title: Reference values for isometric muscle force among workers for the Netherlands: a comparison of reference values.
abstract: BACKGROUND
  Muscle force is important for daily life and sports and can be measured with a handheld dynamometer. Reference values are employed to quantify a subject's muscle force. It is not unambiguous whether reference values can be generalized to other populations. Objectives in this study were; first to confirm the reliability of the utilization of hand-held dynamometers for isometric strength measurement; second to determine reference values for a population of Dutch workers; third to compare these values with those of a USA population.
  
  
  METHODS
  462 Healthy working subjects (259 male, 203 female) were included in this study. Their age ranged from 20 to 60 years with a mean (sd) of 41 (11) years. Muscle force values from elbow flexion and extension, knee flexion and extension, and shoulder abduction were measured with the break method using a MicroFet 2 hand-held dynamometer. Reliability was analyzed by calculating ICC's and limits of agreement. Muscle force expressed in Newton, means, and confidence intervals were determined for males and females in age groups ranging from twenty to sixty years old. Regression equations and explained variances were calculated from weight, height, age, and gender. The mean values and 95% CI were compared to the results from other studies.
  
  
  RESULTS
  Reliability was good; the ICC ranged between 0.83 to 0.94. The explained variance ranged from 0.25 to 0.51. Comparison of data for the Dutch population mean muscle force values with those from the USA revealed important differences between muscle force reference values for the American and Dutch populations.
  
  
  CONCLUSIONS
  Muscle force measurements demonstrate a sound reliability. Reference values and regressions equations are made available for the Dutch population. Comparison with other studies indicates that reference values differ between countries.
authors.affiliation: Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Eysoniusplein 18 9714 CE, Groningen, The Netherlands. k.w.douma@pl.hanze.nl.
authors.forename: Rob Kw
authors.initials: RK
authors.lastname: Douma
authors.forename: Remko
authors.initials: R
authors.lastname: Soer
authors.forename: Wim P
authors.initials: WP
authors.lastname: Krijnen
authors.forename: Michiel
authors.initials: M
authors.lastname: Reneman
authors.forename: Cees P
authors.initials: CP
authors.lastname: van der Schans