Pelvic floor muscle strength testing.
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Exercise Test↗
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Results for “Muscle Strength”
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Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia.
BACKGROUND: Chronicity of muscle weakness from cancer and its treatment may be problematic, particularly in those treated for cancer during childhood. We compared body composition, muscle strength, and mobility between 75 adult survivors of childhood acute lymphoblastic leukemia (ALL) and expected values based on population normative data. METHODS: Subjects were young adults treated for childhood ALL between 1970 and 1986, selected randomly from participants in an ongoing study of cancer survivors. DeXA scans were performed to evaluate body composition, and myometry used to measure strength. Mobility was evaluated with the Timed Up and Go (TUG) and 2-min walk (TMW). One sample t-tests compared ALL survivors to population norms. RESULTS: Males had 4.5% and females had 2.3% more body fat than expected (expected males 21.5%, females 36.0%). Males were 76.7 Newtons and females were 58.6 Newtons weaker in quadriceps strength than expected (expected males 569.87 N, females 464.67 N). Males walked 100.88 m and females walked 85.38 m less on the TMW (expected values: males 304.23 m, females 276.26 m), and took longer to complete the TUG (males 5.82 vs. 2.84 sec, females 5.88 vs. 3.00 sec) than expected. Treatment with cranial radiation and current growth hormone (GH) deficiency were associated with lower body weakness among females. CONCLUSIONS: Young adult survivors of childhood ALL have strength and mobility deficits. Decreased strength may reduce ability to participate in physical activity, perpetuating fitness deficits in survivors of childhood ALL.
Adult↗
Hip and ankle range of motion and hip muscle strength in young female ballet dancers and controls.
OBJECTIVES: To compare the hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls. METHODS: Subjects were 77 dancers and 49 controls (mean (SD) age 9.6 (0.8) and 9.6 (0.7) years respectively). Supine right active hip external rotation (ER) and internal rotation (IR) were measured using an inclinometer. A turnout protractor was used to assess standing active turnout range. The measure of ER achieved from below the hip during turnout (non-hip ER) was calculated by subtracting hip ER range from turnout range, and hip ER:IR was derived by dividing ER range by IR range. Range of right weight bearing ankle dorsiflexion was measured in a standing lunge using two methods: the distance from the foot to the wall (in centimetres) and the angle of the shank to the vertical via an inclinometer (in degrees). Right calf muscle range was measured in weight bearing using an inclinometer. A manual muscle tester was used to assess right isometric hip flexor, internal rotator, external rotator, abductor, and adductor strength. RESULTS: Dancers had less ER (p<0.05) and IR (p<0.01) range than controls but greater ER:IR (p<0.01). Although there was no difference in turnout between groups, the dancers had greater non-hip ER. Dancers had greater range of ankle dorsiflexion than controls, measured in both centimetres (p<0.01) and degrees (p<0.05), but similar calf muscle range. After controlling for body weight, controls had stronger hip muscles than dancers except for hip abductor strength which was similar. Regression analyses disclosed a moderate relation between turnout and hip ER (r = 0.40). There were no significant correlations between range of motion and training years and weekly training hours. CONCLUSIONS: Longitudinal follow up will assist in determining whether or not hip and ankle range in young dancers is genetically fixed and unable to be improved with further balletic training.
Ankle Joint↗
Trunk muscle strength is a strong predictor of bone loss in postmenopausal women.
UNLABELLED: To clarify whether trunk muscle strength and self-reported exercise habits predict subsequent bone loss in healthy post- menopausal women, we examined 143 community-dwelling ambulatory postmenopausal Japanese women (age: 59.9 +/- 6.5 years) without any diseases affecting bone metabolism at baseline, and followed 109 of the 143 subjects for 4 years. Bone mineral density at baseline and at followup was measured at the spine by DEXA to determine the annual change in bone mineral density during the followup. Subjects who lost bone mineral density at an annual rate exceeding -1.78% (1 standard deviation below the mean rate) were defined as rapid bone losers. The isokinetic concentric and eccentric peak torques of the trunk flexors and extensors were measured at baseline. The exercise habits of the subjects were evaluated through detailed interviews. The eccentric trunk flexor and extensor torques were found to correlate with a positive dose-dependent effect on change in bone mineral density while exercise habits showed no correlation. The lower tertile group for the extensor torque showed a ten-fold greater risk for rapid bone loss compared with the upper tertile group. Postmenopausal women with decreased trunk muscle torque may be at increased risk for osteoporosis and should be a target group for preventive measures. LEVEL OF EVIDENCE: Prognostic study, level II (prospective study). See the Guidelines for Authors for a complete description of the levels of evidence.
