Efecto de la práctica mental kinestésica en la fuerza y actividad mioeléctrica del bíceps braquial, luego de un periodo de inmovilización de codo en adultos-jóvenes sanos / Effects of kinesthetic mental practice in strength and myoelectric activity of the brachialis biceps due to an elbow immobilization period in healthy young adults

RESUMEN: El objetivo de este estudio fue determinar el efecto de la práctica mental kinestésica (PMK) en la fuerza y actividad eléctrica muscular (AEM) del bíceps braquial, luego de un periodo de inmovilización del codo en un grupo de personas adultos jóvenes sanos. Un total de 14 personas (18,64 ± 0,92 años de edad) participaron voluntariamente del estudio, a las cuales se les evaluó la fuerza muscular de prensión y la AEM del bíceps braquial utilizando un dinamómetro de mano y un equipo de electromiografía, respectivamente, antes y después de un periodo de inmovilización del brazo no dominante, y se asignaron aleatoriamente a uno de dos grupos: grupo control (GC) o experimental (GE). El GE realizó PMK: tres series de 15 repeticiones con un minuto de descanso entre series, tres veces al día durante los seis días de inmovilización, mientras que el GC no realizó PKM durante su inmovilización. Al aplicar una prueba de ANOVA de dos vías, no se encontraron diferencias significativas en la fuerza ni en la AEM. Sin embargo, la fuerza del GC disminuyó en 23,75%, mientras que la del GE aumentó en 33,19%. Los resultados sugieren que un periodo de inmovilización del codo de seis días no fue suficiente para que la fuerza ni la AEM disminuyan significativamente, lo que supone que la PMK realizada no es necesaria en periodos menores a seis días.

ABSTRACT: The aim of this study was to determine the effect of kinesthetic mental practice (KMP) on the strength and muscular electrical activity (MEA) of the brachial biceps, after a period of immobilization of the elbow in a group of healthy young adults. A total of 14 volunteer participants (18.64 ± 0.92 years of age) were part in the study. The muscle strength and the AEM of the brachial biceps were assessed using a hand dynamometer and an electromyography equipment, respectively, before and after a period of immobilization of the non-dominant arm. After the pretest, they were randomly assigned to one of two groups: control group (GC) or experimental group (GE). The GE performed 3 sets of 15 repetitions with one-minute rest between sets, three times a day of PMK during the 6 days of immobilization, while the GC did not perform PKM during its immobilization. A 2-way ANOVA test (group x measurement) indicated non-significant differences in strength or AEM. However, the strength of the GC decreased by 23.75%, while increased by 33.19% in the GE. The results suggest that a period of immobilization of the elbow of 6 days was not enough for the strength or the AEM to decrease significantly, which means that the PMK is not necessary in periods of immobilization of less than 6 days.

Long-term strength and functional status in inclusion body myositis and identification of trajectory subgroups.

INTRODUCTION: Objective information on longitudinal disease progression in inclusion body myositis (IBM) is lacking. METHODS: Longitudinal dynamometry and functional status data were collated from a cohort of IBM patients. Annual change was calculated by means of linear modeling. Trajectories of change in grip, knee extension, IBM Functional Rating Scale (IBM-FRS) and Neuromuscular Symptom Score (NSS) were identified by means of latent growth mixture modeling. RESULTS: Data were collated from 75 IBM patients (348 person-years follow-up). Annual strength loss was greatest for pinch (-10%) and knee extension (-4%). Functional deterioration was greatest for males. Three distinct trajectory groups were identified. Rapid deterioration trajectory for grip strength was associated with younger diagnosis age. Rapid deterioration for knee extension strength was associated with older age of diagnosis. DISCUSSION: This study has quantified strength change in IBM and identified distinct trajectory groups, which will aid prognostication and stratification for inclusion into future clinical trials.

