Isokinetic Strength in Peritoneal Dialysis Patients: A Reliability Study

Reproducibility of peak force for isometric and isokinetic multi-joint leg extension exercise

BACKGROUND

Isokinetic dynamometry is a common tool for evaluating muscle function and is used across various disciplines. Technical advancements have shifted focus towards multi-joint exercises such as the leg press, offering insights into practical human movement dynamics. However, previous reproducibility studies have focused predominantly on single-joint exercises, warranting investigations into the reliability of multi-joint exercises. This study aimed to assess the reproducibility of peak force (PF) during multi-joint leg press exercises using the IsoMed 2000 dynamometer.

METHODS

Thirty physically active subjects (mean: stature 179.4 cm; body mass 76.0 kg; age 30.6 years) participated in three testing sessions. Each session consisted of isometric and isokinetic leg press exercises. Knee angles for isometric exercises included 100° and 140°; velocities for isokinetic exercise included 30 mm/s and 600 mm/s. The first session served as the familiarization session. Statistical analysis included paired sample t-tests, Cohen's d effect sizes, intraclass correlation coefficients (ICC), standard errors of measurement (SEM), and Bland-Altman calculations, including corresponding plots.

RESULTS

Descriptive data revealed consistent PF across sessions, with a significant between-sessions difference observed only for isometric (100°) leg extension in the right leg (p < 0.001; d = 0.13). ICC calculations showed high relative reproducibility (ICC > 0.911), with SEM ranging from 37.6 to 294.7 N (SEM% 2.3-6.3%, respectively). Bland-Altman plots depicted minimal intersession disparities (-141.8-68.3 N, respectively - 3.02-1.26%), supporting high reliability.

CONCLUSIONS

This study highlights the reliability of assessing peak force during isometric and isokinetic leg press exercises using the IsoMed 2000 after a single familiarization session. These findings support its utility in muscular performance evaluation, urging practitioners to incorporate familiarization trials for accurate assessments.

Reproducibility of peak moment for isometric and isokinetic knee extension exercise

BACKGROUND

Accurate measurements of muscular performance are important for diagnostics, for example during rehabilitation after traumatic injuries but also in competitive sports. For these purposes, dynamometric devices are widely used and considered the gold standard for muscle strength testing. However, few previous studies have tested the reproducibility of peak moment (PM) at velocities close to the maximum device capability, and in general, reproducibility results cannot be transferred to other devices or test protocols. The purpose of this study was to evaluate the reproducibility of PM for different isometric and isokinetic knee extension exercises using the IsoMed 2000.

METHODS

Thirty subjects volunteered in three repeated test sessions, including isometric knee extension (100° and 140° knee angle) and isokinetic knee extension (30°/s and 400°/s). Statistical analysis for comparison of sessions two and three included paired sample t-test, calculation of intraclass correlation coefficient (ICC) and standard error of measurement (SEM). Additionally, Bland Altman statistics and corresponding plots were created.

RESULTS

A significant difference between sessions in PM was found for isometric knee extension in one leg (140° left). Reproducibility was high for all conditions with ICC ranging from 0.964 to 0.988 and SEM in the range of 7.6 to 10.5 Nm. Bland Altman statistics revealed a bias between - 7.3 and 0.7 Nm.

CONCLUSIONS

Reproducibility of PM using the IsoMed 2000 was good after an initial familiarization trial with high values of relative reproducibility. Absolute reproducibility can be interpreted as appropriate for most common practical applications.

Measurement properties of performance-based measures to assess physical function in chronic kidney disease: recommendations from a COSMIN systematic review

Background

There is wide heterogeneity in physical function tests available for clinical and research use, hindering our ability to synthesize evidence. The aim of this review was to identify and evaluate physical function measures that could be recommended for standardized use in chronic kidney disease (CKD).

Methods

MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, Scopus and Web of Science were searched from inception to March 2022, identifying studies that evaluated a clinimetric property (validity, reliability, measurement error and/or responsiveness) of an objectively measured performance-based physical function outcomes using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) based recommendations. Studies with individuals of all ages and of any stage of CKD were included.

Results

In total, 50 studies with 21 315 participants were included. Clinimetric properties were reported for 22 different physical function tests. The short physical performance battery (SPPB), Timed-up-and-go (TUG) test and Sit-to-stand tests (STS-5 and STS-60) had favorable properties to support their use in CKD and should be integrated into routine use. However, the majority of studies were conducted in the hemodialysis population, and very few provided information regarding validity or reliability.

Conclusion

The SPPB demonstrated the highest quality of evidence for reliability, measurement error and construct validity amongst transplant, CKD and dialysis patients. This review is an important step towards standardizing a core outcome set of tools to measure physical function in research and clinical settings for the CKD population.

Test-Retest Reliability of Isokinetic Ankle, Knee and Hip Strength in Physically Active Adults Using Biodex System 4 Pro

BACKGROUND

The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated.

OBJECTIVE

To examine the test-retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro.

METHODS

Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart.

RESULTS

The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CV_TE) values were 6.6-19.5%. Change in the mean expressed as a percent varied from -3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs.

CONCLUSION

Test-retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings.

Editorial “Biomechanical Spectrum of Human Sport Performance”

Several parameters can influence our health capital today and can have a negative impact on our performance, whether physiological or mechanical. Indeed, our health and wellbeing are influenced by a range of social, cultural, economic, psychological, and environmental factors across our lives. These change as we progress through the key transition points in life—from infancy and childhood through our teenage years to adulthood, working life, retirement and the end of life. Sport can be a vector that links many of these factors. Whether it is high-performance sport or sedentary practice, sport is very important for the improvement of psychological wellbeing and physical health. Our overarching aim was to increase quality of life. Sedentary practice can increase mobility and reduce the risk of disease, so changing adults’ behavior through sedentary practice could reduce illness and decrease costs to society concerning health problems. Furthermore, a higher frequency of practice can lead to improvements in technique and optimized performance. Our objective is to summarize the latest research in sport science and to quantify the most important parameters influencing human performance related to the health sciences for all age groups, throughout their lives.