Health Screening Questionnaire Research Articles

The 'Healthy Dads, Healthy Kids' community effectiveness trial: study protocol of a community-based healthy lifestyle program for fathers and their children.

BackgroundThe 'Healthy Dads, Healthy Kids' program was designed to help overweight fathers lose weight and positively influence the health behaviors of their children. The aim of the current study was to evaluate the previously established program in a community setting, in a large effectiveness trial.Methods/DesignThe Healthy Dads, Healthy Kids community trial consists of three stages: (i) Stage 1 - program refinement and resource development (ii) Stage 2 - community randomized controlled trial (iii) Stage 3 - community effectiveness trial. The program will be evaluated in five Local Government Areas in the Hunter Valley Region of NSW, Australia. For the community randomized controlled trial, 50 overweight/obese men (aged 18-65 years) from one Local Government Area with a child aged between 5-12 years of age will be recruited. Families will be randomized to either the program or a 6-month wait-list control group. Fathers and their children will be assessed at baseline, post-intervention (3-months) and 6-months. Inclusion criteria are: body mass index 25-40 kg/m2; no participation in other weight loss programs during the study; pass a health-screening questionnaire; and access to a computer with Internet facilities. In the community trial, the program will be evaluated using a non-randomized, prospective design in five Local Government Areas. The exclusion criteria is body mass index < 25 kg/m2 or lack of doctor's approval. Measures will be collected at baseline, 3-, 6- and 12-months. The program involves fathers attending seven face-to-face group sessions (three with children) over 3-months. Measures: The primary outcome is fathers' weight. Secondary outcomes for both fathers and children include: waist circumference, blood pressure, resting heart rate, physical activity, sedentary behaviors and dietary intake. Father-only measures include portion size, alcohol consumption, parenting for physical activity and nutrition and parental engagement. Process evaluation will determine the fidelity, dose (delivered and received), reach, recruitment and context of the program.DiscussionAs a unique approach to reducing obesity prevalence in men and improving lifestyle behaviours in children, our findings will provide important evidence relating to the translation of Healthy Dads, Healthy Kids, which will enable it to be delivered on a larger scale.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000608066

Asylum Seekers' Perspectives on their Mental Health and Views on Health and Social Services: Contributions for Service Provision Using a Mixed‐Methods Approach

The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, ‘asylum seekers’ are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed‐methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in‐depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using ‘idioms of distress’ across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post‐traumatic stress), but so are post‐migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.

Early evidence implicating the brain derived neurotrophic factor (BDNF) val66met polymorphism in the pathogenesis of oesophageal visceral sensitivity

IntroductionFunctional gastrointestinal disorders are common clinical conditions where visceral hypersensitivity has been strongly implicated. It is recognised that genetic factors may be an important factor in visceral sensation and may...

The SHED-IT community trial study protocol: a randomised controlled trial of weight loss programs for overweight and obese men.

BackgroundObesity is a major cause of preventable death in Australia with prevalence increasing at an alarming rate. Of particular concern is that approximately 68% of men are overweight/obese, yet are notoriously difficult to engage in weight loss programs, despite being more susceptible than women to adverse weight-related outcomes. There is a need to develop and evaluate obesity treatment programs that target and appeal to men. The primary aim of this study is to evaluate the efficacy of two relatively low intensity weight loss programs developed specifically for men.Methods and DesignThe study design is an assessor blinded, parallel-group randomised controlled trial that recruited 159 overweight and obese men in Newcastle, Australia. Inclusion criteria included: BMI 25-40 (kg/m2); no participation in other weight loss programs during the study; pass a health-screening questionnaire and pre-exercise risk assessment; available for assessment sessions; access to a computer with e-mail and Internet facilities; and own a mobile phone. Men were recruited to the SHED-IT (Self-Help, Exercise and Diet using Internet Technology) study via the media and emails sent to male dominated workplaces. Men were stratified by BMI category (overweight, obese class I, obese class II) and randomised to one of three groups: (1) SHED-IT Resources - provision of materials (DVD, handbooks, pedometer, tape measure) with embedded behaviour change strategies to support weight loss; (2) SHED-IT Online - same materials as SHED-IT Resources plus access to and instruction on how to use the study website; (3) Wait-list Control. The intervention programs are three months long with outcome measures taken by assessors blinded to group allocation at baseline, and 3- and 6-months post baseline. Outcome measures include: weight (primary outcome), % body fat, waist circumference, blood pressure, resting heart rate, objectively measured physical activity, self-reported dietary intake, sedentary behaviour, physical activity and dietary cognitions, sleepiness, quality of life, and perceived sexual health. Generalised linear mixed models will be used to assess all outcomes for the impact of group (Resources, Online, and Control), time (treated as categorical with levels baseline, 3-months and 6-months) and the group-by-time interaction. These three terms will form the base model. 'Intention-to-treat' analysis will include all randomised participants.DiscussionOur study will compare evidence-based and theoretically driven, low cost and easily disseminated strategies specifically targeting weight loss in men. The SHED-IT community trial will provide evidence to inform development and dissemination of sustainable strategies to reduce obesity in men.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN12610000699066)