Desplazamiento del centro de presiones en personas con síndrome de Down en bipedestación / Desprendimento do centro de pressão em pessoas com síndrome de Down em posição bípede / Center of pressure displacements in individuals with Down syndrome during a bipedal position

Objetivo. Valorar el equilibrio de adultos con síndrome de Down a través del estudio del desplazamiento del centro de presiones. Método. Estudio transversal de casos y controles. Doce sujetos con síndrome de Down y 12 sin síndrome de Down formaron parte del estudio. Todos los participantes realizaron 2 pruebas sobre plataforma dinamométrica: i) estática con ojos abiertos y ii) estática con ojos cerrados. Las señales del centro de presiones fueron analizadas en el dominio temporal. Se utilizaron contrastes no paramétricos para el análisis estadístico de los datos. Resultados. Los resultados mostraron diferencias significativas entre-grupos en las variables rango anteroposterior, fuerza anteroposterior y fuerza medio-lateral (p < 0.05). Las comparaciones intragrupos mostraron peores resultados en las pruebas con ojos cerrados en ambos grupos. Conclusión. En el presente trabajo las personas con síndrome de Down presentaron un control del equilibrio mermado al compararlo con sujetos sin síndrome de Down. Los datos obtenidos no son concluyentes para determinar cuál de los sistemas involucrados en el control del equilibrio es el responsable de estos resultados (AU)

Objetivo. Avaliar o equilíbrio de adultos com síndrome de Down através do estudo do desprendimento do centro de pressão. Método. Estudo transversal de caso e controlos. Doze sujeitos com SD e 12 sem Síndrome de Down fizeram parte do estudo. Todos os participantes realizaram 2 provas sobre plataforma dinamométrica: i) estática com olhos abertos e ii) estática com olhos fechados. Os sinais dos centros de pressões foram analisados em domínio temporal. Foram utilizados testes não paramétricos para a análise estatística dos dados. Resultados. Os resultados mostraram diferenças significativas entre grupos nas variáveis de intervalo ântero-posterior, força ântero-posterior e força médio-lateral (p < 0.05). As comparações intragrupos mostram piores resultados nas provas de equilíbrio com olhos fechados para ambos os grupos. Conclusão. No presente estudo, as pessoas com Síndrome de Down apresentaram um controlo de equilíbrio diminuído em comparação a sujeitos sem Síndrome de Down. Os dados obtidos não são conclusivos para determinar qual dos sistemas envolvidos no controlo do equilíbrio é responsável por estes resultados (AU)

Objective. To evaluate body balance of adults with Down syndrome based on the analysis of their centre of pressure behaviour. Method. Cross-sectional case control-study. Twelve individuals with Down syndrome and twelve without Down syndrome took part in the study. All the participants were tested under two conditions on a force plate: i) static with eyes open and ii) static with eyes closed. Centre of pressure signals were analyzed in time domain. Non-parametric contrasts were used for statistical analysis. Results. Statistical differences between groups were found in anteroposterior range, anterior-posterior force and medio-lateral force (p < 0.05). Within-groups comparisons showed poorer results in eyes closed conditions for both groups. Conclusion. Individuals with Down syndrome involved in the present study showed deficits in balance control when compared with people without Down syndrome. The obtained data are not conclusive. The participation of the different systems which control balance in people with Down syndrome remains unknown (AU)

Analysis of three different equations for predicting quadriceps femoris muscle strength in patients with COPD.

OBJECTIVE: To compare equations for predicting peak quadriceps femoris (QF) muscle force; to determine the agreement among the equations in identifying QF muscle weakness in COPD patients; and to assess the differences in characteristics among the groups of patients classified as having or not having QF muscle weakness by each equation. METHODS: Fifty-six COPD patients underwent assessment of peak QF muscle force by dynamometry (maximal voluntary isometric contraction of knee extension). Predicted values were calculated with three equations: an age-height-weight-gender equation (Eq-AHWG); an age-weight-gender equation (Eq-AWG); and an age-fat-free mass-gender equation (Eq-AFFMG). RESULTS: Comparison of the percentage of predicted values obtained with the three equations showed that the Eq-AHWG gave higher values than did the Eq-AWG and Eq-AFFMG, with no difference between the last two. The Eq-AHWG showed moderate agreement with the Eq-AWG and Eq-AFFMG, whereas the last two also showed moderate, albeit lower, agreement with each other. In the sample as a whole, QF muscle weakness (< 80% of predicted) was identified by the Eq-AHWG, Eq-AWG, and Eq-AFFMG in 59%, 68%, and 70% of the patients, respectively (p > 0.05). Age, fat-free mass, and body mass index are characteristics that differentiate between patients with and without QF muscle weakness. CONCLUSIONS: The three equations were statistically equivalent in classifying COPD patients as having or not having QF muscle weakness. However, the Eq-AHWG gave higher peak force values than did the Eq-AWG and the Eq-AFFMG, as well as showing greater agreement with the other equations.

