Musculoskeletal Health

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FIT Resource Core

The Musculoskeletal Function, Imaging and Tissue Resource Core (MSK-FITRC) provides standardized assessments of physical function and bone/muscle imaging in the creation of a single database connected to patient medical records. This database facilitates future research. Subjects can physically come to the FIT core on the fifth floor of IU Health University Hospital (Indianapolis), or the core can train individuals in standardized physical function assessments. This core supports expansion of blood, DNA, muscle and bone specimens in the Indiana Biobank from patients with musculoskeletal disorders or healthy volunteers.

Imaging Services

Imaging services provided by this core include Dual-Energy X-Ray Absorptiometry (DXA), Peripheral Quantitative Computed Tomography (pQCT) and High Resolution Peripheral Quantitative Computer Tomography (HR-pQCT).

Physical Function Testing

The FIT Resource Core performs basic physical function tests on participants to determine their baseline physical fitness. These tests measure balance, grip strength, and walking and gait speed.

Usual gait or walking speed is the sixth proposed vital sign. Although predominantly established in the geriatric literature as a generic indicator of health status and prognosis, gait speed summarized the overall burden of disease and has utility across ages and disease states.

An iPod running app Sway is attached via a chest strap to the front of the participant. The app uses the iPod’s accelerometer to provide an objective measure of postural sway. The test times how long (with a maximum time of 10 seconds) participants can stand in each of the following positions: 1) feet together and side-by-side; 2) heel of one foot adjacent and touching the big toe of the other foot (semi-tandem stance); 3) heel of one foot in front of and touching the toes of the other foot (tandem stance), and; 4) standing on leg. At all times the tester is to the side of the subject with the arms positioned to support the subject should they need assistance.

An iPod running the app Sway is handed to the participant. With the participant sitting down and when they are ready, they press the begin button. The screen on the iPod turns white. As soon as the screen turns from white to orange, the participant will be asked to gently shake the iPod. How long it takes the participant takes to react and shake the iPod is recorded by the app as reaction time. The test changes from white to orange a total of five times so as a acquire a mean reaction time.

The 6MW assesses functional capacity in individuals with chronic respiratory disease and heart failure and has become a standard measure in a variety of adult and pediatric health and chronic diseased populations. The test involves walking as far as possible within six minutes, with a lower distance being strongly associated with increased risk of hospitalization and mortality.

Grip strength provides an indication of overall strength and muscle mass and is relevant across a range of scenarios as a simple, clinically implementable measure of strength.

The R-STS is a practical and reliable means of measuring coordination, balance, and lower extremity strength and power. Investigators at IU School of Medicine use the five timed sit-to-stand test. Prospective studies have shown performance on the five timed sit-to-stand test to be predictive of falls, with those who needed more than 15 seconds to complete the test having twice as many falls than those who take less time.