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PubMed1996

[Circumstances and factors related to falls in the institutionalized elderly].

The circumstances and factors related to falls among the elderly living in a nursing home were investigated. Information on falls was obtained from the fall assessment form recorded by the staff of the institution. During the 1-year study period, 65 (37%) of 174 subjects experienced at least one fall. Most falls occured in the subjects' own rooms and during the daytime. In the subsample of 52 elderly whose data on age, sex, gait, grip strength and standing on one leg at tha beginning of this study were available, week grip strength was significantly associated with increasing risk of falling by chi-square test. After adjusting for other factors, weak grip strength remained a significant and independent predictor of falls. Measuring of grip strength may be useful for screening elderly who are at a high risk of falling.

Accidental Falls↗
PubMed2002

Distal radius bone mineral density and grip strength in peri/postmenopausal Thai women.

To determine the relationship between distal radius bone mineral density (BMD) and grip strength (GS) in peri/post menopausal Thai women. 177 healthy volunteers, > or = 40 years old, were included. Distal radius BMD of the non-dominant side was measured using dual energy X-ray absorptiometry. GS of both dominant and non-dominant sides was measured using a Jamar dynamometer. The association between BMD and GS was determined by correlation analysis. Other factors possibly affecting the BMD or GS including age, years since menopause (YSM), body weight (BW), height (Ht) and body mass index (BMI) were analyzed by the multiple regression method. It was found that BMD had statistically significant but weak, positive correlation to GS (r = 0.262, p < 0.001 for the dominant side, r = 0.193, p < 0.001 for non-dominant side). Age and YSM had a negative correlation, whereas, BW and Ht had a positive correlation to either BMD or GS. After multiple regression analysis, the significant predictors of BMD were age and BW, of dominant GS were age and Ht, and of non-dominant GS was YSM. In conclusion, decrements in distal radius BMD and in GS were found in peri/postmenopausal women. Aging seems to be the most important factor for these features. Although the GS has statistically significant correlation to the corresponding BMD, the clinical significance might not be obvious. Furthermore, the stronger correlation of BMD to the contralateral dominant GS than to the ipsilateral non-dominant GS implies that the influence of muscular strength on BMD, if present, is not due to a direct effect in this age group.

Adult↗
PubMed2004

Motor-unit coherence and its relation with synchrony are influenced by training.

The purpose of the study was to quantify the strength of motor-unit coherence from the left and right first dorsal interosseous muscles in untrained, skill-trained (musicians), and strength-trained (weightlifters) individuals who had long-term specialized use of their hand muscles. The strength of motor-unit coherence was quantified from a total of 394 motor-unit pairs in 13 subjects using data from a previous study in which differences were found in the strength of motor-unit synchronization depending on training status. In the present study, we found that the strength of motor-unit coherence was significantly greater in the left compared with the right hand of untrained right-handed subjects with the largest differences observed between 21 and 24 Hz. The strength of motor-unit coherence was lower in both hands of skill-trained subjects (21-27 Hz) and the right (skilled) hand of untrained subjects (21-24 Hz), whereas the largest motor-unit coherence was observed in both hands of strength-trained subjects (3-9 and 21-27 Hz). A strong curvilinear association was observed between motor-unit synchronization and the integral of coherence at 10-30 Hz in all motor-unit pairs (r2 = 0.77), and was most pronounced in strength-trained subjects (r2 = 0.90). Furthermore, this association was accentuated when using synchronization data with broad peaks (>11 ms), suggesting that the 10- to 30-Hz coherence is due to oscillatory activity in indirect branched common inputs. The altered coherence with training may be due to an interaction between cortical inhibition and the number of direct common inputs to motor neurons in skill- or strength-trained hands.

Adolescent↗
PubMed2000

A comparison of mechanical properties of all-ceramic alumina dental crowns prepared from aqueous- and non-aqueous-based tape casting.