Absorptiometry, Photon↗
Back and leg complaints in relation to muscle strength in young men.
Back and leg complaints were studied by using a questionnaire and medical examination in 183 male conscripts and relating the results to background variables, anthropometry, the isometric strength of large muscle groups, and endurance running. A history of sciatica was reported by 8%, lumbago by 13%, back injury by 13% and low back insufficiency by 63%. Weak trunk extensors were associated with a history of sciatica, weak trunk flexors with back injuries and with current backache at work/exercise. Weak leg extensors showed associations with a history of low back insufficiency and of sick leave due to the back and with current hip pain. Men with a history of lumbago and of hip and knee complaints performed poorly during 12 min of running. Back and leg complaints were more frequent in men with high socio-economic status, who engaged in little physical activity, or who were obese. The questionnaire and strength measurements proved suitable for studying low back syndrome in its early stages.
Adult↗
Effect of lumbar orthotics on trunk muscle strength.
Weakening of the trunk muscles is thought to be one disadvantage of prolonged lumbar orthotic use. This study examines weakness of the trunk flexor and extensor muscles in patients who are wearing lumbar orthotics for extended periods. Strength of the trunk flexor and trunk extensor muscles was tested in 24 individuals, using the Kinetic computer. Both concentric and eccentric forces were recorded. Four groups of patients were studied. Group 1 (n = 6) consisted of patients with low back pain who had used a lumbar orthotic for a prolonged period of time. Group 2 (n = 6) consisted of hospital employees with no history of low back pain, who wore lumbar orthotics prophylactically, for back protection. Group 1C (n = 6) consisted of healthy controls, with no history of either back pain or lumbar orthotic use, who were individually age- and gender-matched to each patient in Group 1. Group 2C (n = 6) consisted of healthy controls matched in the same fashion to each patient in Group 2. After consultation with a statistician, statistical analysis was performed using the Wilcoxon's test. Nonparametric statistics were chosen because of the lack of evidence of a normal distribution of the parameters being studied. This analysis revealed significant weakness in concentric flexion (P = 0.0464), concentric extension (P = 0.0277), and eccentric extension (P = 0.0464) in Group 1 compared with matched controls in Group 1C. The only significant weakness compared with controls in Group 2 was in eccentric flexion (P = 0.0277). Trends were toward weakness in the orthotic users for the other motions studied, with a P value of less than 0.1 for eccentric extension. Prolonged use of lumbar orthotics may be associated with trunk muscle weakness in the population studied. Prescribers should continue to limit duration of use when possible and to consider strengthening exercises when prolonged use is anticipated.
Adult↗
Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training.
This study poses two questions: 1) is there an abnormality in isokinetic skeletal muscle strength and endurance in mild chronic obstructive pulmonary disease (COPD)? and 2) what is the effect of a randomized, controlled, 12 week hospital outpatient weight training programme in terms of skeletal muscle function and exercise tolerance? Upper and lower limb isokinetic maximum and sustained muscle function were compared in 43 COPD patients (age 49+/-11 yrs), mean forced expiratory volume in one second (FEV1) 77+/-23% pred and 52 healthy, sedentary subjects (age 51 (10) yrs), mean FEV1 109+/-16% pred. The 43 COPD patients were randomly allocated into training (n=26) and control (n=17) groups. Isokinetic and isotonic muscle function, whole body endurance, maximal exercise capacity and lung function were measured. The COPD patients had reduced isokinetic muscle function (with the exception of sustained upper limb strength) as compared with healthy sedentary subjects. Muscle function improved after weight training in the COPD patients. Whole body endurance during treadmill walking also improved with no change in maximal oxygen consumption. A deficit in skeletal muscle function can be identified in patients with mild chronic obstructive pulmonary disease which cannot be explained by factors such as hypoxaemia and malnutrition. Intervention with weight training is effective in countering this deficit which the authors conclude is probably due to muscle deconditioning.
