Accuracy and cut-off points of different models of knee extension strength analysis to identify walking performance in individuals with chronic stroke

Background: Decreased muscle strength and limited physical performance are key elements of frailty and sarcopenia. The relative value of grip and knee extension strength for explaining walking performance has not been clearly established. Objectives: Compare the ability of grip and knee extension strength to explain gait speed. Design: Retrospective use of cross-sectionally obtained data. Setting: Patients’ homes. Participants:Forty-four ambulatory women patients at least 65 years of age. Measurements: Grip and knee extension forces obtained bilaterally with dynamometers and comfortable gait speed. Results: Knee extension forces were, but grip strength forces were not, correlated significantly with gait speed. Knee extension forces were able, but grip strength forces were not able, to satisfactorily identify patients with gait speeds < .40 m/sec. Conclusions:For women receiving therapy in a home-care setting, physical performance as reflected by gait speed is better explained by knee extension strength than by grip strength.

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Daily Stepping in Individuals With Motor Incomplete Spinal Cord Injury

Physical Therapy ◽

10.2522/ptj.20090064 ◽

2010 ◽

Vol 90 (2) ◽

pp. 224-235 ◽

Cited By ~ 24

Author(s):

Poonam Saraf ◽

Miriam R. Rafferty ◽

Jennifer L. Moore ◽

Jennifer H. Kahn ◽

Kathryn Hendron ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Knee Extension ◽

Small Sample ◽

Substantial Contribution ◽

Activity Limitations ◽

Incomplete Spinal Cord Injury ◽

Knee Extension Strength ◽

Cord Injury ◽

Walking Performance

BackgroundIn individuals with motor incomplete spinal cord injury (SCI), ambulatory function determined in the clinical setting is related to specific measures of body structure and function and activity limitations, although few studies have quantified the relationship of these variables with daily stepping (steps/day).ObjectiveThe aim of this study was to quantify daily stepping in ambulatory individuals with SCI and its relationship with clinical walking performance measures and specific demographics, impairments, and activity limitations.DesignA cross-sectional study was performed to estimate relationships among clinical variables to daily stepping in self-identified community versus non–community (household) walkers.MethodsAverage daily stepping was determined in 50 people with chronic, motor incomplete SCI. Data for clinical and self-report measures of walking performance also were collected, and their associations with daily stepping were analyzed using correlation and receiver operating characteristic (ROC) analyses. Relationships between daily stepping and the measures of demographics, impairments, and activity limitations were identified using correlation and regression analyses.ResultsThe ROC analyses revealed a significant discriminative ability between self-reported community and non–community walkers using clinical gait measures and daily stepping. Stepping activity generally was low throughout the sample tested, however, with an average of approximately 2,600 steps/day. Knee extension strength (force-generating capacity) and static balance were the primary variables related to daily stepping, with metabolic efficiency and capacity and balance confidence contributing to a lesser extent.LimitationsThe small sample size and use of specific impairment-related measures were potential limitations of the study.ConclusionsDaily stepping is extremely limited in individuals with incomplete SCI, with a potentially substantial contribution of impairments in knee extension strength and balance.

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Physical Characteristics Vary According to Body Mass Index in Japanese Community-Dwelling Elderly Women

Geriatrics ◽

10.3390/geriatrics3040087 ◽

2018 ◽

Vol 3 (4) ◽

pp. 87 ◽

Cited By ~ 3

Author(s):

Koji Nonaka ◽

Shin Murata ◽

Kayoko Shiraiwa ◽

Teppei Abiko ◽

Hideki Nakano ◽

...

