It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to ...measure muscle function and physical performance, clinicians often struggle to choose a tool that is appropriate and validated for the population of older people they deal with. In this paper, an overview of different methods available and applicable in clinical settings is proposed. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were organized afterwards where the whole group could amend and discuss the recommendations further. Several characteristics should be considered when choosing a tool: (1) purpose of the assessment (intervention, screening, diagnosis); (2) patient characteristics (population, settings, functional ability, etc.); (3) psychometric properties of the tool (test–retest reliability, inter-rater reliability, responsiveness, floor and ceiling effects, etc.); (4) applicability of the tool in clinical settings (overall cost, time required for the examination, level of training, equipment, patient acceptance, etc.); (5) prognostic reliability for relevant clinical outcomes. Based on these criteria and the available evidence, the expert group advises the use of grip strength to measure muscle strength and the use of 4-m gait speed or the Short Physical Performance Battery test to measure physical performance in daily practice. The tools proposed are relevant for the assessment of muscle weakness and physical performance. Subjects with low values should receive additional diagnostic workups to achieve a full diagnosis of the underlying condition responsible (sarcopenia, frailty or other).
The National Army of Colombia guarantees the education of their students from advanced combat courses, which simulate real military operations. This article seeks to determines the effect of the ...advanced combat course on physical qualities and anthropometric characteristics in students of the Military School. For this, an observational, descriptive study with an analytical component was carried out, whose subjects were measured before and after the Combat Course. The sample included 113 participants, 26 women and 87 men with an average age of 22 ± 1.3 years, belonging to the Colombian Military Cadet School. The variables that were measured were weight, height, waist circumference and body mass index, the maximum indirect VO2 with the Leger test, the maximum force of the upper quadrant with the bench press coupled to the T-Force® system, prehensile and back strength with dynamometry and flexibility with the Sit and Reach test. Results: The following variables showed change: controlled by gender: waist circumference p <.001, BMI p = .000847, flexibility p = .0147, back dynamometry p = 5.12e 05 and the variable RM p = 9.26e-06; controlling for gender and laterality: left grip strength p <.001. There was a reduction of BMI and waist circumference and significant increase in isometric trunk extensor force with decreased lumbar and hamstring flexibility, which generates rigidity, stability of the trunk allowing to support postures and loads. Students developed superior levels of maximum strength in upper limbs and left prehensile strength, improving the ability to hold loads.
El Ejército Nacional de Colombia garantiza la formación de sus alumnos a partir del curso avanzado de combate, que simulan operaciones militares reales. Este artículo busca determinar el efecto del curso avanzado de combate sobre cualidades físicas y antropométricas en alumnos de la Escuela Militar. Para ello se realizó un estudio observacional, descriptivo con componente analítico, cuyos sujetos fueron medidos antes y después del Curso de Combate. La muestra incluyó 113 participantes, 26 mujeres y 87 hombres con edades promedio de 22 ± 1,3 años, pertenecientes a la Escuela Militar de Cadetes de Colombia. Las variables que se midieron fueron peso, talla, perímetro de cintura e Índice de masa corporal, el VO2 máximo indirecto con el test de Leger, la fuerza máxima del cuadrante superior con el press banca acoplado al sistema T-Force®, fuerza prensil y de espalda con dinamometría y la flexibilidad con el test Sit and Reach. Se evidenciaron cambio significativo: controladas por género: perímetro de cintura p <.001, IMC p = .000847, flexibilidad p =.0147, dinamometría de espalda p = 5.12e-05 y la variable RM p = 9.26e-06; controlando por género y lateralidad: fuerza prensil izquierda p <.001. Se logró evidenciar una reducción del IMC y perímetro de cintura. Existe un incremento de la fuerza isométrica extensora de tronco con disminución de la flexibilidad lumbar e isquiotibial, generando rigidez, estabilidad del tronco permitiendo soportar posturas y cargas. Se presentaron mejoras de fuerza máxima en miembros superiores y fuerza prensil izquierda, mejorando la capacidad de mantener cargas.
