Background: The ability to generate muscle strength is a pre-requisite for all human movement. Decreasedquadriceps muscle strength is frequently observed in older adults and is associated with a decreased performance and activity limitations. To quantify the quadriceps muscle strength and to monitor changes over time, instruments and procedures with a sufficient reliability are needed. The Q Force is an innovative mobile muscle strength measurement instrument suitable to measure in various degrees of extension. Measurements between 110 and 130° extension present the highest values and the most significant increase after training. The objective of this study is to determine the test-retest reliability of muscle strength measurements by the QForce in older adults in 110° extension.Methods: Forty-one healthy older adults, 13 males and 28 females were included in the study. Mean (SD) age was 81.9 (4.89) years. Isometric muscle strength of the Quadriceps muscle was assessed with the Q Force at 110° of knee extension. Participants were measured at two sessions with a three to eight day interval between sessions. To determine relative reliability, the intraclass correlation coefficient (ICC) was calculated. To determine absolute reliability, Bland and Altman Limits of Agreement (LOA) were calculated and t-tests were performed.Results: Relative reliability of the Q Force is good to excellent as all ICC coefficients are higher than 0.75. Generally a large 95 % LOA, reflecting only moderate absolute reliability, is found as exemplified for the peak torque left leg of −18.6 N to 33.8 N and the right leg of −9.2 N to 26.4 N was between 15.7 and 23.6 Newton representing 25.2 % to 39.9 % of the size of the mean. Small systematic differences in mean were found between measurement session 1 and 2.Conclusion: The present study shows that the Q Force has excellent relative test-retest reliability, but limitedabsolute test-retest reliability. Since the Q Force is relatively cheap and mobile it is suitable for application in various clinical settings, however, its capability to detect changes in muscle force over time is limited but comparable to existing instruments.
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The primary purpose of this study was to examine whether grip strength is related to total muscle strength in children, adolescents, and young adults. The second purpose was to provide reference charts for grip strength, which could be used in the clinical and research setting. This cross-sectional study was performed at primary and secondary schools and the University of Applied Sciences. Three hundred and eighty-four healthy Dutch children, adolescents, and young adults at the age of 8 to 20 years participated. Isometric muscle strength was measured with a handheld dynamometer of four muscle groups (shoulder abductors, grip strength, hip flexors, and ankle dorsiflexors). Total muscle strength was a summing up of shoulder abductors, hip flexors, and ankle dorsiflexors. All physical therapists participated in a reliability study. The study was started when intratester and intertester reliability was high (Pearson correlation coefficient >0.8). Grip strength was strongly correlated with total muscle strength, with correlation coefficients between 0.736 and 0.890 (p < 0.01). However, the correlation was weaker when controlled for weight (0.485-0.564, p < 0.01). Grip strength is related to total muscle strength. This indicates, in the clinical setting, that grip strength can be used as a tool to have a rapid indication of someone's general muscle strength. The developed reference charts are suitable for evaluating muscle strength in children, adolescents, and young adults in clinical and research settings.
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BACKGROUND: Muscle force is important for daily life and sports and can be measured with a handheld dynamometer. Reference values are employed to quantify a subject's muscle force. It is not unambiguous whether reference values can be generalized to other populations. Objectives in this study were; first to confirm the reliability of the utilization of hand-held dynamometers for isometric strength measurement; second to determine reference values for a population of Dutch workers; third to compare these values with those of a USA population.METHODS: 462 Healthy working subjects (259 male, 203 female) were included in this study. Their age ranged from 20 to 60 years with a mean (sd) of 41 (11) years. Muscle force values from elbow flexion and extension, knee flexion and extension, and shoulder abduction were measured with the break method using a MicroFet 2 hand-held dynamometer. Reliability was analyzed by calculating ICC's and limits of agreement. Muscle force expressed in Newton, means, and confidence intervals were determined for males and females in age groups ranging from twenty to sixty years old. Regression equations and explained variances were calculated from weight, height, age, and gender. The mean values and 95% CI were compared to the results from other studies.RESULTS: Reliability was good; the ICC ranged between 0.83 to 0.94. The explained variance ranged from 0.25 to 0.51. Comparison of data for the Dutch population mean muscle force values with those from the USA revealed important differences between muscle force reference values for the American and Dutch populations.CONCLUSIONS: Muscle force measurements demonstrate a sound reliability. Reference values and regressions equations are made available for the Dutch population. Comparison with other studies indicates that reference values differ between countries.
