Evaluation of the effects of somatotype profiles on pain,proprioception,isokinetic muscle strength and kinesiophobia in patients with meniscopathy

Abstract

BACKGROUND:

Somatotype causes differentiation of physical, physiological and biochemical metabolisms in the body. To what extent meniscopathy (M) is affected by somatotype profiles has been an issue of concern.

OBJECTIVE:

The aim of the study was to investigate whether somatotype profiles have an effect on kinesiophobia, pain, proprioception and isokinetic muscle strength in patients with an M diagnosis.

METHODS:

172 (85 female, 87 male) M patients between the ages of 18 and 65 were included in the study. The Heath-Carter method was used to determine somatotype components. Biodex Isokinetic system at 120 ${}^{\circ}$ /sec angular speed was used for muscle strength measurements, a digital inclinometer with goniometer was used for proprioception measurement, the Tampa Kinesiophobia Scale (TKS) was used for the assessment of kinesiophobia, the Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale was used for the assessment of fatigue and pain, and the visual analogue scale (VAS) was used for pain assessment.

RESULTS:

Five somatotype profiles were found. When the right-left knee proprioception values were compared according to the somatotype profiles of patients, a significant difference was found in favor of balanced ectomorph at 15 ${}^{\circ}$ and 30 ${}^{\circ}$ . No significant difference was found when TKS, FACIT, VAS values were compared in terms of somatotype profiles; while no significant difference was found in TKS, FACIT, VAS (REST-NIGHT) in terms of gender, a significant difference was found in VAS MOVE. Endomorph somatotype was dominant in the M patients.

CONCLUSIONS:

Individuals with M disease showed significant differences in terms of endomorph components. Obesity may also be one of the negative findings for M disease. Somatotype classification may represent a suitable tool for monitoring M.

Keywords

Meniscopathy somatotype VAS FACIT kinesiophobia

1. Introduction

Having knowledge about the isokinetic muscle strength and proprioception status of individuals with different somatotypes is critical in determining the diagnosis and treatment protocols of pathologies such as meniscopathy (M) disease [1].

The knee joint is the largest and the most complex joint in the human body with the widest range of mobility. Disease and dysfunction (loss of balance, gait disturbance) may occur as a result of damage to any structure in this joint [2]. Menisci are the gold standard in providing functionality in the knee joint and protecting the joint from trauma. Menisci are structures located on the tibia; they provide integration with the femoral condyle and there are two menisci in each knee [3, 4]. Both menisci have a fibrocartilage structure; the medial meniscus is semi-circular, while the lateral meniscus is circular. The functions of menisci can be listed as distributing load on the knee, feeding the articular cartilage, facilitating sliding movement in the joint and preventing hyperextension to protect the boundaries of the joint. The meniscus may be ruptured by the simultaneous effects of compressive and rotational forces that occur at the tibiofemoral joint [5]. Meniscal lesions are one of the most common causes of knee dysfunction [6]. Meniscal lesions will increase the load on the knee joint and cause deterioration of meniscal functions such as shock absorption in the joint [7]. In meniscus pathologies, patients usually complain about the pain and instability in their knees [8]. A significant decrease in muscle function, loss of balance and gait disturbance are observed in M patients as a result of decreased load on the knee joint [9]. Patients who do not see pain as a threat continue their activities of daily living, and patients with fear of movement (kinesiophobia) are prone to injury [10, 11]. Menisci contribute to knee biomechanics with their anatomical and proprioceptive features. Damage to these features may cause impairment in knee biomechanics and loss of balance [12].

Proprioception is the sense of knowing body position, which plays an important role in continuing stabilization by providing posture stabilization [13]. In patients with M, decrease or loss of proprioception will cause loss of balance and gait disturbance and such pathological conditions will lead to loss of strength in muscles that carry body weight. A large number of studies have been conducted in the literature on the importance of proprioception. Knee joint is one of the most examined joints in these studies. Loss of proprioception causes loss of strength in muscles carrying body weight [14].

Strength and force produced at a certain angular velocity should be measured in order to determine the performance that occurs during isokinetic muscle strength dynamic muscle contraction. Calculating the isokinetic muscle strength allows us to work the muscle by determining the speed of movement in degrees/second. It also allows for the determination and regulation of appropriate treatment [15]. Factors such as decreased muscle strength and loss of proprioception are important factors that change the body structure of M patients [16].

