Changes In Grip Strength Research Articles

Lifelong voluntary aerobic exercise-mediated preservation of physical function is related to changes in the plasma metabolome in aged mice

Declines in physical function with aging (i.e., grip strength, endurance, and coordination) are strongly linked to age-related diseases, and the plasma metabolome can predict the progression of healthy aging. A single bout of aerobic exercise induces changes in plasma metabolites that are implicated in healthy aging and lifespan (e.g., tRNA biosynthesis is required for protein synthesis; arginine biosynthesis contributes to nitric oxide production and skeletal muscle function; TCA cycle metabolites aid in cellular energy production). Moreover, lifelong voluntary aerobic exercise (VAE) preserves physical function with aging, but its relation to the plasma metabolome is unknown. Hypothesis: Lifelong VAE-mediated preservation of physical function is related to changes in the plasma metabolome. Design: We performed a secondary analysis of data from a lifelong study in male C57BL/6 mice, in which mice that engaged in voluntary wheel running (model of VAE; initiated at 3 mo) were compared to sedentary age-matched controls (SED) (n=8-9/group). Grip strength, endurance, and coordination were assessed at 6 and 18 mo. The plasma metabolome was measured at 19 mo by mass spectrometry. Group differences in metabolites were identified using independent t-tests (p<0.05) following a Shapiro-Wilk test of normality. Then, KEGG pathway analyses (Metaboanalyst) were used to identify metabolic pathways changed with VAE (p<0.05; false discovery rate<0.20). Finally, simple linear regressions were used to assess the relation between the magnitude of change in grip strength, endurance, and coordination from 6 to 18 mo and plasma metabolite concentrations (all p<0.05). Results: At 19 mo, VAE mice ran 3.2±0.1 km/day (mean±SE). Physical function was preserved from 6 to 18 mo (% decline) with VAE vs SED: grip strength, 0.4±1.7% vs 12±4.0% (p<0.05); endurance, 1±15% vs 61±5% (p<0.05); coordination, 10±4% vs 73±10% (p<0.05). Group-related differences in plasma metabolites were identified at 19 mo: 23 single metabolites (p<0.05) and 7 metabolic pathways. The top altered metabolic pathways are implicated in healthy aging (e.g., tRNA and arginine biosynthesis) and exercise metabolism (e.g., TCA cycle). Metabolomic differences in the VAE mice were associated with preservation of physical function: spermidine and DHA omega-3 fatty acid correlated with the change in grip strength, spermidine and L-ornithine correlated with the change in endurance, and 9 metabolites (e.g., citrate and spermidine) correlated with the change in coordination. Conclusions: We show associations between the preservation of physical function with lifelong VAE and plasma metabolite abundance. Plasma metabolomic differences in aged mice following lifelong VAE are consistent with observations of corresponding changes in response to acute exercise in young endurance trained adults. Changes in the plasma metabolome reflect preserved physical function with lifelong VAE. NIH T32 DK007135, R01 HL107120, K99 HL159241 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Changes of improvement in upper limb function predict surgical outcome after laminoplasty in 1 year in patients with cervical spondylotic myelopathy: a retrospective study