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Purpose: To determine the most effective practices for quadriceps strengthening after ACL reconstruction. Methods: An electronic search has been performed for the literature appearing from January 1990 to January 2012. Inclusion criteria were articles written in English, German or Dutch with unilateral ACL-reconstructed patients older than 13 years, RCT rehabilitation programmes containing muscle strengthening, protocol described in detail and time frame of measurements reported. Quadriceps muscle strength and patient-reported outcomes were the endpoints. Included studies were assessed on their methodological quality using the CONSORT Checklist. Results: From 645 identified studies, 10 met the inclusion criteria. Seven studies found an increase in quadriceps strength after intervention programmes regardless of type of training. An eccentric exercise programme showed significantly better values for isometric quadriceps strength compared to a concentric exercise programme. The Tegner activity scale showed a significant increase in activity level for all training programmes. The Cincinnati Knee Rating System showed significant improvements in particular for the neuromuscular training group. Conclusions: The evidence from this review indicates that eccentric training may be most effective to restore quadriceps strength, but full recovery may not be achieved with current rehabilitation practices. Neuromuscular training incorporating motor learning principles should be added to strengthening training to optimise outcome measurements. Level of evidence: II. © 2013 Springer-Verlag Berlin Heidelberg.
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Living independently is an important component of quality of life. Cardiovascular diseases are prominent among the chronic conditions that predispose elderly people to functional limitations and disability, which impair quality of life. Insight into factors that play a role in the development process of limitations and disability of patients with subclinical cardiovascular diseases will aid in the development of preventive interventions. The aim of this study was to investigate the association of vascular status with muscle strength and physical functioning in middle aged and elderly men.
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Background/Aims: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. Methods: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not scheduled within 2 weeks. Results: The 115 participants followed on average 5.7 (3.5) training sessions. Adherence to the exercise program was high: 82% of the planned training sessions were attended, and no adverse events occurred. Mixed model analyses showed a significant increase of maximal inspiratory muscle strength (84.1-104.7 cm H2O; p = 0.00) and inspiratory muscle endurance (35.0-39.5 cm H2O; p = 0.00). No significant changes were found in aerobic capacity and peripheral muscle strength. Conclusion: This exercise program in patients awaiting oncological surgery is feasible in terms of participation and adherence. Inspiratory muscle function improved significantly as a result of inspiratory muscle training. The exercise program however failed to result in improved aerobic capacity and peripheral muscle strength, probably due to the limited number of training sessions as a result of the restricted time interval between screening and surgery.
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Purpose: This study examined the effects of a giant (4×3 m) exercising board game intervention on ambulatory physical activity (PA) and a broader array of physical and psychological outcomes among nursing home residents. Materials and methods: A quasi-experimental longitudinal study was carried out in two comparable nursing homes. Ten participants (aged 82.5±6.3 and comprising 6 women) meeting the inclusion criteria took part in the 1-month intervention in one nursing home, whereas 11 participants (aged 89.9±3.1 with 8 women) were assigned to the control group in the other nursing home. The giant exercising board game required participants to per-form strength, flexibility, balance and endurance activities. The assistance provided by an exercising specialist decreased gradually during the intervention in an autonomy-oriented approach based on the self-determination theory. The following were assessed at baseline, after the intervention and after a follow-up period of 3 months: PA (steps/day and energy expenditure/day with ActiGraph), cognitive status (mini mental state examination), quality of life (EuroQol 5-dimensions), motivation for PA (Behavioral Regulation in Exercise Questionnaire-2), gait and balance (Tinetti and Short Physical Performance Battery), functional mobility (timed up and go), and the muscular isometric strength of the lower limb muscles. Results and conclusion: In the intervention group, PA increased from 2,921 steps/day at baseline to 3,358 steps/day after the intervention (+14.9%, P=0.04) and 4,083 steps/day (+39.8%, P=0.03) after 3 months. Energy expenditure/day also increased after the intervention (+110 kcal/day, +6.3%, P=0.01) and after 3 months (+219 kcal/day, +12.3%, P=0.02). Quality of life (P<0.05), balance and gait (P<0.05), and strength of the ankle (P<0.05) were also improved after 3 months. Such improvements were not observed in the control group. The preliminary results are promising but further investigation is required to confirm and evaluate the long-term effectiveness of PA interventions in nursing homes.
