Quantification of isometric lumbar extension strength using a BackUP lumbar extension dynamometer.
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Adult↗
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Factor structure of trunk performance data for healthy subjects.
OBJECTIVE: To examine the factor structure of various measurements of trunk muscle performance for healthy subjects. DESIGN: A total of 22 performance scores were collected and their univariate and multi-variate relationships were examined. BACKGROUND: Extensive literature exists on the measurement of trunk performance data and the relationships between measurements but what needs to be collected to realize a true performance score remains unclear. METHODS: Trunk muscle performance scores of 150 subjects (71 males and 79 females) were obtained on an Isostation B-200 Dynamometer. Twenty-two parameters measuring range of motion, isometric strength, velocity, and endurance on all three planes of motion were collected. The factor structures were constructed using Principal Components Analysis. RESULTS: Clear-cut factor patterns (explained 96.3% of the total variance) suggests that the five-factor structure might be valid and appropriate for this population. The major loading on each factor indicated that: Factor 1 could be labeled as a static strength measure; Factor 2 as velocity; Factor 3 as flexibility; and Factors 4 and 5 as fatigue-resistance. CONCLUSIONS: No single mode of measurement can provide a good representation of a total trunk muscle performance. RelevanceFor the realization of trunk muscle performance, clinics have to measure all modes of isometric strength, velocity, range of motion, and endurance. Care must be taken in eliminating any parameter.
Adult↗
Effect of one-legged exercise on the strength, power and endurance of the contralateral leg. A randomized, controlled study using isometric and concentric isokinetic training.
The purpose of this investigation was to study the effect of one-legged exercise on the strength, power and endurance of the contralateral leg. The performance of the knee extensor and flexor muscle of 20 healthy young adults (10 men and 10 women) was first tested by Cybex II+ and 340 dynamometers. Then 10 subjects were chosen at random to train using one leg three times a week for 7 weeks whilst the other 10 served as controls. During the 8th week, the tests were repeated. Both quadriceps and hamstring muscles of the trained subjects showed a cross-transfer effect from the trained limb to the untrained side. This concerned the strength and power, as well as endurance characteristics of these muscles. The average change in peak torque of the quadriceps muscle was +19% (P less than 0.001) in the trained limb, +11% (P less than 0.01) in the untrained limb and 0% in the control limbs. In hamstring muscles the changes were +14% (P less than 0.01), +5% and -1%, respectively. Concerning muscle endurance (work performed during the last 5 contractions in the 25-repetition test) the corresponding changes were +15% (P less than 0.01), +7% (P less than 0.01), and -1% in quadriceps muscle, and +17% (P less than 0.05), +7%, and -3% in hamstring muscles. The average strength benefit in the untrained limb was +36% (hamstring muscles) and +58% (quadriceps muscle) of that achieved in the trained limb. Untrained hamstring muscle showed better benefits in the endurance parameters than in strength or power parameters, while in the quadriceps muscle this effect was reversed. A positive relationship was observed between the changes (greater improvement in the trained limb resulted in greater improvement in the untrained limb) (hamstring muscles: r = 0.83, P less than 0.001, quadriceps muscle: r = 0.53, P less than 0.001). In endurance parameters, this relationship was almost linear while in the strength and power parameters the results were more in favour of a curvilinear relationship with limited benefit.
Adult↗
Reliability and smallest detectable change determination for serratus anterior muscle strength and endurance tests.
The purposes of this study were to determine inter-tester reliability, one-week test-retest reliability and smallest detectable difference (SDD) of serratus anterior muscle strength and endurance tests. Asymptomatic subjects were tested on an apparatus designed by the investigators. During strength testing, subjects performed isometric contractions recorded by a hand-held dynamometer. For endurance testing, subjects held a dumbbell of 15% of their body weight and performed repetitions until they became fatigued. Intraclass correlation coefficients (ICC) for the strength test revealed good inter-tester reliability (ICC2,3 = .90-.93) and good one-week test-retest reliability (ICC2,3 = .83-.89). For the endurance test, ICCs showed good inter-tester reliability (ICC2,1 = .71-.76) but moderate one-week test-retest reliability (ICC2,1 = .59-.62). The SDDs at 68% confidence level ranged from 22.7 to 39.2 newtons for the strength test, and 11 to 20 repetitions for the endurance test. In summary, the technique used in the study is reliable for quantifying the SA muscle strength.
