Grip Strength Values Research Articles

Ефективність корекції ознак саркопенії у осіб похилого віку з ендопротезом колінного суглоба

The purpose of the study was to evaluate the effectiveness of the developed physical therapy program on the parameters of sarcopenia in elderly people with total knee arthroplasty in the remote period after surgery. Materials and methods. During the research, 80 elderly people were examined. The control group consisted of 13 men and 15 women who did not undergo total endoprosthetic surgery of the joints of the lower limbs, without signs of sarcopenia. The comparison group consisted of 11 men and 16 women with total knee arthroplasty and diagnosed sarcopenia with low therapeutic (rehabilitation) compliance with the active rehabilitation intervention recommended based on the results of the initial examination. The main group consisted of 9 men, 16 women with total knee arthroplasty and diagnosed sarcopenia with a high level of therapeutic (rehabilitation) alliance regarding the active rehabilitation intervention recommended by the results of the initial examination. For them, a 6-month long physical therapy program was developed and implemented, which included the following elements: therapeutic exercises, functional training, massage of the lower limbs and lower back, kinesiological taping of the operated limbs; dietary recommendations; patient education. The effectiveness of the program was evaluated by the dynamics of the grip strength indicators, the Edmonton Frail Scale, and the SarQoL questionnaire. Results and discussion. In elderly patients with knee arthroplasty and sarcopenia, low strength (according to the value of grip strength), subjective physical weakness, difficulties in performing activities of daily living (according to the Edmonton Frail Scale questionnaire), were revealed, which led to a deterioration in the quality of life (according to the SarQoL questionnaire). The developed physical therapy program revealed a statistically significantly better effect on strength indicators, the state of physical weakness and quality of life parameters in comparison with the initial indicators for all studied parameters (р <0.05). Low rehabilitation compliance in elderly patients with knee arthroplasty and sarcopenia, despite being aware of the risks of this polymorbidity, was associated with a lack of improvement over a similar follow-up period. Conclusion. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and impaired performance of activities of daily life, which increases the quality of life of this contingent of patients

Comparison of Pain Catastrophic Scale and Anxiety in Patients With Boxer's Fracture and Other Types of Hand Fractures.

The Pain Catastrophic Scale (PCS) is generally associated with high and low post-recovery satisfaction and measures the pain perception of patients in the literature.This study aims to evaluate the association ofdeliberate (as in a fight or anger causing punching a wall)boxer's fractureswith catastrophic pain compared to accidental (as in a fall, accidental knocking it against a wall, etc.) fractures and evaluate the effect of anxiety about fracture union and functional recovery on clinical outcomes. A total of 62 male patients with metacarpal fractures, 31 as a result of deliberate punching (1st group) and 31 with metacarpal fractures as a result of an accident (2nd group), who applied to the emergency department or orthopedic clinic with the diagnosis of metacarpal fracture between January 2021 and October 2022, were included in the study. All patients were selected from patients who were followed up with conservative plaster/splint. The PCS scores of the patients were evaluated comparatively with the clinical results measured after at least six weeks. The mean age of the patients was 30.8 (18-50) in the 1st group and 34.8 (18-64) in the 2nd Group, and no statistically significant difference was found (p=0.274). While the median PCS score was 10.5 (interquartile range {IQR}: 12.3) for the 1st group, the median PCS score was 17.5 (IQR: 14.5) for the 2nd group, and the PCS score was statistically significantly lower in group 1 (p=0.009).While the median Visual Analogue Scale (VAS) value was 0 (IQR: 0.3) for the 1st group, the median VAS value was 1 (IQR: 2.0) for the 2nd group, and the VAS score was statistically significantly lower in the 1st group (p<0.001). While the median 'quickdisabilities of the arm, shoulder, and hand'(Q-DASH) value was 0 (IQR:2.3) for the 1st group, the median Q-DASH value was 3.4 (IQR:6.3) for the 2nd group, and the Q-DASH score was statistically significantly lower in the 1st group (p=0.001). No significant difference was observed between the 1st and2nd groups in terms of grip strength values (p=0.815). The etiology of patients presenting with a boxer's fracture should be well understood, and if necessary, these patients should be treated multidisciplinary, with psychiatric help. Better satisfaction can be achieved with lower results in patients whose PCS scoring system has lost its eigenvalue.

