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SHORT RESEARCH REPORT

THE SEATED MEDICINE BALL THROW AS A TEST OF


UPPER BODY POWER IN OLDER ADULTS
CHAD HARRIS,1 ANDREW P. WATTLES,2 MARK DEBELISO,3 PATRICIA G. SEVENE-ADAMS,3
JOSEPH M. BERNING,4 AND KENT J. ADAMS3
1
School of Allied Health, Exercise Science Laboratory, Western New Mexico University, Silver City, New Mexico; 2Kinesiology
Department, Boise State University, Boise, Idaho; 3Kinesiology Department, California State University Monterey Bay, Seaside,
California; and 4Department of Human Performance, Dance and Recreation, New Mexico State University, Las Cruces, New Mexico

ABSTRACT INTRODUCTION

M
Harris, C, Wattles, AP, DeBeliso, M, Sevene-Adams, PG, uch of the literature addressing physical
Berning, JM, and Adams, KJ. The seated medicine ball throw as a attributes central to the functional ability of
test of upper body power in older adults. J Strength Cond Res older adults has been concerned with muscular
25(8): 2344–2348, 2011—Practitioners training the older adult strength levels (3,4). However, muscular
power, in both the upper body and lower body, may be
may benefit from a low-cost, easy-to-administer field test of upper
more important for some functional tasks facing older adults
body power. This study evaluated validity and reliability of the
such as lifting a load, correcting balance after a trip, opening
seated medicine ball throw (SMBT) in older adults. Subjects (n =
a door, and rising from a chair. Maintenance of muscular
33; age 72.4 6 5.2 years) completed 6 trials of an SMBT in each power may also be critical for sustaining independence later
of 2 testing days and 2 ball masses (1.5 and 3.0 kg). Subjects in life. Unfortunately, sarcopenia accompanies aging and
also completed 6 trials of an explosive push-up (EPU) on a force along with the loss in muscle size and strength (7,9,10) is
plate over 2 testing days. Validity was assessed via a Pearson a corresponding decline in muscle power in both the upper
Product–Moment correlation (PPM) between SMBT and EPU and lower extremities (5). This is troublesome because
maximal vertical force. Reliability of the SMBT was determined muscular power production is a predictor of all-cause
using PPMs (r), Intraclass correlation (ICC, R) and Bland–Altman mortality and may be a better indicator than strength of
plots (BAPs). For validity, the association between the SMBT and functional ability and independence (8,9,16).
the EPU revealed a PPM of r = 0.641 and r = 0.614 for the Despite the importance of muscular power, its assessment
1.5- and 3.0-kg medicine balls, respectively. Test–retest reliability is sometimes limited as measurement equipment can be
expensive, and complex and few field tests exist for the
of the 1.5- and 3.0-kg SMBT was r = 0.967 and r = 0.958,
assessment of power in the older adult population (6,12,17).
respectively. The ICC values of the 1.5- and 3.0-kg SMBT were
Recently, however, a safe, low-cost field test of lower body
R = 0.994 and 0.989, respectively. The BAPs revealed 94% of
power was validated (18). This timed test requires subjects to
the differences between day 1 and 2 scores were within the 95% climb up a ramp a vertical distance of 33 cm and a horizontal
confidence interval of the mean difference. Test–retest reliability distance of 3.79 m. This test was practical in nature because it
for the EPU was r = 0.944, R = 0.969. The BAPs showed 94% of involved lower body movements and muscle groups that are
the differences between day 1 and 2 scores were within the 95% similar to those used in normal daily activities.
confidence interval of the mean difference, for both medicine ball Although lower body strength and power often receive the
throws. In conclusion, for the older adult, the SMBT appears to be most attention relative to their relationship with functional
highly reliable test of upper body power. Its validity relative to the independence, the importance of upper body strength and
maximal force exerted during the EPU is modest. The SMBT is an power cannot be ignored, because many activities of daily living
inexpensive, safe, and repeatable measure of upper body power such as carrying groceries, taking out the trash, and lifting
for the older adult.
children are related to upper body strength and power (1,2).
A strong association between upper body power and lower
KEY WORDS aging, functional ability, reliability body power has been reported (14). However, a low-cost,
easy-to-administer field test of upper body power in the older
adult is needed because it has direct value for achieving an
Address correspondence to Dr. Chad Harris, harrisc@wnmu.edu. accurate, specific assessment of upper body function (1,2,6).
25(8)/2344–2348 Therefore, the purpose of this study was to evaluate the
Journal of Strength and Conditioning Research validity and reliability of the seated medicine ball throw
Ó 2011 National Strength and Conditioning Association (SMBT) as a measure of upper body power in older adults.
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Bland–Altman plots (BAPs).