Electromyography↗
[Muscle training techniques and retropatellar chondropathy].
The authors have studied the efficacy of 3 different muscle training programs (electromyostimulation, isokinetic training and isometric training) in cases of patellar chondromalacia. The evaluation of the results was made by measuring the isokinetic strength on a Cybex II+ dynamometer at a low (30 degrees/sec) and a high (300 degrees/sec) angular velocity. The clinical evaluation was based on a modified score determined by the Arpege group. The results showed a better improvement of the muscular strength after electromyostimulation or isokinetic training. The clinical improvement was better on patients of groups I and III.
Cartilage Diseases↗
Isokinetic performance after total hip replacement.
OBJECTIVE: To evaluate differences in isokinetic hip flexion, extension, and abduction muscle performance of operated vs. nonoperated hips in older adults who have undergone elective, unilateral, total hip replacement (THR) surgery and completed rehabilitation. DESIGN: Quasi-experimental study using a nonequivalent posttest-only control group design, comprising 20 unilateral THR patients and a convenience sample of 22 healthy older adults. THR patients participated between 4 and 5 mos after surgery. THR subjects received an average of 13 outpatient or home-based physical therapy sessions. Isokinetic muscle strength and fatigue was assessed through measurement of hip peak torque per body weight, total work, and average power using a robotic dynamometer. RESULTS: Comparisons of THR subjects' operated vs. nonoperated hips showed no significant differences in isokinetic performance for any of the examined variables. THR subjects' operated hips generated significantly less peak torque per body weight, total work, and average power across all exercises as compared with a population of healthy subjects. CONCLUSIONS: THR subjects' operated and nonoperated hips showed similar biomechanical performance. THR patients are not being restored to the same level of strength and muscular endurance as compared with a population of healthy adults. These findings may be useful in providing a preliminary rationale for revising current approaches in THR rehabilitation protocols.
Aged↗
A reliable isokinetic strength test for arm and leg musculature for mildly mentally retarded adults.
This study attempted to establish a reliable test protocol to measure the strength of muscles involved in elbow and knee flexion and extension for mentally retarded (MR) adults. Nineteen mildly MR adults performed strength tests on a Cybex 340 isokinetic dynamometer on two separate days; 12 subjects performed a third trial of knee flexion and extension tests. For the 19 subjects, there were no significant differences in strength measurements--except for peak torque of knee flexion--between the first two test days. There were relatively high correlation coefficients when test parameters were compared for both test days, and best efforts occurred almost as often on test day two as on test day one. For the 12 subjects tested on three test days, there were no significant differences for test parameters among the three test days; however, 25% of best efforts took place on test day three. These findings indicate that when measuring the isokinetic strength of mildly MR individuals, tests should be performed at least two, optimally three, separate times to ensure reliability. The test protocol would be reliable when measuring knee and elbow flexion and extension strength for job assessment or clinical or rehabilitation purposes.
Adult↗
Effects of whole-body exercise training on body composition and functional capacity in normal-weight patients with COPD.
