Systematic Evaluation of Isometric Maximal Muscle Strength in an Orthopaedic Cohort

Background: Although the lower extremities are essential for movement function and human gait, no normalized isometric maximum strength values, which include the factors gender, age, weight, height, and body mass index (BMI), have been defined to date for orthopaedic patients.

Objective: To systematically analyze the isometric maximal muscle strength of a cohort in an orthopaedic outpatient clinic and to evaluate its relation to gender, age, weight, height, BMI, and the differences between diseases.

Study design: Cross-sectional study.

Level of evidence: Level 4.

Methods: Isometric maximal muscle strength of knee extension, knee flexion, hip abduction, and hip adduction was measured in orthopaedic patients of an outpatient clinic using a specific muscle strength measurement device. Correlation analysis was performed for age, gender, height, weight, and BMI. Patients were grouped by disease characteristics.

Results: The cohort consisted of 311 subjects (sex: 164 male, 147 female; age: 48.63 years, SD = 16.595; BMI: 26.56 kg/m², SD = 4.9). Age correlated significantly with maximal isometric muscle strength. At the age of 54 years onward, based on 133 patients, a decline in maximum isometric muscle strength was detected. Gender showed a strong influence on maximal isometric muscle strength, with significantly higher values for male patients. Furthermore, weight and height, but not BMI, correlated significantly with muscle strength.

Conclusion: For clinical studies comparing different evidence-based training interventions for rehabilitation, it is important to consider determinants such as gender, age, weight, and height for isometric maximum strength measurement. For further validation, follow-up examinations taking into account the performance level, other target groups, and other muscle groups are required to avoid the wide dispersion of isometric maximum strength values. These results and associated determinants are highly clinically relevant and can be used as a reference for further studies in the field of musculoskeletal regeneration.