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Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults.

BACKGROUND: The aim of the present study was to compare the changes in voluntary strength (isometric, concentric, and eccentric) and functional mobility in response to maximal isokinetic eccentric-only resistance training to those elicited by maximal isometric-only or maximal isokinetic concentric-only resistance training in older adults. METHODS: Twelve women (73 +/- 7 years) and 18 men (73 +/- 5 years) completed a 12-week training program (three times per week) using a Biodex System 3 dynamometer. Primary outcome measures included peak isometric and isokinetic (concentric and eccentric) knee extensor strength, concentric work, concentric power, stair ascent and descent, and gait speed. Participants were randomly assigned to one of three training groups: isometric-only, isokinetic concentric-only, or isokinetic eccentric-only. RESULTS: All three training groups demonstrated an increase in peak isometric and isokinetic concentric and eccentric strength following 12 weeks of training (p <.01). Step time was positively influenced (p <.03) by all three training modes; however, gait speed was unchanged following 12 weeks of training. All three training groups experienced a significant increase in peak concentric work and concentric power (p <.01) with the concentric training group demonstrating the largest increases in both peak concentric work and concentric power when compared to the isometric and eccentric training groups. CONCLUSIONS: It was clear that all three resistance training programs (isometric, concentric, and eccentric) in older adults were effective in increasing strength, concentric work, and concentric power over the 12-week training period. Furthermore, 12 weeks of resistance training resulted in improved stair ascent and descent performance.

Aged↗

Isometric or dynamic training: differential effects on mechanical properties of a human muscle.

This work compares the specific effects of 3 mo of moderate, isometric, or dynamic voluntary exercises on the contractile properties of human adductor pollicis muscle. Isometric training consisted of 10 daily contractions of 5-s duration at the frequency of one contraction per minute. Dynamic training consisted of 10 daily series of 10 fast contractions (less than 0.5-s duration) moving a load of one-third of the maximal muscle strength at a frequency of one series per minute. Both training programs produced a concomitant increase in maximal tetanic tension and in peak rate of tension development (Ro). A larger increase (P less than 0.05) was found after isometric training (20 vs. 11% after dynamic exercises), whereas Ro augmented more (P less than 0.05) after dynamic contractions (31 vs. 18% after isometric training). Enhancements of twitch force (Pt), rates of twitch tension development (Rt), and of relaxation (St) were, respectively, 20, 20, and 12% after isometric training. There was no modification of contraction time and time of half relaxation (T 1/2R). Conversely, dynamic training produced increases of Rt (25%) and St (16%), associated with an apparently paradoxical decrease of Pt (10%) and reductions of contraction time (11%) and T 1/2R (9%). Maximal shortening velocity was only increased after dynamic training (21%), whereas the maximal muscle power presented a large increase (P less than 0.05) after isometric exercises (51 vs. 19% after dynamic exercises) and a shift of its optimal peak toward heavier loads. This study suggests that human muscle adapts differently to isometric or to dynamic training programs and provides evidence that its contractile kinetics can be altered by exercises performed in physiological conditions.

Adolescent↗

Isometric exercise training lowers resting blood pressure.

Both rhythmic and "resistive" (weight lifting) exercise training can produce modest decreases in resting blood pressure. The next logical point along an exercise continuum consisting of different proportions of rhythmic and isometric efforts is a strictly isometric effort. The purpose of these studies was to assess the effects of isometric, handgrip exercise training on resting blood pressure. To avoid the extreme pressor responses elicited by fatiguing isometric efforts, the isometric exercise training used in this study consisted of brief handgrip contractions separated by rest periods. Modest repeated rises in systolic and diastolic pressures therefore served as the putative stimuli for training adaptations in resting blood pressures. Human subjects in study 1 trained with four, 2-min isometric handgrip contractions with 3-min rests between contractions. The intensity of the contractions was equal to 30% of their maximal effort for each day. The bouts of isometric exercise were performed three times per week for 8 wk. Study 2 training consisted of four contractions of 50% of maximum effort held for a duration of 45 s with 1-min rests. These were performed 5 d.wk-1 for 5 wk. In Study 1, all eight trained subjects had a significant decline in both systolic and diastolic resting blood pressures, with group averages of 12.5 and 14.9 mm Hg, respectively. Seven matched control subjects who did not train had no change in resting pressures. In study 2, subjects were trained in their home or workplace and experienced significant mean declines in resting systolic and diastolic pressures of 9.5 and 8.9 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Comparison of dynamic and isometric loading in echocardiographic examinations in patients with ischemic heart disease].

