•We aimed to identify an objective evaluation system sensitive to analyze changes in different muscular conditions in different neuromuscular tests.•Digital dynamometry was identified as the most ...sensitive tool for detecting changes in neuromuscular tests.•Significant differences were found in objective parameters and clinical judgment between practitioners of different expertise levels.•Higher expertise participant presented a clinical judgment like digital dynamometer.
Muscle testing is an integral component in assessing musculoskeletal function and tailoring rehabilitation efforts. This study aimed i. to identify an objective evaluation system sensitive to analyze changes in different muscular conditions in different neuromuscular tests across a spectrum of professional experience levels; and ii. to analyze differences in objective parameters and clinical judgment between participants of different levels of expertise in different muscular conditions in different neuromuscular tests. Participants included 60 subjects with Level I to III expertise who performed blinded neuromuscular tests on the middle deltoid and rectus femoris muscles of 40 volunteer subjects. The methodology centered on standardizing test protocols to minimize variability, employing EMG to quantify muscle activity, thermography to capture thermographic muscular response, and digital dynamometry to measure muscular resistance. The findings revealed that while traditional methods like thermography and electromyography provide valuable insights, digital dynamometry stands out for its sensitivity in detecting muscle condition changes in neuromuscular test. Moreover, the data underscored the pivotal role of advanced training and expertise in enhancing the precision and accuracy of neuromuscular diagnostics, since there were significant differences in objective parameters and clinical judgment between participants of different levels of expertise in the different muscular conditions in Middle deltoid and Rectus femoris neuromuscular tests analyzed, presenting higher expertise participant clinical judgment like objective validated instrument.
Background: A muscle strength testing device that is convenient, practical, reliable, and valid is essential in clinical and field settings. Objective: Therefore, the purpose of this study was to ...determine the validity and reliability of measuring isometric muscle strength with the Powrlink handheld dynamometer compared to an established force dynamometer. Method: Sixty-one university students (40 males and 21 females) completed two standardized testing sessions seven days apart. Each session consisted of a familiarization period followed by three peak isometric muscle strength tests. Intraclass correlation (ICC, model: two-way mixture with absolute agreement), standard error of measurement (SEM), minimum detectable change (MDC), and 95% limits of agreement (LOA) for intra- and inter-rater reliability were determined. Results: Test-retest reliability (ICC > 0.91) and intertrial reliability (ICC > 0.99) were excellent. No significant differences were observed in peak and mean knee forces and torques between the test and retest, indicating high test-retest reliability. Conclusion: The Powrlink device is portable, convenient, responsive, and cost-effective, has excellent test-retest reliability, and can be used to measure maximal isometric force in the clinic and in the field.
Muscle strength measurements using hand-held dynamometry (HHD) can be affected by the inadequate strength of the tester and lack of stabilization of the participants and the device. A portable HHD ...anchoring system was designed that enabled the measurement of isometric knee extensor muscle strength in a supine position. This can be used with individuals who are unable to assume the sitting position required for the measurement of knee extensor strength in conventional isokinetic dynamometry (IKD). The aim of this study was to evaluate the reliability and validity of knee extensor strength measurements using this device.
The maximal knee extensor isometric strength of the dominant leg in healthy adults aged 20 to 40 years was tested. Three trials of three contractions were assessed by two raters using the portable dynamometer anchoring system whilst the participant was in the supine position. After the three measurement trials, peak knee extensor torque was evaluated using IKD. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) for intra- and inter-rater reliability were obtained.
Thirty-nine participants (19 male and 20 female, aged 30.08 ± 4.16 y), completed the three measurement trials. The ICC for intra-rater reliability was 0.98 for the maximum measurements of knee extensor strength (95% confidence interval CI: 0.96-0.98) and 0.98 (95% CI: 0.96-0.99) for inter-rater reliability. The mean difference (%) between the maximum knee extensor strength measurements of each trial was 1.02% (LOA range: - 11.13 to 13.16%) for intra-rater and - 1.44% (LOA range: - 13.98 to 11.08%) for inter-rater measurements. The Pearson correlation coefficient of the maximum voluntary peak torque measurements with the portable dynamometer anchoring system and IKD was 0.927.
The portable dynamometer anchoring system is a reliable and valid tool for measuring isometric knee extensor strength in a supine position. Future clinical feasibility studies are needed to determine if this equipment can be applied to people with severe illness or disabilities.
KCT0003041 .
Grip strength measured by dynamometry is well established as an indicator of muscle status, particularly among older adults. This review was undertaken to provide a synopsis of recent literature ...addressing the clinical and prognostic value of hand-grip dynamometry.
