Exploration isocinétique de l’avant-bras et du poignet. Méthodologie et application à une pathologie tendineuse

Relatively little is known about isokinetic profiles of the forearm and wrist muscles. The aims of the study were therefore to prove the reproducibility of the measurements, to establish reference concentric and eccentric strength values and to determine the effectiveness of an isokinetic eccentric training model in treating chronic epicondylitis.
The concentric and eccentric assessment of healthy male and female subjects allowed the analysis of different parameters: absolute and bodyweight normalized peak torque; bilateral asymmetries and conventional pronator / supinator and flexor / extensor ratios. We have studied the coefficients of variation in a test – retest session. At the same time, 32 patients diagnosed with chronic lateral epicondylitis benefited from an adapted isokinetic eccentric training model (20 to 30 sessions).
The absolute reliability in repeated tests procedure of peak torque measurement appeared satisfactory with CV inferior to 12 %. The bilateral asymmetries did not exceed 24 %. PT ratio study reflected the superiority of the PRO and FLE muscles in comparison to the opposite groups. The eccentric rehabilitative model presented a very satisfactory effect on treating chronic epicondylitis with a significant reduction of pain (Visual Analogic Scale), improvement in the ultrasonographic examination (normalized echoic aspect in 53 % of cases) and normalization of maximal isokinetic strength.
The isokinetic testing of the forearm pronosupinator muscles and wrist flexor-extensor muscles appeared reproducible. Referential values were proposed for different parameters allowing easier interpretation of pathological cases. The isokinetic eccentric rehabilitative model promoted the epicondylitis treatment.