Muscle Handgrip Strength Research Articles

Characteristics of Body Composition and Relationship between Muscle Mass and Muscle Strength among Elderly Women in Different Age Groups

Age-related changes in the body composition of older adults differ among age groups. The purpose of the present study was to clarify the characteristics of body compositions in young (age, 65 - 74 years; yE group) and old (age, ≥75 years; oE group) elderly women, and compare the relationship between muscle mass and strength in elderly women with that in young women for preventing motor function loss in older adults. A total of 30 elderly and 45 young women aged ≥ 65 and 19 - 22 years, respectively, participated in this study. The participants underwent body composition measurement via bioelectrical impedance analysis and examinations of handgrip and leg muscle strength. The age-related body composition changes varied among age groups. Compared with young women, fat-free mass (FFM) in the yE group did not decrease significantly; however, fat mass (FM) and waist-hip ratio (WHR) were significantly greater. Compared with the yE group, decreases in FFM, FM, and WHR in the oE group were significant; furthermore, the decrease in FM measurements was attributed to the loss of FM in the trunk and limbs (upper and lower). The measurement results suggested that the greater FM decrease in the oE group was characterized by decreases in both visceral and subcutaneous fat. In the yE group, the muscle mass was comparable to that in young women; however, there was a remarkable reduction in the lower-limb muscle mass (9% - 10%). In the oE group, muscle mass was reduced in all body parts, including upper and lower limbs and trunk. In young women, significant positive correlations between muscle mass and muscle strength in the upper and lower limbs were observed. No such correlations in the lower limbs were found in elderly women, indicating that muscle mass is not proportionally reflected in muscle strength. In conclusion, for improving and maintaining the health of elderly women, especially those above the age of 75 years, it is important to maintain muscle mass, including muscle strength, and prevent the loss of muscle quality.

Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery

Introduction: Patients undergoing weight loss surgery do not improve their aerobic capacity or peak oxygen uptake (VO2peak) after bariatric surgery and some still complain about asthenia and/or breathlessness. We investigated the hypothesis that a post-surgery muscular limitation could impact the ventilatory response to exercise by evaluating the post-surgery changes in muscle mass, strength, and muscular aerobic capacity, measured by the first ventilatory threshold (VT). Methods: Thirteen patients with obesity were referred to our university exercise laboratory before and 6 months after bariatric surgery and were matched by sex, age, and height to healthy subjects with normal weight. All subjects underwent a clinical examination, blood sampling, and body composition assessment by dual-energy X-ray absorptiometry, respiratory and limb muscle strength assessments, and cardiopulmonary exercise testing on a cyclo-ergometer. Results: Bariatric surgery resulted in a loss of 34% fat mass, 43% visceral adipose tissue, and 12% lean mass (LM) (p < 0.001). Absolute handgrip, quadriceps, or respiratory muscle strength remained unaffected, while quadriceps/handgrip strength relative to LM increased (p < 0.05). Absolute VO2peak or VO2peak/LM did not improve and the first VT was decreased after surgery (1.4 ± 0.3 vs. 1.1 ± 0.4 L min−1, p < 0.05) and correlated to the exercising LM (LM legs) (R = 0.84, p < 0.001). Conclusions: Although bariatric surgery has numerous beneficial effects, absolute VO2peak does not improve and the weight loss-induced LM reduction is associated to an altered muscular aerobic capacity, as reflected by an early VT triggering early exercise hyperventilation.

Respiratory muscle strength, exercise capacity and physical activity in patients with primary ciliary dyskinesia: A cross-sectional study