Normative values for hand grip and pinch strength for 6 to 18 year-olds in Saudi Arabia

BackgroundNormative values for hand grip and pinch strength among children in Saudi Arabia has not been well established. Therefore, the main aim of this study is to establish normative values for hand grip and pinch strength in children aged 6 to 18 years in Saudi Arabia.MethodsA cross-sectional study was conducted from different 5 regions in Saudi Arabia. Participants between the age of 6 years and 18 years old were recruited through different primary and secondary schools in Saudi Arabia. Data for age, gender, Body Mass Index, and preferred hand were collected. Hand grip strength was measured using digital hand dynamometer and the tip pinch, palmar pinch, and key pinch strength were measured using the hydraulic pinch gauge.ResultsA total of 616 participants included in this study (318 boys and 298 girls). Participants were stratified into 5 chronological age groups of 6–7 years, 8–9, 10–11, 12–13, 14–15, 16–17, and 18 years. The results showed an overall trend of increasing hand grip strength and pinch strength with age regardless of hand preference. Boys had significantly higher grip strength than girls in all age groups (P < 0.05).ConclusionThis study established normative values for hand grip and pinch strength in the healthy Saudi pediatric and adolescent population, using boys and girls aged 6 to 18. The outcomes of this study also demonstrated that gender, age, and hand preference can all have an impact on how strong a handgrip develops.

HAND GRIP STRENGTH IN YOUNG ADULTS: INFLUENCE OF ARM CIRCUMFERENCE, BMI, GENDER AND HANDEDNESS

AIM: In our study we assessed the association between hand grip strength and arm circumference, BMI, dominant hand and gender. METHODOLOGY: Our study population includes 146 young adults (Female-84, Male-62) from Guntur medical college, Guntur, Andhra Pradesh. We have calculated each student's BMI (kg/m2). We measured Hand grip strength in (kg) by taking the average of two hand grip attempts using a handspring dynamometer. We measured the Upper arm circumference using a measuring tape in cm around the thickest part of the upper arm. We compared Hand grip strength with arm circumference, BMI, handedness and gender. Results: The mean values for Maximal grip strength in the right hand for severely underweight, underweight, normal, overweight, and obese are 21, 26, 31.1, 31.6 and 32. The mean values for Maximal grip strength in the left hand for severely under-weight, underweight, normal, overweight and obese are 19, 26, 29.4, 29.6 and 30. The mean values for the arm circumference of the muscle in the right limb for severely underweight, underweight, normal, overweight and obese are 20.8, 21.6, 26.2, 28.6, and 30.6. The mean values for the arm circumference of the left-limb muscles in severely underweight, underweight, normal, overweight and obese are 20.3, 21.3, 25.8, 28.4 and 30.4. Pearson coefcient for maximal grip strength and bulk of the right arm is 0.9095, indicating a strong positive correlation. The P-Value is &lt;0.00001, which is signicant at P&lt;0.05. Pearson coefcient for maximal grip strength and the bulk of the left arm is-0.382, indicating a negative correlation. The P value is &lt;0.00001, which is signicant at P&lt;0.05. Conclusion: Maximal Grip Strength is more in males than females. Bulk and Maximal Grip Strength is more in the dominant hand (right hand).Maximal Grip Strength is less in severely underweight and underweight participants. Maximal Grip Strength is more in overweight and obese

Does idiopathic carpal tunnel syndrome deteriorate proprioception of the hand? A case-control study.

This study aims to investigate the deterioration in kinesthetic kinesthesia (KKS) and visual kinesthesia (VKS) of the hand as a component of proprioception in patients with idiopathic carpal tunnel syndrome (CTS). This study included a total of 90 hands of 60 patients (9 males, 51 females; mean age: 47.6±9.4 years; range, 28 to 60 years) who were diagnosed with CTS and 25 hands of 25 healthy individuals (8 males, 17 females; mean age: 42.6±14.4 years; range, 20 to 60 years) as the controls between January 2019 and January 2021. The KKS and VKS scores were compared between the groups. Clinical parameters such as pain levels, hand grip strength (HGS) values, and two-point discrimination (2PD) test scores were compared between the patients with and without KKS or VKS deficits. The association between the severity of electromyographic findings and KKS or VKS deficits was examined. The mean VKS score of the CTS group was 22.9±1.6 and the KKS score was 20.8±3.4, which was significantly lower than that of the control group (p=0.002 and p<0.001, respectively). The CTS patients performed less accurate repetitions in visually cued (60%) and kinesthetically cued (40%) positions than the control group (100% both). There were significantly more patients with VKS and KKS deficits in the moderate or severe CTS groups than in the mild CTS group (p<0.001 and p=0.007, respectively), and KKS or VKS deficits were significantly associated with the impaired HGS (p=0.042 and p=0.048, respectively) and functional status (p=0.020 and p=0.016, respectively) accompanied by the increased symptom severity (p=0.010 and p=0.002, respectively). Our study results suggest that idiopathic CTS is associated with impaired proprioception and kinesthetic sense of the hand. In addition, idiopathic CTS is related to impaired hand function and severe symptoms. Screening kinesthetic sense in patients with idiopathic CTS prior to decompression surgery or postoperative hand therapy is helpful to set realistic goals and achieve superior clinical outcomes.

