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PubMed2005

Associations between grip strength change and axial postmenopausal bone loss--a 10-year population-based follow-up study.

The aim of the present study was to investigate the associations between grip strength change and postmenopausal bone loss. The study population, 622 peri- and postmenopausal women, was a random sample of the OSTPRE-study cohort (n=13,100) in Kuopio, Finland. Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual X-ray absorptiometry and grip strength with a pneumatic squeeze dynamometer at baseline in 1989-1991, at the 5-year follow-up in 1994-1997 and at the 10-year follow-up in 1999-2001. Women were divided into three groups according to the change in age-grouped grip strength quartile they belonged to in each measurement (n in 5-year/10-year follow-up): "decreased" (n=150/n=140), "maintained" (n=314/n=320) and "improved" (n=158/n=162). Women within the improved group had significantly lower bone loss at both FN and LS in comparison to the other two groups after 10 years of follow-up (P<0.01). Furthermore, in HRT non-users (n=305) the difference between the improved group and maintained group was only modest (P=0.04). In contrast, in HRT users (n=310) the mean annual BMD change among the improved group was positive (bone gain 0.11%/year) and differed significantly in comparison to modest bone loss in the decreased and maintained groups in both LS and FN (P<0.01). The linear trend between grip strength quartile change and LS/FN bone loss was significant in HRT users (P<0.001) in contrast to HRT non-users (P=NS) in the linear regression model. Any of these differences were not affected by adjustments for age, weight, height and other potential confounders. In conclusion, the present study suggests that improvement in age-grouped grip strength quartile is strongly associated with axial bone loss among postmenopausal women. This effect seemed to interact positively with estrogen repletion status. These results encourage performing further clinical studies on associations between muscle strength changes and bone loss.

Absorptiometry, Photon↗
PubMed2002

Asymmetry in hand grip strength and fatigue in low- and high-hostile men.

The present study examined the relationship between hostility level and cerebral hemispheric motor functioning of 70 left-cerebral dominant men. Using the Cook-Medley Hostility Scale, the subject group was divided into thirds: One-third (N = 23) were classified as low-hostile, one-third (N = 23) were classified as high-hostile, and the remainder (N = 24) were excluded from analysis. A hand dynamometer was used to assess hand grip strength, perseveration, and fatigue, as measures of hemispheric motor functioning. Results yielded a hand-by-hostility group interaction, which indicated that high-hostile men evidenced significantly less hand grip strength at the right hand and significantly greater hand grip strength at the left hand relative to low-hostile men. These results suggest that high-hostile men may experience relatively greater right-cerebral arousal relative to their low-hostile counterparts. In other results, both groups showed greater perseveration at the left hand than at the right hand. Both groups also showed significant fatigue across trials at both hands. Analysis also revealed a hand-by-trial interaction, indicating that the right hand fatigued more quickly than the left hand across trials. Resistance to fatigue at the left hand and overestimation or relative imprecision in motor movement at the left hand are discussed in terms of arousal theory. These results and others are cited as contributing inroads into distinguishing between the emotional problems of depression, anxiety, and hostility.

Adult↗
PubMed1991

Effects of hydraulic circuit training following coronary artery bypass surgery.

The effect of hydraulic circuit training (HCT) on stroke volume (SV), cardiac output (Qc), aerobic power (peak VO2), and muscular strength and endurance was evaluated in 24 post-coronary artery bypass (CABS) patients (mean age = 52.8 +/- 2.6 yr). All assessments other than muscular strength and endurance were based upon a symptom limited graded exercise test on a bicycle ergometer. Muscular strength and endurance were assessed on a Cybex II isokinetic dynamometer. Sixteen patients were assigned randomly to 8 wk of cycle training or HCT (N = 8 in each). Subjects assigned to cycle training exercised on bicycle ergometers. The HCT group exercised on a three-station circuit, completing three circuits per day. Each circuit consisted of three 20 s work intervals at each station with a 1:1 work:rest ratio. Results from the training groups were compared with results from eight patients who served as a nonexercising control group. Following training the peak VO2 was significantly increased in the training groups (20% and 11% for the cycle and HCT groups, respectively; P less than 0.05). For both training groups, the increase in peak VO2 was associated with increases in SV and Qc and a reduction in heart rate (HR) at submaximal levels of exercise (P less than 0.05). Only the HCT group demonstrated an increase in both muscular strength and endurance during knee and shoulder exercises (P less than 0.05). These findings suggest that a program of HCT can elicit improvements in cardiovascular fitness and muscular strength and endurance in post-CABS patients.

