Excerpts
Cardiovascular Responses to Velocity-Specific Isokinetic Exercise

Peter C. Douris, EdD, PT

Journal of Orthopaedic and Sports Physical Therapy Vol.13;1:1991
The purpose of this study was to measure cardiovascular responses to velocity-specific isokinetic exercise. Ten experienced recreational weight trainers, aged 20 to 40 years, took part in a repeated measures design consisting of three separate treatments (30/sec, 120 /sec, and 300 /sec performed maximally for one minute by the right knee flexors and extensors on an isokinetic dynamometer). Systolic bood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and rate pressure product (RPP) were measured at rest and during peak response. There were no significant differences between the three treatments in increasing SBP and DBP, although peak SBP for all three treatments was above 188 mm Hg, clinically significant. The 300 /sec treatment was significantly different (P 0.05) than the 30 /sec treatment on increasing HR and RPP. The data suggest that the magnitude of HR and RPP responses are strongly dependent on the velocity of movement utilized during maximal isokinetic exercise.
The Effect of Isokinetic Exerices on the Relationship between Blood Lactate and Muscle Fatigue

 Peter C. Douris, EdD, PT

Journal of Orthopaedic and Sports Physical Therapy Vol.17;1:1993

Exercise velocity may be an important variable in determining the amount of blood lactate accumulation during isokinetic exercise. The purpose of this study was to measure the effects of velocity-specific isokinetic exercise on blood lactate, muscle fatigue index, and rating of perceived exertion and to examine the relationship between blood lactate and muscle fatigue index. Ten experienced recreational weight trainers, aged 20-40 years, took part in a repeated measures design consisting of three separate treatments (constant angular velocity at 30, 120, and 300/sec performed at maximal effort for 1 minute by the right knee flexors and extensors). Rating of perceived exertion, blood lactate, and muscle fatigue index were measured in response to each treatment. Rating of perceived exertion was equal across all three speeds. Muscle fatigue and blood lactate increased significantly as the velocity of exercise increased. There was also a positive correlation coefficient (r = .82, p = 0.01) between muscle fatigue index and blood lactate. The data suggested that the magnitude of muscle fatigue index and blood lactate responses are strongly dependent on the velocity of movement utilized during maximal isokinetic exercise, and there is a relationship between muscle fatigue index and blood lactate.

The Effect of Thoracic Spine Mobilization on Lower Trapezius Strength Testing

Ethan John Liebler, Lisa Tufano-Coors, Peter Douris, Howard W. Makofsky, Raymond McKenna, Christopher Michels, Shawlyn Rattray

The Journal of Manual & Manipulative Therapy Vol.9;4:2001

Evidence shown that muscle strength and function become altered due to motion restrictions. Strengthening muscles with tradition therapeutic exercise will not be completely successful unless inhibition is removed by restoring normal joint mechanics. This study investigates the effect of Grade-IV thoracic spine mobilizations on lower trapezius strength testing in normal subjects. The mobilization for the treatment group (n=20) consisted of posterior-anterior (P-A) oscillations performed from T6-T12 at each segment’s end range (Grade-IV). This technique is aimed at restoring normal joint play. The control group (n=20) received a Grade-I mobilization consisting of P-A oscillations performed at the beginning of the joint’s range, which is not expected to have articular reflexogenic effects. Before and after the mobilizations, isometric muscle strength of the lower trapezius was measured using a Nicholas Manual Muscle Tester. An independent group t-test comparing the groups demonstrated a statistically significant effect of thoracic spine mobilizations on lower trapezius strength testing (P<.05).

Recovery of Maximal Isometric Grip Strength Following Cold Immersion

Peter Douris,Raymond McKenna,Kathrine Madigan, Brian Cesarski, Robert Costiera, and Michael Lu

Journal of Strength and Conditioning Research Vol. 17;3:2003

The purpose of this study was to investigate the effects of various cold immersion durations on maximal grip strength and the subsequent recovery of grip strength. Sixteen healthy men between 20 and 42 years of age participated in this study. Maximal isometric grip strength was measured before, immediately after, and 5, 10, and 15 minutes after cold immersion. Subjects submerged their dominant elbow, forearm, and hand in a cold water whirlpool at 10° C for 5, 10, 15, or 20 minutes. There was a significant decrease in isometric grip strength when the forearm was immersed in 10° C water for durations between 5 and 20 minutes and no recovery of this strength loss for a period of 15 minutes following removal from the cold immersion (p = 0.0001). These findings suggest that clinicians should be aware of the alterations in isometric muscle strength that result from utilizing the temperature and time frames of cold application used in this study.