BACKGROUND: Skeletal muscle wasting is related to muscle dysfunction, exercise intolerance, and increased mortality risk in patients with COPD. STUDY OBJECTIVES: The aims of this study were to investigate the effects of whole-body exercise training on body composition in normal-weight patients with COPD, and to study the relationship between changes in body composition and functional capacity. SETTING AND PARTICIPANTS: Fifty patients with COPD (FEV(1), 39% of predicted [SD, 16]) admitted to the pulmonary rehabilitation center at Hornerheide, and 36 healthy age-matched control subjects (for baseline comparison) were included. INTERVENTIONS: Patients participated in a standardized inpatient exercise training program consisting of daily submaximal cycle ergometry, treadmill walking, weight training, and gymnastics during 8 weeks. MEASUREMENTS: Fat-free mass (FFM) was measured by bioelectrical impedance analysis. None of the patients met the criteria for nutritional supplementation (body mass index </= 21, or FFM index </= 15 kg/m(2) in women and </= 16 kg/m(2) in men). Exercise capacity was measured using incremental cycle ergometry. Isokinetic quadriceps strength was measured with a Biodex dynamometer (Biodex Medical Corporation; Shirley, NY). RESULTS: At baseline, patients were characterized by a significantly lower FFM than the control subjects. Age and FFM were independent predictors of skeletal muscle function and exercise capacity in patients. After rehabilitation, weight (72.4 +/- 9.8 to 73.0 +/- 9.4 kg, p < 0.05) significantly increased, as a result of increased FFM (52.4 +/- 7.3 to 53.4 +/- 7.7 kg, p < 0.05), while fat mass (20.0 +/- 6.1 to 19.6 +/- 5.7 kg) tended to decrease. Peak work rate (63 +/- 29 to 84 +/- 42 W, p < 0.001), maximal oxygen consumption (O(2)max) [1,028 +/- 307 to 1,229 +/- 421 mL/min, p < 0.001], and isokinetic quadriceps strength (82.5 +/- 36.4 to 90.3 +/- 34.9 Newton-meters, p < 0.05) all improved. Changes in FFM were proportionally smaller than functional improvements, and were related to changes in O(2)max (r = 0.361, p < 0.05), but not to other changes in functional capacity. CONCLUSIONS: Intensive exercise training per se is able to induce an anabolic response in normal-weight patients with COPD classified into Global Initiative for Chronic Obstructive Lung Disease stages III-IV. Improvements in exercise performance and muscle function are proportionally larger than increases in FFM.
Aged↗
[Is a dynamic or stable technique needed for metacarpophalangeal joints of the hand in ulnar nerve palsy?].
INTRODUCTION: It seems interesting to choose between the dynamic and the static techniques for the rehabilitation of the hand suffering from an ulnar nerve palsy on the basis of the grasp (F1) and pinch (F2) strengths which are important in this rehabilitation. METHODS: From june 1997 to december 2001, 30 ulnar palsies all post traumatic with non complicated claw deformities have been collected and distributed in three groups of ten patients. In the group A only the static techniques have been used on the MP joints of the fourth and fifth digits and the thumb; in the group B only the dynamic techniques have been used on the fourth and fifth digits, on the flexor pollicis brevis and on the first dorsal interosseous muscle; in the group C, the MP joint of the thumb has been stabilized and dynamic techniques have been used on these two muscles, the MP joints of the fourth and fifth digits have been only stabilized. The techniques used in this study were among the most popular. The grasp and pinch strengths were measured by a mechanical dynamometer at the preoperative period and at third and sixth postoperative month. RESULTS: At sixth month, in the group A, F1 didn't change and F2 has increased by 9%; in the group B, F1 has decreased by 24% without recovery of the preoperative value and F2 has increased by 13%; in the group C, F2 has increased by 19%. DISCUSSION: For a reconstruction of an useful hand in an ulnar nerve palsy, the best solutions seem: for the fourth and fifth digits: simple stabilization of the MP joints for the thumb: an association of this stabilization and a rehabilitation of some muscles involved in the pinch prehension.
Adolescent↗
CNTF genotype is associated with muscular strength and quality in humans across the adult age span.
The relationship between ciliary neurotrophic factor (CNTF) genotype and muscle strength was examined in 494 healthy men and women across the entire adult age span (20-90 yr). Concentric (Con) and eccentric (Ecc) peak torque were assessed using a Kin-Com isokinetic dynamometer for the knee extensors (KE) and knee flexors (KF) at slow (0.52 rad/s) and faster (3.14 rad/s) velocities. The results were covaried for age, gender, and body mass or fat-free mass (FFM). Individuals heterozygous for the CNTF null (A allele) mutation (G/A) exhibited significantly higher Con peak torque of the KE and KF at 3.14 rad/s than G/G homozygotes when age, gender, and body mass were covaried (P < 0.05). When the dominant leg FFM (estimated muscle mass) was used in place of body mass as a covariate, Con peak torque of the KE at 3.14 rad/s was also significantly greater in the G/A individuals (P < 0.05). In addition, muscle quality of the KE (peak torque at 3.14 rad x s(-1) x leg muscle mass(-1)) was significantly greater in the G/A heterozygotes (P < 0.05). Similar results were seen in a subanalysis of subjects 60 yr and older, as well as in Caucasian subjects. In contrast, A/A homozygotes demonstrated significantly lower Ecc peak torque at 0.52 rad/s for both KE and KF compared with G/G and G/A groups (P < 0.05). No significant relationships were observed at 0.52 rad/s between genotype and Con peak torque. These data indicate that individuals exhibiting the G/A genotype possess significantly greater muscular strength and muscle quality at relatively fast contraction speeds than do G/G individuals. Because of high positive correlations between fast-velocity peak torque and muscular power, these findings suggest that further investigations should address the relationship between CNTF genotype and muscular power.