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This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of skeletal muscle training on functional performance in people with spinal muscular atrophy (SMA) type 3 and to identify any adverse effects
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Objective: To determine content validity of the Muscle Power Sprint Test (MPST) and construct validity and reliability of the MPST, 10x5 Meter Sprint Test (10x5MST), slalom test and one stroke push test (1SPT) in wheelchair-using youth with spina bifida (SB). Design: Clinimetric study Setting: Rehabilitation centers, SB outpatient services, private practices Participants: A convenience sample of 53 children (5-19 years, 32 boys / 21 girls) with SB who use a manual wheelchair. Participants were recruited in the Netherlands through rehabilitation centers, SB outpatient services, pediatric physical therapists and the BOSK (Association of and by parents of children, adolescents and adults with a disability). Interventions: Not applicable. Main Outcome Measures: Construct validity of the the MPST was determined by comparing results with the arm-cranking Wingate Anaerobic test (WAnT) using paired t-tests and Pearson Correlation Coefficients, while content validity was assessed using time based criteria for anaerobic testing . Construct validity of the 10x5MST, slalom test and 1SPT was analyzed by hypothesis testing using Pearson Correlation Coefficients and Multiple Regression. For reliability, Intra Class Correlation coefficients (ICC) and smallest detectable changes (SDC) were calculated. Results: For the MPST, mean exercise time of four sprints was 28.1 sec. (±6.6 sec.). Correlations between the MPST and WAnT were high (r>0.72, p<0.01). Excellent correlations were found between the 10x5MST and slalom test (r=0.93, p<0.01), while correlations between the10x5MST or slalom test and MPST and 1SPT were moderate (r=-0.56- -0.70; r=0.56, p<0.01). The 1SPT was explained for 38% by wheelchair mass (Beta -0.489) and total upper muscle strength (Beta 0.420). All ICCs were excellent (ICC>0.95) but the SDCs varied widely. Conclusions: The MPST, 10x5MST and slalom test are valid and reliable tests in wheelchair-using youth with SB for measuring respectively anaerobic performance or agility. For the 1SPT, both validity and reliability are questionable.
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BACKGROUND: In typically developing children, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In children and adolescents with a physical disability or chronic disease participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of the Health in Adapted Youth Sports (HAYS) Study is to determine both negative and positive effects of sports on children and adolescents with a chronic disease or physical disability. METHODS: In this cross-sectional study differences will be compared in regards to physical and psychosocial health, cognitive functioning, school performance, daily physical activity and injuries between children and adolescents with a chronic disease or physical disability who participate in sports and those who do not. Children and adolescents, both ambulatory and wheelchair dependent, in the age of 10-19 years with a physical disability or chronic disease will be included. "Sports" is defined as participation in an organized sport at least two times a week for a duration of 3 months or more prior to the assessment. Parametric and non-parametric statistics will be used to determine the differences between the two groups. DISCUSSION: This study provides insight in the effects of sports participation in relation to health, psychosocial functioning, physical activity and school performance in children and adolescents (10-19 years) with a chronic disease or physical disability. Results will guide healthcare professionals working with these children to better guide this population in reaching optimal levels of health and physical activity levels.
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