Behavior of the muscle quality index and isometric strength in elderly women

Intra-session reliability of isometric muscle strength of the bilateral standing press in female handball players

Background

Systematizing reliable protocols and procedures for strength assessment in handball has allowed for a more thorough kinetic analysis and increased precision in detecting training-induced changes in muscular strength. The evaluation of upper limb strength with a bilateral standing press (BSP) exercise in handball players approximates blocking actions in the defensive phase, pushing and fixation.

Aim

The aim of this study was to analyze the relative and absolute reliability of intra-session comparisons in an isometric peak muscle strength protocol in a bilateral standing press (BSP) exercise among female handball players.

Methods

Sixteen young female handball players at an international level, aged between 22 ± 4 years, with no prior experience in using functional electromechanical dynamometers (FEMD) participated in this study. The participants initiated the assessment of maximum isometric force in a bipedal stance with a forward projection of the dominant foot between 20 and 30 cm. The knees were kept semi-flexed, and the hip extension of the non-dominant limb ranged from 15 to 20°. Bilateral anterior push of the upper limb was performed with shoulder abduction and elbow flexion at 90°, maintaining a pronated hand position. Participants were instructed to exert three sets of maximal force for 5 s in BSP exercise. Relative reliability was assessed using the model intraclass correlation (ICC) and absolute reliability was assessed using the coefficient of variation (CV) and standard error of measurement (SEM). For this study, the parameters of maximum and mean muscle strength were considered.

Results

The results demonstrated high relative reliability (ICC 0.93-0.97) and absolute reliability (SEM 0.19-2.79) y (CV 4.78-9.03) for both mean force and peak force, with no significant differences between the sets (p > 0.05), indicating a negligible effect size (0.01-0.12).

Conclusion

The mean and peak isometric muscle strength for the BSP exercise controlled with FEMD in female handball players exhibits high relative and absolute reliability between series.

Test-Retest Reliability of an Isometric and Isometric/Vibratory Muscular Strength Protocol with Functional Electro-Mechanical Dynamometry

The purpose of the study was to analyze the test-retest reliability of an isometric and isometric/vibratory muscular strength protocol in the bilateral seated bench press (BSBP), bilateral seated rowing (BSR), unilateral seated right knee extension (USKER), and left knee extension (USKEL) tests controlled using functional electromechanical dynamometry (FEMD) in healthy young adults. A repeated measures design was used to determine the reliability of a muscular strength protocol in isometric and isometric vibration modes with FEMD. No significant differences were found in test-retest analysis (p > 0.05; ES < 0.20); and high reliability (CV = 4.65-5.02%; ICC = 0.99-0.98) was found for BSBP measures, and acceptable reliability (CV = 3.71-9.61%; ICC = 0.98-0.95) was found for BSR, USKER, and USKEL. Furthermore, the coefficients between the two measures were strong (r = 0.963-0.839) and highly significant (p = 0.001) for maximal strength in the isometric and maximal isometric/vibratory assessment of muscle strength in all muscle strength tests. This study demonstrates that isometric and maximal isometric/vibratory strength in the BSBP, BSR, USKER, and USKEL tests can be measured with high reliability and reproducibility using the FEMD.

The reliability and suitability of strength assessments in frail and pre-frail older adults: recommendations for strength testing in older populations

BACKGROUND

Lifelong strength is fundamental to physical function, health, and quality of life. Reliable appropriate strength assessment measures for older adults play an important role in effective evaluation of baseline ability and exercise prescription to counter disease and disuse. This study aimed to investigate the within-session reliability of maximal isometric knee extension and flexion, hip abduction and adduction, and handgrip strength measures in frail and pre-frail older adults.

METHOD

The study was conducted at a residential care home in Birmingham, UK. All care home residents aged ≥ 65 years; pre-frail or frail according to the Fried Frailty phenotype criteria; able to speak and read English; not currently involved in any other clinical trial; without severe sensory impairments; and with a predicted life expectancy greater than the trial length were eligible. Maximal isometric lower limb testing was performed using specialised resistance training equipment and a portable measurement device, and grip strength was assessed using a portable dynamometer. All eligible participants attended a single testing session and performed three trials per measure. Peak force measures were obtained for analysis. Within-session reliability for each measure was calculated from repeated-measures analysis of variance, intraclass correlation coefficients (ICC), and coefficients of variation (CV) with 95% confidence intervals.

RESULTS

Eleven frail and eleven pre-frail older adults participated in the study. Within-session absolute and relative measures were found to be reliable with the highest overall repeatability indicated between trial 2 and trial 3 for knee extension, hip abduction, and handgrip (CV ≤ 4.65%, ICC ≥ 0.96) with variation evident across all measures, except knee extension, from trial 1 to 2.

