Reference value for the six-minute peg board and ring test. A cross sectional study
Keywords:
upper extremity exercise test, six-minute peg board and ring test, exercise toleranceAbstract
Introduction: In our daily life, arm activities, whether supported or unsupported play a major role. Both simple and omplex activities require the muscles, namely trapezius, pectoralis minor, scalene, and intercostals, to participate in arm positioning. These muscles also enact as the accessory respiratory muscles. Therefore, arm elevation increases the load on these muscles and they fail to perform dual activities, resulting in arm fatigue and a feeling of dyspnoea in healthy individuals as well as in chronic obstructive pulmonary disease patients. Various upper limb exercise tests were designed to measure this impairment, one of them being the six-minute peg board and ring test. The aim of the study is to derive a reference value for the six-minute peg board and ring test among healthy Indian population (Mangalore) from the age of 20-70 years of either gender. Also, to find a correlation among the number of rings and body mass index, arm length, arm and forearm circumference, the strength of shoulder and elbow flexors-extensors, grip strength of both sides and level of physical activity.
Methods: Participants performed two tests, thirty minutes apart. They were asked to load as many rings as possible in 6 minutes. Arm length, arm and forearm circumference were measured with a measuring tape. Shoulder and elbow flexors-extensors were assessed using a handheld push-pull dynamometer. Grip strength was measured with the Jamar hand-held dynamometer. Level of physical activity was assessed using International Physical Activity Questionnaire long form.
Results: The samples consisted of 450 healthy individuals between the age of 20-70 years. Reference values for each age group for both genders were reported. We found that age was correlated with the six-minute peg board and ring test score (p<0.05). We also found a correlation between the strength variables and the test results (p=0.001). However, no correlation was found between the arm length, arm and forearm circumference and the level of physical activity with the number of rings.
Conclusion: In this study, we derived a reference value for the six-minute peg board and ring test. There was a correlation amongn age, strength variables and the number of rings.
References
Lima VP, Almeida FD, Janaudis-Ferreira T, Carmona B, Ribeiro-Samora GA, Velloso M. Reference values for the six minute peg board and ring test in healthy individuals in Brazil. J Bras Pneumol 2018;44:190-4.
Couser JI Jr, Martinez FJ, Celli BR. Respiratory response and ventilatory muscle recruitment during arm elevation in normal subjects. Chest 1992;101:336-40.
Celli B, Criner G, Rassulo J. Ventilatory muscle recruitment during unsupported arm exercise in normal subjects. J Appl Physiol 1988;64:1936-41.
Baarends EM, Schols AMWJ, Slebos DJ, Mostert R, Janssen PP, Wouters EF. Metabolic and ventilatory response pattern to arm elevation in patients with COPD and healthy age-matched subjects. Eur Respir J 1995;8:1345-51.
Criner GJ, Celli BR. Effect of unsupported arm exercise on ventilatory muscle recruitment in patients with severe chronic airflow obstruction. Am Rev Respir Dis 1988;138:856-61.
Dodd DS, Brancatisano T, Engel LA. Chest wall mechanics during exercise in patients with severe chronic air-flow obstruction. Am Rev Respir Dis 1984;129:33-8.
Epstein SK, Celli BR, Williams J, Tarpy S, Roa J, Shannon T. Ventilatory response to arm elevation. Its determinants and use in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995;152:211-6.
Martinez FJ, Couser JI, Celli BR. Factors influencing ventilatory muscle recruitment in patients with chronic airflow obstruction. Am Rev Respir Dis 1990;142:276-82.
Martinez FJ, Couser JI, Celli BR. Respiratory response to arm elevation in patients with chronic airflow obstruction. Am Rev Respir Dis 1991;43:76-80.
Velloso M, Stella SG, Cendon S, Silva AC, Jardim JR. Metabolic and ventilatory parameters of four activities of daily living accomplished with arms in COPD patients. Chest 2003;123:1047-53.
Kathiresan G, Jeyaraman SK, and Jaganathan, J. Effects of upper extremity exercise in people with COPD. J Thorac Dis 2010;2:223-36.
Celli BR, Rassulo J, Make BJ. Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction. N Engl J Med 1986;314:1485-90.
Dolmage TE, Maestro L, Avendano MA, Goldstein RS. The ventilatory response to arm elevation of patients with chronic obstructive pulmonary disease. Chest 1993;104:1097-100.
Takahashi T, Jenkins SC, Strauss GR, Watson CP, Lake FR. A new unsupported upper limb exercise test for patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2003;23:430-7.
Hill CJ, Denehy L, Holland AE, McDonald CF. Measurement of functional activity in chronic obstructive pulmonary disease: the grocery shelving task. J Cardiopulm Rehabil 2008;28:402-9.
Zhan S, Cerny FJ, Gibbons WJ, Mador MJ, Wu YM. Development of an unsupported arm exercise test in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2006;26:180-7.
Eston R, Hawes M, Martin A, Reilly T. Human Body Composition. In: Eston R, Reilly T, editors. Kinanthropometry and exercise physiology laboratory manual, 3rd ed. Oxon: Routledge; 2009. p. 46.
Sagun G, Oguz A, Karagoz E, Filizer A, Tamer G, Mesci B. Application of alternative anthropometric measurements to predict metabolic syndrome. Clinics 2014;69:347-53.
Rawat P, Eapen C, Seema KP. Effect of rotator cuff strengthening as an adjunct to standard care in subjects with adhesive capsulitis: A randomized controlled trial. J Hand Ther 2017;30:235-41.
Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand held dynamometers. Phys Ther 1996;76:248-59.
Massy-Westropp N, Gill T, Taylor A, Bohannon R, Hill C. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes 2011;4:127.
International Physical Activity Questionnaire (IPAQ). Guidelines for data processing and analysis of international physical activity questionnaire (IPAQ) - short and long forms. Available from: https://sites.google.com/site/theipaq/home
Mohan S, Bagavad Geetha M, Padmavathi R. Study of gender variation in muscle function among young adults. Natl J Physiol, Pharm Pharmacol 2017;7:793-6.
Hoogendam YY, van der Lijn F, Vernooij MW, Hofman A, Niessen WJ, van der Lugt A, et. al. Older age relates to worsening of fine motor skills: a population-based study of middle-aged and elderly persons. Front Aging Neurosci 2014;6:259-65.
Ingram LA, Butler AA, Walsh LD, Brodie MA, Lord SR, Gandevia SC. The upper limb Physiological Profile Assessment: Description, reliability, normative values and criterion validity. PloS One 2019;14:e0218553.
Adamo DE, Alexander NB, Brown SH. The influence of age and physical activity on upper limb proprioceptive ability. J Aging Phys Act 2009;17:272-93.
Thimmaraju L, Anandarao SB. Gender differences in cardiovascular response to upper limb isometric exercises. Int J Res Health Sci 2014;2:454-61.
Ohara DG, Melo CS, Reis IM, Jamami M. Functional capacity assessment of upper limbs in healthy young adult subjects. Fisioter Mov 2017;30:159-67.
Liu X, Li P, Wang Z, Lu Y, Li N, Xiao L, et al. Evaluation of isokinetic muscle strength of upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients. Int J Chron Obstruct Pulm Dis 2019;14:2027-36.
Janaudis-Ferreira T, Hill K, Goldstein RS, Wadell K, Brooks D. Relationship and responsiveness of three upper-limb tests in patients with chronic obstructive pulmonary disease. Physiother Can 2013;65:40-3.
Published
Issue
Section
License
Mattioli 1885 has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
How to Cite