A Comparison of Three Strategies for Scale Construction to Predict a Specific Behavioral Outcome

Using 65 items from a mental health screening questionnaire, the History Opinion Inventory-Revised (HOI-R), the present study compared three strategies of scale construction-(1) internal (based on factor analysis), (2) external (based on empirical performance) and (3) intuitive (based on clinicians' opinion)-to predict whether 203,595 U.S. Air Force trainees would be discharged early for mental health or behavior-related reasons within a 4-year follow-up period. The external strategy significantly outperformed the internal strategy, which in turn outperformed the intuitive strategy. For all strategies, predictive accuracy was consistently higher when items and scales were scored using empirically derived weights rather than unit weights. These findings suggest that the external strategy of scale construction provides the highest accuracy when sample sizes are large and the aim is to predict a specific behavioral event. However, the internal strategy also yields valid results and can be a reasonable choice when outcome data are unavailable.

COPD Screening in General Practice Using a Telephone Questionnaire

ABSTRACTChronic obstructive pulmonary disease (COPD) is a growing health problem, and an underestimated and underdiagnosed disease in primary care. The aim of this survey was to study the feasibility of detecting undiagnosed COPD patients in the general practice population with the aid of a telephone questionnaire. The study was held in 2 general practices in the Netherlands. During 2 weeks, all patients registered with these 2 practices and aged between 40 and 75 years were contacted through a call center. Persons known with a previous history or diagnosis of COPD or asthma or comorbidity were excluded from the telephone list. The telephone interview used the Respiratory Health Screening Questionnaire (DB Price, 2006). Based on the score on this instrument, respondents were classified as having a low, moderate or high risk of having COPD. Smoking behaviour and BMI were also recorded. Patients with medium and high risk for COPD were invited for spirometry, performed by 2 experienced registered nurses. The results of the telephone interview and spirometric findings were assessed by the attending GP, who established the final diagnosis. The call center reached 1032 persons, 813 of whom answered the questions. The percentage of smokers was 49.2%, with an average number of pack-years of 17.9 (SD = 17); mean BMI was 26.1. Spirometry and analysis by the GP showed that 15.7% of the medium-risk group had previously undiagnosed COPD, versus 39.6% of the high-risk group. The number of undiagnosed COPD patients in the general practice population is considerable. Case finding can focus on moderate- and high-risk groups after telephone risk assessment.

농촌지역 고등학생의 정신건강, 우울정도 및 인터넷 중독과의 관계

Adolescent Mental Health & Problem-behavior Screening Questionnaire (AMPQ), Children's Depression Inventory (CDI), and Scales of Internet addiction (K-scales). Results: First, the level of mental health according to the AMPQ for subjects from this study showed problematic behavior was lower when compared to other researches. There were statistically significant differences according to the school type for externalization problems and overall problematic behavior. Based on gender, it was even more problematic for male students in regards to externalization problems. Secondly, the level of depression was relatively low : 5.1% for potential risk and 0.3% for high risk. Thirdly, a total of 96.9% were considered normal for Internet addition levels. 1.7% for potential risk, 1.4% for high risk; however, there was no statistically significant difference between each variable. Fourthly, there was a strong relationship between subjects AMPQ, level of depression and Internet addiction. As depression worsens, Internet addiction also becomes stronger. Conclusion: There is a need for awareness of the mental health of adolescents and precautionary measures, the development of a program for early treatment, adequate management, and decisions on the direction of treatment.