BackgroundCervical spondylotic myelopathy preoperative prognostic factors include age, preoperative severity, and disease duration. However, there are no reports on the relationship between changes in physical function during hospitalization and postoperative course, and in recent years, the length of hospital stay has shortened. We aimed to investigate whether changes in physical function during hospitalization can predict the postoperative outcome.MethodsWe recruited 104 patients who underwent laminoplasty for cervical spondylotic myelopathy by the same surgeon. Physical functions, including Simple Test for Evaluating Hand Function (STEF), grip strength, timed up and go test, 10-m walk, and time to stand on one leg, were assessed at admission and discharge. Patients with the Japanese Orthopaedic Association (JOA) score improvement rate of 50% or more were defined as the improved group. Decision tree analysis was investigated factor for identifying improvement in the JOA score. According to this analysis, we divided into two groups using age. Then, we conducted a logistic regression analysis to identify factors that improve the JOA score.ResultsThe improved and non-improved groups had 31 and 73 patients, respectively. The improved group was younger (p = 0.003) and had better improved Δgrip strength (p = 0.001) and ΔSTEF (p < .0007). Age was significantly positively correlated with disease duration (r = 0.4881, p = < .001). Disease duration exhibited a significant negative correlation with the JOA score improvement rate (r = − 0.2127, p = 0.031). Based on the decision tree analysis results, age was the first branching variable, with 15% of patients ≥ 67 years showing JOA score improvement. This was followed by ΔSTEF as the second branching factor. ΔSTEF was selected as the factor associated with JOA improvement in patients ≥67 years (odds ratio (OR) 1.06, 95% confidence interval (CI) 1.01–1.12, p=.0268); in patients <67 years, Δgrip strength was identified (OR 1.30, CI 1.04‒1.62, p=.0049).ConclusionsIn the improved group, upper limb function improved more than lower limb function from the early postoperative period. Upper limb function changes during hospitalization were associated with outcomes one year postoperatively. Improvement factors in upper extremity function differed by age, with changes in grip strength in patients < 67 years and STEF in patients ≥ 67 years, reflecting the outcome at one year postoperatively.

Efficacy and Safety of 6-Month High Dietary Protein Intake in Hospitalized Adults Aged 75 or Older at Nutritional Risk: An Exploratory, Randomized, Controlled Study

The aim of this study was to investigate the effects of increased dietary protein in daily-life settings in Japan for 6 months on the activities of daily living (ADL) in adults aged 75 or older at nutritional risk. The study was an open-label, exploratory, randomized controlled trial conducted at seven hospitals in Japan. The study participants were adults aged 75 or older who were hospitalized for treatable cancer, pneumonia, fractures, and/or urinary-tract infection at nutritional risk. The primary outcome was change in grip strength, skeletal muscle, and ADL indices (Barthel index, Lawton score). One hundred sixty-nine patients were randomly assigned to the intensive care (IC) or standard care (SC) group; the protein intake goals (g/kgw/day) were 1.5 for IC and 1.0 for SC. There was a significant improvement in grip strength only in the IC group (1.1 kg: 95% CI 0.1 to 2.1) (p = 0.02). While the skeletal muscle index and ADL indices were not significantly improved in either group, the improvement ratio tended to be greater in the IC group. There was no decrease in renal function in either group. Thus, intervention of increased dietary protein in daily-life settings for 6 months in adults aged 75 or older with treatable cancer, pneumonia, fractures, and/or urinary-tract infection and at nutritional risk may be effective in ameliorating loss of muscle strength.

Vitamin D Supplementation and Muscle Power, Strength and Physical Performance in Older Adults: A Randomized Controlled Trial

BackgroundLow 25-hydroxyvitamin D (25[OH]D) concentrations (<30 ng/mL [<50 nmol/L]) have been associated with muscle weakness and impaired physical performance in observational studies. However, the effect of vitamin D supplementation on changes in muscle strength and physical performance in randomized controlled trials has been mixed. ObjectivesTo determine the effect of daily vitamin D supplementation on leg power, strength, and physical performance in low-functioning older adults with 25(OH)D concentrations of 18 to <30 ng/mL. MethodsIn this double-blind, randomized controlled trial, 136 low-functioning [Short Physical Performance Battery (SPPB) scores ≤10] adults aged 65–89 y with 25(OH)D concentrations of 18 to <30 ng/mL were randomly assigned to 2000 IU/d vitamin D3 or placebo for 12 mo. Lower-extremity leg power (primary outcome), leg and grip strength, SPPB, timed up and go (TUG), postural sway, and gait velocity and spatiotemporal parameters (secondary outcomes) were assessed at baseline, 4 and 12 mo. A subset (n = 37) also underwent a muscle biopsy at baseline and 4 mo and muscle fiber composition and contractile properties were assessed. ResultsParticipants’ mean ± SD age and SPPB scores at baseline were 73.4 ± 6.3 y and 7.8 ± 1.8, respectively. Mean ± SD 25(OH)D concentrations at baseline and 12 mo were 19.4 ± 4.2 ng/mL and 28.6 ± 6.7 ng/mL in the vitamin D group and 19.9 ± 4.9 ng/mL and 20.2 ± 5.0 ng/mL in the placebo group for a mean ± SE difference of 9.1 ± 1.1 ng/mL (P < 0.0001). However, there were no differences in change in leg power, leg or grip strength, SPPB score, TUG, postural sway, or gait velocity and spatiotemporal parameters by intervention group over 12 mo or muscle fiber composition and contractile properties over 4 mo. ConclusionsIn low-functioning older adults with 25(OH)D concentrations of 18 to <30 ng/mL, randomization to 2000 IU/d vitamin D3 did not result in improvements in leg power, strength, or physical performance or muscle fiber composition and contractile properties.This trial was registered at clinicaltrials.gov as NCT02015611.