Alumina-glass dental composites were prepared by aqueous- and non-aqueous-based tape casting and sintering at 1120 degrees C, followed by glass infiltration at 1100 degrees C. Flexural strength and fracture toughness of the composites were investigated in terms of influence of tape constituents, namely, alumina powder, binder, and plasticizer on the mechanical properties. For the alumina-glass composites prepared from the aqueous-based tapes, both strength and toughness increased with increasing alumina fraction ratio in tape constituents including organic substances, a/a+o, and binder content ratio in binder/binder + plasticizer mixture, b/b+p. For the composites prepared from the non-aqueous-based tapes, on the other hand, both strength and toughness increased with increasing the a/a+o ratio but decreased with increasing the b/b+p ratio. These observations were consistent with influence of the constituents on mean alumina particle distance in tapes, suggesting that high strength of the glass infiltrated alumina composites is related to toughening by crack bowing. The optimized strength of the aqueous and nonaqueous tape cast composites was 559 and 508 MPa, and the fracture toughness was 3.3 and 3.1 MPam(1/2), respectively.

Aluminum Oxide↗
PubMed1981

Relationship between respiratory muscle strength and vital capacity during partial curarization in awake subjects.

To determine the relationship between respiratory muscle strength and changes in normal vital capacity (VC), graded levels of muscle weakness were produced in six healthy supine male subjects by four successive doses of d-tubocurarine (0.05 mg/kg each). The maximal effect of d-tubocurarine abolished hand-grip strength and ability to sustain head lift for 5 s, but VC was decreased to only 66 +/- 3 per cent of control. At each level of weakness decreases in VC were significantly less than were decreases in respiratory muscle strength (RMS) monitored by maximum static inspiratory and expiratory pressures. The first dose decreased RMS to 86 +/- 3 per cent of control, but VC was unchanged. Following the second dose,, VC (97 +/- 4 per cent). The VC after the third dose was still 85 +/- 3 per cent of control, while RMS had decreased to 58 +- 2 per cent. Following the final dose of d-tubocurarine (cumulative total 0.20 mg/kg), RMS was 39 +/- 2 per cent of control, compared with VC, 66 +/- 3 per cent of control. The relationship between VC and RMS was curvilinear and conformed to predictions based on the static mechanical characteristics of the normal respiratory system. These findings demonstrate that while VC is relatively spared during partial curarization, this sparing of VC does not indicate a similar extent of preserved RMS. Rather, it reflects the relative ease with which weakened respiratory muscles are able to drive the normal respiratory system in the supine subject. The same weakened muscles may be unable to generate sufficient force to handle mechanical challenges such as coughing and vomiting.

Adult↗
PubMed2001

Clinical evaluator reliability for quantitative and manual muscle testing measures of strength in children.

Measurements of muscle strength in clinical trials of Duchenne muscular dystrophy have relied heavily on manual muscle testing (MMT). The high level of intra- and interrater variability of MMT compromises clinical study results. We compared the reliability of 12 clinical evaluators in performing MMT and quantitative muscle testing (QMT) on 12 children with muscular dystrophy. QMT was reliable, with an interclass correlation coefficient (ICC) of >0.9 for biceps and grip strength, and >0.8 for quadriceps strength. Training of both subjects and evaluators was easily accomplished. MMT was not as reliable, and required repeated training of evaluators to bring all groups to an ICC >0.75 for shoulder abduction, elbow and hip flexion, knee extension, and ankle dorsiflexion. We conclude that QMT shows greater reliability and is easier to implement than MMT. Consequently, QMT will be a superior measure of strength for use in pediatric, neuromuscular, multicenter clinical trials.

Child↗
PubMed2002

The muscle-bone relationship: methods and management - perspectives in glycogen storage disease.

UNLABELLED: Currently bone development is commonly presented as a process leading to the 'accumulation of peak bone mass'. Consequently, the usual approach to a suspected bone disorder in a child is to address the question are this child's bones as heavy as those of a healthy child of the same sex and age? However, from a functional perspective the aim of bone development should not be make bones as heavy as possible but to make them as stable as necessary. A functionally oriented approach should address two different questions: how strong are the bones? are they as strong as they need to be? It is clear that the bone has to be strong enough to withstand the mechanical forces to which it is exposed. CONCLUSION: since the main forces applied to bones are due to muscle action, the strength of a bone should be related to the force of the muscles attached to it.