Adult↗
The efficacy of manual assessment of muscle strength using a new device.
The purpose of this study was to compare the manual assessment of muscle strength with a small, handheld (by the examiner) force-measuring device developed by the Institute of Sports Medicine and Athletic Trauma (ISMAT). One hundred twenty-eight patients presented with a known lower extremity orthopaedic pathology. All patients were clinically evaluated for hip abductor and hip flexor weakness in standard positions using the "break test" technique. All 128 patients were then evaluated with the ISMAT Manual Muscle Tester, a small, hand-held device which recorded the peak force (kg) required to break a muscle contraction. Three bilateral measures of hip abduction and hip flexion were recorded, averaged, and compared to the subjective clinical evaluation using a chisquare analysis. Bilateral values which were within 5% of each other were not considered significant and therefore not included in the calculations. The average hip abduction and hip flexion scores measured by the ISMAT tester were consistent with the examiner's perception of muscle weakness (P less than 0.001). The results demonstrate consistent detection of muscle weakness by the ISMAT Manual Muscle tester over a broad range of testing conditions.
Humans↗
Acute antihistamine ingestion does not affect muscle strength and endurance.
Twelve subjects (three females, nine male, age 32 +/- 1.3 yr) performed tests of isokinetic muscle strength and endurance under each of three treatment conditions. The three conditions, administered in double-blind, randomized order, were single oral administrations of placebo, diphenhydramine (50 mg), and terfenadine (60 mg). Tests, separated by 1 wk, began 2 h after ingestion of the drug or a placebo. Subjects performed a velocity spectrum test (VST) consisting of peak torque measurements at five velocities (90, 150, 210, 270, and 330 degrees.s-1) and a 45 s muscle endurance test (MET) at a velocity of 180 degrees.s-1. Five serial, reciprocal contractions of the knee extensors and flexors were performed at maximal effort over the subjects' full range of motion for the VST, and as many contractions as possible within 45 s for the MET. No differences in performance measures were detected across treatment conditions. This study demonstrates that a one-time administration of either terfenadine or diphenhydramine in the dosages described does not significantly affect muscle endurance or maximal peak torque at a variety of velocities.
Adult↗
Specific effects of eccentric and concentric training on muscle strength and morphology in humans.
The purpose of this study was to compare pure eccentric and concentric isokinetic training with respect to their possible specificity in the adaptation of strength and morphology of the knee extensor muscles. Ten moderately trained male physical education students were divided into groups undertaking eccentric (ETG) and concentric (CTG) training. They performed 10 weeks of maximal isokinetic (90 degrees x s(-1)) training of the left leg, 4x10 repetitions - three times a week, followed by a second 10-week period of similar training of the right-leg. Mean eccentric and concentric peak torques increased by 18% and 2% for ETG and by 10% and 14% for CTG, respectively. The highest increase in peak torque occurred in the eccentric 90 degrees x s(-1) test for ETG (35%) whereas in CTG strength gains ranged 8%-15% at velocities equal or lower than the training velocity. Significant increases in strength were observed in the untrained contra-lateral leg only at the velocity and mode used in ipsilateral training. Cross-sectional area of the quadriceps muscle increased 3%-4% with training in both groups, reaching statistical significance only in ETG. No major changes in muscle fibre composition or areas were detected in biopsies from the vastus lateralis muscle for either leg or training group. In conclusion, effects of eccentric training on muscle strength appeared to be more mode and speed specific than corresponding concentric training. Only minor adaptations in gross muscle morphology indicated that other factors, such as changes in neural activation patterns, were causing the specific training-induced gains in muscle strength.
Adaptation, Physiological↗
Age and gender comparisons of muscle strength in 654 women and men aged 20-93 yr.