Analysis of three different equations for predicting quadriceps femoris muscle strength in patients with COPD / Análise de três diferentes fórmulas de predição de força muscular do quadríceps femoral em pacientes com DPOC

AbstractObjective: To compare equations for predicting peak quadriceps femoris (QF) muscle force; to determine the agreement among the equations in identifying QF muscle weakness in COPD patients; and to assess the differences in characteristics among the groups of patients classified as having or not having QF muscle weakness by each equation.Methods: Fifty-six COPD patients underwent assessment of peak QF muscle force by dynamometry (maximal voluntary isometric contraction of knee extension). Predicted values were calculated with three equations: an age-height-weight-gender equation (Eq-AHWG); an age-weight-gender equation (Eq-AWG); and an age-fat-free mass-gender equation (Eq-AFFMG).Results: Comparison of the percentage of predicted values obtained with the three equations showed that the Eq-AHWG gave higher values than did the Eq-AWG and Eq-AFFMG, with no difference between the last two. The Eq-AHWG showed moderate agreement with the Eq-AWG and Eq-AFFMG, whereas the last two also showed moderate, albeit lower, agreement with each other. In the sample as a whole, QF muscle weakness (< 80% of predicted) was identified by the Eq-AHWG, Eq-AWG, and Eq-AFFMG in 59%, 68%, and 70% of the patients, respectively (p > 0.05). Age, fat-free mass, and body mass index are characteristics that differentiate between patients with and without QF muscle weakness.Conclusions: The three equations were statistically equivalent in classifying COPD patients as having or not having QF muscle weakness. However, the Eq-AHWG gave higher peak force values than did the Eq-AWG and the Eq-AFFMG, as well as showing greater agreement with the other equations.

ResumoObjetivo:Comparar diferentes fórmulas de predição do pico de força muscular do quadríceps femoral (QF); investigar a concordância entre elas para identificar fraqueza muscular de QF em pacientes com DPOC; e verificar as diferenças nas características nos grupos de pacientes classificados com presença ou ausência dessa fraqueza de acordo com cada fórmula.Métodos: Cinquenta e seis pacientes com DPOC foram avaliados quanto ao pico de força muscular do QF por dinamometria (contração isométrica voluntária máxima de extensão de joelho). Os valores preditos foram calculados com três fórmulas: uma fórmula composta por idade-altura-peso-gênero (F-IAPG); uma por idade-peso-gênero (F-IPG); e uma por idade-massa magra-gênero (F-IMMG).Resultados: A comparação da porcentagem do predito obtida pelas fórmulas mostrou a F-IAPG com maiores valores do que os valores de F-IPG e F-IMMG, sem diferença entre as duas últimas. A F-IAPG apresentou concordância moderada com F-IPG e F-IMMG, enquanto essas últimas também apresentaram concordância moderada, mas menor, entre si. Do total de pacientes, a fraqueza muscular de QF (< 80% do predito) foi identificada por F-IAPG, F-IPG e F-IMMG em 59%, 68% e 70% dos pacientes, respectivamente (p > 0,05). Idade, massa magra e índice de massa corpórea são características que diferenciam pacientes com e sem fraqueza muscular de QF.Conclusões: As três fórmulas foram estatisticamente equivalentes para classificar pacientes com DPOC como portadores ou não de fraqueza muscular de QF. Entretanto, a F-IAPG apresentou maiores valores de pico de força do que F-IPG e F-IMMG, assim como maior concordância com as outras fórmulas.

Tratamiento rehabilitador postoperatorio de un caso avanzado de rizartrosis del pulgar / Postoperative rehabilitation treatment in an advanced case of osteoarthritis of the base of the thumb

Se presenta el caso clínico de una mujer de 58 años, con una rizartrosis del pulgar de grado III en la escala de Eaton. Tras el fracaso del tratamiento conservador, se procedió a la artroplastia de resección-suspensión-interposición. En estos casos la rehabilitación postoperatoria es fundamental para consolidar los mecanismos quirúrgicos correctores y conseguir el máximo rendimiento funcional. Sin embargo, los protocolos de rehabilitación seguida tras este tipo de cirugía no han sido descritos con detalle. El objetivo de nuestro trabajo es exponer el programa terapéutico postoperatorio llevado a cabo por nosotros, que difiere del seguido por otros autores, así como los resultados funcionales alcanzados en esta patología, que habitualmente no pasa por la consulta del médico rehabilitador (AU)