Somatotype is a method used to define individuals with a series of measurements in terms of body shape and composition, and it is a method that defines the morphological shape of the body and is frequently used in the literature [17]. Somatotype is an important classification technique used in the determination of human body. A large number of studies have reported somatotype level to be an important method in determining and estimating physical and physiological processes [18].

In M patients, body structure, in other words, physical characteristics, are among factors that affect performance directly. This is because they are physical structures or characteristics that affect the emergence of physiological capacities [19]. There is a positive relationship between physiological characteristics and body structure. An increase in muscle structure with body development is a determinant of strength, in other words, body type. Somatotype is morphological identification of human body type and it is the scientific analysis of the relationship between muscularity, fatness and thinness. The relationship between body structure and performance has been and still is a research topic of interest [20].

Although there are many studies in the literature examining the parameters of M disease and body hair, very few body mattresses have an effect on lower extremity muscle strength and proprioception. Especially in M patients, the effect of the functional use of body cells and patients has been a matter of curiosity [21].

Although somatotype analysis is frequently performed in M patients in the literature, the effects of somatotype on muscle strength and proprioception have remained unclear. Detailed body analysis in M patients will provide a better understanding of the disease and will provide a gold standard for orthopaedists and therapists in determining treatment protocols. For this reason, the aim of the study is to determine kinesiophobia, pain, proprioception, isokinetic muscle strength in patients diagnosed with M and to investigate whether somatotype profiles of patients have an effect on these values.

2. Materials and method

172 (85 female, 87 male) M patients between the ages of 18 and 65 were included in the study. Permission for the study was obtained from the Band $\imath$ rma Onyedi Eylül University Faculty of Medicine Ethics Committee (protocol number 2022/131). Patients with surgery on the knee area and patients with neurological disorders were excluded from the study. The sample size was calculated with G-Power 3.1.7 package program, with 95% confidence interval, $\alpha=$ 0.05 and $1-\beta=$ 0.80. All patients included in the study were informed about the study and were asked to read and sign an informed consent form. The study protocol was prepared according to the Declaration of Helsinki.

Participants who were clinically evaluated by specialist orthopaedists with Magnetic Resonance (MR) imaging and who a) had a M level of 1 and 2 according to this evaluation, b) were in the physiotherapy process, c) had not undergone operation, d) who could stand without help during the analysis were included in the study. Patients with a history of recent or previous fracture in the affected or other lower extremity, those with a history of operation on the affected or other lower extremity, those with a history of intraarticular injection to the affected knee within the last 6 months, those with a limitation of joint movement in the bilateral lower extremity and those with a rheumatological disease were excluded from the study.

2.1 Study design

Patients with M on the right knee were included in the study. The participants were chosen randomly and voluntarily. Before the study, after anthropometric measurements of the participants such as age, height, weight and BMI were made, somatotype analysis was performed by measuring flexed arm and calf circumference, humerus and femoral epicondyle diameters and triceps, subscapular, supraspinal and calf skinfold thicknesses. In the light of the parameters taken, after the somatotypes of participants were found, knee isokinetic muscle strength was evaluated at angular velocities of 90 ${}^{\circ}$ /sec, 120 ${}^{\circ}$ /sec, 150 ${}^{\circ}$ /sec according to somatotypes. Isokinetic strength tests of knee and ankle muscles were made by using Biodex System-3 (BS-3, Biodex Medical Systems, Shirley, NY, USA). Before isokinetic tests, a long warm-up of 10 minutes was made with Fitron (Lumex Corp., Ronkonkoma, NY,USA) lower extremity bicycle. To measure strength, the participant was seated and stabilized by using leg, femoral, pelvic and upper body diagonal stabilization bands according to the standard Biodex procedure. The patients watched a demo video of the test before measurements and the exercise phase was performed with 3 repetitions. Following the phase of exercise, the test was performed after a 15-minute resting. Knee extension (0 ${}^{\circ}$ ) and flexion (100 ${}^{\circ}$ ) and ankle dorsiflexion (15 ${}^{\circ}$ ) and plantar flexion (15 ${}^{\circ}$ ) muscle strengths were evaluated by using concentric/concentric mode at an angular velocity of 120 ${}^{\circ}$ /sec. Test procedure was carried out according to manufacturer’s guide [22]. Peak torque (Newton Metre-Nm), average power (Watt), total work (Joule) and H/Q peak torque rate parameters were analysed from the automatic output from the device. Knee joint proprioception sense was evaluated by measuring differences in angular error with the help of a digital inclinometer adapted to the goniometer. The degree of inclinometer was adjusted as 0 ${}^{\circ}$ when the kneed was in full extension and the target angles were determined as 15 ${}^{\circ}$ , 30 ${}^{\circ}$ , 45 ${}^{\circ}$ and 60 ${}^{\circ}$ . For each measurement, three repetitive measurements were made for both knees and the means of differences in angular error were recorded. Fear of movement was evaluated with Tampa Kinesiophobia Scale, while their fatigue was determined with FACIT scale and pain level was determined with VAS.

