Lower extremity strength and power asymmetry assessment in healthy and mobility-limited populations: reliability and association with physical functioning

Carabello, Robert J.; Reid, Kieran F.; Clark, David J.; Phillips, Edward M.; Fielding, Roger A.

doi:10.1007/bf03337729

Cited by 47 publications

(62 citation statements)

References 25 publications

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“…These data indicate that the independent power of limbs is more closely related to function than the symmetry of power between limbs, which is in agreement with previous work by Carabello et al (2010). The Boston RISE study found that while leg strength asymmetry was a significant predictor of self-reported lower-extremity function in older adults, it had the lowest association of the neuromuscular predictor variables, particularly in comparison to leg strength (Bean, Latham et al 2013).…”

Section: Discussionsupporting

confidence: 91%

“…It should be noted that previous investigations of strength and power asymmetry in older adults have used a range of testing modalities including pneumatic resistance, the Nottingham Power Rig, and isokinetic dynamometry, and, some studies measured knee extensor asymmetry whereas others measured whole-leg asymmetry (Skelton, Kennedy et al 2002, Portegijs, Sipila et al 2005, Perry, Carville et al 2007, Carabello, Reid et al 2010, LaRoche, Cook et al 2012, Bean, Latham et al 2013, Straight, Brady et al 2016, Ward, Beauchamp et al 2016). These studies are therefore not directly comparable because of the task-specificity of asymmetry and the use of compensatory mechanisms that may mask single-joint strength and power asymmetries during whole-leg exercises (Bond, Cook et al 2017).…”

Section: Discussionmentioning

confidence: 99%

“…The weak leg was identified as the one that had the lowest average power and the strong leg the highest average power. Asymmetry of muscle power was determined as the percent difference between strong and weak legs as done previously (Carabello, Reid et al 2010, LaRoche, Cook et al 2012). It should be noted that due to the constant velocity of isokinetic contractions, that the asymmetries derived from peak torque (strength) and peak power are identical.…”

Section: Methodsmentioning

confidence: 99%

“…This study led to the hypothesis that strength asymmetry may be associated with physical dysfunction in older adults and that the weaker limb may limit walking performance. Using a pneumatic resistance knee extension, Carabello and colleagues demonstrated that older, mobility-limited participants had greater power asymmetry (≈20%) than healthy, older adults (≈12%), but did not observe any correlation between the degree of asymmetry and physical function (Carabello, Reid et al 2010). Using the Nottingham power rig, Portegijs et al showed in older women that maximal walking velocity was slowest in those that demonstrated poor leg extensor power and high asymmetry and that each variable was an independent predictor of walking velocity (Portegijs, Sipila et al 2005).…”

Section: Introductionmentioning

confidence: 99%

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Knee extensor power asymmetry is unrelated to functional mobility of older adults

LaRoche

Villa

Bond

et al. 2017

Experimental Gerontology

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Purpose To determine whether knee extensor power asymmetry limits functional mobility of older adults who possess muscle weakness. Methods Knee extensor power was measured in 36 older men and women (76.0 ± 7.6 yr), for each leg, on an isokinetic dynamometer at 60, 180, and 300 deg s−1 and power asymmetry was calculated as the percent difference in power between strong and weak legs, at each isokinetic velocity. 400-m walk, stair ascent, and five-repetition chair rise tests were performed to assess functional mobility. Pearson correlations were used to examine the relationship between weak leg power, strong leg power, power asymmetry, and 400-m walk time, stair ascent time, and chair rise time. Participants were then stratified into Low Power-High Asymmetry (LP-HA), Low Power-Low Asymmetry (LP-LA), High Power-High Asymmetry (HP-HA), and High Power-Low Asymmetry (HP-LA) groups who were compared for functional mobility. Results Knee extensor power asymmetry was unrelated to 400-m walk time (r = 0.16, p = 0.180), stair ascent time (r = 0.22, p = 0.094), or chair rise time (r = 0.03, p = 0.437), whereas weak and strong leg powers were equally associated with 400-m time (r = −0.62, p < 0.001; r = −0.62, p < 0.001), stair ascent time (r = −0.55, p < 0.001; r = −0.57, p < 0.001), and chair rise time (r = −0.28, p = 0.048; r = −0.31, p = 0.032), respectively. Power asymmetry was lowest at 60 deg s−1 (12%), and increased with contraction velocity (p = 0.001) to 15% at 180 deg s−1 and to 20% at 300 deg s−1. LP-HA exhibited 26% slower 400-walk time than HP-LA (p = 0.015) and 19% slower than HP-HA (p = 0.037). LP-HA had 31% slower stair ascent time than HP-LA (p = 0.033). There were no differences in chair rise performance between groups. Conclusions Knee extensor power asymmetry was unrelated to 400-m walk, stair ascent, and chair rise performance in older adults. Weak and strong limb powers were equally related to these functional measures, but a leftward shift of the power-mobility curve exists for the weak leg that may hinder clinical assessment if strength or power is measured on a single limb and symmetry is assumed. The greatest degree of knee extensor power asymmetry occurred at the fastest isokinetic velocity, which suggests high-speed muscle contractions may better differentiate laterality of function in older individuals.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Knee extensor power asymmetry is unrelated to functional mobility of older adults