This study is aimed to evaluate pain, muscle strength, scapular muscular endurance and scapular kinesis in individuals with Nonspecific Chronic Neck Pain and to compare them with asymptomatic ...individuals. In addition, to investigate the effect of mechanical changes in the scapular region on neck pain.
40 individuals who applied to Kırıkkale University Faculty of Medicine Hospital Physical Therapy and Rehabilitation Center and diagnosed with NSCNP and 40 asymptomatic individuals for the control group were included the study. Pain was evaluated with Visual Analogue Scale, pain threshold and pain tolerance with algometer, cervical deep flexor group muscle strength with Stabilizer Pressure Biofeedback device, and neck and scapulothoracic muscle strength with Hand Held Dynamometer. Scapular Dyskinesia Test, Scapular Depression Test and Lateral Scapular Slide Test were used to evaluate scapular kinesis. A timer was used to evaluate scapular muscular endurance.
Pain threshold and pain tolerance values of the NSCNP group were lower (p < 0.05). Muscle strength around neck and scapulothoracic region of the NSCNP group were lower than the asymptomatic individuals (p < 0.05). NSCNP group had more scapular dyskinesia (p < 0.05). Scapular muscular endurance values of the NSCNP group were lower (p < 0.05).
As a result, pain threshold and pain tolerance decreased, muscle strength of the neck region and the scapular region decreased, scapular endurance values decreased and the incidence of scapular dyskinesia increased in the individuals with NSCNP compared to the asymptomatic individuals. It is thought that our study will provide a different perspective in the evaluation of neck pain and including the scapular region to the evaluations.
ABSTRACT We evaluated the negative effect of sarcopenic obesity (SO) on muscle strength, physical function and quality of life in obese elderly women using the appendicular lean mass (aLM) adjusted ...for BMI, and aLM adjusted for height and fat mass residuals approach. Participated fifty-eight obese elderly women aged 60 to 70 years separated by two groups (SO) and non-sarcopenic (NSO) in two different approaches. The prevalence of SO was also verified between methods and its effects on handgrip strength, lean body mass, chair-stand test, time-up-and-go test, six-minute-walk test, peak O2 consumption, heart rate recovery and quality of life. The SO group presented significantly lower lean body mass, lower handgrip strength, inferior scores in the functional tests, inferior aerobic fitness, an impaired heart rate recovery, and an inferior aspect of quality of life as compared with the NSO group. Furthermore, no elderly woman was classified with SO by the aLM adjusted for height and fat mass residuals method. The cutoff-point addressed by the aLM/BMI represents a tool in clinical geriatric practice to identify and prevent this obesity/muscle syndrome in elderly women.
RESUMO Objetivo Verificar os efeitos imediatos da fotobiomodulação sobre a pressão máxima dos lábios para diferentes doses. Método Estudo experimental, randomizado e triplo cego. A amostra foi ...composta por 23 mulheres e 17 homens com idade entre 18 e 33 anos (média 23,18 anos, DP=2,1), divididos em quatro grupos: GC (grupo controle), G1, G4 e G7. A pressão máxima foi avaliada com o Iowa Oral Performance Instrument (IOPI). O bulbo foi posicionado entre os lábios e os participantes foram orientados a pressioná-lo com a maior força possível. Aplicou-se o LASER infravermelho (808 nm) da marca DMC, modelo Therapy EC, 100 mW de potência. As doses testadas foram 1 J (G1), 4 J (G4) e 7 J (G7) aplicadas em seis pontos do músculo orbicular da boca. No GC não houve intervenção. Após a aplicação do LASER, foram repetidos os procedimentos de avaliação. Os resultados foram analisados com nível de significância de 95%. Resultados A pressão máxima de lábios aumentou significativamente apenas no grupo irradiado com 7 joules. Conclusão O LASER de baixa intensidade na dose de 7 J promoveu mudanças no desempenho do músculo orbicular da boca em tarefa de pressão máxima.