Adult↗
Dynamic strength training in patients with early rheumatoid arthritis increases muscle strength but not bone mineral density.
OBJECTIVE: To assess the effects of 12 months' dynamic strength training on muscle strength and bone mineral density (BMD) at the lumbar spine and femoral neck in patients with early rheumatoid arthritis (RA). METHODS: Thirty-two subjects in the training group (EG) and 33 in the control group (CG) completed the study. EG carried out strength training 2 times a week with moderate loads of 50-70% of repetition maximum. They were also encouraged to do recreational physical activities. CG performed recreational physical activities and range of motion exercises. Maximal strength of the knee extensors, trunk extensors and flexors, and grip strength were recorded with dynamometers. BMD was measured using dual x-ray absorptiometry. Modified Disease Activity Score, erythrocyte sedimentation rate, and pain were used for the estimation of disease activity, and Stanford Health Assessment Questionnaire to measure functional disability. RESULTS: The 12 month resistance training in EG led to statistically significant mean increases of 22-35% in all muscle groups examined. CG patients were also able to increase their strength to some degree (3-24%), but at the end of the study strengths in CG were significantly lower than in EG. By the end of the study lumbar spine BMD had changed by +0.19% (4.24) in EG and by -1.14% (4.36) in CG. The corresponding changes of femoral BMD were +1.10% (3.71) and -0.03% (3.58). The changes in BMD were minor and statistically not significant in both groups. However, femoral BMD was found to be decreased among those patients treated periodically with oral glucocorticoids (n = 15, 3 subjects from EG and 12 from CG) compared with changes in BMD among those not treated with systemic glucocorticoids (n = 50). CONCLUSION: Minimally supervised strength training resulted in significant improvements in muscle strength without detrimental effects on disease activity. The detected annual changes in central BMD were minor and statistically insignificant in both groups. Special attention should be focused on those patients with RA with high disease activity and concomitant glucocorticoid treatment.
Arthritis, Rheumatoid↗
Gender and age differences in plasma carnitine, muscle strength, and exercise tolerance in haemodialysis patients.
BACKGROUND: Haemodialysis patients have impaired exercise tolerance that may be related to impaired carnitine availability and/or alterations in carnitine metabolism. As carnitine metabolism is sex- and age-related, we examined plasma free and esterified carnitine concentrations, muscle strength, and estimated exercise tolerance in female (n=51) and male (n=63) patients of different ages (18-86 years). METHODS: Concentrations of free carnitine and acetylcarnitine were determined in the plasma of patients. Isometric handgrip strength was measured using a dynamometer while exercise tolerance was predicted from scores for self-reported walking distance on the level and on an incline. RESULTS: Plasma total carnitine concentration in the females was significantly lower than that of males (35.4+/-1.3 and 42.4+/-1.4 micro mol/l, respectively, P<0.01). This was almost entirely due to the lower plasma free carnitine concentration of females when compared with the males (20.6+/-0.9 and 26.3+/-1.1 micro mol/l, respectively, P<0.05). Furthermore, plasma free carnitine concentrations were negatively correlated with age in females (r=-0.45, P<0.001) even when the linear effects of haemoglobin, albumin, body weight, time on dialysis, and muscle strength were removed from the regression analysis (partial correlation coefficient; pcc=-0.43, P=0.018), but not in the males (r=0.03, P>0.05). Isometric handgrip strength and estimated exercise tolerance on the level were lower in females than males (138.9+/-10.9 and 259.0+/-15.2 N, P<0.001; and 3.5+/-0.2 and 4.3+/-0.2, P<0.05, respectively). Isometric handgrip strength and estimated exercise tolerance (walking distance on the level and on an incline) were positively correlated with plasma free carnitine concentrations in females, but not in the males. CONCLUSIONS: There was a strong relationship between plasma free carnitine concentrations and age in female patients, but not in males. It is unlikely that the reduction in plasma free carnitine in females was a direct causative factor in their reduced exercise tolerance, but probably reflects greater muscle de-conditioning/atrophy with age in female patients.
