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PubMed1989

Isokinetic testing in young nonathletic able-bodied subjects.

Isokinetic strength testing has been widely used to assess athletic populations. The purpose of this study was to measure isokinetic strength in nonathletic able-bodied subjects to provide a subsequent comparison with nonathletic injured patients. Using a standard isokinetic protocol, with continuous verbal encouragement, a single investigator tested 16 women and nine men aged 20 to 30 years on an isokinetic dynamometer. Subjects had minimal athletic experience, and none were varsity performers. Peak torque as a percentage of body weight was statistically greater for men than for women in most joints tested both at 60 degrees and 180 degrees per second. The ratio of the last five to the first five of 25 repetitions at 180 degrees/second (Endurance Ratio = ER) rarely (ie, 5/154 tests) fell below the commonly accepted value of 50%. Many subjects had an endurance ratio of 100% or greater (range 4% to 171%). Peak torques were well below and endurance ratios well above those published for similarly aged athletes. The results suggest that before isokinetic testing is considered as a possible way to distinguish malingerers among injured patients, normal values in an age-matched, nonathletic, working population should be clearly defined. The endurance ratio may reflect the level of athletic training or the level of vigorous participation in an exercise program.

Adult↗
PubMed1999

Etiologic factors associated with Achilles tendinitis in runners.

PURPOSE: The purpose of this study was to determine whether relationships exist between selected training, anthropometric, isokinetic muscular strength, and endurance, ground reaction force, and rearfoot movement variables in runners afflicted with Achilles tendinitis. METHODS: Specifically, we examined differences in selected measures between a noninjured cohort of runners (N = 58) and a cohort of injured runners with Achilles tendinitis (N = 31). Isokinetic, kinetic, and kinematic measures were collected using a Cybex II+ isokinetic dynamometer (Medway, MA), AMTI force plate (500 Hz), and Motion Analysis high-speed videography (200 Hz), respectively. Separate discriminant function analyses were performed on each of the five sets of variables to identify the factors that best discriminate between the injured and control groups. RESULTS: Years running, training pace, stretching habits (injured runners were less likely to incorporate stretching into their training routine), touchdown angle, plantar flexion peak torque at 180 degrees x s(-1) and arch index were found to be significant discriminators. CONCLUSION: A combined discriminant analysis using the above mentioned significant variables revealed that plantar flexion peak torque, touchdown angle, and years running were the strongest discriminators between runners afflicted with Achilles tendinitis and runners who had no history of overuse injury.

Achilles Tendon↗
PubMed2000

Coactivation of the ankle musculature during maximal isokinetic dorsiflexion at different angular velocities.

The objectives of this study were to determine the differences in the level of coactivation among the ankle agonist and antagonist muscles during maximal isokinetic dorsiflexion and to determine whether velocity alters the activation levels. Raw surface electromyograms (EMG) were recorded from six muscle sites--two over the agonist tibialis anterior (upper and lower sites) and four over the antagonist (lateral and medial gastrocnemius, plus lateral and medial soleus) muscles--in ten healthy subjects (two males and eight females) as they performed maximal dorsiflexor efforts against an isokinetic dynamometer at each of three angular velocity settings (30, 90 and 150 degrees/s). The root-mean-square amplitude (RMS) was calculated over a 35 degree angular displacement for each EMG recording, then was normalized (RMS(Nji)) to the amplitude measured during maximal voluntary isometric contractions (MVIC) of the dorsifexors and plantarflexors (i.e. RMS(MVICj)). A two-factor repeated-measures analysis of variance (ANOVA) tested the muscle site by velocity interaction and the main effects of muscle site and velocity separately. The raw EMG signals were then full-wave rectified and low-pass filtered (6 Hz) and ensemble average curves of the sample were calculated, for each muscle site, at each velocity. The ANOVA revealed a statistically significant muscle-by-velocity interaction (P < 0.05). The RMS(Nji) values for the two tibialis anterior sites were not significantly different from each other for any of the three velocity settings, nor for the two gastrocnemius muscles at 30 degrees/s velocity. All other between-muscle comparisons were statistically significant (P < 0.05). The RMS(Nji) means were 28, 23, 59, 52, 98 and 98% MVIC for the lateral and medial gastrocnemius, the lateral and medial sites on the soleus, and for the upper and lower sites on the tibialis anterior, respectively. The RMS(Nji) from the lower site on the tibialis anterior yielded the only statistically significant difference (P < 0.05) among velocities; at this site, the RMS(Nji) at 150 degrees/s was higher than at the other two velocities. The ensemble-average curves revealed that not all muscle sites are activated to a consistent level throughout the entire movement. The interaction between agonist and antagonist activation during isokinetic dorsiflexion has implications for interpreting the results of isokinetic dynamometry for strength assessment and for understanding the neuromuscular control strategies used in this exercise modality.

