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Updated: Aug 21, 2026

A Standardized Method for Measurement of Elbow Kinesthesia
Published on: October 10, 2020
Elbow flexion and extension strength relative to body or muscle size in children
Louise E Wood1, Sharon Dixon, Chris Grant
1Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK.
Insights
Muscle size, not just height or arm length, accurately explains differences in children's elbow strength. This finding is crucial for understanding pediatric strength development and avoiding gender bias in assessments.
Area of Science:
- Pediatric exercise science
- Human biomechanics
- Growth and development
Background:
- Assessing strength differences in children often relies on linear body measurements.
- Previous studies may overestimate gender-based strength disparities due to inadequate size metrics.
Purpose of the Study:
- To investigate gender and age influences on elbow flexion/extension strength in children.
- To compare the explanatory power of linear size vs. muscle cross-sectional area (CSA) in strength models.
Main Methods:
- A 3-year longitudinal study of 37 children (18 boys, 19 girls) aged ~13 years.
- Annual assessments included stature, arm length, isokinetic/isometric elbow torques, and MRI-derived muscle CSA.
- Multilevel modeling analyzed relationships between strength, age, gender, and size variables.
Main Results:
- When muscle CSA was included, gender differences in elbow strength became non-significant.
- Linear measures (stature, arm length) alone suggested gender differences not explained by body size.
- Muscle CSA combined with a linear dimension best explained strength variations; age also contributed significantly but varied by action and muscle.
Conclusions:
- Relying solely on linear body dimensions can obscure true strength development patterns in children.
- Accurate assessment of muscle size (CSA) is essential for understanding pediatric strength and minimizing perceived gender differences.
Purpose:
The purpose of this study was to examine gender- and age-related differences in elbow flexion and extension strength in children, when linear size measurements and actual measurements of muscle size were used as explanatory variables in a multilevel model.
Methods:
Thirty-seven children participated in a 3-yr longitudinal study (18 boys and 19 girls). The average age +/- SD at the first test occasion was 13.0 +/- 0.3 yr. Stature, arm length, isokinetic concentric and isometric elbow extension and flexion torques, and MRI-determined elbow flexor and extensor muscle cross-sectional areas (CSAs) were assessed annually. Multilevel modeling was used to describe the relationship between the measured torques and body/muscle size variables, incorporating age, age by gender, and gender as additional explanatory variables.
Results:
When muscle CSA was included in the static and dynamic torque multilevel models, gender differences in strength were nonsignificant. In contrast, use of stature or arm length alone, suggested gender differences in strength that could not be explained by differences in body size. All torque measures were best explained by inclusion of muscle CSA and a linear dimension in the models. Age also explained additional variance in torque, but the influence of age was action and muscle specific.
Conclusion:
Use of only linear dimensions rather than muscle CSA to account for differences in size may have clouded our understanding of strength development in children.
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