LaRoche

Villa

Bond

et al. 2017

Experimental Gerontology

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“…Similarly, asymmetry of leg power was measured as the ratio of the peak leg press power in a similar fashion (17).…”

Section: Asymmetry Of Leg Strength and Leg Powermentioning

confidence: 99%

A Comparison of Straight- and Curved-Path Walking Tests Among Mobility-Limited Older Adults

Odonkor

Thomas

Holt

et al. 2013

The Journals of Gerontology Series A: Biological Sciences and M

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Handgrip strength asymmetry is associated with the risk of neurodegenerative disorders among Chinese older adults

Chen

Chau

2022

J cachexia sarcopenia muscle

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Background Neurodegenerative disorders, as the irreversible condition, have a long, silent preclinical period. Recognition of early physical signs of neurodegenerative disorders had important practical implications for identifying at‐risk population. The aim of this study was to investigate whether handgrip strength (HGS) asymmetry was associated with the incidence of neurodegenerative disorders among Chinese older adults. Methods This study used the data of participants aged 60 years and over from three waves (2011–2015) of China Health and Retirement Longitudinal Study. HGS asymmetry was measured with HGS ratio (maximal non‐dominant HGS/maximal dominant HGS), with the value less than 0.9 or more than 1.1 considered as HGS asymmetry. Physician‐diagnosed neurodegenerative disorders were identified by self‐reported or proxy‐reported information. Competing risk analysis was conducted to examine the association between HGS asymmetry and incident neurodegenerative disorders, with mortality treated as the competing event. Results A total of 4925 participants were included in the analysis [mean (SD) age: 68.1(6.68); female: 49.7%]. Eight hundred and eighty‐eight (18.0%) participants had low HGS and 2227 (45.2%) had HGS asymmetry. During the 4 years of follow‐up, there were 156 cases of neurodegenerative disorders and 422 cases of mortality. The incidence of neurodegenerative disorders was 8.7 per 1000 person‐years [95% confidence interval (CI): 7.4–10.2], and the incidence of mortality was 23.5 per 1000 person‐years (95% CI: 21.4–25.9). Both the cause‐specific model and the Fine–Gray subdistribution hazard model showed that participants with HGS asymmetry had increased hazard of neurodegenerative disorders [hazard ratio (HR) = 1.66, P = 0.002, 95% CI: 1.202–2.297; subdistribution hazard ratio (SHR) = 1.65, P = 0.002, 95% CI: 1.202–2.285]. Low HGS, but not HGS asymmetry, was related to the higher hazard of mortality (HR = 1.61, P < 0.001, 95% CI: 1.297–1.995; SHR = 1.58, P < 0.001, 95% CI: 1.286–1.951). Conclusions Handgrip strength asymmetry was associated with the future risk of neurodegenerative disorders among Chinese older adults. Public healthcare providers could consider examining HGS asymmetry along with the maximal HGS as a way to identify those at elevated risk of neurodegenerative disorders.

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Lower extremity strength and power asymmetry assessment in healthy and mobility-limited populations: reliability and association with physical functioning

Abstract: Background and aims-This study assessed the reliability of evaluating asymmetrical strength and power deficits in the lower limbs of healthy middle-aged, healthy older and mobility-limited elders. We also explored the relationship between limb asymmetry and physical functioning.

Cited by 47 publications

References 25 publications

Knee extensor power asymmetry is unrelated to functional mobility of older adults

Knee extensor power asymmetry is unrelated to functional mobility of older adults

A Comparison of Straight- and Curved-Path Walking Tests Among Mobility-Limited Older Adults

Handgrip strength asymmetry is associated with the risk of neurodegenerative disorders among Chinese older adults

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