The isometric knee extension strength threshold for maintaining walking speed and step length in older male inpatients

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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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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Validity of maximal isometric knee extension strength measurements obtained via belt-stabilized hand-held dynamometry in healthy adults

Journal of Physical Therapy Science ◽

10.1589/jpts.29.1987 ◽

2017 ◽

Vol 29 (11) ◽

pp. 1987-1992 ◽

Cited By ~ 5

Author(s):

Naoko Ushiyama ◽

Yasushi Kurobe ◽

Kimito Momose

Keyword(s):

Knee Extension ◽

Healthy Adults ◽

Knee Extension Strength ◽

Isometric Knee Extension

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NOVEL TOOLS TO ASSESS ISOMETRIC KNEE EXTENSION STRENGTH AND MOBILITY LIMITATION IN ELDERLY WOMEN

The Gerontologist ◽

10.1093/geront/gnv550.17 ◽

2015 ◽

Vol 55 (Suppl_2) ◽

pp. 189-189

Keyword(s):

Elderly Women ◽

Knee Extension ◽

Mobility Limitation ◽

Knee Extension Strength ◽

Isometric Knee Extension

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The Relationship between Walking Speed and Step Length in Older Aged Patients

Diseases ◽

10.3390/diseases7010017 ◽

2019 ◽

Vol 7 (1) ◽

pp. 17 ◽

Cited By ~ 5

Author(s):

Yuji Morio ◽

Kazuhiro Izawa ◽

Yoshitsugu Omori ◽

Hironobu Katata ◽

Daisuke Ishiyama ◽

...

Keyword(s):

Muscle Force ◽

Walking Speed ◽

Step Length ◽

Knee Extension ◽

Height Ratio ◽

Roc Curve Analysis ◽

Aged Patients ◽

Speed Test ◽

Slow Group ◽

Fast Group

Compared with elderly people who have not experienced falls, those who have were reported to have a shortened step length, large fluctuations in their pace, and a slow walking speed. The purpose of this study was to elucidate the step length required to maintain a walking speed of 1.0 m/s in patients aged 75 years or older. We measured the 10 m maximum walking speed in patients aged 75 years or older and divided them into the following two groups: Those who could walk 1.0 m/s or faster (fast group) and those who could not (slow group). Step length was determined from the number of steps taken during the 10 m-maximum walking speed test, and the step length-to-height ratio was calculated. Isometric knee extension muscle force (kgf), modified functional reach (cm), and one-leg standing time (s) were also measured. We included 261 patients (average age: 82.1 years, 50.6% men) in this study. The fast group included 119 participants, and the slow group included 142 participants. In a regression logistic analysis, knee extension muscle force (p = 0.03) and step length-to-height ratio (p < 0.01) were determined as factors significantly related to the fast group. As a result of ROC curve analysis, a step length-to-height ratio of 31.0% could discriminate between the two walking speed groups. The results suggest that the step length-to-height ratio required to maintain a walking speed of 1.0 m/s is 31.0% in patients aged 75 years or older.

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The impact of disease-related immobilization on thigh muscle mass and strength in older hospitalized patients

BMC Geriatrics ◽

10.1186/s12877-020-01873-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Nikola Rommersbach ◽

Rainer Wirth ◽

Gero Lueg ◽

Christiane Klimek ◽

Mirja Schnatmann ◽

...

Keyword(s):

Muscle Mass ◽

Handgrip Strength ◽

Knee Extension ◽

Hospitalized Patients ◽

Thigh Muscle ◽

Knee Extension Strength ◽

Isometric Knee Extension ◽

Intermuscular Fat ◽

Prospective Longitudinal ◽

The Impact

Abstract Background We assessed the quantitative changes in muscle mass and strength during 2 weeks of hospitalization in immobile and mobile acutely ill hospitalized older adults. Methods Forty-one patients (82.4 ± 6.6 years, 73.0% females) participated in this prospective longitudinal observational study. Mobility status was defined according to walking ability as described in the Barthel-Index. Functional status, including handgrip strength and isometric knee-extension strength, and mid-thigh magnetic resonance imaging (MRI) measurements of cross-sectional area (CSA) were conducted on admission and at discharge. Results Twenty-two participants (54%) were immobile and 19 (46%) mobile. In all, 54.0 and 12.0% were at risk of malnutrition and malnourished, respectively. The median time between baseline and follow-up for MRI scans were 13 days in mobile and immobile participants (P = 0.072). Mid-thigh muscle and subcutaneous fat CSA significantly decreased by 3.9cm2 (5.0%, P = 0.002) and 5.3cm2 (5.7%, P = 0.036) during hospitalization whereas intermuscular fat remained unchanged in immobile subjects. No significant changes were observed in mobile patients. In a regression analysis, mobility was the major independent risk factor for changes in mid-thigh muscle CSA as a percentage of initial muscle area (P = 0.022) whereas other variables such as age (P = 0.584), BMI (P = 0.879), nutritional status (P = 0.835) and inflammation (P = 0.291) were not associated with muscle mass changes. There was a significant decrease in isometric knee extension strength (P = 0.002) and no change in handgrip strength (P = 0.167) in immobile patients whereas both parameters increased significantly over time in mobile patients (P = 0.048 and P = 0.012, respectively). Conclusions Two weeks of disease-related immobilization result in a significant loss of thigh muscle mass and muscle strength in older patients with impaired mobility. Concomitantly, there was a significant reduction of subcutaneous adipose tissue in immobile older hospitalized patients whereas no changes were observed in intermuscular fat among these patients. These data highlight the importance of mobility support in maintaining muscle mass and function in older hospitalized patients.

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The effect of a knee ankle foot orthosis incorporating an active knee mechanism on gait of a person with poliomyelitis

Prosthetics and Orthotics International ◽

10.1177/0309364612469140 ◽

2013 ◽

Vol 37 (5) ◽

pp. 411-414 ◽

Cited By ~ 20

Author(s):

Mokhtar Arazpour ◽

Ahmad Chitsazan ◽

Monireh Ahmadi Bani ◽

Gholamreza Rouhi ◽

Farhad Tabatabai Ghomshe ◽

...

Keyword(s):

Knee Flexion ◽

Walking Speed ◽

Horizontal Displacement ◽

Step Length ◽

Knee Extension ◽

Knee Joints ◽

Ankle Foot Orthosis ◽

Stance Control ◽

Control Knee ◽

Foot Orthosis

Background: The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. Case description and methods: A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase. Lower limb kinematic and kinetic data plus data for temporospatial parameters were acquired from three test walks using each orthosis. Findings and outcomes: Walking speed, step length, and vertical and horizontal displacement of the pelvis decreased when walking with the powered stance control knee ankle foot orthosis compared to the knee ankle foot orthosis. When using the powered stance control knee ankle foot orthosis, the knee flexion achieved during swing and also the overall pattern of walking more closely matched that of normal human walking. The reduced walking speed may have caused the smaller compensatory motions detected when the powered stance control knee ankle foot orthosis was used. Conclusion: The new powered SCKAFO facilitated controlled knee flexion and extension during ambulation for a volunteer poliomyelitis person. Clinical relevance The powered stance control knee ankle foot orthosis has the potential to improve knee joint kinematics in persons with poliomyelitis when ambulating.

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