Grip strength: are dinamometers equivalent? JAMAR vs E-Link

Levels of risk for future disability can be assessed with grip strength. This assessment is of fundamental importance for establishing prevention strategies. It also allows verifying relationships with functional capacity of individuals. Most studies on grip strength use the JAMAR Hydraulic dynamometer that provides the value of isometric force obtained during the performance of grip movement and is considered the “gold standard” for measurement of grip strength. However, there are different dynamometers available commercially, such as portable computerized dynamometer E-Link (Biometrics), which provides the value of maximum force (peak force) in addition to other variables as the rate of fatigue for hand strength, among others. Of our knowledge, there are no studies that allow us to accept or not and compare values obtained with both devices and perhaps use them interchangeably. The aim of this study was to evaluate the absolute agreement between the measurements of grip strength (peak force or maximum force in kg) obtained from two different devices (portable dynamometers): a computerized (E-Link, Biometrics) and one hydraulic (JAMAR).

Handgrip strength

The basic function of the human hand is the manipulation and grasping of various objects in all daily activities, including work activities. This is greatly influenced by strength and manual dexterity. However age, gender and other contexts such as work or leisure activities could influence strength. Handgrip strength, a measure of maximum voluntary force of the hand, has proved to be reliable and valid as an objective parameter to evaluate the functional integrity of the hand as part of the musculoskeletal system. It correlates highly with strength in other muscular groups and is therefore considered as a good indicator of overall muscular strength and functional stress and could be used as a predictor of physical disability. Handgrip strength assessment is simple and reliable and used commonly by several investigators and health professionals, in different contexts (medical, nutritional, rehabilitation, professional settings, engineering, etc.) and with different purposes (research, diagnostic, assessment, etc.). In clinical and rehabilitation settings is of vital importance in the determination of effectiveness of several interventions and for monitoring evolution of diseases. Various ways (methods, techniques and equipments) of collecting information on grip strength have been reported. This chapter will review basic concepts on handgrip function, methodologies of assessment, contexts of application and correlates, such as physical activity, health or nutritional status. Several populations and reference values as also the relationships between handgrip and clinical status, aging, risk of disability and diseases, will be discussed.

Association between grip strength, anthropometric data and functional capacity

The hand is one of the most important instruments of the human body, mainly due to the possibility of grip movements. Grip strength has been described as an important predictor of functional capacity. There are several factors that may influence it, such as gender, age and anthropometric characteristics. Functional capacity refers to the ability to perform daily activities which allow the individual to self-care and to live with autonomy. Composite Physical Function (CPF) scale is an evaluation tool for functional capacity that includes daily activities, self-care, sports activities, upper limb function and gait capacity. In 2011, Portugal had 15% of young population (0-14years) and 19% of elderly population (over 65 years). Considering the double-ageing phenomen, it is important to understand the effect of the grip strength in elderly individuals, considering their characteristics, as the need to maintainin dependency as long as possible.

Body composition, muscle strength, functional capacity, and physical disability risk in liver transplanted familial amyloidotic polyneuropathy patients

Abstract: Background: Familial amyloidotic polyneuropathy (FAP) is a neurodegenerative disease leading to sensory and motor polyneuropathies, and functional limitations. Liver transplantation is the only treatment for FAP, requiring medication that negatively affects bone and muscle metabolism. The aim of this study was to compare body composition, levels of specific strength, level of physical disability risk, and functional capacity of transplanted FAP patients (FAPTx) with a group of healthy individuals (CON). Methods: A group of patients with 48 FAPTx (28 men, 20 women) was compared with 24 CON individuals (14 men, 10 women). Body composition was assessed by dual-energy X-ray absorptiometry, and total skeletal muscle mass (TBSMM) and skeletal muscle index (SMI) were calculated. Handgrip strength was measured for both hands as was isometric strength of quadriceps. Muscle quality (MQ) was ascertained by the ratio of strength to muscle mass. Functional capacity was assessed by the six-minute walk test. Results: Patients with FAPTx had significantly lower functional capacity, weight, body mass index, total fat mass, TBSMM, SMI, lean mass, muscle strength, MQ, and bone mineral density. Conclusion: Patients with FAPTx appear to be at particularly high risk of functional disability, suggesting an important role for an early and appropriately designed rehabilitation program.

Strength, muscle quality and functional capacity in liver transplanted familial amyloidotic polineuropathy patients

Liver transplantation is the unique treatment for several end-stage diseases. Familial Amiloidotic Polineuropathy (FAP) is a neurodegenerative disease related with systemic deposition of amyloidal fiber mainly on peripheral nervous system, clinically translated by an autonomous sensitive-motor neuropathy with severe functional limitations in some cases. The unique treatment for FAP disease is a liver transplant with a very aggressive medication to muscle metabolism and force production. To our knowledge there are no quantitative characterizations of body composition, strength or functional capacity in this population.

