Reliability of isokinetic strength and aerobic power testing for patients with chronic heart failure

PURPOSE: The objective of this study was to assess the reliability of testing skeletal muscle strength and peak aerobic power in a clinical population of patients with chronic heart failure (CHF).

METHODS: Thirty-three patients with CHF (New York Heart Association (NYHA) Functional Class 2.3 ± 0.5; left ventricular ejection fraction 27% ± 7%; age 65 ± 9 years; 28:5 male-female ratio) underwent two identical series of tests (T1 and T2), 1 week apart, for strength and endurance of the muscle groups responsible for knee extension/flexion and elbow extension/flexion. The patients also underwent two graded exercise tests on a bicycle ergometer to measure peak oxygen consumption (VO_2peak). Three months later, 18 of the patients underwent a third test (T3) for each of the measures. Means were compared using MANOVA with repeated measures for strength and endurance, and ANOVA with repeated measures for VO_2peak.

RESULTS: Combining data for all four movement patterns, the expression of strength increased from T1 to T2 by 12% ± 25% (P < .001; intraclass correlation coefficient [ICC] = 0.89). Correspondingly, endurance increased by 13% ± 23% (P = .004; ICC = 0.87). Peak oxygen consumption was not significantly different (16.2 ± 0.8 and 16.1 ± 0.8 mL·kg^-1·min^-1 for T1 and T2, respectively;P = .686; ICC = 0.91). There were no significant differences between T2 and T3 for strength (2% ± 17%;P = .736; ICC = 0.92) or muscle endurance (-1% ± 15%;P = .812; ICC = 0.96), but VO_2peak decreased from 16.7 ± 1.2 to 14.9 ± 0.9 mL·kg^-1·min^-1 (-10% ± 18%;P = .021; ICC = 0.89).

CONCLUSIONS: These data suggest that in a population of patients with CHF, a familiarization trial for skeletal muscle strength testing is necessary. Although familiarization is not required for assessing oxygen consumption as a single measurement, VO_2peak declined markedly in the 3-month period for which these patients were followed. Internal consistency within patients was high for the second and third strength trials and the first and second tests of VO_2peak.

Neck strength recovery after a single bout of specific strengthening exercise

Objective : To determine the level of neck strength decrement and the rate of strength recovery of the neck muscles after a single bout of specific neck conditioning exercise in both males and females.

Hypothesis : A decrement in neck strength may be evident after a bout of strengthening exercise.

Design : Intervention study with pre-and-post design.

Setting : Biomechanics laboratory.

Participants : Twenty healthy participants (10 male and 10 female, mean ± standard deviation age 22 ± 1.2 years).

Main Outcome Measures : Participants performed a single bout of neck strengthening exercise. Neck strength testing using an isokinetic dynamometer was performed pre and at five time points (1 h, one, three, five and seven days) post-exercise to assess the level of neck strength decrement and neck strength recovery rate from pre-exercise levels.

Results : Statistically significant (p ≥ 0.036) decreases in neck extension strength were recorded in all participants 1 h and one day post-exercise. The level of neck extension strength returned to pre-exercise levels three days post-exercise and surpassed pre-exercise levels five and seven days post-exercise. The male participants' neck flexion strength decrement and recovery followed a similar pattern to that displayed in neck extension but more variability in neck flexion strength recovery rates were recorded in the female participants in this study.

Conclusion : The consistent strength recovery times for the male participants recorded in this study idealise the prescription of neck strengthening exercises in a periodised fashion. More investigation needs to be instigated for the female neck musculature as consistent strength recovery rates were not identified in this study.