Background and objectivesThe pathophysiological mechanisms of primary ciliary dyskinesia (PCD) may affect many functions, including respiratory, physical, and health status. This study aimed to compare respiratory muscle strength, inspiratory muscle endurance, muscle strength, exercise capacity, physical activity levels, and quality of life in PCD patients and controls. MethodsTwenty-seven patients and 28 controls were included. Respiratory muscle strength (maximal inspiratory (MIP) and maximal expiratory (MEP) pressures), inspiratory muscle endurance (incremental threshold loading test), muscle strength (quadriceps femoris, shoulder abductor, elbow flexor, handgrip), exercise capacity (6-min walk test (6MWT)), physical activity and quality of life (QOL-PCD) were evaluated. ResultsMIP, inspiratory muscle endurance, quadriceps femoris, and handgrip muscle strength, 6MWT distance, total energy expenditure; childrens' (6–12 years) and their parents' physical function, upper, lower respiratory, and hearing symptoms and treatment burden QOL-PCD subscales scores were significantly lower in patients compared with controls (p < 0.05). The 66.7% of patients did not meet the optimal number of steps. MEP, shoulder abductor, and elbow flexor muscle strength, active energy expenditure, physical activity duration, average metabolic equivalents, number of steps, lying time, and sleep duration; childrens' and their parents' other subscales and adolescents’ all QOL-PCD subscales scores were similar between groups (p > 0.05). ConclusionInspiratory muscle strength and endurance, lower extremity and total muscle strength, exercise capacity, total energy expenditure, and childrens’ quality of life are impaired compared to healthy controls. Decreased physical activity level is prevalent in these patients. Effects of pulmonary rehabilitation on these impaired outcomes for PCD patients should be investigated. Trial registrationClinicaltrials.gov: NCT03370029; December 12, 2017.

Comparison of intradialytic neuromuscular electrical stimulation and oral nutritional supplements in hemodialysis patients: study protocol for a multicenter, parallel-group, randomized controlled trial in Korea

BackgroundThe prevalence of sarcopenia increases as renal function decreases, and a considerable number of hemodialysis (HD) patients have sarcopenia. Exercise and nutritional support are established interventions to prevent and treat sarcopenia. Recently, many studies evaluating intradialytic neuromuscular electrical stimulation (NMES) showed improvement of muscular strength and mass, functional capacity, and quality of life (QOL). However, there has been no research about the effect of simultaneous nutritional support and NMES in HD patients.MethodsThis is a 12-week, randomized controlled, parallel-group, multicenter trial of intradialytic NMES and protein supplementation for HD patients. Seventy-two patients receiving HD will be randomly assigned in a 1:1:1:1 ratio to control, intradialytic NMES only, protein supplementation only, and intradialytic NMES combined with protein supplementation groups. NMES will be delivered to a total of four areas of the bilateral vastus medialis and vastus lateralis using a 4-channel NMES instrument. A total of 25 g of protein supplements will be provided at the beginning of every dialysis session or after the NMES. The primary endpoint is the difference of hand grip and leg muscle strength at 12 weeks among 4 treatment groups. Secondary endpoints include muscle mass, physical performances, and questionnaires about QOL and physical activity.DiscussionIn this study, we will evaluate the differential effectiveness of nutritional support and NMES during HD on muscle strength, muscle mass, physical function, and QOL. We expect that this study can provide guidelines for a new therapeutic option for HD patients who are unable or hesitant to exercise. Furthermore, this option can offer an opportunity to improve the physical function, QOL, and prognosis of HD patients.Trial registrationClinical Research Information Service (CRIS), Korea, KCT0005573. Retrospectively registered on 03 November 2020

A descriptive ranking of blood pressure and physical fitness of Latin–American ethnic schoolchildren

ABSTRACT Background There is a general lack of information about how insufficient physical activity impacts blood pressure and physical fitness in Latin-American ethnic minorities. Aims To describe the interactions between insufficient physical activity, blood pressure, and physical fitness outcomes in Latin-American schoolchildren of different ethnicity. Methods This was a prospective, international, multi-center, and cross-sectional study of three Latin-American countries involving schoolchildren from seven ethnic groups of Colombia (Tikuna, Nasa, Embera), Brazil (African, Mulato), and Chile (Mapuche), and also European schoolchildren from Brazil and Chile. Data were categorized based on whether participants were physically active (PA) or insufficient physical activity (iPA) using the WHO physical activity recommendations. The main outcomes were systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressure, and scores for physical and cardiorespiratory fitness (CRF, by estimated O2max), handgrip muscle strength (HGS), and standing long jump (SLJ). Secondary outcomes were anthropometric measures (weight, height, body mass index [BMI], waist circumference [WC], waist-to-height ratio), and body fat percentage (BF%, limited data by country). Primary and secondary outcomes were ranked. Results For both PA and iPA categories, significant interactions between ethnic groups were found concerning SBP/DBP (F (37.7), ES 0.08; F (51.5), ES 0.08), O2max (F (37.7), ES 0.08; F (51.5), ES 0.08), HGS (F (33.8), ES 0.07; F (5.03), ES 0.04), and SLJ (F (64.3), ES 0.14; F (64.3), 0.14). In the iPA category, Mapuche schoolchildren were classified 1st (119.5; 81.5) with highest SBP/DBP and highest MAP (94.6 mmHg); Embera schoolchildren were classified 1st with lowest O2max (33.7 mL/kg/min); and European schoolchildren were classified 1st (19.9 kg) with lowest HGS and SLJ (121.4 m) physical fitness. Conclusions Under conditions of insufficient physical activity conditions, Mapuche schoolchildren had the most detrimental blood pressure, whereas Embera, Tikuna, and European schoolchildren had the lowest levels of physical fitness. These results serve to highlight the need for the early and appropriate promotion of physical activity based on ethnic differences in Latin-American schools.