Analysis of Variance↗
PubMed1990

Assessing sincerity of effort in maximal grip strength tests.

Injuries to the upper extremities sometimes result in a loss of work capacity. One of the methods for measuring this loss of work capacity is the grip test. Such measurements may be compromised by an insincere effort (faking) by the subject. Smith et al. (Am J Phys Med Rehabil 1989;68:73-80) developed a protocol to identify sincere and faking efforts with the use of a modified dynamometer. The present investigation was designed to evaluate the applicability of the previously developed protocol to subjects with hand injuries. The investigators also compared the force-time characteristics for contractions at different percentages of maximum (100, 75, 50, and 25%). Sixty subjects (30 male and 30 female) were tested during two sessions while performing both faking and sincere efforts. The five discriminators previously developed were found to be good detectors for both noninjured and injured hands and provided the basis for cutoff values for the five discriminators. Single discriminator prediction gave at best an 85% faking detection rate (by using D3) for men and a 79.2% detection rate (by using D5) for women. Better results were obtained, when a multiple variable prediction was used. It can be concluded that the protocol developed by Smith et al. for detection of an insincere effort can be used successfully with persons who have sustained upper extremity injuries. Furthermore, sincere and faking grip strength "maxima" can be correctly identified across a wide range of applied force levels.

Adult↗
PubMed2006

Arthroscopic release of the vastus lateralis tendon for recurrent patellar dislocation.

BACKGROUND: Arthroscopic release of the vastus lateralis tendon for treatment of recurrent patellar dislocation has been criticized on the grounds that it may weaken the quadriceps. HYPOTHESIS: Quadriceps strength and outcome measures improve after arthroscopic release of the vastus lateralis tendon in patients with documented patellar dislocation. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twenty patients who had recurrent patellar dislocation underwent arthroscopic lateral retinacular release that included a complete release of the vastus lateralis tendon from the superior pole of the patella and were observed prospectively. Bilateral quadriceps strength was tested preoperatively and at follow-up with an isokinetic dynamometer. Patients also completed the International Knee Documentation Committee Subjective Knee Form and the Short Form-36 preoperatively and postoperatively. RESULTS: Follow-up averaged 27 months (range, 24-43 months). There were no redislocations. Mean quadriceps strength improved by a mean of 28% (from 32.3 to 41.4 N x m). The mean quadriceps torque ratio (involved/uninvolved) improved significantly from a preoperative value of 63% (31/51 N x m) to 80% (42/52 N x m) at follow-up (P = .017). Fourteen patients (70%) increased quadriceps torque, and 6 patients (30%) decreased quadriceps torque. Only 1 patient failed to improve on International Knee Documentation Committee and Short Form-36 scores. The International Knee Documentation Committee scores improved from 45 points preoperatively to 76 points at follow-up (P = .001). The Short Form-36 physical component summary scores improved from 38 points preoperatively to 50 points at follow-up (P = .007), and the Short Form-36 physical functioning subscale scores improved from 53 points to 86 points (P = .015). CONCLUSION: Arthroscopic release of the vastus lateralis tendon and lateral patellar retinaculum in patients with recurrent patellar dislocation can improve quadriceps strength and knee function.

Adolescent↗
PubMed2003

Changes in the relationship between joint angle and torque production associated with the repeated bout effect.

