Handgrip Dynamometry Research Articles

Test-Retest Reliability of Electronic Handgrip Dynamometry and Accelerometry Measured Muscle Function in Older Adults

Test-Retest Reliability of Electronic Handgrip Dynamometry and Accelerometry Measured Muscle Function in Older Adults

Reliability, validity and usability of the K-force® grip dynamometer to evaluate handgrip-strength in patients with intensive care unit-acquired weakness.

Handgrip dynamometry is recognised as a method for evaluating volitional muscle strength in the intensive care, but conventional handgrip dynamometers cannot accurately measure grip strength in very weak patients. The aim of this study was to determine the reliability, validity and usability of the K-force® grip in patients with intensive care unit-acquired weakness. Evaluation of measurement properties of the K-force® grip. Two Intensive Care Units in The Netherlands. Patients diagnosed with intensive care unit-acquired weakness according to a Medical Research Council sum score <48. Intra- and inter-rater reliability of the K-force® grip were assessed using the intraclass correlation coefficient. Concurrent validity was examined using calibration weights. The usability was evaluated with the System Usability Scale. Intra-rater reliability showed an intraclass correlation coefficient of 0.987 for the dominant hand and 0.972 for the non-dominant hand. Inter-rater reliability showed coefficients of 0.944 for the dominant hand and 0.942 for the non-dominant hand. There was a perfect correlation (r = 1) between the K-force® grip and the calibration weights. The usability of the K-force® grip was rated excellent by 11 healthcare professionals with a System Usability Scale score of 86. The K-force® grip is a promising new tool for the evaluation of muscle strength in intensive care unit-acquired weakness patients who are too weak to use conventional hand dynamometers.

Graded association of muscle strength with all-cause and cause-specific mortality in older adults with diabetes: Prospective cohort study across 28 countries.

The worldwide prevalence of diabetes is increasing, particularly among older adults. Understanding the association between muscle strength and mortality in this population is crucial for developing targeted exercise recommendations. To assess the prospective association of muscle strength with mortality in older adults with diabetes. From the Survey of Health, Ageing and Retirement in Europe (SHARE) study, spanning 28 countries, we included 16 149 diabetic adults aged 50 years and older (mean age 68.2 [standard deviation, SD, 9.2] years). Participants fulfilled two criteria: (1) diabetes diagnosis (ever) and (2) current use of diabetes medication. Muscle strength was assessed using handgrip dynamometry (unit: kg). Using time-varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with all-cause and cause-specific mortality, controlling for various confounders. Over a mean follow-up of 5.9 years (SD 3.8), 2754 participants died (17%). Using the median level of muscle strength as reference (30 kg), lower and higher levels were associated in a curvilinear fashion with higher and lower all-cause mortality risk, respectively. The 10th percentile of muscle strength (17 kg) showed a hazard ratio (HR) of 1.65 (95% confidence interval (CI) 1.53-1.79). The 90th percentile (47 kg) of muscle strength showed a HR of 0.55 (95% CI 0.49-0.63). A somewhat similar pattern, with varying strength of associations, was seen for mortality due to cardiovascular disease (CVD), respiratory disease, severe infectious disease, digestive system disease and cancer. Muscle strength is gradually and inversely associated with all-cause and cause-specific mortality risk in older adults with diabetes. As muscle strength is highly adaptable to resistance training at all ages, the present findings highlight the importance of improving muscle strength in older adults with diabetes.

Association of Muscle Strength With All-Cause Mortality in the Oldest Old: Prospective Cohort Study From 28 Countries.

