The Adaptive Force as a Potential Biomechanical Parameter in the Recovery Process of Patients with Long COVID
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Questionnaires
2.3. Handheld Device to Measure the Adaptive Force
2.4. Manual Muscle Test to Assess the Adaptive Force: Procedure and Setting
2.5. Procedure
2.6. Data Processing and Statistical Analyses
- Maximal Adaptive Force (AFmax):
- 2.
- Maximal isometric Adaptive Force (AFisomax):
- 3.
- Adaptive Force at the moment of onset of oscillations (AFosc):
- 4.
- Slope of force rise:
3. Results
3.1. Number of Trials and Subjective MMT Ratings by the Testers
3.2. Parameters of Adaptive Force in the Course of Long COVID
3.2.1. Slope of Force Increase
3.2.2. Maximal Adaptive Force and Maximal Isometric Adaptive Force
3.2.3. Onset of Oscillations during Force Increase
3.3. Patients Characteristics Regarding Long COVID
4. Discussion
4.1. Comparison of the Subjective Ratings of the Manual Muscle Test and Measured AF
4.2. Adaptive Force in the Recovery Process of Long COVID
4.3. Neurophysiological Considerations with Respect to the Reaction of AF in Long COVID
4.4. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Hip Flexors (n = 144) | Elbow Flexors (n = 118) | |||||
---|---|---|---|---|---|---|
MMT Rating | pre | Post | End | pre | Post | End |
unstable | 48 | 2 | 0 | 39 | 2 | 1 |
stable | 0 | 42 | 47 | 0 | 35 | 40 |
unclear | 0 | 3 | 2 | 0 | 1 | 0 |
Parameter | Time Point | M ± SD | 95%-CI | F (df1,df2) or z (df) | Significance p | η2/Kendall’s W |
---|---|---|---|---|---|---|
elbow flexors (n = 14) | ||||||
AFmax (N) | pre | 177.02 ± 53.47 | 149.01; 205.03 | 1.054 (1.43,18.63) a | 0.345 | - |
post | 184.74 ± 39.02 | 164.27; 205.15 | ||||
end | 187.87 ± 52.00 | 160.63; 215.11 | ||||
AFisomax (N) | pre | 87.92 ± 54.41 | 59.42; 116.42 | 114.772 (2,26) | <0.0001 | 0.898 |
post | 182.26 ± 38.58 | 162.05; 202.47 | ||||
end | 187.22 ± 52.15 | 159.90; 214.53 | ||||
Ratio AFisomax to AFmax (%) | pre | 46.58 ± 15.91 | 38.25; 54.91 | 25.064 (2) b | <0.0001 | 0.895 b |
post | 98.73 ± 3.01 | 97.15; 100.31 | ||||
end | 99.62 ± 0.96 | 99.12; 100.13 | ||||
AFosc (N) | pre | 170.95 ± 49.17 | 145.20; 196.71 | 5.274 (2,26) | 0.012 | 0.289 |
post | 144.54 ± 44.83 | 121.06; 168.03 | ||||
end | 146.51 ± 48.64 | 121.04; 171.99 | ||||
Ratio AFosc to AFmax (%) | pre | 96.87 ± 2.85 | 95.38; 98.36 | 23.403 (2,26) | <0.0001 | 0.643 |
post | 76.95 ± 11.89 | 70.73; 83.18 | ||||
end | 76.98 ± 11.09 | 71.17; 82.79 | ||||
Ratio AFosc to AFisomax (%) | pre | 258.83 ± 110.74 | 200.82; 316.84 | 34.701 (1.02,13.19) a | <0.0001 | 0.727 |
post | 78.06 ± 12.30 | 71.62; 84.50 | ||||
end | 77.28 ± 10.92 | 71.55; 83.00 | ||||
Slope lg(N/s) | pre | 1.85 ± 0.23 | 1.73; 1.98 | 1.282 (2,26) | 0.294 | - |
post | 1.87 ± 0.18 | 1.78; 1.97 | ||||
end | 1.90 ± 0.21 | 1.79; 2.01 | ||||
hip flexors (n = 17) | ||||||
AFmax (N) | pre | 174.98 ± 50.03 | 148.77; 148.77 | 0.015 (2,32) a | 0.952 | - |
post | 175.67 ± 40.95 | 154.22; 197.12 | ||||
end | 174.21 ± 46.78 | 149.71; 198.72 | ||||
AFisomax (N) | pre | 88.30 ± 40.67 | 66.99; 109.61 | 88.739 (1.47,23.45) a | <0.0001 | 0.847 |
post | 173.30 ± 41.75 | 151.43; 195.18 | ||||
end | 174.06 ± 46.80 | 149.54; 198.58 | ||||
Ratio AFisomax to AFmax (%) | pre | 49.25 ± 12.01 | 42.96; 55.54 | 32.109 (2) b | <0.0001 | 0.944 b |
post | 98.54 ± 3.44 | 96.74; 100.35 | ||||