Adult↗
PubMed1998

The relationship between strength and function in females with juvenile rheumatoid arthritis.

OBJECTIVE: To describe the relationship between isokinetic concentric and eccentric quadriceps strength and function in females with juvenile rheumatoid arthritis (JRA). METHODS: Twenty girls with JRA aged 6 to 16 years participated in the study. Function and strength were measured on one occasion. Isokinetic concentric and eccentric quadriceps torque was measured on the Kin-Com dynamometer. Function was measured with the Childhood Health Assessment Questionnaire (CHAQ) and the Canada Fitness Award 50 m run. Pain and joint count were taken as measures of disease activity. Pain was assessed on a visual analog scale through parent- and self-report. Correlations between function, standardized torque values, pain, and joint count were determined. Stepwise multiple regression analyses with function as the predicted variable were performed. RESULTS: Correlations between standardized torque and CHAQ scores were moderate (r = -0.48, p = 0.03 for concentric torque and r = -0.43, p = 0.06 for eccentric). Correlations between torque and run scores were also moderate (r = -0.48, p = 0.03 for concentric, r = -0.31, p = 0.19 for eccentric). Pain and total joint count were the best predictors of CHAQ score (r2 = 0.80), while concentric torque was the best predictor of running ability (r2 = 0.23). CONCLUSION: Quadriceps torque was moderately correlated to function in girls with JRA. Function as determined on the CHAQ was best predicted from measures of disease activity, while function as determined on the 50 m run was best predicted from concentric quadriceps torque. Further research is required to determine a cause-effect relationship between strength and function in girls with JRA.

Adolescent↗
PubMed2003

Effects of weakness on symmetrical bilateral grip force exertion in subjects with hemiparesis.

It has been shown that, in a bilateral force-matching task, subjects presenting weakness in one limb produce a lower force in the weakened limb even though they subjectively perceive that they are exerting the same force. The aim of this study was to verify whether subjects with hemiparesis produced asymmetrical forces during a bilateral submaximal grip task and whether this asymmetry is related to weakness of the paretic limb. Fifteen subjects with hemiparesis and 15 healthy subjects were recruited. First, the maximal voluntary force was measured for each hand. Then, subjects were asked to exert equal forces with both hands simultaneously at three submaximal force levels using two dynamometers. In the bilateral task, the force ratios (paretic/nonparetic or nondominant/dominant) differed between groups. Severely weak hemiparetic subjects produced lower force ratios than mildly weak hemiparetic subjects and healthy subjects (P < 0.000), whereas there was no difference between the force ratios produced by mildly weak hemiparetic subjects and those produced by healthy subjects. In subjects with hemiparesis, the force ratios in the bilateral task were related to the ratios of maximal voluntary forces (R2 = 0.39-0.66, P < or = 0.013) and the presence of somatosensory impairment did not affect these relationships. These results suggest that the strategy used is to compare the intensity of the motor commands on both sides and then perform the force-matching task. The use of such a strategy by subjects who have had paresis for 1 year reflects a lack of adaptation to their weakness.

Adult↗
PubMed2004

Inflammatory markers and physical performance in older persons: the InCHIANTI study.

