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PubMed1995

Vaginal weight cones. Theoretical framework, effect on pelvic floor muscle strength and female stress urinary incontinence.

OBJECTIVE: The purpose of the present review article is to analyze the scientific background for the use of vaginal cones in measurement of pelvic floor muscle (PFM) strength and effect on female stress urinary incontinence (SUI). MATERIAL AND METHODS: Literature search is based on articles written in English language compiled from MEDLINE, EMBASE, BIOSIS, and SCISEARCH from 1985 up to 1993. Only one study and one abstract were found dealing with methodology of cones used as measuring devices for PFM strength. Six articles were found evaluating the effect of cones on PFM strength and/or SUI. RESULTS: The analysis of the literature revealed that there is low correlation between PFM strength (measured by vaginal squeeze pressure and vaginal palpation) and ability to hold the cones in incontinent women. The theoretical basis for strength development using cones can be questioned. The studies evaluating effect on PFM strength and SUI have flaws in design, outcome variables and measurement of PFM strength. Including drop out rates, subjective improvement rates vary between 30-63% in uncontrolled studies. CONCLUSION: It is concluded that cones may not be used as objective measuring devices for PFM strength. There is a need for prospective controlled randomized studies applying reliable and valid outcome variables to evaluate the effect of cones in treatment of SUI.

Abdominal Muscles↗
PubMed1993

Magnitude and reliability of measurements of muscle strength across trials for individuals with mental retardation.

The purpose of this investigation was to examine the magnitude and reliability of strength measures on the Nicholas Manual Muscle Tester for individuals with mental retardation. 17 subjects were given six trials with the dominant and nondominant flexor and extensor muscle groups. No significant differences were found between dominant and nondominant muscle groups by side or by muscle group. Interclass correlations ranged from .96 to .98 for six and three trials, respectively. It was concluded that the test was appropriate for reliably assessing strength in this population and that these individuals can achieve a sufficient magnitude on three trials for a reliable measure of strength.

Adolescent↗
PubMedDate not supplied

Effects of eccentric versus concentric training on thigh muscle strength and EMG.

The purpose of this study was to compare pure eccentric and concentric strength training regarding possible specific effects of muscle action type on neuromuscular parameters, such as a decreased inhibition during maximal voluntary eccentric actions. Two groups of young healthy adult men performed 10 weeks of either eccentric or concentric unilateral isokinetic knee extensor training at 90 degrees.s(-1), 4 sets of 10 maximal efforts, 3 days a week. Knee extensor torque and surface EMG from the quadriceps and hamstring muscle groups were collected and quantified in a window between 30 and 70 degrees knee angle (range of motion 90-5 degrees ) during maximal voluntary eccentric and concentric knee extensor actions at 30, 90, and 270 degrees.s(-1). Changes in strength of the trained legs revealed more signs of specificity related to velocity and contraction type after eccentric than concentric training. No major training effects were present in eccentric to concentric ratios of agonist EMG or in relative antagonist (hamstring) activation. Thus, for the trained leg, the muscle action type and speed specific changes in maximal voluntary eccentric strength could not be related to any effects on neural mechanisms, such as a selective increase in muscle activation during eccentric actions. Interestingly, with both types of training there were specific cross-education effects, that is, action type and velocity specific increases in strength occurred in the contralateral, untrained, leg, accompanied by a specific increase in eccentric to concentric EMG ratio after eccentric training.

Adaptation, Physiological↗
PubMed2000

Measurement of isometric muscle strength: a reproducibility study of maximal voluntary contraction in normal subjects and amyotrophic lateral sclerosis patients.