end | 99.91 ± 0.39 | 99.70; 100.11 | ||||
AFosc (N) | pre | 167.10 ± 43.80 | 144.16; 190.04 | 27.952 (2,32) | <0.0001 | 0.636 |
post | 116.47 ± 39.63 | 95.71; 137.23 | ||||
end | 110.06 ± 40.81 | 88.68; 131.44 | ||||
Ratio AFosc to AFmax (%) | pre | 95.19 ± 5.59 | 92.26; 98.12 | 53.417 (2,32) | <0.0001 | 0.77 |
post | 65.62 ± 11.56 | 59.57; 71.68 | ||||
end | 62.01 ± 13.74 | 54.81; 69.21 | ||||
Ratio AFosc to AFisomax (%) | pre | 223.06 ± 69.65 | 186.57; 259.54 | 78.199 (1.07,17.11) a | <0.0001 | 0.83 |
post | 66.88 ± 13.18 | 59.97; 73.78 | ||||
end | 62.07 ± 13.78 | 54.85; 69.29 | ||||
Slope lg(N/s) | pre | 1.85 ± 0.18 | 1.75; 1.94 | 3.260 (1.45,21.73) a | 0.071 | - |
post | 1.93 ± 0.15 | 1.85; 2.00 | ||||
end | 1.89 ± 0.14 | 1.81; 1.97 |
Stress M ± SD (Range, n) | Before COVID | Long COVID State (pre) | End | Friedman Test | Significance p | Effect Size Kendall’s W |
---|---|---|---|---|---|---|
Stress level job-related | 4.23 ± 2.56 (0–9, n = 11) | 5.64 ± 2.95 (0–10, n = 14 *) | 2.29 ± 3.17 (0–8, n = 12) | 0.667 | 0.717 | - |
Stress level personal life | 3.77 ± 2.70 (2–10, n = 12) | 4.76 ± 2.75 (0–10, n = 17) | 3.29 ± 3.53 (0–9, n = 12) | 4.056 | 0.132 | - |
Symptoms M ± SD (range) | n = 14 | n = 14 | n = 13 | |||
Depression/anxiety | 1.43 ± 2.21 (0–8) | 3.96 ± 3.78 (0–10) | 1.58 ± 2.33 (0–7) | 9.389 | 0.009 1,2 | 0.361 |
Fatigue | 0.43 ± 0.76 (0–2) | 7.75 ± 2.50 (1–10) | 2.23 ± 2.67 (0–7.5) | 22.217 | <0.001 1,2 | 0.855 |
Post-exertion malaise | 0.57 ± 1.40 (0–5) | 8.14 ± 1.96 (3–10) | 2.23 ± 3.06 (0–9) | 20.311 | <0.001 1,2 | 0.781 |
Muscle pain | 0.29 ± 0.61 (0–2) | 5.64 ± 4.27 (0–10) | 1.65 ± 2.81 (0–8) | 14.800 | 0.001 1,2 | 0.569 |
Chest pain/tightness | 0.00 ± 0.00 | 3.43 ± 3.01 (0–9.5) | 0.88 ± 1.23 (0–4) | 18.667 | <0.001 1,2 | 0.718 |
Breathing difficulties | 0.29 ± 0.61 (0–2) | 4.29 ± 2.37 (1–8) | 1.23 ± 1.36 (0–3) | 23.106 | <0.001 1,2 | 0.889 |
Cough | 0.14 ± 0.36 (0–1) | 2.23 ± 3.00 (0–10) | 0.46 ± 0.97 (0–3) | 16.267 | <0.001 1,2 | 0.678 |
Strong/fast heartbeat | 0.36 ± 1.08 (0–4) | 4.93 ± 4.03 (0–10) | 0.69 ± 1.18 (0–3) | 17.882 | <0.001 1,2 | 0.688 |
Concentration/memory problems | 0.43 ± 0.76 (0–2) | 5.96 ± 3.20 (0–10) | 2.88 ± 2.60 (0–9) | 23.130 | <0.001 1,2 | 0.890 |
Dizziness | 0.14 ± 0.36 (0–1) | 4.71 ± 3.81 (0–10) | 0.92 ± 1.98 (0–7) | 16.800 | <0.001 1,2 | 0.646 |
Headache | 0.64 ± 1.28 (0–4) | 5.29 ± 4.07 (0–10) | 0.81 ± 1.28 (0–3) | 18.242 | <0.001 1,2 | 0.702 |
Loss of smell or taste | 0.00 ± 0.00 | 4.39 ± 4.85 (0–10) | 1.35 ± 3.16 (0–10) | 13.923 | 0.001 1 | 0.536 |
Fever | 0.00 ± 0.00 | 2.14 ± 3.66 (0–10) | 0.23 ± 0.83 (0–3) | 7.538 | 0.023 | 0.290 |
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Schaefer, L.V.; Bittmann, F.N. The Adaptive Force as a Potential Biomechanical Parameter in the Recovery Process of Patients with Long COVID. Diagnostics 2023, 13, 882. https://doi.org/10.3390/diagnostics13050882
Schaefer LV, Bittmann FN. The Adaptive Force as a Potential Biomechanical Parameter in the Recovery Process of Patients with Long COVID. Diagnostics. 2023; 13(5):882. https://doi.org/10.3390/diagnostics13050882
Chicago/Turabian StyleSchaefer, Laura V., and Frank N. Bittmann. 2023. "The Adaptive Force as a Potential Biomechanical Parameter in the Recovery Process of Patients with Long COVID" Diagnostics 13, no. 5: 882. https://doi.org/10.3390/diagnostics13050882