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[Purpose] The purpose of this study was to examine the reliability of three isometric knee extension strength measurements (IKE) made with a hand-held dynamometer (HHD) and a belt of healthy elderly living in the community as subjects. [Subjects] The subject cohort consisted of 186 healthy elderly people, aged 65 to 79 years, living in local commun...
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Context 1
... 186 subjects comprised of 66 males with an average height of 163.6 cm (SD = 6.0 cm) and an average body weight of 61.4 kg (SD = 6.7 kg), and 120 females with an average height of 150.9 cm (SD = 4.8 cm) and an average body weight of 52.3 kg (SD = 6.4 kg). The subjects were divided into three age groups, 65 to 69, 70 to 74, and 75 to 79 years, as shown in Table 1. Approval was obtained from the research ethics committee of Ryotokuji University and from the city administration, which had organized the physical strength test program, to use the data for this study. ...
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Objective
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Citations
... The measurements were acquired twice, and the better of the two results was selected as the representative value. The test-retest intraclass correlation coefficient (ICC) for this measurement method ranged from 0.85 to 0.92 19) . In addition, the inter-rater ICC was 0.93 20) . ...
Objective: This study aimed to derive a clinical prediction rule (CPR) that can predict changes in health-related quality of life at 5 months for patients with knee osteoarthritis (KOA) undergoing conservative treatment. Methods: Patients with KOA receiving physical therapy and exercise therapy at an outpatient clinic were included in this study. The basic characteristics, medical information, and motor function test results were recorded at baseline. The primary outcome measure was the change in the Japan Knee Osteoarthritis Measure (JKOM) 5 months after the baseline measurement. A decision tree analysis was performed with the basic characteristics, medical information, and the motor function test results as the independent variables and the changes in the JKOM after 5 months (≥8 in the improved groups) as the dependent variable. Results: Analyzed data from 87 patients. The variables included the visual analog scale score, bilateral KOA, 5-m walk test, JKOM, and body mass index. Six CPRs were obtained from the terminal nodes. Accuracy validation of the model for the entire decision tree revealed an area under the receiver operating characteristic curve of 0.87 (validation data: 0.83), a positive likelihood ratio of 2.6, and a negative likelihood ratio of 0.1. Conclusion: This CPR is an inspection characteristic that can exclude the possibility of the occurrence of an event based on a negative result. However, since the results of this study represent the first process of utilizing the CPR in actual clinical practice, its application should be kept in mind.
... Maximal isometric muscle strength was assessed with a handheld dynamometer (μTasF-1; Anima Corporation, Tokyo, Japan). The measurement method used a fixation belt, which has been reported to have high intra-and inter-examiner reliability in previous studies [12,13]. Each measurement was performed twice, and the maximum value was used for analysis. ...
Introduction: Trochanteric fractures (TFs) are common in older individuals and are expected to increase with Japan's aging population. These fractures often result in poor long-term outcomes, such as decreased independent walking and reduced hospital discharge rates. A significant aspect of TF involves displacement of the lesser trochanter (LT), which can weaken hip flexor muscles and potentially affect the recovery of activities of daily living (ADLs), including walking. Previous research has shown conflicting results regarding the effect of lesser trochanteric displacement on hip function and walking ability. This study aimed to determine whether displacement of the LT affects the recovery of hip flexor strength and walking ability at discharge in patients with TF.
Methods: This prospective cohort study included 29 patients with TF admitted to a rehabilitation hospital between April 2023 and June 2024. The patients were classified into two groups: the LT displacement and the non-LT (NLT) displacement groups. Muscle strength (hip flexion, abduction, and knee extension) was measured using a handheld dynamometer. Walking ability assessments included gait speed, timed up-and-go test (TUG), 6-minute walk test (6 MWT), and functional ambulation category (FAC). Cognitive function was evaluated using the Hasegawa Dementia Rating Scale-Revised (HDS-R). Statistical analyses included repeated-measures analysis of variance (ANOVA) for muscle strength comparisons over time, with adjustments for violations of sphericity using the Greenhouse-Geisser correction.