Amyotrophic lateral sclerosis (ALS) is a degenerative disease of unknown cause, resulting in the progressive loss of voluntary motor activity. Traditional methods of evaluating patients with ALS (neurologic assessment, manual muscle testing and rating scales) involve subjective elements and lack the sensitivity needed to detect small but meaningful changes in deterioration and therapeutic efficacy. This paper presents a recently developed strength measurement instrument, useful for the long-term monitoring of muscle strength deterioration in ALS. In addition, a reproducibility study to assess the intra- and interobserver reliability of maximal voluntary isometric contraction is reported. The strength measurement instrument consists of a strain gauge force transducer, a bridge amplifier and a mechanical structure to counteract movements. A personal computer acquires the strength signal during each voluntary contraction and automatically computes the maximal value. Reproducibility of measurement was assessed in 18 normal subjects tested twice, on successive days, with the same examiner and under the same conditions. The interexaminer reproducibility of measurement was assessed in a group of 13 normal subjects and 10 ALS patients. Each subject of the two groups was independently examined by three examiners. The two reproducibility studies showed a high intraclass correlation coefficient (0.91-0.97) and low SEM and measurement error (3-10%) in all muscle regions tested. The Bland and Altman plots confirmed these results.

Adult↗
PubMed1989

Inspiratory and skeletal muscle strength and endurance and diaphragmatic activation in patients with chronic airflow limitation.

To determine whether patients with chronic airflow limitation have a specific alteration in skeletal muscle performance, the strength and endurance of inspiratory and limb muscles were compared in 11 patients with chronic airflow limitation and 11 control subjects during maximal voluntary contractions. Peak inspiratory pressure at observed functional residual capacity (FRC) was significantly less in the patients than in the control subjects (mean 72 (SD 25) v 93 (21) cm H2O), though only two patients had low maximal pressures across a wide volume range. Maximal voluntary torque of the elbow flexor muscles was also reduced in the patients but the difference was not significant (60 (17) v 72 (18) Nm). During the endurance sequence of 18 maximal voluntary contractions (10 s duration, 5 s rest interval) the decline in peak and average force was less for the inspiratory muscles than for the elbow flexors in both groups. Inspiratory muscle endurance was slightly greater in the patients with chronic airflow limitation than in the control subjects, whereas limb muscle endurance was slightly impaired in the patients. In three patients with chronic airflow limitation, two of whom had low maximal inspiratory pressures at FRC, the ability to drive the diaphragm voluntarily was examined by stimulating the phrenic nerves during maximal inspiratory efforts. Each patient was capable of full activation of the diaphragm during the maximal inspiratory efforts. These results suggest that the relative preservation of inspiratory muscle performance in patients with chronic airflow limitation may be an adaptive response to respiratory "loading."

Airway Obstruction↗
PubMed2003

Respiratory muscle strength training with nonrespiratory maneuvers.

The diaphragm and abdominal muscles can be recruited during nonrespiratory maneuvers. With these maneuvers, transdiaphragmatic pressures are elevated to levels that could potentially provide a strength-training stimulus. To determine whether repeated forceful nonrespiratory maneuvers strengthen the diaphragm, four healthy subjects performed sit-ups and biceps curls 3-4 days/wk for 16 wk and four subjects served as controls. The maximal transdiaphragmatic pressure was measured at baseline and after 16 wk of training. Maximum static inspiratory and expiratory mouth pressures and diaphragm thickness derived from ultrasound were measured at baseline and 8 and 16 wk. After training, there were significant increases in diaphragm thickness [2.5 +/- 0.1 to 3.2 +/- 0.1 mm (mean +/- SD) (P < 0.001)], maximal transdiaphragmatic pressure [198 +/- 21 to 256 +/- 23 cmH2O (P < 0.02)], maximum static inspiratory pressure [134 +/- 22 to 171 +/- 16 cmH2O (P < 0.002)], maximum static expiratory pressure [195 +/- 20 to 267 +/- 40 cmH2O (P < 0.002)], and maximum gastric pressure [161 +/- 5 to 212 +/- 40 cmH2O (P < 0.03)]. These parameters were unchanged in the control group. We conclude that nonrespiratory maneuvers can strengthen the inspiratory and expiratory muscles in healthy individuals. Because diaphragm thickness increased with training, the increase in maximal pressures is unlikely due to a learning effect.

