D. R. Pendergast

Muscle function and functional performance are limited in patients with osteoarthritis (OA). Although aerobic exercise can increase aerobic power and reduce fatigue, it does not appear to improve muscle function. The purpose of this study was to demonstrate the effect of a muscle rehabilitation program on muscle strength, endurance, speed, and function for patients with OA of the knees. Fifteen men (67.6 +/- 6.1 years) with OA of the knees underwent a four-month exercise program, three times per week. Muscle strength, endurance, and speed were 50% less in OA patients than in controls. After rehabilitation, there was a significant increase in strength (35%), endurance (35%), and speed (50%). Deficiencies and improvements in the muscles were greater at longer muscle lengths. Increases in muscle function were associated with decreased dependency (10%), difficulty (30%), and pain (40%). The average increase in all measured parameters was 10% and 25% after two and four months of rehabilitation, respectively. Improvements were sustained for eight months after rehabilitation. The muscle rehabilitation program was designed specifically to improve function; the improved muscle function was translated into improved functional performance.

The relationship between half time of the O2 uptake on-response (t1/2 VO2on, seconds) and early blood lactate accumulation (delta Lab, mmol.1(-1) at the onset of submaximal arm and/or leg exercise was the object of a cross-sectional study of sedentary subjects (S,n = 3), and kayakers (K, n = 8), and of a longitudinal study on 11 untrained subjects of specific arm vs. leg training. In supine arm cranking (W = 125 watts) S had an average t1/2 VO2on of 82 s and a delta Aab of 9.2 mmol.1(-1) compared to 47 +/- 7 s and 4 +/- 1.4 mmol.1(-1), respectively, for K. In longitudinal trainees shorter t1/2 VO2on was accompanied by lower Lab for the trained limbs. Specific limb conditioning in swimmers and runners resulted in shorter t1/2 VO2on. A linear relationship was observed between delta Lab and t1/2 VO2on having an intercept on the time axis at congruent to 20 s and a slope proportional to muscle mass. Trained muscles were grouped closest to the intercept indicating local acceleration of the rate of O2 transfer approaching the t1/2 VO2on for isolated perfused muscle at the onset of work. Since t1/2 VO2on, we conclude that factors distal to the capillary are specifically involved in the local training response.

Body drag, D, and the overall mechanical efficiency of swimming, e, were measured from the relationship between extra oxygen consumption and extra drag loads in 42 male and 22 female competitive swimmers using the front crawl at speeds ranging from 0.4 to 1.2 m/s. D increased from 3.4 (1.9) kg at 0.5 m/s to 8.2 (7.0) kg at 1.2 m/s, with D of women (in brackets) being significantly less (P less than 0.05) than that of men. Mechanical efficiency increased from 2.9% at 0.5 m/s to 7.4% at 1.2 m/s for men, the values for women being somewhat greater than those for men. The ratio, D/e was shown to be identical to the directly measured energy cost of swimming one unit distance, V02/d, and was independent of the velocity up to 1.2 m/s. It averaged 52 and 37 l/km for men and women respectively (P less than 0.05). When corrected for body surface area the values were 27 and 22 l/km-m2 for men and women, respectively (P less than 0.05). The underwater torque, T, a measure of the tendency of the feet to sink, was 1.44 kg-m for men and 0.70 kg-m for women (P less than 0.05). VO2/d increased linearly with T for both men and women of similar competitive experience. However, the proportionality constant delta VO2/d-delta T was significantly less for competitive than noncompetitive swimmers. The analysis of the relationship VO2/d vs. T provides a valuable approach to the understanding of the energetics of swimming.

The purpose of this study was to determine whether subjects with knee osteoarthritis (OA) had reduced muscle strength at various muscle lengths, endurance, contraction velocity and functional capacity, compared with control subjects and whether the decrease was related to functional capacity. Forty-five men and 45 women with knee OA were compared with a control group (41 males, 63 females) of similar age for functional capacity, maximal isometric strength (in vivo length-tension relationship) and endurance (in vivo force-time relationship) of knee flexion and extension and maximal angular velocity (in vivo force-velocity relationship) of knee extension. The OA subjects had increased difficulty (2.03 +/- 0.53) and pain (1.65 +/- 0.29) for activities of daily living (ADLs) and significantly lower strength for extension (72%) and flexion (56%), endurance for the quadriceps (203%) and hamstrings (214%) and velocity (128%). The reductions were greater at longer muscle lengths. These data demonstrate that patients with knee OA have reduced muscle function and functional capacity compared to controls.