Reliability of maximal strength testing in older adults

Clinimetric evaluation of five clinically feasible measures of the leg extensor muscle strength in neurological rehabilitation settings

A gold-standard clinical measure of leg muscle strength has not been established. Therefore, the aim of this study was to evaluate clinimetric properties of five clinically feasible measures of lower-limb extensor muscle strength in neurological rehabilitation settings. This was a cross-sectional observational study of 36 participants with leg weakness as a result of a neurological condition/injury. Participants were recruited across a range of walking abilities, from non- to independently ambulant. Each was assessed using each of the following five measures: manual muscle test (MMT), hand-held dynamometry (HHD), seated single leg press one repetition maximum (1RM), functional sit-to-stand (STS) test and seated single leg press measured with a load cell. Each clinical measure was evaluated for its discriminative ability, floor/ceiling effects, test-retest reliability and clinical utility. The load cell and HHD were the most discriminative of the tests and were also resistant to floor/ceiling effects; however, the load cell was superior to the HHD when compared for its clinical utility. The MMT/STS tests received perfect scores for clinical utility, although similar to the 1RM test, they were susceptible to floor and ceiling effects. The load cell leg press test was the only measure of lower limb strength to satisfy all four clinimetric properties. Implications for clinical practice include, firstly, that strength tests available to clinicians vary in their clinimetric properties. Secondly, the functional status of the person will determine selection of the best clinical strength test. And lastly, load cell device technology should be considered for clinical strength assessments.

Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke

Sensor-based devices can record pressure or force over time during grasping and therefore offer a more comprehensive approach to quantifying grip strength during sustained contractions. The objectives of this study were to investigate the reliability and concurrent validity of measures of maximal tactile pressures and forces during a sustained grasp task using a TactArray device in people with stroke. Participants with stroke (n = 11) performed three trials of sustained maximal grasp over 8 s. Both hands were tested in within- and between-day sessions, with and without vision. Measures of maximal tactile pressures and forces were measured for the complete (8 s) grasp duration and plateau phase (5 s). Tactile measures are reported using the highest value among three trials, the mean of two trials, and the mean of three trials. Reliability was determined using changes in mean, coefficients of variation, and intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used to evaluate concurrent validity. This study found that measures of reliability assessed by changes in means were good, coefficients of variation were good to acceptable, and ICCs were very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s in the affected hand with and without vision for within-day sessions and without vision for between-day sessions. In the less affected hand, changes in mean were very good, coefficients of variations were acceptable, and ICCs were good to very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s and 5 s, respectively, in between-day sessions with and without vision. Maximal tactile pressures had moderate correlations with grip strength. The TactArray device demonstrates satisfactory reliability and concurrent validity for measures of maximal tactile pressures in people with stroke.

Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations

ABSTRACT

Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.

Whole-Body Vibration Associated with Strength Training on the Lower-Limb Blood Flow and Mobility in Older Adults with Type 2 Diabetes: A Study Protocol for a Randomized Controlled Trial

Vascular endothelium insults caused by high serum glucose levels affect the oxygen supply to tissues, via the microvascular endothelium, resulting in an increased perfusion heterogeneity. These insults may lead to the underuse of blood capillaries, while other vessels are overused and effectively overload their oxygen supply capacity, which eventually causes damages to distal parts of the peripheral nervous system. Therefore, the proprioceptive and exteroceptive feedback information will be gradually lost and contribute to a mobility reduction. This study aims to assess the efficacy of whole-body vibration (WBV) associated with strength training (ST) on lower-limb blood flow and mobility in older adults with type 2 diabetes (DM2). Methods and analyses: This is a protocol (1st version) for Pa single-blind, randomized, controlled clinical trial guided by the SPIRIT guidelines. Our sample will consist of 51 older adults with DM2 randomly allocated to three groups: low frequency WBV (16−26 Hz) associated to ST (G1), WBV sham (G2) and nonintervention control (G3). The study protocol is set for a 12-week (three times per week) schedule. Primary outcomes: skin temperature using infrared thermographic imaging (ITI); mean peripheral arterial blood flow velocity (MBF) by a handheld Doppler ultrasound (DU), and functional mobility by Timed Up and Go (TUG) test. Secondary outcomes: quasi-static posture using the DX100 BTS Smart optoelectronic system, and plantar pressure and body balance using the MPS stabilometric platform. Data will be collected and analyzed at baseline and post-intervention, considering p-value < 0.05 level of significance. The analyses will also be conducted with an intention-to-treat method and effect size. Dissemination: All results will be published in peer-reviewed journals as well as presented in conferences.

Effectiveness of Whole-Body Vibration Combined with Multicomponent Training on the Risk of Falls and Quality of Life in Elderly Women with Osteoporosis: Study Protocol for a Randomized Controlled Clinical Trial

Osteoporosis and the risk of falls increase the risk of fractures and events of falls. Prescriptions and programs for different forms of exercise have different impacts on the risk of falls, and exercises from multiple categories of whole-body vibration can be effective. This study aims to evaluate the effectiveness of whole-body vibration (WBV) protocol combined with multicomponent training (MCT) in elderly women with osteoporosis and their history of falls. Our proposal is a protocol for a randomized clinical trial, divided into two stages: First, development of a protocol for WVB combined with MCT for elderly women with osteoporosis and a history of falls, under the Guidelines of the American College of Sports Medicine, and following the recommendations of the Standard Protocol Items Recommendations for Interventional Trials (SPIRIT), and second, a randomized controlled clinical trial following the Consolidated Standards of Reporting Trials (CONSORT). This trial will have implications for the effectiveness of a vibration protocol combined with multicomponent exercise on the risk of falls and quality of life for older women with osteoporosis. We expect that adding full-body vibration to an exercise protocol will decrease the risk of falls and improve participants’ quality of life, as well as their strength, balance, and functional capacity.

Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial

PURPOSE

To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults.

METHODS

Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m²] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily.

RESULTS

EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50-1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (-0.4±0.4 kg), and interleukin-6 (-1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (-0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37-0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51).

CONCLUSION

RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at clinicaltrials.gov as NCT03299972.

