Muscle Handgrip Strength Research Articles

6427 Impact of Adrenalectomy On Frailty And Muscle Function In Patients With Mild Autonomous Cortisol Secretion: A Prospective Longitudinal Study

Abstract Disclosure: J. Saini: None. V. Fell: None. B. Atkinson: None. S. Achenbach: None. I. Bancos: None. Background: Patients with mild autonomous cortisol secretion (MACS) have a higher prevalence of frailty and reduced muscle strength as compared to patients with nonfunctioning adrenal adenomas or subjects without adrenal disorders. Objective: To determine the impact of adrenalectomy on frailty and parameters of functional strength in patients with MACS. Methods: We conducted a single-center prospective longitudinal study of adults with MACS scheduled for adrenalectomy and referent subjects evaluated between 2018 and 2023. MACS was defined as serum cortisol>1.8 mcg/dL after 1 mg dexamethasone suppression test in patients with adrenal adenomas and no features of overt hypercortisolism. Referent subjects were included if they had abdominal imaging and had no adrenal disorders. Patients and referent subjects had a baseline and a follow-up evaluation at least 10 months later. Differences were assessed using paired t-tests for (1) Frailty Index (FI)--calculated using a questionnaire containing 47 variables on comorbidities, symptoms, and daily living activities (frailty defined as FI>0.25) (2) physical function assessed using handgrip strength (Jamar Plus digital hand dynamometer), timed up-and-go test (time taken to rise from a chair, walk to and from 3 m, and sit down), gait speed, 6-minute walk test, and (3) Advanced Glycation End (AGE) Product (using AGE reader). Results: We evaluated 41 patients before and after adrenalectomy, and 31 referent subjects at baseline and follow-up visit, at a similar interval (median 1.6, IQR 1.2-2.0 vs 1.5 years, IQR 1.0-2.2, P=0.759). While sex distributions were no different between the 2 groups (women, 66% vs 84%, P=0.086), patients with MACS were older than the referent group (median age 57.3, IQR 48.8-66.9 vs 49.0, IQR 41.7-57.9 years, P=0.005). Post-adrenalectomy, FI decreased by a mean of 0.057 (SD 0.08), P<0.001 in patients, and remained unchanged in the referent group. AGE decreased in patients by 0.148 (SD 0.45), P=0.04 but not in referent subjects (-0.047, SD 0.242, P=0.5). Patients demonstrated no improvement in parameters of muscle strength: gait speed (mean change 0.305 m/s, P=0.453), 6-minute walk test (mean change 16.4 meters, P=0.201), dominant (mean Z score change -0.055, P=0.72) and nondominant (mean Z score change -0.199, P=0.192) hand grip muscle strength. At follow-up, both patients (mean change 1.897 seconds, P<0.001) and referent subjects (mean change=1.475 seconds, P<0.001) demonstrated a deterioration on the timed up-and-go test. Conclusions: While no improvement was seen in the parameters of muscle strength, adrenalectomy improved the frailty index in patients with MACS. In addition, AGE, a biomarker associated with cardiovascular morbidity, decreased after adrenalectomy, suggesting a beneficial cardiovascular impact of MACS reversal. Presentation: 6/1/2024

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.

Instruments for measuring the neuromuscular function domain of vitality capacity in older persons: an umbrella review.

Recently, handgrip, knee extensor and respiratory muscle strength were proposed as candidate biomarkers to assess the neuromuscular function of vitality capacity in older persons. This umbrella review aims to provide an overview of the available instruments and their measurement properties to assess these biomarkers. The databases PubMed, Web of Science and Embase were systematically screened for systematic reviews and meta-analyses reporting on handgrip, knee extensor or respiratory muscle strength assessments, resulting in 7,555 articles. The COSMIN checklist was used to appraise psychometric properties and the AMSTAR for assessing methodological quality. Twenty-seven systematic reviews were included in this study. Some of the identified reviews described the psychometric properties of the assessment tools. We found five assessment tools that can be used to measure neuromuscular function in the context of healthy ageing. Those are the handheld dynamometer for handgrip strength, the dynamometer for knee extensor strength and regarding respiratory muscle strength, the sniff nasal inspiratory pressure, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). The handheld dynamometer for hand grip strength, the dynamometer for knee extensor strength, sniff nasal inspiratory pressure, MIP and MEP were identified. Therefore, these assessments could be used to identify community-dwelling older adults at risk for a declined neuromuscular function in the context of vitality capacity.