Association of changes in grip strength with second digit length adjusted for fourth digit length in young children.

The factors involved in changes in grip strength (GS) during growth/development are not well known. Findings from cross-sectional studies have indicated that digit lengths are associated with physical fitness, including GS. This study aimed to investigate the association of changes in GS over 1 year and the second (2D) and fourth (4D) digit lengths in young children using the 4D as a covariate. One hundred and three young children (54 boys and 49 girls) performed maximum voluntary GS and ultrasound-measured forearm muscle thickness measurements in the right hand. All participants completed the first measurement and underwent a second measurement 1 year after the first one. The 2D and 4D were taken on the palmar surface of the outstretched right hand at the second measurement. The 2D was inversely associated with the change in GS (B = -2.1, p = 0.023) adjusted for all covariates. Girls had numerically lower adjusted changes in grip strength, although this was not statistically significant [-0.61 (-1.2, 0.02) kg]. When sex was removed from the model, the 2D remained inversely associated with the change in GS (B = -2.39, p = 0.011). Finally, when only adjusting for the 4D, the 2D was inversely associated with the change in GS (B = -3.07, p = 0.004). This study documented the association between changes in GS over 1 year and digit lengths in young children. The difference in children's digit length needs to be recognized as a factor involved in weak GS in children.

Scaphoid Bone Nonunions: Clinical and Functional Outcomes of Collagen/PGA Scaffolds and Cell-Based Therapy.

In this study, the procedure for treating the nonunion complication of scaphoid fractures using collagen/poly glycolic acid (CPGA) scaffolds with bone marrow mesenchymal stem cell (BM-MSC) therapy was adopted and compared with the commonly employed autologous bone tissue graft. With conducting a two-armed clinical trial, 10 patients with scaphoid nonunions were enrolled in this investigation. Patients were randomly assigned to two groups treated with (1) CPGA + cell therapy and (2) autologous iliac crest bone graft standard therapy. Treatment outcomes were evaluated three months after surgery, measuring the grip and pinch strengths and wrist range of motion, with two questionnaires: Patient-Rated Wrist Evaluation (PRWE) and Quick form of Disabilities of the Arm, Shoulder, and Hand (QDASH). We have also assessed the union rate using clinical and radiologic healing criteria one and three months post-operatively. Restorative effects of CPGA + cell therapy were similar to those of the autologous bone graft standard therapy, except for the grip strength (P = 0.048) and QDASH score (P = 0.044) changes, which were higher in the CPGA + cell therapy group. Three months following the surgery, radiographic images and computed tomography (CT) scans also demonstrated that the scaphoid union rate in the test group was comparable to that of scaphoids treated with the standard autograft method. Our findings demonstrate that the CPGA + cell therapy is a potential alternative for bone grafting in the treatment of bone nonunions.

Reliability and validity of the K-force grip dynamometer in healthy subjects: do we need to assess it three times?