2.2 Measurements on the patients

2.2.1 Age, height, weight measurements

The patients’ ages were calculated in years and their heights were measured in cm with a steel stadiometer with a precision of 0.1 cm while standing barefoot. Weight was measured in kg by using Tanita BC Segmental Body Analysis System (Tanita Corporation, Tokyo, Japan) while standing barefoot, with no metal on [23].

2.2.2 Isokinetic muscle strength test

Isokinetic strength tests of knee muscles were performed by using Biodex System-3 (BS-3, Biodex Medical Systems, Shirley, NY, USA). Before the isokinetic tests, a 10-minute warm up was performed with Fitron (Lumex Corp., Ronkonkoma, NY, USA) lower extremity bicycle. For strength measurement, the subject was seated and then stabilized by using leg, femoral, pelvic and upper body cross stabilization straps according to the standard Biodex procedure. Before the measurement, the patients watched the demo video of the test and the exercise was performed with three repetitions. The test was performed after a 15-minute rest following the exercise phase. Knee extension (0 ${}^{\circ}$ ) and flexion (100 ${}^{\circ}$ ) and ankle dorsiflexion (15 ${}^{\circ}$ ) and plantarflexion (15 ${}^{\circ}$ ) muscles were evaluated by using concentric/concentric mode at an angular velocity of 90 ${}^{\circ}$ /sec. The test procedure was performed according to manufacturer’s guide [24]. Peak torque (Newton meter-Nm), average power (Watt), total work (Joule) and H/Q peak torque ratio parameters were analysed from the automatic output taken from the device.

2.2.3 Pain analysis (VAS)

Pain analysis was evaluated with VAS. The patients were asked to mark their level of pain on a 10 cm ruler the right and left ends of which read 0 $=$ no pain, 10 $=$ unbearable pain [25]. The marked distance was measured from the left end of the ruler.

2.2.4 Kinesiophobia scale (Tampa)

The original Tampa Kinesiophobia Scale (TKS) was developed in 1991 by Miller, Kopri and Todd, but was not published. Vlaeyen et al. published the 17-item original scale in 1995, with the permission of the researchers who developed it. TKS is a 17-item scale developed to measure the fear of movement/reinjury. The scale includes the parameters of injury/reinjury and fear-avoidance in activities related with work [26].

2.2.5 Proprioception measurement

Sense of proprioception in knee joint was evaluated by measuring differences in angular error by means of a digital inclinometer adapted to goniometer. Three repetitive measurements were made with the patient sitting on a stretcher with the eyes closed and the average of these three measurements were taken. The goniometer’s centre of rotation was located at the knee joint’s centre of rotation. With the knee in full extension, the degree of inclinometer was set to 0 ${}^{\circ}$ and the target angles were set as 15 ${}^{\circ}$ , 30 ${}^{\circ}$ , 45 ${}^{\circ}$ and 60 ${}^{\circ}$ . 3 measurements were made in both knees for each measurement and the average of angular error differences were recorded.

