Isokinetic Training/Testing

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JLS_PT_OCS -> Isokinetic Training/Testing (March 7, 2005 3:46:00 AM)
Does anyone use Isokinetic training or testing in their clinic? If so, do you use it to determine return to activity or return to sports? Do you feel this is or is not a valuable or must-have item for an outpatient clinic that sees athletes? Thanks.

JLS_PT_OCS -> Re: Isokinetic Training/Testing (March 7, 2005 3:53:00 AM)
I know this will come as a surprise to everyone, but I have a strong opinion on this... We have one in our clinic, and I think it is a collossal waste of money and space. Everytime I see it, I just imagine what kind of cool stuff we could put in it's place. I feel that it is probably used by many PTs to provide one piece of a patient's care and treatment, and as one piece of information (along with others) in making return to activity determinations. I don't really feel that is bad or wrong, but I do feel that it has a poor cost vs benefit ratio. Beyond the functional argument of when do you sit down and do something vigorously in a sport or life situation (i know there are some exceptions), there are a multitude of other factors that play into return to activity guidelines. In my opinion the most important things are movement technique, landing/eccentric ability and single leg strength, measured in a closed chain type situation. An expensive isokinetic machine will not help me do any of that. Other thoughts?

Brian Schiff, PT, CSCS -> Re: Isokinetic Training/Testing (March 7, 2005 4:56:00 AM)
Jason, I tend to agree with you that isokinetics is not the end all for clinical decision making. However, that being said, I have found in my experience (and I have rehabbed hundreds of patients with ACL tears) the strength results on the isok tests usually mirror the functional tests I do. For example, if a client tests at 70% quad strength at peak torque compared to uninvolved, they also usually struggle with eceentric loading and single leg squat. Now, I will readily admit there are plenty of exceptions, and I have let athletes run and jump even with substandard isok tests, provided they had no swelling, great Lachman and adequate neuromuscular control. So, in my mind the test is a small part of the overall equation. Would I spend big bucks on it? That would probably depend on if my biggest referring physician thought it was very important or not. Hope this helps. Overall, I feel closed chain testing and evaluation is the best.

JLS_PT_OCS -> Re: Isokinetic Training/Testing (March 7, 2005 6:01:00 AM)
Brian, Thanks for your input. I am glad you brought up the question of Isokinetics vs functional testing, there were a couple of abstracts from CSM i'd like to post. Would you really let the physician's opinion drive your purchase of such an expensive device? Interesting, I can certainly see why it would be important. Actually, we have one in our clinic and occasionally get some referrals for it. We are the only clinic in our area (among multiple other military clinics) that has it, so for now, my boss says it stays. Can I put you in my "No Biodex, please" column? :) The abstracts appear below...

JLS_PT_OCS -> Re: Isokinetic Training/Testing (March 7, 2005 6:11:00 AM)
Well, I'm getting a strange error when I try to post the abstracts...I'll try later, in the meantime everyone feel free to chime in... J

Brian Schiff, PT, CSCS -> Re: Isokinetic Training/Testing (March 7, 2005 7:54:00 AM)
Jason, I would probably be in the "No biodex column." In regard to physicican opinion, it depends on if you are looking at the business side of it. In the clinic I am affiliated with, there is a certain physician who does research and studies using the data and he wants a test at 12 weeks, 16 weeks and 20 weeks. Sometimes he sends them back at 6 months. He refers over 700 patients a year. So, the cost may be worth it based on the referrals (if I am running the clinic as a business manager). However, let me be clear in that I effectively communicate the functioanl evaluation components to all physicians and surely do not base my clinical decisions on this one piece of data. Unless they kick field goals or soccer balls, the isok data may not be worth much. I think this machine ebbs and flows in popularity and is for the most part cost prohibitive and takes up a lot of space.

JLS_PT_OCS -> Re: Isokinetic Training/Testing (March 7, 2005 9:54:00 AM)
Well said, on all points. Thanks for your input. Anyone else?? J

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