Grip strength values and cut-off points based on over 200,000 adults of the German National Cohort - a comparison to the EWGSOP2 cut-off points.

The European Working Group on Sarcopenia in Older People (EWGSOP) updated in 2018 the cut-off points for low grip strength to assess sarcopenia based on pooled data from 12 British studies. Comparison of the EWGSOP2 cut-off points for low grip strength to those derived from a large German sample. We assessed the grip strength distribution across age and derived low grip strength cut-off points for men and women (peak mean -2.5 × SD) based on 200,389 German National Cohort (NAKO) participants aged 19-75years. In 1,012 Cooperative Health Research in the Region of Augsburg (KORA)-Age participants aged 65-93years, we calculated the age-standardised prevalence of low grip strength and time-dependent sensitivity and specificity for all-cause mortality. Grip strength increased in the third and fourth decade of life and declined afterwards. Calculated cut-off points for low grip strength were 29kg for men and 18kg for women. In KORA-Age, the age-standardised prevalence of low grip strength was 1.5× higher for NAKO-derived (17.7%) compared to EWGSOP2 (11.7%) cut-off points. NAKO-derived cut-off points yielded a higher sensitivity and lower specificity for all-cause mortality. Cut-off points for low grip strength from German population-based data were 2kg higher than the EWGSOP2 cut-off points. Higher cut-off points increase the sensitivity, thereby suggesting an intervention for more patients at risk, while other individuals might receive additional diagnostics/treatment without the urgent need. Research on the effectiveness of intervention in patients with low grip strength defined by different cut-off points is needed.

Hand grip strength: A reliable assessment tool of frailty status on the person with type 2 diabetes mellitus

ObjectiveThe aim was to assess the influence of specific type 2 diabetes Mellitus-related features on the hand grip strength in a diabetic outpatient-based population. Material and methodsA cross-sectional population-based study was conducted. Seventy-three individuals were included after excluding cases of refusal to participate or medical concerns that had potential to affect dominant hand strength. A calibrated dynamometer was used to assess dominant hand grip strength. Two multiple linear regression models were used to predict mean hand grip strength values. Spearman and Pearson correlations were calculated for all possible pairwise combinations of significant independent continuous variables and mean hand grip strength values. ResultsReduced hand grip strength prevalence was 54.8%, from which 70.8% people had ≥ 65 years. Twenty four percent of individuals aged < 65 years showed decreased hand grip strength. Increasing age, female gender and type 2 diabetes Mellitus duration were significantly associated with reduced hand grip strength (P<0.001; P=0.017; P=0.001, respectively). For each 10 years of disease duration, individual mean hand grip strength decreased around 3kg (P=0.001). ConclusionsReduced hand grip strength prevalence was substantial in the geriatric subgroup and not negligible in younger patients with a contribution long-term Diabetes, increasing age and female gender as risk factors. This study displays a unique, practical and reliable approach to select at-risk patients who need close screening programs and clinical surveillance concerning frailty status.