2.2.6 Fatigue scale (FACIT)

The Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale is a self-report measure approved for use in elderly adults. The FACIT is a short, easy to administer measure with 13 items that measure the individual’s level of fatigue while doing usual daily activities during the past week [27]. The FACIT is one of the many different FACIT scales that is a part of the collection of health related quality of life (HRQOL) surveys that aim for the management of chronic diseases, called FACIT Measurement System. The group tests the newly constructed FACIT subscales on a sample consisting of at least 50 samples. FACIT has been translated to more than 45 different languages, which allows for intercultural comparisons.

2.3 Somatotype analysis

Somatotype values of the subjects were determined with Heath-Carter somatotype method. The subjects’ weight, height, flexion arm and calf circumference, humerus and femoral epicondyle diameter measurements, and triceps, subcapular, supraspinale and calf skinfold thickness were used according to this method [28].

2.4 Statistical analysis

Statistical analysis was performed using SPSS version 22.0 software (IBM Corp., Armonk, NY, USA). The normality of the data was analysed using the Shapiro-Wilk test. It was found that the data were not normally distributed and therefore, non-parametric tests were used. The Kruskal-Wallis H test was used to analyse data. The descriptive data were expressed in median and range (min-max). A $p$ value of $<$ 0.05 was considered statistically significant.

3. Results

In the study, 185 M patients were examined, of which 13 patients with dominant left extremity were excluded from these patients. Hence, 172 patients with right extremity dominant M were included in the study.

Table 1
Patient demographics and characteristics

Parameters	Male ( $n=$ 87)	Female ( $n=$ 85)	Total ( $n=$ 172)
Age	48 $\pm$ 1.93	50 $\pm$ 2.63
Mass (kg)	78 $\pm$ 9.08	80 $\pm$ 11.4
Height (m)	1.76 $\pm$ 0.6	1.59 $\pm$ 0.9
Stage 1 M	53 (60%)	49 (57%)	102
Stage 2 M	24 (40%)	36 (43%)	70

Five somatotype characters were identified as mesomorphic endomorph, balanced endomorph, mesomorph endomorph, endomorphic mesomorph and balanced ectomorph. Statistical difference was found between the parameters of age and weight according to somatotype characters. Significant difference was also found in the measurements of subscapular ST (skinfold thickness), supraspinale ST, gastrocnemius ST, gastrocnemius, elbow and knee circumference measurements ( $p<$ 0.05) (Table 1).

Table 2

Median (min-max) values of parameters used in somatotype calculations of participants and Kruskal Wallis H test analysis results

Parameter	Mesomorphic endomorph		Balanced endomorph		Mesomorph endomorph		Endomorphic mesomorph		Balanced ectomorph		$p$
Age (year)	50	(18–45)	47	(18–65)	42	(24–65)	48	(20–65)	44	(22–64)	0.022
Height (cm)	166.5	(150–190)	175	(155–191)	168	(158–184)	166	(152–179)	184	(170–184)	0.104
Mass (kg)	80	(55–105)	74	(55–92)	80	(60–124)	81	(55–120)	67	(55–67)	0.039
Triceps ST ${}^{*}$ (mm)	21	(5–42)	20	(8–36)	18	(8–35)	20	(8–45)	19.7	(18.3–19.8)	0.230
Subscapular ST (mm)	25	(5–45)	20	(12–35)	20	(13–40)	20	(10–39)	12	(6–12)	0.000
Supraspinale ST (mm)	28	(15–60)	22	(15–30)	21	(14–38)	21.5	(6–49)	12	(9–13)	0.000
Calf ST (mm)	28.5	(6–50)	30	(15–37)	23	(10–40)	20	(7–43)	9	(6–9)	0.004
Arm Cir. (cm)	32.5	(27–41)	30	(26–35)	33	(25–42)	34	(24–44)	10	(9–12)	0.146
Calf Cir. (cm)	37.5	(28–45)	36	(31–42)	40	(32–45)	39.5	(33–49)	28.5	(24–28.5)	0.004
Elbow width (cm)	62	(44–90)	60	(45–70)	76	(60–90)	81	(66–104)	34.5	(32–34.5)	0.000
Knee width (cm)	80	(56–110)	74	(34–103)	89	(82–120)	103.5	(91–144)	8	(6.5–8.1)	0.000

${}^{*}$ ST: skinfold thickness, ${}^{**}$ Cir: circumferences.

