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Beshara P, Davidson I, Pelletier M, Walsh WR. The Intra- and Inter-Rater Reliability of a Variety of Testing Methods to Measure Shoulder Range of Motion, Hand-behind-Back and External Rotation Strength in Healthy Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14442. [PMID: 36361321 PMCID: PMC9653808 DOI: 10.3390/ijerph192114442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
This study determined the intra- and inter-rater reliability of various shoulder testing methods to measure flexion range of motion (ROM), hand-behind-back (HBB), and external rotation (ER) strength. Twenty-four healthy adults (mean age of 31.2 and standard deviation (SD) of 10.9 years) without shoulder or neck pathology were assessed by two examiners using standardised testing protocols to measure shoulder flexion with still photography, HBB with tape measure, and isometric ER strength in two abduction positions with a hand-held dynamometer (HHD) and novel stabilisation device. Intraclass correlation coefficient (ICC) established relative reliability. Standard error of measurement (SEM) and minimum detectable change (MDC) established absolute reliability. Differences between raters were visualised with Bland-Altman plots. A paired t-test assessed for differences between dominant and non-dominant sides. Still photography demonstrated good intra- and inter-rater reliability (ICCs 0.75-0.86). HBB with tape measure demonstrated excellent inter- and intra-rater reliability (ICCs 0.94-0.98). Isometric ER strength with HHD and a stabilisation device demonstrated excellent intra-rater and inter-rater reliability in 30° and 45° abduction (ICCs 0.96-0.98). HBB and isometric ER at 45° abduction differed significantly between dominant and non-dominant sides. Standardised shoulder ROM and strength tests provide good to excellent reliability. HBB with tape measure and isometric strength testing with HHD stabilisation are clinically acceptable.
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Affiliation(s)
- Peter Beshara
- Department of Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Ingrid Davidson
- Department of Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Matthew Pelletier
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - William R. Walsh
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
- Surgical & Orthopaedic Research Laboratories, Prince of Wales Hospital, Sydney, NSW 2031, Australia
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Assessment of muscle strength in para-athletes: A systematic review of observational studies. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:225-238. [PMID: 36600967 PMCID: PMC9806714 DOI: 10.1016/j.smhs.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/06/2022] [Accepted: 07/29/2022] [Indexed: 01/07/2023] Open
Abstract
Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes, and sport classification. Our aim is to synthesise evidence related to assessing muscle strength in para-athletes. Four databases were searched from January 1990 to July 2021 for observational studies focusing on strength assessment. Independent screening, data extraction, and quality assessment were performed in duplicate. A total of 1764 potential studies were identified. Thirty met the inclusion criteria and were included in the review. The mean age of participants was 30.7 years (standard deviation [SD]: 2.4). The majority were men (88%) participating in wheelchair sports, including basketball, rugby, and tennis (23/30: 76%). Overall quality varied, with more than half of the studies failing to identify strategies for dealing with confounding variables. Despite manual muscle testing being a standard component of para-sport classification systems, evidence examining strength characteristics in para-athletes is derived primarily from isometric and isokinetic testing. In studies that included comparative strength data, findings were mixed. Some studies found strength values were similar to or lower than able-bodied athletic controls. However, an important observation was that others reported higher shoulder strength in para-athletes taking part in wheelchair sports than both able-bodied and disabled non-athletes. Studies need to develop accessible, standardised strength testing methods that account for training influence and establish normative strength values in para-athletes. There is also a need for additional studies that include female para-athletes and para-athletes with greater functional impairments.
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Pinto-Ramos J, Moreira T, Costa F, Tavares H, Cabral J, Costa-Santos C, Barroso J, Sousa-Pinto B. Handheld dynamometer reliability to measure knee extension strength in rehabilitation patients—A cross-sectional study. PLoS One 2022; 17:e0268254. [PMID: 35580110 PMCID: PMC9113580 DOI: 10.1371/journal.pone.0268254] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The Handheld Dynamometer (HHD) has the potential to overcome some of the logistic and economic limitations of isokinetic dynamometers for measuring knee extension muscle strength. However, its reliability has not been fully assessed. The purpose of this study is to measure intra and inter-rater reliability of HHD for knee extension strength in patients receiving rehabilitation treatment, as well as to understand in which conditions is the reliability higher. Methods Twenty-nine patients admitted in an inpatient Physical Medicine and Rehabilitation unit were consecutively included in this cross-sectional study. Two experienced and two inexperienced physicians made two assessments of knee extension strength with HHD, separated by three hours. Intraclass Correlation Coefficients (ICC), absolute differences between assessments, and correlations between strength and functional variables were calculated. Results Intra and inter-rater ICC were overall high (≥ 0.950 and 0.927, respectively). Higher values were found when average of two measurements were made for estimating intra-rater ICC (ICC = 0.978; 95%CI = 0.969–0.985) but not for inter-rater ICC. ICC were not statistically significantly different when calculated based on measurements performed by inexperienced physicians and experienced ones. There was a moderate correlation between strength and functional variables. Conclusion Handheld Dynamometer seems to be a reliable option to measure knee extension muscle strength, particularly when two measurements are performed and their average is reported.