Numerous large-scale normative grip strength projects have been published lately. Other recent studies have reinforced the concurrent relationship of grip strength with measures of nutritional status or muscle mass and measures of function and health status. Studies published in the past few years have confirmed the value of grip strength as a predictor of mortality, hospital length of stay, and physical functioning.
As a whole, the recent literature supports the use of hand-grip dynamometry as a fundamental element of the physical examination of patients, particularly if they are older adults.
This study was aimed to set reference values of hand-grip strength by age and sex and validate cut points for risk of functional limitation and mortality in older Chileans.
This was a pooled analysis ...of four studies including 6,426 people ≥60 years of nondependent community-dwelling Chileans. After exclusion criteria, the final sample included 5,250 subjects, from whom 2,193 were followed to study all-cause mortality associated with low hand-grip strength. Face-to-face interviews registering sociodemographic characteristics, self-reported chronic diseases, and functional limitations were conducted. Anthropometric measurements and observed mobility were performed by trained professionals. Hand-grip strength was measured with a hand dynamometer T-18 (Country Technology, Inc.) before 2008 or with JAMAR brand from 2008 onwards. Percentiles were calculated through descriptive analysis and quantile regression models for specific groups of age and sex. Adjusted Cox regression hazard models for mortality risk according to low dynamometry condition and covariates were developed.
We deliver reference values of hand-grip strength for older Chileans proposing the 25th percentile as the cut-off point for low dynamometry risk: men ≤27 kg, women ≤15 kg. Low hand-grip strength was associated with Instrumental Activities of Daily Living limitations (
=0.001), and altered physical performance evaluated through the Timed Up and Go test (
=0.0001), grasping (
=0.001), bending (
<0.0001), and lifting (
<0.0001). After Cox proportional hazard regression models were assessed with a median follow-up of 9.2 years, the adjusted risk of all-cause mortality associated with a hand-grip strength lower than the 25th percentile in older Chileans showed a hazard ratio of 1.39 (95% confidence interval: 1.13-1.71).
The cut-off points of dynamometry validated for the older Chileans allow the incorporation in the geriatric evaluation in primary health care of an easy-to-use, inexpensive indicator to identify older adults at risk of sarcopenia, frailty, and dismobility. In addition this also helps to optimize the evaluation of intervention strategies focused on the maintenance of functionality.
Rotator cuff tears are a common musculoskeletal condition which can lead to functional limitations and impairments in quality of life. The purpose of the present study was to investigate the effects ...of arthroscopic repair surgery on isokinetic muscle function before and 6-months after surgery. Additionally, the mediating effects of tear type, tear size and tendon retraction were examined.
Data from n = 67 patients (56 ± 9 years) with full-thickness rotator cuff tears were analyzed. Before and 6-months after surgery, isokinetic muscle function in external/internal rotation and abduction/adduction movements was assessed. Further, tear size, tear type (Collin classification) and tendon retraction (Patte classification) were analyzed using magnetic resonance imaging.
After statistical analysis, a significant increase in limb symmetry index of external (P < .001), internal rotation (P < .01), abduction (P < .001), and adduction (P < .001) were observed from preto postsurgery. The results revealed that tear size and tendon tear type significantly mediated the functional outcome, with no significant effect of tendon retraction.
The present findings point toward the notion that the functional outcome following rotator cuff repair was significantly dependent on tear type and tear size but not tendon retraction. Patients with larger sized tears presented pronounced deficits following 6-months indicating that rehabilitation times need to be adjusted accordingly.
Existe un alto riesgo de malnutrición en pacientes hospitalizados, sobre todo en adultos mayores o con múltiples comorbilidades. El presente estudio tuvo como objetivo describir la FPM en pacientes ...hospitalizados en dos centros hospitalarios de Latinoamérica. Retrospectivo y observacional. De un universo poblacional de 169 pacientes de entre 19 y 98 años, 127 conformaron la muestra estudiada. Se recolectaron datos demográficos, diagnóstico médico de base, peso, talla y FPM al ingreso y a los 14 días. Se realizó análisis estadístico con medidas de tendencia central. La edad media que prevaleció fue de 70,9 ± 17 años centro 1 y 55 ± 19 años centro 2. La FPM fue mayor en pacientes normo nutridos que aquellos con bajo peso en ambos centros. También fue mayor en comparación con aquellos con obesidad clase III del centro mexicano y obesidad clase I y II del centro guatemalteco. La FPM disminuyó en todos los pacientes del centro guatemalteco mientras que en el mexicano solo en aquellos con bajo peso, obesidad II y III. La FPM baja estuvo asociada a aquellos pacientes con bajo peso, pero también en aquellos con algún grado de malnutrición por exceso.
