Richard Ferraro
Rutgers University, School of Health Professions
Abstract Title:
The Validation and Use of the Isometric Mid-Thigh Pull as a Total Body Measure of Strength Across Clinical Populations
Biography:
Richard Ferraro PT, Ph.D. received his Masters in Physical Therapy in 2001 from the College of Staten Island and his Ph.D. in Movement Science from Seton Hall University in 2010. Dr. Ferraro is an Assistant Professor who teaches the foundational science courses like Gross Anatomy and Kinesiology and Biomechanics as well as clinical coursework such as Prosthetics and Orthotics and aspects of the Musculoskeletal series in the Doctor of Physical Therapy Program-South. His research focus is on core muscle training and activation and its effect on balance and lower extremity function.
Research Interests:
Accurate assessment of total-body muscle performance is important for evaluating physical function and monitoring the effectiveness of rehabilitation and exercise interventions. However, many commonly used clinical strength measures assess isolated joints or muscle groups and may not fully reflect overall neuromuscular performance. The Isometric Mid-Thigh Pull (IMTP) is a simple, safe, multi-joint assessment that has been widely used in athletic populations and is increasingly being explored for clinical applications. Initial work established the reliability and validity of the body weight–normalized IMTP (IMTPN) in a large sample of recreationally active adults (n=121). IMTPN demonstrated excellent test–retest reliability (ICC>0.98; MDC95=2.1 N/kg) and showed fair to moderately strong correlations with established measures of physical performance, including grip strength (r=0.74), broad jump (r=0.75), five-times sit-to-stand (r=-0.55), and 30-second chair rise (r=0.54). A regression model incorporating these measures explained 76% of the variance in IMTPN, supporting its validity as a global measure of muscle performance. Building on this validation work, IMTP performance was subsequently examined in a clinical population of people living with HIV (PLHIV; n=74) and compared with adults without known HIV (n=121). After adjusting for age and sex, age, sex, and duration of HIV infection were significant predictors of IMTP performance, explaining 54.7% of the variance. PLHIV produced 2.2 to 3.3 N/kg less force than adults without known HIV, with greater deficits observed among those living with HIV for more than 20 years. Women and older adults also demonstrated lower IMTP performance. Collectively, these findings support the IMTP as a reliable, valid, and clinically meaningful measure of total-body muscle performance across healthy and clinical populations. Future research will explore its application for monitoring performance and intervention outcomes in two other more clinical populations: adults with cardio-kidney metabolic disease and children with Down syndrome. Key words: strength outcome measure, validation, total body muscle performance, chronic disease
