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PubMed2005

Shared genetic and environmental effects on strength and power in older female twins.

PURPOSE: This study examined the relative contribution of genetic and environmental effects on maximal leg extensor power and also investigated whether leg extensor power and maximum voluntary isometric knee extensor strength share a genetic component. METHODS: Muscle functions were measured as part of the Finnish Twin Study on Aging in 101 monozygotic (MZ) and 116 dizygotic (DZ) female twin pairs aged 63-76 yr. Leg extensor power was measured using the Nottingham Leg Extensor Power Rig and maximum voluntary isometric knee extensor strength using an adjustable dynamometer chair. The analyses were carried out using the maximum likelihood method in Mx-program on the raw data set. RESULTS: A bivariate Cholesky decomposition model showed that leg extensor power and isometric knee extensor strength shared a genetic component in common, which accounted for 32% of the total variance in leg extensor power and 48% in isometric knee extensor strength. In addition, power and strength had a nonshared environmental effect in common accounting for four percent of the variance in power and 52% in strength. Remaining variance for leg extensor power was due to trait-specific shared and nonshared environmental effects. CONCLUSION: Observed genetic effect in common for leg extensor power and maximum voluntary isometric knee extensor strength indicated that these two traits are regulated by the same genes. However, also environmental effects have a significant role in explaining the variability in power and strength.

Aged↗
PubMed2001

Ageing is not associated with a decline in neuromuscular innervation or reduced specific force in men aged 20 and 50 years.

The exact mechanisms responsible for the decline in strength with age are yet to be completely elucidated. Three proposed mechanisms responsible for the detrimental effect of increasing age on strength include changes in muscle mass, specific force and/or neuromuscular innervation. Thus, the purpose of this investigation was to determine if the age-related reduction in peak isometric strength was primarily associated with changes in muscle cross-sectional area, neuromuscular innervation and/or specific force. The cross-sectional area of the knee extensor muscles (QCSA) was estimated in 13 younger men (YM; 20.8 +/- 1.6 years) and eight middle-aged men (MM; 53.8 +/- 4.2 years) prior to performing a series of four maximal voluntary isometric contractions on an isokinetic dynamometer at an angle of 60 degrees knee flexion. Peak force was determined and surface electromyography was sampled from the rectus femoris muscle during each maximal voluntary contraction. The cross-sectional area of the knee extensor muscles, peak force and integrated electromyography (IEMG) were significantly lower in the MM (P<0.01). However, when peak force and peak IEMG values were corrected for QCSA, there were no significant differences between age groups. These results suggest that the reduction in peak isometric force observed in the MM was primarily associated with quantitative changes in muscle mass, rather than reduced neuromuscular innervation or specific force. Therefore, preserving muscle mass through resistance training may significantly reduce the age-associated differences in peak strength and assist in promoting quality of life and functional independence in older adults.

Adult↗
PubMed2004

Effect of 4-aminopyridine on gait in ambulatory spinal cord injuries: a double-blind, placebo-controlled, crossover trial.

UNLABELLED: Animal and human research have shown that the drug 4-aminopyridine (4-AP) may improve gait in spinal cord lesions by enhancing nerve transmission to affected muscles. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled, crossover trial. OBJECTIVES: To determine the efficacy of 4-AP in improving lower limb muscle strength and biomechanical gait patterns of chronic spinal cord injuries (SCI). SETTING: The Rehabilitation Centre (Ottawa, Canada). METHODS: In all, 15 chronic, ambulatory SCI persons were randomized to an initial 2 weeks of 40 mg/day, oral medication of either placebo or immediate-release, 4-AP and subsequently crossed over to the alternate medication for the following 2 weeks. Evaluations were conducted at baseline (before starting 4-AP or placebo medication), 2 weeks, and 4 weeks. Measures included dynamometer lower limb isometric muscle force and biomechanical gait measures including temporal-spatial parameters, electromyographic activation patterns, joint kinematics and kinetics. Subjective impressions of the drug by the participants were obtained from an exit survey. RESULTS: Despite some positive comments from subjects, statistical and clinical analyses showed no within-subject differences between placebo and 4-AP measures of lower limb muscle force and objective gait analyses (ANOVA statistic P>0.05). CONCLUSION: Results demonstrated the importance of placebo-controlled trials and quantitative outcome measures for the evaluation of 4-AP aimed to enhance gait for chronic, ambulatory SCI persons. Energy expenditure measures and mood may relate more to subjective comments and is suggested for future investigations.