A single bout of eccentric exercise induces a protective adaptation against damage from a repeated bout. The aim of this study was to determine whether this repeated bout effect is due to a change in the length-tension relationship. Twelve individuals performed an initial bout of six sets of 10 eccentric quadriceps contractions and then performed a repeated bout 2 weeks later. Eccentric contractions were performed on an isokinetic dynamometer at 1.04 rad x s(-1) with a target intensity of 90% of isometric strength at 70 degrees of knee flexion. Isometric strength and pain were recorded before and after both eccentric bouts and on each of the next 3 days. Isometric strength was tested at 30 degrees, 50 degrees, 70 degrees, 90 degrees and 110 degrees of knee flexion. On the days following the initial bout, there was a significant loss of isometric strength at all knee flexion angles except 110 degrees (bout x angle: P < 0.01). On day 2, strength averaged 86% of baseline for 30-90 degrees and 102% of baseline for 110 degrees. Strength loss and pain after the initial bout was contrasted by minimal changes after the repeated bout (pain: P < 0.001; strength: P < 0.01). The repeated bout effect was associated with a rightward shift in the length-tension curve; before the repeated bout, isometric strength was 6.8% lower at 30 degrees and 13.6% higher at 110 degrees compared with values before the initial bout (bout x angle: P < 0.05). Assuming that torque production at 110 degrees occurs on the descending limb of the length-tension curve, the increase in torque at 110 degrees may be explained by a longitudinal addition of sarcomeres. The addition of sarcomeres would limit sarcomere strain for subsequent eccentric contractions and may explain the repeated bout effect observed here.

Adult↗
PubMed1994

Performance characteristics of the Kin-Com dynamometer.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the performance characteristics of a Kin-Com dynamometer (model #500-11) under controlled conditions. METHODS: Comparisons were made between measurements of force, angle, and velocity obtained from the Kin-Com and measurements acquired from an external recording system of known weights, angles, and user-set velocities. The strength of the linear relationships between measurements obtained with the different recording systems was analyzed using a coefficient of determination (r2). An intraclass correlation coefficient (ICC[2,1]) was used to examine the reliability of the force, angle, and velocity measurements obtained with each recording system on 2 different days. RESULTS: In all conditions, the coefficient of determination for the force, angle, and velocity comparisons was above .99. The ICC for between-day comparisons for all force, angle, and velocity measurements was above .99. CONCLUSION AND DISCUSSION: Our results indicate that the static measurements of force and angle that are necessary for use in the gravity-correction procedure and isometric testing are accurate and replicable between days. The Kin-Com dynamometer's control system regulating lever arm velocity is also accurate and replicable under a no-load condition. It was ascertained during the velocity testing that the use of any acceleration and deceleration mode other than "high" resulted in a loss of excursion of the lever arm.

Acceleration↗
PubMed2002

Hand strength and fatigue in patients with hereditary motor and sensory neuropathy (types I and II).

OBJECTIVES: To compare maximal isometric hand strength and fatigue between subjects with hereditary motor and sensory neuropathy (HMSN) and healthy controls and to test the reproducibility of handgrip strength (peak force of handgrip [PFgrip]) and fatigue. DESIGN: PFgrip and the decline in PFgrip during 3 sets of 15 contractions were compared. SETTING: University hospital in The Netherlands. PARTICIPANTS: Twenty subjects with HMSN and 20 age- and sex-matched healthy controls; 15 healthy subjects for the reproducibility part of the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: PFgrip and the decline in PFgrip were compared by using a digital handgrip dynamometer. Two-point and lateral pinch measurements of subjects with HMSN were standardized against reference values. Reproducibility measurements were performed on 15 healthy subjects on 2 separate occasions within a 1-week interval. RESULTS: PFgrip was significantly lower in the HMSN subjects compared with controls (P<.05). Pinch measurements also showed a large variance from average normal performance. No significant difference was found in the decline in percentage of PFgrip. Reproducibility was excellent for PFgrip (intraclass correlation coefficient [ICC]=.98; 95% confidence interval [CI],.95-.99) but poor for fatigue (ICC=.62; 95% CI,.20-.85). CONCLUSION: PFgrip and 2-point and lateral pinch in HMSN subjects were significantly reduced compared with healthy controls. Our findings indicated that the rate of decline of PFgrip during effort does not vary between groups.

Adult↗
PubMed1993

Hemodynamic and hormonal responses to lower body negative pressure in men with varying profiles of strength and aerobic power.

