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Cohen, Daniel D. (2013) Assessment of muscular fitness in relation to cardio-metabolic and musculoskeletal health. Doctoral thesis, London Metropolitan University.
Muscular fitness testing has been implemented in athletic settings and as part of youth fitness assessment in schools for many years, with the results compared to norms or used to monitor performance changes over time. Over recent decades however substantial evidence has accumulated showing the value of muscular fitness testing for previously unrecognised purposes. In the area of health, muscular fitness and in particular muscular strength has emerged as an independent marker of metabolic risk in youth, and as a risk factor for cardio-metabolic disease and mortality in adults, sitting alongside cardio-respiratory fitness (CRF) as a marker of current and future health. In the area of athletic performance, assessment of strength and strength imbalances has become part of injury risk screening needs analysis, underpinning the prescription of ("pre-hab") exercises designed to reduce the risk of musculo-skeletal injuries during sports training or competition. The work I present here addresses these areas of strength related research focusing particularly on the use of two measures: the handgrip dynamometer in health related research and the isokinetic dynamometer in injury risk screening. Handgrip (HG) is a tool which we have shown can be employed in large-scale assessment of strength in school settings. I argue that HG has value not only as part of cross-sectional and longitudinal health surveillance but also as a means to engage children who do not excel in the widespread multi-stage fitness test that dominates "fitness" assessment. I highlight that in communities in developing countries, the associations between low strength and poor health may be compounded by low birth-weight. This warrants evaluation of interactions between strength, CRF, body composition and cardio-metabolic health and the potential benefit of interventions. With regard to isokinetic testing I show that the existing approach to hamstring injury risk screening emphasising peak strength may be enhanced by taking into consideration associations between fatigue and hamstring eccentric strength across the range motion.
My work on strength assessment has already had media, educational and scientific "impact" and contributes to the existing knowledge in these two lines of research. I hope to have shown in this synthesis that it is also the basis for significant further developments.
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