Results: There were no significant differences between the LT and NLT groups in terms of demographic characteristics such as age, sex, or cognitive function. Repeated-measures ANOVA revealed a significant difference in hip flexor strength on the injured side between the groups, with the LT group showing persistent weakness until discharge. Significant improvements were noted in hip abduction and knee extension strength on the injured side, although no group differences were observed. Post-hoc analysis indicated significant strength improvements over time, particularly between admission and discharge, for most muscle groups, except for hip flexor strength in the LT group.
Conclusion: Lesser trochanteric displacement in patients with TF resulted in a specific decline in hip flexor strength on the injured side, which persisted until discharge. However, no significant impact on walking ability was observed, likely because of compensatory mechanisms involving other muscles.
... Grip strength was measured using the Grip-D (Takei Kiki Kogyo, Inc., Niigata, Japan) once on each side under maximum effort in the sitting position, according to a previous study 13) . Knee extension muscle strength was measured three times under maximum effort in the sitting position and in 90° flexion at the hip and knee joints using the μ-Tas (Anima, Inc., Tokyo, Japan), according to a previous study 14) . The average of three measurements was divided by body weight to obtain the percentage. ...
Purpose] To investigate the characteristics and factors associated with independence in the activities of daily living in patients with amyotrophic lateral sclerosis at diagnosis based on clinical phenotypes. [Participants and Methods] Fifty-seven participants diagnosed with amyotrophic lateral sclerosis were assessed using the Barthel Index. Participants were classified into three clinical phenotypes (bulbar-onset, upper limb-onset, and lower limb-onset), and the total and subitem scores were compared. To statistically examine factors associated with independence in the activities of daily living, the participants were divided into two groups: Barthel Index of 100 and ≤95. [Results] The total, bulbar-onset, upper limb-onset, and lower limb-onset Barthel Index scores were 87.9 ± 17.7, 96.7 ± 5.9, 92.5 ± 11.9, and 70.0 ± 22.2, respectively. The Total Barthel Index and lower limb-related activities of daily living scores were significantly lower in the lower limb-onset group, and knee extension muscle strength was identified as a factor associated with independence, with a cutoff value of 32.0%. [Conclusion] Patients with lower limb onset had more impairments in lower limb-related activities of daily living than those with other clinical phenotypes. To maintain independence in patients with amyotrophic lateral sclerosis at diagnosis, it is necessary to improve knee extension muscle strength through exercise and perform environment adjustments using the cutoff values as indicators.
... Individual differences were measured by relative grip strength (grip strength divided by body mass). Knee extension strength (KES) [47] was determined using a manual muscle tester equipped with a Lafayette Dynamometer (Model 01163, Lafayette Instrument Company, Lafayette, IN, USA) with an accuracy of ±0.09 kgf at 90 • on both legs, fixed. The test was performed twice on each leg for 5 s with a 1 min rest between each, and the maximum value of the 2 best attempts of both was selected. ...
Background: Evidence suggests that aerobic training with blood flow restriction is beneficial for treating fibromyalgia. This study evaluated the feasibility, safety, and effects of an aerobic training program with blood flow restriction for women with fibromyalgia. Methods: Thirty-seven women with fibromyalgia were included, and thirteen with an average age of 59 ± 3, a BMI of 26 ± 3, and who were polymedicated started the intervention period. The intervention group performed aerobic exercise with blood flow restriction using occlusive bands placed in the upper part of the rectus femoris, with a total duration of 14 min of restriction divided into two periods of 7 min with a rest period of 3 min and a total session duration of 17 min. Pressure intensity was measured using the visual pain scale (VAS), scoring 7 out of 10 (n = 7). The non-intervention group performed aerobic exercise without restriction of blood flow for the same periods, rest periods, and total duration of the session (n = 6). The intervention included 2 weekly sessions with 72 h between aerobic walking for 9 weeks. Walking was measured individually using the rating of perceived exertion scale (RPE) with an intensity between 6 and 7 out of 10. Visual and verbal support for the VAS and RPE scale was always provided throughout the sessions supervised by the investigator. Functional capacity was assessed using tests (six-minute walk test, incremental shuttle walk test, knee extension and handgrip test by dynamometer, 30 s chair stand test, and timed up-and-go test). Symptomatology was assessed using questionnaires (Widespread Pain Index, Symptom Severity Score, Fibromyalgia Impact Questionnaire, and Multidimensional Fatigue Inventory), and blood samples were collected. Results: There were no adverse effects, and only one participant in the intervention group withdrew. Between-group and intragroup differences showed that the intervention group obtained improvements in the functional tests; CST p = 0.005; 6MWT p = 0.011; Handgrip p = 0.002; TUGT p = 0.002 with reduced impact of the disease according to the questionnaires; FIQ Stiffness p = 0.027 compared with the nonintervention group. Biochemical results remained within normal ranges in both groups. Conclusions: Blood flow-restricted aerobic training may be feasible, safe, and more effective than unrestricted aerobic training as a physical exercise prescription tool to improve cardiorespiratory fitness, strength, balance, and stiffness in women with fibromyalgia.
