Decreased Grip Strength Research Articles

Radiofrequency Ablation of Palmar Digital Branches of Ulnar Nerve in a Patient with Ulnar Neuropathy

Ulnar Tunnel Syndrome (UTS) is ulnar neuropathy at the wrist or hand typically caused by ganglion cysts, lipomas, wrist or hand compression, carpal bone fractures, carpal tunnel syndrome, or anything else that can impinge on the nerve. The symptoms of UTS can be uncomfortable and debilitating, with numbness and tingling of the 4th and 5th digits being the most common. Weakness of the ulnar portion of the hand can lead to decreased grip strength. UTS is typically managed with conservative treatment including anti-inflammatory oral medications, splinting, physical therapy, activity modification, acupuncture, and stretching. Second line treatment includes corticosteroid injections, although these have shown to have little efficacy. Surgery is also an option but may lead to iatrogenic ramifications. Radiofrequency ablation (RFA) is a treatment modality used for chronic pain, which utilizes heat to target nociceptive fibers. Traditionally, RFA is used in treating cervical and lumbar radiculopathy, but it is less studied in peripheral nerve areas. This case report examines a patient who had clinically significant pain relief after RFA to the palmar digital branches of the ulnar nerve. The patient was 63-year-old male who presented with left ulnar neuropathy that had been ongoing for 3 years. Despite conservative management, his symptoms of pain, paresthesia, and weakness persisted. The patient then elected to have a left cubital tunnel release at the elbow with anterior subcutaneous transposition. The surgery provided relief for three months but then led to worsening contractures and pain in the 4th and 5th digits of the left hand. Due to persistent symptoms after conservative management and surgical intervention, he was referred to interventional pain clinic. A decision was made to trial a digital nerve block of the left medial and lateral digital palmar nerves. Following the nerve block, the patient reported 100% improvement in pain and increased range of motion and function. Four weeks later, the patient returned for a radiofrequency ablation of the same nerves. In the week following the procedure, the patient reported that the pain in the little finger was entirely resolved. While radiofrequency ablation has become increasingly popular for the treatment of chronic back pain, its use in peripheral nerve pain has been limited to case reports and few randomized control trials. This case report highlights the successful use of radiofrequency ablation in the treatment of little finger pain and ulnar neuropathy by targeting the median and lateral branches of the palmar digital nerve.

CAN ACUTE MUSCLE DAMAGE LEAD TO OSTEOARTHRITIS?

Abstract Skeletal muscles are crucial for maintaining musculoskeletal homeostasis, as they provide mechanical support, joint stability, and biochemical functions via myokine secretion. We investigated whether acute muscle damage or weakness could contribute to the development of osteoarthritis (OA). Using a chemical damage model, we induced muscle damage by injecting 1.2% barium chloride into the tibialis anterior muscle, resulting in an immune response characterized by a significant increase in the concentration of Prostaglandin E2 (PGE2) and other lipid mediators derived from the EPA and DHA signaling pathways, as quantified using our innovative lipidomics methods. The muscle damage was confirmed and visualized by muscle histomorphometry. The damage resulted in muscle weakness, detected by a significant decrease in grip strength at 4-days post-injury, but without changes in mice activity measured with force-plate actimeter. After 1-month post-injury, grip strength and muscle histology returned to normal, but histological changes were observed in the articulating cartilage, indicating surface erosion and cartilage matrix loss (OARSI grade 4). We used Raman Spectroscopy and micro-CT to confirm the joint alterations observed in the changes in subchondral bone and increased bone volume fraction in the cortical shell of the subchondral bone, respectively, features characteristic of OA in rodents and humans. These findings suggest that muscle weakness or imbalance due to injury can contribute to joint degeneration. This study highlights the significance of muscles in preventing OA and provides a novel approach for exploring the relationship between muscle damage and OA development. This new model could prove valuable for aging research.