4-Aminopyridine↗
PubMed1998

Racial differences in muscle strength in disabled older women.

This study examines racial differences in muscle strength, and associations of muscle strength to level of physical activity and severity of disability, among a community sample of 254 black and 665 white, moderately to severely disabled women aged 65 and older. Potential confounders that were adjusted for in the models included age, body weight and height, joint pain, number of chronic conditions, and socioeconomic status. Hand grip, hip flexion, and knee extension forces were measured using portable hand-held dynamometers in the participants' homes. Hand grip strength was measured as the maximal isometric force. Hip flexion and knee extension forces were measured as the greatest force the tester had to apply to break the isometric contraction. A declining strength gradient was observed with increasing severity of disability and for decreasing level of physical activity in both races. At equal levels of disability or physical activity, blacks had better hand grip and hip flexion strength, but knee extension strength did not differ by race. The greater hand grip and hip flexion strength found in black women may be related to their greater muscle mass and known racial differences in body dimensions. No consistent racial differences were observed in the relationship between physical activity and muscle strength, or muscle strength and disability, suggesting that the role of muscle strength in the disablement process does not differ between races. Physical activity and exercise programs may be feasible ways to prevent worsening of disability in blacks and whites.

Aged↗
PubMed2005

[Effects of a exercise program on body composition, physical fitness and lipid metabolism for middle-aged obese women].

PURPOSE: This study was to examine the effects of an exercise program for middle-aged obese women. METHOD: The exercise program combined folk dance and resistance training. The subjects group consisted of 85 middle-aged obese women between 40 and 60 years of age. Three 8 week sessions consisted of a 55-80% maximum heart rate (MHR) exercise for 60-90 minutes a day and 3 times a week from March to November, 2004. Data was collected through a pre- and post-exercise test before and after each session. Data was collected with Inbody, dynamometer and blood. This data was analyzed by descriptive statistics, and a paired t-test with an SPSS/PC (10.0 version) program. RESULTS: There were significant positive changes in body weight, body fat mass, body mass index, percent body fat, muscle strength, muscle endurance, flexibility, and balance quality, but no significant positive changes in skeletal mass, fat free mass, percent abdominal fat (waist-hip ratio), visceral fat area, agility, total cholesterol, high density lipoprotein cholesterol, or triglycerides. CONCLUSION: This study showed that an exercise program has partially positive effects for middle-aged obese women. The results of this study show that exercise at community health centers should continue for middle-aged obese women's health.

Adult↗
PubMed1988

Effects of musculoskeletal work load and muscle strength on strain at work in women and men aged 44 to 58 years.

The effects of musculoskeletal work load and muscle strength on strain at work were analysed among 60 women and 69 men (mean age 52 +/- 3.4) in municipal jobs in Finland. The musculoskeletal work load was determined by analysing the jobs by a job description method. The maximal isometric hand grip strength was assessed with a manometer, trunk flexion and trunk extension strength with a dynamometer, and dynamic trunk flexion endurance strength with a sit-up test. Heart rate was registered continuously and ratings of perceived exertion were determined 4 times during the work shift. The results revealed that high musculoskeletal work load was systematically and significantly related to high strain at work in both sexes. A high mean heart rate related to an individual's range in women was an interaction effect of high work load and low hand grip strength or low trunk flexion strength. Among men, both high mean and maximal heart rates in relation to the heart rate range was due to the interaction effects of high work load and low trunk extension strength. The interaction of work load and strength was not systematically related to the ratings of perceived exertion during work. It was concluded that the musculoskeletal work load exerted the main effects on the cardiorespiratory and perceived strains at work. The interaction effects of work load and strength on strain depended on the sex and the muscle group in the studied work load level of elderly municipal employees.

Female↗
PubMed1984

Comparison of motor unit activation during unilateral and bilateral leg extension.