Peak force in familial amyloidotic polyneuropathy

Familial Amyloidotic Polyneuropathy FAP)- A neurodegenerative disease related with systemic deposition of amyloid fibers mainly at the level of the peripheral nervous system. Clinically, the disease is characterized by an autonomous sensitive-motor neuropathy, beginning nearly always in foot, and subsequently involving the hands. Purpose: Compare the levels of hand grip strength (peak force) in FAP patients with (FAPT) or without (FAPNT) liver transplant and in a healthy group (HG).

Knee muscle strength, balance and functional independence in persons with stroke

Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke. Relevance: cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function.

Muscle strength, balance and functional independence in persons with stroke

Cerebral vascular disease is one of the main causes of morbidity, disability and mortality in developed countries. Problems with movement control are frequent after stroke. Lower limb weakness and impaired balance are common problems that are related with the risk of falls and are likely to interfere with the ability to perform daily life activities. Physiotherapy intervention usually starts early after stroke and addresses impairments related to movement and posture in order to improve motor recovery and restore function. Purpose: to investigate the relationship between knee muscle strength, balance and functional independence within the first month after stroke.

Strength, muscle quality and functional capacity in liver transplanted familial amyloidotic polineuropathy patients

Liver transplantation is the unique treatment for several end stage diseases. Familial Amiloidotic Polineuropathy (FAP) is a neurodegenerative disease related with systemic deposition of amyloidal fibre mainly on peripheral nervous system, clinically translated by an autonomous sensitive-motor neuropathy with severe functional limitations in some cases. The unique treatment for FAP disease is a liver transplant with a very aggressive medication to muscle metabolism and force production. To our knowledge there are no quantitative characterizations of body composition, strength or functional capacity in this population. The purpose of this study was to compare levels of specific strength (isometric strength adjusted by lean mass or muscle quality) and functional capacity (meters in 6 minutes walk test) between FAP patients after a liver transplant (4.1±2 months after transplant surgery) (FAPT) and a healthy group (HG).

Força de preensão – Análise de concordância entre dois dinamómetros: JAMAR vs E‑Link

Introdução – Avaliar a força de preensão mostrou ser de primordial importância pela sua relação com a capacidade funcional dos indivíduos, permitindo determinar níveis de risco para incapacidade futura e, assim, estabelecer estratégias de prevenção. Grande parte dos estudos utiliza o dinamómetro hidráulico JAMAR que fornece o valor da força isométrica obtida durante a execução do movimento de preensão palmar. Contudo, existem outros dinamómetros disponíveis, como é o caso do dinamómetro portátil computorizado E‑Link (Biometrics) que fornece o valor da força máxima (peak force), para além de outras variáveis, como a taxa de fadiga. Não existem, contudo, estudos que nos permitam aceitar e comparar ou não os valores obtidos com os dois equipamentos e porventura utilizá‑los indistintamente. Objetivos – Avaliar a concordância entre as medições da força de preensão (força máxima ou peak force em Kg) obtida a partir de dois equipamentos diferentes (dinamómetros portáteis): um computorizado (E‑Link, Biometrics) e outro hidráulico (JAMAR). Metodologia – Foram avaliados 29 indivíduos (13H; 16M; 22±7 anos; 23,2±3,3 kg/m2) em 2 dias consecutivos, na mesma altura do dia. A posição de teste escolhida foi a recomendada pela Associação Americana de Terapeutas Ocupacionais e foi escolhido o melhor resultado de entre 3 tentativas para a mão dominante. Realizou‑se uma análise correlacional entre os valores obtidos na variável analisada em cada equipamento (coeficiente de Spearman) e uma análise de Bland & Altman para verificar a concordância entre as duas medições. Resultados – O coeficiente de correlação entre as duas medições foi elevado (rS= 0,956; p<0,001) e, pela análise de Bland & Altman, os valores obtidos encontram‑se todos dentro do intervalo da média±2SD. Conclusões – As duas medições mostraram ser concordantes, revelando que os dinamómetros testados podem ser comparáveis ou utilizados indistintamente em diferentes estudos e populações. ABSTRACT: Introduction – Assess grip strength has proved to be of vital importance because of its relationship with functional capacity of individuals, in order to determine levels of risk for future disability and thereby establish prevention strategies. Most studies use the JAMAR Hydraulic dynamometer that provides the value of isometric force obtained during the performance of grip movement. However, there are other dynamometers available, such as portable computerized dynamometer E‑Link (Biometrics), which provides the value of maximum force (peak force) in addition to other variables as the rate of fatigue. There are no studies that allow us to accept or not and compare values obtained with both devices and perhaps use them interchangeably. Purpose – To evaluate the agreement between the measurements of grip strength (peak force or maximum force in kg) obtained from two different devices (portable dynamometers): a computerized (E‑Link, Biometrics) and a hydraulic (JAMAR). Methodology – 29 subjects (13H, 16M, 22 ± 7 years, 23.2 ± 3.3 kg/m2) were assessed on two consecutive days at the same time of day. The test position chosen was recommended by the American Association of Occupational Therapists and was considered the best result from three attempts for the dominant hand. A correlation was studied between values obtained in the variable analyzed in each equipment (Spearman coefficient) and Bland‑Altman analysis to assess the agreement between the two measurements. Results – The correlation coefficient between the two measurements was high (rs = 0,956, p <0,001) and Bland & Altman analysis of the values obtained are all within the range of mean±2SD. Conclusions – The two measurements were shown to be concordant, revealing that the tested dynamometers can be comparable or used interchangeably in different studies and populations.