Selective Attention and Concentration Are Related to Lifestyle in Chilean Schoolchildren.

The objective of this investigation was to determine the association between selective attention and concentration with physical fitness (i.e., cardiorespiratory fitness (CRF), O2max, the standing long jump test (SLJ) and handgrip muscle strength (HGS)), lifestyle parameters (i.e., physical activity (PA) level, screen time (ST), sleep duration and food habits) and anthropometric measures (i.e., body mass index (BMI) and waist circumference (WC)) among Chilean schoolchildren. Two hundred and forty-eight schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated. Selective attention, concentration and lifestyle (PA, ST, sleep duration and Mediterranean diet (MD) adherence) were determined using a standard questionnaire. CRF, SLJ, HGS and anthropometric indicators (BMI and WC) were also measured. Selective attention showed a positive association with MD adherence score (β; 5.012, p = p < 0.05). Concentration was linked inversely to ST (β; −5.498, p = p < 0.05). Likewise, concentration presented a positive association with MD adherence (β; 2.904, p = p < 0.05). In conclusion, children’s lifestyles are related to the selective attention and concentration of children; therefore, promoting healthy habits could be a cost-effective strategy in the promotion of cognitive development, as it relates to selective attention and concentration.

Fragility syndrome: determinant factors in institutionalized elderly

The aim of the study was to evaluate the frailty syndrome in residents of a Long-Term Care Facility for the Elderly. A cross-sectional study was carried out on 24 subjects over the age of 60 years. For the screening of frailty syndrome, the criteria of the Cardiovascular Study were used, which classifies the subjects into fragile, pre-fragile and non-fragile according to five criteria: decreased handgrip strength; self-reported fatigue; decrease in walking speed; unintentional weight loss; and low level of physical activity. The average age of the population studied was 81.13 years, with 54.20% being female. Among the elderly, 83.33% were frail, 12.50% were pre-frail and 4.17% were not frail. Elderly people over 80 years old had a higher incidence of frailty when compared to those aged 60 - 79 years, with 85.7% and 80%, respectively. Since 66.67% of the elderly had decreased handgrip muscle strength, 37.50% reported fatigue, 41.67% demonstrated decreased gait speed, 12.50% unintentional weight loss and 87.50% were physically inactive. We identified a high prevalence of DES among the elderly residing in the institution studied, thus reinforcing the importance of early screening for frailty in institutionalized elderly.

Effect of Strength Versus Strength and Endurance Upper Limb Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A RANDOMIZED CLINICAL TRIAL.

Pulmonary rehabilitation (PR) including exercise training improves muscle strength, exercise capacity, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, the evidence of the effect of upper limb exercise training (ULET) on activities of daily living (ADL) is sparse. This study investigated the effect of two different types of ULET on ADL in addition to standard PR. Patients were randomly assigned to a strength or a combined ULET group. Both groups exercised 2 d/wk for 12 wk. Outcome measures were handgrip strength and muscle strength of biceps and triceps muscles. Moreover, health-related quality of life was assessed through the COPD assessment test (CAT) and Saint George Respiratory Questionnaire. Ability to perform ADL was evaluated through an ADL simulation test. Dyspnea was evaluated by a modified Medical Research Council scale, whereas dyspnea and fatigue perception during strength and ADL tests were measured through a modified Borg scale. Thirty-six patients with COPD (67.4 ± 5.3 yr) participated in the study. Significant improvements in upper limb strength and CAT were found within both groups. At the end of the study period, patients in the combined group improved time of the ADL test (P = .02) with reduced perception of fatigue (P = .03) compared with patients in the strength group. In addition to standard PR of patients with COPD, the combined endurance and resistance ULET program improved ADL and muscle strength, whereas resistance training only increased strength.