CONCLUSIONS

Overall, maximal isometric strength in frail and pre-frail older adults with no previous testing experience can be measured with good to high reliability within their first testing session. An initial two familiarisation trials followed by two measurement trials is recommended to achieve the highest level of overall repeatability.

TRIAL REGISTRATION

The trial was registered with ClinicalTrials.gov: NCT03141879 on 05/05/2017.

Effect of sit-to-stand-based training on muscle quality in sedentary adults: a randomized controlled trial

The aim of this study was to compare the effects of sit-to-stand (STS) training programs with 5 vs. 10 repetitions on muscle architecture and muscle function in sedentary adults. Sixty participants were randomly assigned into three groups: five-repetition STS (5STS), 10-repetition STS (10STS), or a control group (CG). Participants performed three sets of five or 10 repetitions of the STS exercise three times per week for 8 weeks. Before and after 8 weeks, all groups performed ultrasound measures to evaluate muscle thickness (MT), pennation angle (PA), and fascicle length (FL), and the five-repetition STS test to estimate the relative STS power and muscle quality index (MQI). After 8 weeks, both experimental groups improved MQI (40-45%), relative STS power (29-38%), and MT (8-9%) (all p < 0.001; no differences between the 5STS vs. 10STS groups). These improvements in both groups resulted in differences regarding the CG, which did not present any change. In addition, only the 5STS group improved PA (15%; p = 0.008) without differences to the 10STS and CG.This suggests that STS training is time-effective and low-cost for improving muscle function and generating adaptations in muscle architecture.

Feasibility of the 30 s Sit-to-Stand Test in the Telehealth Setting and Its Relationship to Persistent Symptoms in Non-Hospitalized Patients with Long COVID

Fatigue, dyspnea and pain are the main limitations of patients with long COVID. The aim of this study was to determine the feasibility of the 30 s sit-to-stand (30s-STS) test in the telehealth setting and its relationship to persistent symptoms in a sample of non-hospitalized patients with long COVID. A cross-sectional study was conducted in community patients with long COVID. Data collection and assessments were performed by videoconference and consisted of the fatigue assessment scale (FAS), London activity of daily living scale (LCADL), post-COVID-19 functional status (PCFS) and European quality of life questionnaire (EQ-5D-5L), including the pain/discomfort dimension. The 30s-STS test was performed using a standardized protocol adapted for remote use, and the modified Borg scale (0−10) was used to assess dyspnea and lower limb fatigue immediately after the test. The feasibility of the 30s-STS test was assessed by the proportion of eligible participants who were able to complete the test. Safety was assessed by the number of adverse events that occurred during the test. Seventy-nine participants were included (median age: 44 years, 86.1% women). Performance in the 30s-STS test was 11.5 ± 3.2 repetitions with 60.8% of the sample below reference values. All eligible participants were able to complete the test. No adverse events were reported during the evaluation. Participants with lower 30s-STS performance had more fatigue and dyspnea, worse quality of life, more severe pain/discomfort, and worse functional status (p < 0.05). A significant correlation was obtained between LCADL and dyspnea, reported on the Borg scale (0−10) post 30s-STS (r = 0.71; p < 0.001). In conclusion, the 30s-STS test proved to be a feasible test to implement in the telehealth setting and is related to fatigue, dyspnea, quality of life and pain in non-hospitalized patients with long COVID. Clinicians may use this test when assessment of the physical sequelae of COVID-19 in the face-to-face setting is not possible.

Muscle Quality of Knee Extensors Based on Several Types of Force in Multiple Sclerosis Patients with Varying Degrees of Disability

Background and Objectives: Multiple sclerosis (MS) tends to affect muscle performance, mainly in the lower extremities. The degree of disability is associated with the loss of strength and muscle mass, to varying extents. Muscle quality (MQ) expresses the amount of force produced relative to the activated muscle mass. The purpose of this study was to compare the MQ of the knee extensors in the main manifestations of strength (isometric, dynamic strength, and power) among patients with differing degrees of neurological disability and evolutionary forms of the disease. We also establish reference values for MQ in MS patients (pwMS). Materials and Methods: In total, 250 pwMS were evaluated according to the Expanded Disability Status Scale (EDSS). The maximum dynamic and isometric forces and muscle power manifested a load of 60% of the maximum dynamics of the knee extensors. The lean mass of the thigh and hip was determined by densitometry, and the MQ was calculated for the three types of force evaluated. Results: The pwMS with relapsing remitting MS (RRMS) presented isometric MQ values that were 15.8% better than those of pwMS with primary progressive MS (PPMS) and 13.8% better than those of pwMS with secondary progressive MS (SPMS). For pwMS with SPMS, the dynamic MQ was 16.7% worse than that of patients with RRMS, while the power MQ was 29.5% worse. By degree of disability (<4 >7.5 EDSS score), patients with better MQ had mild EDSS scores, and patients with severe EDSS scores had 24.8%, 25.9%, and 40.3% worse isometric, dynamic, and power MQ scores, respectively, than those with RRMS. Based on these results, reference values for MQ in pwMS were established. Conclusions: The pwMS with different types of MS do not show differences in lean mass or strength but do show differences in MQ. In pwMS with different EDSS grades, there are no differences in lean mass, but there are differences in strength based on MQ, especially power MQ.