The Effect of Land and Aquatic Exercise on Balance Scores in Older Adults

Peter Douris, Veronica Southard, Celia Varga, William Schauss, Charles Gennaro, Arthur Reiss

Journal of Geriatric Physical Therapy Vol.26;1:2003

Background and Purpose: Lower body exercises are an important intervention in retaining balance. The aquatic environment has been identified as an appropriate medium to perform these exercises. The purpose of this research was to determine if aquatic exercise was more effective than land-based exercise when training balance. Study Design: The study involved a 2-group pretest-posttest design. The Berg Balance Scale (BBS) scores served as the outcome measure. Methods: Eleven subjects completed this study. Five subjects were from an assisted living facility (age 83.2 + 8.1 years) and 6 subjects were from an outpatient facility (age 75.0 + 3.6 years). Each group did a comparable set of lower body exercises (2 times per week for 6 weeks), but one group exercised in the pool, and the other exercised on land. The data was analyzed using a mixed model 2x2 analysis of variance. Results: There was a significant main effect of time (p < .001) but not group on BBS scores. There was no significant interaction between group and time. Conclusions: Regardless of the treatment medium, significant improvements were evidenced on the BBS between pretest and post-test. The utilization of lower body exercise, whether in water or on land, was accompanied by improved balance. Neither medium however was superior for training balance in the older adult.


Fitness levels of middle aged martial art practitioners

P Douris, A Chinan, M Gomez, A Aw, D Steffens and S Weiss

British Journal of Sports Medicine Vol. 38:2004

Objectives: To quantify and compare fitness levels of middle aged practitioners of soo bahk do (SBD; a Korean martial art similar to karate) with those of sedentary subjects. Methods: Eighteen volunteers, 14 men and four women (aged 40–60 years), participated. Nine sedentary subjects (mean age 46.7 years) and nine SBD practitioners (mean age 46.8 years) were matched for sex and age. All subjects participated in a one day battery of fitness tests. The following dependent variables were tested: body composition, balance, flexibility, quadriceps strength, grip strength, muscle endurance, and aerobic capacity. Results: All dependent variables were analysed using paired t tests. Body composition (% body fat) for the SBD group was 18.9% v 30.8% for the sedentary group (p = 0.004). The SBD group was able to balance for 61.8 seconds v 26.2 seconds for the sedentary group (p = 0.02). The result for the sit and reach flexibility test was 22.3 cm for the SBD group v 10.4 cm for the sedentary group (p = 0.01). The number of push ups performed in one minute was 47.0 for the SBD group v 18.6 for the sedentary group (p = 0.0003), and the number of sit ups performed was 66.1 for the SBD group and 37.3 for the sedentary group (p = 0.00006). Aerobic capacity was 41.0 ml/kg/min v 31.1 ml/kg/min for the sedentary group (p = 0.04). Quadriceps strength was 99.5% (peak torque/body weight) v 83.0% for the sedentary group (p = 0.02). Only grip strength was not significantly different. Conclusions: There were significant differences between the groups for most of the physical fitness tests. The SBD practitioners displayed greater aerobic capacity, balance, flexibility, muscle endurance, and strength, and less body fat than the sedentary controls matched for age and sex. SBD can be considered an excellent form of exercise for the promotion of fitness in adults. Health professionals should be aware that there are alternative methods to traditional exercise that can increase the physical fitness and health of the middle aged population.

The Relationship Between Maximal Repetition Performance and Muscle Fiber Type as Estimated by Noninvasive Technique in the Quadriceps of Untrained Women

 Peter C. Douris, Benjamin P. White, Robert R. Cullen, William E. Keltz, John Meli, Dan M. Mondiello, and David Wenger

 Journal of Strength and Conditioning Research 20(3): 699-703.2006

Abstract: The relationship between maximal repletion performance and muscle fiber type as estimated by noninvasive technique in the quadriceps of untrained women. The purpose of this investigation was to establish a relationship between the number of repetitions an individual can complete at a predetermined load and their percentage of type II muscles fibers in their quadriceps. Subjects included 22 untrained women between the ages of 18 and 34. Day 1 consisted of noninvasive anthropologic testing, 1 repetition maximum (1RM) testing, and recording repetition performance at 70% 1RM. Day 2 consisted of isokinetic dynamometry to determine muscle fiber composition. Results were obtained and analyzed using the Pearson product correlation coefficient (r). The results demonstrated a fair-to-moderate relationship (Pearson r = -0.48, p = 0.02) that individuals with greater percentages of type II muscle fibers performed fewer repetitions at 70% 1RM. The results of this study demonstrate that muscle fiber type composition is an important variable to consider when designing training or rehabilitation programs.

Effect of Phototherapy on Delayed Onset Muscle Soreness

Peter Douris, Veronica Southard, Richard Ferrigi, Joshua Grauer, Dina Katz, Christina Nascimento and Peter Podbielski