Ageing is associated with a gradual loss of muscle strength, which in the end may have consequences for survival. Whether muscle strength and mortality risk associate in a gradual or threshold-specific manner remains unclear. This study investigates the prospective association of muscle strength with all-cause mortality in the oldest old. We included 1890 adults aged ≥ 90 years (61.6% women, mean age 91.0 ± 1.5 years) from 27 European countries and Israel participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) study. Muscle strength was assessed using handgrip dynamometry (unit: kilogram). Using time-varying Cox regression with restricted cubic splines, we determined the prospective association of muscle strength with mortality, controlling for age, sex, smoking, BMI, marital status, education, geographical region and self-perceived health. Over a mean follow-up of 4.2 ± 2.4 years, more than half of the participants died (n = 971, 51.4%). The mean handgrip strength was 20.4 ± 8.0 kg for all participants, with men (26.7 ± 7.5 kg) showing significantly higher strength than women (16.4 ± 5.4 kg) (p < 0.001). Using the median level of muscle strength as reference (18 kg), lower and higher levels were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively. The 10th percentile of muscle strength (10 kg) showed a hazard ratio (HR) of 1.27 (95% CI 1.13-1.43, p < 0.001). The 90th percentile (31 kg) showed an HR of 0.69 (95% CI 0.58-0.82, p < 0.001). Stratified for sex, the median levels of muscle strength were 26 kg for men and 16 kg for women. The 10th percentile of muscle strength showed HRs of 1.33 (95% CI 1.10-1.61, p < 0.001) at 15 kg for men and 1.19 (95% CI 1.05-1.35, p < 0.01) at 10 kg for women. The 90th percentile of muscle strength showed HRs of 0.75 (95% CI 0.59-0.95, p < 0.01) at 35 kg for men and 0.75 (95% CI 0.62-0.90, p < 0.001) at 23 kg for women. Sensitivity analyses, which excluded individuals who died within the first 2 years of follow-up, confirmed the main findings. Rather than a specific threshold, muscle strength is gradually and inversely associated with mortality risk in the oldest old. As muscle strength at all ages is highly adaptive to resistance training, these findings highlight the importance of improving muscle strength in both men and women among the oldest old.

Consolidating Integrated Care: A Joint Falls Prevention Initiative between Community and Hospital Based Physiotherapy Services

Abstract Background Physiotherapists from Primary Care, Integrated Care Programme for Older Persons (ICPOP) and hospital-based Frailty Intervention Team services came together to establish a community working group with the aim of reducing the incidence of falls of those in their collective catchment area. The agreed objective being to pilot a 6 week falls prevention initiative between community and hospital-based services. Methods 7 Physiotherapists across 3 services formed a community working group. A 6-week physiotherapy led, multifaceted intervention program involving exercise, education and an opportunity for socializing was developed. The class was accessible to persons over the age of 65 years who had or were at risk of falling. Participants were recruited from the caseloads of the physiotherapists involved. Objective assessments of gait speed, grip strength and balance were carried out via hand grip dynamometry, Timed Up and Go (TUAG) and Short Physical Performance Battery (SPPB). Subjective measures of participant’s quality of life were assessed via the EQ 5D 5L, Falls Efficacy Scale (FES) and Sarc-F. On completion of the intervention participants were retested. Results 10 participants were recruited to the pilot from both community and hospital based, out-patient services. Over 80% of participants attended 4 out of 6 sessions. Participants grip strength improved by 3.4kg, TUAG by 6.43% (1.03 seconds) and SPPB by 13.3%. EQ 5D 5L scores improved by 15%, FES score improved by 17.81% and SARC-F scores improved by 6%. 40% of participants went on to engage with a follow-on exercise group delivered by the local Sports Partnership. Conclusion Overall, there was a notable improvement in participant’s physical function and quality of life and self-efficacy scores post intervention. This highlights the positive impact of multimodal group interventions, which incorporate both exercise and education to promote self-efficacy within frail older population at risk of falling.

179 Physical activity and physical function in survivors of critical illness after hospital discharge: A prospective, observational study

Abstract Purpose Survivors of critical illness often experience persistent physical, functional and/or cognitive impairments (i.e. Post-Intensive Care Syndrome). Currently, there is very limited rehabilitation provided as part of standard care for this population. Evaluation of physical activity (PA) and function, and the feasibility of collecting data, specifically in people after critical illness could provide insights into their activity levels after critical illness. The aim was to assess and describe PA and function in the year following hospital discharge in patients who have been mechanically ventilated in intensive care. Methods A prospective, observational study. (Ethical approval/REC Reference: 17/N1/0115). Patients discharged from hospital following intensive care unit (ICU) admission were invited to attend up to four assessments: within 2 weeks, 6 weeks, 6 months and 1 year, following hospital discharge. Seven-day accelerometer-based PA (daily step count), modified shuttle walk test (MSWT) and handgrip strength (HGS) were assessed at each timepoint. Results were compared against research guidelines and normative data. Results Participants (n = 14) were: age: 53.9 ± 14.5 years; sex: 8 male/6 female; ICU length of stay: 9.00 days (IQR: 4.50 days); mechanical ventilation duration: 58.50hrs (IQR: 132.75hrs); Acute Physiologic Chronic Health Evaluation: 15.36 ± 8.51. There were several challenges with data collection e.g. participants using mobility aids could not perform MSWT. Participants performed below research guidelines/normative values for mean daily steps (763 – 7744 steps), MSWT (40 – 800m), and HGS (8 – 52kg) across the 12-month study period. Conclusions In the year following hospital discharge, PA and function varied among ICU survivors and remained low. Assessments using accelerometry and handgrip dynamometry were feasible. A more consistently administered test is needed to evaluate exercise capacity across the recovery continuum in this heterogenic population. These findings could be used to guide future development of personalised rehabilitation interventions and goal-setting in this population. Patients have also highlighted that they feel that the provision of physical rehabilitation could support their recovery. Support/Funding Source The Department of Employment and Learning with Seed Funding from the Northern Ireland Clinical Research Facility.