To assess age and gender differences in muscle strength, isometric, concentric (Con), and eccentric (Ecc) peak torque was measured in the knee extensors at a slow (0.52 rad/s) and fast (3.14 rad/s) velocity in 654 subjects (346 men and 308 women, aged 20-93 yr) from the Baltimore Longitudinal Study of Aging. Regression analysis revealed significant (P < 0.001) age-related reductions in Con and Ecc peak torque for men and women at both velocities, but no differences were observed between the gender groups or velocities. Age explained losses in Con better than Ecc peak torque, accounting for 30% (Con) vs. 19% (Ecc) of the variance in men and 28% (Con) vs. 11% (Ecc) in women. To assess age and gender differences in the ability to store and utilize elastic energy, the stretch-shortening cycle was determined in a subset of subjects (n = 47). The older women (mean age = 70 yr) showed a significantly greater enhancement in the stretch-shortening cycle, compared with men of similar age (P < 0.01) and compared with younger men and women (each P < 0.05). Both men and women showed significant declines in muscle quality for Con peak torque (P < 0.01), but no gender differences were observed. Only the men showed a significant decline in muscle quality (P < 0.001) for Ecc peak torque. Thus both men and women experience age-related losses in isometric, Con, and Ecc knee extensor peak torque; however, age accounted for less of the variance in Ecc peak torque in women, and women tend to better preserve muscle quality with age for Ecc peak torque. In addition, older women have an enhanced capacity to store and utilize elastic energy compared with similarly aged men as well as with younger women and men.
Adult↗
Muscle strength and aerobic capacity in primary fibromyalgia.
Twenty-six women with primary fibromyalgia were tested for muscle strength and for aerobic capacity and fatigue. Grip strength was measured with a manometer. In the patient group the grip strength was 58 +/- 22 kPa (mean +/- SD) versus 97 +/- 17 kPa in healthy matched controls (p less than 0.01). The patients performed a mean of 10 +/- 6 repetitions with maximal grip pressure (dynamic endurance work), while the controls performed 13 +/- 6 repetitions (p less than 0.01). The upper extremity was kept in a fixed position for 152 +/- 147 seconds in the patient group versus 413 +/- 244 seconds in the control group (static endurance work), p less than 0.004. Normal aerobic capacity (O2 ml/kg min) was found in the patient group. Expected fatigue values were determined by Borg's rating scale for perceived exertion according to the heart rate in a cycle ergometer test. There was a significantly higher mean fatigue score in the patient group as compared to the expected values (p less than 0.0001).
Adult↗
Inspiratory muscle strength and endurance in steroid-dependent asthma.
The adverse effect of long-term steroid treatment on respiratory muscle function remains controversial. We evaluated inspiratory muscle strength and endurance in steroid-dependent asthmatics in comparison with other asthmatics or with patients with chronic obstructive pulmonary disease exhibiting a comparable level of lung hyperinflation. Inspiratory muscle function was assessed by maximal inspiratory pressure (Pimax) and by an incremental inspiratory threshold loading test in 19 patients who had had steroid-dependent asthma (SDA) requiring a mean daily dose of 20.7 +/- 0.8 mg prednisone for 5 +/- 1.4 yr. They were compared with 16 healthy control subjects, 30 patients with COPD, and 16 patients with non-steroid-dependent asthma (NSDA). Pimax as percentage of predicted values (%Pimax) was not significantly different in patients with SDA (77 +/- 5%) or NSDA (83 +/- 6%) than in control subjects (93 +/- 4%). In contrast, %Pimax was lower in patients with COPD (59 +/- 4.4%) than in those with SDA or NSDA (p < 0.05) or the control subjects (p < 0.0001). A significant correlation was found between %Pimax and hyperinflation assessed by the FRC/TLC ratio (r = 0.42; p < 0.001). Inspiratory endurance, defined as the ratio of maximal peak inspiratory pressure sustained for 2 min to individual Pimax (Plim2/Pimax), was significantly lower in the SDA (43 +/- 3%; p < 0.0001), NSDA (65 +/- 4%; p = 0.01), and COPD (55 +/- 3%; p < 0.0001) groups than in the control group (76 +/- 2%). Plim2/Pimax was also lower in patients with SDA than in those with COPD (p = 0.0073) or NSDA (p < 0.0001). Hyperinflation plays a major role in inspiratory muscle dysfunction associated with obstructive lung disorders, but the finding of a significantly decreased endurance in patients with SDA when compared with patients with COPD, despite a lower level of hyperinflation in the former group, points to a deleterious effect of long-term corticosteroid treatment on inspiratory muscle function in asthmatics.