The reliability of the 1RM strength test for untrained middle-aged individuals

The one-repetition maximum (1RM) test is considered the gold standard for assessing muscle strength in non-laboratory situations. Since most previous 1RM reliability studies have been conducted with experienced young participants, it is unclear if acceptable test–retest reliability exists for untrained middle-aged individuals. This study examined the reliability of the 1RM strength test of untrained middle-aged individuals. Fifty-three untrained males (n = 25) and females (n = 28) aged 51.2 ± 0.9 years participated in the study. Participants undertook the first 1RM test (T1) 4–8 days after a familiarisation session with the same exercises. 1RM was assessed for seven different exercises. Four to eight days after T1, participants underwent another identical 1RM test (T2). Ten weeks later, 27 participants underwent a third test (T3). Intraclass correlation coefficients (ICC), typical error as a coefficient of variation (TEcv), retest correlation, repeated measures ANOVA, Bland–Altman plots, and estimation of 95% confidence limits were used to assess reliability. A high ICC (ICC > 0.99) and high correlation (r > 0.9) were found for all exercises. TEcv ranged from 2.2 to 10.1%. No significant change was found for six of the seven exercises between T1 and T2. Leg press was slightly higher at T2 compared to T1 (1.6 ± 0.6%, p = 0.02). No significant change was found between T2 and T3 for any exercise. 1RM is a reliable method of evaluating the maximal strength in untrained middle-aged individuals. It appears that 1RM-testing protocols that include one familiarisation session and one testing session are sufficient for assessing maximal strength in this population.

The effects of whole-body vibration on the cross-transfer of strength

This study investigated whether the use of superimposed whole-body vibration (WBV) during cross-education strength training would optimise strength transfer compared to conventional cross-education strength training. Twenty-one healthy, dominant right leg volunteers (21±3 years) were allocated to a strength training (ST, m = 3, f = 4), a strength training with WBV (ST + V, m = 3, f = 4), or a control group (no training, m = 3, f = 4). Training groups performed 9 sessions over 3 weeks, involving unilateral squats for the right leg, with or without WBV (35 Hz; 2.5mm amplitude). All groups underwent dynamic single leg maximum strength testing (1RM) and single and paired pulse transcranial magnetic stimulation (TMS) prior to and following training. Strength increased in the trained limb for the ST (41%; ES = 1.14) and ST + V (55%; ES = 1.03) groups, which resulted in a 35% (ES = 0.99) strength transfer to the untrained left leg for the ST group and a 52% (ES = 0.97) strength transfer to the untrained leg for the ST + V group, when compared to the control group. No differences in strength transfer between training groups were observed (P = 0.15). For the untrained leg, no differences in the peak height of recruitment curves or SICI were observed between ST and ST + V groups (P = 1.00). Strength training with WBV does not appear to modulate the cross-transfer of strength to a greater magnitude when compared to conventional cross-education strength training.

Measurement precision and evaluation of the diameter profiles of single wool fibers

A recent model of the Single Fiber Analyzer 3001 (SIFAN3001) was firstly employed to obtain the single wool fiber diameter profiles (SfFDPs) at multiple orientations. The results showed that using SIFAN3001 to measure fiber diameter at four orientations for 50 single fibers randomly sub-sampled from each mid-side sample can produce average fiber diameter profiles (AS fFDPs) of fibers within staples. Within the testing regime used, the precision estimates for the total samples were ±1.3 µm for the mean fiber diameter of staples and 1.4 µm for the average fiber diameter of the AS fFDPs at each scanned step in the diameter profile. The mean diameter ratio (ellipticity) obtained from the four orientations was 1.08±0.01, confirming that the Merino wool fibers under review were elliptical rather than circular. The elliptical morphology of wool fibers and the precision of the fiber diameter measurement at each point along a fiber will be considered in the development of a mechanical model of Staple Strength testing.

The measurement precision and evaluation of the diameter profiles of single wool fibres

A recent model of Single Fibre Analyser 3001 (SIFAN3001) was firstly employed to obtain the single wool fibre diameter profiles (SfFDP’s) at multiple orientations. The results showed that using SIFAN3001 to measure fibre diameter at four orientations for 50 single fibres randomly sub-sampled from each mid-side sample can produce average fibre diameter profiles (ASfFDP’s) of fibres within staples. Within the testing regime used, the precision estimates for the total samples were ±1.3µm for mean fibre diameter of staples and ±1.4µm for average fibre diameter of the ASfFDP’s at each scanned step in the diameter profile. The mean diameter ratio (ellipticity) obtained from the four orientations was 1.08±0.01, confirming that the Merino wool fibres under review were elliptical rather than circular. The elliptical morphology of wool fibres and the precision of fibre diameter measurement at each point along a fibre will be considered in the development of a mechanical model of Staple Strength testing.

