Feasibility and Reliability of Functional Muscle Tests in Lung Transplant Recipients.
ABSTRACT: OBJECTIVE:This study investigates the feasibility, reliability, and correlations of recommended functional tests in lung transplant recipients shortly after surgery. DESIGN:This is an observational study. METHODS:Fifty patients (28 females) performed well-standardized maximum isometric back extension in a sitting position, handgrip strength, and Biering-Sørensen endurance tests shortly before discharge from the acute hospital, shortly thereafter, and 2 mos later after subacute rehabilitation. RESULTS:Back extension testing was well feasible, but only two thirds of the patients could perform the Biering-Sørensen test at baseline and they experienced a greater number of minor but no major adverse events. Absolute reliability measures and the intraclass correlation coefficients were excellent for the strength (0.97-0.98 [0.95-0.99]) and good for the endurance tests (0.69 [0.26-0.87]). Handgrip revealed high correlation with back strength (?0.75) but not with Biering-Sørensen scores. CONCLUSIONS:Well-controlled maximum back strength testing is feasible and reliable, and the scores are highly correlated with grip strength in lung transplant recipients shortly before hospital discharge. The Biering-Sørensen test should be limited to patients without dominant weakness and/or fear. Future research should investigate whether grip instead of back extension strength can safely be used for proper exercise prescription.
Project description:We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19-64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July 2020. Each original study's methodological quality was classified as high, low and very low, according to the number of participants, the description of the study population, statistical analysis and systematic reviews which were appraised via the AMSTAR rating scale. Three evidence levels were constructed (strong, moderate and limited evidence) according to the number of studies and the consistency of the findings. We identified 101 original studies (50 of high quality) and five systematic reviews examining the criterion-related validity of field-based fitness tests in adults. Strong evidence indicated that the 20 m shuttle run, 1.5-mile, 12 min run/walk, YMCA step, 2 km walk and 6 min walk test are valid for estimating cardiorespiratory fitness; the handgrip strength test is valid for assessing hand maximal isometric strength; and the Biering-Sørensen test to evaluate the endurance strength of hip and back muscles; however, the sit-and reach test, and its different versions, and the toe-to-touch test are not valid for assessing hamstring and lower back flexibility. We found moderate evidence supporting that the 20 m square shuttle run test is a valid test for estimating cardiorespiratory fitness. Other field-based fitness tests presented limited evidence, mainly due to few studies. We developed an evidence-based proposal of the most valid field-based fitness tests in healthy adults aged 19-64 years old.
Project description:This meta-analysis aimed to estimate the inter- and intra-tester reliability of endurance measures obtained through trunk extension field-based tests and to explore the influence of the moderators on the reliability estimates. The reliability induction rate of trunk extension endurance measures was also calculated. A systematic search was conducted using various databases, and subsequently 28 studies were selected that reported intraclass correlation coefficients for trunk extension endurance measures. Separate meta-analyses were conducted using a random-effects model. When possible, analyses of potential moderator variables were carried out. The inter-tester average reliability of the endurance measure obtained from the Biering-Sorensen test was intraclass correlation coefficient (ICC) = 0.94. The intra-session reliability estimates of the endurance measures recorded using the Biering-Sorensen test, the prone isometric chest raise test, and the prone double straight-leg test were ICC = 0.88, 0.90, and 0.86, respectively. The inter-session average reliability of the endurance measures from the Biering-Sorensen test, the prone isometric chest raise test, and the dynamic extensor endurance test were ICC = 0.88, 0.95, and 0.99, respectively. However, due to the limited evidence available, the reliability estimates of the measures obtained through the prone isometric chest raise, prone double straight-leg, and dynamic extensor endurance tests should be considered with a degree of caution. Position control instruments, tools, and familiarization session demonstrated a statistical association with the inter-session reliability of the Biering-Sorensen test. The reliability induction rate was 72.8%. Only the trunk extension endurance measure obtained through the Biering-Sorensen test presented sufficient scientific evidence in terms of reliability to justify its use for research and practical purposes.
