Grip and muscle strength dynamometry in acute burn injury: Evaluation of an updated assessment protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: Systematic review and meta-analysis

Indexación: Scopus.The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.https://www.degruyter.com/view/j/med.2017.12.issue-1/med-2017-0052/med-2017-0052.xm

Bilateral and Unilateral Asymmetries of Strength and Flexibility in Young Elite Sailors: Windsurfing, Optimist and Laser Classes

In sport sailing, performance is related to the sailor’s ability to maintain the stability of the boat, and the boat class determines the variables involved in such ability. In monohull-type vessels, such as the Optimist and Laser classes, the flexibility of the hip joint is a key performance factor. In the Windsurfing class, performance is determined by the strength of the flexors of the fingers and elbows. The performance of the sailor may be a ected by asymmetries in the strength and flexibility of the muscles and joints involved in technical actions. The objective of this study was to evaluate asymmetries in strength and flexibility in young sailors. Thirty-three young sailors (ten girls) from the Windsurfing, Optimist and Laser classes were assessed for manual strength and flexibility, by dynamometry and straight leg lift tests, respectively. The symmetry index and the functional asymmetry of compression force were calculated. The results showed no di erences between sailors according to gender. The sailors of the Laser class obtained the highest levels of manual strength, whereas those of the Windsurfing class showed the highest flexibility levels. The girls’ group andWindsurfing class had the highest percentage of sailors with strength asymmetry, whereas, the sailors of the Optimist class presented a greater percentage of asymmetry in flexibility. There were no di erences in upper limb strength and lower limb flexibility between the dominant and non-dominant sides

Power grip, pinch grip, manual muscle testing or thenar atrophy - which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review

<p>Abstract</p> <p>Background</p> <p>Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS). However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust.</p> <p>Methods</p> <p>The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers.</p> <p>Results</p> <p>Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS.</p> <p>Conclusion</p> <p>Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more sensitive if assessed using a hand held dynamometer – the Rotterdam Intrinsic Handheld Myometer. However further research is needed to evaluate its reliability and responsiveness and establish the most efficient and psychometrically robust method of evaluating motor function following surgery for CTS.</p

Validation of ankle strength measurements by means of a hand-held dynamometer in adult healthy subjects

Uniaxial Hand-Held Dynamometer (HHD) is a low-cost device widely adopted in clinical practice to measure muscle force. HHD measurements depend on operator’s ability and joint movements. The aim of the work is to validate the use of a commercial HHD in both dorsiflexion and plantarflexion ankle strength measurements quantifying the effects of HHD misplacements and unwanted foot’s movements on the measurements. We used an optoelectronic system and a multicomponent load cell to quantify the sources of error in the manual assessment of the ankle strength due to both the operator’s ability to hold still the HHD and the transversal components of the exerted force that are usually neglected in clinical routine. Results showed that foot’s movements and angular misplacements of HHD on sagittal and horizontal planes were relevant sources of inaccuracy on the strength assessment. Moreover, ankle dorsiflexion and plantarflexion force measurements presented an inaccuracy less than 2% and higher than 10%, respectively. In conclusion, the manual use of a uniaxial HHD is not recommend ed for the assessment of ankle plantarflexion strength; on the contrary, it can be allowed asking the operator to pay strong attention to the HHD positioning in ankle dorsiflexion strength measurements

Human Performance Assessments in Cadet Populations

This study assessed potential physiological differences between the Ranger Challenge (RC) Competition team and junior year cadets in an Army Reserve Officer Training Corps (ROTC) program. The method included: RC (m = 11, f = 2) and junior year cadets (m = 7, f = 3) were assessed in the following areas: 1) quickness and agility (5-10-5 shuttle run), 2) total-body power (standing broad jump), and 3) grip strength (hand grip dynamometry) assessed. The 5-10-5 shuttle run was performed twice (opening once to the left and once to the right). The standing broad jump required that cadets stand with their toes behind a line, perform a maximum of three preparatory movements, triple extend their knees, hips, and ankles while using their upper body to propel them as far forward as possible. After the jump the distanced reached was measured from the line to the heel of the nearest foot. Hand grip dynamometry was performed once on each hand. The cadet held the dynamometer out to his or her side and squeezed it as they lowered it to their hip. The results were that there were no significant differences between groups for the 5-10-5 shuttle run (p = 0.91), standing broad jump (p = 0.49), or grip strength (p = 0.31). RC did not outperform