Reliability of normalisation methods for EMG analysis of neck muscles

Acceptable reliability of normalisation contractions in electromyography (EMG) is paramount for testing conducted over a number of days or if normal laboratory strength testing equipment is unavailable. This study examined the reliability of maximal voluntary isometric contractions (MVIC) and sub-maximal (60%) isometric contractions for use in neck muscle EMG studies. Surface EMG was recorded bilaterally from eight sites around the neck at C4/5 level from five healthy male subjects. Subjects performed MVIC and sub-maximal normalisation contractions using an isokinetic dynamometer (ID) and a portable cable dynamometer with attached strain gauge (PCD) in addition to a MVIC against a manual resistance (MR). Subjects were tested in flexion, extension, left and right lateral bending and were retested by the same tester within a two-week period. Intra class correlation co-efficients (ICC) were calculated for each testing method and contraction direction and a mean ICC was calculated across all contraction directions. All normalisation methods produced excellent within-day reliability (mean ICC >0.80) but only the MVICs using the ID and PCD had acceptable reliability when assessed between-days. This study confirmed the validity of using MVICs elicited using the ID and PCD as reliable reference contractions for the normalisation of neck EMG.

Insulin sensitivity in response to a single resistance exercise session in apparently healthy individuals

BACKGROUND: Regular resistance exercise completed for a number of weeks has been shown to increase insulin sensitivity and reduce the risk of diabetes-related complications. However, the acute responses to resistance exercise have not been adequately investigated in relation to training frequency.
AIM: To investigate the changes to insulin sensitivity in apparently healthy individuals following a single session of unaccustomed resistance exercise.
SUBJECTS AND METHODS: Ten sedentary, apparently healthy individuals performed a baseline oral glucose tolerance test and maximal strength testing. Participants then performed a single session of moderate-high intensity resistance exercise which was followed by 4 consecutive days of oral glucose tolerance testing, for which participants replicated their initial diet. Mean estimated insulin sensitivity change scores from baseline values and their 95% confidence intervals were compared to the previously determined values for a clinically meaningful change.
RESULTS: Two participants were identified as having hyperinsulinemia and their data were therefore removed from the main analysis. There was a clinically meaningful increase in insulin response (mean >7237 pmol·l⁻¹·120 min⁻¹) on all days following the exercise session and a clinically meaningful increase in glucose response (mean >81 mmol·l⁻¹·120 min⁻¹) on only the 3rd day following exercise. These changes suggest a potentially adverse short-term effect. Additionally, the 2 individuals with hyperinsulinemia displayed more extreme results.
CONCLUSION: These results suggest that insulin sensitivity may be impaired following a single session of unaccustomed resistance exercise for approximately 4 days in healthy untrained, older individuals. Further research is required for individuals with hyperinsulinemia

Hypertrophy in the cervical muscles and thoracic discs in bed rest?

The impact of prolonged bed rest on the cervical and upper thoracic spine is unknown. In the 2nd Berlin BedRest Study (BBR2-2), 24 male subjects underwent 60-day bed rest and performed either no exercise, resistive exercise, or resistive exercise with whole body vibration. Subjects were followed for 2 yr after bed rest. On axial cervical magnetic resonance images from the skull to T3, the volumes of the semispinalis capitis, splenius capitis, spinalis cervicis, longus capitis, longus colli, levator scapulae, sternocleidomastoid, middle and posterior scalenes, and anterior scalenes were measured. Disc height, anteroposterior width, and volume were measured from C2/3 to T6/7 on sagittal images. The volume of all muscles, with the exception of semispinalis capitis, increased during bed rest (P < 0.025). There were no significant differences between the groups for changes in the muscles. Increased upper and midthoracic spine disc height and volume (P < 0.001) was seen during bed rest, and disc height increases persisted at least 6 mo after bed rest. Increases in thoracic disc height were greater (P = 0.003) in the resistive vibration exercise group than in control. On radiological review, two subjects showed new injuries to the mid-lower thoracic spine. One of these subjects reported a midthoracic pain incident during maximal strength testing before bed rest and the other after countermeasure exercise on day 3 of bed rest. We conclude that bed rest is associated with increased disc size in the thoracic region and increases in muscle volume at the neck. The exercise device needs to be modified to ensure that load is distributed in a more physiological fashion.