Keyword(s):

Body Mass Index ◽

Walking Speed ◽

Elderly Women ◽

Knee Extension ◽

Normal Weight ◽

Physical Characteristics ◽

Community Dwelling ◽

Weight Group ◽

Normal Weight Group ◽

Knee Extension Strength

Background: Body mass index (BMI) is related to health in the elderly. The purpose of this study was to investigate the physical characteristics in underweight, overweight, and obese Japanese community-dwelling elderly women compared to normal-weight elderly women. Methods: The study participants included 212 community-dwelling elderly women. They were categorized as underweight (BMI < 18.5), normal weight (18.5 ≤ BMI ≤ 22.9), overweight (23 ≤ BMI ≤ 24.9), and obese (BMI ≥ 25). Data on skeletal muscle mass index (SMI), number of trunk curl-ups performed within 30 seconds, knee extension strength, one-leg standing time, and walking speed were recorded. Results: In the underweight group, the number of trunk curl-ups was significantly lower than that of the normal-weight group (p = 0.011) and the correlation between knee extension strength and walking speed was relatively higher than in the normal-weight group (r = 0.612 vs. r = 0.471). In the overweight group, the SMI was significantly increased (p < 0.001), but knee extension strength was not increased (p = 0.235) compared to that of the normal-weight group. In the obese group, one-leg standing time was significantly shorter than in the normal-weight group (p = 0.016). Conclusions: Physical characteristics vary according to BMI and these findings are useful in assessing and planning interventional programs to improve and maintain physical function in elderly women.

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Correlation of paretic knee extension strength with gait speed after stroke: A meta-analysis

Isokinetics and Exercise Science ◽

10.3233/ies-210139 ◽

2021 ◽

pp. 1-5

Author(s):

Richard W. Bohannon

Keyword(s):

Gait Speed ◽

Meta Analysis ◽

Relevant Literature ◽

Knee Extension ◽

Bibliographic Databases ◽

Knee Extension Strength ◽

Extension Force ◽

Correlational Data ◽

Using Data ◽

The Relationship

BACKGROUND AND OBJECTIVE: Numerous studies have addressed the relationship between paretic knee extension strength and comfortable walking speed after stroke. However, the correlations reported are highly variable. This review sought to summarize the correlational data using meta-analysis. METHODS: Relevant literature was identified via a search of 3 bibliographic databases. Articles were screened and perused for inclusion. Included articles were examined for information on the sample studied, procedures for measuring strength and gait speed, and correlations reported between the 2 variables. Meta-analysis was used to calculate a summary correlation. RESULTS: Of 299 unique articles, 18 met inclusion criteria. Articles were diverse in regard to samples studied, procedures described, and correlations reported. Meta-analysis using data from all included studies revealed a summary correlation of 0.51. For studies using hand-held or isokinetic dynamometry, the summary correlation was 0.46 and 0.59 respectively. CONCLUSIONS: This study provides a better indication of the correlation between paretic knee extension strength and comfortable gait speed than individual studies. The correlation is high enough to provide support for the routine measurement of paretic knee extension force for individuals who have experienced a stroke.

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Knee Extension Strength Measures Indicating Probable Sarcopenia Is Associated with Health-Related Outcomes and a Strong Predictor of 1-Year Mortality in Patients Following Hip Fracture Surgery

Geriatrics ◽

10.3390/geriatrics6010008 ◽

2021 ◽

Vol 6 (1) ◽

pp. 8

Author(s):

Morten Tange Kristensen ◽

Signe Hulsbæk ◽

Louise Lohmann Faber ◽

Lise Kronborg

Keyword(s):

Hip Fracture ◽

Strong Predictor ◽

Knee Extension ◽

Acute Hospital ◽

Cut Points ◽

Knee Extension Strength ◽

Hip Fracture Surgery ◽

Hand Grip ◽

Health Related ◽

Fracture Surgery

To examine if knee-extension strength (KES) measures indicating probable sarcopenia are associated with health-related outcomes and if KES and hand grip strength (HGS) measures are associated with 1-year mortality after hip fracture. Two groups of older patients with hip fracture had either HGS (n = 32) or KES (n = 150) assessed during their acute hospital stay. Cut-points for HGS (<27 kg for men and <16 kg for women), and cut-points for maximal isometric KES (non-fractured limb), being the lowest sex-specific quintile (<23.64 kg for men and <15.24 kg for women), were used to examine association with health-related outcomes and 1-year mortality. Overall, 1-year mortality was 12.6% in the two strength groups, of which 47% (HGS) and 46% (KES) respectively, were classified as probable sarcopenia. Probable sarcopenia patients (KES) had lower prefracture function, performed poorly in mobility measures and expressed a greater concern of falling compared to their stronger counterparts. Hazard ratio for 1-year mortality was 2.7 (95%CI = 0.49–14.7, p = 0.3) for HGS and 9.8 (95%CI = 2.2–43.0, p = 0.002) for KES for probable sarcopenia patients compared to those not. Sex-specific KES measures indicating sarcopenia is associated with health-related outcomes and a strong predictor of 1-year mortality after hip fracture.

