Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature.

The first test for evaluating the isometric endurance of trunk extensor muscles was described by Hansen in 1964. In 1984, following a study by Biering-Sorensen, this test became known as the "Sorensen test" and gained considerable popularity as a tool reported to predict low back pain within the next year in males. The test consists in measuring the amount of time a person can hold the unsupported upper body in a horizontal prone position with the lower body fixed to the examining table. This test has been used in many studies, either in its original version or as variants. Although its discriminative validity, reproducibility, and safety seem good, debate continues to surround its ability to predict low back pain; in addition, the gender-related difference in position-holding time remains unexplained and the influence of body weight unclear. A contribution of the hip extensor muscles to position holding has been established, but its magnitude remains unknown. The influence of personal factors such as motivation complicates the interpretation of the results. Despite these drawbacks, the Sorensen test has become the tool of reference for evaluating muscle performance in patients with low back pain, most notably before and after rehabilitation programs.

Analysis of hand forces in health and disease during maximum isometric grasping of cylinders.

An analysis of force distribution in the hand during maximum isometric grasping actions is reported in a detailed and accurate manner. A microcomputer-controlled instrument which measures all 12 phalangeal forces of fingers simultaneously, in a single attempt at squeezing a cylindrical object, is described. The study involved 20 normal subjects of different weights and age groups grasping tubes of 50 mm, 75 mm, 90 mm and 110 mm diameters. Normal grasp forces decreased significantly with the increase in tube diameter, with the force being concentrated more on the distal segments of the fingers on the proximal and middle segments. The mean percentage contributions of finger forces to total grip strength, from index to little fingers, were 31, 33, 22 and 14 per cent, respectively. The study was extended to cover leprotic and paralytic hands to assess their functional capabilities. In the case of leprosy subjects, the grip strength decreased with the severity of the disease and was only about 50 per cent of that of normal subjects. In hemiplegics, the grip strength was only about one-eighth of the normal values. The above assessment procedure provides baseline data which could serve as guidelines to a clinician in assessing the severity of the disease and observing the patient's recovery following the treatment. It would also be useful in the design of hand-operated controls and prosthetic arms.