One Repetition Maximum Test-Retest Reliability and Safety Using Keiser Pneumatic Resistance Training Machines With Older Women

ABSTRACT

Infante, MA, Harrell, GM, Strand, KL, Parrino, RL, and Signorile, JF. One repetition maximum test-retest reliability and safety using Keiser pneumatic resistance training machines with older women. J Strength Cond Res 35(12): 3513-3517, 2021-Chest press (CP) and leg press (LP) are the most common exercises used to assess strength in older persons; therefore, the reliability of these tests is critical to clinicians and researchers. Because women comprise the highest proportion of the older population, this study examined the test-retest reliability of Keiser A420 pneumatic machines during CP and LP 1 repetition maximum (1RM) testing in 23 older women on 2 separate occasions, trial 1 (T1) and trial 2 (T2), at least 72 hours apart. Significance was set at <0.05. CP1RM and LP1RM showed excellent test-retest reliability (intraclass correlation coefficient = 0.974, 0.972, respectively, p < 0.001) and low coefficients of variation (CP1RM = 5.28%; LP1RM = 6.32%). Standard error of measurement for CP1RM (0.97 kg) was lower than that of LP1RM (6.36 kg). The minimal detectable change (MDC) for the CP1RM and LP1RM was 2.69 and 17.63 kg, respectively. Bland-Altman plots revealed only 1 point outside of the 95% CI for comparison of T1 and T2 for either exercise, there was little systematic error across average values, both lines of equality fell within the limits of agreement (LOA), and the bias between T1 and T2 for both exercises was below 5% of the average 1RM. By contrast, the LOA for CP1RM and LP1RM are somewhat wide because they both exceeded their computed MDC values. Given the excellent test-retest reliability of the Keiser A420 pneumatic CP and LP machines with older women, clinicians and researchers can confidently and safely use these machines for 1RM testing after proper familiarization.

A Novel Assessment Technique Does Not Produce More Reliable Estimates of Maximal Neuromuscular Strength

Accurate determinations of individuals' one-repetition maximum (1RM) are critical when evaluating the effectiveness of an exercise intervention involving progressive resistance training (RT). Traditional ("bottom-up"; BT) testing methods involve progressions from low to maximal loads and are commonly used in clinical and laboratory environments. Concerns about the reliability of BT testing in certain populations suggest a different technique may be more effective. Purpose: To compare the reliability and effectiveness of traditional 1RM testing to a novel technique (TDT) involving progressive load reductions and a starting intensity equal to 130% of exercisers' estimated 1RM. Method: 70 healthy adults (age = 45.03 ± 25.64 y) with diverse RT experience were randomized into a reliability testing trial (RTT; n = 33) or an optimal method trial (OMT; n = 37). Subjects in the RTT performed either TDT or BT on 3 occasions separated by ≥ 72 hours, while subjects in the OMT performed each method once in random order on separate days. Results: No significant differences in percent coefficient of variation were observed between BT and TDT for either exercise used in the study (pneumatic seated chest press: Hedge's g = 0.25, p = .49; pneumatic recumbent leg press: Hedge's g = 0.12, p = .74). TDT was not found to produce significantly higher 1RM values than BT in any group. Conclusion: TDT does not appear to facilitate more reliable 1RM estimates than BT. Further research is needed to determine the stability of these findings across levels of exercisers' age, sex, and previous RT experience.

Relationships Between Midthigh Pull Force Development and 200-m Race Performance in Highly Trained Kayakers

ABSTRACT

Pickett, CW, Nosaka, K, Zois, J, and Blazevich, AJ. Relationships between midthigh pull force development and 200-m race performance in highly trained kayakers. J Strength Cond Res 35(10): 2853-2861, 2021-While increased lower-limb force production during kayaking has been shown to be related to increased boat velocity, poor relationships between maximal deadlift test performances and 200-m race time have been observed previously. This discrepancy may result from either a lack of movement pattern or temporal force production specificity between the test and kayak paddling. The isometric midthigh pull (MTP) test is commonly used in strength testing and quantifies temporal and peak force production, with the lower limbs positioned in a more kayak-specific manner than the deadlift test. Midthigh pull force data collected from 11 high-level kayak athletes were analyzed for both reliability and correlations with 200-m race time and deadlift isoinertial strength 3 repetition maximum (3RM). Strong consideration was given to the collection, processing, and analysis of the MTP data, which markedly affected the study results. Correlations between race time and MTP peak force and rates of force development were poor to moderate (r = -0.49 to 0.07). Strong to very strong relationships (r = 0.66-0.79) were found between forces developed early in the MTP (<0.15 seconds) and deadlift 3RM strength tests but were poor for later time-specific force development (r ≤ 0.12). However, poor reliability was found for force measured up to ≤0.25 seconds from the point of force onset (intraclass correlation coefficient >0.8). Owing to the relatively weak relationships with 200-m race time, and the large variability of the data, it may not be wise to include the MTP in the testing and training of 200-m kayak athletes.

Effects of Photobiomodulation/Laser Therapy Combined With Resistance Training on Quadriceps Hypertrophy and Strength, and Postural Balance in Older Women: A Randomized, Triple-Blinded, Placebo-Controlled Study

BACKGROUND AND PURPOSE

Physical and therapeutic strategies to maintain and rehabilitate skeletal muscle mass, strength, and postural balance are clinically relevant to improve the health, well-being, and quality of life of older adults. The purpose of this study was to investigate the effects of photobiomodulation (PBM)/laser therapy combined with a resistance training (RT) program on quadriceps hypertrophy and strength, and postural balance in older women.

METHODS

In a randomized, triple-blinded, placebo-controlled design, twenty-two older women (age 66.6 ± 5.2 years) were engaged in a supervised 10-wk RT program (2 times per week) involving unilateral leg extension exercise, in which each leg of the same participant was randomly assigned to receive active (λ = 808 nm, optical output = 100 mW, total energy = 42 J) or placebo laser PBM immediately before the RT sessions. Maximal dynamic strength by unilateral knee extension 1-repetition maximum (1RM), muscle hypertrophy by vastus lateralis muscle thickness, and postural balance by one-legged stance test on a force platform were assessed before and after the training program.

RESULTS

Significance statistical analysis revealed a similar improvement (time P = .003) from pre- to posttraining for muscle hypertrophy and strength, and postural balance between active and placebo laser conditions. However, clinical interpretation for muscle hypertrophy showed a moderate effect (effect size [ES] = 0.58) for the active laser and a small effect (ES = 0.38) for the placebo laser. Clinical difference was not noticed between conditions for other analyzed variables.

CONCLUSIONS

These findings indicate that RT alone can be clinically important for counteracting the deleterious effects of aging on muscle size, strength, and balance, and that applying laser PBM therapy before the RT sessions may further improve gains in muscle hypertrophy.