Table 3

Proprioception deviation values, extension, flexion, peak torque values of isokinetic muscle forces and Kruskall Wallis H test analysis results according to somatotypes

Parameter	Valuables	Mesomorphic endomorph		Balanced endomorph		Mesomorph endomorph		Endomorphic mesomorph		Balanced ectomorph		$p$
Right	15 ${}^{\circ}$	4	( $-$ 10–10)	$-$ 4	( $-$ 8–7)	6	( $-$ 7–20)	5	( $-$ 4–12)	1	( $-$ 6–9)	0.018
proprioception	30 ${}^{\circ}$	5	( $-$ 9–10)	3	( $-$ 4–6)	3	( $-$ 6–9)	4	( $-$ 10–7)	1	( $-$ 6–10)	0.025
	45 ${}^{\circ}$	$-$ 10	( $-$ 20–8)	$-$ 4	( $-$ 4–8)	$-$ 6	( $-$ 14–7)	4	( $-$ 10–8)	3	( $-$ 4–6)	0.230
	60 ${}^{\circ}$	1	( $-$ 7–10)	0	( $-$ 2–6)	2	( $-$ 12–9)	1	( $-$ 6–10)	2	( $-$ 4–12)	0.076
Left	15 ${}^{\circ}$	6	( $-$ 10–10)	$-$ 5	( $-$ 9–7)	10	( $-$ 7–20)	6	( $-$ 4–12)	2	( $-$ 5–8)	0.021
proprioception	30 ${}^{\circ}$	5	( $-$ 9–10)	3	( $-$ 4–6)	4	( $-$ 6–9)	4	( $-$ 10–9)	1	( $-$ 6–7)	0.008
	45 ${}^{\circ}$	$-$ 6	( $-$ 20–8)	$-$ 4	( $-$ 8–8)	$-$ 5	( $-$ 14–7)	$-$ 3	( $-$ 10–8)	3	( $-$ 4–6)	0.230
	60 ${}^{\circ}$	3	( $-$ 7–10)	2	( $-$ 2–6)	3	( $-$ 12–9)	4	( $-$ 6–10)	3	( $-$ 4–12)	0.076
Peak torque	Ext	57.5	(17.4–152.4)	57.2	(25.3–166)	73.7	(21.3–186.3)	61.5	(24.1–148.6)	88	(23–188.5)	0.038
	Flex	21.7	(6.2–88.5)	18	(8–85.3)	33.4	(10.8–94.7)	23.5	(8.9–74.7)	44	(12.3–99.7)	0.022
	H/Q rate	42.3	(16.5–99)	36.6	(16.1–89.3)	40.9	(18.3–66)	40.6	(18.7–70.9)	56.9	(17–97)	0.049

Table 4

Model viewer image

Binary comparison	Right proprioception		Left proprioception		Peak torque
	15 ${}^{\circ}$	30 ${}^{\circ}$	15 ${}^{\circ}$	30 ${}^{\circ}$	Ext	Flex	H/Q rate
Balanced ectomorph – mesomorphic endomorph	0.045	0.016	0.022	0.014	0.046	0.034	0.029
Balanced ectomorph – malanced endomorph	0.032	0.024	0.019	0.047	0.033	0.037	0.021
Balanced ectomorph – mesomorph endomorph	0.030	0.036	0.028	0.019	0.030	0.027	0.041
Balanced ectomorph – mndomorphic mesomorph	0.011	0.032	0.033	0.027	0.034	0.019	0.046

Table 5

Comparison of female and male patients in terms of related parties

Parameter	Valuables	Mann Whitney U
Right proprioception	15 ${}^{\circ}$	0.473
	30 ${}^{\circ}$	0.076
	45 ${}^{\circ}$	0.698
	60 ${}^{\circ}$	0.193
Left proprioception	15 ${}^{\circ}$	0.837
	30 ${}^{\circ}$	0.313
	45 ${}^{\circ}$	0.736
	60 ${}^{\circ}$	0.145
Peak torque	Ext	0.000
	Flex	0.035
	H/Q rate	0.366

Kruskall-Wallis H test was used to examine proprioception and knee extension and flexion muscle strength values and according to the results of this test, a significant difference was found in both right and left knee proprioception at 15 ${}^{\circ}$ and 30 ${}^{\circ}$ according to all somatotype profiles. In terms of peak torque values, statistically significant difference was found in extension, flexion and H/Q ratio values according to all somatotype profiles ( $p<$ 0.05) (Table 2).