IDENTIFYING MARKERS OF NEURODEGENERATION FOR MOTORIC COGNITIVE RISK SYNDROME

Abstract Cognitive disorders, particularly dementia, are a major cause of disability in the elderly population. Gait disturbances, decreased grip strength and memory complaints are early signs of dementia that can occur well before the disease manifests. To better understand the close interactions between the physical and cognitive domains, the concept of Motoric Cognitive Risk Syndrome (MCRS) has been proposed. We had 25 older adults (10 cognitively unimpaired and 15 with MCRS) generate multiple force pulses at 15% of their maximum voluntary contraction with a fixed duration of 2 seconds for each pulse in which participants must rely on visual spatial abilities to gauge the amount force required in real-time to reach the criterion target. We also assessed neurofilament light chain levels also a blood-based marker of neuronal loss. Our results indicate the MCRS group demonstrated blood oxygenation level dependent (BOLD) hyperactivity in visual cortical/hippocampal regions, parahippocampal regions, and dorsolateral prefrontal cortex. The MCRS group also demonstrated BOLD hypoactivity in primarily involved with movement, such as cerebellar lobules, supplementary motor areas, middle frontal gyrus, and prefrontal cortex areas.be useful in tracking disease progression. We also found a significant strong positive correlation (0.83) between serum NFL levels and Right BOLD coefficients only for the CI group. This finding suggests that these motor task fMRI measures may be specific in tracking neurodegeneration in MCRS group. Overall, the current preliminary findings provide novel insights into the neurobiological mechanisms underlying early changes in Alzheimer’s disease and related dementias.

Validity of the diagnostic criteria from the Asian Working Group for Cachexia in advanced cancer.

Recently, the Asian Working Group for Cachexia (AWGC) published a consensus statement on diagnostic criteria for cachexia in Asians. We aimed to validate the criteria in adult patients in Japan with advanced cancer. We conducted a single-institution retrospective cohort study between April 2021 and October 2022. The AWGC criteria include chronic comorbidities and either a weight loss of >2% over 3-6months or a body mass index (BMI) of <21kg/m2 . In addition, any of the following items were required: anorexia as a subjective symptom, decreased grip strength as an objective measurement and an elevated C-reactive protein (CRP) level as a biomarker. We used the cut-off value of grip strength of 28/18kg for male/female individuals and CRP level of 5mg/L. Of the 449 consecutive patients, 85 of those who could not be evaluated because of end-of-life or refractory symptoms (n=41) or missing data (n=44) were excluded from the primary analysis. The prevalence of the AWGC-defined cachexia was 76% (n=277), and the median survival time (MST) for all patients was 215 (95% confidence interval [CI] 145-270) days. The prevalence of the following criteria was significantly higher in patients with cachexia than in those without cachexia: a BMI of <21kg/m2 (65% vs. 15%, P<0.001), a weight loss of >2% in 6months (87% vs. 14%, P<0.001), anorexia (75% vs. 47%, P<0.001), a grip strength of <28kg in male individuals (63% vs. 28%, P<0.001) and CRP level of >5mg/L (85% vs. 56%, P<0.001). Overall survival was significantly shorter in patients with cachexia than in those without cachexia (MST 157days, 95% CI 108-226days vs. MST 423days, 95% CI 245days to not available, P=0.0023). The Cox proportional hazards analysis showed that best supportive care (hazard ratio [HR] 2.91, P≤0.001), lung cancer (HR 1.67, P=0.0046), an Eastern Cooperative Oncology Group Performance Status score of ≥3 (HR 1.58, P=0.016), AWGC-defined cachexia (HR 1.56, P=0.015), an age of ≥70years (HR 1.53, P=0.0070), oedema (HR 1.31, P=0.022) and head/neck cancer (HR 0.44, P=0.023) were found to be the significant predictors for mortality. We demonstrated that AWGC-defined cachexia has a significant prognostic value in advanced cancer.

Deletion of transcription factor Satb1 leads to disturbance in mice behavior through changes in the expression of genes-regulators of the excitive component of neurotransmission