Leg press and chest press strength normative values by half-decades in older persons

Evaluating muscular strength is vital to the application of effective training protocols that target quality of life and independence in older individuals. Resistance training is a valuable tool to improve functional capacity, strength, and power in this population; however, the lack of normative values for common lifts such as the leg press (LP) and chest press (CP) reduce its utility. This study developed age- and sex-specific normative strength values for older individuals. LP and CP 1-repetition maximum (1RM) values on Keiser A420 pneumatic machines were compiled from 445 older adults, ages 60-85y. Descriptive statistics and quartile rankings are reported, and two-way ANOVAs were conducted to determine differences between sex and age groups. There were significant sex x age group interactions for LP and CP. Men were significantly stronger than women across all age groups for both exercises (p < .01); however, the mean difference decreased with age. For men, no differences were seen among the 60-64 (237 ± 39 kg), 65-69 (223 ± 43 kg) and 70-74 (219 ± 50 kg) age groups; but the 60-64 group showed higher strength values than the 75-79 group (193 ± 52 kg) and all three groups contained higher strength values than the 80-85 group (172 ± 40 kg). Similarly, for relative strength, the 60-64 group (2.80 ± 0.53 kg·kgBM) surpassed values for all groups but the 65-69, and the 65-69 (2.70 ± 0.54 kg·kgBM) produced greater strength values than the 70-74 (2.45 ± 0.47 kg·kgBM), 75-79 (2.09 ± 0.37 kg·kgBM) and 80-85 (2.19 ± 0.38 kg·kgBM) groups. In contrast, no significant differences in absolute or relative strength were seen among age groups for the women. Our study establishes absolute and relative age- and sex-specific normative values for the LP1RM and CP1RM in older individuals. These values allow practitioners and researchers to interpret the results of various interventions, and evaluate their importance to evaluation of sarcopenia, injury risk, functional mobility and quality of life. Additionally, our results reveal that age-related declines in strength are prominent for male LP and CP, but not female CP or LP.

Mitochondrial Content, but Not Function, Is Altered With a Multimodal Resistance Training Protocol and Adequate Protein Intake in Leucine-Supplemented Pre/Frail Women

Background: Frailty is a clinical condition associated with loss of muscle mass and strength (sarcopenia). Mitochondria are centrally implicated in frailty and sarcopenia. Leucine (Leu) can alter mitochondrial content in myocytes, while resistance training (RT) is the strongest stimulus to counteract sarcopenia and may enhance mitochondrial biogenesis. Objective: We determined the effects of Leu supplementation and RT on mitochondrial content and function in pre/frail elderly women in a randomized double-blinded placebo-controlled study. Methods: Nineteen pre/frail elderly women (77.5 ± 1.3 y, BMI: 25.1 ± 0.9 kg/m²), based on the Frailty Phenotype, underwent 3-months of RT 3×/week with protein-optimized diet and were randomized to 7.5 g/d of Leu supplementation or placebo alanine (Ala). Pre/post-intervention mitochondrial respiration, reactive oxygen species (ROS) production, calcium retention capacity (CRC), time to permeability transition pore (mPTP) opening, mitochondrial voltage-dependent anion channel (VDAC) protein content, leg press 1-repetition maximum (1RM), and 6-min walk test (6MWT) were measured. Results: No time, supplementation, or interaction effects were observed for respiration, ROS, time to mPTP opening, and CRC. VDAC levels significantly increased in the Leu group post-intervention (p = 0.012). Both groups significantly increased leg press 1RM and 6MWT, with no effect of supplementation. Discussion: Leu supplementation with 3 months of RT increased mitochondrial content. Future studies should investigate if there is an increase in mitochondrial turnover or a shift in quality control (mitophagy) in leucine supplemented pre/frail elderly women who undergo 12 weeks of RT. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT01922167.

Agreement and reliability of repeated bedside respiratory muscle strength measurements in acute and subacute stroke

BACKGROUND AND PURPOSE

Many stroke trials include maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and sniff nasal inspiratory pressure (SNIP) outcome measurements. However, data on agreement and reliability of repeated MIP, MEP, and SNIP measurements in acute and subacute stroke patients are scarce.

METHODS

This study employed a test-retest design. Eighteen patients (seven female) with mean (SD) age 59 (14.5) years were recruited from neurological wards. Median (range) time since first stroke was 50.5 (21-128) days. MIP, MEP, and SNIP were measured repeatedly in three testing sessions (S1-3) conducted within 24 h and following international standards. Intra-rater agreement between testing sessions was analyzed using the Bland-Altman method. Test-retest reliability was analyzed using intra-class correlation coefficient (ICC). Association between individual measurement variability, time poststroke, and level of stroke impairment was analyzed using Spearman's rho.

RESULTS

Mean difference and 95% limits of agreement for MIP were -0.40 (-23.02, 22.22) cmH₂ O between S1 and S2, and 2.14 (-12.79, 16.99) cmH₂ O between S2 and S3; for MEP, -4.56 (-29.01, 19.90) cmH₂ O between S1 and S2, and 0.29 (-24.28, 24.87) cmH₂ O between S2 and S3; and for SNIP, -10.56 (-38.48, 17.37) cmH₂ O between S1 and S2, and -6.06 (-27.32, 15.20) cmH₂ O between S2 and S3. ICCs for MIP, MEP, and SNIP were ≥0.9 throughout. There were no strong correlations between individual measurement variability and time poststroke or level of stroke impairment.

DISCUSSION

MIP, MEP, and SNIP in acute and subacute stroke patients show good test-retest reliability for group averages; however, absolute agreement can vary considerably for some individuals.

