Hand Grip Strength: age and gender stratified normative data in a population-based study

Extent: 5p.Background: The North West Adelaide Health Study is a representative longitudinal cohort study of people originally aged 18 years and over. The aim of this study was to describe normative data for hand grip strength in a community-based Australian population. Secondary aims were to investigate the relationship between body mass index (BMI) and hand grip strength, and to compare Australian data with international hand grip strength norms. Methods: The sample was randomly selected and recruited by telephone interview. Overall, 3 206 (81% of those recruited) participants returned to the clinic during the second stage (2004-2006) which specifically focused on the collection of information relating to musculoskeletal conditions. Results: Following the exclusion of 435 participants who had hand pain and/or arthritis, 1366 men and 1312 women participants provided hand grip strength measurement. The study population was relatively young, with 41.5% under 40 years; and their mean BMI was 28.1 kg/m2 (SD 5.5). Higher hand grip strength was weakly related to higher BMI in adults under the age of 30 and over the age of 70, but inversely related to higher BMI between these ages. Australian norms from this sample had amongst the lowest of the hand grip strength of the internationally published norms, except those from underweight populations. Conclusions: This population demonstrated higher BMI and lower grip strength in younger participants than much of the international published, population data. A complete exploration of the relationship between BMI and hand grip strength was not fully explored as there were very few participants with BMI in the underweight range. The age and gender grip strength values are lower in younger adults than those reported in international literature.Nicola M Massy-Westropp, Tiffany K Gill, Anne W Taylor, Richard W Bohannon and Catherine L Hil

Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner's surgery: Study protocol of a single arm trial preparing an RCT [ISRCTN58562962]

<p>Abstract</p> <p>Background</p> <p>Physical activity programmes can help to prevent functional decline in the elderly. Until now, such programmes use to target either on healthy community-dwelling seniors or on elderly living in special residences or care institutions. Sedentary or frail people, however, are difficult to reach when they live in their own homes. The general practitioner's (GP) practice offers a unique opportunity to acquire these people for participation in activity programmes. We conceptualised a multidimensional home-based exercise programme that shall be delivered to the target group through cooperation between GPs and exercise therapists. In order to prepare a randomised controlled trial (RCT), a feasibility study is being conducted.</p> <p>Methods</p> <p>The study is designed as a single arm interventional trial. We plan to recruit 90 patients aged 70 years and above through their GPs. The intervention lasts 12 weeks and consists of physical activity counselling, a home-exercise programme, and exercise consultations provided by an exercise therapist in the GP's practice and via telephone. The exercise programme consists of two main components: 1. a combination of home-exercises to improve strength, flexibility and balance, 2. walking for exercise to improve aerobic capacity. Primary outcome measures are: appraisal by GP, undesirable events, drop-outs, adherence. Secondary outcome measures are: effects (a. motor tests: timed-up-and-go, chair rising, grip strength, tandem stand, tandem walk, sit-and-reach; b. telephone interview: PRISCUS-Physical Activity Questionnaire, Short Form-8 Health Survey, three month recall of frequency of falls, Falls Efficacy Scale), appraisal by participant, exercise performance, focus group discussion. Data analyses will focus on: 1. decision-making concerning the conduction of a RCT, 2. estimation of the effects of the programme, detection of shortcomings and identification of subgroups with contrary results, 3. feedback to participants and to GPs.</p> <p>Conclusion</p> <p>A new cooperation between GPs and exercise therapists to approach community-dwelling seniors and to deliver a home-exercise programme is object of research with regard to feasibility and acceptance. In case of success, an RCT should examine the effects of the programme. A future implementation within primary medical care may take advantage from the flexibility of the programme.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN58562962.</p

Supporting Key Aspects of Practice in Making Mathematics Explicit in Science Lessons

STEM integration has often been recommended as a way to support students to develop 21st Century skills needed to function in the complex modern world. In order for students to experience integration, however, their teachers need support in designing, developing and implementing integrated curricular instruction, which is often at odds with a very subject-focused educational system. This paper reports on the second year of a research study conducted with five secondary science and mathematics teachers, concerned with supporting them to teach explicitly the mathematics components within science lessons, mediated via technology. It outlines how the teachers collaborated with the support of science and mathematics education researchers within a community of practice, named a Teaching and Learning Network (TLN). The network was intended to promote and enhance teacher capacity for the interdisciplinary teaching of mathematics in science in the face of various contextual and other obstacles observed in the first year of the study. This study found that the opportunity to work in a Teaching and Learning Network supported the teachers’ ownership of the design of the integrated learning unit, enhanced their content knowledge of the mathematics, their use of the data logging technology and their understanding of an inquiry based pedagogical approach. Participation in the TLN provided teachers with the mechanism to cross the boundaries of the subject disciplines, and thereby promoted change in their attitudes, professional knowledge and to some extent, practice

Ageing, Muscle Power and Physical Function: A Systematic Review and Implications for Pragmatic Training Interventions.