AB0844 HAND GRIP STRENGTH EVALUATION IN RHEUMATOLOGIC DISEASES

Background:Handgrip muscle strength test describes the strength of the hand muscles used to grasp or grip. Currently, hand grip evaluation is often used in clinical practice, as a marker of function and disability. In fact, it has already been applied as an outcome measure in arthritis rheumatoid clinical trials, to demonstrate the benefits of several treatments [1]. However, hand disability should also be considered in all other rheumatological diseases.Objectives:The main aim of this study is to assess the handgrip muscle strength test in a rheumatological cohort of patients as compared to a control group.Methods:This is a cross-sectional pilot study. We considered eligible 35 rheumatological consecutive female patients followed at our outpatients’ clinic of Internal Medicine (I Policlinico of Naples) and 35 healthy control females (HC). Both groups included only right-handed individuals. Rheumatological patients were distributed as follows: 5 rheumatoid arthritis (14,3%), 9 psoriatic arthritis (25,7%), 4 systemic lupus erythematosus (11,4%), 10 systemic sclerosis (28,6%), 4 fibromyalgia (11,4%), 3 juvenile idiopathic arthritis (8,6%). The course of disease was under optimal treatment in all patients.The type of hand grip used is the power grip, in which an object is held firmly by wrapping the fingers around it, pressing the object against the palm, and using the thumb to apply counter-pressure. We considered as either right or left hand valid measure the mean of three consecutive tests per arm. Between-groups differences were tested both by a uni- and multivariable analysis.Results:The two subgroups were homogeneously distributed for age (median age 42 yrs. [IQR 33-48] vs. 36 yrs. [IQR 30-52] in HC; p=0.902). At univariate analysis, hand grip strength was significantly lower in the rheumatological patients, both at right hand (right 19.5 kg [IQR 13.6-24.8] vs. 24.5 kg [IQR 20.8-29] in HC; p=0.004) and left hand (18.5 kg [IQR 13.9-22.5] vs. 23.7 kg [IQR 19-27.3] in HC; p=0.002), as compared to HC. This finding was further confirmed at multivariable analysis only as for the left hand (OR 0.919, 95%CI: 0.858-0.984; p=0.016).Conclusion:Rheumatological diseases are burdened by hand disability, mostly affecting daily activities performance [2,3]. Beyond an optimal disease control, our pilot study shows a decrease in left hand strength as compared to healthy controls. This might be due to a reduced use of the non-dominant hand, which may lead over time to a higher deficit of strength. As such, these patients should be prescribed to a left hand exercise to improve both mobility and strength and, consequently, hand function.

Adiposity and muscle strength level in pre-scholars according to the educational level and socio-demographic characteristics of their parents

The educational level of the adult population is related to obesity, but there is little knowledge regar ding the relationship of parents' educational level with the obesity and muscle strength of Chilean pre-school children. To describe the levels of adiposity and muscular strength of pre schoolers, according to the educational level and socio-demographic characteristics of their parents. Descriptive, cross-sectional study with participation of pre-schoolers from kindergartens and their parents (n = 99). Variables studied were a) socio-demographic (survey with 4 items), b) anthropometry (weight, height, weight/height ratio, weight/height-z, and body mass index), c) body composition (fat mass in kg and %, muscle mass), and d) muscle strength (hand grip muscle strength). The association between the above factors and the educational level of the parents [mother or father] of "low" [Low-EL] or "high" educational level [High-EL] were analy sed. There were significant differences between the weight/height according to the parents' educational level (father Low-EL; 0.088 ± 0.170 vs High-EL -0.060 ± 0.163, P = 0.024), and in the percentage of fat mass (father Low-EL; 30.8 ± 0.8 vs High-EL; 28.7 ± 0.9%, P = 0.040). In the rest of the obesity markers, there were no significant differences according to the parents' educational level nor in strength and muscle mass. Pre-school children of parents with low educational level show significantly higher values of weight/height and percentage of fat mass than those peers with parents with high educational level. These findings require further and more complex research to be corroborated.

