Reliability of stationary dynamometer muscle strength testing in community-dwelling older adults.

OBJECTIVES: To determine the 1-week test-retest reliability of stationary dynamometer scores in the measurement of muscle strength in older adults and to determine the reliability of composite scores obtained by combining right and left lower limb strength scores for each muscle group. DESIGN: In separate sessions, 1 therapist performed repeated measurements of muscle force production. SETTING: Outpatient physical therapy clinic of a large teaching hospital. PARTICIPANTS: A convenience sample of 25 volunteers aged 70 to 87 years residing independently in the community and who did not have significant health problems. INTERVENTION: On 2 separate occasions, 1 week apart, bilateral isometric force measurements were obtained for the flexor and extensor muscle groups of the ankle, knee, and hip joints. MAIN OUTCOME MEASURES: For test-retest reliability of individual and composite scores, the intraclass correlation coefficients (ICCs) and 90% confidence intervals were determined. RESULTS: The mean scores for ankle dorsiflexion, knee flexion and extension, and hip flexion exhibited excellent reliability with ICCs ranging from.90 to.76 for the individual lower limb scores and.91 to.84 for the composite scores. Scores for the remaining muscle groups exhibited good reliability with ICCs ranging from.74 to.71 for the composite scores. CONCLUSION: The stationary dynamometer is a reliable tool to use in determining lower limb muscle force production in elderly adults.

The individualized treatment of a patient with benign paroxysmal positional vertigo.

The purpose of this case report is to describe the evaluation and treatment of a patient with vertigo. The patient was a 32-year-old male carpenter with a 17-year history of episodic vertigo that occurred when his neck was in the extended position while positioned supine and during walking. His medical and physical therapy evaluative findings were consistent with a diagnosis of benign paroxysmal positional vertigo (BPPV). He was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises. Twenty-four days from the start of physical therapy, the patient was free of symptoms even when his neck was in the extended position.

Test-retest reliability of the sensory organization test in noninstitutionalized older adults.

The purpose of this study was to determine the 1-week test-retest reliability of the Sensory Organization Test (SOT), using computer-generated scores and loss of balance (LOB) episodes in noninstitutionalized older adults. The SOT was administered to each subject on two separate days 1 week apart in an out-patient clinic. A volunteer sample of 40 individuals who were at least 65 years of age participated in this study. The main outcome measures were computer-generated scores for the first trial and the average of the three trials in each of the six sensory conditions of the SOT; computer-generated composite score of the six conditions; LOB on the first trial and any of three trials in each condition. The intraclass correlation coefficients (ICC) for the SOT first trial data ranged from .15 in Condition 3 to 0.70 in Condition 5. The ICCs for the SOT average of three trials ranged from 0.26 in Condition 3 to 0.68 and 0.64 in Conditions 5 and 6. Percent agreement was 77% to 100% for LOB on the first trial, as well as LOB on any of three trials of Conditions 1 through 6. As the conditions became more difficult, an increasing number of subjects experienced LOB. Analysis revealed fair to good test-retest reliability for computer-generated scores and good reliability for LOB across some conditions of the SOT. A modification to the current scoring system is suggested which would improve the reliability of the computer-generated scores of the SOT.

Age differences in movement patterns used to rise from a bed in subjects in the third through fifth decades of age.

BACKGROUND AND PURPOSE: The purposes of this study were to describe the movement patterns of middle-aged adults when rising from a bed and to determine whether there are age-related differences in movement patterns across the third through fifth decades of age. SUBJECTS: Ninety-three adults (30 men, 63 women), ranging in age from 30 to 59 years, participated in the study. METHODS: The subjects were videotaped during 10 trials of rising from a bed. Subjects comprised three age groups, as defined by the decades of the thirties, forties, and fifties. Movement patterns for four body regions were used to classify the videotaped performances. The incidence of each movement pattern was determined for each decade and graphed. RESULTS: Subjects in their thirties differed from older subjects in movement patterns used to rise from a bed. Movement pattern incidence varied across age groups for each body region. The movement patterns of one body region predominated in reverse order of a previously proposed developmental sequence. CONCLUSION AND DISCUSSION: Results indicate physical therapists should consider the patient's age when selecting movement patterns to teach.