... Physical function evaluation included assessment of lower extremity muscle strength and continuous walking distance. Isometric knee extension muscle strength was measured using a handheld dynamometer (μ-Tas F-1, Anima Co., Tokyo, Japan) 19) . The measured values were divided by the body weight to calculate the weight-bearing index (WBI). ...
Purpose] In gastric cancer patients, low muscle mass decreases overall survival and quality of life (QOL). Resistance exercise with leucine-enriched essential amino acid (LEAA) supplementation may prevent muscle mass loss. This study was aimed at determining whether resistance exercise with LEAA supplementation prevents muscle mass loss in post-gastrectomy patients. [Participant and Methods] We conducted a single-center, open-label, randomized controlled pilot trial. Ten participants who underwent gastrectomy were divided into two groups. The intervention group underwent resistance exercise at 70% of one repetition maximum and received a supplement of 3 g of LEAA twice daily for 15 days, while the control group received standard care. We compared changes in muscle mass, physical function (muscle strength and continuous walking distance), and QOL between the groups. [Results] We found good adherence and participation rates in both groups. We failed to detect a significant difference in muscle mass between the groups. The intervention group showed significant improvements in muscle strength and QOL, while the control group showed no significant changes. [Conclusion] We failed to detect a significant difference in muscle mass due to resistance exercise with LEAA supplementation in post-gastrectomy patients. However, resistance exercise with LEAA supplementation might be beneficial for muscle strength recovery and QOL improvements.
... Although many studies on the assessment of knee muscles with MD have mostly used the 90º position to assess both knee flexors and extensors (Bohannon, 1986;Wang et al., 2002;Kelln et al., 2008;Katoh & Yamasaki, 2009;Katoh et al., 2011;Katoh & Isozaki, 2014;Koblbauer et al., 2011;Bohannon, 2012;Hansen et al., 2015;Muff et al., 2016;Jackson et al., 2017;Almeida et al., 2018;Florencio et al., 2019), we used the knee flexion position of 60º to assess the extensors and the 30º position for the flexors, following the example of Lienhard et al. (2013), who state that in these positions the muscles can generate greater isometric torque. ...
Introduction: Many tools can be used for functional assessment following an Anterior Cruciate Ligament (ACL) injury or reconstruction. These include the assessment of stability, the assessment of neuromuscular factors such as strength, and the patient's perception of knee function. The manual dynamometer (MD) is a strength assessment tool that can be used in environments where isokinetic assessment is not feasible. The Lyshom questionnaire, Tegner scale, and the International Knee Documentation Committee (IKDC) scale are validated instruments for subjective functional assessment. Objective: To evaluate the correlation between muscle strength and reported knee function after ACL grafting, unrepaired ACL injury, and healthy knees. Methods: 95 male subjects were evaluated, 36 with ACL reconstruction, 23 with unrepaired ACL injury, and 36 without knee injuries. All were evaluated with the Lysholm questionnaire, Tegner, and IKDC scales. Muscle strength was assessed with the MD, and the limb symmetry index (LSI) was used to correlate with the reported function. Results: The lowest scores on the Lysholm questionnaires and Tegner and IKDC scales occurred in subjects with unrepaired injuries, with significance between groups (p=0.000–0.001). The association involving the ISL with the Lysholm questionnaire and IKDC scale was observed in the ISL of 10% and 15% only for the extension (p<0.01). Conclusion: The Lysholm questionnaire and the Tegner and IKDC scales indicated the level of function according to the clinical condition, and the association of LSI with reported function occurred only for extension. The association of strength tests, functional tests, and questionnaires should be considered for functional assessment of the knee. The MD should be a tool to be considered in the absence of an isokinetic dynamometer, and because it is superior to manual muscle strength testing (MMT).
