scholarly journals Necessity of Leg Length Adjustment When Measuring the Knee Extensor Strength Using Hand-held Dynamometers

2018 ◽  
Vol 33 (4) ◽  
pp. 551-554
Author(s):  
Toshiaki SEKO ◽  
Tsuneo KUMAMOTO ◽  
Shunichi OGAWA ◽  
Shunsuke ITO ◽  
Sayo MIURA ◽  
...  
Keyword(s):  
Knee Extensor ◽  
Leg Length ◽  
Knee Extensor Strength

scholarly journals Not all brawn, but some brain. Strength gains after training alters kinematic motor abundance in hopping

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e6010
Author(s):  
Bernard X.W. Liew ◽  
Andrew Morrison ◽  
Hiroaki Hobara ◽  
Susan Morris ◽  
Kevin Netto
Keyword(s):  
Resistance Training ◽  
Lower Limb ◽  
Knee Extensor ◽  
Uncontrolled Manifold ◽  
Strength Increase ◽  
Leg Length ◽  
Zero Crossing ◽  
Motor Abundance ◽  
Knee Extensor Strength ◽  
Ankle Strength

Background The effects of resistance training on a muscle’s neural, architectural, and mechanical properties are well established. However, whether resistance training can positively change the coordination of multiple motor elements in the control of a well-defined lower limb motor performance objective remains unclear. Such knowledge is critical given that resistance training is an essential and ubiquitous component in gait rehabilitation. This study aimed to investigate if strength gains of the ankle and knee extensors after resistance training increases kinematic motor abundance in hopping. Methods The data presented in this study represents the pooled group results of a sub-study from a larger project investigating the effects of resistance training on load carriage running energetics. Thirty healthy adults performed self-paced unilateral hopping, and strength testing before and after six weeks of lower limb resistance training. Motion capture was used to derive the elemental variables of planar segment angles of the foot, shank, thigh, and pelvis, and the performance variable of leg length. Uncontrolled manifold analysis (UCM) was used to provide an index of motor abundance (IMA) in the synergistic coordination of segment angles in the stabilization of leg length. Bayesian Functional Data Analysis was used for statistical inference, with a non-zero crossing of the 95% Credible Interval (CrI) used as a test of significance. Results Depending on the phase of hop stance, there were significant main effects of ankle and knee strength on IMA, and a significant ankle by knee interaction effect. For example at 10% hop stance, a 1 Nm/kg increase in ankle extensor strength increased IMA by 0.37 (95% CrI [0.14–0.59]), a 1 Nm/kg increase in knee extensor strength decreased IMA by 0.29 (95% CrI [0.08–0.51]), but increased the effect of ankle strength on IMA by 0.71 (95% CrI [0.10–1.33]). At 55% hop stance, a 1 Nm/kg increase in knee extensor strength increase IMA by 0.24 (95% CrI [0.001–0.48]), but reduced the effect of ankle strength on IMA by 0.71 (95% CrI [0.13–1.32]). Discussion Resistance training not only improves strength, but also the structure of coordination in the control of a well-defined motor objective. The role of resistance training on motor abundance in gait should be investigated in patient cohorts, other gait patterns, and its translation into functional improvements.

scholarly journals Efficacy of cardiac rehabilitation with motion assistance from wearable cyborg hybrid assistive limb in patients with chronic heart failure: a randomized controlled trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Watanabe ◽  
A Koike ◽  
H Kato ◽  
L Wu ◽  
K Hayashi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Rehabilitation ◽  
Exercise Therapy ◽  
Knee Extensor ◽  
Control Group ◽  
Cardiac Events ◽  
Rehabilitation Programs ◽  
Sit To Stand ◽  
Knee Extensor Strength

