Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 52, Issue 5 M275-M285, Copyright © 1997 by The Gerontological Society of America

JOURNAL ARTICLE

Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study

L Ferrucci, JM Guralnik, D Buchner, J Kasper, SE Lamb, EM Simonsick, MC Corti, K Bandeen-Roche and LP Fried
Geriatric Department, I Fraticini, National Research Institute (INRCA), Florence, Italy.

BACKGROUND: Sarcopenia, an age-related reduction in muscular mass and strength, may cause a decline in physical functioning and subsequent loss of autonomy. It has been suggested that strength is associated with lower extremity function mainly in the lower portion of the range of strength. Identifying the threshold under which strength is most critical to function may help in targeting groups who may benefit most from exercise interventions. METHODS: The study uses data from the Women's Health and Aging Study. The study population, recruited by screening a population-based sample aged 65 years and older, comprised 1,002 women who represent the one-third most disabled women without severe cognitive impairment living in the community. Knee extensor and hip flexor strength were assessed using a hand-held dynamometer. Lower extremity performance was evaluated using tests of walking, standing balance, and rising from a chair. RESULTS: Among women tested for strength (n = 892), those who could walk (97%), do the side-by-side stand (87%), or complete 5 chair stands (74%) had significantly greater strength. Walking speed was linearly associated with knee extensor strength over the entire range of strength, but its association with hip strength was limited to values below 15 kg. Time for five chair stands was associated with knee extensor and hip flexor strength below 10 and 15 kg, respectively, and no significant association was detected above these values. Stronger women were more likely to hold balance for 10 sec in the side-by-side, semi-tandem, and tandem positions. The percentage of the variance in performance explained by strength alone was always lower than 20%. CONCLUSIONS: In this population, which does not include the strongest older women, there is a departure from linearity in the relationship between muscular strength and some measures of lower extremity performance.

This article has been cited by other articles: (Search Google Scholar for Other Citing Articles)

				C. M Stretton, N. K Latham, K. N Carter, A. C Lee, and C. S Anderson Determinants of physical health in frail older people: the importance of self-efficacy Clinical Rehabilitation, April 1, 2006; 20(4): 357 - 366. [Abstract] [PDF]

				K. M Hermann and C S. Reese Author Response Physical Therapy, March 1, 2001; 81(3): 914 - 914. [Full Text] [PDF]

				D. U Jette, M. D Slavin, P. L Andres, and T. L Munsat The Relationship of Lower-Limb Muscle Force to Walking Ability in Patients With Amyotrophic Lateral Sclerosis Physical Therapy, July 1, 1999; 79(7): 672 - 681. [Abstract] [Full Text] [PDF]

				O.R. Pearson, M.E. Busse, R.W.M. van Deursen, and C.M. Wiles Quantification of walking mobility in neurological disorders QJM, August 1, 2004; 97(8): 463 - 475. [Full Text] [PDF]

				A. M Jette Invited Commentary Physical Therapy, March 1, 2001; 81(3): 912 - 914. [Full Text] [PDF]

				J. F. Bean, S. G. Leveille, D. K. Kiely, S. Bandinelli, J. M. Guralnik, and L. Ferrucci A Comparison of Leg Power and Leg Strength Within the InCHIANTI Study: Which Influences Mobility More? J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2003; 58(8): M728 - 733. [Abstract] [Full Text] [PDF]

				M. A. F. Singh Exercise Comes of Age: Rationale and Recommendations for a Geriatric Exercise Prescription J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2002; 57(5): M262 - 282. [Full Text]

				L. L. Ploutz-Snyder, T. Manini, R. J. Ploutz-Snyder, and D. A. Wolf Functionally Relevant Thresholds of Quadriceps Femoris Strength J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2002; 57(4): B144 - 152. [Abstract] [Full Text] [PDF]

				L.L. Ploutz-Snyder, E.L. Giamis, M. Formikell, and A.E. Rosenbaum Resistance Training Reduces Susceptibility to Eccentric Exercise-Induced Muscle Dysfunction in Older Women J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2001; 56(9): B384 - 390. [Abstract] [Full Text] [PDF]

				I. S. Kwon, S. Oldaker, M. Schrager, L. A. Talbot, J. L. Fozard, and E. J. Metter Relationship Between Muscle Strength and the Time Taken to Complete a Standardized Walk-Turn-Walk Test J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2001; 56(9): B398 - 404. [Abstract] [Full Text] [PDF]

				J. M. Hausdorff, M. E. Nelson, D. Kaliton, J. E. Layne, M. J. Bernstein, A. Nuernberger, and M. A. F. Singh Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise J Appl Physiol, June 1, 2001; 90(6): 2117 - 2129. [Abstract] [Full Text]

				E. M. Simonsick, J. D. Kasper, J. M. Guralnik, K. Bandeen-Roche, L. Ferrucci, R. Hirsch, S. Leveille, T. Rantanen, and L. P. Fried Severity of Upper and Lower Extremity Functional Limitation: Scale Development and Validation With Self-Report and Performance-Based Measures of Physical Function J. Gerontol. B. Psychol. Sci. Soc. Sci., January 1, 2001; 56(1): 10S - 19. [Abstract] [Full Text]

				S. K. Hunter, M. W. Thompson, and R. D. Adams Relationships Among Age-Associated Strength Changes and Physical Activity Level, Limb Dominance, and Muscle Group in Women J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2000; 55(6): 264B - 273. [Abstract] [Full Text]

				M. Brown, D. R. Sinacore, E. F. Binder, and W. M. Kohrt Physical and Performance Measures for the Identification of Mild to Moderate Frailty J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2000; 55(6): 350M - 355. [Abstract] [Full Text]

				M. Visser, T. B. Harris, K. M. Fox, W. Hawkes, J. R. Hebel, J. YuYahiro, R. Michael, S. I. Zimmerman, and J. Magaziner Change in Muscle Mass and Muscle Strength After a Hip Fracture: Relationship to Mobility Recovery J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2000; 55(8): 434M - 440. [Abstract] [Full Text]

				S E Lamb, J M Guralnik, D M Buchner, L M Ferrucci, M C Hochberg, E M Simonsick, and L P Fried Factors that modify the association between knee pain and mobility limitation in older women: the Women's Health and Aging Study Ann Rheum Dis, May 1, 2000; 59(5): 331 - 337. [Abstract] [Full Text]

				T. Rantanen, K. Masaki, D. Foley, G. Izmirlian, L. White, and J. M. Guralnik Grip strength changes over 27�yr in Japanese-American men J Appl Physiol, December 1, 1998; 85(6): 2047 - 2053. [Abstract] [Full Text]