BACKGROUND: Some studies have proposed chronic inflammation as an underlying biological mechanism responsible for physical function decline in elderly people. The aim of this study is to evaluate the relationship between several inflammatory markers and physical performance in an older population. METHODS: This study is part of the "Invecchiare in Chianti" (InCHIANTI) study, a prospective population-based study of older people, aimed at identifying risk factors for late-life disability. The study sample consisted of 1020 participants aged 65 years and older living in the Chianti area of Italy. Physical performance was assessed using walking speed, the chair-stand test, and the standing balance test. Hand-grip strength was assessed using a hand-held dynamometer. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), IL-10, IL-1beta, IL-6sR, and IL-1RA were determined. Linear regression analyses were used to assess the multivariate relationship of inflammatory marker levels with physical performance, scored as a continuous variable from 0 to 3, and hand-grip strength after adjustment for demographics, chronic conditions, medication use, and other biological variables. RESULTS: CRP, IL-6, and IL1RA were significantly correlated with physical performance (r=-0.162, r=-0.251, and r=-0.127, respectively). Significant correlations with hand-grip strength were found for CRP and IL-6 (r=-0.081 and r=-0.089, respectively). After adjustment for covariates, high levels of IL-6 and IL-1RA continued to be strongly associated with worse physical performance (p<.001 and p=0.004, respectively). High levels of CRP (p<.001) and IL-6 (p<.001) were associated with low hand-grip strength. Mean adjusted physical performance scores ranged from 2.21 in the CRP<0.59 mg/dl group to 2.07 in the CRP>0.60 mg/dl group (p for trend=.004), and from 2.25 in the lowest IL-6 quartile to 2.08 in the highest IL-6 quartile (p for trend<.001). This trend was also reflected in mean adjusted hand-grip strength, with a range from 28.8 kg for the CRP<0.59 mg/dl group to 26.0 kg for the CRP>0.60 mg/dl group (p for trend=.001), and from 27.4 kg for the lowest IL-6 quartile to 25.1 kg for the highest IL-6 quartile (p for trend=.001). CONCLUSIONS: Inflammation, measured as high levels of IL-6, CRP, and IL-1RA, is significantly associated with poor physical performance and muscle strength in older persons. These data also support the biological face validity of physical performance measures. The assessment of inflammatory markers may represent a useful screening test and perhaps a potential target of intervention.

Aged↗
PubMed1999

The influence of age on isokinetic torque of the upper and lower leg musculature in sedentary men.

While strength patterns in aging for the knee joint have been well investigated in the concentric mode, few data are available about the behaviour in the eccentric mode and for either modus in the ankle. The purpose of this study was to compile reference data for the lower extremities in untrained men between 20 and 60 years of age to determine the influence of age, especially in the eccentric work mode. Sixty-four male subjects between 20 and 60 years were divided into four age groups. Using a LIDO ACTIVE dynamometer, maximum torque was tested for the knee between 90 degrees to 0 degrees and for the ankle between 30 degrees to -10 degrees at velocities 60, 180, 240, 300 degrees/s concentric, 60 and 120 degrees/s eccentric and isometric with angles 15 degrees, 30 degrees, 45 degrees, 60 degrees, 75 degrees for the knee and 30 degrees, 20 degrees, 10 degrees, 0 degrees , -10 degrees for the ankle. Individual parameters for age-dependence were checked using linear correlation calculation with p < 0.01 set as significant. The peak torque (PT) of the knee extensors and flexors showed a typical course with the highest values in the eccentric and isometric mode and a decrease in the concentric mode with increasing angular velocity. In the concentric mode there was a significant negative correlation between PT and age at all angular velocities, but none for isometric and eccentric mode. The greatest maximum torque in the ankle was attained in the eccentric mode at 60 degrees/s. The difference to the knee was smallest in this mode compared to isometric and concentric. The plantar flexion showed age-dependence at all concentric velocities, less in eccentric and none in isometric mode. There was no correlation in dorsiflexion. The influence of loss of muscle fiber and degeneration in the course of aging has thus less influence in eccentric measurements than in the concentric mode. On the contrary, it must be assumed that the high eccentric tensions which are possible due to the quasi-elastic structures in the muscle, are maintained by the increase in stiffness of the connective tissue.

Adult↗
PubMed1989

Assessing sincerity of effort in maximal grip strength tests.

