scholarly journals A Predictive Model for Hip Abductor Strength and Knee Extensor Strength 12 Months After Total Hip Arthroplasty With an Interaction Term

2021 ◽  
Author(s):  
Junya Sekita ◽  
Naonobu Takahira ◽  
Genki Iwamura ◽  
Hiroyuki Watanabe ◽  
Atsushi Kusaba ◽  
...  
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
Predictive Model ◽  
Disease Duration ◽  
Knee Extensor ◽  
Explanatory Variables ◽  
Interaction Terms ◽  
Knee Extensor Strength ◽  
Hip Abductor ◽  
Interaction Term

Abstract Background: Identifying populations with poor muscle recovery after total hip arthroplasty (THA) is important for postoperative physical therapy. Preoperative muscle strength is a strong factor that determines postoperative muscle strength. However, this effect may depend on other factors. Thus, predictive models with interaction terms are important for accurately predicting postoperative muscle strength. This study aimed to develop a predictive model for lower muscle strength 12 months after THA which incorporates interaction terms.Methods­: Subjects were female patients with hip osteoarthritis who underwent unilateral THA. Patients with locomotor disorders, neurological disorders, or postoperative complications were excluded. Hip abductor and knee extensor strength were measured, and a generalized linear model approach with preoperative muscle strength, age, body weight, height, disease duration, physical activity, and leg extension as explanatory variables was used to identify factors that determine muscle strength 12 months after THA. Models with interaction terms between preoperative muscle strength and other explanatory variables were also examined. Results: A total of 82 patients were analyzed. Preoperative muscle strength, age, body weight, physical activity, and disease duration were extracted as factors that significantly and independently determine hip abductor and knee extensor strength. The interaction term between preoperative muscle strength and age was identified as a factor that significantly determines knee extensor strength. Regression coefficients for preoperative knee extensor strength and postoperative muscle strength were significant when age was +1 SD, but not when age was -1 SD.Conclusions: The predictive model demonstrated that lower muscle strength 12 months after THA is determined by preoperative muscle strength, age, weight, physical activity, disease duration, and preoperative muscle strength, with the effect of preoperative muscle strength on knee extensor strength being dependent on age. When predicting postoperative knee extensor strength using preoperative muscle strength, it is important to consider the effect of age.

scholarly journals A predictive model for hip abductor strength and knee extensor strength 12 months after total hip arthroplasty with an interaction term

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Junya Sekita ◽  
Naonobu Takahira ◽  
Genki Iwamura ◽  
Hiroyuki Watanabe ◽  
Atsushi Kusaba ◽  
...  
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
Predictive Model ◽  
Disease Duration ◽  
Knee Extensor ◽  
Explanatory Variables ◽  
Interaction Terms ◽  
Knee Extensor Strength ◽  
Hip Abductor ◽  
Interaction Term

Abstract Background Identifying populations with poor muscle recovery after total hip arthroplasty (THA) is important for postoperative physical therapy. Preoperative muscle strength is a strong factor that determines postoperative muscle strength. However, this effect may depend on other factors. Thus, predictive models with interaction terms are important for accurately predicting postoperative muscle strength. This study aimed to develop a predictive model for lower muscle strength 12 months after THA which incorporates interaction terms. Methods Subjects were female patients with hip osteoarthritis who underwent unilateral THA. Patients with locomotor disorders, neurological disorders, or postoperative complications were excluded. Hip abductor and knee extensor strength were measured, and a generalized linear model approach with preoperative muscle strength, age, body weight, height, disease duration, physical activity, and leg extension as explanatory variables was used to identify factors that determine muscle strength 12 months after THA. Models with interaction terms between preoperative muscle strength and other explanatory variables were also examined. Results A total of 82 patients were analyzed. Preoperative muscle strength, age, body weight, physical activity, and disease duration were extracted as factors that significantly and independently determine hip abductor and knee extensor strength. The interaction term between preoperative muscle strength and age was identified as a factor that significantly determines knee extensor strength. Regression coefficients for preoperative knee extensor strength and postoperative muscle strength were significant when age was +1 SD, but not when age was -1 SD. Conclusions The predictive model demonstrated that lower muscle strength 12 months after THA is determined by preoperative muscle strength, age, weight, physical activity, disease duration, and preoperative muscle strength, with the effect of preoperative muscle strength on knee extensor strength being dependent on age. When predicting postoperative knee extensor strength using preoperative muscle strength, it is important to consider the effect of age.

scholarly journals Work Ability and Employment in Rheumatoid Arthritis: A Cross-Sectional Study on the Role of Muscle Strength and Lower Extremity Function