Asthma↗
Effect of intravaginal electrical stimulation on pelvic floor muscle strength.
The aim of this study was to evaluate the effect of intravaginal electrical stimulation (IES) on pelvic floor muscle (PFM) strength in patients with mixed urinary incontinence (MUI). Between January 2001 and February 2002, 40 MUI women (mean age: 48 years) were studied. Urge incontinence was the predominant symptom; 92.5% also presented mild stress urinary incontinence (SUI). Selection criteria were clinical history and urodynamics. Pre-treatment urodynamic study showed no statistical differences between the groups. Ten percent of the women in each group had involuntary detrusor contractions. Patients were randomly distributed, in a double-blind study, into two groups. Group G1 (n=20), effective IES, and group G2 (n=20), sham IES, with follow-up at 1 month. The following parameters were studied: (1) clinical questionnaire, (2) examiner's evaluation of perineal muscle strength, (3) objective evaluation of perineal muscle by perineometry, (4) vaginal weight test, and (5) urodynamic study. The IES protocol consisted of three 20-min sessions per week over a 7-week period using a Dualpex Uro 996 at 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence, present in all patients before treatment, was reduced to 15% in G1 and 31.5% in G2 post-treatment. The subjective evaluation of PFM strength demonstrated a significant improvement in G1. Objective evaluation of PFM force by perineometer showed a significant improvement in maximum peak contraction post-treatment in both groups. In the vaginal weight test, there was a significant increase in average number of cone retentions post-treatment in both groups. With regard to satisfaction level, after treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant improvement in PFM strength from both effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy in treating MUI.
Adult↗
Muscle strength following total hip arthroplasty. A comparison of trochanteric osteotomy and the direct lateral approach.
Twenty-seven patients who had hip arthroplasty operated on with trochanteric osteotomy were compared with 54 patients when the direct lateral approach was used. The strength of the hip abductors, adductors, extensors, and flexors were measured at least 2 years following surgery. The strength of these muscle groups recovered to the same level as those on the nonoperated side, and there was no significant difference between the two groups of patients. Functionally, the direct lateral approach is a safe alternative to trochanteric osteotomy.
Aged↗
INCREASING muscle strength.
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Exercise Therapy↗
Effect of propranolol and phenoxybenzamine on muscle strength and physical endurance, and on exercise-induced changes in muscle glycogen and blood lactic acid levels in rats.
Propranolol and phenoxybenzamine (PBZ) had no major effect on swimming-endurance performance and skeletal muscle pulling-strength in rats. Propranolol, like exercise itself diminished the resting skeletal muscle glycogen (SMG) content, but the drug did not lower the resting blood lactic acid (BLA) levels. Propranolol significantly antagonised the 25-min exercise-induced BLA elevation, indicating that lactacidaemia is possibly a beta-receptor response. However, propranolol did not exhibit an overall beneficial effect on swimming endurance. PBZ had a negligible effect on maximal swimming time (MST) and had no major effects on the SMG content and BLA levels.
Animals↗
Isokinetic muscle strength and its association with neuropsychological capacity in cirrhotic alcoholics.
Alcoholic cirrhotics (n = 49), nonalcoholic cirrhotics (n = 42), and normal controls (n = 50) were compared on measures of isokinetic muscle strength and neuropsychological capacity. Alcoholic cirrhotics were deficient on measures of eccentric and concentric muscle movements, compared with normal controls but were not different from nonalcoholic cirrhotics. Nor were differences observed between the two cirrhotic groups on neuropsychological tests of cognitive and psychomotor capacity, suggesting that cirrhosis rather than alcoholism per se is responsible for the manifest deficits. Psychomotor capacity correlated negatively with isokinetic strength in cirrhotic subjects. These findings suggest that muscle weakness, due either directly to advanced liver disease or mediated by subclinical hepatic encephalopathy, accounts for a portion of the variance on the neuropsychological test performance of cirrhotic alcoholics.
Adult↗