Cytospin I and Cytospin II and stained by the May-Grünwald-Giemsa method. The percentage of cells identified as lymphocytes was significantly lower on the cytocentrifuge preparations than with the Malassez hemocytometer. In the second study, the differential cell counts on smears prepared by the two types of cytocentrifuge (Cytospin I and Cytospin II) were compared for 32 bronchoalveolar lavage fluids. The percentage of small cells (especially lymphocytes) was lower on preparations made with the Cytospin I than on those made with the Cytospin II, but the difference was not significant. The results indicate that (1) cytocentrifugation of bronchoalveolar lavage fluids does result in a significant loss of small cells, especially lymphocytes, and (2) this loss is not significantly lessened by the use of the Cytospin II.
Objectifs. –
Préciser, à partir d'une revue de la littérature, l'apport de l'isocinétisme dans l'évaluation et la rééducation de l'épaule.
Méthode. –
La revue de la littérature a porté sur les ...publications en langues anglaise et française, recueillies à partir de la banque de données Medline, des références des articles ainsi colligés ce qui a permis l'analyse de publications non indexées. Quatre-vingt-sept articles présentant un intérêt direct pour cette étude ont été retenus.
Résultat. –
La validité de l'évaluation isocinétique de l'épaule est bonne. La reproductibilité, bien qu'inférieure à celle du genou, est satisfaisante sous réserve d'une méthodologie de test rigoureuse. Les valeurs normales, pour les rotateurs, les abducteurs–adducteurs et extenseurs–fléchisseurs sont dépendantes de divers paramètres tels que l'âge, le sexe, la corpulence, l'activité physique pratiquée. Le calcul des ratios agonistes–antagonistes est surtout intéressant en pathologie. Dans le conflit sous-acromial et l'instabilité de l'épaule est constamment observée une modification du ratio des rotateurs, qui apparaît plus comme un agent causal que comme une conséquence de l'affection. Cette modification perdure habituellement après traitement chirurgical de ces atteintes et la normalisation des ratios doit constituer un des éléments de la rééducation postopératoire.
Conclusion. –
L’isocinétisme constitue une méthode de référence en matière d'évaluation de la force musculaire, permettant de détecter les déficits portant sur certains groupes et plus encore les perturbations de la balance agonistes–antagonistes constatées lors de certaines pathologies d'épaule. Il constitue une aide précieuse à la rééducation en orientant la prise en charge préférentiellement sur les groupes déficitaires, en complétant les techniques de renforcement classiques et en permettant un suivi précis des progrès accomplis.
Objective. –
To evaluate the contribution of isokinetic methods of shoulder strength measurement and training.
Method. –
A Medline search of English and French publications, including referenced articles, allowed us to analyse non-indexed publications. Eighty-seven articles were retained for analysis.
Results. –
The isokinetic evaluation of the shoulder is valid. Although reproducibility of shoulder evaluation is inferior to that of the knee, it is nevertheless satisfactory when a rigorous test method is used. Normal values for the rotators, abductors–adductors, and extensors–flexors depend on diverse parameters such as age, gender, fat mass, and the type and intensity of physical activity. The agonist to antagonist ratio is particularly informative in pathological conditions. The ratio is modified in cases of impingement syndrome and shoulder instability, and this modification appears to be a cause rather than a consequence of pathologic features. The ratio generally remains modified post-surgery, and normalization must be a major focus of post-surgery rehabilitation.
Conclusion. –
Isokinetic measurement, particularly disturbances in the agonist–antagonist balance, is a reference method for evaluating shoulder muscle strength and detecting deficits in specific muscle groups seen in certain shoulder abnormalities. Such measurement is a valuable tool for orienting rehabilitation towards the deficient muscle groups, complements classical techniques of muscle strengthening, and is an accurate means for following the rehabilitation progress.
To evaluate the contribution of isokinetic methods of shoulder strength measurement and training.
A Medline search of English and French publications, including referenced articles, allowed us to ...analyse non-indexed publications. Eighty-seven articles were retained for analysis.
The isokinetic evaluation of the shoulder is valid. Although reproducibility of shoulder evaluation is inferior to that of the knee, it is nevertheless satisfactory when a rigorous test method is used. Normal values for the rotators, abductors-adductors, and extensors-flexors depend on diverse parameters such as age, gender, fat mass, and the type and intensity of physical activity. The agonist to antagonist ratio is particularly informative in pathological conditions. The ratio is modified in cases of impingement syndrome and shoulder instability, and this modification appears to be a cause rather than a consequence of pathologic features. The ratio generally remains modified post-surgery, and normalization must be a major focus of post-surgery rehabilitation.
Isokinetic measurement, particularly disturbances in the agonist-antagonist balance, is a reference method for evaluating shoulder muscle strength and detecting deficits in specific muscle groups seen in certain shoulder abnormalities. Such measurement is a valuable tool for orienting rehabilitation towards the deficient muscle groups, complements classical techniques of muscle strengthening, and is an accurate means for following the rehabilitation progress.
A trapped atom interferometer involving state-selective adiabatic potentials with two microwave frequencies on a chip is proposed. We show that this configuration provides a way to achieve a high ...degree of symmetry between the two arms of the interferometer, which is necessary for coherent splitting and recombination of thermal (i.e., noncondensed) atoms. The resulting interferometer holds promise to achieve high contrast and long coherence time, while avoiding the mean-field interaction issues of interferometers based on trapped Bose-Einstein condensates.
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