Project description:This study aimed to investigate the influence of different exercise training modalities [(i) a concurrent training based on physical activity recommendation from the World Health Organization group (PAR group), (ii) a high intensity interval training group (HIIT group), and (iii) a high intensity interval training adding whole-body electromyostimulation group (WB-EMS group)] on physical fitness in sedentary middle-aged adults. A total of 89 (52.7% women) middle-aged sedentary adults (53.7 ± 5.1 years old) were enrolled in the FIT-AGING study. Cardiorespiratory fitness was determined by a maximum treadmill test using indirect calorimetry. Lower, upper, and core body muscular strength were assessed by an isokinetic strength test, by the handgrip strength test, and by several core strength endurance tests, respectively. All the exercise types induced similar increases on cardiorespiratory fitness (? VO2max ? 11%, ? maximal heart rate ? 8%, and ? total test duration ? 14%; all P ? 0.034), as well as on muscular strength (? extension and flexion peak torque ? 10%, ? total hand grip ? 3%, ? core strength endurance tests ? 20%; all P ? 0.050) compared with a control group. In conclusion, our results suggest that a 12-week structured exercise intervention improves physical fitness regardless of the training program in sedentary middle-aged adults. Despite slightly greater improvements in some physical fitness variables, the changes observed in the WB-EMS group were not superior to the other exercise programs.
Project description:Muscle strength is important for firefighters work capacity. Laboratory tests used for measurements of muscle strength, however, are complicated, expensive and time consuming. The aims of the present study were to investigate correlations between physical capacity within commonly occurring and physically demanding firefighting work tasks and both laboratory and field tests in full time (N = 8) and part-time (N = 10) male firefighters and civilian men (N = 8) and women (N = 12), and also to give recommendations as to which field tests might be useful for evaluating firefighters' physical work capacity. Laboratory tests of isokinetic maximal (IM) and endurance (IE) muscle power and dynamic balance, field tests including maximal and endurance muscle performance, and simulated firefighting work tasks were performed. Correlations with work capacity were analyzed with Spearman's rank correlation coefficient (rs). The highest significant (p<0.01) correlations with laboratory and field tests were for Cutting: IE trunk extension (rs = 0.72) and maximal hand grip strength (rs = 0.67), for Stairs: IE shoulder flexion (rs = -0.81) and barbell shoulder press (rs = -0.77), for Pulling: IE shoulder extension (rs = -0.82) and bench press (rs = -0.85), for Demolition: IE knee extension (rs = 0.75) and bench press (rs = 0.83), for Rescue: IE shoulder flexion (rs = -0.83) and bench press (rs = -0.82), and for the Terrain work task: IE trunk flexion (rs = -0.58) and upright barbell row (rs = -0.70). In conclusion, field tests may be used instead of laboratory tests. Maximal hand grip strength, bench press, chin ups, dips, upright barbell row, standing broad jump, and barbell shoulder press were strongly correlated (rs≥0.7) with work capacity and are therefore recommended for evaluating firefighters work capacity.
Project description:AIMS/INTRODUCTION:To carry out a cross-sectional single-center study in a Japanese hospital to determine the diagnostic value of handgrip measurement to detect locomotive syndrome (LS). MATERIALS AND METHODS:Consecutive outpatients underwent an LS risk test, which comprised a stand-up test and a two-step test, and a handgrip measurement, along with general diabetes-related tests. We calculated the prevalence of LS, and evaluated the association between handgrip strength and LS. RESULTS:We enrolled 234 patients in this study. The prevalence of LS in the stand-up and two-step tests was 51.5 and 79.0%, respectively. The prevalence of LS in the stand-up or two-step tests increased with age both in men and women. Using the stand-up and two-step tests, 107 patients (46.7%) were diagnosed with LS. The area under the receiver operating characteristic curve, used to assess our identification of LS in terms of grip strength in men and women, showed 95% confidence intervals of 0.703 (0.563-0.813) and 0.698 (0.500-0.842), respectively. The odds ratios of grip strength for LS were 0.90 (95% confidence interval 0.83-0.97) and 0.87 (95% confidence interval 0.76-0.98) in men and women, respectively. CONCLUSIONS:Our findings showed that handgrip measurement was useful in detecting LS, and LS should be considered when evaluating patients with type 2 diabetes mellitus.