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Affiliation(s)
- João Pinto-Ramos
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
- CINTESIS – Center for Health Technologies and Services Research, University of Porto, Porto, Portugal
- * E-mail:
| | - Tiago Moreira
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Frederico Costa
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Helena Tavares
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
| | - João Cabral
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Cristina Costa-Santos
- CINTESIS – Center for Health Technologies and Services Research, University of Porto, Porto, Portugal
- MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Barroso
- Department of Physical Medicine and Rehabilitation, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
- i3s – Institute for Health Research and Innovation, University of Porto, Porto, Portugal
- Departments of Neuroscience and Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Bernardo Sousa-Pinto
- CINTESIS – Center for Health Technologies and Services Research, University of Porto, Porto, Portugal
- MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
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Buendía-Romero Á, Hernández-Belmonte A, Martínez-Cava A, García-Conesa S, Franco-López F, Conesa-Ros E, Courel-Ibáñez J. Isometric knee extension test: A practical, repeatable, and suitable tool for lower-limb screening among institutionalized older adults. Exp Gerontol 2021; 155:111575. [PMID: 34582970 DOI: 10.1016/j.exger.2021.111575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 09/22/2021] [Indexed: 12/13/2022]
Abstract
We aimed to analyze the isometric knee extension test (IKE) test in terms of i) intra- and inter-session repeatability, and ii) relationship with functional and body composition factors of sarcopenia among institutionalized older adults. Thirteen institutionalized older adults (age = 87 ± 10 years, body mass [BM] = 73.1 ± 10.9 kg, body mass index [BMI] = 28.5 ± 3.8 kg·m2) were recruited from a nursing home. Variability of maximal isometric force registered in three IKE trials performed on the same day was used to examine intra-session repeatability, whereas inter-session repeatability was analyzed by comparing maximal isometric force from two different days. Furthermore, functional (Handgrip, 6-m Gait Speed, Time Up and Go [TUG], and Sit-to-stand tests) and body composition (appendicular lean mass adjusted by BMI, ALM/BMI) evaluations were conducted. Statistics included the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM), expressed in both absolute (N·kg-1) and relative terms (coefficient of variation, CV = 100 × SEM / mean). High to very high intra-session repeatability was found for both the dominant and non-dominant legs (CV ≤ 6.0%, ICC ≥ 0.989). Similarly, both legs showed high inter-session repeatability (SEM ≤ 0.26 N·kg-1, ICC ≥ 0.959). On the other hand, significant relationships were found between Dominant and Non-dominant IKE tests and 6-m Gait Speed (r = 0.77; r = 0.58), ALM/BMI (r = 0.62; r = 0.58), and Non-dominant Handgrip/BM (r = 0.60; r = 0.68). In addition, a significant association was found between Dominant IKE/BM and TUG (r = -0.74), as well as between Non-dominant IKE/BM and Dominant Handgrip/BM (r = 0.67). These findings suggest that the IKE test is a repeatable and suitable strategy for lower-limb screening in institutionalized older adults.
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Affiliation(s)
- Ángel Buendía-Romero
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Alejandro Hernández-Belmonte
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Alejandro Martínez-Cava
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Silverio García-Conesa
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Francisco Franco-López
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Elena Conesa-Ros
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Javier Courel-Ibáñez
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain).
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Saygin D, Oddis CV, Moghadam-Kia S, Rockette-Wagner B, Neiman N, Koontz D, Aggarwal R. Hand-held dynamometry for assessment of muscle strength in patients with inflammatory myopathies. Rheumatology (Oxford) 2021; 60:2146-2156. [PMID: 33026081 DOI: 10.1093/rheumatology/keaa419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Muscle weakness in idiopathic inflammatory myopathies (IIMs) is conventionally assessed using manual muscle testing (MMT). However, more objective tools must be developed to accurately and reliably quantify muscle strength in myositis patients. Hand-held dynamometry (HHD) is a quantitative, portable device with reported reliability in neuromuscular disorders. Our aim was to assess the reliability, validity and responsiveness of HHD in myositis. METHODS Myositis patients [DM, necrotizing myopathy (NM), PM and anti-synthetase syndrome] evaluated at the University of Pittsburgh myositis centre were prospectively enrolled. Each patient was assessed at 0, 3 and 6 months for validated outcome measures of myositis disease activity and physical function. At each visit, muscle strength was assessed using both MMT and HHD (Micro FET2, Hoggan Health Industries, Draper, UT, USA). The reliability, validity and responsiveness of the HHD was assessed using standard statistical methods. RESULTS Fifty IIM patients (60% female; mean age 51.6 years; 6 PM, 9 NM, 24 DM and 11 anti-synthetase syndrome) were enrolled. HHD showed strong test-retest intrarater reliability (r = 0.96) and interrater reliability (r = 0.98). HHD correlated significantly with the MMT score (r = 0.48, P = 0.0006) and myositis disease activity and functional measures. Longitudinal analysis showed a significant and strong association between the HHD and MMT as well as 2016 ACR/EULAR myositis response criteria (r = 0.8, P < 0.0001) demonstrating responsiveness. The mean effect size and standardized response mean of HHD was large: 0.95 and 1.03, respectively. MMT had a high ceiling effect compared with HHD. CONCLUSION HHD demonstrated strong reliability, construct validity and responsiveness in myositis patients. External validation studies are required to confirm these findings.
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Affiliation(s)
| | - Chester V Oddis
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | | | - Bonny Rockette-Wagner
- Department of Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Nicole Neiman
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | - Diane Koontz
- Division of Rheumatology and Clinical Immunology, Department of Medicine
| | - Rohit Aggarwal
- Division of Rheumatology and Clinical Immunology, Department of Medicine
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Coleman SA, Cunningham CJ, Murphy N, Feaheny J, Robinson D, Lannon R, McCarroll K, Casey M, Harbison J, Horgan NF. Progressive resistance training in a post-acute, older, inpatient setting: A randomised controlled feasibility study. J Frailty Sarcopenia Falls 2021; 6:14-24. [PMID: 33817447 PMCID: PMC8017350 DOI: 10.22540/jfsf-06-014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/04/2022] Open
Abstract
Objectives: Progressive resistance training can successfully target functional decline in healthy older community-dwelling adults. There are concerns about the safety and acceptance of its use in frail older populations. The aim of this study was to evaluate the feasibility of using progressive resistance training in an older, post-acute, inpatient setting. Methods: A randomised controlled feasibility study was conducted. Appropriate older inpatients undergoing post-acute rehabilitation were recruited. Feasibility measures examined were safety, recruitment, outcome measurement, adherence and retention rates and satisfaction. A range of clinical measures were used to capture changes in body structure and function, activity and participation. Assessments were performed on admission to the study and six weeks later. Results: A sample of 33 patients were included and randomised to the treatment group (n=16) or the control group (n=17). There were no serious adverse events, adherence rates were 63% and retention rates were 82%. While both groups improved between time 1 and 2, there were no significant differences in clinical measures between the groups. Conclusion: Progressive resistance training is a safe and acceptable intervention for use with this population. Further work on the effectiveness of progressive resistance training in this setting is now required.