The measurement of maximum hand grip strength in ergonomic or clinical settings has been a useful means of assessing physical characteristics, progress in rehabilitation and degree of disability in upper extremity injuries. The validity of the peak forces observed in such measurements is compromised by the requirement of subject cooperation in giving a maximum effort. Thus, an easily administered analysis of subject sincerity would improve this basic strength-testing tool. Several variables were developed for the discrimination of faking (submaximal) from sincere (maximal) grip contractions. A microcomputer-based grip force data collection system was assembled in which analog output from a Jamar hand dynamometer was sampled at 200 Hz and digitally analyzed. A total of 43 normal subjects (20 male, 23 female) were tested under sincere and faking conditions (three trials of each condition for each hand). The force-time curves of each trial were analyzed for peak and average forces and force variability. From these basic parameters five discriminator variables were developed. The frequency distribution of the sincere values for each of these variables was used to determine a criterion value for discrimination of sincere from faking trials. The five discriminators correctly detected 95.0, 92.5, 100, 100 and 97.5% of the male faking trials. Female faking was less successfully detected: 59.7, 52.2, 78.3, 71.7 and 87.0% correct detection resulted for the variables (with a 95% confidence level of correctly identifying sincerity). Multiple variable predictions improved the female faking detection up to 93.5% with little apparent decrement in sensitivity to sincerity identification.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Grip strength in different positions of elbow and shoulder.

This study investigated the effect of shoulder position on grip strength in 80 men and 80 women. A Jamar dynamometer was used to measure the grip strength in the four testing positions. The four hand strength tests consisted of three positions in which the elbow was maintained in full extension combined with varying degrees of shoulder flexion (ie, 0 degrees, 90 degrees, and 180 degrees) and of one position in which the elbow was flexed at 90 degrees with the shoulder in 0 degrees of flexion. Only the dominant hand was tested. The highest mean grip strength measurement was recorded when the shoulder was positioned at 180 degrees of flexion with elbow in full extension; whereas the position of 90 degrees elbow flexion with shoulder in 0 degrees of flexion had the lowest grip strength score. In addition, the grip strength measured with the elbow in extension, regardless of shoulder position (ie, 0 degrees, 90 degrees, and 180 degrees of flexion), was significantly higher than when the elbow was flexed at 90 degrees with the shoulder positioned at 0 degrees of flexion. Finally, grip strength differed significantly for both sexes and for each age group. The grip values of the standardized 90 degrees elbow flexed position were further analyzed to determine the average performances in the study population. For men, grip strength peaked within the 20 to 39 years age group and gradually declined thereafter. For women, the highest mean grip strength measurement was recorded in the 40- to 49-year-old age group and then deteriorated with age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Reliability of a single-session isokinetic and isometric strength measurement protocol in older men.

BACKGROUND: The purposes of the current study were (a) to determine the test-retest reliability of a single-session isokinetic and isometric strength testing protocol in older healthy men, and (b) to compare the outcomes of the reliability measures derived from averaged torque scores with those derived from a single peak torque score. METHODS: In 19 men (mean age, 72 +/- 5 years), both lower limbs were assessed independently on 2 separate test days using the Biodex System 3 dynamometer. After completing a 5-minute warm-up, each man performed three submaximal knee extensions followed by five maximal contractions at 90 degrees /s (CON), 0 degrees /s (ISO), and -90 degrees /s (ECC). Average (best 3 of 5) and peak CON, ISO, and ECC torque, and CON work and CON power were determined. Peak CON work and CON power were recorded from the highest peak torque concentric contraction (HPTCC). RESULTS: Intraclass correlation coefficients ranging from 0.84 to 0.94 were found to have good reliability. The typical error as a coefficient of variation ranged from 8% to 10% for averaged measures and from 8% to 17% for peak torque and HPTCC. The ratio limits of agreement for average and peak CON, ISO, and ECC torque ranged from 23% to 33% and from 40% to 54% for average CON and HPTCC work and power. CONCLUSIONS: The test-retest reliability of a single-session isokinetic and isometric strength testing protocol in this group of older healthy men displayed good relative reliability (intraclass correlation coefficient > 0.84); however, because the typical error as a coefficient of variation and ratio limits of agreement (absolute reliability) were large, single-session testing is not recommended.

Aged↗
PubMed2002

Muscle analysis by measurement of maximal isometric grip force: new reference data and clinical applications in pediatrics.

