Manual muscle testing overlooks many knee extension strength deficits among older adults

2010 ◽  
Vol 18 (4) ◽  
pp. 185-187 ◽  
Author(s):  
Richard W. Bohannon
Keyword(s):  
Older Adults ◽  
Knee Extension ◽  
Manual Muscle Testing ◽  
Knee Extension Strength ◽  
Muscle Testing

scholarly journals Is knee extension strength a better predictor of functional performance than handgrip strength among older adults in three different settings?

2015 ◽  
Vol 60 (2) ◽  
pp. 252-258 ◽  
Author(s):  
Sofie Martien ◽  
Christophe Delecluse ◽  
Filip Boen ◽  
Jan Seghers ◽  
Johan Pelssers ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Performance ◽  
Handgrip Strength ◽  
Knee Extension ◽  
Knee Extension Strength

scholarly journals A single-arm feasibility study of community-delivered Baduanjin (Qigong practice of the eight Brocades) training for frail older adults

2020 ◽  
Author(s):  
Xiao Liu ◽  
Jean Wei Ting Seah ◽  
Benedict Wei Jun Pang ◽  
Mary Ann Tsao ◽  
Falong Gu ◽  
...  
Keyword(s):  
Older Adults ◽  
Adverse Events ◽  
Training Program ◽  
Grip Strength ◽  
Fall Risk ◽  
Knee Extension ◽  
Hand Grip Strength ◽  
Frail Older Adults ◽  
Knee Extension Strength ◽  
Hand Grip

Abstract Background: Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. We studied the feasibility of a community-delivered Baduanjin (BDJ) training program among pre-frail/frail community-dwelling older people. We examined 1) safety (adverse events), physical and psychological effects; and 2) feasibility of recruitment, retention, adherence; recruitment efforts and any program challenges, so as to inform future studies.Methods: Our study was a single arm pre-post study in a community setting. Sixteen week group BDJ training (2x/week in the first 4 weeks, and 3x/week thereafter) co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results: Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation, resulting in 12 older adults (9 women) enrolled into the program. During the program, one participant was hospitalized (unrelated to BDJ training) and the other 11 (aged 77±6 years; 2 frail, 9 prefrail at baseline) completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance >80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n=2) or maintained (n=9) their frailty statuses. There post-training outcomes in hand grip strength, knee extension strength, TUG , MQ , FES , MoCA , GDS and EQ-5D-5L index score appeared to be better. The reduction of frailty and PPA fall risk scores were of moderate-to-large effect size. Conclusions: Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.

scholarly journals Sarcopenic Obesity Indices Are Major Determinants of Bone Strength in Older Adults With Obesity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A239-A239
Author(s):  
Giulia Gregori ◽  
Arjun Paudyal ◽  
Yann Barnouin ◽  
Alessandra Celli ◽  
Reina Condevillamar Villareal ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Grip Strength ◽  
Bone Strength ◽  
Distal Radius ◽  
Bone Quality ◽  
Gait Speed ◽  
Failure Load ◽  
Knee Extension ◽  
Knee Extension Strength

Abstract Background: The increasing number of older adults with obesity is a growing public health problem because of increased risk of fractures especially at the ankle and upper leg despite normal or high bone mineral density. Among the contributory factors for fracture risk in this population may be aging- and obesity- associated physical frailty and impaired bone quality. However, how the adverse changes in physical function and body composition in this aging and obese population contribute to bone quality as assessed by finite element analyses (FEA) of bone strength has not been determined. Methods: One-hundred sixty-nine older (age ≥ 65 yrs.) adults with obesity (BMI ≥ 30 kg/m2) were recruited to participate in lifestyle intervention trials at our Medical Center. All underwent baseline measurements of bone strength (failure load [N] and stiffness [N.mm-1]) as estimated using FEA from high-resolution peripheral quantitative tomography (HR-pQCT) of the distal radius and tibia. In addition, body composition (appendicular lean mass/BMI [ALMBMI], fat mass/height2 [FMI]) was assessed by dual-energy x-ray absorptiometry (DXA) and physical function by the modified physical performance test (PPT), knee extension strength (isokinetic dynamometry), hand grip strength, and 4-meter gait speed. Results: Bivariate analyses showed that ALMBMI (r=.57 to .58), FMI (r=-.16 to -.17), gait speed (r=.20 to .21), grip strength (.56 to .57), and knee extension strength (r=.40 to .42) correlated with stiffness and failure load at the distal radius (all P<0.05). In addition, ALMBMI (r=.65 to .67), FMI (r=-.22 to .23), gait speed (r+.18 to .19), grip strength (r=.58 to .59), and knee extension strength (r=.44 to .45) correlated with stiffness and failure load at the distal tibia (all P<0.05). Controlling for age and sex, multiple regression analyses revealed that ALMBMI (β=.34 to .35) and grip strength (β=.28 to .29) were the independent predictors of stiffness and failure load at the distal radius, explaining 45% to 46% of the variance in stiffness and failure load (P<0.001). On the other hand, multiple regression analyses revealed that ALMBMI (β=.45 to .52), grip strength (β=.27 to .28), and FMI (β=.17 to .18) were the independent predictors of stiffness and failure load at the distal tibia, explaining 74% to 75% of the variance in stiffness and failure load (P<0.001). Conclusions: These findings suggest the importance of preserving muscle mass while reducing fat mass and improving physical function to maintain bone quality and decrease the risk of fractures when older adults with obesity undergo lifestyle intervention.