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Affiliation(s)
| | | | - Niamh Murphy
- Physiotherapy Department, St James's Hospital, Ireland
| | - Jean Feaheny
- Physiotherapy Department, St James's Hospital, Ireland
| | | | | | | | | | | | - N Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, Ireland
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McGillivray MK, Haldane C, Doherty C, Berger MJ. Evaluation of muscle strength following peripheral nerve surgery: A scoping review. PM R 2021; 14:383-394. [PMID: 33751851 DOI: 10.1002/pmrj.12586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/24/2021] [Accepted: 03/07/2021] [Indexed: 12/14/2022]
Abstract
Peripheral nerve injury (PNI) can result in devastating loss of function, often with poor long-term prognosis. Increased use of peripheral nerve surgical techniques (eg, nerve transfer, nerve grafting, and nerve repair) has resulted in improved muscle strength and other functional outcomes in patients with PNI. Muscle strength has largely been evaluated with the British Medical Research Council (MRC) scale. MRC is convenient to use in clinical settings, but more robust measures of muscle function are necessary to fully elucidate patient recovery. This scoping review aims to examine alternative instruments used to assess muscle function in studies of peripheral nerve surgery for PNI of the upper and lower limbs. A scoping review was conducted using Ovid MEDLINE, CINAHL, EMBASE, and PubMed databases in May and December of 2020, yielding a total of 20 studies pertaining to the review question. Studies pertaining to handheld dynamometry, grip and pinch dynamometry, Rotterdam Intrinsic Hand Myometers, isokinetic dynamometry, ultrasonography, and electromyography were reviewed. We provide a synopsis of each method and current clinical applications and discuss potential benefits, disadvantages, and areas of future research.
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Affiliation(s)
- Meghan K McGillivray
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chloe Haldane
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Doherty
- Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael J Berger
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada.,Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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Reliability and Validity of a Novel Wearable Device for Measuring Elbow Strength. SENSORS 2020; 20:s20123412. [PMID: 32560409 PMCID: PMC7349842 DOI: 10.3390/s20123412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 11/27/2022]
Abstract
Muscle strength is an important clinical outcome in rehabilitation and sport medicine, but options are limited to expensive but accurate isokinetic dynamometry (IKD) or inexpensive but less accurate hand-held dynamometers (HHD). A wearable, self-stabilizing, limb strength measurement device (LSMD) was developed to fill the current gap in portable strength measurement devices. The purpose of this study was to evaluate the reliability and validity of the LSMD in healthy adults. Twenty healthy adults were recruited to attend two strength testing sessions where elbow flexor and extensor strength was measured with the LSMD, with HHD and with IKD in random order, by two raters. Outcomes were intra-rater repeatability, inter-rater reproducibility and inter-session reproducibility using intra-class correlation coefficients (ICC). Limits of agreement and weighted least products regression were used to test the validity of the LSMD relative to the criterion standard (IKD), and calibration formulas derived to improve measurement fidelity. ICC values for the LSMD were >0.90 for all measures of reliability and for both muscle groups, but over-predicted extensor strength and under-predicted flexor strength. Validity was established by transforming the data with the criterion standard-based calibration. These data indicate that the LSMD is reliable and conditionally valid for quantifying strength of elbow flexors and extensors in a healthy adult population.
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Combret Y, Medrinal C, Bonnevie T, Gravier FE, Le Roux P, Lamia B, Prieur G, Reychler G. Clinimetric evaluation of muscle function tests for individuals with cystic fibrosis: A systematic review. J Cyst Fibros 2020; 19:981-995. [PMID: 32534958 DOI: 10.1016/j.jcf.2020.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 12/26/2022]
Abstract
Accurate testing of muscle function is essential in individuals with cystic fibrosis (CF). A literature search was conducted in MEDLINE, CENTRAL, CINAHL, PEDro, ScienceDirect and Web of Science according to PRISMA and COSMIN guidelines from inception to September 2019 to investigate the clinimetric properties of muscle tests in individuals with CF. The search identified 37 studies (1310 individuals) and 34 different muscle tests. Maximal inspiratory pressure, inspiratory work capacity and quadriceps strength measured by computerised dynamometry were identified as reliable tests of muscle function. The one-minute sit-to-stand test was found to have high reliability but its validity to measure quadriceps strength is unknown. The clinimetric properties of other routinely used tests have not been reported in people with CF. Very different measurement procedures were identified. Inspiratory muscle and quadriceps testing can be considered as reliable but high-quality studies evaluating tests of other muscles function (e.g. muscle endurance) are lacking.