Skeletal muscle development is one of the key features of childhood and adolescence. Determining maximal isometric grip force (MIGF) using a hand-held Jamar dynamometer is a simple method to quantify one aspect of muscle function. Presently available reference data present MIGF as a function of chronological age. However, muscle force is largely determined by body size, and many children undergoing muscle performance tests in the clinical setting suffer from growth retardation secondary to a chronic disorder. Reference data were established from simple regressions between age or log height and log MIGF in a population of 315 healthy children and adolescents aged 6 to 19 y (157 girls). These data were used to calculate age- or height-dependent SD scores (SDS) for MIGF in three pediatric patient groups. In renal graft recipients (n = 14), the age-dependent MIGF SDS was markedly decreased (-2.5 +/- 1.9; mean +/- SD). However, these patients had short stature (height SDS, -2.5 +/- 1.2), and the height-dependent MIGF SDS was close to normal (-0.4 +/- 1.5). Similarly, in cystic fibrosis patients (n = 13) age-dependent MIGF SDS was -1.6 +/- 1.6, but height-dependent MIGF SDS was -0.5 +/- 1.1. Children with epilepsy who were taking anticonvulsant therapy (n = 34) had normal stature, and consequently age- and height-dependent MIGF SDS were similar (0.4 +/- 1.0 and 0.4 +/- 0.8, respectively). In conclusion, MIGF determination provides information on an important aspect of physical development. Height should be taken into account to avoid misinterpretation.

Adolescent↗
PubMed2004

Maximal resultant four fingertip force and fatigue of the extrinsic muscles of the hand in different sport climbing finger grips.

This study investigates the effect of simulated sport climbing finger grips on the resultant four fingertip force and the rate of fatigue of finger flexor muscles. Six elite sport climbers sat on a chair with the right forearm placed in a handgrip dynamometer modified so that only the fingertips applied direct force. They were asked to perform three maximal voluntary contractions (MVC). After ten minutes, they had to reach 80 % of the peak MVC intermittently with a 5 s contraction followed by 5 s of rest for 20 repetitions. Two common sport climbing finger grips were tested: the "slope" grip and the "crimp" grip. In the "crimp" grip, the distal interphalangeal joint (DIP) is hyper-extended and the proximal interphalangeal joint (PIP) is flexed from 90 degrees to 100 degrees . In the "slope" grip, DIP is flexed from 50 degrees to 70 degrees and PIP is flexed just slightly. The surface EMG of the hand extrinsic flexors and the maximal resultant four fingertip force were recorded. Results show that the maximal resultant four-fingertip force does not depend on the type of finger grips (on average 420 N, p > 0.05). EMG median frequency of finger flexor muscles and resultant four fingertip force rate decrease are similar between both sport climbing finger grips (p > 0.05). This shows that the fatigue rate is not dependent upon the sport climbing finger grips. In conclusion, the results suggest that the use of the "crimp" or the "slope" grip does not provide any benefit with respect to muscular fatigue in sport climbing.

Biomechanical Phenomena↗
PubMed1994

Time-of-day dependence of isokinetic leg strength and associated interday variability.

The purpose of this study was to assess the interday variability and time-of-day effects on selected isokinetic leg strength indices. Nine adult collegiate sportsmen (mean(s.e.) age 19.6(0.5) years; mean(s.e.) height 1.81(0.02) m; mean(s.e.) body mass 76.5(3.1) kg) completed a series of nine test sessions, organized so that each subject was tested three times within a day (08.00-09.00 hours; 13.00-14.00 hours; 18.00-19.30 hours), on three occasions, each separated by a minimum of 7 days. Gravity-corrected indices of extension peak torque (EPT), flexion peak torque (FPT), and the peak torque ratio (PTR), at contraction velocities of 1.05 rad s-1 and 3.14 rad s-1, were calculated for each subject using an isokinetic dynamometer. Two-way repeated measures analysis of variance of coefficient of variation (V%) scores revealed no significant differences in performance variability across within-subject factors of time-of-day and performance index (P > 0.05). Overall mean(s.e.) V% for scores across experimental conditions were 3.97(0.72)% at 1.05 rad s-1 and 5.98(1.23)% at 3.14 rad s-1, suggesting that similar levels of measurement error occur between 08.00-19.30 hours. One-way repeated measures analysis of variance of absolute strength indices (EPT, FPT and PTR) revealed that significantly higher scores were achieved during session 3 (18.00-19.30 hours), with mean(s.e.) values of 249.1(40.0) N m, 149.0(32.3) N m, 59.5(5.0)% at 1.05 rad s-1, and 172.1(38.7) N m, 121.3(27.7) N m, 71.1(6.2)% at 3.14 rad s-1, respectively (P < 0.05). This finding appears to be consistent with current knowledge about time-of-day effects on the assessment of muscular strength. Thus for stable and maximal values to be obtained during isokinetic leg testing, the use of multiple-trial protocols is recommended, with testing occurring as close to 18.00-19.30 hours as possible. In addition, the observed significant time-of-day effect suggests that appropriate comparison of maximal isokinetic leg strength can only be achieved based on data obtained within 30 min of the same time of day.