Possible differences between the extent of muscle utilization during leg extensions performed bilaterally (BL, both legs acting together) and unilaterally were investigated in young males in college. Significantly less integrated electromyographic activity was recorded from the quadriceps muscles of the dominant leg during BL compared with UL maximal voluntary contractions (MVC). BL strength was significantly lower than the summed (UL; sum of 2 legs acting singly) UL value under isometric conditions [BL = 91 +/- 2.5% (mean +/- SE) of UL; P less than 0.01, n = 9]. By use of a modified isokinetic dynamometer, it was also shown that the effect of increasing the velocity of concentric contraction was significantly greater (P less than 0.001) on BL than UL force development; thus at 424 degrees/s mean BL MVC was only 51 +/- 3.5% of UL. Greater resistance to fatigue was shown in the BL condition in repeated concentric contractions (% decline over 100 MVC at 105 degrees/s was 28 +/- 2.7% for BL vs. 38 +/- 2.9% for UL, P less than 0.001). Results indicated that the extent of motor unit activation appeared to be reduced in BL relative to UL MVC. Compatible evidence from the strength-velocity and fatigability comparisons suggested that this reduction was due to a lesser utilization of the fast-twitch fatigable type of motor unit.

Adult↗
PubMed2000

Exercise training in the debilitated aged: strength and functional outcomes.

OBJECTIVE: Resistance and endurance training result in gains in fitness in the aged. It is unclear whether the debilitated elderly can perform moderate-intensity training and whether such training results in short-term improvements in strength, endurance, and function in this population. DESIGN: Randomized, controlled trial. SETTINGS AND PATIENTS: Subjects were from a Veterans Affairs nursing home and rehabilitation unit and a community nursing home. They were older than 60 yrs with impairment in at least one physical activity of daily living. Seventy-eight subjects volunteered and 58 (mean age, 75 yrs; 9 women, 49 men) completed the intervention and initial posttest. Only one subject withdrew because of injury or disinterest. INTERVENTION: Thrice-weekly resistance training (using an isokinetic dynamometer) and twice-weekly endurance training for 4 to 8 weeks. MAIN OUTCOMES: Isometric strength in dominant arm and leg, heart rate response to timed endurance test, and activities of daily living score. RESULTS: The mean change in isometric strength across the muscle movements tested was 32.8% in the training group and 10.2% in the control group (difference, 22.6%; 95% confidence interval, 6.2% to 39.0%). No change in heart rate during exercise was seen in the training group. Trained subjects tended to have a greater improvement in functional activity than control subjects, which was statistically significant (p = .04) for those subjects who at enrollment were most dysfunctional (i.e., activities of daily living score less than 13 [maximum score 26]). CONCLUSION: This group of debilitated elderly patients effectively performed resistance training and increased their strength, with the most impaired gaining the most function. Few in the group could effectively perform endurance training.

Aged↗
PubMedDate not supplied

Dynamic joint control training for knee ligament injuries.

The purpose of this study was to introduce dynamic joint control training and to assess its effects in improving neuromuscular coordination of injured knees using the Kin-Com Isokinetic Dynamometer. Although four patients had a sensation of "giving way" on one knee, all eight knees were trained for 3 months using unstable boards with added sudden force given by a therapist. The training group (four patients) was examined during four sessions and the control group (five subjects) was examined during three sessions within a 3 month period. All subjects were instructed to react to the sudden forward movement of the input arm of the Kin-Com Isokinetic Dynamometer with contraction of the hamstring. Results of the first and final trials of peak torque time (PTT) and rising torque value (RTV) of the hamstring between the training and control groups showed significant improvement. There was no correlation between isometric muscle strength (IMS) and PTT in the total 76 sessions. There is a strong implication that simple muscle training does not increase the speed of muscular reaction but dynamic joint control training has the potential to shorten the time lag of muscular reaction.

Adolescent↗
PubMed2002

Releasing the A3 pulley and leaving flexor superficialis intact increases pinch force following the Zancolli lasso procedures to prevent claw deformity in the intrinsic palsied finger.