Brief mental health screening questionnaire for children and adolescents in primary care settings

Early detection of mental health problems is important. The implication of primary care professionals and the adequacy of instruments could be of great help. To study the validity of a brief questionnaire based on psychosocial functioning to detect mental health problems in a high-risk general population. 151 children and adolescents were assessed as part of a longitudinal 3 year follow-up study of two cohorts born in 1989 and 1993, respectively. semi-structured diagnostic interviews were used to evaluate their psychopathological condition, to test for functional impairment, and to determine whether it would be appropriate for them to be referred to Mental Health Services. Parents also answered a Brief Mental Health Screening Questionnaire (BMHSQ) containing questions about main psychosocial functioning areas. Logistic and multiple regressions were applied to study the predictive power of the questionnaire. The BMHSQ showed good clinical screening properties and was useful in determining who should be addressed to a specialized psychopathological service. General practitioners could play an essential role in detecting and referring such disorders if provided with the proper tools. The use of brief questionnaires on functioning and outcomes in pediatric practice could improve comprehensive health care for children and adolescents. Rapid detection of mental health problems in a primary care setting is possible, as is better use and planning of health services.

Screening Populations at Increased Risk of CKD: The Kidney Early Evaluation Program (KEEP) and the Public Health Problem

The epidemiological characteristics of the US end-stage renal disease population growth and increased costs in the late 1980s framed the public health agenda for the development of a community-based chronic kidney disease (CKD) screening program. Development of the National Kidney Foundation Kidney Early Evaluation Program (KEEP) included 2 preliminary screening programs, the Computerized Assessment of Risk and Education and the KEEP pilot, which was organized around the African American Study of Kidney Diseases clinical centers. The current KEEP program, launched in August 2000, targets individuals with diabetes, hypertension, or a family history of diabetes or hypertension or CKD. The screening includes informed consent, health screening questionnaire, diagnostic panel, and physician consultation. Participants are followed up by telephone and mail. Of 100,000 KEEP participants screened, 28.7% have CKD and 6.7% self-reported CKD stages 1 to 5. Conversely, National Health and Nutrition Examination Survey 1999-2002 results show 13.1% CKD prevalence; 2.9% of women and 17.9% of men with an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) self-report CKD. CKD prevalences in KEEP by stage are 3.1% for stage 1; 4.8%, stage 2; 19.7%, stage 3; and 1.1%, stages 4 and 5, confirming the ability of this targeted screening program to detect CKD early. In addition to identifying individuals at increased risk of kidney disease, KEEP's structured data collection provides an opportunity to advance knowledge about kidney disease and advance the CKD public health agenda.

Developing a Health Screening Questionnaire for Women in Welfare Transition Programs in the United States

Women in United States Welfare Transition Programs (WTPs) have high rates of chronic health problems that might present significant barriers to obtaining and/or maintaining employment. Inadequate, standardized health screening in WTPs across the United States contributes to the problem of achieving self-sufficiency for disadvantaged women. Using community-based participatory research as a framework, the study's purpose was to develop a culturally relevant and sensitive health screening questionnaire that would be acceptable for use with women enrolled in WTPs. Three rounds of focus groups (n = 10) were conducted with a total of 61 women. Analysis of focus group interviews revealed not only content areas identified as important to health, but critical process issues involved in administering the tool. The distinction between process and content was a critical finding because it stressed the importance of not only what women were asked, but how, when, and by whom they were asked.