Digital dynamometers to assess grip strength are becoming more common in research and clinical settings. The aim of the study was to assess validity and reliability of the K-force dynamometer compared to the Jamar dynamometer. We also aimed to assess differences over the course of three measurements. Twenty-seven healthy participants were included. Three trials with the K-force and Jamar dynamometers were completed. Testing order was randomised. Intraclass correlation coefficients (ICCs) with absolute agreement assessed reliability and validity. Standard error of the measurement (SEM) and minimal detectable change (MDC95) were calculated. Concurrent validity was assessed using Pearson's correlations and ICCs. Differences between the three repetitions were assessed using one-way repeated measures ANOVAs. Both the K-force and the Jamar presented excellent intra-rater reliability with ICCs ranging from 0.96 to 0.97. The SEM ranged from 1.7 to 2kg and the MDC from 4.7 to 5.7kg for both dynamometers. The concurrent validity of the K-force was high (r ≥ 0.89). However, the K-force underestimated the grip strength by 4.5-8.5kg. There was no change in grip strength with either dynamometer over the course of three trials. The K-force is reliable, but it underestimates grip strength by 4.5-8.5kg compared to the Jamar dynamometer. K-force can be used to monitor progress over time but cannot be used to compare results against normative data. The use of a single measurement when assessing grip strength is sufficient when assessing healthy subjects.

Annual changes in grip strength and skeletal muscle mass in chronic liver disease: observational study

Sarcopenia is a common complication in patients with chronic liver disease (CLD); however, the progression of sarcopenia over the course of CLD is unclear. The present study therefore determined the natural course of the progression of sarcopenia in patients with CLD and the effect of liver cirrhosis (LC) on this progression. This observational study analyzed patients with chronic hepatitis (CH) (n = 536) and LC (n = 320) who underwent evaluations of the grip strength and skeletal muscle mass of the arms, trunk, and legs for sarcopenia between 2016 and 2021. A bioelectrical impedance analysis was used to evaluate skeletal muscle mass. The annual rate of change (%/year) in two tests were compared between patients with CH and LC. The annual rates of change in grip strength and skeletal muscle of arms, trunk, and legs of patients with CH and LC were − 0.84% vs. − 2.93%, − 0.54% vs. − 1.71%, − 0.43% vs. − 1.02%, and − 0.76% vs. − 1.70% for men and − 0.12% vs. − 1.71%, − 0.66% vs. − 1.71%, − 0.49% vs. − 1.31%, and − 0.76% vs. − 1.54% for women, respectively. The progression of sarcopenia was greater in LC patients than in CH patients and that the decrease in grip strength was most prominent in the progression of sarcopenia in patients with LC.

A Systematic Review of Testosterone Therapy in Men With Spinal Cord Injury or Traumatic Brain Injury.

Spinal cord injuries (SCI) and traumatic brain injuries (TBI) increase the risk of testosterone deficiency and result in adverse changes in body composition and poor functional outcomes. The current systematic review aims to provide insights into the use of testosterone therapy for treating men with SCI and TBI. The PubMed and EMBASE databases were systematically reviewed using appropriate terms, and resulting manuscripts were screened using defined Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The patient population included male patients with SCI or TBI. Further inclusion criteria were: a) human participants 18 years of age or older; b) manuscript published in English; c) study included an intervention with exogenous testosterone; and d) articles published in peer-reviewed journals with full text available. Two reviewers independently extracted data regarding injury type, intervention, and outcomes. Following screening for inclusion/exclusion criteria, a total of 12 primary research studies conducted over the last 30 years were included. Men with SCI were investigated in 11 articles. The combination of testosterone patches and resistance training with functional electrical stimulation (FES) for 16 weeks in men with SCI and an average baseline testosterone level above the cutoff for testosterone deficiency increased muscle mass, strength, bone quality, and basal metabolic ratewhile testosterone patches without exercise for 16 weeks produced no significant changes in these parameters. Testosterone patches for 12 months in men with SCI and testosterone deficiency also increased lean tissue mass (LTM) and resting energy expenditure (REE). In one study, men with TBI and testosterone deficiency receiving testosterone gel for eight weeks showed a non-statistically significant greater absolute change in functional independence measure (FIM) and grip strength compared to a placebo group. Testosterone therapy with exercise may help improve muscle mass, bone health, strength, energy expenditure, and cardiac health in men with SCI without major side effects. It is difficult to draw conclusions regarding the effects of testosterone therapy in men with TBI based on the limited available evidence. Further investigation is warranted to explore the relationship between testosterone therapy and recovery after SCI and TBI.

The Effects of Yoga Exercise on Blood Pressure and Hand Grip Strength in Chronic Stroke Patients: A Pilot Controlled Study.