... The weight-bearing index (WBI) was calculated by measuring the isometric knee extension muscle strength (kgf) of the right lower extremity using a pull sensor for manual muscle testing (SAKAIMED, MT-150) and dividing by body weight (kg) [23]. ...
Background
Type 2 diabetes mellitus (T2DM) is associated with changes in skeletal muscle quantity and quality, such as increased ectopic fat. Cardiac rehabilitation (CR) aims to improve the exercise capacity and muscle strength. This study aimed to determine the relationship between qualitative changes in the skeletal muscles and exercise function in patients with and without diabetes mellitus.
Methods
The study included patients with cardiovascular diseases who entered CR. Of 72 CR patients (68.1±9.0 years) who underwent a cardiopulmonary exercise test and skeletal muscle assessment at discharge, 15 patients with T2DM and 15 without DM were selected using propensity score matching by age and gender.
Results
No significant differences in the skeletal muscle echo intensity (EI) (T2DM: 58.4, Non-DM: 53.4, p=0.32), skeletal muscle index (T2DM: 7.5 kg/m², Non-DM: 7.2 kg/m², p=0.36), or the weight-bearing index (WBI)(T2DM: 0.44, Non-DM: 0.50, p=0.35) existed between the two groups. The phase angle (PhA) (T2DM: 3.67°, Non-DM: 4.49°, p<0.05) and peak oxygen uptake (T2DM: 12.3 mL/kg/min, Non-DM: 14.8 mL/kg/min, p<0.05) were significantly lower in the T2DM group. PhA values showed a significant correlation with the WBI, a parameter of lower limb muscle strength (r=0.50, p<0.05).
Conclusion
The coexistence of cardiovascular disease and T2DM resulted in a decrease in the PhA, indicating a qualitative decrease in skeletal muscle mass. The PhA is also associated with lower limb muscle strength.
... Testing protocol: The testing protocol was performed on a knee extension machine with a load cell attached (Cefise Biotechnology, Nova Odessa, SP, Brazil). The equipment was adjusted to a relative knee angle of 90° (19,20). The protocol consisted of eight maximal voluntary isometric contractions of 20 seconds, with 10 seconds of rest, totaling four minutes (24). ...
International Journal of Exercise Science 16(2): 1025-1037, 2023. Ischemic preconditioning (IPC) has been an excellent strategy for enhancing sports performance recovery, although there is still no consensus on the ideal protocol. Thus, this study aimed to evaluate the effects of IPC with different cuff pressures (low pressure, medium pressure, and high pressure) on the attenuation of neuromuscular fatigue after an isometric test protocol. And to verify whether this improvement was related to muscle oxygen saturation during the test protocol. Thirty males (18-35 years old) with experience in resistance training were allocated to three different groups: low pressure (20 mmHg), medium pressure (100 mmHg), and high pressure (190 mmHg). The individual occlusion pressure of each participant was identified using ultrasound. Each participant performed two test protocols (8 maximal isometric contractions lasting 20-s with a 10-s rest interval) in an extension chair; after the first test protocol, the participant received the IPC intervention with a low, medium, or high cuff pressure or received the noncuff
intervention (randomized order). Only the medium-pressure group showed a smaller decrease in mean force change compared to the no-cuff condition (-4.40% vs. -13.10%, p=0.01, respectively), and the low- and high-pressure groups did not exhibit significant pressure differences (IPC vs. noncuff: -8.40% vs. -13.10%, p=0.11 and -9.10% vs. - 14.70%, p=0.12, respectively). Muscle oxygen saturation across test protocols showed no significant differences in all IPC conditions (p>0.05). Although, IPC with medium pressure was effective at optimizing the recovery of neuromuscular performance, this improvement is not related to an increase in muscle oxygen saturation during exercise.