Effects of aerobic, resistance and concurrent exercise on pulse wave reflection and autonomic modulation in men with elevated blood pressure

The acute effects of exercise modes on pulse wave reflection (PWR) and their relationship with autonomic control remain undefined, particularly in individuals with elevated blood pressure (BP). We compared PWR and autonomic modulation after acute aerobic (AE), resistance (RE), and concurrent exercise (CE) in 15 men with stage-1 hypertension (mean ± SE: 34.7 ± 2.5 years, 28.4 ± 0.6 kg/m², 133 ± 1/82 ± 2 mmHg). Participants underwent AE, RE, and CE on different days in counterbalanced order. Applanation tonometry and heart rate variability assessments were performed before and 30-min postexercise. Aortic pressure decreased after AE (− 2.4 ± 0.7 mmHg; P = 0.01), RE (− 2.2 ± 0.6 mmHg; P = 0.03), and CE (− 3.1 ± 0.5 mmHg; P = 0.003). Augmentation index remained stable after RE, but lowered after AE (− 5.1 ± 1.7%; P = 0.03) and CE (− 7.6 ± 2.4% P = 0.002). Systolic BP reduction occurred after CE (− 5.3 ± 1.9 mmHg). RR-intervals and parasympathetic modulation lowered after all conditions (~ 30–40%; P < 0.05), while the sympathovagal balance increased after RE (1.2 ± 0.3–1.3 ± 0.3 n.u., P < 0.05). Changes in PWR correlated inversely with sympathetic and directly with vagal modulation in CE. In conclusion, AE, RE, and CE lowered central aortic pressure, but only AE and CE reduced PWR. Overall, those reductions related to decreased parasympathetic and increased sympathetic outflows. Autonomic fluctuations seemed to represent more a consequence than a cause of reduced PWR.

Assessing physical activity and function in patients with chronic kidney disease: a narrative review

Physical activity potentially improves health outcomes in patients with chronic kidney disease (CKD) and recipients of kidney transplants. Although studies have demonstrated the beneficial effects of physical activity and exercise for primary and secondary prevention of non-communicable diseases, evidence for kidney patients is limited. To enlarge this evidence, valid assessment of physical activity and exercise is essential. Furthermore, CKD is associated with a decline in physical function, which may result in severe disabilities and dependencies. Assessment of physical function may help clinicians to monitor disease progression and frailty in patients receiving dialysis. The attention on physical function and physical activity has grown and new devices have been developed and (commercially) launched on the market. Therefore the aims of this review were to summarize different measures of physical function and physical activity, provide an update on measurement instruments and discuss options for easy-to-use measurement instruments for day-to-day use by CKD patients. This review demonstrates that large variation exists in the different strategies to assess physical function and activity in clinical practice and research settings. To choose the best available method, accuracy, content, preferable outcome, necessary expertise, resources and time are important issues to consider.

Test-Retest Reliability of the One-Repetition Maximum (1RM) Strength Assessment: a Systematic Review

Background

The test–retest reliability of the one-repetition maximum (1RM) test varies across different studies. Given the inconsistent findings, it is unclear what the true reliability of the 1RM test is, and to what extent it is affected by measurement-related factors, such as exercise selection for the test, the number of familiarization trials and resistance training experience.

Objectives

The aim of this paper was to review studies that investigated the reliability of the 1RM test of muscular strength and summarize their findings.

Methods

The PRISMA guidelines were followed for this systematic review. Searches for studies were conducted through eight databases. Studies that investigated test–retest reliability of the 1RM test and presented intra-class correlation coefficient (ICC) and/or coefficient of variation (CV) were included. The COSMIN checklist was used for the assessment of the methodological quality of the included studies.

Results

After reviewing 1024 search records, 32 studies (pooled n = 1595) on test–retest reliability of 1RM assessment were found. All the studies were of moderate or excellent methodological quality. Test–retest ICCs ranged from 0.64 to 0.99 (median ICC = 0.97), where 92% of ICCs were ≥ 0.90, and 97% of ICCs were ≥ 0.80. The CVs ranged from 0.5 to 12.1% (median CV = 4.2%). ICCs were generally high (≥ 0.90), and most CVs were low (< 10%) for 1RM tests: (1) among those without and for those with some resistance training experience, (2) conducted with or without familiarization sessions, (3) with single-joint or multi-joint exercises, (4) for upper- and lower-body strength assessment, (5) among females and males, and (6) among young to middle-aged adults and among older adults. Most studies did not find systematic changes in test results between the trials.

Conclusions

Based on the results of this review, it can be concluded that the 1RM test generally has good to excellent test–retest reliability, regardless of resistance training experience, number of familiarization sessions, exercise selection, part of the body assessed (upper vs. lower body), and sex or age of participants. Researchers and practitioners, therefore, can use the 1RM test as a reliable test of muscular strength.

Optimal Approach to Load Progressions during Strength Training in Older Adults

Progressive resistance training (RT) is one of the most effective interventions for reducing age-related deficits in muscle mass and functional capacity.

PURPOSE

To compare four approaches to load progressions in RT for older adults to determine if an optimal method exists.

METHODS

Eighty-two healthy community-dwelling older adults (71.8 ± 6.2 yr) performed 11 wk of structured RT (2.5 d·wk) in treatment groups differing only by the method used to increase training loads. These included percent one repetition maximum (%1RM): standardized loads based on a percentage of the one repetition maximum (1RM); rating of perceived exertion (RPE): loads increased when perceived difficulty falls below 8/10 on the OMNI-Resistance Exercise Scale perceived exertion scale; repetition maximum (RM): loads increased when a target number of repetitions can be completed with a given load; repetitions in reserve (RiR): identical to RM except subjects must always maintain ≥1 "repetition in reserve," thus avoiding the possibility of training to temporary muscular failure.

RESULTS

Multiple analyses of covariance indicated no significant between-group differences on any strength (chest press 1RM; leg press 1RM) or functional performance outcome (usual walking speed, maximum walking speed, 8-ft timed up-and-go, gallon jug transfer test, 30 s sit-to-stand). The RPE group found the exercise to be significantly more tolerable and enjoyable than subjects in the RiR, RM, and %1RM groups.

CONCLUSION

Given the RM, RPE, %1RM, and RiR methods appear equally effective at improving muscular strength and functional performance in an older population, we conclude that the RPE method is optimal because it is likely to be perceived as the most tolerable and enjoyable, which are two important factors determining older adults' continued participation in RT.

Maximum isokinetic familiarization of the knee: Implication on bilateral assessment

PURPOSE

Familiarization is necessary for an accurate strength assessment as it reduces confounding factors such as learning and training effects. However, the number of contractions required for familiarization and whether cross-limb transfer during familiarization could affect bilateral assessment are unknown. This study aimed at identifying the number of maximum contractions required for isokinetic knee extension and flexion familiarization in both dominant (D) and non-dominant limb (ND).

METHODS

Twenty-eight right-limb dominant males (age: 22.64 ± 2.60 years, BMI: 23.82 ± 2.85 kg/m²) performed a total of 6 sets (each consisted of 5 continuous maximum contractions) at 60^o/s for each limb.