The objective of the work was to compare functional indicators of the left ventricle during isometric (HG) and dynamic (Ergo) echocardiographic load examinations in patients with different grades of ischaemic heart disease. In group A they compared results in 34 patients with affection of three coronary arteries and in group B 15 patients with 1-2 coronary arteries affected. They evaluated the systolic, diastolic blood pressure, heart rate (HR), the index of the diastolic end volume EDV/m2, the index of the systolic end volume ESV/m2, Limacher's index for evaluation of left ventricular motility and the left ventricular ejection fraction (EF) at rest and after both types of loads. The EDV/m2 index increased in group A by 5.2 ml during an isometric load and by 10.4 ml during a dynamic load, in group B it increased by 1.6 and 7.0 ml resp. The values of the ESV/m2 index increased in group A by 8.5 ml during the isometric load and by 14.0 ml during the dynamic load, in group B by 4.1 and 10.8 ml resp. EF values at rest were similar in both groups: group A: 51.4%, B: 51.5%. During the isometric load the EF declined to 45.3% in group A and to 47,1% in group B. During the dynamic load the EF declined to 42% in group A and 42.5 in group B. The dynamic load produces, as compared with the isometric one, a statistically more significant drop of Limacher's index and greater volumetric changes of the left ventricular cavity in the group with 1-2 affected coronary arteries, as compared with the isometric load. In patients with three affected coronary arteries the volumetric changes during an isometric load are comparable with changes after a dynamic load.

Coronary Disease↗

Comparing the Effects of Push and Hold Isometric Training on Strength and Musculotendinous Adaptations: A Within-Subject Randomized Controlled Trial.

Lum, D, Oranchuk, DJ, Chen, SE, and Kong, PW. Comparing the effects of push and hold isometric training on strength and musculotendinous adaptations: A within-subject randomized controlled trial. J Strength Cond Res 40(9): 1050-1058, 2026-Despite recent interest in delineating pushing (PIMA) and holding (HIMA) isometric muscle actions, training-induced adaptations have not been examined. As such, we compared the strength and morphological adaptations between PIMA and HIMA training. Twenty limbs across 10 adults (5 men, 5 women, age: 31.4 &#xb1; 6.5 years) were randomly assigned to PIMA or HIMA conditions and underwent 12 training sessions over 6 weeks. PIMA required subjects to exert force against a fixed lever while the HIMA limb maintained a set joint angle while resisting an isotonic lever. During each contraction, subjects had to exert force at 70% of maximal voluntary contraction for 20 seconds at an 80&#xb0; knee angle, for 4-6 repetitions. Subjects completed isometric, concentric, and eccentric knee extension assessments for both limbs before and after the intervention. Pre- and postintervention ultrasound scans were performed to determine quadriceps muscle architecture and patellar tendon thickness. Increased isometric torque was found following both conditions (p < 0.05, g = 0.30-0.36), while concentric (p < 0.05, g = 0.31) and eccentric (p < 0.01, g = 0.50) torque only increased following PIMA. Both conditions increased muscle thickness (p < 0.05, g = 0.27-0.88) and vastus lateralis fascicle length (p < 0.05, g = 0.20-0.31). Only HIMA increased patellar tendon thickness (p < 0.05, g = 0.12). The increase in total quadriceps (p < 0.05, g = 0.46) and especially rectus femoris (p < 0.05, g = 1.44) thickness was greater in HIMA. The results suggest that PIMA may be more effective at improving strength, while HIMA may be superior for inducing morphological adaptations. Larger sample sizes and more ecologically valid training programs are warranted to further elucidate potential differences between different isometric types.

Humans↗

Motor unit recruitment and discharge behavior in movements and isometric contractions.