... Physical function data were knee joint extensor strength, knee joint range of motion (knee ROM), the pain of knee during gait (visual analog scale, VAS), and 10-meters (10-m) walking time, which was determined preoperatively, 3 months postoperatively, and 12 months postoperatively. Knee joint extensor strength was determined using a Mobile manual muscle tester (Sakai Medical Co., Ltd., Tokyo, Japan), with the bed and machine fixed with a special belt, and the optimum value of the maximum isometric muscle force (N) divided by the body weight (kg) for 3 s was measured twice 11) . Knee ROM was measured by the maximum values of knee flexion and extension ROM in automatic exercise using a goniometer following the Japanese Orthopedic Association measurement method. ...
[Purpose] This study aimed to examine the impact of physiotherapy on various patients who underwent hybrid closed-wedge high tibial osteotomy. [Participants and Methods] Eighty-four patients were divided into three groups: non-weight-bearing, enhanced recovery after surgery, and grouping exercise. The number of hospital days, distinctions in the duration of cane-walking independence, and postoperative complications were compared among the three groups. Furthermore, the Japanese Orthopaedic Association score and physical function were assessed preoperatively and at 3 and 12 months postoperatively. [Results] There were no considerable differences in postoperative complications among the three groups, and the mean hospital stay was the shortest for the grouping exercise group. At 3 months postoperatively, the grouping exercise group reported less walking pain than the enhanced recovery after surgery group. At 3 and 12 months postoperatively, the grouping exercise group showed greater mean knee extensor strength and a higher mean Japanese Orthopaedic Association score than the non-weight-bearing group. [Conclusion] Grouping exercise therapy, in addition to enhanced recovery after surgery protocol, results in shorter hospital stays, no difference in postoperative complications, and good clinical outcomes.
... Testing protocol: The testing protocol was performed on a knee extension machine with a load cell attached (Cefise Biotechnology, Nova Odessa, SP, Brazil). The equipment was adjusted to a relative knee angle of 90° (19,20). The protocol consisted of eight maximal voluntary isometric contractions of 20 seconds, with 10 seconds of rest, totaling four minutes (24). ...
Ischemic preconditioning (IPC) has been an excellent strategy for enhancing sports performance recovery, although there is still no consensus on the ideal protocol. Thus, this study aimed to evaluate the effects of IPC with different cuff pressures (low pressure, medium pressure, and high pressure) on the attenuation of neuromuscular fatigue after an isometric test protocol. And to verify whether this improvement was related to muscle oxygen saturation during the test protocol. Thirty males (18-35 years old) with experience in resistance training were allocated to three different groups: low pressure (20 mmHg), medium pressure (100 mmHg), and high pressure (190 mmHg). The individual occlusion pressure of each participant was identified using ultrasound. Each participant performed two test protocols (8 maximal isometric contractions lasting 20-s with a 10-s rest interval) in an extension chair; after the first test protocol, the participant received the IPC intervention with a low, medium, or high cuff pressure or received the noncuff intervention (randomized order). Only the medium-pressure group showed a smaller decrease in mean force change compared to the no-cuff condition (-4.40% vs. -13.10%, p=0.01, respectively), and the low- and high-pressure groups did not exhibit significant pressure differences (IPC vs. noncuff: -8.40% vs. -13.10%, p=0.11 and -9.10% vs. -14.70%, p=0.12, respectively). Muscle oxygen saturation across test protocols showed no significant differences in all IPC conditions (p>0.05). Although, IPC with medium pressure was effective at optimizing the recovery of neuromuscular performance, this improvement is not related to an increase in muscle oxygen saturation during exercise.