The transcription factor Satb1 exhibits widespread expression in multiple tissues and different regions of the brain. Notable levels of expression are observed in the neocortex, the nucleus of the diagonal band, the amygdala, and the tegmental area. In the ventral midbrain, Satb1-positive neurons are only found in a small portion of the substantia nigra, the ventral tegmental area, and the retrorubral field, and none were detected in the inferior colliculus. The transcription factor Satb1 is highly expressed in interneurons labeled as SST+, CR+, and NPY+, but not VIP+ interneurons. In mice with the Satb1 mutation, incomplete eye opening and a constriction reflex were observed. Behavioral tests revealed that mice lacking Satb1 exhibited deficits in motor coordination, characterized by reduced mobility on flat bars and decreased grip strength on metal wires. In addition, these mice exhibited elevated levels of motor activity in novel environments and heightened anxiety in the light-dark test. Satb1-deficient males demonstrated proficiency in passive avoidance tests, while their female counterparts exhibited no significant difference in entrance time to the dark compartment between the reproduction and learning stages, indicating an impairment in the process of conditioned response formation. To investigate the expression patterns of genes encoding vital protein kinases and proteins associated with neurotransmission, we extracted total RNA from the cerebral cortex of adult males with an incomplete deletion of Satb1. Real-time PCR analysis was conducted, which revealed a higher expression level of the pik3ca, pik3cb, and pic3cg genes responsible for phosphoinositide-3-kinase isoforms in Satb1-deficient mice compared to wild-type mice. The expression levels of genes encoding protein kinase C (Prkce and Prkcg) as well as Ca2+/calmodulin-dependent protein kinase II (Camk2) were lower in comparison to wild-type mice. Satb1-deficient mice displayed notably higher expression levels of genes encoding NMDA receptor subunits (Grin1, Grin2a, and Grin2b), whereas the expression of Gria1 (encoding the Glua2 subunit of AMPA receptors responsible for Ca2+ receptor conductance) decreased. The influence on excitatory glutamate receptor expression can cause hyperexcitability in animals, particularly when inhibitory neurotransmission is suppressed due to decreased Gabra1 and Gad65/67 expression encoding the GABA(A) receptor and glutamate decarboxylase. In addition, the levels of expression for the Calb1, Calb2, and Pvalb genes responsible for encoding the calcium-binding proteins calbindin, calretinin, and parvalbumin decreased in comparison to the wild-type mice. Thus, a correlation was found between behavioral disturbances and expression of genes that encode proteins related to brain development and neurotransmission after deleting the Satb1 transcription factor. Satb1-deleted mice exhibited hyperexcitation and impaired motor activity due to impaired gene expression.

Decreased muscle strength in adjuvant-induced rheumatoid arthritis animal model: A relationship to behavioural assessments

Rheumatoid arthritis (RA) is an autoimmune disorder with unknown aetiology. Patients suffering from RA face persistent pain due to joint inflammation, and tissue destruction. Behavioural phenotyping is an approach to target the role of different behavioural traits associated with disease progression. The study aimed to assess behavioural patterns associated with decreased muscle strength in the adjuvant-induced rheumatoid arthritis animal model. The study was conducted on male Albino Wister rats (n = 30) [Control, Vehicle, and Disease groups]. After taking ethical approvals RA was induced by complete Freund's adjuvant (CFA) intradermally base of tail. The weight of animals, macroscopic analysis of inflammatory signs, and arthritic scores were measured weekly. Grip strength, ganglia-based movement, cataleptic activity, and motor-coordination-related behaviours were assessed among the groups. Radiographs and spleen index assay were performed followed by data analysis using one-way and two-way ANOVA (Analysis of Variance). A significant decrease in weight and an increase in arthritic scores among the diseased group was observed. Behavioural analyses confirmed that diseased animals had significantly decreased grip strength and increased cataleptic activity with less motor coordination. Radiographic images and spleen index assay confirmed the pattern of RA. Therefore, it can be suggested that the development of the disease animal model is an effective approach to identifying the disease progression and associated behavioural changes. Moreover, this prepared laboratory animal model may be utilised for pathway analyses to understand the key role of immune regulators and genetic insight into molecular pathways associated with acute and chronic phases of RA.

Extensor Carpi Ulnaris “Turn Around” Ligamentoplasty For Distal Radioulnar Joint Instability

Extensor Carpi Ulnaris “Turn Around” Ligamentoplasty For Distal Radioulnar Joint Instability

Grip Strength is a Predictor for Subsyndromal Delirium Among Older Adults Following Joint Replacement.