RESULTS

The number of sets required for familiarization is determined when the average peak torque achieved stabilization from the series of contractions of each limb. For knee extension, 3 sets (15 contractions) were required for familiarization, whereas 2 sets (10 contractions) for knee flexion in both limbs. Interestingly, for knee extension in ND, the number of sets required for familiarization was reduced to 2 following contralateral contractions in D, however, for knee extension in D, there was no difference in the number of sets required for familiarization following contralateral contractions in ND. While for knee flexion, no cross-limb transfer was observed. These observations suggest the presence of cross-limb transfer from D to ND during familiarization which implies the involvement of the central nervous system.

CONCLUSIONS

Practically, familiarization for bilateral isokinetic strength assessment for knee extension and flexion at 60^o/s should begin with the dominant limb for 3 sets to obtain accurate and reliable measurements.

Differences in the magnitude and reliability of velocity variables collected during 3 variants of the bench press exercise

This study aimed to compare the reliability and magnitude of velocity variables between 3 variants of the bench press (BP) exercise in participants with and without BP training experience. Thirty males, 15 with and 15 without BP experience, randomly performed 3 variants of the BP on separate sessions: (I) concentric-only, (II) fast-eccentric and (III) controlled-eccentric. The mean velocity (MV) and maximum velocity (V_max) of the concentric phase were collected against 3 loads (≈30%1RM, 50%1RM, and 75%1RM) with a linear velocity transducer. Reliability was high regardless of the variable, BP variant, and load (coefficient of variation [CV] ≤ 4.47%, intraclass correlation coefficient [ICC] ≥ 0.87). The comparison of the CVs suggested a higher reliability for the fast-eccentric BP (8 out of 12 comparisons), followed by the concentric-only BP (5 out of 12 comparisons), and finally the controlled-eccentric BP (never provided a higher reliability). No differences in reliability were observed between experienced (CV ≤ 4.71%; ICC ≥ 0.79) and non-experienced (CV ≤ 6.29%; ICC ≥ 0.76) participants. The fast-eccentric BP provided the highest MV (p < 0.05) and no differences were observed for V_max. These results support the assessment of movement velocity during the fast-eccentric BP even in participants without experience.

A single whole body vibration session influences quadriceps muscle strength, functional mobility and balance of elderly with osteopenia and/or osteoporosis? Pragmatic clinical trial

BACKGROUND

The purpose of this study verify the immediate effect of whole body vibration (WBV) on quadriceps muscle strength, functional mobility and balance in elderly patients with Osteopenia and/or Osteoporosis.

METHODS

This was a randomized pragmatic clinical trial with 34 elderly (32 women) randomly assigned to two groups: the experimental group (EG; n = 17) who underwent low-frequency (16 Hz) WBV and the control group (CG; n = 17) who performed the walk. Outcome measures were: quadriceps muscle strength measured by a maximal repetition test (1RM); functional mobility assessed by the Timed Up and Go (TUG) test and balance assessed by the Berg Balance Scale (BBS).

RESULTS

In within-group interaction, a significant increase was observed in quadriceps muscle strength (EG:p = 0.047) and balance (EG: p = 0,012; CG: p = 0,007). In between-groups interaction, a significant difference was not observed. There was an increase in the muscular strength of the EG and in the balance in both groups.

CONCLUSION

An WBV training session was able to alter the muscular strength of the LQ and the balance of the elderly with Osteopenia and/or Osteoporosis. It is suggested, however, that future studies involving larger sample number and/or populations should be developed to analyze the short-term effects of WBV.

CORP: Measurement of upper and lower limb muscle strength and voluntary activation

Muscle strength, the maximal force-generating capacity of a muscle or group of muscles, is regularly assessed in physiological experiments and clinical trials. An understanding of the expected variation in strength and the factors that contribute to this variation is important when designing experiments, describing methodologies, interpreting results, and attempting to replicate methods of others and reproduce their findings. In this review (Cores of Reproducibility in Physiology), we report on the intra- and inter-rater reliability of tests of upper and lower limb muscle strength and voluntary activation in humans. Isometric, isokinetic, and isoinertial strength exhibit good intra-rater reliability in most samples (correlation coefficients ≥0.90). However, some tests of isoinertial strength exhibit systematic bias that is not resolved by familiarization. With the exception of grip strength, few attempts have been made to examine inter-rater reliability of tests of muscle strength. The acute factors most likely to affect muscle strength and serve as a source of its variation from trial-to-trial or day-to-day include attentional focus, breathing technique, remote muscle contractions, rest periods, temperature (core, muscle), time of day, visual feedback, body and limb posture, body stabilization, acute caffeine consumption, dehydration, pain, fatigue from preceding exercise, and static stretching >60 s. Voluntary activation, the nervous system’s ability to drive a muscle to create its maximal force, exhibits good intra-rater reliability when examined with twitch interpolation (correlation coefficients >0.80). However, inter-rater reliability has not been formally examined. The methodological factors most likely to influence voluntary activation are myograph compliance and sensitivity; stimulation location, intensity, and inadvertent stimulation of antagonists; joint angle (muscle length); and the resting twitch.

High 1RM Tests Reproducibility and Validity are not Dependent on Training Experience, Muscle Group Tested or Strength Level in Older Women

Background: The maximal one-repetition test (1-RM) is widely used in scientific research; however, there are conflicting results regarding its reproducibility in elderly populations. The present study aimed to analyze the reproducibility of the test both before and after a 12-week training period by using the bench press and leg press 45° 1-RM tests in the elderly, taking into consideration the training experience and strength level of the women. Methods: Elderly women (n = 376; age, 68.5 ± 14.1 years; height, 162.7 ± 5.5 cm; body mass, 71.2 ± 16.0 kg) who underwent ≥3 months of resistance training performed an initial week of familiarization and a second week of testing and retest, with a 48–72 h interval. Results: The results showed that Kappa indices ranged from 0.93 to 0.95, and the intraclass correlation coefficients were 0.99 for both the lower and upper limbs. In addition, minimal detectable changes were found that ranged between 1 and 3%, which means that changes lower than 1 kg could be detected. Conclusion: The present study confirms that the 1-RM test has high reliability and reproducibility in the elderly, for both upper and lower limbs.

