1000 NORMS PROJECT: MEASURES OF PHYSICAL FUNCTION ACROSS THE LIFESPAN

Abstract

Meaningful, reliable, and sensitive outcome measures are required to track the progression of neuromuscular disorders and evaluate the significance of changes attributed to therapies. Determining whether changes are statistically significant as well as clinically meaningful, relies on comparison with normative reference data. Knowledge of what is normal is essential to accurately identify and evaluate pathology that is abnormal. The aim of this thesis was to generate normative reference data for clinimetrically sound performance-related outcome measures, assessing muscle strength, joint range of motion, spatiotemporal and plantar pressure gait and functional capabilities and to investigate the influence of demographic and physical characteristics. Chapter 2 describes the recruitment process and development of the standardised and reliable protocol used to assess 1000 healthy people aged from 3-101 years in the 1000 Norms Project. Chapter 3 presents age- and gender-stratified normative reference data for 13 active joint movements assessed using goniometry and the isometric strength of 12 muscle groups assessed using hand held and fixed dynamometry. Chapter 4 presents reference data for 15 spatiotemporal gait parameters assessed using an instrumented walkway system and 16 measures of plantar pressure for four regions of the foot captured by a capacitance pressure distribution platform. Chapter 5 presents reference data for 12 functional capability measures classified as gross motor function (6-minute walk test, stair climb test, sit to stand test, reaction time, vertical and long jump), fine motor function (9-hole peg test, Functional Dexterity test) and balance (dynamic: star excursion balance test and static: single leg and tandem stance). Chapter 6 summarises the findings of Chapters 2-5 and discusses the influence of demographic and physical characteristics on performance-related outcome measures across the lifespan and implications for future research. The normative reference data presented in this thesis provide a framework to determine the presence and extent of impairments in children and adults with neuromuscular disorders as well as other neurological and musculoskeletal conditions.