Adult↗
PubMed1999

Standards for judgments of unilateral impairments in muscle strength.

A secondary analysis of a data base of isometric strength measures from 136 asymptomatic adults (50-79 years) was conducted to estimate the normal difference between dominant and nondominant side strengths. Measures of strength obtained by hand-held dynamometry from 13 muscle actions were expressed as a ratio, dominant side strength:nondominant side strength. The ratios indicated that the dominant side was stronger on average but that the normal range of differences between sides could reach 23.2 to 40.2%, depending on the action. The findings do not provide much support for the convention of using a 10% difference in strength between sides to designate impairment.

Aged↗
PubMed2000

Bone-muscle strength indices for the human lower leg.

This cross-sectional study is based on images from the lower leg as assessed by peripheral quantitative computer tomography (pQCT). Measurements were performed in 39 female and 38 male control subjects and 15 female professional volleyball players, all between 18 and 30 years of age. The images were obtained at shank levels of 4%, 14%, 33%, and 66% from the distal end. Bone and muscle cross-sectional areas, and the bones' density-weighted area moment of resistance and of inertia were assessed. From these, muscle-bone strength indices (MBSIs) were developed for compression (CI = 100. bone area/muscle area) and bending (BI = 100. bone area moment of resistance/muscle area/tibia length). Significant correlations between muscle cross-sectional area and bone were found at all section levels investigated. The strongest correlation for compression was observed in the sections at 14% (correlation coefficient r = 0.74), where 4.10 +/- 0.46 cm(2) bone, on average, was related to 100 cm(2) muscle. The compression index (CI) at the 14% level was independent of the tibia length. Interestingly, the 15 athletes had significantly greater CIs than the control subjects. This is most probably due to the greater tension development in the athletes. The highest correlation for bending was for anteroposterior bending at 33% of tibia length (r = 0.81), where the area moment of resistance, R, was on, average, 4.21 +/- 0.54 cm(3)/100 cm(2) muscle/m tibia length. Analysis of the bones' area moment of inertia showed that buckling is a possible cause of bending at the 33% and 66% levels, but not at the 14% level. No gender differences in MBSI were found. Likewise, age was without significant effect. The data show that bone architecture depends critically on muscle cross section and tension development. Moreover, bone geometry (e.g., the tibia length) influences the geometrical distribution of bone mineral, as it was found that long bones adapted to the same compressive strength are wider than short ones. We conclude that MBSIs offer a powerful diagnostic tool for bone disorders and may contribute to improving the treatment of bone metabolic and other diseases.

Absorptiometry, Photon↗
PubMed2005

Selective androgen receptor modulator treatment improves muscle strength and body composition and prevents bone loss in orchidectomized rats.

The partial agonist activity of a selective androgen receptor modulator (SARM) in the prostate was demonstrated in orchidectomized rats. In the current study, we characterized the full agonist activity of S-3-(4-acetylamino-phenoxy)-2-hydroxy-2-methyl-N-(4-nitro-3-trifluoromethyl-phenyl)-propionamide (a structurally related SARM referred to in other publications and hereafter as S-4) in skeletal muscle, bone, and pituitary of castrated male rats. Twelve weeks after castration, animals were treated with S-4 (3 or 10 mg/kg), dihydrotestosterone (DHT) (3 mg/kg), or vehicle for 8 wk. S-4 (3 and 10 mg/kg) restored soleus muscle mass and strength and levator ani muscle mass to that seen in intact animals. Similar changes were also observed in DHT-treated (3 mg/kg) animals. Compared with the anabolic effects observed in muscle, DHT (3 mg/kg) stimulated prostate and seminal vesicle weights more than 2-fold greater than that observed in intact controls, whereas S-4 (3 mg/kg) returned these androgenic organs to only 16 and 17%, respectively, of the control levels. S-4 (3 and 10 mg/kg) and DHT (3 mg/kg) restored castration-induced loss in lean body mass. Furthermore, S-4 treatment caused a significantly larger increase in total body bone mineral density than DHT. S-4 (3 and 10 mg/kg) also demonstrated agonist activity in the pituitary and significantly decreased plasma LH and FSH levels in castrated animals in a dose-dependent manner. In summary, the strong anabolic effects of S-4 in skeletal muscle, bone, and pituitary were achieved with minimal pharmacologic effect in the prostate. The tissue-selective pharmacologic activity of SARMs provides obvious advantages over steroidal androgen therapy and demonstrates the promising therapeutic utility that this new class of drugs may hold.