Adult↗
Muscle fatigue from intermittent stimulation with low and high frequency electrical pulses.
OBJECTIVE: To evaluate muscle fatigue resulting from intermittent low frequency and high frequency stimulation for the application of closed-loop control in functional electrical stimulation (FES). DESIGN: Nonrandomized trial. SETTING: General community, a referral center, institutional practice, and ambulatory care. PATIENTS: Twenty healthy nondisabled men volunteered for the normal muscle group. Four paraplegic men with implanted percutaneous intramuscular electrodes for FES volunteered for the paralyzed muscle group. INTERVENTION: The stimulation frequency was set at low (20 Hz) or high (100 Hz). Stimulation was administered in 4-second bursts at the start of 60-second, 120-second, and 240-second periods (duty cycles of 1/15, 1/30, and 1/60, respectively). MAIN OUTCOME MEASUREMENTS: Knee extensor torques were measured during intermittent electrical stimulation. A strength decrement index (SDI) was used to assess muscle fatigue. Actual knee extensor torques in the paraplegic men were also measured with an isokinetic dynamometer. RESULTS: Muscle fatigue was significantly greater at 20 Hz than at 100 Hz for both the nondisabled and the paraplegic subjects (p < .0001). Muscle fatigue at the 1/15 cycle was significantly reduced (p < .01). CONCLUSIONS: Muscle fatigue was greater at the lower frequency (20 Hz) than at the higher frequency (100 Hz) during intermittent electrical stimulation, suggesting that intermittent high frequency stimulation may be valuable in the development of closed-loop control strategies for FES.
Adult↗
Eccentric and concentric knee extensor muscle performance in professional ballet dancers.
Ballet dancers are exposed to great eccentric loading of the lower extremities due to a high frequency of repetitive jumps and leaps. The purpose of this study was to evaluate eccentric (ECC) and concentric (CON) knee extensor muscle endurance and strength in professional ballet dancers (six men and 11 women) in relation to moderately active control subjects (17 men and 18 women). A Biodex dynamometer was used for isokinetic torque measurements. The ECC endurance (total work per kilogram) was on average 31% greater in professional ballet dancers compared to control subjects, while the corresponding average difference for CON endurance was 7%. A greater ECC CON total work ratio was observed for ballet dancers (mean ballet, 2.07; mean control, 1.74). The ECC and CON strengths (peak torque per kilogram) were greater in professional ballet dancers compared to controls (27 and 22%). No intraindividual torque difference between left and right limbs was found. Men showed significantly greater strength (peak torque per kilogram) and endurance (total work per kilogram) compared to women, similar in both groups. No differences in the ECC/CON relationship between genders were observed. In essence, our results favor the hypothesis that repetitive loading of the lower extremities in ballet dance leads to a higher standard of ECC knee extensor endurance.
Adult↗
[Principles of muscle efficiency in weightlessness].
Depending on the time spent in a space station, weightlessness causes varying changes to various organs and regulatory mechanisms of the human organism, among them the structures of the active and passive locomotor system. Experience has shown that regular physical activity using varying forms of training is necessary to keep astronauts and cosmonauts healthy, efficient and fit for work and to prepare them for a safe return to terrestrial conditions. One of the main tasks of physical activity is therefore to counteract the changes in the neuromuscular function, muscle strength, endurance and fatigability under conditions of weightlessness. So far, the diagnostics of these changes was limited to dynamometric measurements before and after space flights as no dynamometric method had been devised which was precise enough under conditions of weightlessness. The development and the introduction of the dynamoergometer Motomir is described against the background of previous results obtained by dynamometric, ergometric, morphometric, biochemical, histochemical and neuromuscular examinations before and after missions of varying duration under conditions of weightlessness. This device was used for the first valid and reproducible examinations of muscle strength and endurance aboard the space station Mir during the Austro-Russian space mission Austromir. The results of the examinations with this speed-controlled dynamometer and training device obtained during a short-term flight of 10 days and a long-term flight of 6 months are described and compared to previous results in the literature. Based on the existing training devices, training methods and training plans and the results of the Motomir Study, plans for devices and methodologies for future long-term space flights of up to 3 years' duration will be discussed. Finally, the possible use of a speed-controlled dynamometer and training device for rehabilitation on earth after injuries, surgery and immobilization of the active and passive locomotor system as well as in the bed-rest syndrome is being presented.