The Telehealth Skills, Training, and Implementation Project: An evaluation protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Reliability of shoulder rotators isometric strength test using a novel pulley electromechanical dynamometer. Influence of the assessment position

Indexación: Scopus.Background: The shoulder complex, because of its relatively extensive freedom of motion, offers a great variety of testing positions and articular planes for strength examination. Despite this, reliability of results are not clearly addressed. A novel pulley electromechanical dynamometer (FED) (functional electronic dynamometer) could be an alternative in strength assessment, however, the relative and absolute reliability have not been reported in the literature. Objectives: To report the results of shoulder internal (IR) and rotators (ER) peak torque reliability in two assessment positions by FED in asymptomatic subjects. Methods: Fifty-two healthy college students were included and tested twice within a two week period. In a supine position, the subjects randomly performed four isometric strength tests (i.e. IR at 40°, IR at 90°, ER at 40°, and ER at 90° of shoulder abduction). Results: The intra-class correlation coefficients (ICC) for relative reliability at 90° were 0.96 (0.94-0.98) for IR and 0.94 (0.90-0.96) for ER. ICC at 40° were 0.89 (0.80-0.94) for IR and 0.97 (0.94-0.98) for ER. Absolute reliability expressed as standard error of measurement compared to the mean (SEM%) and 95% confidence interval (CI) of minimal detectable change percentage (MDC%) at 90° were 8.8% (-20.8, 28.4%) and 11.4% (-28.0, 35.2%) for ER. MDC% at 40° were 12.6% (-35.5, 34.8%) for IR and 18.1% (-28.1, 35, 2%) for ER. Conclusions: Isometric strength testing protocol using FED showed an excellent reproducibility and can be safely used in clinical settings to monitor the strength changes in a group of individuals or in a single individual. © 2018, Asian Journal of Sports Medicine.http://asjsm.com/en/articles/60406.htm

Assessment of reliability in isokinetic testing among adolescent basketball players

Background. The reproducibility of day-to-day testing of isokinetic concentric and eccentric muscular actions among adolescent basketball players aged 14 to 16 years and relationships of mean within-subject variation in two isokinetic testing sessions with chronological age, biological maturation (estimated age at peak height velocity), training experience, body size, lower-body morphology, and initial strength performance were evaluated. Material and Methods. The sample included 27 basketball players who completed replicate test sessions of 5 repetitions of reciprocal concentric and eccentric knee extensions and flexions at 60 degrees s(-1). A randomly selected subsample of 8 players completed a third testing session to confirm reliability estimates. Results. Coefficients of variation (CV) between sessions 1 and 2 ranged from 8.1% to 17.4%, and intraclass coefficients (ICCs) ranged from 0.72 to 0.89. For sessions 1 and 3, CVs ranged from 3.9% to 6.0%, and ICCs ranged from 0.95 to 0.99. The initial level of strength of eccentric knee flexion (r=-0.43) and eccentric knee extension (r=-0.42) were correlated (P<0.05) with eccentric knee extension within-variation between two sessions. Training experience (r=-0.37, P<0.05) and initial values of concentric knee flexion (r=-0.62, P<0.01) were correlated with concentric knee flexion within-subject differences. Within-subject variation of eccentric knee extension was correlated (P<0.05) with chronologic age (r=0.41), estimated age at peak height velocity (r=-0.38), body size (r=0.41 to 0.47), and leg volume (r=0.39). Conclusions. Familiarization sessions may improve the reliability of concentric and eccentric knee isokinetic strength testing at 60 s(-1) in adolescent basketball players. Age, maturity status, and training experience of young athletes should be considered when testing knee isokinetic strength at 60 degrees s(-1)