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Carolin Berner ◽  
Sandra Haider ◽  
Igor Grabovac ◽  
Thomas Lamprecht ◽  
Karl Heinrich Fenzl ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Work Ability ◽  
Employment Status ◽  
Knee Extensor ◽  
Lower Extremity Function ◽  
Cross Sectional ◽  
Hand Grip ◽  
Extremity Function ◽  
Knee Extensor Strength

Objective. The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients. Methods. One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors. Results. Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables. Conclusions. The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.

scholarly journals Association between Levocarnitine Treatment and the Change in Knee Extensor Strength in Patients Undergoing Hemodialysis: A Post-Hoc Analysis of the Osaka Dialysis Complication Study (ODCS)

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 343
Author(s):  
Shota Matsufuji ◽  
Tetsuo Shoji ◽  
Suhye Lee ◽  
Masao Yamaguchi ◽  
Mari Nishimura ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Extensor ◽  
Positive Association ◽  
Hemodialysis Patients ◽  
Carnitine Deficiency ◽  
Knee Extensor Strength ◽  
Effect Of Treatment ◽  
One Year ◽  
The One ◽  
Post Hoc

Carnitine deficiency is prevalent in patients undergoing hemodialysis, and it could result in lowered muscle strength. So far, the effect of treatment with levocarnitine on lower limb muscle strength has not been well described. This observational study examined the association between treatment with levocarnitine with the change in knee extensor strength (KES) in hemodialysis patients. Eligible patients were selected from the participants enrolled in a prospective cohort study for whom muscle strength was measured annually. We identified 104 eligible patients for this analysis. During the one-year period between 2014 to 2015, 67 patients were treated with intravenous levocarnitine (1000 mg per shot, thrice weekly), whereas 37 patients were not. The change in KES was significantly higher (p = 0.01) in the carnitine group [0.02 (0.01–0.04) kgf/kg] as compared to the non-carnitine group [−0.02 (−0.04 to 0.01) kgf/kg]. Multivariable-adjusted regression analysis showed the positive association between the change in KES and the treatment with levocarnitine remained significant after adjustment for the baseline KES and other potential confounders. Thus, treatment with intravenous levocarnitine was independently and positively associated with the change in KES among hemodialysis patients. Further clinical trials are needed to provide more solid evidence.

Abstract 18801: Light-intensity Physical Activity After Discharge Predicts 6-month Postdischarge Adverse Events in Older Japanese Patients With Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Naoki Fujimoto ◽  
Kaoru Dohi ◽  
So Miyahara ◽  
Keishi Moriwaki ◽  
Taku Omori ◽  
...  
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
Light Intensity ◽  
Knee Extensor ◽  
Extensor Muscle ◽  
Moderate Intensity ◽  
Sf 36 ◽  
Patients With Heart Failure ◽  
Steps Per Day ◽  
Knee Extensor Muscle Strength

Introduction: Moderate physical activity (PA) is recommended in patients with heart failure (HF). However, patient’ characteristics in those with low PA and the impact of light-intensity PA on postdischarge major adverse cardiovascular events (MACE) remain unclear in older Japanese HF patients. Methods: Thirty seven patients (Stage C/D: 76±5 yrs, 21m) who had been admitted due to HF and 23 Stage A/B patients (73±5 yrs) with risk factors were enrolled. PA was measured using the Omuron HJ350IT accelerometer from the day of discharge for 7 days. Light-intensity PA at an intensity of 1.5-3.0 metabolic equivalents (METs), moderate-intensity PA (≥3METs), and total PA were determined. At discharge, knee-extensor muscle strength, 6-min walking distance (6MWD),SF-36 score, and left ventricular (LV) structure by echocardiography were evaluated. Stage C/D patients were stratified into High-PA and Low-PA according to the median total PA value of 8.4 METs·hour/day. Stage A/B patients underwent these measurements, and values were compared. Factors related to the 6-month postdischarge MACE were assessed. Results: Stage C/D patients were anemic, took fewer steps per day, and had higher brain natriuretic peptide (BNP) than Stage A/B patients. Patients in Low-PA were less likely to engage in household work, and had shorter active time, fewer steps per day, and lower light- and moderate-intensity PA than those in High-PA. No differences were observed in 6MWD (263±110 vs. 303±77 m), knee-extensor muscle strength, BNP (405±346 vs. 267±179 pg/ml), SF-36 physical composite score, or LV ejection fraction between Low-PA and High-PA. Light-intensity and total PA, but not moderate-intensity PA, were associated with the 6-month postdischarge MACE through univariate analyses. Multivariate regression analysis showed that total PA was the independent predictor of the 6-month postdischarge MACE (odds ratio: 0.66) among functional capacity variables including 6MWD and knee-extensor muscle strength. Conclusions: Physical activity, especially at light-intensity, is inversely associated with the 6-month postdischarge MACE in older HF patients. Our results may indicate that postdischarge PA assessed by accelerometer is useful to distinguish those at high risks for MACE.