The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population

Alcohol has been associated with COPD-related mortality but has not yet been demonstrated to be an independent risk factor for COPD exacerbation. Our objective was to evaluate the association between alcohol consumption and the subsequent risk of COPD exacerbation. A prospective cohort study of general medicine outpatients seen at one of seven Veterans Affairs (VA) medical centers who returned health screening questionnaires. Three screening questionnaires, AUDIT-C (0 to 12 points), CAGE (0 to 4 points), and a single item about the frequency of drinking six or more drinks on an occasion (binge drinking), were used to classify alcohol consumption. The main outcome, COPD exacerbation, was based on primary VA discharge diagnosis (International Classification of Diseases, Ninth Revision) or outpatient diagnosis of COPD accompanied by prescriptions for either antibiotics or prednisone within 2 days. Among the 30,503 patients followed up for a median of 3.35 years, those patients with AUDIT-C scores > or = 6, CAGE scores > or = 2, or who reported binge drinking at least weekly were at an increased risk of COPD exacerbation in age-adjusted analysis. Adjusted hazard ratios were 1.4 (95% confidence interval [CI], 1.1 to 1.7) for AUDIT-C score > or = 6, 1.4 (95% CI, 1.3 to 1.5) for CAGE score > or = 2, and 1.6 (95% CI, 1.2 to 2.2) for those who reported binge drinking daily or almost daily. However, with adjustment for measures of tobacco use, the association between alcohol consumption and increased risk of COPD exacerbation was no longer evident. Alcohol consumption, whether quantified by AUDIT-C, CAGE score, or binge drinking, was not associated with an increased risk of COPD exacerbation independent of tobacco use.

Resistance Training for Medial Compartment Knee Osteoarthritis and Malalignment

1) To evaluate the effects of a 12-wk high-intensity knee extensor and flexor resistance training program on strength, pain, and adherence in patients with advanced knee osteoarthritis and varus malalignment and 2) to generate pilot data for change in dynamic knee joint load, patent-reported outcomes, and self-efficacy after training. Fourteen patients (48.35 +/- 6.51 yr) with radiographically confirmed medial compartment knee osteoarthritis and varus malalignment of the lower limb were recruited from a surgical waiting list for high tibial osteotomy. Participants completed a high-intensity isokinetic resistance training program three times per week for 12 wk. Knee extensor and flexor strength were assessed every third week, whereas pain and adherence were recorded at every training session. The external knee adduction moment during the gait, the 6-min-walk test, the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Arthritis Self-Efficacy Scale (ASES) were also evaluated before and after training. Significant improvements in knee extensor and flexor strength were observed without increases in pain during or after training. Adherence to the high-intensity program was high. No significant changes were observed for dynamic knee joint load or the KOOS. There was a significant increase in the function subscale of the ASES only. These findings suggest that patients with advanced knee osteoarthritis and malalignment can experience substantial gains in strength after a high-intensity resistance training program without concomitant increases in pain, adverse events, or compromised adherence. These findings provide support for future clinical trials with longer-term outcomes.

Anxiety and Depression Screening for Youth in a Primary Care Population

Prior studies have shown a low rate of accurate identification by primary care physicians of mental health disorders in youth. This study tested the psychometric properties of 2 brief mental health screening questionnaires, the Mood and Feelings Questionnaire, short form, (MFQ-SF) and Childhood Anxiety Sensitivity Index (ASI), in a large sample of youth. In a sample of 1375 youth aged 11 to 17 (779 with asthma, 596 randomly selected controls) enrolled in a health maintenance organization, the psychometric properties (optimum cutoffs on receiver operator characteristic (ROC) curves, sensitivity, specificity, positive and negative predictive values) of 2 brief anxiety and depression screens were compared with a gold standard-structured psychiatric interview. Both the MFQ-SF and ASI performed well on ROC analysis for screening youth for 1 or more Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) anxiety or depressive disorders. The MFQ-SF performed better on ROC analysis than the ASI for youth with major depression (area under the curve of 0.84 vs 0.77). For screening youth with anxiety disorders, ROC curves showed that both the MFQ-SF and ASI only performed in the fair range (area under the curve of 0.76). The MFQ-SF and ASI are 2 relatively brief questionnaires that performed well for screening youth for 1 or more DSM-IV anxiety or depressive disorders. The MFQ-SF performed better than the ASI for screening youth with major depression. Use of these instruments could increase the accuracy of identification of mental health disorders in youth by primary care physicians.