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Affiliation(s)
- Yann Combret
- Physiotherapy Department, Le Havre Hospital, F-76600, Le Havre, France; Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels1200, Belgium.
| | - Clement Medrinal
- Physiotherapy Department, Le Havre Hospital, F-76600, Le Havre, France; Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France
| | - Tristan Bonnevie
- Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France; ADIR Association, Rouen University Hospital, F-76000, Rouen, France
| | - Francis-Edouard Gravier
- Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France; ADIR Association, Rouen University Hospital, F-76000, Rouen, France
| | - Pascal Le Roux
- Paediatric Department, Le Havre Hospital, F-76600, Le Havre, France
| | - Bouchra Lamia
- Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France; Pulmonology Department, Le Havre Hospital, F-76600, Le Havre, France; Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France
| | - Guillaume Prieur
- Physiotherapy Department, Le Havre Hospital, F-76600, Le Havre, France; Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels1200, Belgium; Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Institute for Research and Innovation in Biomedicine (IRIB), F-76000, Rouen, France
| | - Gregory Reychler
- Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels1200, Belgium; Department of Physical Medicine and Rehabilitation, Saint-Luc University Clinics, Brussels1200, Belgium
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IJspeert J, Kerstens HCJW, Janssen RMJ, Geurts ACH, van Alfen N, Groothuis JT. Validity and reliability of serratus anterior hand held dynamometry. BMC Musculoskelet Disord 2019; 20:360. [PMID: 31391035 PMCID: PMC6686461 DOI: 10.1186/s12891-019-2741-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/25/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Strength testing of the serratus anterior muscle with hand held dynamometry (HDD) in supine subjects has low reproducibility, and is influenced by compensatory activity of other muscles like the pectoralis major and upper trapezius. Previously, two manual maximum voluntary isometric contraction tests of the serratus anterior muscle were reported that recruited optimal surface electromyography (sEMG) activity in a sitting position. We adapted three manual muscle tests to make them suitable for HHD and investigated their validity and reliability. METHODS Twenty-one healthy adults were examined by two assessors in one supine and two seated positions. Each test was repeated twice. Construct validity was determined by evaluating force production (assessed with HHD) in relation to sEMG of the serratus anterior, upper trapezius and pectoralis major muscles, comparing the three test positions. Intra- and interrater reliability were determined by calculating intra-class correlation coefficients (ICC) smallest detectable change (SDC) and standard error of measurement (SEM). RESULTS Serratus anterior muscle sEMG activity was most isolated in a seated position with the humerus in 90° anteflexion in the scapular plane. This resulted in the lowest measured force levels in this position with a mean force of 296 N (SEM 15.8 N). Intrarater reliability yielded an ICC of 0.658 (95% CI 0.325; 0.846) and an interrater reliability of 0.277 (95% CI -0.089;0.605). SDC was 127 Newton, SEM 45.8 Newton. CONCLUSION The results indicate that validity for strength testing of the serratus anterior muscle is optimal with subjects in a seated position and the shoulder flexed at 90° in the scapular plane. Intrarater reliability is moderate and interrater reliability of this procedure is poor. However the high SDC values make it difficult to use the measurement in repeated measurements.
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Affiliation(s)
- Jos IJspeert
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans C. J. W. Kerstens
- Department of paramedical studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renske M. J. Janssen
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Alexander C. H. Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nens van Alfen
- Department of Neurology and Clinical Neurophysiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan T. Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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Daun F, Kibele A. Different strength declines in leg primary movers versus stabilizers across age-Implications for the risk of falls in older adults? PLoS One 2019; 14:e0213361. [PMID: 30845168 PMCID: PMC6405087 DOI: 10.1371/journal.pone.0213361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/20/2019] [Indexed: 11/19/2022] Open
Abstract
This study investigated differences in the declines of isometric strength in hip abductors and adductors versus knee extensors across four different age groups (n = 31: 11.2 ± 1.0 y, n = 30: 23.1 ± 2.7 y, n = 27: 48.9 ± 4.4 y, and n = 33: 70.1 ± 4.2 y) with a total of 121 female subjects. As a starting point, we assumed that, during their daily activities, elderly people would use their leg stabilizers less frequently than their leg primary movers as compared to younger people. Given that muscle strength decreases in the course of the aging process, we hypothesized that larger strength declines in hip abductors and hip adductors as compared to knee extensors would be detected across age. Maximal isometric force for these muscle groups was assessed with a digital hand-held dynamometer. Measurements were taken at 75% of the thigh or shank length and expressed relative to body weight and lever arm length. Intratester reliability of the normalized maximal torques was estimated by using Cronbach’s alpha and calculated to be larger than 0.95. The obtained results indicate a clearly more pronounced strength decline in hip abductors and hip adductors across age than in the knee extensors. Therefore, a particular need for strength training of the lower extremity stabilizer muscles during the aging process is implied.
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Affiliation(s)
- Franziska Daun
- Institute for Sports and Sport Science, University of Kassel, Germany
| | - Armin Kibele
- Institute for Sports and Sport Science, University of Kassel, Germany
- * E-mail:
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Chopp-Hurley JN, Wiebenga EG, Gatti AA, Maly MR. Investigating the Test-Retest Reliability and Validity of Hand-Held Dynamometry for Measuring Knee Strength in Older Women with Knee Osteoarthritis. Physiother Can 2019; 71:231-238. [PMID: 31719719 PMCID: PMC6830419 DOI: 10.3138/ptc-2018-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose: Hand-held dynamometry (HHD) can be used to evaluate strength when gold-standard isokinetic dynamometry (IKD) is not feasible. HHD is useful for measuring lower limb strength in a healthy population; however, its reliability and validity in individuals with knee osteoarthritis (OA) has received little attention. In this research, we examined the test-retest reliability and validity of HHD in older women with knee OA. We also examined the associations between reliability and symptom and disease severity. Method: A total of 28 older women with knee OA completed knee extension and flexion exertions measured using HHD and IKD. Intra-class correlation coefficients (ICC2,3), standard error of measurement, and minimal detectable change were calculated. Correlation coefficients and regressions evaluated the relationships between inter-trial differences and symptom and disease severity. Results: High test-retest reliability was demonstrated for both exertions with each device (ICC2,3 = 0.83-0.96). Variance between trials was not correlated with OA symptoms. Criterion validity was good (ICC2,3 = 0.76), but extension yielded lower agreement than flexion. Regression analysis demonstrated that true strength can be predicted from HHD measurements. Conclusions: HHD is a reliable tool for capturing knee extension and flexion in individuals with OA. Because of lower agreement, HHD might be best suited for evaluating within-subject strength changes rather than true strength scores. However, gold-standard extension strength magnitudes may reasonably be predicted from regression equations (r 2 = 0.82).