The purpose of this study was to contrast the discharge patterns of the same motor units during movements and during isometric contractions that were produced with comparable torque-time characteristics. Subjects performed elbow flexion and extension movements with predetermined acceleration characteristics. The average acceleration and deceleration profiles for the movements were reproduced in the isometric setting by presenting the kinematic profiles as templates for torque production. Trained subjects were able to match the first agonist (AG1) and antagonist (ANT) electromyographic (EMG) bursts, but tended to produce a smaller second agonist burst (AG2) in the isometric contraction. Twenty-five motor units from triceps brachii were studied. The same motor units (with one exception) were recruited and subsequently discharged in a similar fashion in both the isometric and movement tasks in the AG1 and ANT EMG bursts, with fewer motor unit discharges in the AG2 burst in the isometric contraction. The central control mechanisms appear to be the same for the acceleration phase of movement and isometric contraction, but differ during the deceleration phase.

Adult↗

Isometric tension of cultured endothelial cells: new technical aspects.

In this paper new technical aspects are discussed in the measurement of the low amount of force typically expressed in cultured endothelial cells. We illustrate how potential background noises interfere with signal acquisition. We present a new generation prototype that measures isometric tension in vitro in multiple samples and in more than on isometric vector. We report that thrombin increases isometric tension in at least two separate vectors that are directed in opposite directions. We also report that phorbol ester dibutyrate can randomly mediate a false relaxation (anisotropic contraction) in cultured PPAEC, when the force vector is directed opposite to the referenced isometric vector of the transducer. In contrast, stimulation of cultured HUVEC with the cAMP agonists, theophylline and forskolin, decreased isometric force in both vectors. Thus direction of the force vector needs to be considered when interpreting isometric tension in cultured endothelial cells.

Animals↗

Changes in perceived finger force produced by muscular contractions under isometric and anisometric conditions.

We compared matching of finger forces under isometric conditions with matching of forces produced against a spring load (anisometric conditions) in twenty normal subjects. The instruction was to generate the same force in both hands holding a grip between thumb and index finger in each hand. Visual feedback indicating the target force and the actual force applied were presented for one (reference) hand only. The forces produced in each hand were measured continuously during matching trials. A special device provided the opportunity to change from isometric to anisometric force production. Matching was required under symmetric conditions, in which force was generated in both hands either isometrically or anisometrically, as well as under asymmetric conditions in which isometric force has to be matched to anisometric force or the reverse. Under symmetric conditions matching error was consistently smaller in anisometric than in isometric force production. However, the striking feature was a severe mismatch between hands when forces had to be produced differently. For most subjects, a force generated against the spring load in the reference hand was greatly overestimated by the matching hand working isometrically. For the reverse condition consistent underestimations were observed. This effect cannot be attributed to left/right differences or a simple confusion of subjects in the asymmetric tasks. Some of the factors confounded with the conditions of force production were ruled out as an explanation by additional experimental controls. The mismatch neither depends on signals related to different finger positions associated with target forces nor is it alleviated when differently produced forces are matched sequentially.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Structural muscle damage and muscle strength after incremental number of isometric and forced lengthening contractions.

Exercise-induced muscle damage is characterized by histological changes, like Z-line streaming, inflammatory response and decreased muscle function reflected in a prolonged decline in maximal isometric muscle strength after eccentric work. It is assumed that force decrement is mainly related to the amount of structural damage. However, the relationship between number of eccentric contractions, magnitude of structural damage and force decrement is not very well documented. Therefore we studied the effect of an increasing number of both isometric and eccentric (forced lengthening) contractions on histological parameters of muscle damage and maximal isometric force in an experimental in situ rat model. Tibialis anterior muscles of male Wistar rats were subjected to an increasing number of either isometric or eccentric contractions and were examined for histological markers of muscle damage. The present study shows that muscle damage increases progressively with the number of forced lengthening contractions. Maximal isometric torque was found to decline after both types of exercise. However, the decline after forced lengthening exercise was more pronounced. Only a weak relationship between percentage of histological muscle damage and isometric torque after forced lengthening contractions was found. The findings of the present study suggest that the decline in muscle force after eccentric exercise may partly be attributed to other factors than structural damage.

Analysis of Variance↗

Myo-electric signals from two extrinsic hand muscles and force tremor during isometric handgrip.