The Patient Health Questionnaire, Japanese Version: Validity According to the Mini-International Neuropsychiatric Interview–Plus

To validate the Japanese version of the Patient Health Questionnaire against the Mini-International Neuropsychiatric Interview-Plus in Japan 131 patients in 4 primary care settings and 2 general hospital settings participated. These patients completed the Patient Health Questionnaire and returned it to their physician within 48 hr. Subsequently, the subjects underwent a diagnostic evaluation interview based on the Mini-International Neuropsychiatric Interview-Plus by an interviewer blind to the results of the Patient Health Questionnaire screening. The Patient Health Questionnaire diagnosis was characterized using kappa values between 0.70 and 1.0 for Somatoform Disorder, Major Depressive Disorder, Panic Disorder, Bulimia Nervosa, Alcohol Abuse/Dependence, and Premenstrual Disorder. Sensitivities, specificities, and negative predictive values were very good (between 0.84 and 1.0) for the first 4 diagnoses but not Alcohol Abuse/Dependence or Premenstrual Disorder, as were the Positive predictive values (between 0.78 and 1.0). Findings show very good concordance of the Japanese version of the Patient Health Questionnaire with the Japanese version of the Mini-International Neuropsychiatric Interview-Plus.

Health Plan Requirements for Mental Health and Substance Use Screening in Primary Care

Screening for substance abuse and mental health in primary care can improve detection. One way to advance screening is for health plans to require it. We developed national estimates of the prevalence and type of mental and substance-use condition screening health plans require of primary care practitioners. In 1999 (N = 434, response rate = 92%) and 2003 (N = 368, response rate = 83%), we conducted a nationally representative health plan survey regarding alcohol, drug, and mental health services, including screening requirements. Health plans reported on screening requirements of their top three private insurance products. Products were categorized by type (HMO, POS, or PPO), behavioral health contracting arrangements, tax status, market area population, and region. We asked whether primary care practitioners are required to use a general health screening questionnaire (including mental health, alcohol, or drugs items) and/or a screening questionnaire focused on mental health, alcohol, or drug problems. By 2003, 34% of products had any behavioral health screening requirements. Although there was no increase from 1999 to 2003 in requirements for any kind of behavioral health screening, requirements for using a standard screening instrument declined for mental health but increased for alcohol and drug screening. PPOs showed the largest increase in prevalence of behavioral health screening requirements. Products contracting with managed behavioral health organizations were more likely to require screening. Most products do not require behavioral health screening in primary care. More screening could help to improve identification of behavioral health conditions, a first step towards effective treatment.

Depersonalisation/derealisation symptoms in vestibular disease

Background: Depersonalisation is a subjective experience of unreality and detachment from the self often accompanied by derealisation; the experience of the external world appearing to be strange or unreal. Feelings...

Screening for physical and psychological illness in the British Armed Forces: II: Barriers to screening--learning from the opinions of Service personnel.

To identify any potential barriers to the effectiveness of a military health screening programme based on the beliefs of British Service personnel. As part of a pilot evaluation of the suitability of a new health screening questionnaire for the British Armed Forces, 73 men and women from the three Services, of various ranks and age, underwent a semi-structured interview after completing a screening questionnaire. Participants were asked about the veracity of their answers and their views regarding a screening questionnaire. Afterwards questionnaires were sent to 4496 randomly selected personnel from the three Services, which validated the main emerging themes. A constant comparative method of analysis was used to identify and categorise all ideas presented. The main barriers to health screening were lack of trust, perceived low quality of healthcare, and perceived lack of concern within the institution about work environments and home life. The central issue was 'confidence' in military health care provision. Screening was considered worthwhile, but many confided that they would not honestly answer some items in the questionnaire. Lack of trust in medical confidentiality, stigmatisation and fears that the process would jeopardise career prospects were stressed. Many Service personnel admitted to seeking medical help outside the Armed Forces. Concerns raised by Service personnel may endanger the value of a screening programme and the provision of health services. Greater emphasis needs to be placed upon gaining the confidence of those targeted for health screening.