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Affiliation(s)
- Jaclyn N. Chopp-Hurley
- School of Rehabilitation Science
- School of Kinesiology and Health Science, York University, Toronto
| | - Emily G. Wiebenga
- School of Rehabilitation Science
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
| | | | - Monica R. Maly
- School of Rehabilitation Science
- Department of Kinesiology, McMaster University, Hamilton
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
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13
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Grote M, Maihöfer C, Weigl M, Davies-Knorr P, Belka C. Progressive resistance training in cachectic head and neck cancer patients undergoing radiotherapy: a randomized controlled pilot feasibility trial. Radiat Oncol 2018; 13:215. [PMID: 30400971 PMCID: PMC6219249 DOI: 10.1186/s13014-018-1157-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer cachexia is a prevalent symptom of head and neck neoplasms. The reduction in skeletal muscle mass is one of the main characteristics which can lead to poor physical functioning. The purposes of this pilot randomized controlled trial were to determine the feasibility of progressive resistance training in cachectic head and neck cancer patients during radiotherapy and to explore possible risks and benefits. METHODS Twenty cachectic participants with head and neck cancer receiving radiation were randomized to obtain either a machine supported progressive resistance training (n = 10) or usual care (n = 10). The training took place 3 times weekly for 30 min. Intervention included 3 exercises for major muscle groups with 8-12 repetition maximum for 3 sets each. Bioelectrical impedance analysis, hand-held dynamometry, Six-Minute Walk Test and standardized questionnaires for fatigue and quality of life were used for evaluating outcomes at baseline before radiotherapy (t1), after 7 weeks of radiotherapy (t2) and 8 weeks after the end of radiotherapy (t3). RESULTS All participants (n = 20) completed the trial. No serious adverse events occurred. At the initial assessment the cachectic patients had already lost 7.1 ± 5.2% of their body weight. General fatigue (score 10.7 ± 3.3) and reduced quality of life (score 71.3 ± 20.6) were prevalent in cachectic head and neck cancer patients even before radiotherapy. An average improvement of weight loading for leg press (+ 19.0%), chest press (+ 29.8%) and latissimus pull-down (+ 22.8%) was possible in the intervention group. Participants had at least 13 training sessions. The outcome measures showed nonsignificant changes at t2 and t3, but a trend for a better course of general fatigue and quality of life at t2 in the intervention group. CONCLUSIONS Despite advanced tumor stage and burdensome treatment the intervention adherence is excellent. Progressive resistance training in cachectic head and neck cancer patients during radiotherapy seems to be safe and feasible and may have beneficial effects of general fatigue and quality of life. TRIAL REGISTRATION ClinicalTrials.gov, NCT03524755 . Registered 15 May 2018 - Retrospectively registered.
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Affiliation(s)
- Manuel Grote
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany. .,Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany. .,Present Address: Department of Health Promotion/Occupational Health Management, AOK Baden-Württemberg, 70191, Stuttgart, Germany.
| | - Cornelius Maihöfer
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer' Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
| | - Martin Weigl
- Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Patricia Davies-Knorr
- Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany.,Clinical Cooperation Group 'Personalized Radiotherapy in Head and Neck Cancer' Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, 85764, Neuherberg, Germany
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14
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Lower-extremity magnetic resonance imaging in patients with hyperkalemic periodic paralysis carrying the SCN4A mutation T704M: 30-month follow-up of seven patients. Neuromuscul Disord 2018; 28:837-845. [DOI: 10.1016/j.nmd.2018.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 02/07/2023]
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15
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Awatani T, Morikita I, Mori S, Shinohara J, Tatsumi Y. Relationship between isometric shoulder strength and arms-only swimming power among male collegiate swimmers: study of valid clinical assessment methods. J Phys Ther Sci 2018; 30:490-495. [PMID: 29706692 PMCID: PMC5908988 DOI: 10.1589/jpts.30.490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/09/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study was to confirm the relationships between
shoulder strength (extensor strength and internal rotator strength) of the abducted
position and swimming power during arm-only swimming. [Subjects and Methods] Fourteen
healthy male collegiate swimmers participated in the study. Main measures were shoulder
strength (strength using torque that was calculated from the upper extremity length and
the isometric force of the abducted position) and swimming power. [Results] Internal
rotation torque of the dominant side in the abducted external rotated position (r=0.85)
was significantly correlated with maximum swimming power. The rate of bilateral difference
in extension torque in the maximum abducted position (r=−0.728) was significantly
correlated with the swimming velocity-to-swimming power ratio. [Conclusion] The results of
this study suggest that internal rotator strength measurement in the abducted external
rotated position and extensor strength measurement in the maximum abducted position are
valid assessment methods for swimmers.