We present the clinical case of a 58-year old woman suffering osteoarthritis of the base of the thumb with grade III on the Eaton classification. After failure of conservative treatment, surgical treatment based on a trapeziectomy, with ligament reconstruction and tendon interposition arthroplasty, was performed. In these cases, postoperative rehabilitation is important to consolidate surgical correction mechanisms and achieve maximum functional performance. However, rehabilitation protocols following this type of surgery have not been described in depth. The purpose of this article is to explain our postoperative rehabilitation program which differs from that followed by other authors and to explain the functional results achieved in this condition, which is generally not treated by the rehabilitation physician (AU)

Efectos del vendaje neuromuscular (kinesiotaping) en el síndrome del supraespinoso / Kinesio taping effects of the supraspinatus syndrome

El objetivo principal de este trabajo es conocer la eficacia del vendaje neuromuscular en un deportista de élite con síndrome del supraespinoso respecto a otros tratamientos conservadores en los que no se aplica. Se ha realizado una valoración inicial (pretest) y final (postest) en donde las variables sometidas a estudio fueron el dolor, la amplitud articular del hombro, la fuerza muscular y el índice de esfuerzo percibido. Los tratamientos aplicados con duración de 3 semanas se dividen en dos fases: fase 1, termoterapia de alta frecuencia, ultrasonidos y masoterapia, y fase 2, el tratamiento anterior combinado con la técnica de vendaje neuromuscular. Los resultados indican una reducción del dolor en ambas fases (mayor en la fase 2) y aumento y estabilización en cantidad y/o calidad de la movilidad glenohumeral en la fase 2. El vendaje neuromuscular podría considerarse una técnica complementaria al tratamiento conservador ya que podría reducir el dolor y mejorar la movilidad articular (AU)

The main objective of this work is to determine the effectiveness of kinesio taping in an elite athlete with supraspinatus syndrome compared to other conservative treatments in which this Taping was not used. An initial assessment (pretest) and final assessment (posttest) were carried out in which the variables studied were pain, shoulder range of motion, muscle strength and the Perceived Exertion Index. The treatments were applied for three weeks and were divided into two phases: Phase 1, high frequency thermotherapy, ultrasound and massage therapy and phase 2, previous treatment combined with the kinesio taping technique. The results indicate a reduction in pain in both phases (higher in phase 2) and an increase as well as stabilization in quantity and/or quality of glenohumeral mobility in phase 2. Kinesio taping can be considered a complementary technique to the conservative treatment as it may reduce pain and improve joint mobility (AU)

Evaluación de los sistemas de medición de la fuerza muscular en el ámbito de la práctica musical. Aproximación a un prototipo apto para la práctica instrumental / Evaluation of the systems for measuring muscle strength applied to musical practice. Approach to a prototype suitable for instrumental practice

Objetivo: Evaluar los sistemas de medida de la fuerza, en tiempo real, que ejerce la mano sobre el instrumento al tocar (piano y guitarra) y conocer la fuerza ejercida por la mano del músico, en tiempo real, sobre el instrumento. Material y Método: Se analizaron sobre el instrumento, en un guitarrista y un pianista experimentados. En cada sistema analizado se valoró: el grado de interferencia con el gesto técnico musical; la posibilidad de intercambiarlo de un instrumento a otro; la resistencia al deterioro con el uso (especialmente al trabajar sobre cuerdas); la existencia de un sistema y software de captura y análisis de los datos que permitiera al usuario definir alarmas o niveles de alerta útiles para poder hacer un trabajo de reeducación de la tensión utilizada para tocar (biofeedback). Se estableció un protocolo de pruebas y se experimentó sobre ambos instrumentos. Con el método que dio mejor resultado se procedió al estudio de la fuerza ejercida por la mano del músico sobre el instrumento. Resultados: Las medidas recogidas mostraron en el caso de la guitarra un pico de fuerza máximo de 9,14N (0,93Kg) y en el piano se superaban habitualmente los 9,8N (1kg de fuerza). Conclusiones: Los sensores de presión miniaturizados recubiertos con una funda de látex ultrafino han resultado ser eficaces para el estudio de la fuerza isométrica y concéntrica desarrollada por la mano del músico (AU)