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Normalized Muscle Strength, Aerobic Capacity, and Walking Performance in Chronic Stroke: A Population-Based Study on the Potential for Endurance and Resistance Training

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2011.04.022 ◽

2011 ◽

Vol 92 (10) ◽

pp. 1663-1668 ◽

Cited By ~ 40

Author(s):

Kaare Severinsen ◽

Johannes K. Jakobsen ◽

Kristian Overgaard ◽

Henning Andersen

Keyword(s):

Resistance Training ◽

Muscle Strength ◽

Aerobic Capacity ◽

Population Based ◽

Chronic Stroke ◽

Population Based Study ◽

Walking Performance

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A Prospective Clinical and Radiological Evaluation at 5 Years After Arthroscopic Matrix-Induced Autologous Chondrocyte Implantation

The American Journal of Sports Medicine ◽

10.1177/0363546516663493 ◽

2016 ◽

Vol 45 (1) ◽

pp. 59-69 ◽

Cited By ~ 32

Author(s):

Jay R. Ebert ◽

Michael Fallon ◽

David J. Wood ◽

Gregory C. Janes

Keyword(s):

Autologous Chondrocyte Implantation ◽

Knee Extension ◽

Composite Score ◽

Physical Component Score ◽

Knee Extension Strength ◽

Sf 36 ◽

Peak Knee ◽

Chondrocyte Implantation ◽

Minute Walk ◽

Autologous Chondrocyte

Background: While midterm outcomes after matrix-induced autologous chondrocyte implantation (MACI) are encouraging, the procedure permits an arthroscopic approach that may reduce the morbidity of arthrotomy and permit accelerated rehabilitation. Hypothesis: A significant improvement in clinical and radiological outcomes after arthroscopic MACI will exist through to 5 years after surgery. Study Design: Case series; Level of evidence, 4. Methods: We prospectively evaluated the first 31 patients (15 male, 16 female) who underwent MACI via arthroscopic surgery to address symptomatic tibiofemoral chondral lesions. MACI was followed by a structured rehabilitation program in all patients. Clinical scores were administered preoperatively and at 3 and 6 months as well as 1, 2, and 5 years after surgery. These included the Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee scale (LKS), Tegner activity scale (TAS), visual analog scale for pain, Short Form–36 Health Survey (SF-36), active knee motion, and 6-minute walk test. Isokinetic dynamometry was used to assess peak knee extension and flexion strength and limb symmetry indices (LSIs) between the operated and nonoperated limbs. High-resolution magnetic resonance imaging (MRI) was performed at 3 months and at 1, 2, and 5 years postoperatively to evaluate graft repair as well as calculate the MRI composite score. Results: There was a significant improvement ( P < .05) in all KOOS subscale scores, LKS and TAS scores, the SF-36 physical component score, pain frequency and severity, active knee flexion and extension, and 6-minute walk distance. Isokinetic knee extension strength significantly improved, and all knee extension and flexion LSIs were above 90% (apart from peak knee extension strength at 1 year). At 5 years, 93% of patients were satisfied with MACI to relieve their pain, 90% were satisfied with improving their ability to undertake daily activities, and 80% were satisfied with the improvement in participating in sport. Graft infill ( P = .033) and the MRI composite score ( P = .028) significantly improved over time, with 90% of patients demonstrating good to excellent tissue infill at 5 years. There were 2 graft failures at 5 years after surgery. Conclusion: The arthroscopically performed MACI technique demonstrated good clinical and radiological outcomes up to 5 years, with high levels of patient satisfaction.