Delirium is common in older patients during the postoperative period, increasing the number of adverse events, and grip strength is associated with delirium. Subsyndromal delirium (SSD) is a prostate of clinical delirium; nevertheless, the relationship between grip strength and SSD has not been elucidated. This study aimed to examine the association between grip strength and SSD in the elderly after arthroplasty. A total of 181 patients were recruited from two Chinese hospitals. SSD and delirium were evaluated before the surgery and the first week after surgery using the confusion assessment method. The Mini-mental State Examination was used to assess patients' cognitive function, and their grip strength was evaluated with an electronic hand dynamometer before surgery. Logistic regression and ROC curve analysis were conducted to determine the odds ratio and predictive value of grip strength for SSD. The incidence of SSD and postoperative delirium (POD) was 41.44% and 14.36% for the elderly following arthroplasty respectively, and approximately 1/3 of SSD progressed into POD. Older age, declined cognitive function, fall history, and lower grip strength were risk factors for SSD (P<0.05). The area under the ROC curve of grip strength was 0.863 and 0.900 for males and females respectively, and the cut-off point of it was determined to be 22.050 kg for men and 18.050 kg for women. SSD and POD are common among older people. Decreased grip strength, advanced age, lower cognitive function, and fall history were independent risk factors for SSD, and grip strength was a significant predictor for SSD in aged patients after the arthroplasty.

Factors Leading to a Decrease in Grip Strength Among the Oldest Old: A Large, Representative, Longitudinal Survey

ObjectivesGrip strength is an indicator for physical performance and highly correlated with general health among older adults. To date, there is limited knowledge regarding the factors contributing to grip strength exclusively among the oldest old based on data from large representative samples and also including institutionalized individuals. Consequently, the purpose of our current study was to address this gap in knowledge. DesignA large representative, longitudinal study. Setting and ParticipantsSurvey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+), including individuals ≥80 years (residing in institutionalized settings and living in private households) in North Rhine-Westphalia (n = 1824, mean age was 86.7 years, 80 to 104 years). MethodsIn accordance with other large cohort studies, isometric grip strength was measured using a dynamometer (Smedley Dynamometer, 100 kg). ResultsLinear fixed effects regressions showed that decreases in grip strength were significantly associated with increases in age (β = −0.70, P < .001), decreases in social network size (β = 0.08, P < .05), and worsening self-rated health (β = 0.80, P < .01). In contrast, decreases in grip strength were not significantly associated with changes in marital status, changes in living situation, changes in the number of chronic conditions, changes in depressive symptoms, and changes in health literacy. Conclusions and ImplicationsIt has been shown that age, social network size, and self-rated health were associated with grip strength among the oldest old longitudinally. Our current study may assist in identifying individuals at risk for low grip strength. For example, efforts to maintain social contacts may be beneficial to maintain grip strength. This is relevant because low grip strength contributes to unfavorable outcomes such as poor quality of life, functional impairment, cognitive decline, and reduced longevity.

Diagnosis and outcomes of cachexia in Asia: Working Consensus Report from the Asian Working Group for Cachexia.

Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three-round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (<28kg in men and <18kg in women), or elevated C-reactive protein levels (>5mg/L [0.5mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3-6month period and suggested a tentative cut-off value of 21kg/m2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ-5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient-reported outcomes. The AWGC consensus offers a comprehensive definition and user-friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co-morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.

Assessment of Scapholunate Instability on 4D CT Scans in Patients with Inconclusive Conventional Images.

Background Initial imaging work-up using radiography and CT arthrography sometimes can be insufficient to identify a scapholunate (SL) instability (SLI) in patients suspected of having SL ligament tears. Purpose To determine the diagnostic performance of four-dimensional (4D) CT in the identification of SLI and apply the findings to patients suspected of having SLI and with inconclusive findings on radiographs and CT arthrograms. Materials and Methods This prospective single-center study enrolled participants suspected of having SLI (recent trauma, dorsal pain, positive Watson test results, decreased grip strength) between March 2015 and March 2020. Participants with wrist fractures, substantial joint stiffness, or history of wrist surgery were excluded. Each participant underwent radiography, CT arthrography, and 4D CT on the same day. Participants were divided into three groups: those with no SLI, those with SLI, and those with inconclusive results. SL gap and radioscaphoid and lunocapitate angle were measured using semiautomatic quantitative analysis of 4D CT images by two independent readers. Receiver operating characteristic curves were used to evaluate the diagnostic performance of 4D CT. Thresholds were determined with the Youden index and were applied to the inconclusive group. Results Of the 150 included participants (mean age, 41 years ± 14 [SD]; 102 male, 48 female), there were 63 with no SLI, 48 with SLI, and 39 with inconclusive results. The maximum value and range of SL gap measurements on 4D CT scans showed high sensitivity (83% [40 of 48] and 90% [43 of 48], respectively) and high specificity (95% [59 of 62] and 81% [50 of 62], respectively) in the identification of SLI. At least one of these parameters was abnormal on 4D CT scans in 17 of 39 (44%) participants in the inconclusive group, and 10 of 17 (59%) participants had confirmed SLI. In the 22 participants in the inconclusive group with no indication of SLI at 4D CT, follow-up showed no evidence of SLI in 10 (45%) and enabled confirmation of SLI via arthroscopy in three (14%). Conclusion Scapholunate gap measurements on kinematic 4D CT scans enabled correct identification of SLI in 59% of participants with inconclusive results on conventional images. ClinicalTrials.gov registration no. NCT02401568 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Demehri and Ibad in this issue.