We investigated the beneficial effect of add-on yoga with rehabilitation on blood pressure (BP) and hand grip strength in patients with chronic stroke (more than 90 days). The study included patients 30-80 years of age who could stand independently for 1 min. Patients with psychiatric diseases or undergoing other therapies (like acupuncture) were excluded. The yoga group received training (1 h session twice weekly) with standard rehabilitation for 8 weeks. The control group received standard rehabilitation only. There were no differences in age, gender, hand grip strength, or BP between the two groups (16 subjects in each group) at baseline. The systolic BP (p = 0.01) decreased significantly, and the diastolic BP also decreased but not significantly in the yoga group (p = 0.11). For hand grip strength, both the unaffected hand (p = 0.00025) and the affected hand (p = 0.027) improved significantly. The control group showed no significant change in systolic or diastolic BP, nor did the grip strength change in both hands. Gender and age also affected the results of overall rehabilitation in that women benefited more from a decrease in BP, while men and young people (lower than the mean age of 60) benefited from hand grip strength improvement. Combining yoga with rehabilitation in chronic stroke patients can improve hand grip strength and decrease systolic BP.

PS-BPC06-8: FACTORS ASSOCIATED WITH POTENTIAL COGNITIVE FUNCTIONAL CHANGES IN OLDER PATIENTS WITH HYPERTENSION

Objective: There are many cases of potentially impaired cognitive function in older patients with hypertension. Therefore, we investigated factors associated with one-year changes in cognitive function in older hypertensive patients during outpatient visits. Design and method: We included 223 hypertensive patients (age 76.3 ± 6.3 years, 106 males) aged 65 years or older who attended outpatient hypertension clinics at six specialized institutions nationwide and had no prior diagnosis of dementia. We obtained the mini-mental state examination (MMSE) from all participants. We defined the impaired cognitive function as an MMSE score of 27 or less. At baseline and one year later, the participants were evaluated for comprehensive geriatric assessment, including MMSE, and muscle strength, with the converted group defined as having new cognitive decline at one year and the reverted group as having cognitive improvement one year after the cognitive decline. All participants gave informed consent, and our institutional review board approved the study protocol. Results: At baseline, 81 of 223 elderly hypertensive patients had impaired cognitive function. At one-year follow-up, 40 of 142 patients in the maintained cognitive function group were classified as converted, and 33 of 81 patients in the impaired cognitive function group were classified as converted. The converted group was older than the cognitively intact group (76.8 vs. 73.9 years, p &lt; 0.05), had higher home blood pressure, and had more significant grip strength loss over the year. Multivariate analysis identified age (odds ratio 1.1, 95% CI 1.0–1.2) and change in grip strength (odds ratio 0.84, 95% CI 0.72–0.99) as factors associated with the converted group. The reverted group was younger, had a higher percentage of males, and had weaker grip strength than the group with persistent cognitive decline. In multivariate analysis, grip strength (odds ratio 0.80, 95%CI 0.68–0.94) was extracted as a factor associated with the revert group. Conclusions: Potential cognitive decline was observed in 36% of older patients with hypertension. Furthermore, we examined a high rate of cases of cognitive function change over one year. Age and grip strength decline was considered responsible for cognitive conversion and baseline grip strength for revert, respectively.

Exercise intervention during chemotherapy for pancreatic cancer: Changes in body composition and function