Different protein and derivatives supplementation strategies combined with resistance training in pre-frail and frail elderly: Rationale and protocol for the "Pro-Elderly" Study

BACKGROUND

Frailty is a multifactorial geriatric syndrome characterized by progressive decline in health and associated with decreased muscle mass, strength, and functional capacity. Resistance training (RT) combined with protein or amino acids supplementation has been shown to be promising for mitigating age-related impairments.

AIM

To investigate the chronic effects of different strategies of protein and derivatives supplementation in association with RT on selected health-related parameters in pre-frail and frail elderly.

METHODS

This is a series of double-blind, randomized, placebo-controlled, parallel-group clinical trials. Volunteers will be divided into nine groups, comprising four different sub-studies evaluating the effects of: isolated leucine supplementation (study 1); protein source (whey vs. soy - study 2); combination of whey protein and creatine (study 3); and sexual dimorphism on the response to protein intake and RT (males vs. females - study 4). Muscle cross-sectional area, fiber cross-sectional area, body composition, lower-limb maximal dynamic and isometric strength, functionality, lipid profile, biochemical parameters, renal function, quality of life, and nutritional status will be assessed before and after a 16-week intervention period. Data will be tested for normality and a mixed-model for repeated measures will be conducted to assess within- and between-group effects of the intervention on the dependent variables. Confidence intervals (95%), effect sizes, and relative changes will also be determined, with significance set at p < 0.05.

The Effects of Resistance Exercise on Biomarkers of Breast Cancer Prognosis: A Pooled Analysis of Three Randomized Trials

Background: Using a secondary data analysis from randomized controlled trials comparing one year of resistance exercise (n = 109) to a placebo control condition (n = 106) in postmenopausal, posttreatment breast cancer survivors, we investigated the influence of resistance training and changes in body composition on markers associated with cancer progression.Methods: Measures included serum levels of insulin, IGF-1, IGFBP1-3, leptin, serum amyloid A (SAA), adiponectin, C-reactive protein (CRP), IL1β, TNFα, IL6, and IL8, and body composition (total, lean and fat mass in kg) by DXA at baseline, 6, and 12 months. Linear mixed effects models were used to examine the association between group, biomarkers, and body composition and whether or not changes in muscle strength or body composition influenced the effect of exercise on biomarkers.Results: CRP decreased over time among women participating in resistance training compared with increases in controls (P = 0.045). In stratified analyses and compared with increases in controls, women who gained strength reduced CRP (P = 0.003) and maintained levels of IL1β and IL6. Among exercisers who lost weight (≥2 kg), CRP (P = 0.045), leptin (P < 0.01), and SAA (P = 0.029) decreased, whereas IGF-BP1 (P = 0.036) increased compared with controls.Conclusions: Resistance training may lower inflammation and improve insulin pathway profiles, but the magnitude and degree of benefit from exercise may depend upon whether or not women gained strength, a possible marker of compliance with training, and/or lost weight during exercise.Impact: Future resistance training trials should consider these potential influencing factors as they may determine how well exercise can slow cancer progression and prevent disease recurrence. Cancer Epidemiol Biomarkers Prev; 27(2); 146-53. ©2017 AACR.

Fractionated Concurrent Exercise throughout the Day Does Not Promote Acute Blood Pressure Benefits in Hypertensive Middle-aged Women

Hypertension is a chronic disease that affects about 30% of the world’s population, and the physical exercise plays an important role on its non-pharmacological treatment. Anywise, the dose–response of physical exercise fractionation throughout the day demands more investigation, allowing new exercise prescription possibilities. Therefore, this study aimed to analyze the acute blood pressure (BP) kinetics after 1 h of exercises and the BP reactivity after different concurrent exercise (CE) sessions and its fractioning of hypertensive middle-aged women. In this way, 11 hypertensive women voluntarily underwent three experimental sessions and one control day [control session (CS)]. In the morning session (MS) and night session (NS), the exercise was fully realized in the morning and evening, respectively. For the fractionized session (FS), 50% of the volume was applied in the morning and the remaining 50% during the evening. The MS provided the greatest moments (p ≤ 0.05) of post-exercise hypotension (PEH) for systolic BP (SBP) and highest reduction of BP reactivity for SBP (~44%) and diastolic BP (DBP) (~59%) compared to CS (p ≤ 0.05). The findings of the present study have shown that MS is effective for PEH to SBP, as well as it promotes high quality of attenuation for BP reactivity, greater than the other sessions.

Effect of Preexercise Creatine Ingestion on Muscle Performance in Healthy Aging Males

Preexercise creatine supplementation may have a beneficial effect on aging muscle performance. Using a double-blind, repeated measures, crossover design, healthy males (N = 9, 54.8 ± 4.3 years; 92.9 ± 11.5 kg; 179.2 ± 11.1 cm) were randomized to consume creatine (20 g) and placebo (20 g corn starch maltodextrin), on 2 separate occasions (7 days apart), 3 hours before performing leg press and chest press repetitions to muscle fatigue (3 sets at 70% 1-repetition maximum; 1 minute rest between sets). There was a set main effect (p ≤ 0.05) for the leg press and chest press with the number of repetitions performed decreasing similarly for creatine and placebo. These results suggest that a bolus ingestion of creatine consumed 3 hours before resistance exercise has no effect on upper or lower-body muscle performance in healthy aging males.

Muscle strength testing with one repetition maximum in the arm/shoulder for people aged 75 + - test-retest reliability

Objective: To investigate the reliability of a muscle strength test of the arm/shoulder in elderly people, aged 75 and older, and to compare subjects with and without previous muscle strength training experience.

Design: Reliability study - test-retest.

Setting: Research centre for the elderly.

Main measures: One repetition maximum (1 RM) was measured using an arm/shoulder strength-training device (Pull Down, Norway). Two measurements were conducted, approximately one week apart.

Results: Forty people were included in the study and 34 completed both sessions. Eleven participants had previous muscle strength training experience on the indicated device. There was a high correlation between the test sessions, r = 0.97 for both groups. The analysis of 95% limits of agreement for the mean difference was -4.3/+6.9 kg for the group without and -3.0/+6.4 kg for the group with previous experience, respectively.

Conclusion: One repetition maximum evaluated by the Pull Down device seems to be a reliable and safe method for dosing and evaluating a muscle strength training programme for elderly people. The observed variation of approximately -4/+7 kg cannot be interpreted as an effect of muscle training, but is more likely an effect of learning, fluctuations in daily condition and/or motivation.

The effect of exercise of the affected foot in stroke patients-a randomized controlled pilot trial

Objective: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients.

