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.
DOCUMENT
Background and Purpose: Decreased muscle mass and muscle strength are independent predictors of poor postoperative recov- ery in patients with esophageal cancer. If there is an association between muscle mass and muscle strength, physiotherapists are able to measure muscle strength as an early predictor for poor postoperative recovery due to decreased muscle mass. Therefore, in this cross-sectional study, we aimed to investigate the association between muscle mass and muscle strength in predominantly older patients with esophageal cancer awaiting esophagectomy prior to neoadjuvant chemoradiation. Methods: In patients with resectable esophageal cancer eligible for surgery between March 2012 and October 2015, we used computed tomographic scans to assess muscle mass and compared them with muscle strength measures (hand- grip strength, inspiratory and expiratory muscle strength, 30 seconds chair stands test). We calculated Pearson correla- tion coefficients and determined associations by multivariate linear regression analysis. Results and Discussion: A tertiary referral center referred 125 individuals to physiotherapy who were eligible for the study; we finally included 93 individuals for statistical analysis. Mul- tiple backward regression analysis showed that gender (95% confidence interval [CI], 2.05-33.82), weight (95% CI, 0.39- 1.02), age (95% CI, −0.91 to −0.04), left handgrip strength (95% CI, 0.14-1.44), and inspiratory muscle strength (95% CI, 0.08-0.38) were all independently associated with muscle surface area at L3. All these variables together explained 66% of the variability (R2) in muscle surface area at L3 (P < .01). Conclusions: This study shows an independent association between aspects of muscle strength and muscle mass in patients with esophageal cancer awaiting surgery, and phys- iotherapists could use the results to predict muscle mass on the basis of muscle strength in preoperative patients with esophageal cancer.
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BackgroundPatients undergoing total knee arthroplasty (TKA) often experience strength deficits both pre- and post-operatively. As these deficits may have a direct impact on functional recovery, strength assessment should be performed in this patient population. For these assessments, reliable measurements should be used. This study aimed to determine the inter- and intrarater reliability of hand-held dynamometry (HHD) in measuring isometric knee strength in patients awaiting TKA.MethodsTo determine interrater reliability, 32 patients (81.3% female) were assessed by two examiners. Patients were assessed consecutively by both examiners on the same individual test dates. To determine intrarater reliability, a subgroup (n = 13) was again assessed by the examiners within four weeks of the initial testing procedure. Maximal isometric knee flexor and extensor strength were tested using a modified Citec hand-held dynamometer. Both the affected and unaffected knee were tested. Reliability was assessed using the Intraclass Correlation Coefficient (ICC). In addition, the Standard Error of Measurement (SEM) and the Smallest Detectable Difference (SDD) were used to determine reliability.ResultsIn both the affected and unaffected knee, the inter- and intrarater reliability were good for knee flexors (ICC range 0.76-0.94) and excellent for knee extensors (ICC range 0.92-0.97). However, measurement error was high, displaying SDD ranges between 21.7% and 36.2% for interrater reliability and between 19.0% and 57.5% for intrarater reliability. Overall, measurement error was higher for the knee flexors than for the knee extensors.ConclusionsModified HHD appears to be a reliable strength measure, producing good to excellent ICC values for both inter- and intrarater reliability in a group of TKA patients. High SEM and SDD values, however, indicate high measurement error for individual measures. This study demonstrates that a modified HHD is appropriate to evaluate knee strength changes in TKA patient groups. However, it also demonstrates that modified HHD is not suitable to measure individual strength changes. The use of modified HHD is, therefore, not advised for use in a clinical setting.
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Teachers have a crucial role in bringing about the extensive social changes that are needed in the building of a sustainable future. In the EduSTA project, we focus on sustainability competences of teachers. We strengthen the European dimension of teacher education via Digital Open Badges as means of performing, acknowledging, documenting, and transferring the competencies as micro-credentials. EduSTA starts by mapping the contextual possibilities and restrictions for transformative learning on sustainability and by operationalising skills. The development of competence-based learning modules and open digital badge-driven pathways will proceed hand in hand and will be realised as learning modules in the partnering Higher Education Institutes and badge applications open for all teachers in Europe.Societal Issue: Teachers’ capabilities to act as active facilitators of change in the ecological transition and to educate citizens and workforce to meet the future challenges is key to a profound transformation in the green transition.Teachers’ sustainability competences have been researched widely, but a gap remains between research and the teachers’ practise. There is a need to operationalise sustainability competences: to describe direct links with everyday tasks, such as curriculum development, pedagogical design, and assessment. This need calls for an urgent operationalisation of educators’ sustainability competences – to support the goals with sustainability actions and to transfer this understanding to their students.Benefit to society: EduSTA builds a community, “Academy of Educators for Sustainable Future”, and creates open digital badge-driven learning pathways for teachers’ sustainability competences supported by multimodal learning modules. The aim is to achieve close cooperation with training schools to actively engage in-service teachers.Our consortium is a catalyst for leading and empowering profound change in the present and for the future to educate teachers ready to meet the challenges and act as active change agents for sustainable future. Emphasizing teachers’ essential role as a part of the green transition also adds to the attractiveness of teachers’ work.
The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
Dit project richt zich op de ontwikkeling van de biotechnologische en chemische procesvoering om op basis van mycelium een alternatief voor leer te produceren. In vergelijking met leer is het voordeel van mycelium dat geen runderen nodig zijn, de productie kan plaatsvinden onder industriële condities en met gebruik van reststromen, de CO2 uitstoot alsook hoeveelheid afval verlaagd wordt, en het gebruik van toxische stoffen zoals chroom wordt vervangen door biobased alternatieven. In het project zullen de procescondities worden bepaald die leiden tot de vorming van optimaal mycelium. Daartoe zullen twee verschillende schimmels worden gekweekt in bioreactoren bij de Hogeschool Arnhem Nijmegen (HAN), waarbij specifiek de effecten van de procescondities (temperatuur, pH, shear, beluchting) en de samenstelling van het kweekmedium op groei van het mycelium en materiaal eigenschappen zullen worden onderzocht. De meest optimale condities zullen vervolgens worden opgeschaald. Op het op deze wijze verkregen materiaal zal Mylium BV een aantal nabehandelingsstappen uitvoeren om de sterkte, elasticiteit, en duurzaamheid van het product te vergroten. Daartoe worden biobased plasticizers, cross-linkers en/of flexibility agents gebruikt. Het resulterende eindproduct zal middels specifiek fysieke testen vergeleken worden met leer alsook worden voorgelegd aan mogelijke klanten. Indien beide resultaten positief zijn kan het betreffende proces na het project verder worden opgeschaald voor toepassing naar de markt.