Objetive: determine, in real time, its usefulness in the study of the force exerted by the hand of the musician on the instrument (piano and guitar) and the force exerted by the hand of the musician on the instrument, in real time. Material and methods: systems better adapted to the requirements of musical practice were chosen and analyzed on the instrument, using as experimental subjects a guitarist and a pianist. For every system examined the following was considered: the degree of interference with the musical technical act; easiness to swap the system from one instrument to another; resistance to deterioration with use (especially working on strings) and existence of a system and software to capture and analyze data that allow the user to set alarms or alert levels that will help him to do reeducation of the tension used to play (biofeedback) were analysed. Results: The guitar measures showed a maximum peak force of 9.14 N (0.93Kg) and the piano usually exceeded 9.8 N (1kg force). The other analized systems (thermal imaging, Chronopic, EMG and accelerometer) let us study the force, however important limiting factors behaved they were discarded. Conclusions: Miniature pressure sensors coated with an ultrathin latex sheath have proved effective for the study of the isometric and concentric force developed by the hand of the musician (AU)

Age and sex differences of controlled force exertion measured by a computer-generated quasi-random target-pursuit system.

OBJECTIVES: This study examined age and sex differences of controlled force exertion measured by a computer-generated quasi-random target-pursuit system in 207 males and 249 females aged 15 to 86 years. METHODS: The participants matched submaximal grip exertion of their dominant hand to changing demand values, appearing as a moving quasi-random waveform on the display of a personal computer. They performed the test three times with 1-min intervals (one trial was 40 sec). The total sum of the percent of differences between the demand value and the grip exertion value for 25 sec was used as an evaluation parameter. RESULTS: The errors in controlled force exertion tended to increase constantly with age in both sexes. Significant linear regressions were identified, but there was no significant difference in the rate of increase in both sexes. Analysis of variance showed nonsignificant sex differences among means, except for those in individuals older than 60 years; significant differences between means in the groups older than the 40 yr.-old age group and the 20-24 yr.-old group were found in both sexes. CONCLUSIONS: Controlled force exertion did not show a significant sex difference and decreased gradually with age in both sexes, but decreased remarkably after 40 years of age.

Aportación de la dinamometría isocinética de columna lumbar en una mutua laboral / Contribution of isokinetic dynamometry of the lumbar spine in an occupational mutual insurance company

Objetivo: Conocer la discordancia entre la clínica y las pruebas complementarias en la patología del raquis lumbar. Pacientes y metodología: Estudiamos 64 pacientes (50 hombres, 14 mujeres), con una edad media de 45 años (rango: 33–55), que fueron evaluados con un dinamómetro para conocer la fuerza concéntrica y excéntrica de los músculos extensores de la columna lumbar. Padecían de lumbalgia, 36 procedían de accidente laboral y 28 de contingencia común. La mayoría de los hombres realizaban trabajos en la construcción y las mujeres trabajos de manipulación o en cadenas de montaje. Se obtuvo la sinceridad del esfuerzo mediante REC (índice excéntrico / concéntrico) y DEC (diferencia entre REC a velocidad alta y REC a velocidad baja). Resultados: La media de días desde la baja hasta realizar la prueba fue de 280 días en accidentes laborales y 157 días en las contingencias. En el 68% de las pruebas se registraron parámetros indicativos de esfuerzo máximo. En ellos se registraron unos valores deficitarios de extensores en modalidad excéntrica (50%) y concéntrica (60%). Conclusiones: La dinamometría isocinética de columna lumbar permite hacer una estimación sobre la funcionalidad de la columna (AU)

Objetive: To determine the discrepancy between the clinical manifestations and complementary test findings in lumbar spine disorders. Patients and methods: A total of 64 patients (50 males, 14 females) with a mean age of 45 years (range: 33-55) were subjected to dynamometric testing to determine concentric and eccentric strength of the extensor muscles of the lumbar spine. The patients presented lumbar disorders; 36 had suffered occupational accidents and 28 common contingencies. Most of the males worked in construction, while the women were involved in processing or assembly operations. Exertion sincerity was determined by REC (eccentric / concentric ratio) and DEC (difference between REC at high velocity and REC at low velocity). Results: The mean days from the start of sick leave to the moment of testing was 280 days in the case of occupational accidents and 157 days in the case of contingencies. Most of the tests (68%) registered parameters indicative of maximum exertion. These tests showed extensor deficiencies in the eccentric (50%) and concentric modalities (60%). Conclusions: Isokinetic dynamometry of the lumbar spine offers an estimation of spinal functionality (AU)