Grip Strength and Body Balance in Static and Dynamic Push Walkers Measurement Using Force Sensing Resistors and Kinect System

Most parents use push walkers to encourage toddlers in gross and fine motor stimulation to develop basic walking skills. Push walkers are a choice for parents other than baby walkers to help toddlers under one year learn to walk. The push walker options for toddlers include static (the shaft moves in place) and dynamic (moving mobile). This study aimed to compare the effect of push walkers between static and dynamic types on motor stimulation of toddlers using biomechanics by measuring hand grip strength and body balance. This research contributes to selecting a push walker for parents to support gross and fine motor development after agreeing on the consideration of the toddler expert panel for the toddler walking task simulation using a push walker involving nine toddlers according to body mass index. Simulation of toddler walking in two experimental sessions using static and dynamic push walkers in measuring hand grip strength using force-sensing resistors and body balance using the Kinect system with Vitruvius software. The grip strength value was tested by paired t-test to determine the significance of the grip strength value. Body balance values were tested by paired t-test to determine the significance of leg compression force and leg moment. Dynamic push walker has a greater value of grip strength than static, and p-value = 0.001 (&lt; 0.005), providing good motor stimulation to toddlers when pushing with more muscular grip strength, allowing the toddler's hand muscles to tighten up. Static push walkers have a greater compression force and foot moment than dynamic and p-value = 0.001 (&lt; 0.005), providing gross motoric stimulation to toddlers while walking in a balanced and stable manner, allowing the toddler's leg muscles to tighten up.

COMBINED PLATE VERSUS EXTERNAL FIXATION FOR DISTAL RADIUS FRACTURES.

This study aimed to compare the functional and radiological results of patients who had intra-articular comminuted distal radius fractures and were operated on with external fixation percutaneous pinning or the volar-dorsal combined plate osteosynthesis. In this study, 49 patients operated on and followed up for the comminuted distal radius fractures between May 2015 and January 2019 were retrospectively evaluated. The surgical outcomes of the patients, who were operated on with combined dorsal-volar plate osteosynthesis or external fixation percutaneous pinning, were compared in this study. Functional and radiological scores were evaluated and analyzed statistically. There was no statistical difference between external fixation and volar-dorsal combined plate groups regarding the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, the Visual Analog Scale (VAS), the Mayo scoring system, range of motion, and grip strength values. Although the combined volar-dorsal plate osteosynthesis technique had a longer operation time and a more complicated surgical procedure, the combined volar-dorsal plate osteosynthesis had lower complication rates and permitted early mobilization. The combined volar-dorsal plate osteosynthesis could be an alternative to external fixation percutaneous pinning. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

Effectiveness of early rehabilitation in hand burns.

Hand burn trauma occurs quite commonly and the outcome of hand burns can significantly impact self-care daily function, work and employment, leisure activities, and overall health-related quality of life. The overall goal of the management of hand burn trauma is to optimize hand function. Rehabilitation and restoration of hand function are critical for the patient's independence and re-integration into society and work. The purpose of this study is to present our experience with 105 hand burn trauma patients admitted and treated in our burn center and to show the efficacy of early rehabilitation on their ability to return to their prior social life and work. In our study, we included that 105 patients with acute severe hand burn trauma were hospitalized in Gulhane burn center between 2017 and 2021. They underwent rehabilitation program daily sessions. Patients with hand burns are evaluated by ranges of motions (ROM), grip strength, Cochin Hand Function Scale (CHFS), and Michigan Hand Questionnaire (MHQ) 12 months after the injury. Overall, mean digital total active motion were >180°. The mean values for grip strength of dominant hand for men were 27.2±9.3 kg, for women were 22.0±8.8 kg and non-dominant hand for men were 24.05±13.8 kg, for women were 17.8±10.3 kg. Total score of 5 items was 19.0 in CHFS. The mean overall score on the MHQ was 62.3±27.4. All obtained data were within normal or accepted functional ranges. Spearman correlation coefficient indicates a negative correlation between MHQ and CHFS (p≤0.01). A comprehensive rehabilitation program is essential in helping patients to regain optimal function after hand burn trauma. Physiotherapy and occupational therapy is most beneficial when started at the time of admission.

Orthostatic hypotension is associated with malnutrition diagnosed by GLIM in elderly hypertensive patients