Associations of cardiometabolic multimorbidity with grip strength and gait speed among older Chinese adults

Objective: To investigate the associations of cardiometabolic multimorbidity (CMM) with grip strength and gait speed among older Chinese adults. Methods: This study included participants aged ≥60 years from the China Health and Retirement Longitudinal Survey during 2011-2015. Generalized estimating equation models were employed to estimate the associations of CMM with grip strength and gait speed. Results: A total of 6 357 participants were included to measure grip strength and 6 250 participants to measure gait speed. Compared with no cardiometabolic disease, participants with 1 (β=-0.018, 95%CI: -0.026--0.010), 2 (β=-0.029, 95%CI: -0.041- -0.018), and ≥3 (β=-0.050, 95%CI: -0.063- -0.037) cardiometabolic diseases were associated with a decreased grip strength. The associations between cardiometabolic disease counts (1: β=-0.052, 95%CI: -0.326-0.222; 2: β=-0.083, 95%CI: -0.506-0.340; ≥3: β=-0.186, 95%CI: -0.730-0.358) and gait speed were not statistically significant. The predictive value of gait speed of the participants with 0, 1, 2, and ≥3 cardiometabolic diseases were found to be 1.98 (95%CI: 1.38-2.58), 1.93 (95%CI: 1.34-2.51), 1.89 (95%CI: 1.18-2.61), and 1.79 (95%CI: 1.10-2.48) m/s respectively, which was clinically significant for the magnitude of the decrease. Cardiometabolic combinations with a higher risk of decreased grip strength and gait speed mainly seen in diabetes. Conclusions: Cardiometabolic disease counts and combinations were associated with grip strength and gait speed. Grip strength and gait speed can be used to measure CMM severity.

Clinical outcome of dorsal versus lateral plating in proximal phalangeal fracture: A retrospective study

Background: Plating of proximal phalangeal fracture is the commonly adopted fixation method. However, whether placing the implant at the dorsal or lateral aspect of the phalanx can yield a better clinical outcome is still under debate. Our study aims to compare the functional outcome of dorsal plating versus lateral plating in patients suffering from a proximal phalangeal fracture. Methods: A retrospective comparative study was performed comparing the clinical outcome of dorsal and lateral plating in proximal phalangeal fracture. Fourteen patients from our center with a total of 17 proximal phalangeal fractures (excluding the thumb) were included in this study. The total range of movement and range of movement of each finger joint together with grip strength were the main focuses of this study. Operative complications and the need for subsequent related operations were also analyzed. Results: Nine cases were treated by dorsal plating and eight cases adopted lateral plating. There was no significant difference in demographic data between the two groups with a mean follow-up period of 20.75 months. Lateral plating provided better total range of movement (dorsal plating (D): 203.9 ± 35.2 vs. lateral plating (L): 248.8 ± 23.7; p-value = 0.01) and percentage change in total range of movement (D: 79.41% ± 10.35, L: 94.47% ± 6.09; p-value &lt; 0.01). There was less extension lag in lateral plating as evidenced by the sum of extension lag of the three finger joints being statistically significantly smaller (D: 32.8 ± 14.2 vs. L: 4.44 ± 6.2, p &lt; 0.01). Less percentage decrease in grip strength compared with the contralateral normal hand was also noted in the lateral plating group (D: 68.17% ± 31.11 vs. L: 98.13% ± 10.88, p = 0.02). Conclusions: Based on this study, lateral plating provides better functional outcomes in terms of range of movement, extension lag, and grip strength than dorsal plating. Level of Evidence: Therapeutic, retrospective comparative study, Level III.