The physical fitness evaluation of medical student in Semarang : a cross sectional study

Objective: Physical activity (PA) is one of the most important determinants for physical fitness (PF) in adolescence and young age. The previous study showed that most medical students as part of young population were found to be physically inactive. Our study aims to evaluate the correlation between PA and PF status among medical students.&#x0D; Materials and methods: One hundred and twenty five medical students of UNISSULA were enrolled in this study. PA level was measured using international physical activity questionnaire (IPAQ)-short form. PF status was evaluated by cardiorespiratory capacity (VO2max score), handgrip muscle strength (HGS), and body composition (fat persentage and BMI). The data were analyzed using pearson correlation analysis.&#x0D; Results and discussion: The majority of PA level among participants were low. There was a correlation between PA level and sex (p= 0.001, r = 0.272), PA level and BMI (p = 0.001, r = 0.264), PA level and HGS score (p=0.000, r = 0.345). However, there was no correlation between PA level and VO2max or fat percentage.&#x0D; Conclusion: The PA level and PF status among participants were considered to be low and fair, respectively. Only one component of PF status (HGS) was correlated with PA level. Further investigations on the correlation between PA level and PF status using more objective methods are needed especially when involving medical students.&#x0D; Bangladesh Journal of Medical Science Vol.20(3) 2021 p.625-630

Respiratory and peripheral muscle involvement in patients with pulmonary arterial hypertension due to congenital heart diseases.

Skeletal and respiratory muscle dysfunction has been previously described in patients with other etiologic subgroups of pulmonary arterial hypertension (PAH) but has never been investigated in patients with PAH due to congenital heart diseases (CHD). This study aims to show the involvement of skeletal and respiratory muscles in these patients. This cross-sectional study included patients with PAH due to CHD and healthy controls. Patients' demographic properties, six-minute walk tests; shoulder abduction, handgrip, knee extension, and ankle dorsiflexion muscle strength, maximum inspiratory (MIP) and expiratory pressures (MEP) were measured. Deltoid, flexor digitorum superficialis, and profundus, tibialis anterior and rectus femoris muscles were visualized with ultrasonography and their cross-sectional areas (CSA) were also measured in both groups. 12 patients and 12 controls were included. Mean MIP was 104.22±32.57 cm H2O for healthy participants while 61.33±29.74 cm H2O for patients (p<0.001). For mean MEP, it was 100.08±26.05 cm H2O in healthy participants and 69.75±39.79 cmH2O in controls (p=0.004). When the strength of skeletal muscles was compared, there were significant differences between the groups in all measurements except for bilateral grip strength. In the correlation analysis, MIP and MEP values showed no significant correlations with clinical parameters. They showed significant moderate correlations with skeletal muscle strength. When CSAs of the muscles were compared, there were significant differences in all measurements except for left FDS and FDP and bilateral rectus femoris. This study showed that in patients with pulmonary arterial hypertension due to CHD, respiratory muscle strength is significantly worse than healthy participants. Patients had also significantly worse skeletal muscle strength except for grip strength.

Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study.

Handgrip and knee extension strengths have each been used to characterize disability. However, it has been reported that the association between handgrip and knee extension strengths is weak. To evaluate the influence of knee extensor and handgrip muscle strength on Timed Up and Go (TUG) test results among elderly women with worse (≥ 10 seconds) and better (< 10 seconds) performance, after controlling for confounders. Cross-sectional study on a sample selected according to convenience, carried out in a federal public institution of higher education. Assessment of handgrip was carried out using the Jamar dynamometer (Lafayette Instrument Company, Inc., Lafayette, United States). Knee extensor muscle performance was measured using an isokinetic dynamometer (Biodex System 3 Pro; Biodex Medical Systems, Inc., United States), The confounding factors were education, age, comorbidities, body mass index and Geriatric Depression Scale and Human Activity Profile scores. Functional performance was assessed through the TUG test. A backward linear regression model was used. 127 elderly women performed the TUG test in more than 10 seconds and 93 in less than 10 seconds. However, regardless of test performance, handgrip strength and knee extension strength comprised the reduced final model. Knee extension strength and handgrip strength might be particularly useful indicators for measuring disability.