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors

Introduction

After hospitalization, early detection of musculoskeletal sequelae might help healthcare professionals to improve and individualize treatment, accelerating recovery after COVID-19. The objective was to determine the association between the 30s sit-to-stand muscle power (30s-STS) and cross-sectional area of the chest muscles (pectoralis) in COVID-19 survivors.

Method

This cross-sectional study collected routine data from COVID-19 survivors one month after hospitalization: 1) a chest computed tomography (CT) scan and 2) a functional capacity test (30s-STS). The pectoralis muscle area (PMA) was measured from axial CT images. For each gender, patients were categorized into tertiles based on PMA. The 30s-STS was performed to determine the leg extension power. The allometric and relative STS power were calculated as absolute 30s-STS power normalized to height squared and body mass. The two-way ANOVA was used to compare the gender-stratified tertiles of 30s-STS power variants.

Results

Fifty-eight COVID-19 survivors were included (mean age 61.2 ± 12.9 years, 30/28 (51.7%/48.3%) men/women). The two-way ANOVA showed significant differences between the PMA tertiles in absolute STS power (p = .002) and allometric STS power (p = .001). There were no significant gender x PMA tertile interactions (all variables p > .05). The high tertile of PMA showed a higher allometric STS power compared to the low and middle tertile, p = .002 and p = .004, respectively. Absolute STS power and allometric STS power had a moderate correlation with the PMA, r = 0.519 (p < .001) and r = 0.458 (p < .001) respectively.

Conclusion

The 30s-STS power is associated with pectoralis muscle thickness in both male and female COVID-19 survivors. Thus, this test may indicate global muscle-wasting and may be used as a screening tool for lower extremity functional capacity in the early stages of rehabilitation planning in COVID-19 survivors.

Test-retest reliability of a functional electromechanical dynamometer on swing eccentric hamstring exercise measures in soccer players

Background

The use of a functional electromechanical dynamometer (FEMD) has been proposed as a valid and effective tool to evaluate specific movement patterns. The aim of this study was to determine the reliability of FEMD on swing eccentric hamstring exercise (SEHE) measures in soccer players.

Methods

Nineteen federated male soccer players (20.74 ± 4.04 years) performed the SEHE at three different isokinetic velocities (20–40–60 cm/s). These evaluations were conducted in four sessions, two for familiarization and two for registration. The average and maximum load (N) of the three isokinetic velocities was calculated from the values obtained from the FEMD (Dynasystem^®, Bangalore).

Results

The main results of this research showed that the reliability was high for the average load in the condition of 40 cm/s, presenting the highest ICC value (0.94). For maximum load, reliability was high in the condition of 20 cm/s. The manifestation of the most reliable load was the maximum load (ICC = 0.91–0.87).

Conclusions

FEMD (Dynasystem^®, Bangalore) is a reliable device to evaluate the eccentric strength of the hamstring muscles in soccer players.

Test-Retest Reliability of Functional Electromechanical Dynamometer on Five Sit-to-Stand Measures in Healthy Young Adults

Background: The purpose of this study was to determine the reliability for the strength and movement velocity of the concentric phase from the five Sit-to-Stand (5STS), using three incremental loads measured by a functional electromechanical dynamometer (FEMD) in healthy young adults. Methods: The average and peak strength and velocity values of sixteen healthy adults (mean ± standard deviation (SD): age = 22.81 ± 2.13 years) were recorded at 5, 10 and 15 kg. To evaluate the reliability of FEMD, the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and coefficient of variation (CV) were obtained. Results: Reliability was high for the 10 kg (CV range: 3.70–4.18%, ICC range: 0.95–0.98) and 15 kg conditions (CV range: 1.64–3.02%, ICC: 0.99) at average and peak strength, and reliability was high for the 5 kg (CV range: 1.71–2.84%, ICC range: 0.96–0.99), 10 kg (CV range: 0.74–1.84%, ICC range: 0.99–1.00) and 15 kg conditions (CV range: 0.79–3.11%, ICC range: 0.99–1.00) at average and peak velocity. Conclusions: The findings of this study demonstrate that FEMD is a reliable instrument to measure the average and peak strength and velocity values during the five STS in healthy young adults.