Objective estimates of fingertip force magnitude following surgery to prevent digital metacarpophalangeal (MCP) hyperextension (clawing) in cases of paralysis of the hand's intrinsic muscles will assist clinicians in setting realistic expectations for post-operative pinch strength. We used a cadaveric/optimization approach to predict and confirm the maximal biomechanically possible fingertip force in the intrinsic palsied hand before and after two popular tendon transfer methods to the volar plate of the MCP joint. Both surgeries were also evaluated after release of the A3 pulley-a modification predicted by our published computer model of the forefinger to increase fingertip force magnitude. We predicted maximal static fingertip force by mounting eight fresh cadaveric hands on a frame, placing their forefinger in a functional posture (neutral abduction, 45 degrees of flexion at the MCP and proximal interphalangeal joints, and 10 degrees at the distal interphalangeal joint) and pinning the distal phalanx to a 3D dynamometer. We pulled on individual tendons with tensions up to 25% of maximal isometric force of their associated muscle and measured fingertip force and torque output. Using these measurements, we predicted the optimal combination of tendon tensions that maximized palmar force (analogous to pinch force, directed perpendicularly from the midpoint of the distal phalanx, and in the plane of finger flexion-extension) for four cases: (i) the non-paretic case (all muscles available), (ii) intrinsic palsied hand (no intrinsic muscles functioning), (iii) transfer of flexor superficialis tendon to the volar plate of the MCP (Zancolli lasso) in the intrinsic palsied hand, and (iv) leaving flexor superficialis intact and transferring a tendon of comparable strength to the volar plate of the MCP in the intrinsic palsied hand. Lastly, we applied these optimal combinations of tension to the cadaveric tendons and measured fingertip output. With the A3 pulley intact, the maximal palmar force in cases (ii)-(iv) averaged 48 +/- 23% SD (non-paretic = 100%; case (iv) (61 +/- 25%) > cases (ii) and (iii) (43 +/- 23% and 39 +/- 19%, respectively), p < 0.05). Releasing the A3 pulley significantly increased the average palmar force in cases (ii)-(iv) (73 +/- 42%, p < 0.05), with no significant differences among them. Thus, releasing the A3 pulley may improve palmar force magnitude when it is necessary to transfer the digit's own flexor superficialis tendon to the volar plate of the MCP to prevent clawing in the intrinsic palsied hand.

Biomechanical Phenomena↗
PubMed2000

[New bioadhesive ADAL-1: determination of its tensile strength to join muscle tissue to sclera].

PURPOSE: To quantify tensile force to separate the adhesive joint between muscle and sclera obtained by the ADAL-1 adhesive. METHODS: Strabismus surgery including over the Superior Recti was performed. 4 different groups (5 eyes each) were included in this study on New Zealand albino rabbits and lamb eyes. We used Dexon 6/0 suture as control group. We evaluated the tensile force by means of a dynamometer in two periods of time. First, we evaluated just after the adhesion (groups I and II), and after 7 days of the adhesion (groups III and IV). RESULTS: By statistical supported methods SPSS 6.0. The tensile force in group I was: X=1.23 +/- 0.17 Newtons. In group II was X=0.793+/-0.02. In group III the tensile force was: X=1.01+/-0.17 and in group IV was X=0.89+/-0.09 Newtons. There was a significant difference between the two groups: suture and ADAL-l, just immediately after the adhesion. (P=0.004). There was no significant difference between the suture and ADAL-1 adhesive group, one week after the adhesion. CONCLUSIONS: The joint between sclera and muscle by the ADAL-1 adhesive is as resistant as Dexon 6/0 suture group to the traction force one week after surgery.

Animals↗
PubMed2005

Thigh muscle strength and endurance in patients with COPD compared with healthy controls.

The aim of this study was to evaluate thigh muscle strength and endurance in patients with COPD compared with healthy controls. Forty-two patients (26 women; 16 men) with moderate to severe COPD and 53 (29 women; 24 men) age-matched healthy controls participated in the study. The subjects were tested for maximum voluntary contractions (MVC), endurance and fatigue of the thigh muscles on an isokinetic dynamometer (KinCom). Endurance was expressed as the number of attained repetitions of knee extension and muscle fatigue as a fatigue index (FI). MVC in knee extension was 17% lower in female patients (P=0.017) but no difference was found in male patients (P=0.56) compared to controls. MVC in knee flexion was lower both in female (51%) (P<0.001) and male patients (40%) (P<0.001) compared to controls. Both female and male patients had significantly lower muscle endurance compared to controls. Female patients had a higher FI (22.5%) than female controls (10%) (P=0.001) while no difference was found regarding FI between male patients (15%) and male controls (10%) (P=0.103). The level of self-reported everyday physical activity did not differ between groups. The results showed impaired skeletal muscle function in COPD, except for MVC in knee extension in male patients. Female patients seemed to be more prone to decrease in thigh muscle function. More focus on improving muscle strength and muscle endurance should be considered when designing pulmonary rehabilitation programs. Patients with preserved level of physical activity can be included in exercise programs and gender-related differences should be taken into account.