Impaired exercise capacity in electrostatic polyester powder paint workers

Purpose Limited number of studies investigated the effects of Electrostatic powder paints (EPP) on human health. We investigated the effects of EPP exposure on lung function, exercise capacity, and quality of life, and the factors determining exercise capacity in EPP workers. Methods Fifty-four male EPP workers and 54 age-matched healthy male individuals (control group) were included. Lung function and respiratory muscle strength were measured. The lower limit of normal (LLN) cut-points for FEV1 and FEV1/FVC were calculated. An EPT was used to evaluate bronchial hyperactivity. The handgrip and quadriceps muscle strength were evaluated using a hand-held dynamometer. An ISWT was used to determine exercise capacity. The physical activity level was questioned using the IPAQ. The SGRQ and NHP were used to assessing respiratory specific and general quality of life, respectively. Results Duration of work, FEV1, MIP, handgrip strength, and ISWT distance were significantly lower, and the change in FEV1 after EPT and %HRmax were significantly higher in the EPP group compared to the control group (p < 0.05). There were no subjects with a < LLN for FEV1 and FEV1/FVC in both groups. In the EPP group, ISWT distance was significantly related to age, height, duration of work, FEV1, change in FEV1 after EPT, MIP, MEP, handgrip strength, IPAQ, SGRQ, and NHP total scores (p < 0.05). The change in FEV1 after EPT, MIP, and duration of work explained % 62 of the variance in the ISWT distance (p < 0.001). Conclusions Changes in lung function based on LLN for the FEV1 and FEV1/FVC were not clinically relevant in EPP workers. Exercise capacity is impaired in EPP workers. Degree of exercise-induced bronchospasm, inspiratory muscle strength, and duration of work are the determinants of exercise capacity in EPP workers.

Health-Related Factors in Rural and Urban Mexican Adolescents from the State of Jalisco: The HELENA-MEX Study.

Mexico shows a high prevalence of obesity in children and adolescents. Geographical location and cultural environment could play a role in the promotion of healthy lifestyles in terms of physical activity (PA), sedentary behavior (SB) and nutrition. The purpose of this study was to assess rural and urban differences in body composition (BC), physical fitness (PF), PA and nutritional status of adolescents from the state of Jalisco (Mexico). The study involved 469 students aged 13–17 years (55.0% girls) from eight high schools. BC was analyzed by bioimpedance and PF by standardized field tests. Objective measurements of PA and SB were taken in a subsample (n = 240). Energy intake (EI) was calculated from two 24h recalls. Rural residents presented a higher prevalence of overweight, waist circumference, trunk fat mass, regional fat free mass and muscle handgrip strength (all p < 0.05, η2p < 0.06). Cardiorespiratory fitness was similar among participants, whereas urban adolescents showed higher muscle power, speed-agility and flexibility scores (all p < 0.05, η2p < 0.07). Overall lifestyle behavior in urban adolescents was more sedentary (p < 0.05, η2p = 0.11). EI was similar in both locations. In conclusion, rural Mexican adolescents presented a generally lower sedentary behavior and a lower fitness and fatness profile than their urban peers.

Blended home-based exercise and dietary protein in community-dwelling older adults: a cluster randomized controlled trial.

