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PubMed1995

Symmetric and asymmetric two-handed pull-push strength of young adults.

Forty normal young adults volunteered for an experiment in which they were required to perform two-handed maximal pull-push in isometric and isokinetic modes (50 cm/s linear velocity of the handle) at 50-, 100-, and 150-cm heights of handle in sagittal, 30-deg lateral, and 60-deg lateral planes. Subjects were stabilized on a circular platform that rotated on its axis and allowed fixation in any position to achieve asymmetric settings. The pull-push strengths were applied to a 53-cm wide handle and were measured through the load cell assembly of the Static Dynamic Strength Tester. The peak and average strengths were compared statistically, and an ANOVA and multiple regression were performed. The main effects of gender, activity (pull or push), mode (isometric or isokinetic), plane (sagittal, 30 deg lateral, or 60 deg lateral), and height (low, medium, or high) of activity for both peak and average strengths were highly significant (p < 0.01). All subjects were strongest in pulling activity in the isometric mode in the sagittal plane at medium height. Males were significantly stronger than females for most activities. However, with increased postural asymmetry, the difference between genders declined.

Adolescent↗

PubMed1992

The effect of elbow flexion and time of assessment on the measurement of grip strength in rheumatoid arthritis.

Grip strength is one of the traditional outcome measures commonly used in rheumatoid arthritis trials. This study evaluated the degree of morning variation and the effect of elbow flexion in the assessment of grip strength in patients with rheumatoid arthritis. Grip strength was measured in 37 patients (1987 American Rheumatism Association criteria) at 8, 10, and 12 AM with a sphygmomanometer cuff folded on itself, taped permanently, and inflated to 20 mm Hg, with the elbow flexed at 90 degrees. At 10 AM grip strength was also measured with the elbow flexed at 30 and 130 degrees. Mean values for grip strength at 8, 10, and 12 AM were, respectively, 69, 79, and 83 mm Hg. Mean grip strength values with the elbow flexed at 30, 90, and 130 degrees were, respectively, 78, 79, and 75 mm Hg. There was a statistically significant correlation between grip strength and morning stiffness, grip strength and hand function, and grip strength and number of active joints. In rheumatoid arthritis trials, grip strength should be assessed at the same time of the day. Elbow flexion does not play a role in grip strength measurement.

Adult↗

PubMedDate not supplied

Test-retest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders.

This study examined the test-retest reliability of hand-grip strength measured over a 12-week period. Twenty-one apparently healthy elders (age=75.0+/-5.9 yr) participated. Single strength measurements obtained bilaterally using a Jamar dynamometer were compared across time. Test and retest measurements did not differ significantly over time on either side. Intraclass correlation coefficients were 0.954 and 0.912 for the left and right hands, respectively. Technical errors of measurement were 15.8 and 21.3N for the left and right hands, respectively. Measurements of hand-grip strength obtained from elders over a 12-week period are reliable.

Age Factors↗

PubMed2000

Rapid repeat testing of grip strength for detection of faked hand weakness.

This study assessed the use of rapid, repeated measurement of grip strength to detect feigned hand weakness. Normal participants, performing with maximum effort or feigning hand weakness, and patients recovering from carpal tunnel surgery were asked to grip a Jamar dynamometer alternately with each hand on ten occasions. The results showed that grip strength fatigued by an average of 23% during the test in the normal participants, 18% in participants faking weakness, and increased by 2% in the carpal tunnel decompression patients. An increase in grip strength after the first effort was found in 39% of normal participants, 52% of participants faking hand weakness and in 69% of the carpal tunnel decompression patients. These results suggest that rapid, repeated measurement of grip strength is not a reliable discriminator of true and faked hand weakness.

Adult↗

PubMed2025

Impact of Muscle Quality on Muscle Strength and Physical Performance Beyond Muscle Mass or Diabetes Status.