BackgroundOrthostatic Hypotension (OH) and malnutrition, are common health problems in elderly hypertensive patients. This study aimed to analyze the relationship between malnutrition and OH in elderly hypertensive patients.MethodsThis is a cross-sectional single-center study. All participants underwent a Comprehensive Geriatric Assessment (CGA), in which malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria based on four different methods of diagnosing muscle mass loss. Furthermore, the accuracy of these methods was verified by Receiver Operating Characteristic (ROC) analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors for OH in elderly hypertensive patients.ResultsFor GLIM criteria, when Fat-Free Mass Index (FFMI) was the gold standard for muscle mass loss, the Area Under ROC Curve (AUC) values for Upper Arm Circumference (UAC), Calf Circumference (CC), and Hand Grip Strength (HGS) were 0.784, 0.805, and 0.832, with moderate accuracy in diagnosing malnutrition. Multivariate analysis showed that females, Diabetes Mellitus (DM), diuretics, and malnutrition diagnosed by GLIM-UAC were risk factors for OH in elderly hypertensive patients.ConclusionPrompt detection of malnutrition in the elderly and attention to changes in UAC may be critical. Similarly, we should strengthen medication and disease management in elderly hypertensive patients.

Association between Handgrip Strength and the Systemic Immune-Inflammation Index: A Nationwide Study, NHANES 2011-2014.

(1) Background: The Systemic immune-inflammatory index (SII) has been proven to be an effective biomarker of human immune and inflammatory levels and has prognostic significance for most diseases. Handgrip strength (HGS) is a simple and low-cost strength measurement method, which is not only highly correlated with overall muscle strength but also accurately and reliably predicts the risk of multiple chronic diseases and mortality; (2) Purpose: Association between HGS and the SII is unclear. The purpose of this study was to investigate the association between HGS and the SII in American adults; (3) Methods: We used the data from the 2011–2012 and 2013–2014 cycles of the National Health and Nutrition Examination Survey (NHANES), involving a total of 8232 American adults (aged 18–80 years). The SII was calculated as the Platelet count × Neutrophil count/Lymphocyte count; HGS was recorded as the ratio of the sum of the highest grip-strength values of each hand to body mass index taken as the relative grip strength. A weighted generalized linear regression model and analysis of restricted cubic spline regression, adjusted for confounding factors, were used in this study to assess associations between HGS and the SII in American adults; (4) Results: There was a negative correlation between the HGS and the SII of different sexes (p < 0.05), and there was a significant negative nonlinear relationship between the HGS and the SII in males (p for nonlinear = 0.0035), and the SII showed a downward trend with the increase in the HGS in males (Q2: β = −61.03, p = 0.01; Q3: β = −61.28, p = 0.04, Q4: β = −64.36, p = 0.03, p for trend = 0.04), when the HGS exceeds 3.16, with the HGS increasing, the downward trend of increasing the SII slowed down. The nonlinear relationship between the HGS and the SII in females was not significant (p for nonlinear = 0.1011), and the SII showed a linear downward trend with the increase in the HGS (Q2: β = −24.91, p = 0.25; Q3: β = −62.01, p = 0.03, Q4: β = −74.94, p = 0.03, p for trend = 0.01); (5) Conclusions: HGS is inversely and independently associated with SII levels, and although the limited cubic spline regression analysis showed gender differences, the overall trend of the HGS and the SII in different genders was consistent, with both showing that the SII decreased with increasing the HGS. In addition, HGS has high general applicability based on its ease of measurement; it is possible to understand one’s own grip-strength level through routine grip-strength tests, and to make preliminary predictions on the current level of immunity and inflammation in the body.

Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?

The postoperative residual neuromuscular block (PRNB) has a significant impact on patient safety and well-being, but continues to remain underestimated. Objective evaluation of handgrip strength using a force dynamometer can be useful to identify postoperative muscle weakness. Thirty-two American Society of Anesthesiologists (ASA) class I and II patients who received general anesthesia were included. Patients were extubated after the train-of-four (TOR) ratio (TOFR) was >0.90 and the clinical criteria for motor power recovery were judged as adequate. The measurements of handgrip strength and peak expiratory flow rate (PEFR) were obtained at baseline, 15 min after extubation, and 1, 2, and 4 h postoperatively. The incidence of significant decline from baseline (>25%) was determined. The correlation between handgrip strength and PEFR was assessed using Spearman correlation. The time to return to baseline for muscle grip strength and PEFR was performed using Kaplan-Meier survival analysis. A P value of 0.05 was considered significant for all tests. The incidence of the significant decline in handgrip strength from baseline was 100% at 15 and 60 min, 76% at 2 h, and 9.4% at 4 h. There was a strong correlation between muscle grip strength and PEFR (0.89, P < 0.001). None of the patients exhibited the potential complications of PRNB. (PRMB in abstract. It should be uniform) The mean time to return to the baseline value of muscle grip strength was 3.8 h (95% confidence interval [CI] 3.6-3.9), and the mean time to return to baseline for PEFR was 3.2 h (95% CI 2.9-3.4 h). Objective assessment of muscle grip strength using a force dynamometer has the potential to be a new objective metric to monitor postoperative muscle weakness.