A model viewer image table was created to indicate which values of right-left proprioception at (15 ${}^{\circ}$ –30 ${}^{\circ}$ ) and (ext, flex and H/Q rate) were found to have significant differences and were more significant amongst themselves (Table 3).

Table 6

Comparison of the values of TKS, FACIT, VAS (resting, night, moving) applied in terms of all somatotype profiles

Parameter	Mesomorphic endomorph		Balanced endomorph		Mesomorph endomorph		Endomorphic mesomorph		Balanced ectomorph	Kruskal Wallis $T$
TKS	41	(16–55)	39	(36–44)	40	(28–49)	42.5	(31–55)		0.491
FACIT	26	(3–50)	26	(9–45)	29	(7–52)	26	(6–47)		0.983
VAS REST	4	(0–8)	5	(0–7)	4	(0–9)	5	(0–8)		0.332
VAS NIGHT	5	(0–9)	4	(0–8)	5	(0–9)	5	(0–10)		0.944
VAS MOVE	5	(0–10)	6	(1–9)	7	(0–10)	6.5	(0–10)		0.242

Table 7

Comparison of female and male patients in terms of related parties

Parameter	Mann Whitney U
TKS	0.633
FACIT	0.374
VAS REST	0.056
VAS NIGHT	0.113
VAS MOVE	0.003

Mann-Whitney U test was used to compare the right-left knee proprioception values (15 ${}^{\circ}$ , 30 ${}^{\circ}$ , 45 ${}^{\circ}$ , 60 ${}^{\circ}$ ) and peak torque values (flex, ext, H/Q rate) of the female and male in terms of the involved gender. According to the results of this test, a statistically significant difference was found only in flex and ext peak torque values ( $p<$ 0.05) (Table 4).

Kruskal-Wallis T test was used to compare the values of TKS, FACIT, VAS (resting, night, moving) applied to patients with M in terms of all somatotype profiles. No significant difference was found in terms of the results of the test ( $p>$ 0.05) (Table 5).

MannWhitney U test was used to compare the TKS, FACIT, VAS (resting, night, moving) values of females and males in terms of the involved gender. According to the results of this test, a significant difference was found only in VAS (moving) value ( $p<$ 0.05) (Table 6).

4. Discussion

This study aimed to determine kinesiophobia, pain, proprioception and isokinetic muscle strength in patients diagnosed with M and to examine whether the patients’ somatotype profiles had an effect on these values. Five somatotype characters were found: mesomorphic endomorph, balanced endomorph, mesomorph endomorph, endomorphic mesomorph and balanced ectomorph. A statistical difference was found between somatotypes and knee proprioception and quadriceps muscle strength of the patients. In clinical studies conducted, body fat was found to be significantly higher in many diseases such as disc hernia and gonarthrosis [29]. Since this can affect the lateral meniscus and medial meniscus in individuals with excessive body fat, pathologies such as genu varum and genu valgum [30]. Since there may be lateral or medial shifts of the knee at the end of the chain, it will provide a basis for M disease.

Katzmarzyk et al. stated that somatotype classification can be used as a prediction parameter in terms of susceptibility to the disease [31]. Therefore, it can be expected for somatotype classification to be dominant in certain diseases. For example, high level of correlation between coronary artery disease and endomorphy scores that which express fatness or Alzheimer’s disease patients’ being less mesomorphic or more ectomorphic can be concrete examples explaining this situation [32].

It has been found that there is a relationship between M disease and body composition [33], as well as a positive correlation between body fat ratio and knee pathology [34]. Therefore, it can be said that endomorphic tendency increases the risk of developing M. In the current study, M patients had statistically higher endomorphy scores which correlates with the existing literature. At this point, it can be said that body fat is an important risk factor in developing diseases [35]. Excess endomorphic component, which is an indicator of fatness, is an important factor for M disease in patients.