The objective of the present study was to investigate the myo-electric signs of muscle fatigue and the isometric force tremor of two extrinsic hand muscles, extensor digitorum communis and flexor digitorum superficialis, during isometric power grip. In addition, the synergy between flexor and extensor muscles and hand differences in a right-handed population have been studied. During isometric hand-dynamometry the myo-electric signal was recorded using surface electrodes and isometric force tremor was recorded using a special load cell. Eight subjects participated in this study and contractions were performed at 20%, 40%, 60% and 80% of maximal voluntary contraction (MVC) with left and right hands. The decrease of mean power frequency (MPF) with duration of contraction was greater in the left extensor as compared to the ipsilateral flexor muscle. No differences in the decrease in MPF with the duration of the contraction were found between the right extensor and flexor muscles. Isometric force tremor root mean square did not change during contractions at a given contraction level. Isometric tremor amplitude increased from 20% to 60% MVC and decreased at higher contraction levels. Tremor amplitude was higher in the left hand at all contraction levels but 60% MVC. These data would suggest differences in fatiguability and muscle fibre composition between the dominant and nondominant hand, which may be due to preferred use. The significance of force tremor for the evaluation of recruitment order and muscle fatigue is discussed.

Adult↗

Circulatory effects of isometric muscle contractions, performed separately and in combination with dynamic exercise.

Studies on central circulation and regional blood flow were performed in healthy male volunteers at rest, during sustained isometric forearm contraction at 20% of MVC, during dynamic leg exercise (100 W) and during combined isometric and dynamic exercise. In 10 subjects pulmonary oxygen uptake, arterio-venous oxygen difference, heart rate, leg blood flow and blood pressures in the pulmonary and subclavian arteries and in the right atrium were measured. In 4 of these subjects the temperature was measured in mixed venous blood and in subcutaneous tissue in an attempt to further analyse the blood flow distribution through central versus peripheral parts of the circulatory system. In 5 other subjects the splanchnic blood flow was estimated by hepatic vein catheterization and dye dilution technique at rest and during isometric forearm contraction. It was found that cardiac output, oxygen uptake, heart rate and arterial blood pressure all increased in response to isometric contraction. Quantitatively the changes in heart rate and cardiac output induced by a sustained contraction were more marked when the contraction was performed separately than when it was added to dynamic exercise. In spite of the increased arterial pressure, the leg blood flow did not increase significantly. Neither did the splanchnic blood flow increase in response to hand-grip contrmic exercise. Isometric exercise, however, caused a blood temperature fall and a rise in subcutaneous temperature indicating an increased blood flow through the skin. It is concluded that during sustained isometric muscle contraction 1. the blood flow increase is mainly distributed to peripheral circulatory areas, 2. a concomitant dynamic exercixe interferes with the circulatory adaptation only to a small extent.

Abdomen↗

The effects of mild one-legged isometric or dynamic training.

Four men isometrically trained their stronger leg for 19 weeks (attempted knee extension against a restraining strap incrementally increasing to 30 brief maximal contractions X 6 wk-1). Five others similarly trained dynamically (repeated knee extension against a 63 N resistance force, incrementally increasing to 300 extensions X 6 wk-1). Before, at regular intervals during training and after de-training (between 7-11 weeks) measurements were made using trained and control legs of: Maximum Voluntary Isometric Contraction (M.V.C.), Endurance at 60% M.V.C., Knee Extension Performance Test (K.E.P.T.) and One-legged Work Test. Isometric training produced a 30% (p less than 0.01) increase in M.V.C. with a 15% (p less than 0.05) increase in the control leg. These changes persisted with some deterioration after the de-training period. Endurance at 60% M.V.C. remained unchanged, even though M.V.C. was increasing in both trained and control legs. There was some evidence that isometric training improved the cardio-vascular response to one-legged exercise. Dynamic training did not result in changes in M.V.C., Endurance at 60% M.V.C. or the One-legged work Test, but K.E.P.T. (time taken for 50 knee extensions at a comfortable pace against 63 N resistance) improved by 33% (p less than 0.01) and 28% (p less than 0.01) in the trained and control legs respectively. Isometric training resulted in similar improvements in performance of K.E.P.T. (28%, p less than 0.05, trained leg; 18%, p less than 0.05 control leg). For similar time spent in training, isometric work appeared more effective than dynamic work in improving the parameters of muscle function, these improvements appeared to be both centrally (C.N.S.) and locally mediated.

Adult↗

Muscle weakness following sustained and rhythmic isometric contractions in man.