BACKGROUND: Muscle quality, represented by myosteatosis, is recognized as an important factor in sarcopenia. In this study, we aimed to determine the associations between myosteatosis, muscle strength and physical performance among the elderly South Korean population. METHODS: We included 1440 participants (mean age 62.7 ± 6.2 years) from the Korean Genome and Epidemiology Study (KoGES). Based on the computed tomography attenuation of mid-thigh imaging, the total muscle area (TMA), normal-attenuation muscle area (NAMA), low-attenuation muscle area (LAMA) and inter-intramuscular adipose tissue (IMAT) and its indices were used to evaluate myosteatosis. Muscle strength was evaluated using hand grip strength, whereas physical performance was evaluated through 4-m gait speed, a 30-s sit-to-stand test and 2-min walking test. RESULTS: Of the 1440 patients, 51.5% were women, and 37.2% had diabetes. With aging, the LAMA index gradually increased, and the NAMA index gradually decreased in both men and women (p for trend < 0.001). The NAMA index was positively associated, whereas the LAMA and IMAT indices were negatively associated with muscle strength and physical performance after adjusting for age and sex. Higher tertiles of the NAMA index were consistently associated with improved physical performance across all appendicular skeletal muscle tertiles. The relationship between the NAMA index or LAMA index and muscle strength and physical performance did not differ according to diabetic status. Regular exercise was associated with a higher NAMA index and a lower LAMA index in the non-diabetic group; however, no significant difference in muscle quality was observed in the diabetic group in relation to exercise. CONCLUSIONS: Reduced myosteatosis was positively associated with greater muscle strength and better physical performance in both men and women, regardless of muscle mass or diabetes status; improving myosteatosis may be a therapeutic target for the prevention of sarcopenia.

Humans↗

PubMed1985

Confirmative study of the effectiveness of thymopentin in active rheumatoid arthritis.

Forty-one patients with active rheumatoid arthritis entered a controlled double-blind randomized study. Of these patients, 21 received prolonged intravenous injections (10 min) of thymopentin 50 mg three times a week for 3 consecutive weeks, whereas 20 received placebo. Both groups were comparable with regard to clinical parameters. No immunological tests were performed. Analysis of the results after 3 weeks showed that the improvement in the thymopentin group was statistically significant (p less than 0.05 or p less than 0.01) for all clinical parameters, except for the left-hand grip strength. On the other hand, no significant improvement was observed for any parameter, except morning stiffness, in the patients on placebo. The intergroup comparison showed statistically significant differences, favoring thymopentin over placebo treatment, in the Ritchie index, the scores of swollen joints, the assessment of severity of pain, and the scores for changes in the activity of the disease. The present placebo-controlled double blind study thus confirms the positive results generated in a similar open study, i.e., the beneficial therapeutic effect of prolonged intravenous injections of thymopentin in patients with severe rheumatoid arthritis. The drug appears to be safe at the dose regimen used.

Adjuvants, Immunologic↗

PubMed2002

The effects of graded compression of the median nerve in the carpal canal on grip force.

The relationship between tactile hypoesthesia and precision grip force was examined using compression of the median nerve in healthy adults. Hypoesthesia was graded by varying the pressure that an external clamp exerted over the carpal canal. Electrical stimulation of the median nerve in the forearm evoked a compound sensory nerve action potential (SNAP) that we recorded from the digital nerves of the index finger. Clamp pressure was varied to achieve SNAPs that were 75%, 50%, and 25% of precompression amplitude (100%). Grip force and tactile sensibility (Semmes-Weinstein filaments, cotton wisps, sharp/dull) did not change in parallel with reductions of the SNAP. Subjects reported paresthesias at the thumb and index finger at 75% SNAP. Tactile pressure thresholds increased to the clinical range of 'diminished light touch', but subjects detected cotton wisps stroked along the finger. At 75% SNAP grip force did not change compared to 100% SNAP. Simple prehension can proceed efficiently despite these modest reductions in tactile signals. At 50% SNAP the digits remained sensate, but were reported to feel "thick, like cardboard". No subject could detect cotton wisps and tactile thresholds increased by one filament. Sharp/dull distinctions remained. Grip force increased by 55% compared to grip force at SNAPs of 100% and 75%. There were no changes in skin slipperiness, so the increased grip force represented elevated 'safety margin' (grip force exceeding that needed to prevent slip). At 25% SNAP subjects described the skin innervated by the median nerve as feeling "numb", but grip force increased little compared to 50% SNAP. Grip force continued to reflect changes in grip surface friction, and mechanical transients from setting the object on the table triggered coordinated reductions in grip force. We suspect that the loss of information from SA I and FA I, but not FA II, tactile afferents provoked the increased grip force.