Validity of the throws was de-
termined from PPM values
calculated between the medi-
cine ball throws and peak
vertical force recorded from
a modified EPU done off of
a floor mounted force plate.
Subjects
Thirty-three community dwell-
ing older adults (20 men,
13 women) with a mean age of
72.4 6 5.2 years completed this
study and were used for analysis.
All subjects were part of a senior
resistance training class, where
they performed resistance exer-
cises twice weekly. The resis-
tance training class initially
included 42 seniors who agreed
to participate in the study, but 9
Figure 1. Day 1 vs. day 2; 1.5-kg medicine ball throw.
of those subjects failed to com-
plete all testing sessions, thereby
METHODS resulting in the final 33 subjects used for analysis. Those who
failed to complete the study did not report any deleterious
Experimental Approach to the Problem effects of testing but missed follow-up testing because of travel
To assess the validity and test-retest reliability of the SMBT and other such training interruptions. All subjects obtained
in older adults, the modified explosive push-up (EPU) done physician approval for participation and institutional approval
off a floor mounted force plate was used as the criterion for the study was obtained from the Institutional Review Board
measure, and, similar to Davis et al. (6), the SMBT was used as for the Protection of Human Subjects in Research. Informed
the field test for validation. Subjects performed 3 trials of consent was obtained from all subjects before participation.
throws for each weight medicine ball (1.5 and 3.0 kg) on each
of 2 testing days. The variable of interest for the throws Procedures
was the horizontal distance achieved. Reliability measures During testing days, subjects performed either the SMBTs
were assessed using Pearson product-moment (PPM) or the EPUs after a 5-minute warm-up, which included
correlation coefficients, intraclass coefficients (ICCs) and walking or stationary cycling. No resistance training activity
was performed before testing
on any testing day.
For the SMBTs, subjects were
asked to sit on a chair placed
against a wall. A tape measure
was placed on the ground at the
front end of the subjects’ chair
and stretched out to a distance of
10 m. Subjects were instructed to
sit in the chair with their backs
against the chair back for support
and their feet flat on the ground.
To account for different arm
lengths of the subjects, they were
asked to sit in the chair and hold
the ball in both hands with their
arms extended away from their
Figure 2. Bland–Altman plot for 1.5-kg medicine ball throw. chests. They were then instructed
to drop the ball straight down on

VOLUME 25 | NUMBER 8 | AUGUST 2011 | 2345

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Medicine Ball Throw in Older Adults

a basketball chest pass. The spot


where the front end of the ball hit
the measuring tape was recorded.
Subjects performed 3 trials with
the 1.5-kg ball, with a 90-second
rest between trials. Subjects then
repeated the procedure for 3 trials
using the 3.0-kg ball. A 3-minute
rest occurred between throws
with the different ball weights.
The mean score was used for
analysis. This procedure was re-
peated again 72 hours later. All
medicine ball trials were con-
ducted at the same time of the
day. However, nutrition and hy-
dration status was not controlled.
Modified EPUs were per-
formed 48 hours after the last
seated medicine ball trials. The
modified EPU testing was con-
Figure 3. Day 1 vs. day 2; 3.0-kg medicine ball throw. ducted on a Kistler Force Plate,
type 9281C. Data from the force
plate were collected at a fre-
to the tape measure. The tape was adjusted so that this point was quency of 1,250 Hz. Subjects were instructed to begin the
the zero mark. Three practice trials were then provided at which modified push-up in the down position with both hands on the
time they were instructed to push the ball away from the center force plate and elbows flexed to 90° and knees on the ground. A
of their chest as far as possible, using a motion similar to small cardboard box (10 cm high) was placed on the force plate
a basketball chest pass. The proper angle of release to achieve under each subjects’ chest to standardize starting position. On
maximum distance was also discussed, as instruction was shown command, subjects were instructed to forcefully push up and
as useful in a previous investigation (11). A 3-minute rest was explode off of the force plate with a maximal effort. This
given between the practices and actual throws. movement was similar to the movement subjects used during
Next, for the actual test, subjects grasped the medicine ball and the seated medicine ball toss. Subjects were required to perform
were instructed to forcefully push the ball away from the center of 3 maximal effort modified EPUs. Standardized instructions and
their chest as far as possible, again using a motion similar to encouragement were given throughout the trials, and a spotter
was used to ensure subjects’
safety. Practice trials and rest
periods were the same as with
the medicine ball throws, and all
testing was conducted at the
same time of day. Again, the
mean score was used for analy-
sis, and 72 hours was provided
between the initial and retest
conditions. From the positive
portion of the force–time curve,
peak vertical force (Fz) was
obtained. Peak force (N) was
simply the highest Z force value
on the force–time curve.