Project description:BACKGROUND AND AIMS:Examining factors that may explain disparities in fitness levels among youth is a critical step in youth fitness promotion. The purpose of this study was twofold; 1) to examine the influence of school-level characteristics on fitness test performance; 2) to compare Irish adolescents' physical fitness to European norms. METHODS:Adolescents (n = 1215, girls = 609) aged 13.4 years (SD .41) from a randomised sample of 20 secondary schools, stratified for gender, location and educational (dis)advantage, completed a series of field-based tests to measure the components of health-related physical fitness. Tests included: body mass index; 20 metre shuttle run test (20 m SRT); handgrip strength; standing broad jump (SBJ); 4 x 10 metre shuttle run; and back-saver sit-and-reach (BSR). RESULTS:Overall, boys outperformed girls in all tests, aside from the BSR (p < 0.005, t-test, Bonferroni correction). Participants in designated disadvantaged schools had significantly higher body mass index levels (p < 0.001), and significantly lower cardiorespiratory endurance (20 m SRT) (p < 0.001) and muscular strength (handgrip strength) (p = 0.018) levels compared to participants in non-disadvantaged schools. When compared to European norms, girls in this study scored significantly higher in the 20 m SRT, 4 x 10 metre shuttle run and SBJ tests, while boys scored significantly higher in the BSR test (Cohen's d 0.2 to 0.6, p < 0.001). However, European adolescents had significantly higher handgrip strength scores (Cohen's d 0.6 to 0.8, p < 0.001). CONCLUSION:Irish adolescents compared favourably to European normative values across most components of HRPF, with the exception of muscular strength. School socioeconomic status was a strong determinant of performance among Irish adolescents. The contrasting findings for different fitness components reiterate the need for multi-component testing batteries for monitoring fitness in youth.
Project description:<h4>Aims</h4>To investigate the longitudinal relation between physical capacity (isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine) and low back, neck, and shoulder pain.<h4>Methods</h4>In this prospective cohort study, 1789 Dutch workers participated. At baseline, isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine were measured in the pain free workers, as well as potential confounders, including physical workload. Low back, neck, and shoulder pain were self-reported annually at baseline and three times during follow up.<h4>Results</h4>After adjustment for confounders, Poisson generalised estimation equations showed an increased risk of low back pain among workers in the lowest sex specific tertile of performance in the static back endurance tests compared to workers in the reference category (RR = 1.42; 95% CI 1.19 to 1.71), but this was not found for isokinetic trunk lifting strength or mobility of the spine. An increased risk of neck pain was shown for workers with low performance in tests of isokinetic neck/shoulder lifting strength (RR = 1.31; 95% CI 1.03 to 1.67) and static neck endurance (RR = 1.22; 95% CI 1.00 to 1.49). Among workers in the lowest tertiles of isokinetic neck/shoulder lifting strength or endurance of the shoulder muscles, no increased risk of shoulder pain was found.<h4>Conclusions</h4>The findings of this study suggest that low back or neck endurance were independent predictors of low back or neck pain, respectively, and that low lifting neck/shoulder strength was an independent predictor of neck pain. No association was found between lifting trunk strength, or mobility of the spine and the risk of low back pain, nor between lifting neck/shoulder strength or endurance of the shoulder muscles and the risk of shoulder pain.
Project description:Decline in both telomere length and physical fitness over the life course may contribute to increased risk of several chronic diseases. The relationship between telomere length and aerobic and muscular fitness is not well characterized. We examined whether there are cross-sectional associations of mean relative leukocyte telomere length (LTL) with objective measures of aerobic fitness, muscle strength, and muscle endurance, using data on 31-year-old participants of the Northern Finland Birth Cohort 1966 (n = 4,952-5,205, varying by exposure-outcome analysis). Aerobic fitness was assessed by means of heart rate measurement following a standardized submaximal step test; muscular fitness was assessed by means of a maximal isometric handgrip strength test and a test of lower-back trunk muscle endurance. Longer LTL was associated with higher aerobic fitness and better trunk muscle endurance in models including adjustment for age, sex, body mass index, socioeconomic position, diet, smoking, alcohol consumption, physical activity level, and C-reactive protein. In a sex-stratified analysis, LTL was not associated with handgrip strength in either men or women. LTL may relate to aspects of physical fitness in young adulthood, but replication of these findings is required, along with further studies to help assess directions and causality in these associations.