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Plasma Phospholipid PUFAs Are Associated with Greater Muscle and Knee Extension Strength but Not with Changes in Muscle Parameters in Older Adults1–3

Journal of Nutrition ◽

10.3945/jn.114.200337 ◽

2014 ◽

Vol 145 (1) ◽

pp. 105-112 ◽

Cited By ~ 26

Author(s):

Ilse Reinders ◽

Xiaoling Song ◽

Marjolein Visser ◽

Gudny Eiriksdottir ◽

Vilmundur Gudnason ◽

...

Keyword(s):

Plasma Phospholipid ◽

Knee Extension ◽

Knee Extension Strength

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Isokinetic knee extension strength and pain before and after advancement osteotomy of the tibial tuberosity

Archives of Orthopaedic and Traumatic Surgery ◽

10.1007/bf02498723 ◽

1983 ◽

Vol 102 (2) ◽

pp. 95-101 ◽

Cited By ~ 16

Author(s):

Bengt Nordgren ◽

Lars-Olof Nordesjö ◽

Wolfgang Rauschning

Keyword(s):

Knee Extension ◽

Tibial Tuberosity ◽

Knee Extension Strength ◽

Before And After

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EARLY STRENGTH TESTING AFTER ACL RECONSTRUCTION IMPACTS ISOKINETIC STRENGTH PERFORMANCE AT TIME OF RETURN TO SPORT

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00119 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0011

Author(s):

Adam Weaver ◽

Dylan Roman ◽

Maua Mosha ◽

Nicholas Giampetruzzi

Keyword(s):

Test Performance ◽

Knee Extension ◽

Strength Test ◽

Strength Testing ◽

Isokinetic Strength ◽

Rehabilitation Process ◽

Strength Performance ◽

Knee Extension Strength ◽

Isometric Knee Extension ◽

Strength Tests

Background: The standard of care in ACL reconstruction (ACLR) typically involves standardized strength testing at 6 months or later to assess a patient’s readiness to return to play (RTP) using isokinetic and isometric testing, and functional strength testing. Recent literature suggests that isokinetic knee extension strength should demonstrate 89% limb symmetry index (LSI) or greater prior to returning to sport. However, there is little known on the effects of strength testing early in the rehabilitation process and the relationship to strength test performance at time of RTP. Purpose: The purpose of this study was to examine how early post-operative strength test performance impacts isokinetic strength outcomes at RTP testing in adolescents. Methods: The retrospective cohort study included patients undergoing primary ACLR between 12 and 18 years of age, early post-operative strength measures, and isokinetic dynamometer strength at RTP from July 2017 and April 2019. Data was dichotomized into desired outcomes at 3 months: >70% isometric knee extension LSI, > 20 repetitions on anterior stepdown test (AST), > 90% LSI Y Balance. At RTP testing, isokinetic knee extension strength data was categorized into >89% LSI at 3 speeds (300, 180, 60°/sec). Chi square testing and odds ratio statistics were used to examine association and its magnitude. Results: 63 patients met inclusion criteria (38 females; 15.37±1.66 years old). >70% LSI isometric knee extension strength at 3 months showed a significant association (Table 2) and demonstrated the strongest odds of having >89% LSI on isokinetic strength tests at all 3 speeds at RTP with 180°/sec being the highest (OR=14.5; 95% CI=4.25,49.43; p= <0.001). Performance on AST showed a significant association (χ2 (1, n=63) = 17.00, p <0.001), and highest odds at 180°/sec (OR=4.61; 95% CI = 1.59, 13.39, p=<0.001) and 60°/sec (OR= 3.07; 95% CI = 1.10, 8.63, p= 0.04). Combination of performance on isometric strength tests and AST showed a significant association to isokinetic strength at all three speeds, but less predictive then isometrics in isolation. (Table 2). There was no significant relationship between YBR LSI at 3 months and isokinetic strength at 6 months. Conclusion: Standardized strength testing early in rehabilitation can help identify patients that will successfully complete RTP testing. Our results suggest that isometric knee extension strength and timed anterior stepdown test provide meaningful clinical information early in the rehabilitation process. This data also suggests that the use of YBAL for predicting isokinetic strength performance is limited. [Table: see text][Table: see text]

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