Action Potentials↗

PubMed1999

Brachial plexus and supraclavicular nerve injury caused by manual carotid compression for spontaneous carotid-cavernous sinus fistula.

BACKGROUND: Manual carotid compression is an established treatment for a spontaneous carotid-cavernous sinus fistula unless emergency treatment is required for it. CASE REPORT: A 63-year-old woman presented with a spontaneous carotid-cavernous sinus fistula. Manual carotid compression of 5 minutes duration, twice a day, for 10 days resulted in injury to the upper trunk (C 5-6) of the brachial plexus and the supraclavicular nerve (C 3-4), which subsequently resolved within a month after cessation of the procedure. CONCLUSION: It is important to know the possible neurological complications of manual carotid compression.

Arteriovenous Fistula↗

PubMed1998

Proximal row carpectomy through a palmar approach.

From 1990 to 1994, nine proximal row carpectomies were done through a palmar approach. With an average follow-up of 20 months, seven of the nine patients were completely painfree. Average range of wrist flexion/extension remained unchanged, and average radial/ulnar deviation increased from 25 degrees to 46 degrees . All the patients demonstrated an increase in grip strength in the operated hand. Four cases showed a slight reduction in articular space and subchondral sclerosis in the radiocapitate articulation, in spite of good function. Dynamic studies demonstrated no sign of radiocarpal instability. All the patients were very satisfied with the results and returned to their previous work within 2 months, on average.

Adult↗

PubMed2003

[The treatment of carpal collapse: proximal row carpectomy or limited midcarpal arthrodesis? A comparative study].

Between July 2000 and February 2002, 26 wrists were treated because of SLAC, SNAC and radiocarpal arthrosis after fracture of the distal radius. In 14 cases proximal row carpectomy (PRC) and in twelve cases limited midcarpal arthrodesis (LWF) was performed. Follow-up was after a mean time of 16.8 (PRC) and 13.7 months (LWF) on ten wrists each. There was one complication in the PRC group and two in the LWF group. In all cases significant reduction of extension/flexion was observed with a mean range of motion of 69 degrees (PRC) and 71 degrees (LWF). The reduction of pain postoperatively was almost identical in both groups. Comparing grip-strength to the unoperated hand, we measured 26 compared to 39 kg in the PRC group and 28 compared to 46 kg in the LWF group, respectively. The DASH-score for the LWF group was 30 points and therefore better than the 36 points for the PRC group.

Adult↗

PubMed1986

The influence of color and demand characteristics on muscle strength and affective ratings of the environment.

Demand characteristics may influence claims that the color pink inhibits muscle strength whereas blue increases muscle strength. In Experiment 1, undergraduates (N = 59; 30 women, 29 men) were told either that the experimenters thought pink would increase and blue decrease strength or that blue would increase muscle strength and pink decrease muscle strength. A hand dynamometer assessed grip strength as subjects stared at each of 8 differently colored panels. Results indicated that men viewing the pink or orange panels had higher grip strength under pink-strengthen than under pink-weaken instructions. The reverse relationship was found for men viewing a green panel. For women, the pink-weaken instructions resulted in a higher grip strength than did the pink-strengthen instructions, regardless of actual color present. In Experiment 2, women in a no-instruction control condition had lower grip strength than women given the pink-weaken instructions. For men, the control (no-instruction) condition resulted in higher grip strength than the pink-weaken condition. Results of both studies suggest that men followed overt demand characteristics but that women reacted with increased intensity to any suggestion that a stereotypically feminine pink is associated with weakness.

Adult↗

PubMed2000

Force production in the rugby union scrum.

