Is maximal muscle strength and fatigability of three lower limb muscle groups associated with walking capacity and fatigability in multiple sclerosis? An exploratory study

This research aimed to assess the correlation between isometric muscle strength of the lower limb and motor skills. This is a cross sectional study performed among volunteer nursing home residents included in the SENIOR (Sample of Elderly Nursing home Individuals: an Observational Research) cohort. The present analysis focused on isometric muscle strength of 6 lower limb muscle groups (i.e. knee extensors, knee flexors, hip abductors, hip extensors, ankle flexors and ankle extensors), assessed using a validated hand-held dynamometer (i.e. the MicroFET2 device), and motor skills evaluated using the Tinetti test, the Timed Up and Go test, the Short Physical Performance Battery test (SPPB) and the walking speed. The relationship between all these parameters was tested by means of a multiple correlation, adjusted on age, sex and body mass index. 450 nursing home residents (69.8% of women) with a mean age of 83.1±9.4 years were included in this study. Our results showed a significant inverse correlation between lower limb muscle strength and the time required to perform the TUG test or gait speed, except for ankle flexors and ankle extensors. The relationship between the Tinetti test or the SPPB score, and lower limb muscle strength was significant, except for ankle flexors and ankle extensors. In conclusion, a positive association between lower limb muscle strength of the four main muscle groups and motor skills of the elderly nursing residents was found in this research. Therefore, special attention should be given to these muscle groups during rehabilitation programs.

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Reliability and validity of hand-held dynamometry for assessing lower limb muscle strength

Isokinetics and Exercise Science ◽

10.3233/ies-210168 ◽

2021 ◽

pp. 1-10

Author(s):

Tjaša Lipovšek ◽

Alan Kacin ◽

Urška Puh

Keyword(s):

Muscle Strength ◽

Lower Limb ◽

Reliability And Validity ◽

Knee Extensors ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Rater Reliability ◽

Extensor Muscles ◽

Good For ◽

Muscle Groups

BACKGROUND: Hand-held dynamometry (HHD) is used to assess muscle strength in various patient populations, but many variations in protocols exist. OBJECTIVE: First, to systematically develop a protocol of HHD for all lower limb muscle groups and evaluate intra-rater reliability; second, to validate HHD with fixed dynamometry for the knee flexor and extensor muscles. METHODS: Thirty healthy young adults (women: men – 15:15) participated in two testing sessions. HHD of 12 lower limb muscle groups was performed in both sessions, while fixed dynamometry of knee muscle groups was performed only in the second session. RESULTS: The intra-rater reliability of HHD was good for five muscle groups and excellent for seven muscle groups (ICC3, k= 0.80–0.96). The criterion validity of HHD ranged from very good to excellent for the knee flexors (r= 0.77–0.89) and from good to very good for the knee extensors (r= 0.65–0.78). However, peak moment values for the knee extensor muscles were underestimated by 32% (p< 0.001). CONCLUSIONS: The proposed HHD protocol provides reliable and valid measurements of lower limb muscle isometric strength in healthy adults, which may also be used to test patients with mild muscle strength deficits. However, possible underestimation of absolute strength must be considered when interpreting the results of knee extensors or other large muscles.

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