Project description:BACKGROUND:Low back pain (LBP) is a common cause of disability among U.S. military personnel. Approximately 20% of all diagnoses resulting in disability discharges are linked to back-related conditions. Because LBP can negatively influence trunk muscle strength, balance, and endurance, the military readiness of active-duty military personnel with LBP is potentially compromised. Chiropractic care may facilitate the strengthening of trunk muscles, the alteration of sensory and motor signaling, and a reduction in pain sensitivity, which may contribute to improving strength, balance, and endurance for individuals with LBP. This trial will assess the effects of chiropractic care on strength, balance, and endurance for active-duty military personnel with LBP. METHODS/DESIGN:This randomized controlled trial will allocate 110 active-duty military service members aged 18-40 with non-surgical acute, subacute, or chronic LBP with pain severity of ?2/10 within the past 24?h. All study procedures are conducted at a single military treatment facility within the continental United States. Participants are recruited through recruitment materials approved by the institutional review board, such as posters and flyers, as well as through provider referrals. Group assignment occurs through computer-generated random allocation to either the study intervention (chiropractic care) or the control group (waiting list) for a 4-week period. Chiropractic care consists primarily of spinal manipulation at a frequency and duration determined by a chiropractic practitioner. Strength, balance, and endurance outcomes are obtained at baseline and after 4?weeks. The primary outcome is a change between baseline and 4?weeks of peak isometric strength, which is measured by pulling on a bimanual handle in a semi-squat position. Secondary outcomes include balance time during a single-leg standing test and trunk muscle endurance with the Biering-Sorensen test. Patient-reported outcomes include pain severity, disability measured with the Roland Morris Disability Questionnaire, symptom bothersomeness, PROMIS-29, Fear Avoidance Beliefs Questionnaire, expectations of care, physical activity, and global improvement. DISCUSSION:This trial may help inform further research on biological mechanisms related to manual therapies employed by chiropractic practitioners. TRIAL REGISTRATION:ClinicalTrials.gov, NCT02670148 Registered on 1 February 2016.
Project description:Strength training is an important means for performance development in young rowers. The purpose of this study was to examine the effects of a 9-week equal volume heavy-resistance strength training (HRST) versus strength endurance training (SET) in addition to regular rowing training on primary (e.g., maximal strength/power) and secondary outcomes (e.g., balance) in young rowers. Twenty-six female elite adolescent rowers were assigned to an HRST (n = 12; age: 13.2 ± 0.5 yrs; maturity-offset: +2.0 ± 0.5 yrs) or a SET group (n = 14; age: 13.1 ± 0.5 yrs; maturity-offset: +2.1 ± 0.5 yrs). HRST and SET comprised lower- (i.e., leg press/knee flexion/extension), upper-limbs (i.e., bench press/pull; lat-pull down), and complex exercises (i.e., rowing ergometer). HRST performed four sets with 12 repetitions per set at an intensity of 75-95% of the one-repetition maximum (1-RM). SET conducted four sets with 30 repetitions per set at 50-60% of the 1-RM. Training volume was matched for overall repetitions × intensity × training per week. Pre-post training, tests were performed for the assessment of primary [i.e., maximal strength (e.g., bench pull/knee flexion/extension 1-RM/isometric handgrip test), muscle power (e.g., medicine-ball push test, triple hop, drop jump, and countermovement jump), anaerobic endurance (400-m run), sport-specific performance (700-m rowing ergometer trial)] and secondary outcomes [dynamic balance (Y-balance test), change-of-direction (CoD) speed (multistage shuttle-run test)]. Adherence rate was >87% and one athlete of each group dropped out. Overall, 24 athletes completed the study and no test or training-related injuries occurred. Significant group × time interactions were observed for maximal strength, muscle power, anaerobic endurance, CoD speed, and sport-specific performance (p ? 0.05; 0.45 ? d ? 1.11). Post hoc analyses indicated larger gains in maximal strength and muscle power following HRST (p ? 0.05; 1.81 ? d ? 3.58) compared with SET (p ? 0.05; 1.04 ? d ? 2.30). Furthermore, SET (p ? 0.01; d = 2.08) resulted in larger gains in sport-specific performance compared with HRST (p < 0.05; d = 1.3). Only HRST produced significant pre-post improvements for anaerobic endurance and CoD speed (p ? 0.05; 1.84 ? d ? 4.76). In conclusion, HRST in addition to regular rowing training was more effective than SET to improve selected measures of physical fitness (i.e., maximal strength, muscle power, anaerobic endurance, and CoD speed) and SET was more effective than HRST to enhance sport-specific performance gains in female elite young rowers.