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Affiliation(s)
- Takenori Awatani
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8 Jiyuugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan.,Graduate School of Sport and Exercise Sciences, Osaka University of Health and Sport Sciences, Japan
| | - Ikuhiro Morikita
- Graduate School of Sport and Exercise Sciences, Osaka University of Health and Sport Sciences, Japan.,Faculty of Physical Education, Osaka University of Health and Sport Sciences, Japan
| | - Seigo Mori
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8 Jiyuugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Junji Shinohara
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8 Jiyuugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Yasutaka Tatsumi
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8 Jiyuugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
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16
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Baschung Pfister P, de Bruin ED, Sterkele I, Maurer B, de Bie RA, Knols RH. Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study. PLoS One 2018; 13:e0194531. [PMID: 29596450 PMCID: PMC5875759 DOI: 10.1371/journal.pone.0194531] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 03/05/2018] [Indexed: 11/19/2022] Open
Abstract
Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC) were calculated. To measure reliability of MMT linear Cohen`s Kappa was computed for single muscle groups and ICC for total score. Additionally, correlations between MMT8 and HHD were evaluated with Spearman Correlation Coefficients. Fifty people with myositis (56±14 years, 76% female) were included in the study. Intra-and interrater reliability of HHD yielded excellent ICCs (0.75–0.97) for all muscle groups, except for interrater reliability of ankle extension (0.61). The corresponding SEMs% ranged from 8 to 28% and the SDCs% from 23 to 65%. MMT8 total score revealed excellent intra-and interrater reliability (ICC>0.9). Intrarater reliability of single muscle groups was substantial for shoulder and hip abduction, elbow and neck flexion, and hip extension (0.64–0.69); moderate for wrist (0.53) and knee extension (0.49) and fair for ankle extension (0.35). Interrater reliability was moderate for neck flexion (0.54) and hip abduction (0.44); fair for shoulder abduction, elbow flexion, wrist and ankle extension (0.20–0.33); and slight for knee extension (0.08). Correlations between the two tests were low for wrist, knee, ankle, and hip extension; moderate for elbow flexion, neck flexion and hip abduction; and good for shoulder abduction. In conclusion, the MMT8 total score is a reliable assessment to consider general muscle weakness in people with myositis but not for single muscle groups. In contrast, our results confirm that HHD can be recommended to evaluate strength of single muscle groups.
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Affiliation(s)
- Pierrette Baschung Pfister
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
- Department of Health, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
- Functioning and Rehabilitation, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Eling D. de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE141 83 Huddinge, Sweden
- * E-mail:
| | - Iris Sterkele
- Nursing and Allied Health Professions Office, Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Britta Maurer
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Rob A. de Bie
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Ruud H. Knols
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
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17
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Gittings PM, Hince DA, Wand BM, Wood FM, Edgar DW. Grip and Muscle Strength Dynamometry in Acute Burn Injury: Evaluation of an Updated Assessment Protocol. J Burn Care Res 2018; 39:939-947. [DOI: 10.1093/jbcr/iry010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Paul M Gittings
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Burn Injury Research Node, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Dana A Hince
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Fiona M Wood
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
- Burn Injury Research Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Dale W Edgar
- Burn Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Burn Injury Research Node, University of Notre Dame Australia, Fremantle, Western Australia, Australia
- The Fiona Wood Foundation, Murdoch, Western Australia, Australia
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18
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Chen Y, Niu M, Zhang X, Qian H, Xie A, Wang X. Effects of home-based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients. J Clin Nurs 2018; 27:e1022-e1037. [PMID: 29076609 DOI: 10.1111/jocn.14131] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Yi Chen
- Department of Emergency and Critical Care Medicine; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Mei'e Niu
- Department of Nursing; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Xiuqin Zhang
- Respiratory Department; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Hongying Qian
- Respiratory Department; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | - Anwei Xie
- Department of Infectious Diseases; The Children's Affiliated Hospital of Soochow University; Suzhou Industrial Park Jiangsu China
| | - Xiya Wang
- Gastrointestinal Endoscopy Center; The First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
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19
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Standing balance and strength measurements in older adults living in residential care communities. Aging Clin Exp Res 2017; 29:1021-1030. [PMID: 28000144 DOI: 10.1007/s40520-016-0693-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87 ± 6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and mediolateral directions was calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93-0.99). An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.
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20
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Blomkvist AW, Andersen S, de Bruin E, Jorgensen MG. Unilateral lower limb strength assessed using the Nintendo Wii Balance Board: a simple and reliable method. Aging Clin Exp Res 2017; 29:1013-1020. [PMID: 27995527 DOI: 10.1007/s40520-016-0692-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/24/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Lower limb weakness is an important risk factor for fall accidents and a predictor for all-cause mortality among older adults. Unilateral whole-lower limb strength may be a better measure of fall risk than the bilateral measure. In addition, a number of clinical conditions affect only one leg, and thus this type of assessment is relevant in clinical settings. AIM To explore the intra-rater reproducibility of the Nintendo Wii Balance Board (WBB) to measure unilateral whole-lower limb strength and to compare the method with stationary isometric muscle apparatus (SID). METHOD Intra-rater test-retest design with 1 week between sessions. Thirty community-dwelling older adults (69 ± 4.2 years) were enrolled and examined for maximum lower limb strength in their dominant and non-dominant leg. Intraclass correlation coefficient (ICC) was calculated to describe relative reproducibility, while standard error of measurement (SEM), limits of agreement (LOA) and smallest real difference (SRD) were calculated to describe absolute reproducibility between test sessions. Concurrent validity with the SID was explored using the Pearson product-moment correlation coefficient (PCC). RESULTS No systematic difference was observed between test sessions. ICC was 0.919-0.950 and SEM, LOA and SRD was 2.9-4.1 kg, 24.1-28.3 kg and 7.6-11.3 kg, respectively. Further, the PCC was 0.755 and 0.730 for the dominant limb and the non-dominant limb, respectively. CONCLUSION A high relative and an acceptable absolute reproducibility was seen when using the Nintendo Wii Balance Board for testing unilateral lower limb strength in community-dwelling older adults. The WBB correlated strongly with the SID.