In this study, we examined the relationship between anthropometric, strength and power characteristics of rugby forwards, their body position when scrummaging, and their ability to apply force when scrummaging. Force applied to an instrumented scrum machine was measured for 56 players, both individually and as scrum packs. Measurements of body position for individuals were made by digitizing videotape records of the trials. Forty players subsequently had their anthropometry assessed and completed several strength and power tests. Body mass, each component of somatotype, maximal anaerobic power developed on a cycle ergometer, and isokinetic knee extension strength correlated significantly with individual scrummaging force. A regression model (P < 0.001) including body mass, mesomorphy, maximal anaerobic power and hip angle while in the scrummaging position accounted for 45% of the variance in individual scrummaging force. The packs that produced the largest scrummaging forces were, in general, characterized by a greater pack force to sum of individual force ratio than the packs producing lower forces. Our results emphasize the need for a scrum pack to develop technique and coordination as a unit to maximize scrummaging force.

Adult↗

PubMed2001

Concurrent dorsal dislocations and fracture-dislocations of the index, long, ring, and small (second to fifth) carpometacarpal joints.

OBJECTIVE: To review the outcome of patients with concurrent dorsal dislocations and fracture-dislocations of the second, third, fourth, and fifth carpometacarpal (CMC) joints treated with open reduction and internal fixation (ORIF). DESIGN: Retrospective review. SETTING: Level 1 trauma center. PATIENTS: Between 1991 and 1997, twelve multiply injured patients with the described CMC injury complex (one open injury) were treated with ORIF (eleven patients) or percutaneous wire fixation (one patient) by the same surgeon. INTERVENTION: Treatment consisted of ORIF with Kirschner wires followed by splints and immediate metacarpophalangeal and interphalangeal joint range of motion exercises. MAIN OUTCOME MEASUREMENTS: Grip strength, wrist and finger range of motion, pain, need for additional surgery, and return to work. RESULTS: Of the ten patients available for follow-up (mean, three years), all had been treated with ORIF (eight within forty-eight hours of injury and two had treatment delayed for four weeks because of delayed diagnosis and management of more serious injuries). Three patients had additional surgery (planned secondary second and third CMC arthrodeses). Grip strength of the operated hand in the five patients with JAMAR testing was 50 percent (n = 3), 75 percent (n = 1), and 90 percent (n = 1) of that in their contralateral hands. Five patients were pain-free, and five reported occasional, activity-related pain. The five patients who worked before the injury returned to their previous occupations (one with slightly modified duties). CONCLUSION: This is the largest series of patients with this CMC injury complex and the first report of open CMC dorsal dislocations and fracture-dislocations. Although early ORIF is suggested, delay of up to four weeks did not adversely affect results.

Adult↗

PubMed2001

Anthropometric correlates of basketball free-throw shootings by young girls.

The purpose of this analysis of data from a larger investigation was to assess effects of anthropometric factors on free throw shooting performance of 15 girls from Michigan and 18 from Puerto Rico. Subjects performed 60 free throws (10 trials x 3 ball sizes x 2 basket heights). Correlations were low, with two exceptions, .53 between shooting performance at the low basket and grip strength (as measured by hand grip dynamometer) for girls from Michigan, and .49 for hand width and performance at the low basket for girls from Michigan.

Anthropometry↗

PubMed1984

Interim results on the clinical effects of i.v. administered thymopentin in active rheumatoid arthritis.

Forty-one patients with active rheumatoid arthritis entered a controlled, double-blind, randomized study; 21 received prolonged i.v. injections (10 min) of thymopentin 50 mg 3 times a week for 3 consecutive weeks; the other 20 received placebo under the same conditions. The groups were comparable at the start of the study. Statistical tests of changes within the treatment groups after 3 weeks showed that the improvement achieved in the thymopentin group was significant (p less than 0.05 or p less than 0.01) for each clinical parameter, except for left-hand grip strength. On the other hand, no significant improvement was observed for any parameter except morning stiffness in the patients on placebo. The intergroup comparison showed significant differences, favouring thymopentin over placebo treatment, in the Ritchie index, scores for swollen joints, assessment of severity of pain and scores for changes in the activity of the disease. Only minor side-effects were experienced in the two treatment groups. The present placebo-controlled double-blind study confirms the previous positive results achieved in open studies, i.e., the beneficial therapeutic effect of prolonged i.v. injections of thymopentin in patients with severe rheumatoid arthritis observed after 3 weeks of therapy. The drug appears to be safe at the dose regimen used.

Arthritis, Rheumatoid↗

PubMed2006

Relationships between performance-based tests and patients' ratings of activity limitations, self-efficacy, and pain in fibromyalgia.

