title: Decreased muscle strength relates to self-reported stooping, crouching, or kneeling difficulty in older adults.
abstract: BACKGROUND
  Bending down and kneeling are fundamental tasks of daily living, yet nearly a quarter of older adults report having difficulty performing or being unable to perform these movements. Older adults with stooping, crouching, or kneeling (SCK) difficulty have demonstrated an increased fall risk. Strength (force-generating capacity) measures may be useful for determining both SCK difficulty and fall risk.
  
  
  OBJECTIVE
  The purposes of this study were: (1) to examine muscle strength differences in older adults with and without SCK difficulty and (2) to examine the relative contributions of trunk and leg muscle strength to SCK difficulty.
  
  
  METHODS
  This was a cross-sectional observational study.
  
  
  METHODS
  Community-dwelling older adults (age [X+/-SD]=75.5+/-6.0 years) with SCK difficulty (n=27) or without SCK difficulty (n=21) were tested for leg and trunk strength and functional mobility. Isometric strength at the trunk, hip, knee, and ankle also was normalized by body weight and height.
  
  
  RESULTS
  Compared with older adults with no SCK difficulty, those with SCK difficulty had significant decreases in normalized trunk extensor, knee extensor, and ankle dorsiflexor and plantar-flexor strength. In 2 separate multivariate analyses, raw ankle plantar-flexor strength (odds ratio [OR]=0.97, 95% confidence interval [CI]=0.95-0.99) and normalized knee extensor strength (OR=0.61, 95% CI=0.44-0.82) were significantly associated with SCK difficulty. Stooping, crouching, and kneeling difficulty also correlated with measures of functional balance and falls.
  
  
  CONCLUSIONS
  Although muscle groups that were key to rising from SCK were examined, there are other muscle groups that may contribute to safe SCK performance.
  
  
  CONCLUSIONS
  Decreased muscle strength, particularly when normalized for body size, predicts SCK difficulty. These data emphasize the importance of strength measurement at multiple levels in predicting self-reported functional impairment.
authors: Department of Biomedical Engineering, Mobility Research Center, University of Michigan, 2025 Traverwood Dr, Suite E, Ann Arbor, MI 48105, USA. manueleh@umich.edu
authors: Manuel E
authors: ME
authors: Hernandez
authors: Allon
authors: A
authors: Goldberg
authors: Neil B
authors: NB
authors: Alexander
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007866:Leg / Q000502:physiology*; D008297:Male; D015999:Multivariate Analysis; D053580:Muscle Strength; D004856:Postural Balance / Q000502:physiology; D016059:Range of Motion, Articular