Effects of different inspiratory muscle training protocols on functional exercise capacity and respiratory and peripheral muscle strength in patients with chronic kidney disease: a randomized study

BackgroundPathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested for patients with CKD; however, the most appropriate intensity for IMT has not been determined. Therefore, this study aimed to investigate the effects of different IMT protocols on respiratory muscle strength, quadriceps femoris muscle strength (QMS), handgrip muscle strength (HGS), functional exercise capacity, quality of life (QoL), pulmonary function, dyspnoea, fatigue, balance, and physical activity (PA) levels in patients with CKD.MethodsThis randomized, controlled, single-blind study included 47 patients and they were divided into three groups: Group 1 (n = 15, IMT with 10% maximal inspiratory pressure (MIP)), Group 2 (n = 16, IMT with 30% MIP), and Group 3(n = 16; IMT with 60% MIP). MIP, maximal expiratory pressure (MEP), 6-min walking test (6-MWT), QMS, HGS, QoL, pulmonary function, dyspnoea, fatigue, balance, and PA levels were assessed before and after eight weeks of IMT.ResultsIncreases in MIP, %MIP, 6-MWT distance, and %6-MWT were significantly higher in Groups 2 and 3 than in Group 1 after IMT (p < 0.05). MEP, %MEP, FEF25-75%, QMS, HGS, and QoL significantly increased; dyspnoea and fatigue decreased in all groups (p < 0.05). FVC, PEF, and PA improved only in Group 2, and balance improved in Groups 1 and 2 (p < 0.05).ConclusionsIMT with 30% and 60% MIP similarly improves inspiratory muscle strength and functional exercise capacity. IMT with 30% is more effective in increasing PA. IMT is a beneficial method to enhance peripheral and expiratory muscle strength, respiratory function, QoL and balance, and reduce dyspnoea and fatigue. IMT with %30 could be an option for patients with CKD who do not tolerate higher intensities.Trial registrationThis study was retrospectively registered (NCT06401135, 06/05/2024).

Upper limb muscle strength and exercise endurance as predictors of successful extubation in mechanically ventilated patients

BackgroundFailed extubation increases the intensive care unit (ICU) length of stay, hospital length of stay, and financial costs and it reduces the patient’s functional ability. Avoiding failed extubation is of utmost importance, therefore predictors for successful extubation are paramount.ObjectiveTo determine if successful extubation in mechanically ventilated patients can be predicted by physiotherapists using upper limb muscle strength and exercise endurance.MethodsFifty-seven patients from the medical and trauma ICUs of a large academic hospital were eligible for testing. Muscle strength was evaluated using the Oxford grading scale, Medical Research Council score (MRC score), handgrip dynamometer, and maximum inspiratory pressure (MIP). Exercise endurance was tested while the patient was actively riding the MOTOmed® letto2 cycle ergometer for six minutes with the upper limbs.ResultsExercise endurance (time the patient rode actively) (P = 0.005), MRC-score (P = 0.007), and number of days ventilated (P = 0.005) were associated with successful extubation. The handgrip strength (P = 0.061), MIP (P = 0.095), and muscle strength of the sternocleidomastoid (P = 0.053) and trapezius muscles (P = 0.075) were marginally associated with successful extubation. Due to multicollinearity when developing the prediction equation, the final multivariable logistic regression prediction model included only exercise endurance and the number of days ventilated. The newly developed prediction equation conferred a sensitivity of 81.82% and a specificity of 77.14% to predict successful extubation.ConclusionSuccessful extubation of mechanically ventilated patients can be predicted by physiotherapists using the newly developed prediction equation consisting of exercise endurance and number of days ventilated.