Cut-off points of knee extension strength allometrically adjusted to identify sarcopenia risk in older adults: A cross-sectional study

2020 ◽  
Vol 89 ◽  
pp. 104100 ◽  
Author(s):  
Pedro Pugliesi Abdalla ◽  
Anderson dos Santos Carvalho ◽  
André Pereira dos Santos ◽  
Ana Claudia Rossini Venturini ◽  
Thiago Cândido Alves ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Extension ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knee Extension Strength

scholarly journals Relationship of Knee Extension Force to Independence in Sit-to-Stand Performance in Patients Receiving Acute Rehabilitation

2003 ◽  
Vol 83 (6) ◽  
pp. 544-551 ◽  
Author(s):  
Ola Eriksrud ◽  
Richard W Bohannon
Keyword(s):  
Body Weight ◽  
Knee Extension ◽  
Upper Extremities ◽  
Manual Muscle Testing ◽  
Specific Reference ◽  
Muscle Testing ◽  
Sit To Stand ◽  
Extension Force ◽  
Relationship Of ◽  
Acute Rehabilitation

Abstract Background and Purpose. The ability to rise from a chair is important for independence in everyday life. This study was conducted to determine to what extent knee extension force (KEF) could explain independence in sit-to-stand (STS) performance from a standard chair. Subjects and Methods. This was a descriptive and correlational study of patients receiving acute rehabilitation (N=107). Measurements of KEF of both lower extremities were obtained using manual muscle testing (MMT) and hand-held dynamometers (HHDs). The HHD measurements were normalized based on body weight and age- and sex-specific reference values. Measurements of the ability to stand without using the upper extremities (STS [without hands]) and to stand using the upper extremities (STS [with hands]) were correlated with the force measurements. Results. The correlations (r) of the KEF measurements with STS success ranged from .652 to .708 for STS (without hands) and from .545 to .638 for STS (with hands). Body weight added to the explanation of STS (without hands) (R=.662) and STS (with hands) (R=.584) provided by KEF measured by HHD. The receiver operating characteristic curves showed that HHD (weight normalized) was the most sensitive and specific measure for explaining independence in STS. Discussion and Conclusion. Manual and dynamometric measurements of KEF are related to independence in STS. Measurements of KEF quantified with a dynamometer and normalized against body weight provided the most valid, specific, and sensitive cutoff point for explaining STS independence.

Lower Extremity Strength and Coordination Are Independent Contributors to Maximum Vertical Jump Height

2001 ◽  
Vol 17 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Masao Tomioka ◽  
Tammy M. Owings ◽  
Mark D. Grabiner
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Relative Phase ◽  
Vertical Jump ◽  
Knee Extension ◽  
Jump Height ◽  
Knee Extension Strength ◽  
Vertical Jump Height ◽  
Lower Extremity Strength

We previously reported that lower extremity muscular strength of older adults did not predict success of a balance recovery task. We propose that lower extremity coordination may limit performance independently of lower extremity strength. The present study was conducted to determine the extent to which knee extension strength and hip–knee coordination independently contribute to maximum vertical jump height. Maximum vertical jump height and isometric and isokinetic knee extension strength and power were determined in 13 young adults. Hip–knee coordination during the vertical jump was quantified using relative phase angles. Stepwise nonlinear multiple regression determined the variable set that best modeled the relationship between the dependent variable, maximum vertical jump height, and the independent variables of strength, power, and coordination. The quadratic terms of the normalized knee extension strength at 60 deg·s–1, and the average relative phase during the propulsion phase of the vertical jump, collectively accounted for more than 80% of the shared variance (p= .001). The standardized regression coefficients of the two terms, .59 and .52, respectively (p= .004 and .008), indicated the independence and significance of the contributions of knee extension strength and hip–knee coordination to maximum vertical jump height. Despite the pitfalls of extrapolating these results to older adults performing a balance recovery task, the results are interpreted as supporting the contention that while muscle strength confers a number of functional benefits, the ability to avoid falling as a result of a trip is not necessarily ensured. Increased muscle strength per se can occur in the absence of improved kinematic coordination.

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