Bone Density↗
PubMed2005

Trans-scaphoid perilunate fracture dislocations: results of screw fixation of the scaphoid and lunotriquetral repair with a dorsal approach.

PURPOSE: To review the clinical and radiographic outcome of dorsal trans-scaphoid perilunate fracture-dislocations treated with screw fixation of the scaphoid and repair of the lunotriquetral ligament with bone anchors. METHODS: Twenty-five patients treated over an 11-year period for dorsal trans-scaphoid perilunate fracture-dislocations were reviewed retrospectively at a mean of 44.3 months. The mean age of the patients was 28.6 years, and 22 patients were men. Delay to surgery was 3.5 days. Five scaphoids had bone grafting from the distal radius. Six patients developed carpal tunnel syndrome requiring release. The functional outcome was determined by comparing the range of motion of the injured extremity with the uninjured extremity, grip strength, ability to return to pre-injury employment, and overall patient satisfaction. Radiographic evaluation comprised time to scaphoid union, any changes in the lunotriquetral interval, development of a volar intercalated segmental instability pattern, and any development of arthritis over time. RESULTS: Total range of motion achieved was 91% of the uninjured wrist and grip strength was 80%. Average extension was 54 degrees with an average flexion of 60 degrees . Ulnar deviation was 23 degrees with radial deviation averaging 18 degrees . The average supination was 76 degrees and the average pronation was 76 degrees . All scaphoids united primarily. The average time to union of the scaphoid was 16 weeks. For those scaphoids with bone grafting the union time was an average of 18.4 weeks. The average postreduction lunotriquetral gap was 1.8 +/- 0.4 mm. The average lunotriquetral gap at the last follow-up evaluation was 1.9 +/- 0.6 mm. None of the patients developed a volar intercalated segmental instability deformity. All but 2 patients returned to their pre-injury occupation. All patients, however, returned to some type of employment. Complications included 1 superficial pin track infection that resolved with removal of the pin and a short course of oral antibiotics. CONCLUSIONS: A dorsal approach to the wrist provides adequate exposure for reduction of carpal bones, internal fixation of the scaphoid, and lunotriquetral repair. Although perilunate fracture-dislocations are challenging problems to treat, all of the patients had acceptable pain relief and achieved sufficient range of motion and strength to return to gainful employment.

Adolescent↗
PubMed2000

Endurance training in patients with chronic obstructive pulmonary disease: a comparison of high versus moderate intensity.

PURPOSE: To create a maximum tolerated 45-minute aerobic training program for patients with chronic obstructive pulmonary disease (COPD) and to compare its outcomes with those of commonly prescribed moderate exercise. DESIGN: Prospective, randomized trial. SETTING: A work physiology laboratory. PATIENTS AND METHODS: The maximum exercise intensities that 7 COPD patients could sustain for 45 minutes were determined on a bilevel exercise ergometer. The patients then exercised 45 minutes daily, 5 days a week for 6 weeks, working 2.03+/-0.4 kJ/kg per session. They were matched with 6 COPD patients who pushed an O2 cart for 45 minutes daily, 5 days a week for 6 weeks, working 1.44+/-.35 kJ/kg per session. RESULTS: A 45 minute maximal regimen was established by alternating 1-minute peak exercise at peak VO2-levels with 4 minutes at the ventilatory anaerobic threshold or at 40% of peak VO2. Maximal bilevel training significantly decreased dyspnea at rest (p< or =.01) and the blood lactate level during submaximal exercise (p<.001), and increased peak VO2 and total physical work (p<.01), maximum inspiratory and expiratory pressures (p<.01), and grip and forearm strength and endurance (p<.01). The training also increased maximum voluntary ventilation while decreasing the ventilatory equivalent during exercise (p<.001). The O2 cart pushers significantly improved only on the 12-minute walk (p<.05). CONCLUSIONS: A maximally intense anaerobic exercise program can be created for most COPD patients that can significantly improve both skeletal and respiratory muscle strength and endurance as well as dyspnea and physiologic parameters.