Palabras clave: Dinamometría ; fuerza de prensión manual ; malnutrición ; evaluación nutricional.
The purpose of this study was to critically appraise and summarize the evidence for reliability of muscle strength and muscle power assessment in patients with neuromuscular diseases (NMDs) using ...isokinetic dynamometry.
PubMed, CINAHL, and Embase electronic databases were searched from inception to March 8, 2022. Studies designed to evaluate reliability of muscle strength and power measurements using isokinetic dynamometry were included in this review. First, the methodological quality of the studies was assessed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Next, the quality of measurement properties was determined. Finally, the methodological quality and quality of measurement properties of the studies were combined to obtain a best-evidence synthesis.
A best-evidence synthesis of reliability was performed in 11 studies including postpoliomyelitis syndrome (n = 5), hereditary motor and sensory neuropathy (n = 2), motor neuron diseases (n = 1), myotonic dystrophy (n = 1), and groups of pooled NMDs (n = 2). A best-evidence synthesis on measurement error could not be performed. Quality of evidence on reliability ranged from high in postpoliomyelitis syndrome to very low in hereditary motor and sensory neuropathy, motor neuron diseases, and groups of pooled NMDs. The most frequently used outcome measure was peak torque, which was reliable in all populations (intraclass correlation coefficient >0.7).
The quality of evidence for reliability of isokinetic dynamometry was found to vary substantially among different NMDs. High quality of evidence has been obtained only in patients with postpoliomyelitis syndrome. Further research is needed in the majority of known NMDs to determine reliability and validity of isokinetic dynamometry.
The ability of isokinetic dynamometers to capture clinically relevant changes in muscle strength and muscle power in NMDs remains unclear. Isokinetic dynamometry results in NMDs should be interpreted with caution.
Plantar flexion force in recreational athletes after repair of Achilles tendon tears has rarely been reported, due to the lack of a widely available and fast measurement method. Knowledge of this ...parameter would allow optimisation of muscular and sports recovery. The main objective of this study was to measure the isometric force of the triceps surae at least 1 year after unilateral Achilles-tendon repair, comparatively to the unaffected side, using a portable device. The secondary objectives were to compare Achilles tendon and calf-muscle trophicity, dorsiflexion, and the single-leg heel-rise test versus the normal side and to assess functional scores at last follow-up.
(i) Plantar flexion force does not differ significantly between the operated and contralateral sides. (ii) Calf-muscle trophicity, dorsiflexion, and the single-leg heel-rise test do not differ significantly between the operated and contralateral sides.
This single-centre retrospective study included patients aged 18 to 65 years with a history of open repair of an acute unilateral Achilles tear at least 1 year earlier. Plantar flexion force, calf-muscle trophicity, dorsiflexion, and the heel-to-floor distance were measured on both sides and compared. The ATRS, VISA-A score, and EFAS score were determined. All complications were recorded.
The study included 30 patients with a mean follow-up of 20.3 months (range, 12-28 months). The operated side had significantly lower values for isometric triceps surae force, calf circumference, and heel-to-floor distance compared to the contralateral side (p<0.0001). Tendon width was significantly greater on the operated side (p<0.0001). Dorsiflexion did not differ significantly between sides (p=0.106). Mean functional score values were 91.5±6 for the ATRS (maximum, 100), 85±12 for the VISA-A score (maximum, 100), and 19.5±4 for the EFAS score (maximum, 24).
Isometric triceps-surae force measured using a portable device at least 1 year after open surgical Achilles-tendon repair was significantly decreased compared to the contralateral side. Calf circumference and heel-to-floor distance were also significantly lower. These data indicate a need for improved monitoring of triceps surae recovery to optimise rehabilitation and sports resumption.
IV, retrospective comparative cohort study.
The evaluation of rate of force development during rapid contractions has recently become quite popular for characterising explosive strength of athletes, elderly individuals and patients. The main ...aims of this narrative review are to describe the neuromuscular determinants of rate of force development and to discuss various methodological considerations inherent to its evaluation for research and clinical purposes. Rate of force development (1) seems to be mainly determined by the capacity to produce maximal voluntary activation in the early phase of an explosive contraction (first 50–75 ms), particularly as a result of increased motor unit discharge rate; (2) can be improved by both explosive-type and heavy-resistance strength training in different subject populations, mainly through an improvement in rapid muscle activation; (3) is quite difficult to evaluate in a valid and reliable way. Therefore, we provide evidence-based practical recommendations for rational quantification of rate of force development in both laboratory and clinical settings.
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