Enhancing physical fitness testing: integrating Bluetooth connectivity for improved hand grip dynamometry

Enhancing physical fitness testing: integrating Bluetooth connectivity for improved hand grip dynamometry

Association of baseline muscle mass with functional outcomes in intensive care unit survivors: A single-center retrospective cohort study in Korea.

In critical care settings, ultrasound (US) of the quadriceps muscle and Bioelectrical Impedance Analysis (BIA) are noninvasive and widely available tools to evaluate muscle mass. We studied whether baseline muscle mass affects physical function in intensive care unit (ICU) survivors after discharge. This retrospective review of a prospective cohort enrolled 30 patients admitted to the medical ICU between April 2016 and June 2018. On ICU admission, quadriceps muscle thickness and skeletal muscle mass were measured using US and BIA, respectively. Muscle strength and physical function were measured using handgrip dynamometry, the 6-min walk test, and the Barthel index questionnaire survey during every clinic visit at 1, 3, 6, and 12 months after hospital discharge. Skeletal muscle mass at ICU admission was statistically correlated with the 6-min walk distance (6MWD) and Barthel index score. The segmental lean mass of the right arm was also positively correlated with handgrip muscle strength at 6 months after discharge. Likewise, the correlation between quadriceps muscle thickness at ICU admission and 6MWD at 6 months after discharge was positive and statistically significant. Multivariate regression analysis showed that skeletal muscle mass was associated with a reduced 6MWD, but the length of ICU stay was not. The segmental lean mass of the right arm also showed a significant association with handgrip strength after discharge. Low muscle mass on ICU admission is associated with reduced muscle strength, causing impaired physical function after hospital discharge in ICU survivors.

Longitudinal assessment of physical function in adults with X-linked hypophosphatemia following initiation of burosumab therapy.

X-linked hypophosphatemia (XLH) is a rare genetic disorder of phosphate metabolism. Burosumab is a monoclonal antibody treatment shown to improve phosphate homeostasis and improve symptoms as well as fracture healing when used as a therapy for XLH in adults. However, little is known about its effects on the large deficits in multiple components of physical function previously reported in XLH. Ten adults (6 females, age 41.1 ± 15.7 y) were recruited from specialist centres in London and Bristol. During clinical visits for initial burosumab treatment and at 6-month and 12-month follow-up, physical function, and physical activity (PA) assessments were performed. In detail, lower limb power was assessed by mechanography via a countermovement jump, mobility by short physical performance battery (SPPB), functional capacity by 6-min walk test (6MWT), upper limb strength by hand grip dynamometry, and PA via an International Physical Activity Questionnaire (IPAQ). Differences between baseline and 6-month follow-up, and in a subset of 5 patients between 6- and 12-month follow-up, were assessed. Lower limb power increased by 9% (P = 0.049) from baseline to 6 months, as did SPPB score (+ 1.2 points, P = 0.033) and total PA (+ 65%, P = 0.046) although hand grip and 6MWT did not differ. Only for hand grip was a significant improvement (+ 10%, P = 0.023) seen between 6 and 12 months. Burosumab treatment is associated with improved lower limb function and mobility at 6 months, with improvement in hand grip strength at 12 months. Future studies should explore the underlying mechanisms and describe on function and other patient outcomes.