Bone mineral density, limb muscle mass, muscle strength, and exercise capacity are reduced in female patients with distal radius fractures when the unaffected side grip strength is less than 18 kg

BackgroundPrevention of domino effects after distal radius fractures is important for improving life expectancy. Fragility fractures secondary to falls are associated with decreased bone mineral density, muscle strength, and exercise capacity. Grip strength is one of the simplest and most useful tests to comprehensively judge muscle strength. The purpose of this study was to examine whether grip strength is associated with bone mineral density, limb muscle mass, muscle strength, and exercise capacity, by comparing patient backgrounds based on the presence or absence of grip weakness in female patients with distal radius fractures. MethodsThis study included women with distal radius fractures who visited our orthopedics outpatient department between April 2015 and April 2020. Bone mineral density, limb muscle mass, skeletal muscle mass index, muscle strength (grip strength on unaffected side and quadriceps muscle strength), the Timed Up and Go test, and the Two-Step test were evaluated six to eight weeks after injury. Patients were divided into two groups according to the cutoff value of grip strength (18–21 kg), and 90 age-adjusted and matched participants were compared and examined. ResultsAt the cutoff value of 18 kg, a significant decrease in lumbar spine and total proximal femur bone mineral density (p < 0.05, p < 0.05), limb muscle mass and skeletal muscle mass index (p < 0.01, p < 0.05), quadriceps femoris muscle strength (p < 0.01), the Timed Up and Go test (p < 0.05), and the Two-Step test (p < 0.01), was observed in the grip-weakness group compared to that in the no-grip-weakness group. ConclusionsIn women with distal radius fracture and grip strength <18 kg on the unaffected side, bone mineral density, limb muscle mass, quadriceps femoris strength, and exercise capacity may be reduced. These results suggest reduced grip strength may be an indicator for further testing to prevent domino effects.

Normative values of hand grip strength of older Filipinos aged 60 to 85 years

BackgroundHand grip strength (HGS) is associated with a range of health outcomes in older persons. Interpretation of an individual older person's HGS requires comparison with normative values of HGS for the population the older person belongs to, but normative values of HGS for older Filipinos are not established. MethodsUsing data on a subset (n = 3406) of ‘healthy’ persons aged 60 to 85 years from the baseline survey of the nationally representative Longitudinal Study of Ageing and Health in the Philippines (LSAHP), we established normative values of HGS and determined the association of older person characteristics with the normative values. We also compared the health status of mutually exclusive groups, defined using the normative values among all LSAHP participants aged 60 to 85 years with measured HGS, to assess the efficiency of the normative values. HGS was measured using a Smedley spring-type dynamometer, in a standing position with elbows extended, thrice for each hand. ResultsSingle-year age, gender-, and hand-specific values and graphs for the normative values (5th, 20th, 50th, 80th, and 95th percentiles) of HGS were delineated. Height, weight, education, and occupation of the older person were associated with the normative values. Individuals classified into groups representing weaker HGS had a poorer health status. ConclusionThe established normative values provide a reference for interpreting HGS values, measured using Smedley spring-type dynamometers, in older Filipinos aged 60 to 85 years.

Association Between The Status Of Sarcopenic Obesity And Osteoarthritis Using The KNHANES 2014-2019 Data