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Affiliation(s)
- A W Blomkvist
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Aalborg, Denmark.
| | - S Andersen
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - E de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - M G Jorgensen
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Aalborg, Denmark
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21
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Awatani T, Morikita I, Shinohara J, Mori S, Nariai M, Tatsumi Y, Nagata A, Koshiba H. Intra- and inter-rater reliability of isometric shoulder extensor and internal rotator strength measurements performed using a hand-held dynamometer. J Phys Ther Sci 2016; 28:3054-3059. [PMID: 27942118 PMCID: PMC5140798 DOI: 10.1589/jpts.28.3054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/19/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of the present study was to establish the intra- and inter-rater reliability of measurement of extensor strength in the maximum shoulder abducted position and internal rotator strength in the 90° abducted and the 90° external rotated position using a hand-held dynamometer. [Subjects and Methods] Twelve healthy volunteers (12 male; mean ± SD: age 19.0 ± 1.1 years) participated in the study. The examiners were two students who had nonclinical experience with a hand-held dynamometer measurement. The examiners and participants were blinded to measurement results by the recorder. Participants in the prone position were instructed to hold the contraction against the ground reaction force, and peak isometric force was recorded using the hand-held dynamometer on the floor. Reliability was determined using intraclass correlation coefficients. [Results] The intra- and inter-rater reliability data were found to be "almost perfect". [Conclusion] This study investigated intra- and inter-rater reliability and reveald high reliability. Thus, the measurement method used in the present study can evaluate muscle strength by a simple measurement technique.
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Affiliation(s)
- Takenori Awatani
- Faculty of Sports Science, Kyushu Kyoritsu University, Japan; Graduate School of Sport and Exercise Sciences, Osaka University of Health and Sport Sciences, Japan
| | - Ikuhiro Morikita
- Graduate School of Sport and Exercise Sciences, Osaka University of Health and Sport Sciences, Japan; Faculty of Physical Education, Osaka University of Health and Sport Sciences, Japan
| | - Junji Shinohara
- Faculty of Sports Science, Kyushu Kyoritsu University, Japan
| | - Seigo Mori
- Faculty of Sports Science, Kyushu Kyoritsu University, Japan
| | - Miki Nariai
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | | | - Akinori Nagata
- Faculty of Sports Science, Kyushu Kyoritsu University, Japan
| | - Hiroya Koshiba
- Faculty of Health and Well-being, Kansai University, Japan
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22
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Gea J, Casadevall C, Pascual S, Orozco-Levi M, Barreiro E. Clinical management of chronic obstructive pulmonary disease patients with muscle dysfunction. J Thorac Dis 2016; 8:3379-3400. [PMID: 28066619 DOI: 10.21037/jtd.2016.11.105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs. Limb muscle weakness is generally diagnosed through voluntary isometric maneuvers such as handgrip or quadriceps muscle contraction (dynamometry); while respiratory muscle loss of strength is usually recognized through a decrease in maximal static pressures measured at the mouth. Both types of measurements have validated reference values. Respiratory muscle strength can also be evaluated determining esophageal, gastric and transdiaphragmatic maximal pressures although there is a lack of widely accepted reference equations. Non-volitional maneuvers, obtained through electrical or magnetic stimulation, can be employed in patients unable to cooperate. Muscle endurance can also be assessed, generally using repeated submaximal maneuvers until exhaustion, but no validated reference values are available yet. The treatment of muscle dysfunction is multidimensional and includes improvement in lifestyle habits (smoking abstinence, healthy diet and a good level of physical activity, preferably outside), nutritional measures (diet supplements and occasionally, anabolic drugs), and different modalities of general and muscle training.
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Affiliation(s)
- Joaquim Gea
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Carme Casadevall
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Sergi Pascual
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Mauricio Orozco-Levi
- Department of Respiratory, Cardiovascular Foundation from Colombia Floridablanca, Santander, Colombia, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Esther Barreiro
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
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23
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Keep H, Luu L, Berson A, Garland SJ. Validity of the Handheld Dynamometer Compared with an Isokinetic Dynamometer in Measuring Peak Hip Extension Strength. Physiother Can 2016; 68:15-22. [PMID: 27504043 DOI: 10.3138/ptc.2014-62] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether the handheld dynamometer (HHD) is an appropriate tool to assess and quantify peak hip extension strength in prone standing position by (1) evaluating the concurrent validity of the HHD versus an isokinetic dynamometer (IKD), (2) establishing the minimal detectable change (MDC), and (3) determining the validity of single-trial versus multi-trial measures. METHOD A convenience sample of 20 healthy adults was recruited for this cross-sectional study. Measures of peak hip extension strength were collected in prone standing position with both the HHD and the IKD and in supine position with the IKD. RESULTS Values of r were 0.37 for HHD versus IKD prone standing and 0.51 for HHD versus IKD supine. MDC was 14.8 Nm for the HHD, 25.6 Nm for IKD prone standing, and 41.5 Nm for IKD supine. High correlations (r values of 0.92-0.94) were observed between trial 1 and the mean of three trials. CONCLUSIONS The HHD has moderate concurrent validity in measuring peak hip extension strength in the prone standing position in healthy adults. MDC for hip extension strength was lowest using the HHD. Single-trial values showed a high correlation with three-trial mean values.