Activities of Daily Living↗
PubMed1999

Disability, physical activity, and muscle strength in older women: the Women's Health and Aging Study.

OBJECTIVE: To study associations of motor disability, physical activity, and muscle strength in older women, in particular to investigate whether model of spiraling decrease is expressed in the data. DESIGN: Cross-sectional analysis using data from the baseline measurements of The Women's Health and Aging Study (WHAS). SETTING: Participants' homes. PARTICIPANTS: A total of 1,002 disabled women aged 65 years and older living in the community. OUTCOME MEASURES: Motor disability was measured by the number of self-reported difficulties in grasping, lifting 101b, walking across a small room, walking 1/4 mile, climbing 10 steps, and doing heavy housework. Level of physical activity was determined from response to a series of questions on the frequency and amount of common activities and physical exercise. Hand grip and knee extension forces were measured using portable hand-held dynamometers. RESULTS: Disability and physical activity were inversely associated, with inactivity being most common among the most disabled women. Those with poorer strength reported more difficulties in motor activities. Greater strength was found among the physically more active. In stratified analyses, the positive association of physical activity on knee extension strength was consistent across disability levels. Multiple regression analysis showed that both physical activity and muscle strength were significant predictors for severity of disability. Structural equation model (LISREL) showed that muscle strength had a mediating role between physical activity and disability; disability was associated with physical inactivity, which correlated with lower muscle strength, which was associated with greater degree of disability. CONCLUSION: Even though causality cannot be confirmed in this cross-sectional analysis, our findings suggested a spiraling model of decline in which muscle strength has a significant role.

Activities of Daily Living↗
PubMed2002

The diurnal rhythm in isometric muscular performance differs with eumenorrheic menstrual cycle phase.

The aim of this study was to examine the effect of the interaction of circamensal and diurnal rhythms in temperature upon the production of maximal voluntary muscle force. Ten eumenorrheic females (mean age: 24 +/- 3 yr mean body mass: 58.4 +/- 6.9 kg) participated in the experiment at both 06:00 and 18:00h at the mid-point of both the follicular and luteal phases of the menstrual cycle. Subjects performed tasks of maximal isometric lifting strength (MILS) at knee height, and endurance time (t) for lifting 45% of MILS, upon an isometric lift dynamometer. Body temperature was elevated at 18:00h and in the luteal phase by 0.52 +/- 0.4 and 0.26 +/- 0.35 degrees C, respectively. The amplitude of the diurnal variation in temperature was blunted by 0.3 degrees C within the luteal phase. Maximal isometric performance was elevated by 8% at 18:00h in the luteal phase of the cycle (p < 0.05 interaction for MILS) but unaffected by time of day in the follicular phase. Endurance time was unaffected by time or phase (p > 0.05). It should be noted that the classic diurnal rhythm in maximal voluntary isometric muscle force may not be evident in all phases of the female menstrual cycle.

Adult↗
PubMedDate not supplied

The Cybex II evaluation of lateral ankle ligamentous reconstructions.

Chronic lateral ankle instability is a costly disability to the athlete. The Chrisman-Snook and Evans lateral ligamentous reconstructions are two procedures frequently performed to correct ligamentous instability. The entire peroneus brevis tendon is transected in the Evans procedure, thus sacrificing its eversion strength and power. The importance of preserving the eversion function of the peroneus brevis muscle is speculative, but may be of significance for good long-term results. The ankle eversion strength and power of 10 patients with Chrisman-Snook and 10 patients with Evans lateral ligamentous reconstructions were objectively evaluated with the Cybex II Isokinetic Dynamometer. The mean postoperative time to testing was 4.2 years. The uninvolved ankle was also tested and used as the normal strength of the patient. Twenty normal controls matched for age, sex, and physical activity were tested to assure maximum test reproducibility. The eversion strength was tested at several speeds, but torque values at speeds of 30 and 120 deg/sec were selected for analysis. At slow speeds, 30 deg/sec, and ankles that had Evans and Chrisman-Snook reconstruction were 4% and 7% weaker, respectively, than the contralateral normal ankles. At 120 deg/second the ankles were 8% and 9% weaker with the Evans and Chrisman-Snook reconstructions, respectively. A three factor analysis of variance with repeated measures on two of the factors was used to analyze the data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Handgrip strength is an independent predictor of distal radius bone mineral density in postmenopausal women.