Alcohol counseling as part of general wellness counseling.

Healthcare providers, and nurses in particular, are increasingly being called upon for health promotion counseling. Alcohol risk assessment is often included in general health screening questionnaires, but often little use is made of this information. Alcohol consumption is infrequently included as a focus of health promotion campaigns. Because alcohol intake influences many other health risks, it is logical and practical to include alcohol risk reduction in general wellness counseling. This article presents evidence that incorporating alcohol counseling lowers alcohol risk and lowers the risk of other chronic diseases. It also provides examples of ways nurses and other health professionals can discuss alcohol risk reduction in the context of general health, thus helping remove the stigma associated with alcohol risk and engage clients in efforts to lower their alcohol risk.

Gender differences in self-reported minor mental disorder and its association with suicide. A 20-year follow-up of the Renfrew and Paisley cohort.

Suicide rates are around three times higher in men than women; in contrast women have a higher prevalence of community-diagnosed depression. To investigate this paradox we examined the association of General Health Questionnaire (GHQ)-caseness (score > or = 4), a measure of possible minor mental disorder, with suicide risk in a general population cohort. Data were derived from a cohort study based on the 8,466 men and women in the Renfrew and Paisley cohort who completed a 30-item GHQ in the period from 1972 to 1976 and who were followed up to 1995 for all-cause and suicide mortality. The long-term suicide risk associated with possible minor mental disorder was higher in men [hazard ratio 6.78 (1.36-33.71)] than women [hazard ratio 1.66 (0.43-6.45)]; test for interaction between gender and GHQ with respect to suicide risk: p = 0.09. These findings indicate either that the long-term risk of suicide in the context of a past episode of minor mental disorder is higher in males than females or that there are sex differences in the validity of responses to mental health screening questionnaires. Further research is required to replicate our finding in larger studies and, if confirmed, clarify which explanation underlies it.

COMPARISON OF STRENGTH AND PEAK FORCE BETWEEN YOUNGER AND OLDER MALES DURING A LEG PRESS

Muscle strength and peak force measures are important functional determinates for meeting the physical challenges in activities of daily living, sports and response to both emergency and non-emergency type situations. The purpose of this study was to compare leg strength and peak force measures of both younger and older subjects during a leg press at 90% subjects single repetition maximums (1-RM). Twelve younger males (Age: 21.41 ± 2.1 yrs., HT: 176 ± 12 cm., WT: 80 ± 9.2 kg) and twelve older males (Age: 50.66 ± 6.5 yrs., HT: 179 ± 10.4 cm., WT: 85.6 ± 10.8 kg) volunteered for this study. Subjects were classified as untrained by Godin leisure time activity questionnaire and apparently healthy according to both a general health screening and physical readiness activity questionnaires. Lower body strength was assessed using a 1-RM protocol on a Cybex seated leg press machine. Leg press peak force was assessed by a modified accelerometer, developed to measure relative peak force and velocity patterns of human movement. A load equaling 90% of the subjects' 1-RMs was used to assess peak force developed during each repetition. Subjects were given approximately 5 seconds rest between each repetition and instructed to perform each repetition as forcefully as possible. Independent t-tests examined between group measures on strength and peak force variables between groups for each independent variable. Mean 1-RM values for the young were 134 ± 29kg and 118 ± 25kg for older subjects. This 12% difference in the older group was not significant (t = 1.402; df = 22; p = .088). However, the cumulative peak force group means for the young was 24,223 Newtons and 16,986 Newtons respectfully, indicating a 30% performance decrease in the older group (t = 2.629; df = 22; p = .007). This study indicates that this sample of older adults did not have significant differences in the absolute measures of leg strength during a leg press when compared to younger adults. However, during heavy and continuous work represented by cumulative peak force group means revealed that significant differences between groups exist.