Muscle-Strength and Gait-Speed Changes after Bicycle Exercise in Participants with Unilateral CVA

2001 ◽  
Vol 9 (4) ◽  
pp. 386-397 ◽  
Author(s):  
Karen L. Perell ◽  
Robert J. Gregor ◽  
A.M. Erika Scremin
Keyword(s):  
Muscle Strength ◽  
Gait Speed ◽  
Knee Extensor ◽  
Eccentric Contraction ◽  
Knee Extensors ◽  
Bicycle Exercise ◽  
Contralateral Limb ◽  
Knee Extensor Strength ◽  
Walking Tests ◽  
Knee Muscle

The purpose of this study was to determine the effect of bicycle exercise on knee-muscle strength and gait speed in 8 male participants with cerebrovascular accident (CVA). Isokinetic knee-extensor and -flexor strength were measured in both concentric- and eccentric-contraction modes. Fifty-foot walking tests were used for gait speed. After only 4 weeks of stationary recumbent cycling (12 sessions), participants improved eccentric muscle strength of the knee extensors, bilaterally. Walking-speed improvements approached but did not achieve significance with training. Improvement in concentric muscle strength of the knee extensors was observed in the involved limb, although most participants demonstrated a nonsignificant increase in muscle strength in the contralateral limb, as well. No improvements were demonstrated in the knee-flexor muscles. Thus, bicycle exercise serves to improve knee-extensor strength. In addition, these strength improvements might have implications for better control of walking in terms of bilateral improvement of eccentric muscle strength.

scholarly journals Knee Extensor Strength Measurement in Patients With Limited Physical Activity Using a Supine Dynamometer Anchoring Frame

2020 ◽  
Vol 44 (6) ◽  
pp. 502-509
Author(s):  
Min-Yong Lee ◽  
Kwan-Sik Sung ◽  
Hyungsuk Ham ◽  
You Gyoung Yi ◽  
Hyung-Ik Shin
Keyword(s):  
Physical Activity ◽  
Intraclass Correlation ◽  
Knee Extensor ◽  
Correlation Coefficients ◽  
Isometric Strength ◽  
Intraclass Correlation Coefficients ◽  
Knee Extensor Strength ◽  
Anchoring System ◽  
Seated Posture ◽  
Limited Physical Activity

Objective To investigate the reliability of knee extensor strength measurements using a supine hand-held dynamometer (HHD) anchoring frame in patients with limited physical activity. Although an HHD is suitable for bedside use, its inter-rater reliability is low because measurements can be influenced by tester strength.Methods Maximal knee extensor isometric strength was measured using an HHD anchored to the supine frame. Three trials of three maximal contractions were assessed by two raters.Results A total of 33 inpatients who were non-ambulatory due to acute illness participated in the study. The intraclass correlation coefficients were 0.974 (inter-rater) and 0.959 (intra-rater). The minimal detectable changes in intra- and inter-observer measurements were 29.46 N (24.10%) and 36.73 N (29.26%), respectively. The limits of agreement ranged from -19.79% to 24.81% for intra-rater agreement and from -21.45% to 37.07% for inter-rater agreement.Conclusion The portable dynamometer anchoring system can measure the isometric strength of the knee extensor reliably in the supine position, and could be used for measurements in patients who have difficulty visiting the laboratory and maintaining a seated posture.

Prevalence of frailty and associated factors among community-dwelling older adults after total hip arthroplasty

2021 ◽  
pp. 112070002110481
Author(s):  
Kazunari Ninomiya ◽  
Naonobu Takahira ◽  
Takashi Ikeda ◽  
Koji Suzuki ◽  
Ryoji Sato ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Associated Factors ◽  
Multinomial Logistic Regression ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Calf Circumference ◽  
Hip Abductor ◽  
Knee Extensor Muscle Strength ◽  
Community Dwelling Older Adults

Objective: To evaluate the prevalence of frailty and associated factors among community-dwelling older adults who have undergone total hip arthroplasty (THA). Materials and methods: This study, which employed a cross-sectional, observational design, was conducted between April and November 2020. The participants were older adults (⩾65 years) who had undergone primary THA at the study hospital. Based on Fried’s modified phenotype, frailty was stratified into 3 degrees according to the presence of 3 or more of the following components: weight loss, weakness, exhaustion, low activity level, and slow walking speed. Multinomial logistic regression was used to analyse the associations of frailty with its potential risk factors. Results: The data of 518 participants were analysed. The overall prevalence of frailty and prefrailty was 11.4% and 51.0%, respectively. The multinomial logistic regression analysis showed that calf circumference (odds ratio [OR] 0.716, 95% confidence interval [CI], 0.611–0.839; p < 0.001), fall history (OR 2.435, 95% CI, 1.114–5.322; p = 0.026), hip abductor muscle strength (OR 0.962, 95% CI, 0.938–0.987; p = 0.003), knee extensor muscle strength (OR 0.980, 95% CI, 0.964–0.996; p = 0.013), and Timed Up and Go test (TUG) performance (OR 1.802, 95% CI, 1.458–2.228; p < 0.001) were associated with frailty. Conclusions: Frailty was highly prevalent in community-dwelling older adults after THA. Further, its potential associations with calf circumference, hip abductor and knee extensor muscle strength, TUG performance, and fall history highlight the significance of these factors for interventions.