The effects of sustained and rhythmically performed isometric contractions on electrically evoked twitch and tetanic force generation of the triceps surae have been investigated in 4 healthy male subjects. The isometric contractions were performed separately and on different occasions at 30%, 60% and 100% of the force of maximal voluntary contraction (MVC). The area under the maximal voluntary contraction (MVC) force/time curve during the rhythmic and sustained contractions was the same for each experiment. The results showed that following rhythmic isometric exercise there was a small decrease in low (10 and 20 Hz) and high (40 Hz) frequency tetanic tension which was associated with % MVC. However, there was no change in the 20/40 ratio of tetanic forces, MVC or the contraction times and force of the maximal twitch. In contrast, following sustained isometric exercise tetanic forces were markedly reduced, particularly at low frequencies of stimulation. The 20/40 ratio decreased and the induced muscle weakness was greater at 30% than 60% or 100% MVC. The performance of sustained isometric contractions also effected a decrease in contraction time of the twitch and MVC. The results are in accord with previous findings for dynamic work (Davies and White 1982), and show that if isometric exercise is performed rhythmically the effect on tetanic tensions is small and there is no evidence of a preferential loss of electrically evoked force at either high or low frequencies of stimulation following the contractions. For sustained contractions, however, the opposite is true, the ratio of 20/40 Hz forces is markedly reduced and following 30% sustained MVC there is a significant (p less than 0.05) change in the time to peak tension (TPT) of the maximal twitch.

Adult↗

Submaximal force production during perceptually guided isometric exercise.

The aim of this study was to examine submaximal isometric force production guided by perceptual feelings of exertion. Thirty young adults performed isometric knee extensions on an isokinetic dynamometer. Subjects performed five different tests; the first test was the same for all subjects (standard naïve test). During the standard naïve test, subjects were asked to randomly produce force at perceived contraction intensities (25%, 50% and 75% of their maximum voluntary contraction (MVC)), with 100% MVC performed as the final intensity. All intensities, including the 100% MVC, were randomly performed in the other four tests (control tests 1 and 2, post 20% MVC and post 100% MVC tests). Post 20% MVC and post 100% MVC tests included fatiguing isometric exercise at 20% and 100% MVC respectively, which were performed prior to the test protocol. Results show that absolute peak force increased with increasing intensity (P<0.001) during all tests. During the standard naïve test, absolute peak force at 25% and 50% MVC was significantly lower (P=0.009) compared to control test 2, post 20% MVC and 100% MVC tests, and relative peak force was lower at all intensities compared to all other tests (P<0.001). Absolute and relative peak force was most accurate at 50% MVC (-12.06 N and -2.42%, respectively). Prior fatiguing isometric exercise did not affect the subsequent perceptual response range. In conclusion, isometric force was most accurate at 25% MVC but under-produced (perceptually overestimated) during higher contraction intensities preceding a maximal voluntary contraction (100% MVC). The ability to match absolute force with target contraction intensities was most accurate at 50% MVC during all five experimental conditions and poor at opposite ends of the force domain. Furthermore, prior fatiguing isometric exercise did not have an effect on the subsequent perceptual response range.

Adult↗

Do knee injuries have long-term consequences for isometric and dynamic muscle strength?

To ascertain whether decrements in knee extensor muscle strength persist years after a traumatic ligamentous or meniscal knee injury, with reference to (1) the type of muscle activity, (2) the dominance of injury, and (3) the time since injury, 36 subjects with previous unilateral knee injuries were assessed. Peak voluntary quadriceps muscle strength was measured using the KinCom 500H dynamometer during isometric, concentric (30 degrees.s-1 and 120 degrees.s-1) and eccentric contractions (30.s-1), and the findings for each type of contraction were compared. Significant differences in quadriceps muscle strength were seen between (1) the injured and uninjured limbs during maximal voluntary isometric (P = 0.0003), concentric (P < 0.0001) and eccentric (P < 0.0001) contractions, and (2) the isometric and concentric decrements (P = 0.004), and the isometric and eccentric decrements (P = 0.012) within the same injured limb. The decrements in eccentric strength were significantly greater if they affected the dominant rather than the non-dominant limb (P = 0.0186). No relationship was seen between the time since injury and the degree of isometric or dynamic decrement. Deficits in quadriceps muscle strength remained for a long time after traumatic knee injury, with exercise levels rarely returning to the previously uninjured state. The degree of decrement in muscle strength was dependent upon the type of muscle activity, with concentric and eccentric activity showing greater decrements than those seen with isometric activity. Deficits in the type of activity varied widely in the same individual, and eccentric decrements were significantly worse following dominant knee injuries. Possible explanations for these findings and the implications for rehabilitation following knee injury are discussed.