BACKGROUND: The physiological impairments most strongly associated with functional performance in older people are logically the most efficient therapeutic targets for exercise training interventions aimed at improving function and maintaining independence in later life. OBJECTIVES: The objectives of this review were to (1) systematically review the relationship between muscle power and functional performance in older people; (2) systematically review the effect of power training (PT) interventions on functional performance in older people; and (3) identify components of successful PT interventions relevant to pragmatic trials by scoping the literature. METHODS: Our approach involved three stages. First, we systematically reviewed evidence on the relationship between muscle power, muscle strength and functional performance and, second, we systematically reviewed PT intervention studies that included both muscle power and at least one index of functional performance as outcome measures. Finally, taking a strong pragmatic perspective, we conducted a scoping review of the PT evidence to identify the successful components of training interventions needed to provide a minimally effective training dose to improve physical function. RESULTS: Evidence from 44 studies revealed a positive association between muscle power and indices of physical function, and that muscle power is a marginally superior predictor of functional performance than muscle strength. Nine studies revealed maximal angular velocity of movement, an important component of muscle power, to be positively associated with functional performance and a better predictor of functional performance than muscle strength. We identified 31 PT studies, characterised by small sample sizes and incomplete reporting of interventions, resulting in less than one-in-five studies judged as having a low risk of bias. Thirteen studies compared traditional resistance training with PT, with ten studies reporting the superiority of PT for either muscle power or functional performance. Further studies demonstrated the efficacy of various methods of resistance and functional task PT on muscle power and functional performance, including low-load PT and low-volume interventions. CONCLUSIONS: Maximal intended movement velocity, low training load, simple training methods, low-volume training and low-frequency training were revealed as components offering potential for the development of a pragmatic intervention. Additionally, the research area is dominated by short-term interventions producing short-term gains with little consideration of the long-term maintenance of functional performance. We believe the area would benefit from larger and higher-quality studies and consideration of optimal long-term strategies to develop and maintain muscle power and physical function over years rather than weeks

Exercise and bone health across the lifespan

With ageing, bone tissue undergoes significant compositional, architectural and metabolic alterations potentially leading to osteoporosis. Osteoporosis is the most prevalent bone disorder, which is characterised by progressive bone weakening and an increased risk of fragility fractures. Although this metabolic disease is conventionally associated with ageing and menopause, the predisposing factors are thought to be established during childhood and adolescence. In light of this, exercise interventions implemented during maturation are likely to be highly beneficial as part of a long-term strategy to maximise peak bone mass and hence delay the onset of age- or menopause-related osteoporosis. This notion is supported by data on exercise interventions implemented during childhood and adolescence, which confirmed that weight-bearing activity, particularly if undertaken during peripubertal development, is capable of generating a significant osteogenic response leading to bone anabolism. Recent work on human ageing and epigenetics suggests that undertaking exercise after the fourth decade of life is still important, given the anti-ageing effect and health benefits provided, potentially occurring via a delay in telomere shortening and modification of DNA methylation patterns associated with ageing. Exercise is among the primary modifiable factors capable of influencing bone health by preserving bone mass and strength, preventing the death of bone cells and anti-ageing action provided

Preliminary studies on the lithostratigraphy and depositional environment of the oil shale deposits of Abakaliki anticlinorium, southeastern Nigeria

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Tourism potential of the confluence between river Niger and river Benue in Nigeria: implication for project finance

Abstract Introduction This research proposes the development of the confluence of river Niger and river Benue in Nigeria as a viable international tourist center. Case description The confluence of river Niger and river Benue in Lokoja Nigeria, is the site proposed for intervention. The study recommends the use of the mechanism of project financing for the funding of the project by the government. Discussion and Evaluation. Existing studies indicates that inadequate empirical data on viability of investments in most tourism destinations in Nigeria has been a challenge to investors as well as policy makers. Using the case study method which also included actual site visitation for on the spot assessment, this paper attempts to provide information on the prospects of tourism development in Lokoja town of Nigeria by simulating real-world scenarios. The research found that investments in tourism in Lokoja town has better viability prospects with the application of Project finance models of Management Contract and Forfeiting Contract. Conclusion The study showed that the confluence of river Niger and river Benue can be developed based on the methods outlined above and that the project can be a great benefit to tourists, investors and the government

Effects of age and starting age upon side asymmetry in the arms of veteran tennis players: a cross-sectional study

Summary While tennis playing results in large bone strength benefits in the racquet arm of young players, the effects of tennis playing in old players have not been investigated. Large side asymmetries in bone strength were found in veteran players, which were more pronounced in men, younger players and childhood starters. Introduction Regular tennis results in large racquet arm bone and muscle strength advantages; however, these effects have not been studied in old players. The non-racquet arm can act as an internal control for the exercising racquet arm without confounding factors, e.g. genotype. Therefore, veteran tennis player side asymmetries were examined to investigate age, sex and starting age effects on bone exercise benefits. Methods Peripheral quantitative computed tomography (pQCT) scans were taken at the radius, ulna and humerus mid-shaft and distal radius in both arms of 88 tennis players (51males, 37 females;mean age 63.8±11.8 years). Thirty-two players began playing in adulthood, thereby termed ‘old starters’; players were otherwise termed ‘young starters’. Results Muscle size and bone strength were greater in the racquet arm; notably, distal radius bone mineral content (BMC) was 13±10 % higher and humeral bone area 23± 12 % larger (both P<0.001). Epiphyseal BMC asymmetry was not affected by age (P=0.863) or sex (P=0.954), but diaphyseal asymmetries were less pronounced in older players and women, particularly in the humerus where BMC, area and moment of resistance asymmetries were 28–34 % less in women (P<0.01). Bone area and periosteal circumference asymmetries were smaller in old starters (all P<0.01); most notably, no distal radius asymmetry was found in this group (0.4±3.4 %). Conclusions Tennis participation is associated with large side asymmetries in muscle and bone strength in old age. Larger relative side asymmetries in men, younger players and young starters suggest a greater potential for exercise benefits to bone in these groups