Abstract Introduction: The impairment of muscle strength and fatigue in leprosy remains a problem that requires careful attention to avoid or minimize its progression, as well as prevention of ...disabilities and deformities. Objective: To investigate the maximum voluntary contraction and time to muscle fatigue in leprosy patients. Method: A total of 21 leprosy patients and 21 healthy subjects completed the sample. The method used to determine the maximum voluntary contraction (MVC) of the handgrip followed the recommendation of the American Society of Hand Therapists with the use of a hydraulic hand grip dynamometer. The test was performed three times with each hand, with a time interval of 60 seconds between successive trials. The subject was instructed to perform a maximal isometric force against the dynamometer for 5 seconds. The peaks were recorded and used for the fatigue test. For the fatigue test, we recorded the electromyogram of the forearm muscles to offline determine the onset time for the muscle contraction (14 bits, Miograph 2 USB®, Miotec, Brazil). Results: Leprosy patients had lower MVC compared with healthy subjects (p > 0.05), both in the dominant and the non-dominant hands. The time to fatigue in the leprosy and control groups was similar (p < 0.05). We observed that leprosy patients had more contractions than the healthy subjects (22.6 ± 11.8 contractions for the leprosy group vs. 12.3 ± 6.9 contractions for the control group, p > 0.05). Conclusion: Multibacillary leprosy patients lost muscle force without modifying the resistance to fatigue.
Resumen Introducción: El compromiso de la fuerza muscular y la fatiga en la lepra sigue siendo un problema que requiere atención cuidadosa para evitar o minimizar su progresión, así como la prevención de incapacidades y deformidades. Objetivo: Evaluar la fuerza muscular y el tiempo hasta la fatiga de pacientes con lepra. Método: Veintiún pacientes con lepra y 21 sujetos sanos completaron la muestra. El método utilizado para determinar la contracción voluntaria máxima (CVM) de la fuerza de asimiento palmar siguió la recomendación de la Sociedad Americana de Terapeutas de la Mano con el uso de un dinamómetro de asimiento manual. La prueba se realizó tres veces con cada mano, con un intervalo de tiempo de 60 segundos entre intentos sucesivos. El sujeto fue instruido a realizar una fuerza isométrica máxima contra el dinamómetro durante 5 segundos. Los picos se registraron y se utilizaron para la prueba de fatiga. Para la prueba de fatiga, registramos el electromiograma de los músculos del antebrazo para determinar fuera de línea el tiempo de inicio de la contracción muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Los pacientes con lepra presentaron menor CVM con relación a los sanos (p < 0,05) en las manos dominante y no dominante. No hubo diferencia en el tiempo de fatiga entre los grupos de lepra y control (p > 0,05). Se observó que los pacientes con lepra tenían más contracciones que los sanos (22,6 ± 11,8 contracciones para el grupo con hanseniasis frente a 12,3 ± 6,9 para el grupo control, p < 0,05). Conclusión: Pacientes con hanseniasis multibacilar presentaron pérdida de fuerza muscular sin modificación de la resistencia a la fatiga.
Resumo Introdução: O comprometimento da força muscular e a fadiga na hanseníase continuam sendo problemas que requerem cuidadosa atenção para evitar ou minimizar sua progressão, bem como prevenir incapacidades e deformidades. Objetivo: Avaliar a força muscular e o tempo até a fadiga em pacientes com hanseníase Método: Vinte e um pacientes com hanseníase e 21 indivíduos saudáveis completaram a amostra. O método utilizado para determinar a contração voluntária máxima (CVM) da força de preensão palmar seguiu a recomendação da Sociedade Americana de Terapeutas da Mão com o uso de um dinamômetro de preensão manual. O teste foi realizado três vezes em cada mão, com intervalo de tempo de sessenta segundos entre tentativas sucessivas. O sujeito foi instruído a realizar força isométrica máxima contra o dinamômetro durante cinco segundos. Os picos foram registrados e usados para o teste de fadiga. Para o teste de fadiga, registrou-se o eletromiograma dos músculos do antebraço para determinar off-line o tempo de início da contração muscular (14 bits, Miograph 2 USB ® , Miotec, Brasil). Resultados: Os pacientes com hanseníase apresentaram menor CVM em relação aos saudáveis (p < 0,05) nas mãos dominante e não dominante. Não houve diferença no tempo de fadiga entre os grupos hanseníase e controle (p > 0,05). Foi observado que os pacientes com hanseníase tinham mais contrações do que os saudáveis (22,6 ± 11,8 contrações para o grupo com hanseníase vs. 12,3 ± 6,9 para o grupo controle, p < 0,05). Conclusão: Pacientes com hanseníase multibacilar apresentaram perda de força muscular sem modificação da resistência à fadiga.