Hemodynamic, cardiac, and hormonal responses to lower-body negative pressure (LBNP) were examined in 24 healthy men to test the hypothesis that responsiveness of reflex control of blood pressure during orthostatic challenge is associated with interactions between strength and aerobic power. Subjects underwent treadmill tests to determine peak oxygen uptake (VO2max) and isokinetic dynamometer tests to determine knee extensor strength. Based on predetermined criteria, subjects were classified into one of four fitness profiles of six subjects each, matched for age, height, and body mass: (a) low strength/average aerobic fitness, (b) low strength/high aerobic fitness, (c) high strength/average aerobic fitness, and (d) high strength/high aerobic fitness. Following 90 min of 0.11 rad (6 degrees) head-down tilt (HDT), each subject underwent graded LBNP to -6.7 kPa or presyncope, with maximal duration 15 min, while hemodynamic, cardiac, and hormonal responses were measured. All groups exhibited typical hemodynamic, hormonal, and fluid shift responses during LBNP, with no intergroup differences between high and low strength characteristics. Subjects with high aerobic power exhibited greater (P < 0.05) stroke volume and lower (P < 0.05) heart rate, vascular peripheral resistance, and mean arterial pressure during rest, HDT, and LBNP. Seven subjects, distributed among the four fitness profiles, became presyncopal. These subjects showed greatest reduction in mean arterial pressure during LBNP, had greater elevations in vasopressin, and lesser increases in heart rate and peripheral resistance. Neither VO2max nor leg strength were associated with fall in arterial pressure or with syncopal episodes. We conclude that interactions between aerobic and strength fitness characteristics do not influence responses to LBNP challenge.

Adult↗
PubMed2003

A modified neuromuscular electrical stimulation protocol for quadriceps strength training following anterior cruciate ligament reconstruction.

STUDY DESIGN: Randomized clinical trial, single-masked. OBJECTIVES: To determine the effectiveness of using a modified neuromuscular electrical stimulation (NMES) training program as an adjunct treatment for improving quadriceps strength and physical function in rehabilitation following anterior cruciate ligament reconstruction (ACLR). BACKGROUND: NMES training for quadriceps strengthening has previously been shown to be an effective adjunct treatment following ACLR when performed against isometric resistance using a dynamometer with the knee positioned in flexion. We developed a modified version of published NMES protocol because some patients have difficulty tolerating the existing protocol and many clinics may not have instrumented dynamometers. There is a need to determine the effectiveness of this modified protocol. METHODS AND MEASURES: Forty-three subjects who had undergone ACLR were randomly assigned to either a group that received (NMES group) or did not receive (comparison group) the NMES treatment in conjunction with their rehabilitation. Group means for quadriceps strength and self-reported measures of knee function were compared after 12 and 16 weeks of rehabilitation. The proportion of subjects in each group achieving clinical criteria to initiate ambulation without crutches, treadmill running, and agility training at selected times during rehabilitation were also compared. RESULTS: The NMES group demonstrated moderately greater quadriceps strength at 12 weeks (effect size, 0.48), and moderately higher levels of self-reported knee function at both 12 (effect size, 0.72) and 16 (effect size, 0.65) weeks of rehabilitation compared to the comparison group. A greater proportion of subjects in the NMES group achieved clinical criteria for advancing to agility training at 16 weeks. CONCLUSIONS: The modified NMES quadriceps training protocol can be a useful adjunct to ACLR rehabilitation programs, but the treatment effect is smaller than what has been reported in previous studies.

Adult↗
PubMed1993

Knee flexor-extensor strength in children.

Isokinetic measurements of knee flexion extension in children and adolescents are a useful means of quantifying strength. In the routine clinical situation with a unilateral problem, evaluation of the affected extremity is usually based on comparisons with the unaffected side. To interpret these results, there must be an appreciation for normal side-to-side differences. Twenty-one normal, healthy children (ages 6-16 years) were evaluated using a Cybex II isokinetic dynamometer at 90 and 240 degrees/sec. In children who were able to generate peak torque values greater than 50 ft-lbs, the side-to-side differences in peak torque averaged 11 +/- 12% (mean +/- SD). A similar amount of variability has been reported with adults. For children with whom peak torque values were less than 50 ft-lbs, the side-to-side differences were much greater (mean = 22 +/- 19%). The stronger leg was equally likely to be on the nondominant side as the dominant side. Side-to-side variability was slightly decreased if the mean of several repetitions was used for comparisons rather than comparing just the single highest peak torque values.

Adolescent↗
PubMed1997

Reliability of a hand gripping endurance test.