AbstractBackgroundPatients with pancreatic cancer often lose weight during chemotherapy with associated changes in body composition. The goal of the present analysis was to describe changes in body composition in pancreatic cancer patients on an exercise regimen. The long‐term goal is to determine whether an exercise intervention may attenuate changes in body composition and function.MethodsTwenty‐two pancreatic cancer patients of all stages who were to receive chemotherapy were recruited into a pre‐post exercise intervention study. A standard exercise prescription was individualized to include aerobic, resistance, stretch, and balance exercises. Pre‐ and post‐intervention computed tomography‐derived measures of body composition [skeletal muscle index (SMI), skeletal muscle density, visceral fat area, and subcutaneous fat area] and physical function measures (grip strength, timed up and go, 30‐s chair stand, and tandem balance stand) were evaluated using paired t‐tests, χ2 tests, and Pearson correlation coefficients.ResultsThe subjects were, on average, 62 years of age, 55% were female, 95% non‐Hispanic White, and 45% were Stage IV. Body composition changes included a median 4.6% decrease in SMI (P = 0.04), 7.91% increase in skeletal muscle density (P = 0.05), 25.07% decrease in visceral fat area (P = 0.0001), and 22.08% decrease in subcutaneous fat area (P = 0.001). Adherence to aerobic and strength exercise was 65% and 57%, respectively. Some physical function measures improved, though not significantly: chair stands increased from a mean of 11.5 to 13.0 (P = 0.59) and timed up and go improved from a mean of 11.7 to 10.3 (P = 0.26). Change in right hand grip strength was marginally positively associated with changes in SMI (r = 0.53, P = 0.06). Improvements in skeletal muscle density were seen in 63% of patients, including Stage IV patients but did not correlate with change in function.ConclusionsExercise is feasible during neoadjuvant chemotherapy for pancreatic cancer patients of all stages and may assist with maintaining physical function and improving body composition. Further research is needed.

Minimum Detectable Change in Toe Grip Strength of Patients with Femoral Neck Fracture

[Purpose] The purpose of this study was to clarify whether there is a difference between operative and non-operative side toe grip strength of patients with femoral neck fractures, and to examine the reliability and the minimum detectable change (MDC) in toe grip strength measurements. [Participants and Methods] Twenty patients with femoral neck fractures had their toe grip strength measured, and the results were analyzed. [Results] There was no significant difference between the operative and non-operative side toe grip strength. Bland Altman analysis revealed no systematic error. The MDC was 2.1 kg on the operative side and 1.3 kg on the non-operative side. [Conclusion] If the change in toe grip strength of patients after femoral neck fracture surgery is less than 2.1 kg on the operative side and 1.3 kg on the non-operative side, it may be due to a measurement error.

Patient Satisfaction with Pisiform Excision for Pisotriquetral Instability or Arthritis: A Prospective Review.

Background Pisotriquetral pain and instability is an elusive cause of ulnar-sided wrist pain. Initial treatment of chronic pisotriquetral pathology should involve a trial of nonoperative therapy such as neutral wrist splint, anti-inflammatories, and intra-articular steroid injections. The mainstay of surgical management of pisotriquetral pain is pisiform excision. Purpose This prospective study seeks to understand patient satisfaction after pisiform excision in patients with isolated pisotriquetral pathology. Patients and Methods A consecutive series of nine cases of pisiform excision was performed by the senior surgeon. The primary outcome measure was determined a priori to be the Patient-Rated Wrist Evaluation (PRWE) score. Wrist range of motion, grip strength, and QuickDASH (shortened version of Disabilities of the Arm, Shoulder and Hand) scores were also collected preoperatively and at 3 and 12 months postoperatively as secondary outcome measures. Results There was a very rapid improvement in the PRWE by 3 months, which was maintained at 12 months. The QuickDASH score was slower to improve, with a significant improvement by 12 months. There was no change in grip strength or wrist range of motion at any time point. Conclusion Pisiform excision results in a very rapid improvement of symptoms and should be considered in cases of pisotriquetral instability or arthritis that fail conservative management. Level of Evidence Level IV, case series.