Acetamides↗
PubMed1999

Development of muscle strength in relation to training level and testosterone in young male soccer players.

Isometric and functional strength of ninety-eight 11-yr-old male soccer players at an elite (E) and nonelite (NE) level were determined (3-4 times) through a 2-yr period, and the changes were related to growth and maturation. The initial isometric strength for extension with dominant leg [1,502 +/- 35 (E) vs. 1,309 +/- 39 (NE) N], extension with nondominant leg (1,438 +/- 37 vs. 1,267 +/- 45 N), extension with both legs (2,113 +/- 76 vs. 1,915 +/- 72 N), back muscles (487 +/- 11 vs. 414 +/- 10 N), abdominal muscles (320 +/- 9 vs. 294 +/- 8 N), and handgrip (304 +/- 10 vs. 259 +/- 8 N) increased by 15-40% during the period. Broad jump increased (P < 0. 05) by 15 (E) and 10% (NE). The E players had higher (P < 0.05) initial isometric strength and broad jump performance compared with NE players, and differences were maintained throughout the period (multiple ANOVA for repeated measures) also when adjustment was made for age, dimensions, testosterone, and insulin-like growth factor I (generalized estimating equations analyses). The development of strength for both E and NE players together was significantly (P < 0. 001) related to changes in serum testosterone concentrations. The present data indicate that testosterone is important for development of strength in young boys and that, independent of serum testosterone concentration, E players have developed greater muscle strength compared with NE players.

Adolescent↗
PubMed2006

Changes in lung function and respiratory muscle strength after sternotomy vs. laparotomy in patients without ventilatory limitation.

A relevant ventilatory defect occurs after sternotomy, a very common thoracic surgical opening. The mechanism of the ventilatory impairment is unclear. Moreover, until now, the effect of sternotomy on pulmonary gas exchange has scarcely been investigated. We evaluated the time-course up to recovery and changes in spirometry, maximum static inspiratory (PI(max)) and expiratory (PE(max)) mouth pressures and pulmonary gas exchange in 6 patients after sternotomy and in 8 patients after laparotomy. All patients were free of cardiopulmonary diseases and had normal preoperative lung function. Sternotomy and laparotomy decreased forced vital capacity (FVC) by 67 and 49%, respectively. Moreover, the percent decreases in PI(max), PE(max) and PaO(2) after sternotomy vs. laparotomy were respectively 54 vs. 57%, 54 vs. 60%, and 22.6 vs. 7.5% (p < 0.05). Following sternotomy, the percent decreases in FVC correlated with the percent decreases in PI(max) (p < 0.05) and PE(max) (p < 0.01). The return to baseline values occurred after approximately 2 weeks. The present study shows that sternotomy can induce greater respiratory effects than laparotomy and suggests a relevant involvement of respiratory muscle weakness after surgical opening of the thorax. The study also supports the view that the evaluation of patient's lung function before sternotomy can be clinically relevant.

Adolescent↗
PubMed2005

The use of vibration training to enhance muscle strength and power.