Photo medicine and Laser SurgeryVol.24; 3:2006

Abstract: The purpose of this study was to investigate the effects of phototherapy on delayed onset muscle soreness (DOMS) as measured using the Visual Analog Scale (VAS), McGill Pain Questionnaire Resting Angle (RANG), and girth measurements. Background Data: Previous research has failed to prove the beneficial effects of phototherapy on DOMS. Methods: This was a randomized double-blind controlled study with 27 subjects (18-35 years) assigned to one of three groups. The experimental group received 8 J/cm2 of phototherapy each day for five consecutive days using super luminous diodes with wavelengths of 880 and visible diodes of 660 nm at three standardized sites over the musculotendinous junction of the bicep.  The sham group received identical treatment from a dummy cluster. The controls did not receive treatment.  The study was completed over five consecutive days: on day one baseline measurements of RANG and upper arm girths were recorded prior to DOMS induction. On days 2-5, RANG, girth, and pain were assessed using VAS and the McGill Pain Questionnaire. Results: The experimental group exhibited a significant decrease in pain associated with DOMS compared to the control (p = 0.01) and sham groups (p = 0.03) based upon the VAS at the 48-h period. The McGill Pain Questionnaire showed a significant difference in pain scores at the 48-h period between the experimental and the sham groups (p = 0.01). There were no significant differences day to day and between the groups with respect to girth and RANG. Conclusion: The results of this study provide scientific evidence that phototherapy as used in this study provides a beneficial effect to patients who may experience DOMS after a novel exercise session.

Comparison of Once-Weekly and Twice-Weekly Strength Training in Older Adults

 Joanne DiFrancisco-Donoghue, William Werner and Peter Douris

 British Journal of Sports Medicine Vol.42: 2007

 Background: Strength training has been shown to benefit the health and function of older adults. Objective: To investigate whether one set of exercises performed once a week was as effective in increasing muscle strength as training twice a week. Methods: 18 subjects (7 women and 11 men) aged 65-79 years were randomly assigned to two groups. Both groups performed one set of exercises to muscular fatigue; group 1 trained 1 day/week and group 2-trained two days/week on three lower and three upper body exercises for 9 weeks.  The data were analyzed using a mixed model 2x2 analysis of variance. Results: A significant main effect of time (p<0.001), but not group, on one-repetition maximum scores was observed. No significant interaction was observed between time and group and therefore no differences in strength changes between training once a week versus twice a week after 9 weeks. Conclusions: One set of exercises performed once weekly to muscle fatigue improved strength as week as twice a week in the older adult. Our results provide information that will assist in designing strength-training programmes that are more time and cost efficient in producing health and fitness benefits for older adults.

Use of the Occivator for the Correction of Forward Head Posture, and the Implications for Temporomandibular Disorders: A Pilot Study

 Catherine Augustine, Howard Makofsky, Christina Britt, Barbara Adomsky, Jennifer Martire Deshler, Paula Ramirez, and Peter Douris

 Cranio Vol.26; 2:2008

 Abstract: Numerous studies suggest that temporomandibular disorders may be associated with forward head posture. The current study presents a need for an intervention that will effectively facilitate an ideal postural alignment of the head. The Occivator (Posteocentric Systems, Mastic Beach, NY) is an intervention speculated to improve forward head posture (FHP). However there has not been a randomized study to correlate use of the Occivator with improvement of FHP. The purpose of this study was to evaluate the effectiveness off the Occivator as a therapeutic intervention for the correction of FHP. Using a plumb line, twenty-nine (29) subjects were selected on the basis of having FHP. The CROM (cervical range of motion) device was used to determine measurement of forward head position for each group, pre and post an eight-week period. The experimental group followed a specific protocol of 20 minutes of stretches and exercises on the Occivcator, two times a week for eight weeks. The control group did not receive any intervention. The experimental group as compared to the control group demonstrated significant improvement for forward head posture (p=. 02). Further research is needed to evaluate the effectiveness of the Occivator.

Martial Art Training Enhances the Glutathione Antioxidant System in Middle Aged Adults

 Peter C Douris, Ahmed S Elokda, John P Handraki, Suze Principal Eleni Rondo Juan Bovell William P Coughlin Charles N Mastroianni Michael J Won, and Thomas Zimmerman

 Journal of Strength and Conditioning Research 23(5)1518-1523 2009

 The purpose of this study was to compare the antioxidant capacity of physically active middle-aged martial artists to age-matched sedentary controls. Nine sedentary subjects (mean age 52.9) and 9 martial artists (mean age 51.8), who practice Soo Bahk Do, a Korean martial art, were age and sex-matched, performed a graded exercise test (GXT) utilizing a modified Bruce protocol. Ages ranged from 41 to 58 years. A GXT has been shown to be an effective technique for inducing oxidative stress. Glutathione (GSH) is the body’s most highly concentrated antioxidant, is the central component of the antioxidant system, and plays an essential role in protecting tissues against oxidative stress. Free radical oxidation leads to the transformation of GSH to glutathione disulfide (GSSG).  Venous blood samples for GSH and GSSG were collected prior to and immediately following the GXT. Repeated measures ANOVA were performed on the resting baseline values and immediate post-GXT values of GSH, GSSG and GSH:GSSG in order to compare both groups. The blood GSH, GSSG, and GSH:GSSG levels were significantly different (p<0.001), between the 2 groups at rest and after the GXT. The Soo Bahk Do practitioners had higher resting levels of GSH, lower levels of GSSG and responded more effectively to acute oxidative stress than the age-matched sedentary controls. Soo Bahk Do appears to enhance the antioxidant defense system and may be an effective intervention for improving overall health by protecting against the adverse effects of oxidative stress that is associated with free radical theory of aging. Health professionals should be aware of alternative methods of training, conditioning and exercise that can improve the general adaptation response to oxidative stress.
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