Strength Protocol

Floor Lift

1. Instruments: APAS analog program and Force Plate
2. Instructions to Examinee: �You will be asked to exert maximum force in various lift postures, push and pull postures. Please note we expect you to exert maximum force upon each effort. You are in control. You are not going to be asked to lift actual weights. You will exert force, we will measure the force in three separate force dimensions, through your feet on the force platform.�
3. Recording the data: Conduct test as below and record data as instructed.

Lift Floor to Waist

1. Position Examinee on force plate, position and secure force lifting bar to floor or under force plate (depending upon your laboratory setup.) Position lifting bar approximately at knee level or below. Instruct Examinee to assume a proper lifting posture, with knees bent, back straight (instruct and assist as necessary.)
2. Zero the Plate with the Examinee squatting in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Lift-Hold-Relax, Lift-Hold-Relax, Lift-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Floor Lift.�
5. Repeat as need until you are satisfied the Examinee has given maximum effort each time or claims to have given maximum effort. Results will look similar to the picture:

Waist Lift

1. Position lifting bar approximately at base of sternum level. Instruct Examinee to assume a proper lifting posture, with slightly knees bent, back straight (instruct and assist as necessary.)
2. Zero the Plate with the Examinee in a mildly squatting, relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Lift-Hold-Relax, Lift-Hold-Relax, Lift-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Waist Lift.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Over-Shoulder Lift

1. Position lifting bar approximately with shoulder at 90 degrees forward flexion, elbow skewed towards head. Hands with Dorsal surface facing face. Instruct Examinee to assume a proper lifting posture, with slightly knees bent, back straight (instruct and assist as necessary.)
2. Zero the Plate with the Examinee in lift posture and in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Lift-Hold-Relax, Lift -Hold-Relax, Lift -Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Shoulder Lift.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Over-Shoulder Right Lift

1. Position lifting bar anterior superior to the right shoulder. Position the Examinee�s shoulder and elbow at approximately 90 degrees while Examinee is holding the lifting bar. Repeat the Over-Shoulder Lift test with Right hand only. Instruct Examinee to assume a proper lifting posture, with slightly knees bent, back straight (instruct and assist as necessary.)
2. Zero the Plate with the Examinee in lift posture and in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Lift-Hold-Relax, Lift-Hold-Relax, Lift-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Right Vertical Lift.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Over-Shoulder Left Lift

1. Position lifting bar anterior superior to the shoulder. Position the Examinee�s shoulder and elbow at approximately 90 degrees while Examinee is holding the lifting bar. Repeat the Over-Shoulder Lift test with Left hand only. Instruct Examinee to assume a proper lifting posture, with slightly knees bent, back straight (instruct and assist as necessary.)
2. Zero the Plate with the Examinee in lift posture and in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Lift-Hold-Relax, Lift-Hold-Relax, Lift-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Left Vertical Lift.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Two Hand Pull

1. Position bar in front of the Examinee, securely anchored to the wall. Instruct Examinee to assume a proper pulling posture, with slightly knees bent, back straight, one foot back, one foot forward (instruct and assist as necessary.)
2. Zero the Plate with the Examinee squatting in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Pull-Hold-Relax, Pull-Hold-Relax, Pull-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Pull.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Right Hand Push

1. Rotate the Examinee 180 degrees. Position bar in front of the patient, between trunk and right arm, securely anchored to the wall. Instruct Examinee to assume a proper pushing posture, with slightly knees bent, back straight, right foot back, left foot forward (instruct and assist as necessary.)
2. Zero the Plate with the Examinee squatting in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Push-Hold-Relax, Push-Hold-Relax, Push-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Push R.� e. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort.

Left Hand Push

1. Position bar in front of the Examinee, between trunk and left arm, securely anchored to the wall. Instruct Examinee to assume a proper pushing posture, with knees slightly bent, back straight, left foot back, right foot forward (instruct and assist as necessary.)
2. Zero the Plate with the Examinee squatting in a relaxed posture, no pressure on the lift handle.
3. Examiner will initiate the test by instructing the Examinee to (�Push-Hold-Relax, Push-Hold-Relax, Push-Hold-Relax�). Each word will have the value of approximately 1 second of time. Total elapsed time will be 10 seconds.
4. Save the data as �Push L.�
5. Repeat as needed until you are satisfied the Examinee has given maximum effort each time or claims to give maximum effort. Kinetic Gait Force Plate Stance Analysis: When the FCE includes an injury claim of the upper, mid or low back, the protocol includes multiple right and left stance analysis during gait. The analog setup is as follows (Period = 1.5 sec., TrigCh = E, F, G or H, TrigLev = 5, PreTrig% = 15):

Kinetic Gait

1. Instruments: APAS analog program and Force Plate
2. Instructions to Examinee: �You will be asked to walk down the gait platform with a casual, relaxed, natural walk. We will position you on the platform. Our goal is to plan your gait in a manner that will allow you to step on the platform with one foot only. Please do not change your step length.
3. Recording the data:

Conduct test as below and record data as instructed.

1. Position the Examinee on the gait runway, approximately 36� from the edge of the force plate. Mark the starting toe position. Have the Examinee walk over the plate. If one foot only strikes the plate (inside the four transducers), you are ready to commence the test. If the foot strike is short, advance Examinee start position accordingly. If foot strike is long, move start position back accordingly (instruct and assist as necessary.)
2. Zero the plate with the Examinee off the plate.
3. Instruct the Examinee to walk. If the Examinee strikes the plate with one foot only. Collect 4 right and 4 left gait stance trials. The graphs will look as follows: Right Stance Left Stance
4. Save the data as �R1, R2, R3, R4, L1, L2, L3, L4,� respectively.

See also