Microstructure-property relationship of the high strength low alloy steels during tensile testing at high strain rates

Positive The influence of strain-rate on the room temperature mechanical properties of the Dual-Phase and Transformation Induced Plasticity (TRIP) steels was investigated.The results showed that both the plastic strain, and strength properties increased with increasing strain rates at high strain rates.At strain rates lower than approximateil 1s ~ (-1) the properties no longer have an advantageous proportionality to strain rate and remain strain rate neutral.Possible explanations are offered for trends exhibited, in terms of thermal and athermal considerations, in relation to the respective microstructures of the two steels

The mechanical characterization of low work hardening, high strength steel

One of the major challenges in assessing the mechanical properties of recovery annealed steel is the strain localization that occurs almost immediately on the formation of the first Lüders band, such that no or limited propagation of the Lüders band occurs along the tensile coupon. The stress raiser associated with the geometry of the standard tensile coupon means that this plastic deformation is often completely outside the standard extensometers on the coupon. Hence, no strain is measured during the test. While this is not important for assessing the tensile strength of the steel, it does mean that the strain related properties, such as the elastic limit of the steel, cannot be measured using standard testing techniques.This work addresses this issue by examining three techniques for ensuring that the strain occurs inside the extensometer. It is shown that the best technique is the extended extensometer, where the gauge length covers slightly more than the tensile coupon parallel length. While this leads to some variation in the width of the material being measured, compensation can be be made by adjusting the strain to correct the Young's Modulus.This technique has direct implications not just for recovery annealed steels, but for other high strength, low work hardening materials such as ultrafine ferrite. A particular requirement of these high strength steels in structural applications is a high elastic limit; hence, measurement of the strain related properties for these high strength materials must be considered vital in their mechanical assessment.

Testing the design for Web-based electronic services acceptance model (E-SAM)

This paper reports on the design and testing of a model, which evaluates the relationship components of a Web-based EServices Acceptance Model (E-SAM). The paper proposes that user experience, user motivation, perceived usefulness, perceived ease of use that may determine user acceptance of web-based eServices. The model is tested in a university environment where students and staff use services that have moved from an old paper-based to Web-based eService system. The results of data analysis highlight that user experience is strongly related to perceived ease of use; and perceived usefulness to user motivation in user acceptance of Web-based eServices. The strength of these relationships and the lack of strong relationships between other components suggest that the model's application to eServices is able to highlight the complexity of the eService process and the need for researchers to seek additional components in studying technology acceptance on the World Wide Web.

Microstructural analysis of pre-strained TRIP steel after fatigue testing

The widespread introduction of multiphase sheet steels in the automotive industry has led to considerable interest in the fatigue properties of these materials. The different microstructural phases within matelials such as TRIP steels can influence the fatigue behaviour due to the manner in which the cyclic strain is accommodated within these phases. In this study fully reversed straincontrolled fatigue tests were perfonnrmed on a commercially-produced uncoated TRIP 780 steel both in the as-received and 20 % prestrained condition. The pre-strained TRIP steel showed significant cyclic softening at higher strain amplitudes, whereas some initial work hardening was observed at lower strain amplitudes before cyclic softening. The cyclic stabilised strength of the pre-strained TRIP steel was independent of strain amplitude, while the cyclic stabilised strength of the as-received TRIP steel increased with strain amplitude. Transmission Electron Microscopy TEM was used to examine the effect of the cyclic deformation on the microstructure of the different conditions, with the differences in fatigue behaviour explained based on the differences in the deformation structure formed within the steel (i.e. dislocation density and sub-structure and microband formation).

Rock strength : a control of shore platform elevation

This study determined whether a previous laboratory finding relating platform elevation to rock strength could be verified when tested in the field. Testing took place along the Otway coast in southeastern Australia. Fourteen platforms were profiled using a total station while rock strength tests were performed with a type L Schmidt hammer. Results established that higher mean platform elevation correlated with increased rock strength (r = 0.661, p < 0.05). This confirmed that a relation exists between elevation and rock strength when tested in the field. This finding has implications for the interpretation of shore platforms and marine terrace elevations in relation to sea level.

Effects of strength, flexibility and moderate intensity cardiovascular exercise on measures of fitness in sedentary women