Adult↗
PubMed2002

Effect of force-feedback treatments in patients with chronic motor deficits after a stroke.

OBJECTIVE: To assess the effects a motor reeducation approach based on static dynamometers used to provide feedback on the force produced. DESIGN: The study design was a single-blind, randomized, controlled trial. Chronic stroke subjects participated in a 6-wk, thrice-weekly, force-feedback program of either the upper paretic limb (n = 13) or the lower paretic limb (n = 12). Baseline and postintervention assessments of the performance of both the upper and the lower limb were measured for each subject, the untreated paretic limb of each group serving as a control for the other group. RESULTS: With the exception of the handgrip force, strength measurements of the treated limb increased after completion of the treatment. The outcome measurements of the upper limb of the subjects included in the upper paretic limb were not significantly different after treatment from those measured in the lower paretic limb. In contrast, gait velocity and the distance walked in 2 min increased after treatment in the lower paretic limb as compared with the upper paretic limb, whereas the scores in the Fugl-Meyer test for the lower limb and the timed up-and-go test did not increase for either group after treatment. CONCLUSION: The results indicate that treatment of the lower limb based on force feedback produces an improvement of gait velocity.

Adult↗
PubMed2006

The effects of isokinetic contraction velocity on concentric and eccentric strength of the biceps brachii.

The purpose of this investigation was to determine the influence of contraction velocity on the eccentric (ECC) and concentric (CON) torque production of the biceps brachii. After performing warm-up procedures, each male subject (n = 11) completed 3 sets of 5 maximal bilateral CON and ECC isokinetic contractions of the biceps at speeds of 90, 180, and 300 degrees x s(-1) on a Biodex System 3 dynamometer. The men received a 3-minute rest between sets and the order of exercises was randomized. Peak torque (Nm) values were obtained for CON and ECC contractions at each speed. Peak torque scores (ECC vs. CON) were compared using a t-test at each speed. A repeated measures analysis of variance was used to determine differences between speeds. ECC peak torque scores were greater than CON peak torque scores at each given speed: 90 degrees x s(-1), p = 0.0001; 180 degrees x s(-1), p = 0.0001; and 300 degrees x s(-1), p = 0.0001. No differences were found between the ECC peak torque scores (p = 0.62) at any of the speeds. Differences were found among the CON scores (p = 0.004). Post hoc analysis revealed differences between 90 degrees x s(-1) (114.61 +/- 23) and 300 degrees x s(-1) (94.17 +/- 18). These data suggest that ECC contractions of the biceps brachii were somewhat resistant to a force decrement as the result of an increase in velocity, whereas CON muscular actions of the biceps brachii were unable to maintain force as velocity increased.

Adult↗
PubMed1999

Coimpairments: strength and balance as predictors of severe walking disability.