Several cross-sectional studies have reported a positive correlation between muscle strength and local bone mineral density. However, very few studies have evaluated the possible role of confounding variables, which may be substantial as both bone mineral density and muscle strength are multifactorial variables. We studied 140 postmenopausal women who underwent their first osteodensitometry in our hospital. Of these, 102 women affected neither by bone diseases apart from primary osteoporosis nor treated with drugs affecting bone mass were selected. Distal radius bone mineral density of the non-dominant arm was assessed by dual photon absorptiometry. Handgrip strength was measured by a handheld dynamometer. The following factors influencing bone mass were also considered: age, years since menopause, years of cyclic ovarian activity, body weight, body height, body mass index, and both calcium and alcohol dietary intake. Statistical evaluation was performed by stepwise multiple regression analysis. This showed that only two variables were independently related to bone mineral density: handgrip strength (which was the best bone density predictor among the studied independent variables) and years since menopause. R2 value was 0.43 (F=38.04, p < 0.001). All the other variables studied were not significantly related to bone density when the effects of both strength and years since menopause were considered. In conclusion, the data showed that handgrip strength was a strong independent predictor of distal radius bone mineral density in postmenopausal women. Clinical assessment of osteoporosis risk factors, including muscle strength, is recommended: although it is not an adequate substitute for bone densitometry, it can help clinicians to identify the risk groups at which to direct bone density measurement.

Adult↗
PubMed2006

Percentile values of isokinetic peak torque in children six through thirteen years old.

PURPOSE: The purpose of this study was to standardize an isokinetic testing protocol for quadriceps and hamstrings in children who are typically developing and are six through 13 years of age, to establish percentile charts of isokinetic peak torque strength for quadriceps and hamstrings by gender and age, and to determine the best predictors of strength for each of three testing speeds. METHODS: A total of 3587 children were tested for isokinetic knee strength according to our protocol on Biodex System II and III isokinetic dynamometers. Therapists participating in the study were trained on the protocol and inter-rater reliability was established. Both dominant and nondominant legs were tested at three speeds. Data were collected on peak torque, time to peak torque, and agonist/antagonist ratio. Data were also gathered on maturation level, gender, height, weight, leg length, laterality, and activity level to allow for investigation of correlations with peak torque. All data were entered in an Excel spreadsheet. RESULTS: Percentile charts of normal isokinetic muscle strength were generated using SPSS 12.0 for each age and gender at three speeds (60, 120, and 180 degrees per second). Stepwise regression analysis determined height to be the best predictor of peak torque for both quadriceps and hamstrings at all speeds. CONCLUSIONS: This study is the first to report normative peak torque values for quadriceps and hamstrings in children. By using a standardized testing protocol and normative data, clinicians will be able to assess the degree of muscle weakness as well as the effectiveness of intervention strategies.

Adolescent↗
PubMed2005

What change in isokinetic knee muscle strength can be detected in men and women with hemiparesis after stroke?

OBJECTIVE: To assess the intra-rater (between occasions) test-retest reliability of isokinetic knee muscle strength measurements in subjects with chronic poststroke hemiparesis and to define limits for the smallest change that indicates real (clinical) improvements for stroke patients. SUBJECTS: Fifty men and women (mean age 58 +/- 6.4 years) 6-46 months post stroke, able to walk at least 300 m with or without a unilateral assistive device. METHODS: Maximal concentric knee extension and flexion contractions at 60 degrees/s and 120 degrees/s, and maximal eccentric knee extension contractions at 60 degrees/s, with the paretic and nonparetic limbs, were performed seven days apart using a Biodex dynamometer. MEASURES: Reliability of the maximum peak torque measurements was evaluated with the intraclass correlation coefficient (ICC(2,1)), the Bland and Altman analyses, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%). RESULTS: Test-retest agreements were high (ICC(2,1) 0.89-0.96) with no discernible systematic differences between limbs, angular velocities and modes. The SEM%, representing the smallest change that indicates a real (clinical) improvement for a group of subjects, was relatively small (8-20%). The SRD%, representing the smallest change that indicates a real improvement for a single subject ranged from 26% to 33% for concentric knee extension, from 39% to 55% for concentric knee flexion, and from 22% to 25% for eccentric knee extension. CONCLUSION: Isokinetic knee muscle strength can be reliably measured and used to detect real improvements following an intervention for single subjects as well as for groups of subjects with chronic mild to moderate hemiparesis after stroke.

Aged↗