Avaliação da aptidão física funcional em idosos hipertensos da Cidade da Praia - Cabo Verde

Mestrado em Fisioterapia.

Do fatigue, physical activity, handgrip strength and quality of life change between pre and post liver transplant?

Analisar: níveis de fadiga, força de preensão, HRQoL, níveis de actividade física. Será que se alteram em doentes PAF após o transplante de fígado? Dado que os níveis de actividade física se encontram abaixo dos valores mínimos recomendados deveria ser encontrada uma estratégia de aumento do tempo dispendido na actividade física leve a moderada idealmente no PRÉ TRANSPLANTE.

Beyond methodological nationalism: The contribution of Robert E. Park to the history of intercultural communication

The legacy of nineteenth century social theory followed a “nationalist” model of society, assuming that analysis of social realities depends upon national boundaries, taking the nation-state as the primary unit of analysis, and developing the concept of methodological nationalism. This perspective regarded the nation-state as the natural - and even necessary - form of society in modernity. Thus, the constitution of large cities, at the end of the 19th century, through the intense flows of immigrants coming from diverse political and linguistic communities posed an enormous challenge to all social research. One of the most significant studies responding to this set of issues was The Immigrant Press and its Control, by Robert E. Park, one of the most prominent American sociologists of the first half of the 20th century. The Immigrant Press and its Control was part of a larger project entitled Americanization Studies: The Acculturation of Immigrant Group into American Society, funded by the Carnagie Corporation following World War I, taking as its goal to study the so-called “Americanization methods” during the 1920s. This paper revisits that particular work by Park to reveal how his detailed analysis of the role of the immigrant press overcame the limitations of methodological nationalism. By granting importance to language as a tool uniting each community and by showing how the strength of foreign languages expressed itself through the immigrant press, Park demonstrated that the latter produces a more ambivalent phenomenon than simply the assimilation of immigrants. On the one hand, the immigrant press served as a connecting force, driven by the desire to preserve the mother tongue and culture while at the same time awakening national sentiments that had, until then, remained diffuse. Yet, on the other hand, it facilitated the adjustment of immigrants to the American context. As a result, Park’s work contributes to our understanding of a particular liminal moment inherent within many intercultural contexts, the space between emigrant identity (emphasizing the country of origin) and immigrant identity (emphasizing the newly adopted country). His focus on the role played by media in the socialization of immigrant groups presaged later work on this subject by communication scholars. Focusing attention on Park’s research leads to other studies of the immigrant experience from the same period (e.g., Thomas & Znaniecki, The Polish Peasant in Europe and America), and also to insights on multi-presence and interculturality as significant but often overlooked phenomena in the study of immigrant socialization.

Incorporação de resíduo da indústria petrolífera em argamassas de cal hidráulica para a reabilitação de edifícios

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

The effect of superplasticizers on the workability and compressive strength of concrete made with fine recycled concrete aggregates

The reuse of structural concrete elements to produce new concrete aggregates is accepted as an alternative to dumping them and is favourable to the sustainability of natural reserves. Even though the construction sector is familiar with the use of coarse recycled concrete aggregates, the recycled concrete fines are classified as less noble resources. This research sets out to limit the disadvantages associated with the performance of concrete containing fine recycled concrete aggregates through the use of superplasticisers. Two types of latest generation superplasticisers were used that differ in terms of water reduction capacity and robustness, and the workability, density and compressive strength of each of the compositions analysed were then compared: a reference concrete, with no plasticisers, and concrete mixes with the superplasticisers. For each concrete family mixes with 0%, 10%, 30%, 50% and 100% replacement ratios of fine natural aggregates (FNA) by fine recycled concrete aggregates (FRA) were analysed. Concrete with incorporation of recycled aggregates was found to have poorer relative performance. The mechanical performance of concrete with recycled aggregates and superplasticisers was generally superior to that of the reference concrete with no admixtures and of conventional concrete with lower performance superplasticisers.