Blood Gas Analysis↗
PubMed2000

Testosterone and leptin in older African-American men: relationship to age, strength, function, and season.

Testosterone (T) and bioavailable testosterone (BT) levels have been shown to decline with aging in Caucasian males. We are unaware of any studies that have examined this in African-American men. Previous studies have suggested a relationship of T to strength and leptin levels, but no such correlation with measured functional tests exists. This study explores these associations in a cross-sectional sample of older African-Americans from the Saint Louis University Inner City Aging Project. The participants were 65 African-American males aged 70 to 102 years. Measurements included T, BT, and leptin levels, isometric muscle strength, and relevant physical impairments. Statistical analysis included a t test and simple and multiple ordinary least-squares regression. Age was inversely related to T and BT. Of these older African-American males, 90.7% had a BT value less than the normal range for young males. T correlated with upper- and lower-limb strength and functional tests. Leptin was correlated with the body mass index (BMI) and inversely with T, but not with BT. Circannual rhythms for T, BT, and leptin were present. This study demonstrates for the first time an age-related decrease in T and BT in African-Americans and a circannual rhythm for leptin. T was correlated with upper- and lower-limb strength and functional status.

Aged↗
PubMed2002

Comparison of 1 and 2 days per week of strength training in children.

The purpose of this study was to compare the effects of 1 and 2 days per week of strength training on upper body strength, lower body strength, and motor performance ability in children. Twenty-one girls and 34 boys between the ages of 7.1 and 12.3 years volunteered to participate in this study. Participants strength trained either once per week (n = 22) or twice per week (n = 20) for 8 weeks at a community-based youth fitness center. Each training session consisted of a single set of 10-15 repetitions on 12 exercises using child-size weight machines. Thirteen children who did not strength train served as age-matched controls. One repetition maximum (1RM) strength on the chest press and leg press, handgrip strength, long jump, vertical jump, and flexibility were assessed at baseline and posttraining. Only participants who strength trained twice per week made significantly greater gains in 1RM chest press strength, compared to the control group (11.5 and 4.4% respectively, p < .05). Participants who trained once and twice per week made gains in 1RM leg press strength (14.2 and 24.7%, respectively) that were significantly greater than control group gains (2.4%). On average, participants who strength trained once per week achieved 67% of the 1RM strength gains. No significant differences between groups were observed on other outcome measures. These findings support the concept that muscular strength can be improved during the childhood years and favor a training frequency of twice per week for children participating in an introductory strength training program.

Adaptation, Physiological↗
PubMedDate not supplied

Prediction equations for handgrip strength in healthy Indian male and female subjects encompassing a wide age range.

PRIMARY OBJECTIVE: Handgrip strength is a simple index of skeletal muscle function and a functional index of nutritional status. A major lacuna in the use of handgrip strength is the limited availability of normative data. The main objective of this paper was to develop prediction equations for handgrip strength in Indians covering a wide age range. METHODS: Handgrip strength and basic anthropometric parameters were measured in 1024 healthy Indian subjects of both genders (613 males, 411 females) between the ages of 5 and 67 years. The sample was randomly divided into two sets; one set (n = 677) was used to develop the prediction equations for handgrip strength and the other (n = 347) was used to validate the equations. Each data set was further divided into two subsets (adults > 18 years, sub-adults <or= 18 years), since separate equations were developed for adults and sub-adults. Simple models that included one of the following variables: height, forearm circumference and age as well as a full model that included all three variables were developed. Gender was included in all models. RESULTS: In general, all simple models predicted handgrip strength better in sub-adults (R(2) = 0.78-0.81) as compared to adults (R(2) = 0.52-0.57). The best simple model in sub-adults was that which included age and gender (R(2) = 0.81), while for adults it was that which included forearm circumference and gender (R(2) = 0.57). The full model explained a further 3.4-6.5% of the variance in handgrip strength in sub-adults and a further 6.3-13.3% in adults. CONCLUSIONS: The simple and full model equations for handgrip strength had high predictive power in the sub-adults, while they were less predictive in adults. The equations will be of particular use in physiological studies assessing muscle strength and in clinical investigations of patients with malnutrition and neuromuscular disorders.