PURPOSE: To investigate the association between the 4 body composition status of sarcopenic obesity and the prevalence of osteoarthritis (OA). METHODS: 10,514 participants aged over 60 years in the Korean National Health and Nutrition Examination Survey 2014-2019 (KNHANES VI-II-VIII) were included in this study. Sarcopenia was defined by the value of hand grip strength of <26 kg for men and < 18 kg for women. Obesity was defined as waist circumference of ≥90 cm for men and ≥ 85 for women. OA was defined as who responded ‘yes’ for whether the participant being diagnosed as OA in the past (yes/no) and whether currently receiving treatments for OA (yes/no). Logistic regression analysis was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of OA according to the 4 body composition categories, classifying participants into groups of sarcopenic obesity (48%), nonsarcopenic obesity (33%), sarcopenic nonobesity (11%), and nonsarcopenic nonobesity (8%). RESULTS: Sarcopenic obesity (OR 1.77; 95% CI 1.45-2.15) and nonsarcopenic obesity (OR 1.70; 95% CI 1.48-1.94) demonstrated significantly higher prevalence of OA compared to nonsarcopenic nonobesity reference group after adjusting for age and sex. However, sarcopenic nonobesity (OR 1.18; 95% CI 0.97-1.44) did not show significant association with OA. CONCLUSIONS: The existence of obesity was rather more strongly associated with the prevalence of OA than the presence of sarcopenia in the aspect of the 4 body composition categories. These findings support the importance of the status of obesity and its systemic metabolic effects on the prevalence of OA. Furthermore, group of sarcopenic obesity showing slightly stronger association with the prevalence of OA than nonsarcopenic obesity group suggests the impact of the sarcopenia among obese population in the prevalence of OA.

Development of a Novel Diagnostic Support Tool for Degenerative Cervical Myelopathy Combining 10-s Grip and Release Test and Grip Strength: A Pilot Study

Early diagnosis of degenerative cervical myelopathy (DCM) is desirable, as delayed treatment can cause irreversible spinal cord injury and subsequent activity of daily living (ADL) impairment. We attempted to develop a straightforward and accurate diagnostic tool for DCM by combining the grip and release test (GRT) and grip strength. As a pilot study, we measured the GRT and grip strength of patients with DCM (n = 247) and a control group (n = 721). Receiver operating characteristic analysis was performed using the lower left and right. The Youden index was used to set cutoff values by sex and age group. The diagnostic performance of each test varied by sex and age, and a diagnostic support tool was created to determine any abnormal results in a test. The calculated M/F cutoff values for GRT were as follows: 40–59 years, 21/18; 60–69 years, 17/17; 70–79 years, 15/15; and 80–89 years, 11/12. The calculated M/F cutoff values for grip strength 32/20, 29/13, 21/15, and 19/10. When either GRT or grip strength was judged as positive, the overall sensitivity was 88.2%, specificity was 78.1%, positive likelihood ratio was 4.03, and the negative likelihood ratio was 0.15. This novel diagnostic support tool was superior to using GRT and grip strength alone in the early DCM diagnosis. Future research to obtain age- and sex-specific data is necessary to validate and further improve the tool.

Patterns of Muscle-Related Risk Factors for Sarcopenia in Older Mexican Women.

Early detriment in the muscle mass quantity, quality, and functionality, determined by calf circumference (CC), phase angle (PA), gait time (GT), and grip strength (GSt), may be considered a risk factor for sarcopenia. Patterns derived from these parameters could timely identify an early stage of this disease. Thus, the present work aims to identify those patterns of muscle-related parameters and their association with sarcopenia in a cohort of older Mexican women with neural network analysis. Methods: Information from the functional decline patterns at the end of life, related factors, and associated costs study was used. A self-organizing map was used to analyze the information. A SOM is an unsupervised machine learning technique that projects input variables on a low-dimensional hexagonal grid that can be effectively utilized to visualize and explore properties of the data allowing to cluster individuals with similar age, GT, GSt, CC, and PA. An unadjusted logistic regression model assessed the probability of having sarcopenia given a particular cluster. Results: 250 women were evaluated. Mean age was 68.54 ± 5.99, sarcopenia was present in 31 (12.4%). Clusters 1 and 2 had similar GT, GSt, and CC values. Moreover, in cluster 1, women were older with higher PA values (p < 0.001). From cluster 3 upward, there is a trend of worse scores for every variable. Moreover, 100% of the participants in cluster 6 have sarcopenia (p < 0.001). Women in clusters 4 and 5 were 19.29 and 90 respectively, times more likely to develop sarcopenia than those from cluster 2 (p < 0.01). Conclusions: The joint use of age, GSt, GT, CC, and PA is strongly associated with the probability women have of presenting sarcopenia.

Does grip strength of the less-affected side of ischemic stroke survivors influences performance of self-care activities?