The aim of this study was to assess the reproducibility of a new endurance test for hand grip movements. On six occasions separated by at least 3 days, 30 healthy subjects performed six maximal endurance tests in two different positions with a hand grip tool attached to an isokinetic dynamometer. The test consisted of repeated maximal grip movements (1-min bouts for men and 30-s bouts for women subjects) at an angular velocity of 45 degrees/s. A custom-made PC programme was used to collect data on peak torque and mechanical work, and to provide the following parameters: basal torque, basal work, time until basal values fell to 20, 30 and 50% of the initial peak values, slopes of decay of torque and work over time. The intraclass correlation coefficient (ICCC) was then computed to assess the reproducibility of the parameters obtained during the tests. An 'almost perfect' (0.8 < ICCC = 1) reproducibility of the basal torque values in both positions and a 'substantial' (0.6 < ICCC = 0.8) or 'almost perfect' reproducibility of the slope values referred to the torque decay over time was observed. Feasible applications of this new endurance test in ergonomics and vocational rehabilitation are discussed.

Adult↗
PubMed2006

[Tissue resistance: what about tension-free?].

OBJECTIVES: The purpose is to quantify objective tissue resistances before healing of prostheses used in pelvic floor surgery. PATIENTS AND METHODS: We measured tissue resistances offered to five types of meshes by four classical surgical routes. We also tested the incidence of the modification of the width of meshes on tissue resistance. This study was realized on frozen cadavers, by pull on prostheses just after implantation. Tests are realized with a dynamometer and results obtained in Newton. RESULTS: In the Retzius space, TVT offers a better resistance than IVS or LIFT meshes. We did not bring to the fore a significant difference between four routes for 1 cm wide prosthesis. The increase of width of Prolene meshes improves their resistance in tissues and thus quality of their fixation. We underscore a better resistance of the trans sacrospinous route with regard to the trans muscular one. DISCUSSION AND CONCLUSION: The increase of resistance is bound to the increase of the contact area between the prosthesis and the tissues. This increase of resistance should be taken into account in prolapse surgery: constraints are stronger than for stress incontinence. The posterior arms of meshes have to measure more than 1 cm wide and be set up through the sacrospinous ligament rather than through the elevator muscles. The type of knitting of prostheses is important and influences the resistance in tissues in the immediate postoperative time. Manufacturers should be interested in conceiving specific meshes for the tension-free fixation, with special and adapted mechanical properties.

Cadaver↗
PubMed1996

Method-related variations in estimates of gravity correction values using electromechanical dynamometry: a knee extension study.

Dynamometry is widely used to measure subject strength. The method employed to correct dynamometry scores for gravitational influences can result in differing correction estimates. This study investigates differences between mathematical estimates of correction values and directly measured passive forces. Using the Kin-Com dynamometer, passive force measurements from 90 degrees of knee flexion to full extension were collected for nine asymptomatic subjects. These measurements were then compared with correction estimates mathematically extrapolated from a force reading obtained at one point in the test range. Direct passive measurements obtained between 0 and 70 degrees of knee flexion and mathematical estimates of correction values differed by as much as 50 N. The equivalence of gravity correction values obtained using the two methods detailed cannot be assumed. Mathematical estimates of correction values for knee scores obtained between 0 and 90 degrees of flexion were found to be clinically identical to direct passive measurements when: 1) the limb was weighed close to 50 degrees of flexion and 2) the angular location of the lower limb mass relative to the horizontal was not assumed to be represented by the angular location of the lever arm, but rather 15 degrees further below the horizontal than the lever arm.

Adult↗
PubMedDate not supplied

An analysis of anterior cruciate ligament reconstruction in middle-aged patients.

The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive patients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate ligament reconstructions with midthird patellar tendon autografts were evaluated. The patients returned for interviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrometer testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly normal and 2 (4%) severely abnormal. Side-to-side differences as determined by the KT-1000 arthrometer were < or = 3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and > 5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthroscopic surgery for persistent knee pain and two patients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.

Adult↗
PubMed1983

Simple method to determine sincerity of effort during a maximal isometric test of grip strength.