Statistical Analyses
Validity of the SMBT was
Figure 4. Bland–Altman plot for 3.0-kg medicine ball throw. assessed via a the PPM co-
efficient between medicine ball
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coefficient was R = 0.994. The


SEM for the ICC was 19.1 cm.
The BAPs revealed 94% of the
differences between day 1 and
2 scores were within the 95%
confidence interval of the mean
difference. Scatterplots of day 1
and 2 results and BAPs can be
seen in Figures 1 and 2.

Reliability of 3.0-kg Seated


Medicine Ball Throw
Test–retest reliability value for
the 3.0-kg medicine ball throw
from the PPM correlation co-
efficient was r = 0.958. The
reliability of the test from the
ICC coefficient was R = 0.989.
The SEM for the ICC was 14.8
cm BAP revealed 94% of the
mean differences for day 1 and
Figure 5. Day 1 vs. day 2; explosive push-up.
2 fell within the 95% confidence
interval of the mean difference.
Scatterplots of day 1 and 2
results and BAPs can be seen in
Figures 3 and 4.

Reliability of Maximal Vertical


Force (Fz ) of Modified
Explosive Push-Up
For the maximal Fz reliability
from the explosive modified
push-up, the PPM correlation
coefficient value was r = 0.944
and the ICC coefficient value
was R = 0.969. The SEM for
the ICC was 42.7 N. The BAPs
revealed 94% of the differences
between day 1 and 2 scores
were within the 95% confi-
dence interval of the mean
Figure 6. Bland–Altman plot for explosive push-up. difference. Scatterplots of day
1 and 2 results and BAPs can be
seen in Figures 5 and 6.
throws and the maximal Fz values from the EPUs. Reliability Validity of Seated Medicine Ball Throw
of the SMBT was determined using PPMs, ICCs, and BAPs Validity of the medicine ball throw was determined by
between the repeated trials. A priori statistical power was 0.8 correlating the throwing distances with the peak Fz from the
with a sample size of 30. This study had 33 participants at the modified EPU. The PPM correlation coefficient for the 1.5-kg
completion of the study. medicine ball throw was r = 0.641 and the PPM correlation
coefficient was r = 0.614 for the 3.0-kg medicine ball throw.
RESULTS
Reliability of 1.5-kg Seated Medicine Ball Throw DISCUSSION
Test–retest reliability for the 1.5-kg medicine ball throw as The purpose of this study was to evaluate the validity and
determined from the PPM correlation coefficient value was reliability of the SMBT as a measure of upper body power in
r = 0.967. Reliability of the test as determined from the ICC older adults. Power incorporates both the force and velocity

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Medicine Ball Throw in Older Adults

of contraction, and to be able to throw a medicine ball from many older adults, subjects in this study displayed a wide
a seated position, the physical traits needed to be successful range of upper body strength. Because both medicine ball
include both muscular strength and power in the shoulder weights displayed similar validity and reliability, the practi-
flexors and elbow extensors. The movements in the medicine tioner can meet the needs of a diverse, older adult client base.
ball throw and the muscle groups employed are similar to This will enable the practitioner to better individualize their
those incorporated in activities of daily living such as rising strength and conditioning program to optimize outcomes for
from a chair, lifting loads, and pushing open doors. Thus, the the older adult.
content validity of the test appears to be reasonable.
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