Supervised Machine Learning to Examine Factors Associated with Respiratory Sinus Arrhythmias and Ectopic Heart Beats in Adults: A Pilot Study

Background: There are many types of arrhythmias which may threaten health that are well-known or opaque. The purpose of this pilot study was to examine how different cardiac health risk factors rank together in association with arrhythmias in young, middle-aged, and older adults. Methods: The analytic sample included 101 adults aged 50.6 ± 22.6 years. Several prominent heart-health-related risk factors were self-reported. Mean arterial pressure and body mass index were collected using standard procedures. Hydraulic handgrip dynamometry measured strength capacity. A 6 min single-lead electrocardiogram evaluated arrhythmias. Respiratory sinus arrhythmias (RSAs) and ectopic heart beats were observed and specified for analyses. Classification and Regression Tree analyses were employed. Results: A mean arterial pressure ≥ 104 mmHg was the first level predictor for ectopic beats, while age ≥ 41 years was the first level predictor for RSAs. Age, heart rate, stress and anxiety, and physical activity emerged as important variables for ectopic beats (p &lt; 0.05), whereas age, sodium, heart rate, and gender were important for RSAs (p &lt; 0.05). Conclusions: RSAs and ectopic arrhythmias may have unique modifiable and non-modifiable factors that may help in understanding their etiology for prevention and treatment as appropriate across the lifespan.

Personal protective equipment impacts firefighters' anaerobic fitness.

Personal protective equipment (PPE) is vital for firefighters' safety and effectiveness during daily operations. However, concerns have emerged about its potential impact on firefighters' anaerobic fitness (AF), which is crucial for their operational readiness. The Physical Ability Test (PAT) is used to assess readiness, but there is inconsistency among fire departments regarding whether PAT is conducted with full PPE or regular exercise clothing. This variation in testing conditions may exacerbate the stress on firefighters' AF. To analyse differences in firefighters' AF performance while wearing full PPE compared to regular exercise clothing. We studied two cohorts totalling 62 firefighters from specific fire departments in South Florida. We conducted occupation-specific AF tests, including handgrip dynamometry (HG), vertical jump (VJ), Margaria-Kalamen (MK), and a 300-yard shuttle run (300YD), both with full PPE (WPPE) and without PPE (NPPE). We adjusted AF variables for body weight (e.g. NPPE) and occupational weight (e.g. WPPE) and used a repeated-measures design in Jamovi (P < 0.05). Wearing WPPE significantly reduced relative HG strength by 59%, VJ peak power by 11%, and MK mean power by 49%, while increased 300YD completion time by 18%. The study reveals that PPE substantially impairs firefighters' anaerobic performance during occupation-specific tests. This emphasizes the need for tailored AF training programs to support the anaerobic system and related performance while wearing PPE, acknowledging the significance of occupational specificity in assessing firefighters' fitness components.

Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk.

A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice.

Neighbourhood walkability and greenspace and their associations with health-related fitness in urban dwelling Canadian adults

ObjectiveMuscular strength and body composition are important components of health-related fitness (HRF). Grip strength and body fat percent, in particular, are associated with chronic disease and affected by health behaviours. Evidence suggests relationships between the neighbourhood built environment (BE) and HRF exist, however, few studies have focused on grip strength and body fat percent. Therefore, our study aimed to estimate the sex-specific associations between the neighbourhood BE, grip strength, and body fat percent among urban-dwelling Canadian adults. MethodsWe analyzed cross-sectional survey and HRF data collected in 2011-2015 from 4052 males and 7841 females (Alberta's Tomorrow Project, Canada). Grip strength and body fat percent were measured via handgrip dynamometry and bioelectrical impedance analysis, respectively. Walkability (Canadian Active Living Index) and greenness (Normalized Difference Vegetation Index) estimates were linked to participant data. Sex-stratified covariate-adjusted linear regression models estimated the associations between the BE and HRF variables. ResultsWalkability was negatively associated with grip strength and body fat percent in males (β -0.21, 95%CI: -0.31 to -0.11 and β -0.08, 95%CI: -0.15 to -0.02, respectively) and females (β -0.06, 95%CI: -0.10 to -0.01 and β -0.08, 95%CI: -0.14 to -0.02, respectively). Greenness was positively associated with grip strength in males (β 6.99, 95%CI: 3.62 to 10.36) and females (β 2.72, 95%CI: 1.22 to 4.22) but not with body fat percent. Controlling for physical activity and sitting did not attenuate these associations. ConclusionCharacteristics of the neighbourhood BE appear to be associated with muscular strength and body composition, independent of physical activity and sedentary behaviour.

