Methods for measurement of muscle function. Methodological aspects, reference values for children, and clinical applications.
In children isometric muscle force can be measured with acceptable reproducibility by using a simple hand-held dynamometer. Reference values for 10 different muscle groups are given for children aged 3.5-15 years. If age and weight are known, the force can be predicted. The most pronounced differences between the dominant and the non-dominant side were found in the elbow flexors, 3 of the 6 age groups showing greater force on the dominant side, and in the wrist extensors, the 2 oldest age groups being stronger on the dominant side. Sex differences were present as early as 9.5-11 years of age, boys being stronger than girls. Isokinetic muscle torque of the dorsiflexors of the ankle increased with age. Reference values are given for peak torque in children 6, 9, 12, and 15 years of age. The most intense force development occurs between 12 and 15 years of age in boys, and earlier in girls. Sex differences appear in early puberty. In young children the dominant leg was the stronger at the highest velocities. In the older children the non-dominant leg was the stronger at low velocities. Isokinetic measurements are time-consuming and require experience, and should be regarded as complementary to isometric testing. In muscle groups that are too weak to overcome gravity isometric and isokinetic methods cannot be used. Functional tests of motor ability are especially useful in patients with severely impaired muscle function when other test methods are inadequate or difficult to evaluate. The natural course of Duchenne muscular dystrophy was followed in 16 boys by means of functional tests, isometric tests, isokinetic tests of concentric muscle contraction, and manual tests. Of these only the isokinetic method proved unreliable, possibly because of difficulty in activating the muscles at different speeds. The function of adductor pollicis was studied by supramaximal electrical stimulation of the ulnar nerve. Force-frequency curves and reference values for relaxation rate and half contraction time to tetanus for children aged 9, 12, and 15 years are presented. The half contraction time to tetanus was briefer in the older children than in the younger. The relative force developed at a stimulation of 10 Hz increased with age. Apart for the increase in muscle force with increasing age, no other differences emerged between the different age groups. No sex differences were found. The electrical stimulation test is rather painful, and only about 60% of the children persevered to the end of the test.(ABSTRACT TRUNCATED AT 400 WORDS)