Developing normalized strength scores for neuromuscular research

Patricia L. Andres, Robert English, Michelle Mendoza, Julaine Florence, Elizabeth Malkus, Jeanine Schierbecker, Catherine Siener, Susan Malspeis, David A. Schoenfeld, Theodore L. Munsat, Merit E. Cudkowicz

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Introduction: The Accurate Test of Limb Isometric Strength (ATLIS) device can reliably measure the strength of 12 muscle groups using a fixed load cell. The purpose of this study was to analyze ATLIS data from healthy adults to calculate an individual's predicted strength scores. Methods: ATLIS data were collected from 432 healthy adults. Linear regression models were developed to predict each muscle group's strength. The R-squared statistic assessed variability accounted for by the models. Results: Simple main effects models stratified by gender were used to establish regression equations for each muscle using factors of age, weight, and height. Conclusions: Normalizing raw strength scores controls for biometric factors, thus enabling meaningful comparisons between subjects and allowing each muscle to contribute equally to a summary score. Normalized scores are easily interpreted for broad clinical uses, and derived summary scores establish individuals' disease progression rates using a common scale, allowing for more efficient clinical trials.

Original languageEnglish
Pages (from-to)177-182
Number of pages6
JournalMuscle and Nerve
Issue number2
StatePublished - Feb 2013


  • ALS
  • Neuromuscular
  • Outcomes measures
  • Strength testing
  • Summary scores

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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