scholarly journals Preoperative Predictors of Ambulation Ability at Different Time Points after Total Hip Arthroplasty in Patients with Osteoarthritis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Akiko Kamimura ◽  
Harutoshi Sakakima ◽  
Fumio Tsutsumi ◽  
Nobuhiko Sunahara
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Knee Extensor ◽  
Time Points ◽  
Total Hip ◽  
Knee Extensor Strength ◽  
Postoperative Time ◽  
Hip Abductor ◽  
Preoperative Factors ◽  
Abductor Strength

The aims of this study were to identify the preoperative factors influencing ambulation ability at different postoperative time points after total hip arthroplasty (THA) and to examine the cutoff values of predictive preoperative factors by receiver operating characteristic (ROC) curves. Forty-eight women with unilateral THA were measured for hip extensor, hip abductor, and knee extensor muscle strength in both legs; hip pain (visual analog scale, VAS); and the Timed Up and Go (TUG) test pre- and postoperatively. Multiple regression analysis indicated that preoperative knee extensor strength(β=-0.379,R2=0.409)at 3 weeks, hip abductor strength(β=-0.572,R2=0.570)at 4 months, and age(β=0.758,R2= 0.561)at 7 months were strongly associated with postoperative ambulation, measured using the TUG test. Optimal preoperative cutoff values for ambulation ability were 0.56 Nm/kg for knee extensor strength, 0.24 Nm/kg for hip abductor strength, and 73 years of age. Our results suggest that preoperative factors predicting ambulation ability vary by postoperative time point. Preoperative knee extensor strength, hip abductor strength, and age were useful predictors of ambulation ability at the early, middle, and late time points, respectively, after THA.

scholarly journals A portable isometric knee extensor strength testing device: test-retest reliability and minimal detectable change scores of the Q-Force ӀӀ in healthy adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Johanneke Hartog ◽  
Sandra Dijkstra ◽  
Joke Fleer ◽  
Pim van der Harst ◽  
Massimo A. Mariani ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Standardized Test ◽  
Knee Extensor ◽  
Knee Extension ◽  
Minimal Detectable Change ◽  
Clinical Settings ◽  
Detectable Change ◽  
Retest Reliability ◽  
Knee Extensor Strength ◽  
Test Retest Reliability

Abstract Background Although knee extensors are essential in daily activities (e.g. walking, climbing stairs), knee extensor strength is often not measured in clinical settings. Existing devices to test muscle strength are not always suitable to accurately measure the high forces of this muscle group. Therefore, a device to test muscle strength that is convenient, feasible, reliable, and valid in clinical settings is required. This study evaluated the reliability, responsiveness, and level of discomfort of the newly developed Q-Force ӀӀ (i.e. a portable device to measure isometric knee extensor strength) in healthy middle-aged and elderly adults. Methods Participants (n = 22) conducted two standardized test sessions on the Q-Force ӀӀ (five to ten days apart). Each session consisted of one familiarisation trial followed by three trials of peak isometric knee extension per each leg. Per trial, peak and mean knee extension force (N) and torque (Nm) were measured at 90° flexion. The level of discomfort was determined using a visual analog scale (VAS: 0-100). Intra Class Correlation (ICC, model: two-way mixed with absolute agreement), Standard Error of Measurement (SEM), and minimal detectable change (MDC) were determined. A repeated measures ANOVA was used to determine between-test variation. Results Excellent test-retest (ICC > 0.95) and inter-trial (ICC > 0.91) reliability for both legs were shown. No significant differences were found in peak and mean knee forces and torques between test and retest of both legs, indicating good test-retest reliability (P-value range: 0.360-0.538; F(1,21) range: 0.4-0.9). The SEM of the peak and mean forces and torques ranged from 28.0 to 30.4 N (6.0-6.8%) and from 9.2 to 10.4 Nm (6.4-7.7%), respectively. The MDC for these outcomes ranged respectively from 77.6 to 84.1 N (16.5-18.8%) and from 25.5 to 28.9 Nm (17.6-21.4%). The level of discomfort was low (median range: 7-10, IQR: 4-18). Conclusion The portable Q-Force ӀӀ is a comfortable, responsive, and relatively cheap device with excellent test-retest reliability. This device would be potentially suitable to measure isometric knee extensor strength in clinical settings.

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