Adolescent↗

Value of isometric exercise testing during cardiac catheterization in mitral stenosis.

To examine the value of preoperative isometric exercise testing during cardiac catheterization in patients with mitral stenosis, the isometric handgrip exercise test was performed on 28 patients during preoperative diagnostic catheterization. Eighteen patients who subsequently underwent mitral valve surgery were recatheterized and reevaluated clinically 12 months after operation. Preoperatively, the patients were divided into 2 groups: 16 whose mean mitral valve pressure gradient increased greater than 4 mm Hg during isometric exercise (group A) and 12 whose pressure gradient decreased or increased less than 4 mm Hg (group B). The ejection fraction remained unchanged and the peak systolic pressure/end-systolic volume ratio increased during isometric exercise in group A (p less than 0.001). In group B, the ejection fraction decreased (p less than 0.001) and the peak systolic pressure/end-systolic volume ratio remained unchanged. In the total group, a positive correlation existed between the change in mean mitral valve pressure gradient during isometric exercise and the changes in measures of left ventricular function during exercise. The patients in group A had a significant improvement in both symptoms and in exercise tolerance as determined by symptom-limited bicycle ergometry after surgery. The patients in group B showed minimal or no symptomatic improvement and their exercise tolerance did not improve. The change in mitral valve pressure gradient during isometric exercise appears to reflect the left ventricular response to exercise.

Adult↗

Changes in left ventricular wall stress during isometric and isotonic exercise in healthy men.

Changes in left ventricular (LV) meridional and circumferential end-systolic wall stress during isometric and isotonic exercises were determined noninvasively in 12 healthy subjects using echocardiography and cuff blood pressure measurements. Isometric exercise was performed at 20 and 40% of maximal voluntary contraction using a handgrip dynamometer, and isotonic exercise was done on a cycle ergometer at 150 kpm/min increments every 3 minutes to a maximum of 600 kpm/min. Although the increase in systolic blood pressure was similar in both forms of exercise, LV systolic stress in the circumferential and meridional planes increased markedly during isometric exercise but decreased slightly during higher intensity isotonic exercise. Isometric exercise also produced a significant decrease in fractional shortening, whereas isotonic exercise significantly increased fractional shortening. Wall stress and fractional shortening were linearly and inversely related, but isometric and isotonic exercise produced divergent and significantly different linear regressions. In normal subjects isometric exercise produces a significant increase in LV afterload that leads to a decrease in LV global function. In contrast, isotonic exercise causes an increase in LV global function, most likely from an unchanged or slight decrease in afterload associated with increased LV contractility from greater catecholamine release.

Adult↗

Reliability of isokinetic and isometric measurement of leg strength on men with mental retardation.

The purpose of this study was to determine the reliability of isokinetic and isometric measurement of strength for tests of knee extension and hip abduction on men with mental retardation (MR). In addition, the relationships between isokinetic measures of peak torque (PT) and total work (TW) and isometric peak torque were examined. Twenty-two men with mild to moderate MR were tested for isokinetic knee extension and hip abduction strength on a Musculoskeletal, Evaluation, Rehabilitation and Conditioning (MAREC) systems dynamometer at velocities of 60 and 30 degrees/sec, respectively. Isometric peak torque was determined by an examiner using a Nicholas Manual Muscle Tester (NMMT). Intrarater correlation coefficients for the isokinetic PT and TW scores ranged from .97 to .99, whereas coefficients for isometric NMMT scores ranged from .97 to .98. Pearson correlation coefficients between PT and TW scores ranged from .76 to .93. Coefficients between isokinetic and isometric scores ranged from .43 to .73. These results indicate that highly reliable isokinetic and isometric measurements can be obtained on men with MR. Also, the relatively simple measurement of PT may be the isokinetic parameter of choice at the clinical setting. Moderate relationships between NMMT and isokinetic scores were found, indicating that the generalization of test scores from one test modality to another is not warranted.

Adult↗