Animals↗
Response of the trunk muscles to training assessed by magnetic resonance imaging and muscle strength.
A group of 12 sedentary medical students (1 man and 11 women aged 21-27 years) participated in a strength training programme for the trunk muscles lasting 18 weeks. The maximal isometric flexion and extension forces of the trunk muscles were measured before the training and at 18 weeks by dynamometer. The cross-sectional area of the back muscles, i.e. erector spinae, multifidus and psoas muscles, was measured from magnetic resonance images (spin echo sequence TR/TE 1500/80, slice thickness 10 mm) obtained at the L4-L5 disc level before the training, at 11 and 18 weeks. During training, no significant change in the body mass or body fat content was found. Muscle forces or muscle cross-sectional area were not related to body mass. There was a significant increase in both trunk muscle cross-sectional area (psoas muscle P < 0.001 and back muscles P < 0.01) and trunk muscle forces (flexion and extension forces P < 0.01) during the training but no direct association between the muscle cross-sectional area and strength of the flexors and extensors was detected before or after the training.
Adipose Tissue↗
Decreased isokinetic trunk muscle strength and performance in long-term survivors of childhood malignancies: correlation with hormonal defects.
OBJECTIVE: To evaluate trunk muscle strength and performance in long-term survivors of childhood malignancies relative to age and sex-matched controls, and to relate the muscle strength observations to the therapeutic agents used and possible hormonal disturbances. DESIGN: Age and sex-matched cohort study. SETTING: Referral center in the northern part of Finland. PATIENTS: Forty-six long-term survivors of childhood cancer. Mean age at examination 19.1 years and median off-therapy time 9.4 years. INTERVENTION: Isokinetic dynamometer testing. MAIN OUTCOME MEASURES: Measurements of trunk muscle peak torque (PT) and total work done (TWD) were performed at angle speeds of 50 degrees/sec and 200 degrees/sec. The results were normalized relative to body fat-free weight (FFW). RESULTS: PT in the trunk muscles was lower in the patients at both angle speeds (mean normalized PT = 5.7Nm/kgFFW vs 7.6Nm/kgFFW for controls at 50 degrees/sec), as also was TWD except for extension TWD at the higher angle speed (mean normalized TWD = 59.9J/kgFFW vs 84.6J/kgFFW for controls at 200 degrees/sec). The normalized PT at 50 degrees/sec and TWD at 200 degrees/sec were lower in the males with testicular damage; also, low age at diagnosis correlated positively with muscle strength and performance. There were no differences in normalized PTs or TWDs between cranial radiation and non-radiation cases, or between growth-hormone-deficient and non-deficient cases, and the patients without cranial radiation or with normal growth hormone secretion still had lower normalized PTs and TWDs than the controls. CONCLUSIONS: Survivors of childhood malignancies have decreased maximal trunk muscle strength and performance. The etiology of this effect remains unclear, but young age at diagnosis, as well as serum testosterone levels in male survivors, evidently influence muscle strength and performance.
Adolescent↗
[The effect of meniscectomy on the strength of the femoral quadriceps muscle after more than 3 years].
This paper investigates the strength of the quadriceps extensor femoris following partial meniscectomy by means of arthrotomy. Measurements were carried out on 30 patients using a velocity-controlled dynamometer. Follow-up ranged from three to twelve years. On clinical examination 17 patients revealed atrophy of the quadriceps, amounting to 1 cm in 12 patients and up to 2 cm in 5 patients. The average difference in muscular strength between the operated leg and the non-operated one totalled 11% in the cases of 1 cm atrophy and 19% in the 2 cm cases. Those patients who presented with no atrophy on the operated leg had an average loss of 4% in muscular strength, which is within the normal range. In addition, an interrelationship was established between measurements carried out at different angular velocities and the extent of quadriceps atrophy. The high percentage of patients showing a weakness of the quadriceps extensor femoris after a long follow-up period is most likely due to the severing of proprioceptors during surgery and to inadequate or lacking postoperative physiotherapy.
Adult↗