OBJECTIVE: To investigate the relationship between performance-based tests, ratings of activity limitations, self-efficacy, and pain in fibromyalgia. DESIGN: Descriptive. SETTING: University hospital. PARTICIPANTS: Sixty-nine women with fibromyalgia (mean age, 45+/-7.8y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The patients completed 4 performance-based tests focusing on muscle power function and 3 unloaded arm movements. The patients rated their activity limitations by means of the subscales of physical function (PF) and pain on the Fibromyalgia Impact Questionnaire (FIQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Arthritis Self-Efficacy Scale (ASES). Spearman correlation coefficient (rho) and multivariate regression analysis were conducted. RESULTS: The highest correlations were found between the 6-minute walk test (6MWT) (rho range, -.48 to .68) and the activity limitations and between hand grip strength (rho range, -.34 to .57) and the activity limitations. The regression analysis indicated that hand grip strength explained 25% of the variation in the SF-36 PF scale. The 6MWT plus endurance of the shoulder muscles explained 24% of the variation in the FIQ PF scale and the 6MWT plus active abduction of the shoulder explained 48% of the variation in the ASES function scale. Correlations between the performance-based tests and the activity limitations tended to be higher than those between performance and pain. CONCLUSIONS: The majority of the performance-based tests and the patients' subjective ratings of activity limitations showed significant relationships. The 6MWT and hand grip strength, reflecting activity limitations in the SF-36, FIQ, and ASES, are recommended for use in clinical research and in the clinical examination when planning treatment for patients with fibromyalgia.

Female↗

PubMed1986

Grip strength, muscle fatigue, and body composition in nomadic Turkana pastoralists.

Tests of hand grip strength and hand grip muscle fatigue were conducted on Ngisonyoka Turkana pastoralists of northwest Kenya to explore some of the functional relationships between activity and body composition. The test of maximal voluntary contraction (MVC) of hand grip flexors was conducted on 151 Turkana and 38 U.S. men and women. The fatigue test was conducted on the same number of subjects who were instructed to attempt to maintain 80% of the MVC for 90 seconds. The results of these tests, combined with arm measurements of size and body composition, were used to evaluate muscle size and strength relationships and to estimate muscle fiber type distribution in the forearm. MVC values of Turkana men were low by U.S. and European standards. The low values resulted from smaller Turkana muscle areas. MVC values of Turkana women were comparable to those of U.S. and European women, reflecting comparable muscle areas. The fatigue curves of Turkana and U.S. men and women suggest that slow-twitch aerobic muscle fibers predominate for the hand grip flexors of the Turkana pastoralists.

Adult↗

PubMed1995

Normal inspiratory muscle strength is restored more rapidly after laparoscopic cholecystectomy.

Respiratory complications after laparotomy cholecystectomy may result from generalised muscle weakness and fatigue, or from reduced respiratory muscle function secondary to an upper abdominal incision. In a prospective study we compared maximal inspiratory effort (Pimax/mmHg) and dominant hand grip strength (kPa) (expressed as a percentage of zero hour value) in patients undergoing open cholecystectomy (OC) (n = 12), laparoscopic cholecystectomy (LC) (n = 25) and a control group of patients undergoing lower limb surgery (n = 12). Of the 12 OC patients, three suffered respiratory complications: two had atelectasis and one a chest infection, compared with no such complications in the other two groups (P < 0.05). Pimax decreased postoperatively in all groups (P < 0.05) and had returned to normal by 48 h in the LC and control groups. In contrast, in the OC group Pimax fell from 112.5 +/- 17.8 mmHg to as low as 81.3 +/- 16.5 mmHg at 72 h and only returned to preoperative levels at 120 h. The hand grip strength fell significantly in all groups at 24 h (P < 0.05) but normal levels were achieved again by 48 h in all groups, and there was no significant difference in the hand grip strength between the groups over the 5 days. These results suggest that generalised muscle fatigue after surgery is similar after open and laparoscopic cholecystectomy. Open cholecystectomy does, however, cause a more prolonged reduction in respiratory muscle function and this is likely to contribute to the higher incidence of respiratory complications in this group of patients.

Adult↗