The purpose of this study was to establish a simple method to determine the legitimacy of a maximal voluntary grip contraction (MVGC). To achieve this, 36 subjects were randomly assigned to either a sincere (S) or faker group (F) and asked without investigator knowledge to execute either a MVGC or 75% MVGC on a specially designed grip dynamometer. The dynamometer was attached to a load cell with analog output obtained from a strip chart recorder at 50 mm X sec.-1. The force curves were evaluated empirically and also analyzed according to the following components: rate of force application (SLP), peak force (PK), average force divided by peak force (DEV) and peak force divided by body weight (WTRATIO). Average values for S and F subjects respectively were; SLP 2217 vs 1642 n X s-1, PK 499 vs 387 n, and DEV 0.91 vs 0.72. When all variable were transformed to z-scores, summed for each subject and categorized by sum into upper and lower 50% groups by gender, 87.5% of the females (N = 16) and 80% of the males (N = 20) were correctly classified as S or F subjects. Based upon a discriminant analysis performed by gender, DEV was found to be the only significant predictor for females with DEV, SLP and WTRATIO being significant predictors for the males. It was concluded that S and F subjects can be determined from the results of a maximal isometric grip strength test based upon a simple configuration analysis of an isometric force curve.

Adult↗
PubMed1996

Isometric strength measurements of knee extensors in women with osteoarthritis of the knee.

OBJECTIVE: To compare torque-angle characteristics of the knee extensors of women with and without osteoarthritis (OA) of the knee, and to determine the reliability of these measures. METHODS: The isometric torque of the knee extensors of both legs was tested on 3 occasions in 17 women with OA of the knee and 17 healthy women. Tests were performed on an isokinetic dynamometer at 3 knee angles (30 degrees, 60 degrees, 90 degrees). The peak torque values were subjected to 4 way analysis of variance (group vs leg vs angle vs time), and intraclass correlation coefficients were calculated. RESULTS: The reliability coefficients for repeated measures of isometric torque varied from 0.83 to 0.94 in the OA group and from 0.90 to 0.95 in the comparison group. The ANOVA and post hoc analyses revealed that the OA group had significantly (p < 0.05) lower knee extensor torque than the comparison group, and that the more symptomatic OA knee had lower torque than the contralateral limb. The torque was different across the 3 angles, but the torque-angle relationship was the same for both groups. CONCLUSION: Isometric torque of the knee extensors can be measured reliably in women with OA of the knee. The torque is lower in women with OA than in women with no knee problems, and the changes are similar across different knee angles.

Aged↗
PubMed2003

Influence of prolonged intermittent high-intensity exercise on knee flexor strength in male and female soccer players.

This study investigated the effect of an acute, prolonged, intermittent, high-intensity single-leg pedalling exercise task (PIHIET) on the isokinetic leg strength of the knee flexors in six male and seven female collegiate soccer players. Following determination of single-leg VO(2peak), subjects completed a PIHIET designed to simulate the energetics of soccer match play (approximately 90 min in total; approximately 70% single-leg VO(2peak)). Pre-, mid- and post-PIHIET gravity-corrected indices of knee flexion peak torque (PT) and range of motion-relativised torque at 15% of knee flexion (RRT(15%); 0% = full knee extension) were assessed at a lever-arm angular velocity of 1.05 rad.s(-1)for intervention and control limbs using an isokinetic dynamometer. Repeated measures ANOVAs revealed significant condition (PIHIET, control) x time (pre-, mid-, post-PIHIET) interactions for knee flexion PT (F([2,22])=26.2; P<0.001) and RRT(15%) (F([2,22])=20.1; P<0.001). Flexion PT and RRT(15% )were observed to decrease, pre- to post-intervention, from 92.8 (28.7) N.m to 72.1 (28.0) N.m and from 63.8 (17.5) N.m to 47.9 (18.4) N.m respectively, for the intervention limb alone. These data corresponded to 22.3% and 24.9% mean reductions pre-post intervention in PT and RRT(15%). Exploratory post hoc analysis of the pattern of the relative deterioration (%) of PT and RRT(15%), for the intervention limb alone, revealed a three-way interaction [group (male, female) x parameter (PT, RRT(15%)) x assessment phase (pre- to mid-PIHIET, mid- to post-PIHIET)] (F(1,11)=5.2; P<0.05). This interaction characterised a greater deterioration of strength performance during the mid- to post-PIHIET assessment phase, at the extremes of range of motion (RRT(15%)) for the female group. The greater percentage of mid-post phase strength loss observed in women near the end-range extension may potentially be implicated in the higher incidence of knee injury reported in female soccer players.

Adult↗