BackgroundEffective and sustainable interventions are needed to counteract the decline in physical function and sarcopenia in the growing aging population. The aim of this study was to determine the 6 and 12 month effectiveness of blended (e‐health + coaching) home‐based exercise and a dietary protein intervention on physical performance in community‐dwelling older adults.MethodsThis cluster randomized controlled trial allocated 45 clusters of older adults already engaged in a weekly community‐based exercise programme. The clusters were randomized to three groups with ratio of 16:15:14; (i) no intervention, control (CON); (ii) blended home‐based exercise intervention (HBex); and (iii) HBex with dietary protein counselling (HBex‐Pro). Both interventions used a tablet PC with app and personalized coaching and were targeting on behaviour change. The study comprised coached 6 month interventions with a 6 month follow‐up. The primary outcome physical performance was assessed by modified Physical Performance Test (m‐PPT). Secondary outcomes were gait speed, physical activity level (PAL), handgrip muscle strength, protein intake, skeletal muscle mass, health status, and executive functioning. Linear mixed models of repeated measured were used to assess intervention effects at 6 and 12 months.ResultsThe population included 245 older adults (mean age 72 ± 6.5 (SD) years), 71% female, and 54% co‐morbidities observed. Dropout of the intervention was 18% at 6 months and 26% at 12 months. Participants were well functioning, based on an m‐PPT score of 33.9 (2.8) out of 36. For the primary outcome m‐PPT, no significant intervention effects (HBex, +0.03, P = 0.933; HBex‐Pro, −0.13, P = 0.730) were found. Gait speed (+0.20 m/s, P = 0.001), PAL (+0.06, P = 0.008), muscle strength (+2.32 kg, P = 0.001), protein intake (+0.32 g/kg/day, P < 0.001), and muscle mass (+0.33 kg, P = 0.017) improved significantly in the HBex‐Pro group compared with control group after 6 month intervention. The protein intake, muscle mass, and strength remained significantly improved after 12 months as compared with those of control. Health change and executive functioning improved significantly in both intervention groups after 6 months.ConclusionsThis HBex and dietary protein interventions did not change the physical performance (m‐PPT) in community‐dwelling older adults. Changes were observed in gait speed, PAL, muscle mass, strength, and dietary protein intake, in response to this combined intervention.

Effects of a resistance training program in kidney transplant recipients: A randomized controlled trial.

Kidney transplant recipients are at risk of developing important adverse effects after transplantation. The objective of this study was to investigate the effects of a 10-week supervised resistance exercise-based intervention in kidney transplant recipients. Sixteen participants were randomized to a training (n=8, 49.7±9.6years) or control group (n=8, 48.6±10.6years). The primary endpoint was health-related quality of life evaluated through the Kidney Disease Quality of Life-Short Form (KDQOL-SF), which includes the 36-Item Short Form Survey (SF-36), and secondary endpoints included physical performance (6-minute walk distance [6-MWD], 60-second sit to stand test [60-STS], 8-foot up and go test, and handgrip and lower limb muscle strength), muscle mass, and biochemical parameters. Endpoints were assessed at baseline and after 10weeks. Resistance exercise significantly increased (P<.05) some SF-36 domains and tended to induce improvements in one specific KDQOL-SF domain (P=.050). Further, exercise benefits were observed for 6-MWD (9% and 1% for the training and control groups, respectively; P<.001), handgrip strength (7% and -1%; P=.005), 60-STS repetitions (18% and -7%; P<.001), and 8-foot up and go test performance time (-5% and 6%; P=.010). No between-group differences (P>.05) were found for the remaining endpoints. There were no adverse events, musculoskeletal injuries, hypoglycemic episodes, cardiovascular events, or hospitalizations related to the intervention. In conclusion, 10weeks of supervised resistance training is enough to improve quality of life and physical performance without side effects such as musculoskeletal injuries, hypoglycemic episodes, cardiovascular events, or hospitalizations related to the intervention in kidney transplant recipients.

Relationship among the quality of cognitive abilities, depression symptoms, and various aspects of handgrip strength in the elderly

Background/Aim. Both the cognitive and physical functioning changes occur within the normal aging, suggesting possible common biological processes. The aging process is often characterized by a reduction of adaptive responses, an increasing vulnerability and functional limitations. The aim of this study was to determine if there were correlations between particular cognitive abilities (verbal ability, spatial ability, processing speed, memory, verbal fluency, divergent thinking, memory, attention, executive functions, conceptualization, orientation, computation), depression symptoms and different dynamometric parameters of muscle contraction, during handgrip (HG) of both hands, in the elderly population. Methods. The sample consisted of 98 participants, 16 males and 82 females, aged from 65 to 85. Neuropsychological assessment included Montreal Cognitive Assessment (MoCA), Frontal Function Test (Go/No-Go), Categorical and Phonemic fluency tests and Geriatric Depression Scale Short Form (GDS-SF). Physical measures were assessed by Handgrip Dynamometry Tests (HG), and included: the maximum force (Fmax), maximal rate of force development (RFDmax), static endurance HG time realized at 50% of maximal HG force (tFmax50%) of dominant (Do) and non-dominant (NDo) hand. Results. Higher MoCA score was followed by higher values of muscle endurance of dominant hands. Higher values of F max of dominant hand were associated with higher values of Alternating Trail Making that is by visuoconstructive abilities (MoCA). The variable Categorical fluency was in a small, positive correlation with Fmax. No correlation of depressive symptoms with HG parameters was found except in the subgroup of female subjects. Conclusion. Better cognitive performance was associated with better HG muscle strength. Therefore, HG strength can be a useful tool in geriatric practice in monitoring not only physical, but also cognitive function status and de-cline. The link between lower cognitive functioning and lower values of HG variables, emphasize the need for in-creased awareness about it in clinical practice.

KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞINDA DOSE İNDEKSİ KAS FONKSİYON BOZUKLUĞU, GÜNLÜK YAŞAM AKTİVİTELERİ VE YAŞAM KALİTESİ İLE İLİŞKİLİDİR

Purpose: Composite measures have potential to account for many of the facets of disease in chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the relationship between the DOSE (Dyspnea, Obstruction, Smoking, Exacerbation) Index which is a multi-component assessment tool and handgrip and respiratory muscle strength, activities of daily living (ADL) and health-related quality of life in patients COPD. Methods: Forty-five patients with COPD (30 males, 15 females, mean FEV1 =50.60±16.00%) were included. The DOSE Index was calculated using the modified Medical Research Council dyspnea scale, obstruction level, smoking status, and exacerbation rate. Inspiratory and expiratory muscle strength (MIP and MEP) was measured using a mouth-pressure device. Handgrip strength was determined using hand dynamometer. Activities of daily living were evaluated using the London Chest Activity of Daily Living Scale (LCADL), and quality of life was assessed using the diseasespecific COPD Assessment Test (CAT). Results: The DOSE Index score was related with handgrip strength (r=-0.388, p=0.009), MIP (r=- 0.323, p=0.033), LCADL-physical activity score (r=0.314, p=0.038), LCADL-leisure activities score (r=0.397, p=0.008), and CAT score (r=0.435, p=0.003). Conclusion: Increased multi-component disease severity is related to decreased handgrip and respiratory muscle strength, physical activity and leisure time activities of daily living, and worse health-related quality of life in COPD patients. The DOSE Index, a simple disease severity assessment tool, is a convenient and practical tool for assessment in pulmonary rehabilitation programs.

Association between peak inspiratory flow rate and hand grip muscle strength in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease.

RationaleIneffective peak inspiratory flow rate (PIFR) generation in patients using inhalers results in insufficient drug delivery to the lungs and poor clinical outcomes. Low inspiratory muscle strength is associated with suboptimal PIFR.ObjectiveTo examine in a prospective study the relationship between PIFR and skeletal muscle strength using hand grip strength (HGS) as a surrogate.MethodsAdult patients admitted with acute exacerbation of chronic obstructive pulmonary disease (COPD) were enrolled. PIFR was measured within 48 hours before discharge. PIFR below 60L/min was considered suboptimal. HGS was measured using a handheld dynamometer. Any readmissions and emergency department visit data were collected. The associations between PIFR, HGS, 30 and 90-day COPD and all-cause readmissions were examined, without and with adjustment for age, race and gender.ResultsOf the 75 enrolled patients, 56% had suboptimal PIFR; they were older (63.9±9.7 vs. 58.2±7.7 years) and had significantly lower HGS (24.2±11.1 vs. 30.9±10.9 Kg) compared to those with optimal PIFR. There were no significant differences between the two PIFR groups by gender, race, history of coronary artery disease, congestive heart failure, hypertension or functional scores. Each kilogram increase in HGS was associated with 0.50 (95%CI 0.18–0.89, p = 0.003) L/min increase in PIFR. We did not observe an association between PIFR and 30 or 90-day readmission rates.ConclusionWe found a significant association between HGS and PIFR in hospitalized patients with acute exacerbations of COPD. Whether interventions aimed at increasing skeletal muscle strength also result in improvement in PIFR remains unclear and need further study.