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Muscular Function Assessment Gallagher - OEH ch 21(CCW) 1 Outline • Muscle strength is a complex function that can vary with the methods of assessment • Definitions and introduction • Assessment methods • Variables impacting performance 2 Muscle Function • Gallagher • Strength - capacity to produce a force or torque with a voluntary muscle contraction • Power - Force * distance * time-1 • Endurance -ability to sustain low force requirements over extended period of time • Measurement of human strength – Cannot be measured directly – interface between subject and device influences measurement – Fig 21.1 Biomechanical eg. • Q = (F * a)/b or c or d • force from muscle is always the same • results are specific to circumstances • • dynamic strength - motion around joint – variable speed - difficult to compare static or isometric strength- no motion – easy to quantify and compare – not representative of dynamic activity 3 4 Factors Affecting Strength • • • • Gender Age Anthropometry Psychological factors motivation – table 21.1 5 Factors Affecting Strength • Task influence – Posture • fig 21.2 - angle and force production – – – – – – Duration - Fig 21.3 Velocity of Contraction - Fig 21.4 Muscle Fatigue Static vs dynamic contractions Frequency and work / rest ratio Temperature and Humidity • inc from 20-27 C - decrease of 10-20% in muscle capacity 6 7 8 Strength Testing (intro) • Isometric strength testing – standardized procedures – 4-6 sec contraction, 30-120 sec rest – standardized instruction • posture, supports, restraint systems, and environmental factors – worldwide acceptance and adoption • Dynamic strength – isoinertial (isotonic)- mass properties of an object are held constant – Psychophysical - subject estimate of (submax) load - under set conditions – isokinetic strength • through ROM at constant velocity • Uniform position on F / V curve • Standardized • Isolated muscle groups 9 Strength Testing • Testing for worker selection and placement – Used to ensure that worker can tolerate physical aspects of job – similar rates of overexertion injuries for stronger and weaker workers • Key principles – Strength test employed must be directly related to work requirements • must be tied to biomechanical analysis • Isometric analysis fig 21.5 – for each task - posture of torso and extremities is documented (video) • recreate postures using software – values compared to pop. norms • industrial workers – estimate % capable of level of exertion – predict stress on lumbar spine 10 11 Isometric Considerations • Discomfort and fatigue in isometrics thought to result from ischemia – Increasing force, increases intramuscular pressure which approaches then exceeds perfusion pressure - lowering then stopping blood flow – Partial occlusion at 20-25% MVC – Complete occlusion above 50% MVC • Fig 15-19 Astrand – Max hold time affected by % MVC – Recommend less than 15% for long term requirements • Fig 15-20 Astrand – With repeated isometric contractions Force and Frequency influence endurance – Optimal work / rest ratio of 1/2 – Duration important as well (Astrand - blood flow) 12 13 14 Isoinertial Testing • Consider - biomechanics and grip – Stabilization requirements – justification of cut off scores • Examples from industry • SAT - strength aptitude testing – air force standard testing – Pre-selected mass - increase to criterion level - success or failure – found incremental weight lifted to 1.83m to be best test as well as safe and reliable • PILE - progressive inertial lifting evaluation – lumbar and cervical lifts -progressive weight - 4 lifts / 20 seconds • standards normalized for age, gender and body weight – variable termination criteria • voluntary, 85 % max HR, 55-60% body weight 15 Psychophysical testing • psychophysical methods – workers adjust demand to acceptable levels for conditions – provides ‘submax’ endurance estimate • Procedure – subject manipulate one variable-weight – Either test : starting heavy or light – add / remove weight to fair workload – Fair defined as : without straining, becoming over tired, weakened, over heated or out of breath • Study must use large number’s of subjects – evaluate/design jobs within capacities of workers – 75% of workers should rate as acceptable • If demand is over this acceptance level; 3 times the injury rate 16 observed to occur Psychophysical (cont) • Summary – Table 21.2 (Snook and Cirello) (see Job analysis lecture) • Advantages – realistic simulation of industrial tasks – very reproducible - related to incidence of low back injury • Disadvantages – results can exceed “safe” as determined through other methodology – biomechanical, physiological 17 Isokinetic Testing • Isokinetic testing – Evaluates muscular strength throughout a range of motion at a constant velocity – Consider - velocity, biomechanics – However; • humans do not move at constant velocity • isokinetic tests usually isolated joint movements • may not be reflective of performance ability • Redesign of isokinetic testing – multi joint simulation tasks for industry • fig 21.8 • Better, as they require core stabilization • still in development, therefore limited validity 18 19