PLASMA PROTEOMIC SIGNATURE OF DECLINE IN GAIT SPEED AND GRIP STRENGTH

Abstract Physical function predicts health-related quality of life. The biological mechanisms underlying declines in physical function with age remain unclear. We examined the plasma proteomic profile associated with longitudinal changes of physical functions measured by gait speed and grip strength in community-dwelling adults. We applied aptamer-based platform to assay 1,161 plasma proteins on 2,871 participants (60% women, aged 76 years) in Cardiovascular Health Study (CHS) in 1992/1993 and 1,550 participants (55% women, aged 54 years) in Framingham Offspring Study (FOS) in 1991-1995. Gait speed and grip strength were measured annually for 6 years in CHS and at cycles 7 (1998-2001) and 8 (2005-2008) in FOS. The associations of individual protein levels (log-transformed and standardized) with longitudinal changes of gait speed and grip strength in two populations were examined separately by linear mixed effect models. Meta-analyses were implemented using random effect models with a Bonferroni correction for multiple testing. We found that plasma levels of 18 and 12 proteins were associated with changes in gait speed and grip strength, respectively (Bonferroni-corrected p &amp;lt; .05). The proteins most strongly associated with gait speed decline were growth/differentiation factor 15 (GDF-15) (uncorrected Meta-analytic p = 1.60E-15), pleiotrophin (PTN) (1.29E-08), and metalloproteinase inhibitor 1 (TIMP-1) (2.02E-08). For grip strength decline, the strongest associations were for GDF-15 (1.39E-07), carbonic anhydrase III (6.60E-07), and TIMP-1 (3.21E-06). Several statistically significant proteins are involved in the alternative complement pathway, extracellular matrix remodeling or immune function. These novel proteomic biomarkers may inform our understanding of the pathophysiology of functional decline.

Feasibility and acceptability of novel functional electronic stimulated rehabilitation application for treatment in patients with cerebrovascular disorders: the FRAT study protocol

BackgroundThe prognosis of patients with cerebrovascular disorders is poor owing to their high residual rate of hemiplegia. Delayed withdrawal from synkinesis is a major cause of prolonged hemiplegia; however, effective rehabilitation has not been established. This single-arm, open-label study aims to evaluate the influence of a low-frequency treatment device on canceling synkinesis in patients with incomplete paralysis and cerebrovascular disorders.MethodsEligible participants will include patients aged 20 years or older with incomplete paralysis, defined as upper limb Brunnstrom stage (BRS) of 2–4, who are within 1 month of onset of a cerebrovascular disorder. Qualified patients will be assigned to the novel rehabilitation treatment with IVES+ for 4 weeks. The primary endpoint of the study is the change from baseline in the upper-limb Fugl-Meyer Assessment (FMA) 2 weeks after the start of treatment. The secondary endpoints are changes in the amount of Functional Independence Measure, changes in the amount of upper-limb BRS, and changes in the amount of Barthel Index (BI) compared to the pre-intervention value at weeks 2 and 4; changes in the upper-limb FMA scores at 1, 3, and 4 weeks; changes in grip strength compared to the pre-intervention values at 1, 2, 3, and 4 weeks; and changes in upper-limb strength (manual muscle test) compared to the pre-intervention values at 1, 2, 3, and 4 weeks.DiscussionThis study will explore the usefulness of IVES+ for recovery from motor paralysis in patients with cerebrovascular disorders.Trial registrationJapanese Clinical Registry, jRCTs052180226. Date of registration: February 1, 2022

Chronic Loneliness, Gender, and Trajectories of Change in Hand Grip Strength in OlderAdults.

This study examined whether exposure to chronic loneliness is associated with a persistent decline in hand grip strength among community-dwelling older adults in Korea, and this association varies by gender. This study analyzed data from 2,570 adults aged 65 or older collected over the course of 7 waves (12years) of the Korean Longitudinal Study of Ageing from 2006 to 2018 (1,403 women and 1,167 men). Exposure to chronic loneliness was assessed by the experience of loneliness over a period of years, and hand grip strength was measured by an objective diagnostic tool. Gender-stratified fixed effects models were estimated to determine whether the association between chronic loneliness and hand grip strength differs by gender while accounting for time-invariant individual heterogeneity. Chronic loneliness was associated with a persistent decline in hand grip strength in older adults over an extended period of time. Gender-specific analyses revealed that only men continued to experience a decline in hand grip strength up to the fifth and subsequent waves of exposure (b=-1.889). By contrast, for older women, a significant decrease in hand grip strength was observed only in the second wave of exposure (b=-0.690). These gendered trajectories were statistically significant. Chronic loneliness impairs the physical health of older adults in the long run. These physical health consequences of chronic loneliness were more pronounced among older men than older women. The study's findings inform the development of interventions that mitigate the adverse health consequences of chronic loneliness.