BACKGROUND: Little information is available on the joint effects of multiple impairments (coimpairments) on the risk of disability. Our aim was to study the joint effects of strength and balance impairments on severe walking disability. METHODS: The data are from the baseline of the Women's Health and Aging Study (WHAS), a study of moderately to severely disabled women. A total of 1,002 women aged 65 and older participated in the tests, which took place in their homes. Severe walking disability was defined as self-reported inability to walk one-quarter mile and customary walking speed in a 4-meter test of < or =0.4 m/s. Balance was measured as an ability to hold progressively more difficult stands (feet side-by-side, semitandem and tandem stands). Maximal knee extension strength was measured using a hand-held dynamometer. RESULTS: There were 129 women who were severely walking disabled but able to walk at least minimally. In logistic regression analysis, balance and knee extension strength were independent predictors of severe walking disability. To study the combined effects, nine groups were formed on the basis of strength tertiles by balance categories in the entire population. In the best balance category, the crude prevalences of severe walking disability were 1.2%, 4.9%, and 14.3% in the highest to lowest strength tertiles. In the middle balance category, the rates were 2.9%, 10.0%, and 45.4.1%, and in the poorest balance category 4.9%, 22.1%, and 42.6%, correspondingly. The age, body weight, and height-adjusted odds ratios (OR) showed that the risk of severe walking disability in the subgroup with best balance and strength was less than 5% of the risk in the subgroup with poorest balance and strength (OR .034, 95% confidence interval [CI] .007-.166). Correspondingly, in the subgroups with poorest strength and best balance (OR .097, 95% CI .025-.38) or poorest balance and best strength (OR .102, 95% CI .012-.866) the risk was about 10%. The age-specific estimates of prevalence of severe walking disability in women were: 2.0% for ages 65-74 years, 3.4% for ages 75-84 years, and 9.1% for ages 85 years and older. CONCLUSIONS: The burden of coimpairments seems to be greater than the sum of single impairments involved. An effective way to reduce severe disabilities could be prevention of coimpairments.

Age Factors↗
PubMedDate not supplied

Isokinetic assessment of knee flexor/extensor muscular strength in elderly women.

OBJECTIVE: To assess knee flexor-extensor muscular strength in elderly women with no previous history of musculoskeletal disorders on the lower limbs using an isokinetic dynamometer, in order to obtain data that could be used as a comparative parameter in the evaluation of elderly women with knee disorders, thus facilitating a better rehabilitation of these patients. METHODS: Twenty-six volunteers aged 75 to 83 years were studied using a Cybex 6000 isokinetic dynamometer. The chosen angular velocity was 60 degrees /s, and concentric exercise was used for either flexion or extension. The studied parameters were: peak torque, angle of peak torque, and flexor-extensor torque rate. RESULTS: There were no differences between dominant (D) and nondominant (ND) knee peak torque values. This was true for both flexor (D = 42.46 +/- 9.09 Nm / ND = 40.65 +/- 9.38 Nm) and extensor (D = 76.92 +/- 13.97 Nm / ND = 77.65 +/- 15.21 Nm) movements. The descriptive statistical analysis of the values obtained for the flexor-extensor peak torque rate and for the angle of occurrence of peak torque was the same for the dominant and nondominant sides. CONCLUSIONS: The values of peak torque for the contralateral side can be used as a reference during rehabilitation of elderly women with acute disease of the knee, and the angular velocity of 60 degrees /s is proper and safe for isokinetic assessment of elderly people.

Acute Disease↗
PubMed2005

A practical posture for hand grip dynamometry in the clinical setting.

BACKGROUND & AIMS: The optimal testing position for hand grip strength, which is a useful functional measure of nutritional status, is open to debate. We therefore examined the systematic difference between different postures in order to establish a methodology that is clinically relevant, easy to perform and reproducible. METHODS: Grip strength was measured in the dominant and non-dominant hands with a strain gauge dynamometer in three positions: lying at 30 degrees in bed with elbows supported, seated in an armchair with elbows supported and in a chair with elbows unsupported. The average of three readings made in each position, each 1 min apart, was recorded. RESULTS: 55 normally nourished subjects (26 male) were studied. Mean (95% CI) grip strengths measured in the dominant hand with the subject in bed, sitting in an armchair and sitting in a chair were 45.7 (42.3-49.2), 46.3 (42.9-49.8) and 48.5 (45.4-51.7) kg, respectively for males. Corresponding values for females were 29.4 (27.0-31.8), 29.3 (26.8-31.9) and 31.6 (28.8-34.3) kg. There was no significant difference (Student t-paired test) between measurements made in bed and on an armchair (P = 0.49), but the measurements made in a chair were significantly higher than those made in bed (P = 0.001) and in an armchair (P = 0.004). No statistical difference was present, comparing the three separate measurements in each position (Student t-paired test). CONCLUSIONS: Measurement of grip strength using hand dynamometry is reproducible and consistent. As all patients are not able to sit in a chair with elbows unsupported, in clinical practice it is more practicable to perform hand dynamometry with the elbows supported in a bed or armchair.

Adult↗