https://orcid.org/0000-0003-2842-3067
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ABSTRACT
Purpose
To review the effectiveness of isokinetic training as an alternative method to traditional isotonic resistance training.
Materials and methods
Researchers examined data from PubMed, CENTRAL, MEDLINE COMPLETE, and Web of Science until February 2023. A total of 365 entries were obtained from databases, including studies that analyzed the effects of isokinetic vs. isotonic-based rehabilitation in athletes (16–50 years) after a surgical knee intervention. Return to sport (RTS), strength of the flex/extensor compartment of the thigh, muscle mass of the thigh, and knee function were screened as main outcomes. Two reviewers independently screened the studies for eligibility and assessed the risk of bias of the included ones.
Results
Six studies involving 181 athletes were included. Isokinetic training demonstrated significant benefits in peak torque for knee flexor-extensor muscles in four studies. Two studies favored isokinetic training over isotonic for strength. Muscle mass findings were mixed, with one study favoring isokinetic significantly and two showing no significant differences. In terms of returning to sport, the isotonic group displayed slightly better limb symmetry index values, but without significance. Isokinetic training outperformed isotonic in two functionality questionnaire studies, while two others showed no significant differences.
Conclusions
Isokinetic training appears equally, if not more effective than isotonic, for restoring strength balance between hamstrings and quadriceps. This could lead to more favorable muscle mass changes. Isokinetic training also parallels isotonic rehabilitation for functional outcomes and meeting return-to-sport criteria. Therefore, isokinetic training should be included as one of the main strength restoration strategies after knee surgery, especially in early and middle rehabilitation stages.
Registration number
The present systematic review was registered on PROSPERO (registration number: CRD42022370398).
Abbreviations
| ACL | = | Anterior cruciate ligament |
| RTS | = | Return to sport |
| PT | = | Peak torque |
| ROM | = | Range of motion |
| PRISMA | = | Preferred Reporting Items for Systematic Reviews and Meta-Analyses |
| RCTs | = | Randomized controlled trials |
| LSI | = | Limb symmetry index |
| H/Q | = | Hmastrings/quadriceps |
| MRI | = | Magnetic resonance imaging |
| IKDC | = | International Knee Documentation Committee |
| RoB 2 | = | Risk of Bias 2 |
| IKG | = | Isokinetic group |
| STG | = | Self-training group |
| ITE | = | Isokinetic torque of extensors |
| ITF | = | Isokinetic torque of flexors |
| WTG | = | Weight training group |
| ACL-RSI | = | Anterior Cruciate Ligament-Return to Sport after Injury |
| KOOS | = | Knee Injury and Osteoarthritis Outcome Score |
Disclosure statement
No potential conflict of interest was reported by the author(s).
Authors contribution
AP, DG, and HP-G contributed to the study conception and design. Material preparation, data collection and analysis were performed by AP, DG, and JP. The first draft of the manuscript was written by AP and DG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/00913847.2023.2297666