Manual therapy improves symptom severity and disability in patients with carpal tunnel syndrome

Aim: The aim of the study was to assess early outcomes of manual therapy in patients with carpal tunnel syndrome. Materials and methods: In this study, patients diagnosed with electrophysiologically confirmed carpal tunnel syndrome received manual therapy. The therapy was used in 41 individuals who received one session in line with IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists) standards per week for 5 weeks. Grip strength was assessed using a dynamometer, disability was assessed using the DASH (Disability of Arm, Shoulder and Hand) questionnaire, and the quality of life was assessed using VASEQ5D5L (Visual Analog Scale of the 5-level EQ-5D). Data was collected before the first treatment and one week after the last treatment. Results: We observed significant change in DASH score and quality of life. Grip strength tended to improve, but the effect was statistically significant only in patients over 50 years of age. Symptom severity (Carpal Tunnel 6 score, Douleur Neuropathique 4 score and peripheral cutaneous threshold assessed with Semmes–Weinstein monofilament) improved significantly. There was no significant correlation between changes in DASH score and grip strength. Conclusion: Manual therapy significantly improves quality of life and reduces upper limb disability in patients with carpal tunnel syndrome.

Walking Speed Is Better Than Hand Grip Strength as an Indicator of Early Decline in Physical Function with Age in Japanese Women Over 65: A Longitudinal Analysis of the Tanno-Sobetsu Study Using Linear Mixed-Effects Models

The decline in physical function with age is a major contributor to the need for long-term care. Age-related changes in hand grip strength, knee extension, and walking speed have been reported in cross-sectional studies, but longitudinal data are needed. This longitudinal study measured changes in these three measures among community-dwelling adults aged 65-89 years who participated in general health examinations between 2017 and 2019. Analyses were stratified by sex. Linear mixed-effects models adjusted for confounding factors were used to examine the interaction of different patterns of change with age of the three measures. A total of 284 participants were included in the analysis. The interaction term of age × walking speed, with age × handgrip strength as the reference, was statistically significant in women and showed different patterns in walking speed and hand grip strength. In men, none of the age × physical function interaction terms were significant in any model. For early recognition of the onset of physical function decline in older adults, any of the three measures may be used in men, but walking speed may be more suitable than hand grip strength in women. These findings may be useful in devising sex-specific screening strategies.

Grip strength is inversely associated with DNA methylation age acceleration.

There is a large body of evidence linking muscular weakness, as determined by low grip strength, to a host of negative ageing-related health outcomes. Given these links, grip strength has been labelled a 'biomarker of aging'; and yet, the pathways connecting grip strength to negative health consequences are unclear. The objective of this study was to determine whether grip strength was associated with measures of DNA methylation (DNAm) age acceleration. Middle age and older adults from the 2006 to 2008 waves of the Health and Retirement Study with 8-10years of follow-up were included. Cross-sectional and longitudinal regression modelling was performed to examine the association between normalized grip strength (NGS) and three measures of DNAm age acceleration, adjusting for cell composition, sociodemographic variables and smoking. Longitudinal modelling was also completed to examine the association between change in absolute grip strength and DNAm age acceleration. The three DNAm clocks used for estimating age acceleration include the established DunedinPoAm, PhenoAge and GrimAge clocks. There was a robust and independent cross-sectional association between NGS and DNAm age acceleration for men using the DunedinPoAm (β: -0.36; P<0.001), PhenoAge (β: -8.27; P=0.01) and GrimAge (β: -4.56; P=0.01) clocks and for women using the DunedinPoAm (β: -0.36; P<0.001) and GrimAge (β: -4.46; P=0.01) clocks. There was also an independent longitudinal association between baseline NGS and DNAm age acceleration for men (β: -0.26; P<0.001) and women (β: -0.36; P<0.001) using the DunedinPoAm clock and for women only using the PhenoAge (β: -8.20; P<0.001) and GrimAge (β: -5.91; P<0.001) clocks. Longitudinal modelling revealed a robust association between change in grip strength from wave 1 to wave 3 was independently associated with PhenoAgeAA (β: -0.13; 95% CI: -0.23, -0.03) and GrimAgeAA (β: -0.07; 95% CI: -0.14, -0.01) in men only (both P<0.05). Our findings provide some initial evidence of age acceleration among men and women with lower NGS and loss of strength over time. Future research is needed to understand the extent to which DNAm age mediates the association between grip strength and chronic disease, disability and mortality.