Change in grip strength, hang time, and knot tying speed after 24 hours of endurance rock climbing.

Non-professional climbers are increasingly attempting long routes in a single day. Many suffer injury or rely on search and rescue teams when they become too fatigued to finish. Predicting fatigue is difficult, and existing studies have only studied climbers over durations less than an hour, while many outdoor multipitch climbs require more than an hour of climbing. To determine how strength, endurance, and dexterity reflect fatigue after 24 h of continuous climbing. Volunteer competitors completed measurements of grip strength, static hang time to failure, and time to tie a figure-eight follow-through knot. Measurements were taken during the registration period before the competition and again within an hour after the competition ended. Measurements were compared using the paired t-test. Subgroup analysis was applied to competitors by division. Linear regression was applied to determine the relationship between vertical feet climbed and the number of routes climbed during the competition on each metric. Thirty-six total climbers (average age 29.4 years old) completed pre- and post-competition measurements. After 24 h of climbing (n = 36), mean grip strength decreased by 14.3-15 lbs or 14.7%-15.1% (p < 0.001) and static hang time decreased by 54.2 s or 71.2% (p < 0.001). There was no significant change in time to tie a figure-eight-follow-through knot. Grip strength and hang time decreases were significant in climbers with outdoor redpoints of 5.10a and above. Hang time decreased by 5.4 s per 1,000 vertical feet climbed (p = 0.044). Climbers can expect to experience a 14.7%-15.1% decrease in grip strength and 71.2% decrease in static hang time after 24 h of continuous climbing. These changes may make it difficult to climb consistently over a long objective, and climbers can use these measures at home to train for longer climbing routes. Future studies on shorter climbing intervals can help determine rates of decline in performance measures.

Efficacy of extension wrist hand orthosis on pain, grip strength and electromyographic activities in lateral epicondylitis: A randomized single-blind clinical trial

BackgroundLateral epicondylitis (LE) is one of the most common work-related complications characterized by pain, decreased grip strength and dysfunction of upper limb. Although conservative management such as physiotherapy and orthosis is reported as first line of treatment, sufficient evidence to decide their effectiveness is lacking and remains controversial. PurposeThe current study evaluated and compared the efficacy of a custom-made extension wrist hand orthosis adjunct to usual physiotherapy and therapeutics alone for subjects with LE. Study DesignProspective randomized single-blinded clinical trial. Methods62 subjects with LE were selected as samples using convenience method in this experimental study. They were randomly divided into two groups: usual physiotherapy only and its combination with orthosis. Pain and grip strength were measured using Visual Analog Scale and Jamar hydraulic digital hand dynamometer. Muscle activity of extensor carpi radialis brevis during hand gripping was measured using surface electro-myographic by PowerLab electromyography (AD Instruments, Castle Hill, Australia). Data analysis and comparison were performed for baseline and post-intervention (12weeks). ResultsAfter 12weeks of treatment, there were significant differences in mean scores of pain (1.22 ± 0.51, p = 0.001), maximum voluntary grip strength (5.82 ± 7.84, p = 0.04), and extensor carpi radialis brevis muscle activation (0.082 ± 0.094, p = 0.02) between the therapeutics alone group and the therapeutics plus orthosis group. Compared to therapeutics alone, those getting a combination of physiotherapy and orthosis had greater treatment efficacy (p < 0.05). ConclusionsBoth postintervention (12-week) treatments could affect pain scores, grip strength, and extensor muscle activation. Custom-made extension wrist hand orthosis adjunct to usual physiotherapy is more effective than therapeutics alone in subjects with LE. Therefore, the use of wrist orthosis adjunct to physiotherapy should be recommended in rehabilitation settings for LE.

Relationship between dysphagia and motor function in community-dwelling older people.