Design: A randomized controlled pilot study.

Setting: A research centre.

Subjects: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle.

Interventions: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period.

Main measures: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life.

Results: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups.

Conclusion: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.

The effects of water-based exercise in combination with blood flow restriction on strength and functional capacity in post-menopausal women

Water-based exercise and low-intensity exercise in combination with blood flow restriction (BFR) are two methods that have independently been shown to improve muscle strength in those of advancing age. The objective of this study was to assess the long-term effect of water-based exercise in combination with BFR on maximum dynamic strength and functional capacity in post-menopausal women. Twenty-eight women underwent an 8-week water-based exercise program. The participants were randomly allocated to one of the three groups: (a) water exercise only, (b) water exercise + BFR, or (c) a non-exercise control group. Functional capacity (chair stand test, timed up and go test, gait speed, and dynamic balance) and strength testing were tested before and after the 8-week aquatic exercise program. The main findings were as follows: (1) water-based exercise in combination with BFR significantly increased the lower limb maximum strength which was not observed with water-based exercise alone and (2) water-based exercise, regardless of the application of BFR, increased functional performance measured by the timed up and go test over a control group. Although we used a healthy population in the current study, these findings may have important implications for those who may be contraindicated to using traditional resistance exercise. Future research should explore this promising modality in these clinical populations.

Strategic creatine supplementation and resistance training in healthy older adults

Creatine supplementation in close proximity to resistance training may be an important strategy for increasing muscle mass and strength; however, it is unknown whether creatine supplementation before or after resistance training is more effective for aging adults. Using a double-blind, repeated measures design, older adults (50–71 years) were randomized to 1 of 3 groups: creatine before (CR-B: n = 15; creatine (0.1 g/kg) immediately before resistance training and placebo (0.1 g/kg cornstarch maltodextrin) immediately after resistance training), creatine after (CR-A: n = 12; placebo immediately before resistance training and creatine immediately after resistance training), or placebo (PLA: n = 12; placebo immediately before and immediately after resistance training) for 32 weeks. Prior to and following the study, body composition (lean tissue, fat mass; dual-energy X-ray absorptiometry) and muscle strength (1-repetition maximum leg press and chest press) were assessed. There was an increase over time for lean tissue mass and muscle strength and a decrease in fat mass (p < 0.05). CR-A resulted in greater improvements in lean tissue mass (Δ 3.0 ± 1.9 kg) compared with PLA (Δ 0.5 ± 2.1 kg; p < 0.025). Creatine supplementation, independent of the timing of ingestion, increased muscle strength more than placebo (leg press: CR-B, Δ 36.6 ± 26.6 kg; CR-A, Δ 40.8 ± 38.4 kg; PLA, Δ 5.6 ± 35.1 kg; chest press: CR-B, Δ 15.2 ± 13.0 kg; CR-A, Δ 15.7 ± 12.5 kg; PLA, Δ 1.9 ± 14.7 kg; p < 0.025). Compared with resistance training alone, creatine supplementation improves muscle strength, with greater gains in lean tissue mass resulting from post-exercise creatine supplementation.

Is the self-selected resistance exercise intensity by older women consistent with the American College of Sports Medicine guidelines to improve muscular fitness?

The purpose of this study was to verify the self-selected intensity during resistance training (RT) in older women. Twenty healthy women (mean age, 65.6 years) underwent a 2-week familiarization period followed by 3 experimental sessions. During the first session, anthropometric measurements were taken. The second session involved completion of a 1 repetition maximum (1RM) test for the following exercises: chest press, leg press, lat pull-down, leg extension, lateral shoulder raise, leg curl, biceps curl, and triceps pushdown. Last, a single RT session was performed at a self-selected intensity. During the RT session, participants were instructed to self-select a load for performing 3 sets of 10-15 repetitions. Data were analyzed by mean (SD) and analysis of variance with repeated measures (p < 0.05). Global mean of the 3 sets was bench press 41.0% 1RM (11.9), leg press 43.0% 1RM (17.2), lat pull-down 47.2% 1RM (11.1), leg extension 33.0% 1RM (8.1), lateral shoulder raise 51.1% 1RM (12.1), leg curl 43.5% 1RM (8.8), biceps curl 48.0% 1RM (15.5), and triceps pushdown 51.7% 1RM (13.3); there were no significant differences between the sets (p > 0.05). These results indicate that inactive older women self-selected an intensity exercise during RT below the recommendation for improvements on muscle fitness in apparently healthy older adults. However, this intensity is recommended for very deconditioned individuals. Nevertheless, the use of self-selection strategy during an exercise program can have greater advantages because of its easy applicability, its positive relation with exercise adherence, and for promoting initial muscle conditioning in older adults. Furthermore, it is crucial to gradually increase the RT load to guarantee better and sustainable effects on muscle fitness. Finally, future studies are needed to establish the chronic effects of RT at self-selected intensity on muscle fitness and the functional health of older adults.

Resistance exercise performance variability at submaximal intensities in older and younger adults

We assessed the variability in the number of repetitions completed at submaximal loads in three resistance tasks in older (N=32, 16 female, 74.3±5.4 years) and younger (N=16, 8 female, 22.8±1.8 years) men and women. One repetition maximum (1RM) was determined on two separate visits on three tasks: leg press (LP), leg extension (LE), and bicep curl (BC). Subjects then completed repetitions to failure on each of the three tasks during two visits, a minimum of 48 hours apart, at either 60% 1RM or 80% 1RM. High reliability for all 1RM assessments was observed. Greater muscular strength was observed in younger compared to older men and women on all tasks (P<0.05). At both 60% and 80% 1RM, considerable interindividual variability was observed in the number of repetitions completed. However, the average number of repetitions completed by younger and older men and women at 60% and 80% 1RM in each of the three tasks was similar, with the only significant difference occurring between younger and older men at 80% 1RM on the leg press (P=0.0258). We did not observe any abnormal blood pressure responses to either the 1RM testing or maximal repetition testing sessions. Considerable interindividual variability was observed in the number of repetitions completed by younger and older men and women at relative intensities typical of resistance training programs. Practitioners should give consideration to individual variability when attempting to maximize the benefits of resistance training.