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Affiliation(s)
- Heather Keep
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - Levana Luu
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - Ayli Berson
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
| | - S Jayne Garland
- Neural Control of Force Production Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver
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24
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Awatani T, Mori S, Shinohara J, Koshiba H, Nariai M, Tatsumi Y, Nagata A, Morikita I. Same-session and between-day intra-rater reliability of hand-held dynamometer measurements of isometric shoulder extensor strength. J Phys Ther Sci 2016; 28:936-9. [PMID: 27134388 PMCID: PMC4842469 DOI: 10.1589/jpts.28.936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/12/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The purpose of present study was to establish the same-session and between-day intra-rater reliability of measurements of extensor strength in the maximum abducted position (MABP) using hand-held dynamometer (HHD). [Subjects] Thirteen healthy volunteers (10 male, 3 female; mean ± SD: age 19.8 ± 0.8 y) participated in the study. [Methods] Participants in the prone position with maximum abduction of shoulder were instructed to hold the contraction against the ground reaction force, and peak isometric force was recorded using the HHD on the floor. Participants performed maximum isometric contractions lasting 3 s, with 3 trials in one session. Between-day measurements were performed in 2 sessions separated by a 1-week interval. Intra-rater reliability was determined using intraclass correlation coefficients (ICC). Systematic errors were assessed using Bland-Altman analysis for between-day data. [Results] ICC values for same-session data and between-day data were found to be "almost perfect". Systematic errors not existed and only random error existed. [Conclusion] The measurement method used in this study can easily control for experimental conditions and allow precise measurement because the lack of stabilization and the impact of tester strength are removed. Thus, extensor strength in MABP measurement is beneficial for muscle strength assessment.
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Affiliation(s)
- Takenori Awatani
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8
Jiyugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Seigo Mori
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8
Jiyugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Junji Shinohara
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8
Jiyugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Hiroya Koshiba
- Graduate School of Sport and Exercise Sciences, Osaka
University of Health and Sport Sciences, Japan
| | - Miki Nariai
- Graduate School of Comprehensive Human Sciences, University
of Tsukuba, Japan
| | - Yasutaka Tatsumi
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8
Jiyugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Akinori Nagata
- Faculty of Sports Science, Kyushu Kyoritsu University: 1-8
Jiyugaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8585, Japan
| | - Ikuhiro Morikita
- Graduate School of Sport and Exercise Sciences, Osaka
University of Health and Sport Sciences, Japan
- Faculty of Physical Education, Osaka University of Health
and Sport Sciences, Japan
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Abstract
BACKGROUND The grip strength test is widely used; however, little has been investigated about its reliability when used in elderly with subjects thumb carpometacarpal (CMC) osteoarthritis (OA). The purpose of this study was to examine the test-retest reliability of the grip strength test in elderly subjects with thumb CMC OA. METHODS A total of 78 patients with unilateral thumb CMC OA, 84.6 % female (mean ± SD age 83 ± 5 years), were recruited. Each patient performed three pain free maximal isometric contractions on each hand in two occasions, 1 week apart. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95 % limits of agreement (LOA) were calculated. RESULTS Test-retest reliability was excellent for side affected (ICC = 0.947; p = 0.001) and contralateral (ICC = 0.96; p = 0.001) thumb CMC OA. CONCLUSIONS The present results indicate that maximum handgrip strength can be measured reliably, using the Jamar hand dynamometer, in patients with thumb CMC OA, which enables its use in research and in the clinic to determine the effect of interventions on improving grip.
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Oncology Section EDGE Task Force on Prostate Cancer Outcomes: A Systematic Review of Clinical Measures of Strength and Muscular Endurance. REHABILITATION ONCOLOGY 2015. [DOI: 10.1097/01893697-201533020-00006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Kodesh E, Laufer Y. The reliability of hand-held dynamometry for strength assessment during electrically induced muscle contractions. Physiother Theory Pract 2014; 31:61-6. [PMID: 25221851 DOI: 10.3109/09593985.2014.958264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To determine inter- and intra-tester reliability of strength measurements during maximal electrically induced contractions (MEIC) using a hand-held dynamometer (HHD). METHODS Thirty-seven healthy young female adults, mean age (SD) 23.4 (2.4) years, were tested by two examiners during two sessions, with order of examiners randomized. Biphasic pulses (phase duration--300 µs; pulse frequency--75 Hz) were employed in order to induce contractions of the quadriceps femoris muscle at a maximally tolerated current level. Strength of maximal voluntary isometric contractions (MVIC) and of MEIC was recorded with a HHD utilizing a stabilization belt. RESULTS Good to excellent inter- and intra-tester reliability were determined with intra-class correlation coefficients ranging between 0.8 and 0.9, and no bias in the Bland-Altman plots. The 95% repeatability ranged between 8.7 and 13.0 kg for the MVIC and MEIC, and between 20.7 and 25.6% for the % MVIC. CONCLUSION Our results confirm previous findings indicating good to excellent reliability of quadriceps femoris muscle MVIC assessment with a HHD. However, a high 95% repeatability range indicates the HHD is not sufficiently reliable as an indicator of the force level attained during electrically induced contractions. Other methods need to be investigated to assist in determining whether MEIC have reached therapeutic levels.
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Affiliation(s)
- Einat Kodesh
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa , Mount Carmel, Haifa , Israel
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Maltais F, Decramer M, Casaburi R, Barreiro E, Burelle Y, Debigaré R, Dekhuijzen PNR, Franssen F, Gayan-Ramirez G, Gea J, Gosker HR, Gosselink R, Hayot M, Hussain SNA, Janssens W, Polkey MI, Roca J, Saey D, Schols AMWJ, Spruit MA, Steiner M, Taivassalo T, Troosters T, Vogiatzis I, Wagner PD. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2014; 189:e15-62. [PMID: 24787074 DOI: 10.1164/rccm.201402-0373st] [Citation(s) in RCA: 692] [Impact Index Per Article: 69.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. PURPOSE The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. METHODS An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. RESULTS We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. CONCLUSIONS Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed.
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Clements S, Samuel D. Knee extensor strength measured using a Biodex dynamometer and an adapted hand held dynamometer. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.6.274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shaun Clements
- Pre-registration student at the Faculty of Health Sciences, University of Southampton
| | - Dinesh Samuel
- Lecturer at the Faculty of Health Sciences, University of Southampton, UK
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