Dysphagia is a problem typically associated with aging. The aim was to investigate the relationship between dysphagia and motor function using a simple assessment method that can be performed in the community setting, and to promote the early detection and prevention of dysphagia. Data from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS) were used. Those aged ≥65 years were included. Motor function was assessed using a grip strength test, single limb standing test (SLS), and timed up and go test (TUG). Swallowing function was assessed using the Japanese version of the 10-item Eating Assessment Tool (EAT-10). The association between motor function and swallowing function was analyzed. In total, 1732 participants were included. In logistic regression modes in which grip strength, SLS, and TUG results were included separately, the odds ratio for dysphagia increased by 1.08 (P = 0.001) for each 1-kg decrease in grip strength, and increased by 1.15 (P < 0.001) for each 1-s increase in TUG time. No association was found for SLS. In the model in which grip strength and TUG were included simultaneously, the odds ratio for dysphagia increased by 1.06 (P = 0.01) in grip strength, and increased by 1.11 (P = 0.009) in TUG time. Our results suggest that skeletal muscle strength and dynamic balance function are associated with dysphagia in community-dwelling older people. Geriatr Gerontol Int 2023; 23: 603-608.

Behavioral changes in FPR2/ALX and Chemr23 receptor knockout mice are exacerbated by prenatal alcohol exposure.

Prenatal alcohol exposure (PAE) causes neuroinflammation that may contribute to the pathophysiology underlying Fetal Alcohol Spectrum Disorder. Supplementation with omega-3 polyunsaturated fatty acids (PUFAs) has shown success in mitigating effects of PAE in animal models, however, the underlying mechanisms are unknown. Some PUFA metabolites, specialized pro-resolving mediators (SPMs), play a role in the resolution phase of inflammation, and receptors for these are in the brain. To test the hypothesis that the SPM receptors FPR2 and ChemR23 play a role in PAE-induced behavioral deficits, we exposed pregnant wild-type (WT) and knockout (KO) mice to alcohol in late gestation and behaviorally tested male and female offspring as adolescents and young adults. Maternal and fetal outcomes were not different among genotypes, however, growth and behavioral phenotypes in the offspring did differ and the effects of PAE were unique to each line. In the absence of PAE, ChemR23 KO animals showed decreased anxiety-like behavior on the elevated plus maze and FPR2 KO had poor grip strength and low activity compared to age-matched WT mice. WT mice showed improved performance on fear conditioning between adolescence and young adulthood, this was not seen in either KO. This PAE model has subtle effects on WT behavior with lower activity levels in young adults, decreased grip strength in males between test ages, and decreased response to the fear cue indicating an effect of alcohol exposure on learning. The PAE-mediated decreased response to the fear cue was also seen in ChemR23 KO but not FPR2 KO mice, and PAE worsened performance of adolescent FPR2 KO mice on grip strength and activity. Collectively, these findings provide mechanistic insight into how PUFAs could act to attenuate cognitive impairments caused by PAE.

Relationship between sacral‐abdominal wall distance and grip strength in postmenopausal osteoporotic patients

AbstractBackgroundAn increase in waist circumference (WC) is a factor in lifestyle‐related diseases. The rectus abdominis muscle is a skeletal muscle that attaches to the pelvis from the xiphoid process and is thought to be affected by kyphosis deformity and posterior pelvic tilt. The purpose of this study is to examine differences between sacral‐abdominal wall distance (SAD) and WC and to determine whether they are associated with fall risk, frailty, markers of sarcopenia (grip strength and lean body mass), and spinal alignment. A secondary objective is to examine these differences by stratification by grip strength.MethodsThis retrospective study included 239 women aged 65 years or older (mean age 76.5 ± 6.7 years) attending an outpatient osteoporosis clinic. Bone mineral density and skeletal body composition (muscle mass index and trunk lean mass) were measured using dual‐energy X‐ray absorptiometry. SAD, pelvic tilt, and sagittal longitudinal axis were measured from simple X‐ray images of the spine sides. WC, grip strength, frailty, and fall risk score were investigated. Statistics were performed using Stat Flex, with two‐sided P &lt; 0.05 being significantly different.ResultsWC was correlated with SAD (R = 0.68, P &lt; 0.001). The SAD cut‐off value for a WC of 90 cm was 167 mm. The relationship between grip strength, SAD, and WC, weaker grip strength was associated with greater SAD; however, no significant difference was noted in WC. WC was not correlated with pelvic alignment but was correlated with body mass index (P &lt; 0.01). Meanwhile, SAD was correlated with body mass index, pelvic tilt, sagittal longitudinal axis (P &lt; 0.01), spinal alignment, and WC. Logistic regression analysis was performed with a grip strength of less than 18 kg as the objective variable. We found that the conditions for a grip strength of less than 18 kg were older age (P &lt; 0.001), increased SAD (P = 0.02), and decreased trunk lean body mass. There was a decrease in grip strength (P &lt; 0.05) and an increase in frailty (P &lt; 0.05) and falls (P &lt; 0.01) score in patients with SAD of 167 mm or greater.ConclusionsSAD and WC were found to be correlated; SAD was associated with body weight, posterior pelvic tilt, and anterior spinal tilt deformity, while WC was related to body weight. Increased SAD was found to be linked with decreased grip strength and increased risk of falls. This study was the first to examine a new measurement, SAD, for its utility in assessing grip strength, spinal alignment, frailty, and fall risk.