Validity and reliability of isometric, isokinetic and isoinertial modalities for the assessment of quadriceps muscle strength in patients with total knee arthroplasty

Reliability of isometric, isokinetic and isoinertial modalities for quadriceps strength evaluation, and the relation between quadriceps strength and physical function was investigated in 29 total knee arthroplasty (TKA) patients, with an average age of 63 years. Isometric maximal voluntary contraction torque, isokinetic peak torque, and isoinertial one-repetition maximum load of the involved and uninvolved quadriceps were evaluated as well as objective (walking parameters) and subjective physical function (WOMAC). Reliability was good and comparable for the isometric, isokinetic, and isoinertial strength outcomes on both sides (intraclass correlation coefficient range: 0.947-0.966; standard error of measurement range: 5.1-9.3%). Involved quadriceps strength was significantly correlated to walking speed (r range: 0.641-0.710), step length (r range: 0.685-0.820) and WOMAC function (r range: 0.575-0.663), independent from the modality (P < 0.05). Uninvolved quadriceps strength was also significantly correlated to walking speed (r range: 0.413-0.539), step length (r range: 0.514-0.608) and WOMAC function (r range: 0.374-0.554) (P < 0.05), except for WOMAC function/isokinetic peak torque (P > 0.05). In conclusion, isometric, isokinetic, and isoinertial modalities ensure valid and reliable assessment of quadriceps muscle strength in TKA patients.

Reliability and effects of muscular pretension on isometric strength of older adults

There were two objectives to this study: (a) to determine the reliability of measuring isometric maximum torque (MT) and maximum rate of torque development (MRTD) of the knee extensor and flexor muscles and (b) to assess the effects of different muscular pretensions on MT and MRTD of older adults. Maximum strength of 35 untrained healthy older adults (aged 66.9 ± 6.6 years; height 1.72 ± 0.07 m; weight 75.2 ± 9.6 kg) was measured. Strength measurement was performed with the Dr. Wolff ISO Check using a piezo-electric force transducer. MT intra-day coefficient of variation (CV) was between 3.30 and 12.40 % for both measurement sessions. Intraclass correlation coefficients (ICC) ranging from 0.71 to 0.99 showed good relative reliability. MT test–retest reliability (between sessions 1 and 2) of knee extension reached a CV between 7.10 and 9.30 % and high ICC values. The measurement of the knee flexion achieved an acceptable CV (9.40 %) at 40 % muscular pretension. MRTD was negatively influenced by muscular pretension (p <0.05). In conclusion, MT could be measured reliably over different trials using isometric strength measurement. The test–retest reliability was acceptable at knee extension with 10 to 40 % muscular pretension and with 40 % muscular pretension at knee flexion. A higher muscular pretension has no impact on MT but decreases MRTD in older adults.

Upper extremity muscle volumes and functional strength after resistance training in older adults

Aging leads to a decline in strength and an associated loss of independence. The authors examined changes in muscle volume, maximum isometric joint moment, functional strength, and 1-repetition maximum (1RM) after resistance training (RT) in the upper extremity of older adults. They evaluated isometric joint moment and muscle volume as predictors of functional strength. Sixteen healthy older adults (average age 75 ± 4.3 yr) were randomized to a 6-wk upper extremity RT program or control group. The RT group increased 1RM significantly (p < .01 for all exercises). Compared with controls, randomization to RT led to greater functional pulling strength (p = .003), isometric shoulder-adduction moment (p = .041), elbow-flexor volume (p = .017), and shoulder-adductor volume (p = .009). Shoulder-muscle volumes and isometric moments were good predictors of functional strength. The authors conclude that shoulder strength is an important factor for performing functional reaching and pulling tasks and a key target for upper extremity RT interventions.

Segurança, reprodutibilidade, fatores intervenientes e aplicabilidade de testes de 1-RM

Um dos métodos mais utilizados para mensuração da força muscular é o teste de uma repetição máxima (1-RM), tendo em vista a sua versatilidade para aplicação em diferentes exercícios, a especificidade do movimento e o baixo custo operacional. Neste trabalho discutimos as evidências disponíveis a respeito da segurança, da reprodutibilidade, dos fatores intervenientes e da aplicabilidade prática do teste de 1-RM. Com base nas informações disponíveis até o presente momento, o teste de 1-RM parece ser um método seguro do ponto de vista ortopédico e cardiovascular e a sua reprodutibilidade depende, fundamentalmente, da realização de procedimentos de testagem adequados para a estabilização da carga, assim como do controle dos fatores intervenientes os quais podem influenciar no desempenho do teste. Embora a aplicabilidade para o diagnóstico e acompanhamento da força muscular seja ampla, a utilização de testes de 1-RM para a prescrição de treinamento com pesos ainda é bastante discutível.

Peak power output provides the most reliable measure of performance in prolonged intermittent-sprint cycling

The aims of this study were to determine the reliability of an intermittent-sprint cycling protocol and to determine the efficacy of one practice session on main trials. Eleven men, moderately trained team-sport athletes, completed three visits to the laboratory involving a graded-exercise test and practice session and two trials of a cycling intermittent-sprint Protocol separated by three days. Data for practice and main trials were analysed using typical error of measurement, intra-class correlation and least-products regression to determine reliability. Typical error of measurement (expressed as a coefficient of variation) and intra-class correlation for peak power output from all 20 sprints for trial 1 and trial 2 were 2.9 ± 12.8% (95% confidence interval: 2.0-5.0%) and 0.96 (95% confidence interval: 0.85-0.99), respectively. Typical errors of measurement and intra-class correlation for mean power output for all 20 sprints for trials 1 and 2 were 4.2 ± 11.9% (95% confidence interval: 2.9-7.4%) and 0.90 (95% confidence interval: 0.66-0.97), respectively. The results suggest that peak power output provides a more reliable measure than mean power output. The Cycling Intermittent-Sprint Protocol provides reliable measures of intermittent-sprint performance.

Physical Capability Scale

The purpose of this study was to describe the psychometric testing of the Basic Physical Capability Scale. The study was a secondary data analysis of combined data sets from three studies. Study participants included 93 older adults, recruited from 2 acute-care settings and 110 older adults living in long-term care facilities. Rasch analysis was used for the testing of the measurement model. There was some support for construct validity based on the fit of the items to the scale across both samples. In addition, there was support for hypothesis testing as physical function was significantly associated with physical capability. There was evidence for internal consistency (Alpha coefficients of .77-.83) and interrater reliability based on an intraclass correlation of .81. This study provided preliminary support for the reliability and validity of the Basic Physical Capability Scale, and guidance for scale revisions and continued use.