Reliability of isometric knee extension muscle strength measurements made by a hand-held dynamometer and a belt: a comparison of two types of device

Abstract Objective Insufficient physical activity and excessive sedentary behavior can contribute to decreased skeletal muscle strength, which is strongly associated with increased mortality in patients with chronic kidney disease (CKD). However, the potential impact of replacing sedentary behavior with physical activity on skeletal muscle strength remains unclear in these patients. The purpose of this study was to examine the associations of physical activity, sedentary behavior, and skeletal muscle strength in patients with CKD using an isotemporal substitution model to estimate the associations on replacing time from one behavior to another while keeping the total time and other behaviors fixed. Methods A total of 108 patients with CKD (mean age = 65 [SD = 9] y; mean estimated glomerular filtration rate = 57 [SD = 22] mL/min/1.73m2) participated in this cross-sectional analysis study. The time spent in sedentary behavior, light-intensity physical activity, and moderate- to vigorous-intensity physical activity (MVPA) were assessed using a triaxial accelerometer. Handgrip strength, isometric knee extension strength, and 30-second chair stand test were used to measure skeletal muscle strength. Results In multivariate analyses (single-factor and partition models), the time spent in MVPA was beneficially associated with both isometric knee extension strength and 30-second chair stand test. Furthermore, the isotemporal substitution model found that replacing 10 minutes per day of sedentary behavior or light-intensity physical activity with equivalent MVPA time was beneficially associated with both isometric knee extension strength and 30-second chair stand test. Conclusions Our cross-sectional findings indicate that MVPA time is beneficially associated with lower extremity muscle strength and that a slight increase in the MVPA time may contribute to maintaining skeletal muscle strength in patients with CKD. Impact Increasing the time spent in MVPA (10 min/day) may be a feasible strategy in patients with CKD, who have a high prevalence of impaired physical function.

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Impaired knee extension muscle strength in adolescents but not in children with Fontan circulation

Cardiology in the Young ◽

10.1017/s1047951120001675 ◽

2020 ◽

Vol 30 (8) ◽

pp. 1138-1143

Author(s):

Camilla Sandberg ◽

Emelie Frisk ◽

Lena Hansson ◽

Annika Isberg ◽

Eva Rylander Hedlund ◽

...

Keyword(s):

Muscle Strength ◽

Lean Mass ◽

Plantar Flexion ◽

Knee Extension ◽

Fontan Circulation ◽

Group Level ◽

Cross Sectional ◽

Knee Extension Strength ◽

Isometric Knee Extension ◽

Isometric Muscle

AbstractIntroduction:Impaired isometric muscle strength was previously reported in adults with Fontan circulation. However, it is unclear if this impairment is present in children and adolescents with Fontan circulation. We investigated isometric muscle strength of the lower limb in patients (6–18 years) with Fontan circulation in comparison with healthy controls.Method:In this cross-sectional study, 43 patients (6–18 years) with Fontan circulation and 43 age- and sex-matched controls were included. Isometric knee extension and plantar flexion muscle strength were assessed using dynamometry (Newton, N). Lean mass of the legs was assessed with dual-energy X-ray absorptiometry. Analyses were performed on group level (n = 43), and for subgroups that included children aged 6–12 years (n = 18) and adolescents aged 13–18 years (n = 25).Results:On group level, the patients with Fontan circulation had impaired isometric knee extension strength in comparison with the controls (p = 0.03). In subgroup analyses, impaired isometric knee extension strength was present in the adolescents (p = 0.009) but not in the children groups. For plantar flexion, there was no difference between patients and controls. There was no difference in lean mass between patients and controls (9.6 ± 4.3 kg vs. 10.8 ± 5.6 kg, p = 0.31). However, the lean mass was highly correlated to isometric knee extension strength (patients r = 0.89, controls r = 0.96, p < 0.001) and isometric plantar flexion strength (patients r = 0.7, controls r = 0.81, p < 0.001).Conclusion:The finding of impaired isometric knee extension muscle strength in adolescents (13–18 years) with Fontan circulation and no corresponding impairment in the children group (6–12 years) could imply that isometric muscle strength gets more impaired with age.

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Factors Influencing Lower Extremity Muscle Strength in Interstitial Pneumonia Patients: The Association of Isometric Knee Extension Strength with Respiratory Function, Dyspnea and Exercise Capacity

Journal of the Japanese Physical Therapy Association ◽

10.1298/jjpta.vol18_027 ◽

2015 ◽

Vol 18 (1) ◽

pp. 46-46

Author(s):

Rie TAKEICHI ◽

Hitoshi YOKOYAMA ◽

Yosuke WATANABE ◽

Yuri YOKOYAMA ◽

Yusuke KASAHARA ◽

...

Keyword(s):

Muscle Strength ◽

Lower Extremity ◽

Exercise Capacity ◽

Interstitial Pneumonia ◽

Respiratory Function ◽

Knee Extension ◽

Knee Extension Strength ◽

Lower Extremity Muscle ◽

Factors Influencing ◽

Isometric Knee Extension

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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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