Effects of elastase-induced emphysema on muscle and bone in mice.

Chronic obstructive pulmonary disease (COPD) causes sarcopenia and osteoporosis. However, the mechanisms underlying muscle and bone loss as well as the interactions between muscle and bone in the COPD state remain unclear. Therefore, we herein investigated the effects of the COPD state on muscle and bone in mice intratracheally administered porcine pancreatic elastase (PPE). The intratracheal administration of PPE to mice significantly reduced trabecular bone mineral density (BMD), trabecular bone volume, trabecular number, cortical BMD and cortical area. It also significantly decreased grip strength, but did not affect muscle mass or the expression of myogenic differentiation-, protein degradation- or autophagy-related genes in the soleus and gastrocnemius muscles. Among the myokines examined, myostatin mRNA levels in the soleus muscles were significantly elevated in mice treated with PPE, and negatively related to grip strength, but not bone parameters, in mice treated with or without 2 U PPE in simple regression analyses. Grip strength positively related to bone parameters in mice treated with or without PPE. In conclusion, we showed that a PPE model of COPD in mice exerts dominant effects on bone rather than skeletal muscles. Increased myostatin expression in the soleus muscles of mice in the COPD state may negatively relate to a reduction in grip strength, but not bone loss.

1642-P: Deferoxamine Prevented Dexamethasone-Induced Muscle Atrophy through Inhibition of KLF15 and FOXO3a

Aim/hypothesis: Muscle atrophy is caused by various factors such as aging, a lack of exercise, and diseases. During these events, the balance between protein synthesis and degradation is disrupted and finally muscle mass is decreased. This has been reported to occur via the ubiquitin-proteasome dependent pathway, autophagy, or apoptosis. In this study, we investigated the main mechanisms of dexamethasone-induced muscle atrophy and preventing mechanisms of deferoxamine on DEX-induced muscle atrophy. Method: To measure the effects of DFO on muscle atrophy, C2C12 myotubes were treated with dexamethasone, with or without DFO, then myotubes atrophy was measured by phalloidin staining, RT-PCR, and western blotting. Results: In differentiated C2C12 myotubes, DEX induced muscle atrophy in a time- and dose-dependent manner. DEX induced expressions of muscle-specific ligases, including muscle ring finger 1 and muscle atrophy F box, and activated the ubiquitin-proteasome system leading to muscle atrophy, not autophagy or apoptosis. Interestingly, DFO administration alleviated DEX-induced myotubes atrophy. DFO inhibited DEX-activated expressions of KLF15, not REDD or FOXO3a. DFO dramatically diminished FOXO3a translocation from cytosol to nucleus through the activation of AKT. Finally, expressions of muscle-specific ligases, such as MURF1 and Atrogin-1, were reduced by treatment of DFO, and ubiquitinated myoprotein was also reduced. In addition, mice treated with DEX for 12 days had a significant decrease in grip strength and TA muscle mass. However, treatment with DFO prevented DEX-induced reduction of muscle fiber size, loss of TA muscle, and grip strength. Conclusion: DEX activated muscle specific E3 ligase and induced-muscle atrophy through ubiquitin-proteasome system. DFO ameliorates muscle atrophy by inhibition of E3 ligase expression via KLF15 and FOXO3a in DEX-treated C2C12 myotubes and C57BL6J mice. Disclosure Y.Kim: None. H.Kim: None. D.Kim: None. T.Kim: None. S.An: None. K.Lee: None. N.Lee: None. S.Choi: None. Y.Kim: None. Y.Son: None. S.Choi: None. Y.Y.Kang: None. J.Jeon: None. S.Han: None.