Strength, power output and symmetry of leg muscles: effect of age and history of falling

Risk factors for medically unexplained falls may include reduced muscle power, strength and asymmetry in the lower limbs. Conflicting reports exist about strength and there is little information about power and symmetry. Forty-four healthy young people (29.3 +/- 0.6 years), 44 older non-fallers (75.9 +/- 0.6 years), and 34 older fallers (76.4 +/- 0.8 years) were studied. Isometric, concentric and eccentric strength of the knee and ankle muscles and leg extension power were measured bilaterally. The younger group was stronger in all muscles and types of contraction than both older groups (P < 0.02-0.0001). Strength differences between the older groups occasionally reached significance in individual muscles and types of contraction but overall the fallers had 85% of the strength and 79% of the power of the non-fallers (P < 0.001). Young subjects generated more power than both older groups (P < 0.0001) and the fallers generated less than the non-fallers (P = 0.03). Strength symmetry showed an inconsistent age effect in some muscles and some contraction types. This was similar overall in the two older groups. Both older groups had greater asymmetry in power than the young (P < 0.02-0.004). Power asymmetry tended to be greater in the fallers than the non-fallers but this did not reach significance. These data do not support the suggestion that asymmetry of strength and power are associated with either increasing age or fall history. Power output showed clear differences between age groups and fall status and appears to be the most relevant measurement of fall risk and highlights the cumulative effects on function of small changes in strength in individual muscle groups.