Download PDF
Int J Sports Med 2012; 33(06): 452-458
DOI: 10.1055/s-0032-1301889
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

Force Normalization in Paraplegics

P. Serra-Añó
1   Department of Physiotherapy, University of Valencia, Valencia, Spain
,
X. García-Massó
2   Department of Physical Education and Sports, Laboratory of Physical Activity and Health, University of Valencia, Valencia, Spain
,
M. Pellicer
2   Department of Physical Education and Sports, Laboratory of Physical Activity and Health, University of Valencia, Valencia, Spain
,
L.-M. González
2   Department of Physical Education and Sports, Laboratory of Physical Activity and Health, University of Valencia, Valencia, Spain
,
J. López-Pascual
3   Instituto de Biomecánica de Valencia, Valencia, Spain
,
M. Giner-Pascual
4   Department of Physical Medicine and Rehabilitation (Spinal Cord Injury Unit), University Hospital ‘La Fe’, Valencia, Spain
,
J. L. Toca-Herrera
5   Department of Nanobiotechnology, University of Natural Resources and Life Sciences-BOKU, Vienna, Austria
› Author Affiliations
Further Information

Publication History



accepted after revision 30 December 2011

Publication Date:
29 February 2012 (online)

Also available at
    Permissions and Reprints

Abstract

The principal aim of our study was the determination of the effectiveness of a standardized ratio, allometric scaling model and a gamma function model in normalizing the isometric torque data of spinal cord patients and healthy subjects. For this purpose we studied a sample of 21 healthy males and 23 spinal cord injury males. The experiment consisted of the measurement of the force of the upper limb movement executed by all the subjects. We also determined anthropometric variables with dual-energy x-ray absorptiometry. The experimental data were analyzed with 3 force normalization methods. Our results indicate that the most important confounding variable was the fat free mass of the dominant upper limb (r>0.36, p<0.05). With the standardization by body mass and allometric scaling model, the normalized torque was influenced by body size variables. However, the normalized torque by the gamma function model was independent of body size measures. Paraplegics were weaker (p<0.05) in extension movements when the data were normalized by the gamma function model. In summary, this study shows that the gamma function model with fat free mass of the dominant upper limb was more effective than the standardized ratio in removing the influence of body size variables.

