Objective: To establish reference values for isometric strength of 12 muscle groups and flexibility of 13 joint movements in 1,000 children and adults and investigate the influence of demographic and anthropometric factors.Methods: A standardized reliable protocol of hand-held and fixed dynamometry for isometric strength of ankle, knee, hip, elbow, and shoulder musculature as well as goniometry for flexibility of the ankle, knee, hip, elbow, shoulder, and cervical spine was performed in an observational study investigating 1,000 healthy male and female participants aged 3-101 years. Correlation and multiple regression analyses were performed to identify factors independently associated with strength and flexibility of children, adolescents, adults, and older adults. Results:Normative reference values of 25 strength and flexibility measures were generated.Strong linear correlations between age and strength were identified in the first 2 decades of life. Muscle strength significantly decreased with age in older adults. Regression modeling identified increasing height as the most significant predictor of strength in children, higher body mass in adolescents, and male sex in adults and older adults. Joint flexibility gradually decreased with age, with little sex difference. Waist circumference was a significant predictor of variability in joint flexibility in adolescents, adults, and older adults. Conclusions:Reference values and associated age-and sex-stratified z scores generated from this study can be used to determine the presence and extent of impairments associated with neuromuscular and other neurologic disorders, monitor disease progression over time in natural history studies, and evaluate the effect of new treatments in clinical trials. Neurology ® 2017;88:36-43Meaningful, reliable, and sensitive outcome measures are required to monitor treatment and progression of neuromuscular and other neurologic disorders. While there have been substantial advances in the understanding of the pathogenesis and natural history of many neuromuscular disorders, the identification and development of new outcome measures that best reflect the efficacy of specific treatments have not advanced at the same rate. 1 Establishing valid and responsive outcome measures is a priority for the field. 2 To assist in the development of new outcome measures, normative reference values generated from large populations across the lifespan using standardized methods are required. Normative reference values can be utilized to generate z scores, which can be used in multicenter studies to improve outcome measure precision and responsiveness.Muscle weakness and joint contractures predispose to numerous pathologies requiring intervention. Reference data play an important role in identifying and quantifying these impairments and evaluating the effectiveness of interventions. Currently, few comprehensive datasets detail the normal variation of active range of motion in healthy individuals and are limited by the number of joints assessed, 3...

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This is the first study to document the clinically meaningful benefits of an exercise intervention for falls prevention and gait performance in LLAs. Specialised exercise programmes for community-dwelling LLAs should be implemented as a method to reduce falls and improve walking performance in this population.

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This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.

These normative reference values provide a framework to accurately track functional decline associated with neuromuscular disorders and assist development and validation of responsive outcome measures for therapeutic trials.

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This project will be a powerful resource to assist physiotherapists and clinicians across all areas of healthcare to diagnose pathology, track disease progression and evaluate treatment response. This reference dataset will also contribute to the development of robust patient-centred clinical trial outcome measures.