Impact of perioperative high-protein nutritional support on postoperative outcomes in the treatment of primary lung cancer: Russian prospective multicenter comparative study (NUTRILUNC-study)

BACKGROUND: Up to 60% of lung cancer pts experience weight loss. Prevalence of sarcopenia in patients (pts) with non-small cell lung cancer (NSCLC) is about 43% and is an independent predictor of worse overall survival. It was shown that nutritional support improves outcomes in pts with cancer. AIM: To evaluate impact of perioperative nutritional support on surgical treatment outcomes of patients with NSCLC. MATERIALS AND METHODS: Patients with primary NSCLC (n=112, 69 males), aged 57,2±8,2, awaiting lung surgery and being at risk of malnutrition (Nutritional Risk Screening Assessment 2002 score ≥3) were randomized into 2 groups. Study group (n=55) received oral nutritional support (Nutridrink Compact Protein, Nutricia LLC), 250 ml/d (36 g of protein, 612 kcal) for 14 d before and 14 d after surgery in addition to standard diet. Control group (n=57) had a standard diet. The number of respiratory complications after surgery, length of hospitalization, anthropometric, functional, laboratory parameters, quality of life (according to Quality of Life Questionnaire Core-30) were assessed. Results were presented as mean ± standard deviation. Differences were considered significant at p ≤0.05. RESULTS: In the study group there were fewer respiratory complications (p 0.01), and a shorter length of hospitalization (p=0.03). Body weight in the study group did not change significantly, while in the control group it decreased (0.15±3.7 kg versus loss of 3.47±3.6 kg). Results of six-minute walk test and hand grip dynamometry were higher in the study group then in the control group (411.8±56.0 m versus 383.2±52.1 m; 33.5±8.4 kg versus 27.1±6.8 kg). Quality of life was better in the study group, p 0.05. The total protein and albumin levels were higher in the study group (70.9±5.6 g/l versus 63.1±4.0 g/l; 38.5±5.8 g/l versus 33.2±3.0 g/l). One patient in study group experienced 1st grade diarrhea. CONCLUSION: In patients with NSCLC at risk of malnutrition perioperative nutritional support with high protein oral nutritional support has a positive effect on surgical treatment outcomes.

Abstract PO2-12-03: Home-based Resistance Exercise Improves Fatigue and Functional Strength in Female Breast Cancer Survivors Post Chemotherapy

Abstract Introduction: Chemotherapy is associated with an increase in fatigue and loss of strength in female breast cancer (BCa) survivors. Strength training has been found to reverse these effects, however, the COVID pandemic added a complexity to clinic-based exercise intervention. The purpose of this study is to determine if a home-based resistance exercise program can attenuate these debilitating effects in a cohort of breast cancer survivors that have recently completed chemotherapy. Methods: Ten BCa survivors who completed chemotherapy within the previous 6 months were recruited to participate in a 12-week home-based resistance exercise proof of concept study. Exercise was performed 3 times per week, supervised via Zoom. Participants completed 2-3 sets of upper body and lower body exercises to volitional fatigue. Self-reported fatigue was measured using the respective subscale from the EORTC QLQ-C30. Strength was measured using hand grip dynamometry and isometric leg strength. Physical function was measured using the 6-minute walk test. Assessments were completed at baseline and end of study. As a comparison, age matched controls (AMCs) were recruited to complete cross-sectional analysis of each of these variables. A one-way analysis variance was done with Tukey’s post hoc test. Significance was set at p&amp;lt; 0.05. Results: BCa survivors were 46.4 ± 12.5 years old with a BMI of 28.11 ± 5.25. AMCs were 50.3 ±13.3 years old with a BMI of 30.8 ± 5.8. There was no significant difference in patient characteristics. A significant difference in self-reported fatigue was found between groups (F=18.52; p&amp;lt; 0.0001). Post hoc analysis found significant difference in fatigue between BCa survivors at baseline (48 ± 23) and the age matched controls (p&amp;lt; 0.0001). Exercise was able to significantly reduce fatigue in BCa survivors (21 ± 15; p=0.003) to levels not significantly different to AMCs (3.3 ± 7.5). A significant difference was also observed between groups for right-hand grip strength (F= 4.923; p=0.015) and left-hand grip strength (F=8.685, p=0.001). Post hoc analysis found a significant increase in right hand grip strength in the BCa survivor group following the intervention (p=0.012). Left hand grip strength was found to be significantly lower at baseline than AMCs (p=0.048). Left hand grip strength was significantly increased in BCa survivors at end of study (p&amp;lt; 0.001). Finally, a significant difference was observed between groups for isometric leg strength (F= 3.699; p=0.038). Post hoc analysis found a significant difference in leg strength in the BCa survivor group following intervention (pre: 105.9 ± 50.6 N-M; post: 158.4 ± 13.2 N-M; p=0.030) which was 16.5% higher than AMCs (127.4 ± 36.5 N-M). No significant difference was found in 6-minute walk distance. However, there was a 21% increase in the distance walked for BCa survivors after interventions (pre: 441.2 ± 66.5m; post: 501.4 ± 123m), identical to distances walked by AMCs (501.4 ± 90.8m). Conclusion: The results of our study suggest that a virtually supervised resistance exercise program can attenuate the negative effects of chemotherapy in BCa survivors to levels similar to their peers that never had breast cancer. Further research using powered sample sizes is needed to validate these results. Citation Format: Taylor Moncrief, Crisann Moon, Angela Gonzalez, Allison Stepanenko, Tiffany Cortes, Darpan Patel. Home-based Resistance Exercise Improves Fatigue and Functional Strength in Female Breast Cancer Survivors Post Chemotherapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-12-03.