Adolescent↗
PubMed1997

Effects of acute changes in oestrogen on muscle function of the first dorsal interosseus muscle in humans.

1. To investigate the effect of the female reproductive hormones on muscle function, patients undergoing in vitro fertilization were tested during two phases of treatment. The first was following the downregulation of pituitary gonadotrophin releasing hormone (GnRH) receptors and the second after 9 days of gonadotrophin injections. 2. Maximal strength and fatiguability of the first dorsal interosseus muscle were assessed when oestrogen and progesterone were low, and less than 2 weeks later when oestrogen production reached supraphysiological levels. 3. There were no significant changes in either strength or fatigue resistance during acute, massive fluctuations in oestrogen. These results occurred at a time when progesterone levels remained relatively low. 4. Contrary to previous work, the present results suggest that oestrogen does not affect muscle strength.

Adult↗
PubMed2006

Grip strength and physical demand of previous occupation in a well-functioning cohort of Chinese older adults.

The grip strength of 214 independently ambulatory Chinese older adults (M age = 75.1 +/- 7.0 yr.) was measured, and preliminary mean values presented. Their previous occupations were recorded, and the physical demands of those occupations in terms of oxygen consumption and work done were classified. Grip strength generally decreased across age groups. The physical demand of individuals' previous occupations had significant associations with grip strength, for example, participants who previously worked as construction site workers had a greater grip strength than those who worked previously as office workers.

Aged↗
PubMed2003

Upper and lower body strength in relation to ball speed during a serve by male collegiate tennis players.

The relation of leg, shoulder, and grip strength to ball speed in the tennis serve was investigated. For 15 collegiate male tennis players, leg and shoulder strength were measured using a Lido Active isokinetic dynamometer, grip strength with a handgrip dynamometer, and ball speed with a radar gun. Regression analysis showed no significant (p<.05) relationship among the strength variables and ball speed. Results were explained in terms of strength not being the only factor involved in producing ball speed during the tennis serve.

Adult↗
PubMed2003

The functional importance of malunion in distal radius fractures.

The purpose of our study was to investigate which radiological parameter had the maximal detrimental effect on functional outcome following malunion of distal radius fractures. Sixty-four women over 40 years of age who had sustained low-energy wrist fractures were included in the study. The mean age of the patients was 64 years. We compared the ulnar variance, radial inclination and palmar tilt of the fractured wrist to the non-injured contralateral side on radiographs obtained after fracture healing. The functional outcome was assessed at a mean follow-up of 28 months. Wrist mobility, grip strength, and pain with daily activities were determined and combined to give a final outcome rating. An increase in ulnar variance was found to be the most important radiological parameter affecting functional outcome and the outcome tended to be influenced by age, hand dominance and the presence of articular involvement.

Adult↗
PubMed1994

Extensor indicis proprius transfer for loss of extensor pollicis longus function.

In the period 1969-1991, 46 extensor indicis proprius tendon transfers were performed for functional loss of extensor pollicis longus. The long-term function of the thumb was reviewed in 22 patients with an average follow-up of 7 years. Based on Geldmacher's evaluation scheme for assessment of the results of extensor tendon reconstruction, we report 5 excellent (23%), 4 good (18%), 12 satisfactory (55%) and 1 poor (4%) result. The mean loss of pinch strength was 8% compared with the contralateral, non-operated thumb. Subjectively, the majority of the patients (86%) described no limitations in their daily life activities. It is recommended that the transfer be tight enough to give full thumb extension and that the hand be immobilized with the thumb in this position for 4 weeks.

Activities of Daily Living↗