Key words

spinal cord injury - body size - muscle strength - shoulder
 

  • References

  • 1 Apple D. Pain above the injury level. Top Spinal Cord Inj Rehabil 2001; 7: 18-29
    CrossrefPubMedGoogle Scholar
  • 2 Atkins SJ. Normalizing expressions of strength in elite rugby league players. J Strength Cond Res 2004; 18: 53-58
    PubMedGoogle Scholar
  • 3 Bernard PL, Codine P, Minier J. Isokinetic shoulder rotator muscles in wheelchair athletes. Spinal Cord 2004; 42: 222-229
    CrossrefPubMedGoogle Scholar
  • 4 Burnham RS, May L, Nelson E, Steadward R, Reid DC. Shoulder pain in wheelchair athletes. The role of muscle imbalance. Am J Sports Med 1993; 21: 238-242
    CrossrefPubMedGoogle Scholar
  • 5 Covey MK, Smith DL, Berry JK, Hacker ED. Importance of cross-calibration when replacing DXA scanners: QDR4500W and Discovery Wi. J Nurs Meas 2008; 16: 155-170
    CrossrefPubMedGoogle Scholar
  • 6 Folland JP, Mc Cauley TM, Williams AG. Allometric scaling of strength measurements to body size. Eur J Appl Physiol 2008; 102: 739-745
    CrossrefPubMedGoogle Scholar
  • 7 Fullerton HD, Borckardt JJ, Alfano AP. Shoulder pain: a comparison of wheelchair athletes and nonathletic wheelchair users. Med Sci Sports Exerc 2003; 35: 1958-1961
    CrossrefPubMedGoogle Scholar
  • 8 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Hastings J, Goldstein B. Paraplegia and the shoulder. Phys Med Rehabil Clin N Am 2004; 15: 699-718
    CrossrefPubMedGoogle Scholar
  • 10 Jaric S. Muscle strength testing: use of normalisation for body size. Sports Med 2002; 32: 615-631
    CrossrefPubMedGoogle Scholar
  • 11 Jaric S, Radosavljevic-Jaric S, Johansson H. Muscle force and muscle torque in humans require different methods when adjusting for differences in body size. Eur J Appl Physiol 2002; 87: 304-307
    CrossrefPubMedGoogle Scholar
  • 12 Kotajarvi BR, Basford JR, An KN. Upper-extremity torque production in men with paraplegia who use wheelchairs. Arch Phys Med Rehabil 2002; 83: 441-446
    CrossrefPubMedGoogle Scholar
  • 13 McDonald CM, Abresch-Meyer AL, Nelson MD, Widman LM. Body mass index and body composition measures by dual x-ray absorptiometry in patients aged 10 to 21 years with spinal cord injury. J Spinal Cord Med 2007; 30: S97-S104
    PubMedGoogle Scholar
  • 14 Mulroy SJ, Gronley JK, Newsam CJ, Perry J. Electromyographic activity of shoulder muscles during wheelchair propulsion by paraplegic persons. Arch Phys Med Rehabil 1996; 77: 187-193
    CrossrefPubMedGoogle Scholar
  • 15 Nevill AM, Bate S, Holder RL. Modeling physiological and anthropometric variables known to vary with body size and other confounding variables. Am J Phys Anthropol 2005; 41: 141-153
    PubMedGoogle Scholar
  • 16 Pentland W, McColl MA, Rosenthal C. The effect of aging and duration of disability on long term health outcomes following spinal cord injury. Paraplegia 1995; 33: 367-373
    CrossrefPubMedGoogle Scholar
  • 17 Powers CM, Newsam CJ, Gronley JK, Fontaine CA, Perry J. Isometric shoulder torque in subjects with spinal cord injury. Arch Phys Med Rehabil 1994; 75: 761-765
    PubMedGoogle Scholar
  • 18 Sie IH, Waters RL, Adkins RH, Gellman H. Upper extremity pain in the postrehabilitation spinal cord injured patient. Arch Phys Med Rehabil 1992; 73: 44-48
    PubMedGoogle Scholar
  • 19 Spungen AM, Adkins RH, Stewart CA, Wang J, Pierson Jr RN, Waters RL, Bauman WA. Factors influencing body composition in persons with spinal cord injury: a cross-sectional study. J Appl Physiol 2003; 95: 2398-2407
    CrossrefPubMedGoogle Scholar
  • 20 Subbarao JV, Klopfstein J, Turpin R. Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury. J Spinal Cord Med 1995; 18: 9-13
    PubMedGoogle Scholar
  • 21 Vanderburgh PM, Mahar MT, Chou CH. Allometric scaling of grip strength by body mass in college-age men and women. Res Q Exerc Sport 1995; 66: 80-84
    PubMedGoogle Scholar
  • 22 Wren TA, Engsberg JR. Normalizing lower extremity strength data for children, adolescents, and young adults with cerebral palsy. J Appl Biomech 2009; 25: 195-202
    PubMedGoogle Scholar
  • 23 Wren TA, Engsberg JR. Normalizing lower-extremity strength data for children without disability using allometric scaling. Arch Phys Med Rehabil 2007; 88: 1446-1451
    CrossrefPubMedGoogle Scholar
  • 24 Zoeller RF, Ryan ED, Gordish-Dressman H, Price TB, Seip RL, Angelopoulos TJ, Moyna NM, Gordon PM, Thompson PD, Hoffman EP. Allometric scaling of isometric biceps strength in adult females and the effect of body mass index. Eur J Appl Physiol 2008; 104: 701-710
    CrossrefPubMedGoogle Scholar
  • 25 Zoeller Jr RF, Riechman SE, Dabayebeh IM, Goss FL, Robertson RJ, Jacobs PL. Relation between muscular strength and cardiorespiratory fitness in people with thoracic-level paraplegia. Arch Phys Med Rehabil 2005; 86: 1441-1446
    CrossrefPubMedGoogle Scholar