Vibration has been combined with conventional resistance training in an attempt to attain greater gains in neuromuscular performance than from conventional resistance training alone. Although there is a lack of strictly controlled studies on the vibration training effect, current findings in this area suggest that vibration may have a beneficiary acute and/or chronic training effect on strength and power enhancement. However, the effect of vibration on strength and power development appears dependent upon the vibration characteristics (method of application, amplitude and frequency) and exercise protocols (training type, intensity and volume) employed. Vibration amplitude and frequency determine the load that vibration imposes on the neuromuscular system. This vibration load should be in an optimal range to elicit strength and power enhancement. To activate the muscle most effectively, vibration frequency should be in the range of 30-50 Hz. It is less clear to what the optimal amplitude should be, but smaller amplitudes may be insufficient to elicit an enhancement. It should also be noted that the method of vibration application (i.e. vibration applied directly or indirectly to a targeted muscle) may have an influence on the magnitude of amplitude and frequency that are delivered to the muscle and, therefore, may have an influence on vibration training effect. The employment of a greater exercise intensity and volume within a vibration training programme may facilitate a larger enhancement in strength and power. In addition, benefits from vibration training may be greater in elite athletes than non-elite athletes. Further studies are required to examine these inter-dependencies, especially in relation to chronic adaptation to dynamic exercises, which are the most relevant response to practitioners, but where the least amount of research has been undertaken.

Exercise↗
PubMed2005

Cervical muscle strength measurement in two groups of elite Greco-Roman and free style wrestlers and a group of non-athletic subjects.

BACKGROUND: Free style and Greco-Roman are two types of wrestling. [figure: see text] OBJECTIVES: The aim of this study was to examine the maximal isometric strength of cervical extension (ISCE) and the maximal isometric strength of cervical flexion (ISCF) in two groups of elite wrestlers and a group of non-athletic subjects. METHODS: Fourteen elite Greco-Roman wrestlers (aged 19-25 years), 16 elite free style wrestlers (aged 18-25 years), and 16 non-athletic subjects (aged 18-25 years) participated in this study. All wrestlers competed at international level with the Iranian national team. Maximum voluntary contractions (MVC) of cervical extensor and flexor muscles were measured using a custom made device. The ratios of ISCE to weight (ISCE/weight), ISCF to weight (ISCF/weight), and ISCF to ISCE (ISCF/ISCE) were calculated for group comparisons. Pearson product moment test was used to estimate correlation between maximal isometric strength measurements and anthropometric variables. A one way analysis of variance was computed to compare ISCE/weight, ISCF/weight, and ISCF/ISCE among groups. RESULTS: There was significant correlation between maximum cervical extension and flexion strengths and weight in all groups (p<0.05, n = 46). The ratios of cervical muscle strengths to weight were significantly higher in wrestlers than in non-athletic subjects (p<0.00). Greco-Roman wrestlers appeared to be stronger than free style wrestlers following comparison of all ratios. CONCLUSIONS: Neck muscle force measurements may be a useful test for athletes in combat sports like wrestling. They can be applied to identify the weakness of a group of muscles in the neck area and to devise a proper training program.

Adolescent↗
PubMed1999

Assessment of human muscle strength for engineering purposes: a review of the basics.

Contracting skeletal muscles pull on body segments to withstand or overcome internal and external opposing forces. Various methods and techniques can be employed for measuring muscular exertions. Information on strength that can be applied to objects such as hand tools or handling loads is of great importance for ergonomic design. This paper establishes a systematic context regarding: (1) the contractile muscle actions and their associated metabolic and circulatory processes, which are often the limiting factors for exertion; (2) the internal biomechanical effects of muscle contraction in terms of the application of muscle force to body links and the internal transmission of the generated torque through the body to the point of external exertion; (3) the various kinds of muscular efforts, ranging from strictly bounded statics (isometrics) to freely executed dynamics; and (4) the ensuing possibilities to measure human muscular capabilities for the application of this information to ergonomic design of tasks and equipment.

Biomechanical Phenomena↗