Frequency of sarcopenia in Turkish women with systemic lupus erythematosus

ObjectiveThis study aimed to evaluate the prevalence of sarcopenia and its clinical significance in Turkish women with SLE, exploring the association between muscle mass, muscle strength and SLE disease activity.MethodsA...

Assessing the Diagnostic Efficacy of Handgrip Dynamometry and Diaphragmatic Ultrasound in Intensive Care Unit-Acquired Weakness.

The aim of this study is to examine the diagnostic significance of using handgrip dynamometry and diaphragmatic ultrasound in intensive care unit-acquired weakness (ICU-AW). This study included patients who received mechanical ventilation in the ICU at the Fourth Hospital of Hebei Medical University from July to December 2020. We collected comprehensive demographic data and selected conscious patients for muscle strength and ICU-AW assessments. The evaluation comprised grip strength measurement and bedside ultrasound for diaphragmatic excursion (DE) and thickening fraction (DTF). Results were documented for comparative analysis between patient groups, focusing on the diagnostic efficacy of grip strength, DE, DTF, and their combined application in diagnosing ICU-AW. A total of 95 patients were initially considered for inclusion in this study. Following the exclusion of 20 patients, a final cohort of 75 patients were enrolled, comprising of 32 patients (42.6%) diagnosed with ICU-AW and 43 patients (57.4%) classified as non-ICU-AW. Comparative analysis revealed that grip strength, DE, and DTF were significantly lower in the ICU-AW group (P < 0.05). Subgroup analysis specific to male patients demonstrated a noteworthy decrease in grip strength, DE, and DTF within the ICU-AW group (P < 0.05). Receiver operating characteristic curve analysis indicated statistically significant diagnostic value for ICU-AW with grip strength, DE, DTF, and grip strength and diaphragmatic ultrasound (P < 0.01). Furthermore, it was observed that the amalgamation of grip strength and diaphragmatic ultrasound significantly enhanced the diagnostic accuracy of ICU-AW in patients who are critically ill. Grip strength, DE, DTF, and the combined use of grip strength with diaphragm ultrasound demonstrated diagnostic efficacy in ICU-AW. Notably, the integration of grip strength with diaphragm ultrasound exhibited a heightened capacity to enhance the diagnostic value specifically in patients diagnosed who are critically ill with ICU-AW.

The effect of Ashtanga-Vinyasa Yoga method on air force pilots' operational performance.