Background and aimAdequate grip strength is needed to execute various self-care activities. This study was aimed to assess the influence of grip strength of the less-affected side of ischemic stroke survivors on performance of self-care activities, and also to determine the reference values of less-affected grip strength needed for independent performance of each of the self-care activities.MethodsSeventy-three consenting patients with ischemic stroke participated in this cross-sectional study. Handheld dynamometer was used to measure grip strength of the less-affected hand, while functional independence measure was used to evaluate self-care activities (eating, grooming, bathing, dressing of upper body, dressing of lower body and toileting) as independent and dependent. Data was analyzed using inferential statistics of Pearson’s correlation, binomial logistic regression, and receiver operating characteristics. Alpha level was set at p < 0.05.ResultsThe mean hand grip strength, functional independence measure and trunk control test scores were 23.8 kg, 29.9 kg, and 68.2 kg respectively. Grip strength was significantly associated with independence in all of the self-care activities (p < 0.05). Less-affected grip strength of 19.5 kg (sensitivity, 80.4%; specificity, 80.1%; area under curve, 0.85), 23.7 kg (sensitivity, 79%; specificity, 72.2%; area under curve, 0.79), 24.8 kg (sensitivity, 70.2%; specificity, 65.2%; area under curve, 0.75), 24.7 kg (sensitivity, 82.1%; specificity, 80.1%; area under curve, 0.84), 23.7 kg (sensitivity, 80.1%; specificity, 76.1%; area under curve, 0.84), and 19.9 kg (sensitivity, 76.9%; specificity, 76.2%; area under curve, 0.79) was needed for independent performance in eating, grooming, bathing, dressing of upper body, dressing of lower body, and toileting respectively.ConclusionThe less-affected grip strength of patients with ischemic stroke influences their ability to independently perform self-care activities. The reference values of less-affected grip strength in association with other stroke-related characteristics may help clinicians to estimate independence in eating, grooming, bathing, dressing of upper body, dressing of lower body, and toileting among patients with ischemic stroke.

Compartment-specific effects of muscle strength on bone microarchitecture in women at high risk of osteoporosis.

BackgroundIt is well known that skeletal integrity is influenced by the musculature. Poor muscle strength (i.e. sarcopenia) is considered a major predictor of fragility fractures. While this observation appears particularly relevant for older women with increased risk of osteoporosis, there has been no comprehensive investigation to determine the influence of muscle performance on compartment‐specific bone microarchitecture in multiple body regions.MethodsWe retrospectively analysed data from different muscle performance and bone microarchitecture assessments in 230 women (aged 21 to 87 years) at high risk of osteoporosis. Muscle performance tests included grip strength and chair rising test (CRT) combined with mechanography. Balance was determined by Romberg posturography. Areal bone mineral density (BMD) was measured by dual‐energy X‐ray absorptiometry (DXA) at the hip and lumbar spine. Compartment‐specific volumetric BMD, microarchitecture, and geometry were assessed by second‐generation high‐resolution peripheral quantitative computed tomography (HR‐pQCT) at multiple skeletal sites (distal radius, tibia, and fibula). Regression models were applied to test for interactions between muscle and bone parameters. Subgroups were defined to compare women with osteoporosis and osteosarcopenia regarding BMD and microarchitecture.ResultsWhile osteoporosis was diagnosed in 115/230 (50.0%) women, sarcopenia was detected in 38/230 (16.5%). Positive associations of both grip strength and CRT maximum force with cortical geometric and microarchitectural parameters were detected at all measured sites, with the strongest effect applying to CRT maximum force and tibial parameters (e.g. tibial cortical area R 2 = 0.36, P < 0.0001, and tibial cortical thickness R 2 = 0.26, P < 0.0001). Balance parameters showed much weaker or no associations with HR‐pQCT parameters. Major associations between muscle strength and trabecular parameters could not be confirmed. Age and body mass index were confirmed as negative and positive predictors for several microarchitectural parameters, respectively. An independent predictive value of grip strength on radial, tibial, and fibular (all P < 0.01) cortical area and of CRT maximum relative force on cortical thickness (all P < 0.05) was revealed. Women with osteosarcopenia showed significantly reduced cortical HR‐pQCT parameters but no differences in DXA values compared with women with osteoporosis but no sarcopenia. Stratification by fracture and treatment status revealed that vertebral fractures and denosumab treatment altered the muscle–bone interaction.ConclusionsA systemic interaction between muscle strength and bone microarchitecture was demonstrated, and this interaction appears to be primarily with the cortical bone compartment. The value of muscle assessments in fracture risk evaluation may be partly mediated by their effects on bone microarchitecture.