Reproducibilidad de la medida de la fuerza muscular de la rodilla mediante dinamometría manual en pacientes con gonartrosis grave / Reliability of knee muscle strength measurement with manual dynamometry in patients with severe knee arthritis

Introducción. El objetivo fue valorar la reproducibilidadde la dinamometría manual para medir lafuerza muscular de la rodilla en pacientes con gonalgia porgonartrosis grave, con el dinamómetro Nicholas ManualMuscle Tester (NMMT).Métodos. Se reclutaron los pacientes antes de realizaruna artroplastia total de rodilla. Se midió la fuerza muscularde los flexores y los extensores de la rodilla (FR, ER) con eldinamómetro NMMT, mediante un protocolo estándar, conuna prueba isométrica y un diseño test-retest. Se calcularonlos coeficientes de correlación intraclases (CCI) y elerror técnico de medida (ETM), y se realizó una prueba devarianza para descartar un sesgo entre los observadores.Resultados. El CCI inter-observador (n = 20) fue 0,85 (intervalode confianza [IC] 95 % 0,66-0,94) para ER, y 0,90(IC 95 % 0,68-0,96) para FR. El CCI intra-observador(n = 13) fue 0,99 (IC 95 % 0,97-0,99) para ER, y 0,95 (IC 95 %0,84-0,98) para FR. El ETM fue 1,487 kg para ER, y 1,153 kgpara FR. Se encontró una diferencia significativa entre lasfuerzas medidas por los dos exploradores de una media de1,0 kg para la fuerza de los FR (p = 0,01, IC 95 % 0,28-1,78).Conclusiones. La reproducibilidad inter-observador de ladinamometría manual fue entre moderada y alta, mientrasque la reproducibilidad intra-observador fue alta(AU)

Background. The aim of the study was to determinethe reliability of the knee muscle strength measurementwith the Nicholas Manual Muscle Tester (NMMT) dynamometerin patients with pain due to severe knee arthritis.Methods. Patients were recruited before a total knee arthroplasty.The flexor and extensor knee muscle strength wasmeasured with the NMMT using a standardised protocol forisometric “make” tests, and a test-retest design was done. Theintra-class correlation coefficients (ICC), and the technical errorof measurement (TEM) were determined. A paired samplet-test was performed to detect any possible rater bias.Results. The inter-rater ICC (n = 20) was 0.85 (95 % CI0.66-0.94) for knee extensor force (KEF), while it was 0.90(95 % CI 0.68-0.96) for knee flexor force (KFF). The intra-rater ICC (n = 13) for KEF was 0.99 (95 % CI 0.97-0.99),whereas for KFF it was 0.95 (95 % CI 0.84-0.98). The TEMwas 1.487 kg for KEF, and 1.153 kg for KFF. The paired samplet-test showed a significant difference of an average of1.0 kg between the two raters in the KFF measurement(p = 0.01, 95 % CI 0.28-1.78).Conclusions. With this protocol, dynamometry was reliablefor patients with knee pain, achieving moderate to highinter-rater reliability for KFF and KEF, and high intra-raterreliability for both KFF and KEF(AU)

Validation of a pictorial rating scale for grip strength evaluation in 3- to 6-year-old children.

The present study aimed to validate a pictorial rating scale to evaluate the child's ability to produce grip forces. Thirty-seven children aged 3 to 6 years participated as subjects in this investigation. We used a tailor-made pictorial scale and a hand grip strength meter, as well as a Piaget's clinical interview aimed to gather information on the child's understanding of the rating scale. The sensitivity of the rating scale was measured by testing a 4-intensity-level hand grip effort with 3- to 6-year-old children. In addition, the reproducibility of this pictorial rating scale was investigated by a test and randomised re-test procedure. Statistical analysis revealed that no significant main effect (P>0.05) for test was observed in any child. In addition, no significant main effect (P>0.05) for intensity was found in 3-year-old children. However, in the 4-year-old children and over, a significant main effect (P<0.05) was found for intensity. The results also showed that 5- and 6-year-old children were able to produce four differentiated intensities of grip forces. These findings suggest that the pictorial rating scale for grip strength evaluation showed acceptable reproducibility and was sensitive to the age of the children tested. To conclude, this pictorial rating scale appears to be a valid tool to investigate accurately the child's ability to produce grip forces in young children from 5-year-old and over.