OBJETIVO: Investigar as associações entre diversas medidas indicadoras do estado nutricional, a força muscular e as diferentes variáveis estabilométricas em uma amostra de idosas. MÉTODOS: Neste ...estudo exploratório de corte transversal, 108 idosas tiveram suas variáveis estabilométricas avaliadas através de uma plataforma de força, em duas condições experimentais: olhos abertos e olhos fechados. Verificaram-se as associações entre as variáveis explicativas: idade, massa corporal, estatura, índice de massa corporal, circunferência de quadril, circunferência de cintura, relação cintura/quadril, percentual de gordura corporal, massa gorda, massa magra, área muscular de braço corrigida, força isométrica voluntária máxima e diversas variáveis estabilométricas: amplitude anteroposterior, deslocamento da oscilação e área elíptica da superfície, dentre outras. RESULTADOS: Com exceção da estatura, todas as variáveis explicativas associaram-se significativamente com as variáveis estabilométricas. A regressão múltipla (forward) revelou que a circunferência de cintura e a força isométrica voluntária máxima foram as variáveis que mais influenciaram as variáveis estabilométricas, entretanto sem diferenças significativas entre as condições olhos abertos e olhos fechados. O percentual de gordura parece não sobrecarregar o sistema de controle postural. Na condição olhos abertos, a variável estabilométrica desvio--padrão médio-lateral foi a mais influenciada pelas variáveis explicativas. A circunferência de cintura foi respon-sável por 8,8% de toda variação do desvio-padrão médio-lateral e a força isométrica voluntária máxima contribuiu com 9,4% adicionais. CONCLUSÃO: Os resultados sugerem que a distribuição centrípeta de gordura corporal associada à diminuição da força muscular são as principais responsáveis pelas alterações estabilométricas em idosas.
Trunk muscle strength affects trunk controlling playing an important role in performance and to define the classes of wheelchair basketball players. Trunk control capacity differs among players and ...quantitative assessments of trunk muscle strength have not been investigated. The aim of this study was to identify and correlate quantitative measures of trunk muscle strength with the wheelchair basketball players' classification. Twenty-two male wheelchair basketball players with spinal cord injury, amputation, post-poliomyelitis sequelae, and cerebral palsy had their trunk extension and flexion strength evaluated with isokinetic dynamometer. The classes 1.0, 2.0, 3.0, and 4.0 were considered for statistical analysis. Comparison of trunk muscle strength differed significantly between classes: 1.0 and 3.0; 1.0 and 4.0; 2.0 and 3.0; and 2.0 and 4.0. High correlation was found between the trunk muscle strength and players' classes. The findings of the present study showed a strong correlation of trunk muscle strength and wheelchair basketball classes being able to distinguish players in their classes. However, this quantitative method of evaluation of the trunk muscle strength cannot be solely used to make a decision on the full trunk control.
All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This ...significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg.
This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60º/s and 180º/s.
Data analysis showed a statistically significant difference (p < 0.01) between the ACL and the healthy leg in the following parameters: peak torque for thigh extensors (Ptrq_E), angle to peak torque during extension (Ang_E), power of extension (Pow_E) and work during extension (Work_E). Analysing hamstrings to quadriceps (H/Q) ratio we found the unilateral disbalance of thigh muscle strength in ACL leg.
A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.
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