The maintenance of functional physical fitness across the lifespan depends upon the presence or absence of disease, injury, and the level of habitual physical activity. The prevalence of sedentariness rises with increasing age culminating in 31% of elderly women being classified as leading a sedentary lifestyle. Exercise prescription that involves easily accomplished physical activity may result in the maintenance of mobility into old age through a reduction in the risk of premature death and disablement from cardiovascular disease and a reduction in the risk of falls and injuries from falls. It may be that short bouts of physical activity are more appealing to the sedentary and to those in full time employment than longer bouts, and it may be that short bouts of exercise, performed three times per day, can improve physical fitness. The purpose of this study was therefore to examine the problem: Does exercise session duration, initial cardiovascular fitness, and age group effect changes in functional physical fitness in sedentary women training for strength, flexibility and aerobic fitness? Twenty-three, sedentary women aged between 19 and 54 years who were employed at a major metropolitan hospital undertook six weeks of moderate intensity physical activity in one of two training groups. Participants were randomly allocated to either short duration (3 x 10 minute), or long duration (30 minute), exercise groups. The 3 x 10 minute group (n=13), participated in three, 10 minute sessions per day separated by at least 2 hours, 3 days per week. The 30 minute group (n=10), participated in three 30 minute sessions per week. The total amount of work was similar, with an average of 129 and 148 kcal training day for the 3 x 10 minute and 30 minute groups, respectively. The training program incorporated three walking and stair climbing courses for aerobic conditioning, a series of eleven static stretches for joint flexibility, and isotonic and isometric strength exercises for lower and upper body muscular strength. Measures of functional strength, functional flexibility and cardiovascular fitness were assessed prior to training, and immediately following the six week exercise program. A two way analysis of variance (Group x Time) was used to examine the effect of training and group on the dependent variables. The level of significance, 0.05 was adopted for all statistical tests. Mean hand grip strength showed for both groups no significant change over time for the 3 x 10 minute group (30.7kg to 31.7kg) and 30 minute group (30.2kg to 32.4kg). Leg strength showed a trend for improvement (p=0.098) in both the 3 x 10 minute and 30 minute training groups representing a 15% and 18% improvement, respectively. Combined right and left neck rotation significantly improved in the 3 x 10 minute group (82.8° to 92.0°) and 30 minute group (82.5° to 91.5°). Wrist flexion and extension improved significantly in 3 out of the 4 measurements. Left wrist flexion improved significantly by an average of 7.0% for the 3 x 10 minute and 4.9% for the 30 minute group. Right and left wrist extension improved significantly in the 3 x 10 minute and 30 minute training groups (5.9% and 6.8%, respectively). Hip and spine flexibility improved 3.4cm (35.2cm to 38.6cm) in the 3 x 10 minute group, and 6.6cm (37.4cm to 44.0cm) in the 30 minute group. There was a significant improvement in cardiovascular fitness for both groups representing a 22% improvement in the 3 x 10 minute group (27.2 to 33.2 ml kg min), and a 25% improvement in the 30 minute group (27.5 to 34.4 ml -kg min). No significant difference was shown in the degree of improvement in cardiovascular fitness over six weeks of training for subjects of either low or moderate initial aerobic fitness. Grip strength showed no significant changes over time for either the young-aged (19-35 years) or middle-aged (36-54 years) groups. Leg strength showed a trend for improvement (p=0.093) in the young-aged group (63.5kg to 71.9kg) and middle-aged group (69.3kg to 85.8kg). Neck rotation flexibility improved a similar amount in both the young and middle aged groups representing an improvement of 9.9° and 8.0° respectively. There was significant improvement in two of the four measures of wrist flexibility. Hip and spine flexibility was significantly greater in the young-aged group compared to the middle-aged group (38.5cm and 30.7cm, respectively). There was a significant improvement in hip and spine flexibility over the six week training program representing an increase in reach of 6.5cm for the young age group and 4.9cm for the older group. The middle-aged subjects had significantly lower cardiovascular fitness than their younger peers, scoring 22.8 and 30.7 ml -kg min, respectively. Cardiovascular fitness improved a similar amount in both age groups representing a significant improvement of 23.8% and 28.1% for the younger-aged and middle-aged subjects, respectively. The findings of this study suggest that short bouts of exercise may be equally as effective as longer bouts of exercise for improving the flexibility and cardiovascular components of functional physical fitness in sedentary young and middle aged women. Additionally short bouts of exercise may be more attractive than longer bouts of exercise for the beginning exerciser as they may more easily fit into the busy lifestyle encountered by many people in today's society. Sedentary young and middle-aged women should benefit from static flexibility exercises designed to improve and/or maintain functional flexibility and thus maintain mobility and reduce the incidence of muscular injury. Regular, brisk walking, incorporating some stair climbing, is likely to be beneficial in improving cardiovascular health and perhaps also in improving leg strength, thereby helping to improve and maintain functional physical fitness for both young and middle-aged sedentary women.