In today's military landscape, optimizing performance and bolstering physical health and mental resilience are critical objectives. Introducing a 12-week Ashtanga Vinyasa Yoga Supta Method (AVYSM) to the training protocol of military trained Airforce pilots, we aim to assesses the feasibility and impact of the method. Borg Scale assesses the intensity level of physical activity during the intervention. Flight simulator data gauges operational performance responses. Postural control responses are measured using a force platform, stress responses are monitored via heart monitor, and handgrip dynamometry will measure strength. Respiratory capacity is assessed using a spirometer, body composition is evaluated using impedance balance, and aviation-related questionnaires are administered before and after the intervention period. In a randomized controlled trial, the totality of pilots from the "Masters in Military Aeronautics: aviator pilot specialist" course at the Portuguese Air Force Academy (PAA) were randomly assigned to the yoga intervention or the waiting list control groups, with participants providing written informed consent. The control group followed protocolized course classes for 12 weeks, while the intervention group integrated two weekly one-hour yoga sessions into their course. The PAA has approved the implementation of this intervention protocol at Airbase 11 in Beja, highlighting its significance for the organization's policy makers. We hypothesize that this method will enhance operational performance and, subsequently, elevate flight safety. This research's potential extends beyond the PAA, as it can be adapted for use in Airforce departments of other nations and various military contexts. Évora University research ethics committee-approval number 21050. Study registered on ClinicalTrials.gov under identifier NCT05821270, registered on April 19, 2023.

Collective Weakness Is Associated With Time to Mortality in Americans.

McGrath, R, McGrath, BM, Jurivich, D, Knutson, P, Mastrud, M, Singh, B, and Tomkinson, GR. Collective weakness is associated with time to mortality in Americans. J Strength Cond Res 38(7): e398-e404, 2024-Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg·kg -1 (body mass normalized), or <1.05 kg·kg -1 ·m -2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg·kg -1 , or <0.79 kg·kg -1 ·m -2 . Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all-cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (CI: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging.

SAFETY AND EFFICACY OF SURGICAL PREHABILITATION IN CARDIOVASCULAR SURGERY PATIENTS

https://youtu.be/rQFd3dU-8AM BACKGROUND There are many complications that patients experience after cardiothoracic surgery, including prolonged intubation, increased length of ICU stay, infection, cardiovascular and muscular deconditioning and decreased quality of life. To reduce post-surgical complication risk, pre-surgical rehabilitation (Prehab) has developed as a potential countermeasure. Prehab may include exercise training, nutrition counseling, social support, patient and family education, smoking cessation and weight management. METHODS Thirty-nine, high risk surgical patients scheduled for major cardiovascular surgery were referred to the Prehab program by their cardiovascular surgeon to prepare them for upcoming intervention. Each patient underwent pre- and post-assessments, to include a six-minute walk test (6MWT), hand grip dynamometry (GRIP), and 30-second chair stands (30SCS). Patients attended supervised exercise sessions twice weekly for at least 2 weeks leading up to their surgical procedure. The 60-minute session included symptom-limited aerobic and resistance training, along with education on nutrition and post-surgical expectations. Dependent samples t-tests were used to determine statistical significance for all pre-post comparison measures. RESULTS Average program duration was 6.3 ± 3.3 wk, average number of sessions attended was 9.9 ± 5.7 sessions and the average number of sessions per week was 1.7 ± 0.3 sessions per week. Patients exercised for 27.1 ± 5.0 min with a mean exercise heart rate at 20.7 ± 12.4 bpm above rest. There were significant increases in 30SCS (pre = 9.5 ± 4.2 reps vs. post = 11.3 ± 4.5 reps), 6MWT (pre = 343.2 ± 117.9 m vs. post = 386.1 ± 96.9 m) and MET-min -1 (pre = 64.8 ± 27.5 MET-min -1 vs. post = 87.6 ± 7.3 MET-min -1). There were no changes in weight (pre = 87.5 ± 19.7 kg vs. post = 87.7 ± 19.3 kg), BMI (pre = 29.0 ± 6.2 kg·m 2 vs. post = 29.0 ± 6.0 kg·m 2), or GRIP (15.5 ± 6.7 kg vs. post = 17.8 ± 9.6 kg). Regarding safety, 385 exercise sessions were completed by all patients and 7 sessions were deferred by the staff for clinical reasons. In addition, of the 422.5 patient-hours of exercise, no untoward events occurred. CONCLUSION Patients awaiting cardiovascular surgery can exercise safely at a low to moderate intensity and see improvements in functional capacity and muscular strength.