Abstract Background Recent Cochrane Systematic Review suggested that the participation in cardiac rehabilitation is associated with approximately 20% lower cardiovascular mortality and morbidity. Exercise therapy is the key component of cardiac rehabilitation programs. In recent years, innovative technologies have been introduced into the field of rehabilitation, and a typical example is the wearable cyborg Hybrid Assistive Limb (HAL). The wearable cyborg HAL provides motion assistance based on detection of bioelectrical signals on the skin surface when muscle forces are generated. The lumbar-type HAL is expected to expand the therapeutic options for severe cardiac patients who have difficulty in performing usual cardiac rehabilitation programs, such as bicycle pedaling or walking. Purpose We aim to compare the efficacy of exercise therapy performed with motion assistance from a lumbar-type HAL versus conventional training (sit-to-stand exercise without HAL) in patients with chronic heart failure. Methods This clinical trial is a randomized, non-blinded, and controlled study. Twenty-eight heart failure patients (73.1±13.8 years) who have difficulty in walking at the usual walking speed of healthy subjects were randomly assigned to 2 groups (HAL group or control group) with a 1:1 allocation ratio and performed sit-to stand exercise either with HAL or without HAL for 5 to 30 minutes once a day, and 6 to 10 days during the study period. The brain natriuretic peptide (BNP), isometric knee extensor strength, standing ability (30-seconds chair-stand test: CS-30), short physical performance battery (SPPB) and 6-minute walking distance (6MWD) were measured before and after the completion of cardiac rehabilitation. Cardiac events such as death, re-hospitalization, myocardial infarction and worsening of angina pectoris and heart failure during 1 year after discharge were evaluated. Results There was no significant difference in the number of days of exercise therapy between the two groups. BNP, SPPB and 6MWD were improved in both groups. In the HAL group, the isometric knee extensor strength (0.29±0.11 vs 0.35±0.11 kgf/kg, p=0.003) significantly improved and CS-30 (5.5±5.1 vs 8.2±5.3, p=0.054) tended to improve. However, in the control group, either the isometric knee extensor strength (0.35±0.11 vs 0.36±0.14 kgf/kg, p=0.424) or CS-30 (6.0±4.3 vs 9.2±6.2, p=0.075) did not significantly change. HAL group showed significantly more improvement in the isometric knee extensor strength than control group (p=0.045). Cardiac events occurred in 20% in the HAL group and 43% in the control group. Conclusion The improvement in isometric knee extensor strength with the assistance from lumbar-type HAL suggests that exercise therapy using this device may be useful in chronic heart failure patients with flail or sarcopenia, a strong poor prognostic factor in these patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported in part by a grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (JSPS KAKENHI grant number JP17K09485) and funded by the ImPACT Program of the Council for Science, Technology and Innovation (Cabinet Office, Government of Japan) (grant number 2017-PM05-03-01).

scholarly journals Walking time measures for evaluating OA of the knee

2019 ◽  
Vol 50 (1) ◽  
pp. 5-8
Author(s):  
R. Marks
Keyword(s):  
Functional Performance ◽  
Intraclass Correlation ◽  
Knee Extensor ◽  
Quadriceps Strength ◽  
Knee Extensor Strength ◽  
Before And After ◽  
Walking Tests ◽  
Experimental Subjects ◽  
Test Retest Reliability ◽  
Walking Time

This study assessed the test-retest reliability and the sensitivity of self-paced walking time measurements for evaluating the functional performance of persons with knee osteoarthritis (OA). The 13 m timed walking tests were carried out on two separate occasions over a six-week period for 10 patients using a standardised protocol. The same measurements were recorded also for three additional patients before and after a six-week quadriceps strength training regimen. As indicated by an intraclass correlation coefficient of 0.83 with no significant intersession test differences for the group (P=0.98), the gait measurements were reliable. However, despite marked increase in knee extensor strength and significant subjective improvements in walking time for the three experimental subjects were smaller than the error of measurement. The findings suggest that regardless of reliability, measurements of self-paced level walking time might not be sufficiently sensitive for evaluating longitudinal changes in functional performance in this patient population.

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.