According to the five somatotypes that were found as a result of the study, mesomorph endomorph was high in right proprioception at angular velocities of 15 ${}^{\circ}$ and 30 ${}^{\circ}$ , mesomorph endomorph was high at 15 ${}^{\circ}$ , and mesomorphic endomorph was high at 30 ${}^{\circ}$ in left proprioception. This proves that 15 ${}^{\circ}$ –30 ${}^{\circ}$ angle is important in determining knee proprioception and that different somatotype profiles can be found at different angles. Şenol et al. [36] examined the muscle strength of the participants with the isokinetic system at 90 ${}^{\circ}$ /min, 120 ${}^{\circ}$ /min and 150 ${}^{\circ}$ /min angular velocities and compared these values with their somatotype profiles and found six somatotype characters as a result.

Determination of knee strength is of great importance in the diagnosis of M [37]. The isokinetic system is the gold standard for determining knee strength. While flexion and extension strength were found to be low in M patients, higher values were obtained in H/Q rations [38]. The results of the current study are parallel with the literature. In this case, low knee flexion and extension strength is a risk factor for M disease. We found that knee joint pain occurred during movement in M patients; a study conducted found that menisci are exposed to stress due to the compression of the lateral condyle of the femur on the tibial plateau in endomorphic individuals and as a result, pain occurs [39]. When compared with the results of the current study, pain score during movement was higher in endomorphic individuals, which can be due to damage in artrochinematics [36].

In a study which examined the effects of somatotype on knee perception in M patients, Elek et al. [14] found that proprioception was worse in patients with endomorph component and also knee muscle strength was lower in favour of these individuals. In parallel with the literature, endomorph was higher in right and lefr proprioception. Endomorphy, in other words, high fat ratio, is a negative factor in proprioception.

Balanced ectomorph somatotype was dominant in M patients with high knee extension angle, we also found that this somatotype was higher at 45 ${}^{\circ}$ –60 ${}^{\circ}$ in this somatotype. This suggested that knee extension strength was better at 45 ${}^{\circ}$ –60 ${}^{\circ}$ knee proprioception values in M patients.

The increase in body fat is one of the important health problems that paves the way for the formation of M disease and triggers its progression. Knee problems are common in people with obesity [40]. Therefore, it can be mentioned that the endomorphic tendency increases the risk of developing M disease [21]. The results of the current study support this.

5. Conclusions

Determining proprioception and isokinetic muscle strength according to the somatotype profiles of M patients will shed light on treatment planning. A selective exercise program according to each somatotype profile of M patients will shorten the treatment time. The results found five somatotype classifications that were important distinguishing factors in M patients. Therefore, it can be said that somatotype classification is a parameter that can be applied clinically and can give important clues about M disease. According to the results of the study, different somatotypes have different effects on knee proprioception and isokinetic knee strength in M patients. In this case, planning the treatment according to the somatotype profiles of the patients will contribute to the recovery of the disease in a shorter time.

Funding

The study was not funded by any instution or person.

Author contributions

The author was solely responsible for the conception, design, supervision, materials, data collection and processing, analysis and interpretation, literature review, writing, and critical review.

Ethics statemant

Permission for the study was obtained from the Bandırma Onyedi Eylül University Faculty of Medicine Ethics Committee (protocol number 2022/131). All patients included in the study were informed about the study and were asked to read and sign an informed consent form. The study protocol was prepared according to the Declaration of Helsinki.

Footnotes

Acknowledgments

The author would like to thank the patients who contributed to the study.

Conflict of interest

No financial or non-financial interests related to the subject of this article have been received or will be received from any party. The author declares that no relevant conflicts of interest exist.

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Evaluation of the effects of somatotype profiles on pain,proprioception,isokinetic muscle strength and kinesiophobia in patients with meniscopathy

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Keywords

1. Introduction

2. Materials and method

2.1 Study design

2.2 Measurements on the patients

2.2.1 Age, height, weight measurements

2.2.2 Isokinetic muscle strength test

2.2.3 Pain analysis (VAS)

2.2.4 Kinesiophobia scale (Tampa)

2.2.5 Proprioception measurement

2.2.6 Fatigue scale (FACIT)

2.3 Somatotype analysis

2.4 Statistical analysis

3. Results

Table 1 Patient demographics and characteristics

5. Conclusions

Funding

Author contributions

Ethics statemant

Footnotes

Acknowledgments

Conflict of interest

References

Table 1
Patient demographics and characteristics