The Role of Knee Extensor Strength in Balance-Restoring Step Initiation and Execution

2008 ◽  
Author(s):  
Gregory W. King ◽  
Carl W. Luchies
Keyword(s):  
Knee Extensor ◽  
Step Length ◽  
Step Response ◽  
Balance Recovery ◽  
Step Initiation ◽  
Age Related ◽  
Knee Extensor Strength ◽  
Step Duration ◽  
Stepping Response

A stepping response is often used to restore balance following a fall. Using laboratory-induced balance perturbations, various researchers have reported age-related alterations in balance recovery step characteristics including earlier step liftoff time [1; 2], shorter step length [1; 3], and longer step duration [2]. Such age-related changes in the step response may be related to older adults’ reduced strength reserve, which is prominent in the lower extremities [4] and therefore likely plays an important role in balance recovery.

scholarly journals Should We Use Unilateral or Bilateral Tasks to Assess Maximal and Explosive Knee Extensor Strength in Patients with Knee Osteoarthritis? A Cross-Sectional Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4353
Author(s):  
Jonas Pfeifle ◽  
David Hasler ◽  
Nicola Maffiuletti
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Relevance ◽  
Knee Extensor ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Strength Performance ◽  
Explosive Strength ◽  
Knee Extensor Strength ◽  
And Performance ◽  
Voluntary Contractions

Deficits in maximal and explosive knee extensor strength, which are usually assessed with unilateral tasks, are substantial in patients with knee osteoarthritis (KOA). The aim of this study was to investigate the clinical relevance of unilateral vs. bilateral tasks for assessing knee extensor strength in patients with KOA. This was achieved primarily by comparing unilateral and bilateral inter-limb strength asymmetries and secondarily by examining the relationship between unilaterally and bilaterally measured strength, and performance-based and self-reported function. Twenty-four patients with unilateral KOA (mean age: 65 ± 7 years) performed isometric gradual and explosive maximal voluntary contractions to assess, respectively their maximal and explosive strength. Performance-based and self-reported function were also evaluated with standard functional tests and questionnaires, respectively. Inter-limb asymmetries of maximal and explosive strength did not differ significantly between unilateral (mean asymmetry: 26 ± 15%) and bilateral tasks (22 ± 21%). In the same way, the relationships between knee extensor strength—measured either unilaterally or bilaterally—and performance-based or self-reported function were not influenced by the type of task. In conclusion, it does not seem to make a difference in terms of clinical relevance whether maximal and explosive knee extensor strength are evaluated with unilateral or bilateral tasks in KOA patients.

The Relationship between Knee Extension Strength and Activities of Daily Living in Patients with Dementia

2011 ◽  
pp. 244-256
Author(s):  
Makoto Suzuki ◽  
Hikari Kirimoto ◽  
Atsushi Inamura ◽  
Yoshitsugu Omori ◽  
Sumio Yamada
Keyword(s):  
Lower Extremity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Knee Extensor ◽  
Functional Independence ◽  
Knee Extension ◽  
Daily Activities ◽  
Lower Body ◽  
Knee Extensor Strength

The purpose of this study was to examine the test-retest reliability of hand-held dynamometer measurements in patients with dementia and determine if predictions about a patient’s ability to perform daily activities can be made from knee extension strength measurements. This study was composed of two rounds of data collection. Sixty patients with dementia were enrolled in the first round to assess the reliability of hand-held dynamometer measurements, and 54 patients with dementia were enrolled in the second round for predicting their ability to perform daily activities. Knee extensor strength was measured twice, separated by a three minute interval, with hand-held dynamometer. The authors also assessed daily activities related to the patient’s lower extremities, including dressing the lower body, using the toile, transferring to the bed/toilet/shower, and walking. Lower extremity activities of the Functional Independence Measure were assessed by the nursing home caregiver that had the most regular contact with each subject. When the Functional Independence Measure score of each lower extremity function was =6 points, the subject was considered to be independent. The intraclass correlation coefficient was 0.97. Bland-Altman plots showed the 95% difference value to be within 2 SDs of the mean. The curves of negative and positive predictive values revealed the following threshold levels: 0.8 Nm/kg was the best predictor for dressing the lower body and using the toilet; 1.2 Nm/kg was the best predictor for transferring to the bed/toilet/shower; and 0.6 Nm/kg was the best predictor for gait performance. Strength measurements taken with a hand-held dynamometer were reliable in patients with dementia, and normalized knee extensor strength was found to be a predictor of the ability to perform activities of daily living.

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