Comparison of Feature Selection Methods—Modelling COPD Outcomes

Selecting features associated with patient-centered outcomes is of major relevance yet the importance given depends on the method. We aimed to compare stepwise selection, least absolute shrinkage and selection operator, random forest, Boruta, extreme gradient boosting and generalized maximum entropy estimation and suggest an aggregated evaluation. We also aimed to describe outcomes in people with chronic obstructive pulmonary disease (COPD). Data from 42 patients were collected at baseline and at 5 months. Acute exacerbations were the aggregated most important feature in predicting the difference in the handgrip muscle strength (dHMS) and the COVID-19 lockdown group had an increased dHMS of 3.08 kg (CI95 ≈ [0.04, 6.11]). Pack-years achieved the highest importance in predicting the difference in the one-minute sit-to-stand test and no clinical change during lockdown was detected. Charlson comorbidity index was the most important feature in predicting the difference in the COPD assessment test (dCAT) and participants with severe values are expected to have a decreased dCAT of 6.51 points (CI95 ≈ [2.52, 10.50]). Feature selection methods yield inconsistent results, particularly extreme gradient boosting and random forest with the remaining. Models with features ordered by median importance had a meaningful clinical interpretation. Lockdown seem to have had a negative impact in the upper-limb muscle strength.

FATORES PREDITORES DE HOSPITALIZAÇÃO E ÓBITO EM IDOSOS COM COMPROMETIMENTO COGNITIVO: UM ESTUDO LONGITUDINAL

ABSTRACT Objective: to identify sociodemographic factors, clinical conditions and sarcopenia parameters that predict hospital admission and death in older adults with cognitive impairment. Method: this is a longitudinal observational study carried out with 170 older adults with cognitive impairment assessed between 2019 and 2021. Predictor variables were sociodemographic characteristics, clinical conditions and sarcopenia parameters. Sarcopenia was operationalized through handgrip muscle strength (dynamometry), muscle mass (calf circumference) and the Timed Up and Go test. Occurrence of hospital admission and death within one year after assessment of older adults were the predicted variables. Analyzes were carried out using descriptive statistics, independent Student’ t-test, Mann-Whitney U test, chi-square test and univariate logistic regression. Results: most participants were female (±77.57 years old), with low education, sedentary, 15.9% with sarcopenia and 13% with a history of hospital admission. It was identified that education level had an effect on occurrence of hospital admission (U=1,423.5, p=0.027) and death (U=647.0, p=0.025) within one-year follow-up. Furthermore, there is an association between history of hospital admission in the last 6 months and occurrence of hospital admission [χ2(1)=4.729; p=0.030] and death [χ2(1)=3.919; p=0.048] within one year follow-up. It was identified that history of hospital admission in the last 6 months was associated with occurrence of hospital admission within one-year follow-up (OR=2.963; 95%CI 1.076-8.165, p=0.036). Conclusion: history of hospital admission in the last six months is associated with occurrence of hospital admission over a year in older adults with cognitive impairment.

Investigation of the effects of COVID-19 on muscle skeletal pain, fatigue, and hand grip strength in pregnant woman

Aims: Hand grip strength is an important parameter that can be measured with a cheap, effective, and simple technique that can provide information about general health status. This study aimed to investigate the relationship between hand grip strength and musculoskeletal system findings and fatigue in pregnant COVID-19 patients. The data on common symptoms, laboratory findings, vaccination rates, and smoking rates of pregnant COVID-19 patients were evaluated as secondary results in the study. Methods: The study had a cross-sectional, single-center, and retrospective case design. Demographic information, clinical findings, musculoskeletal symptoms, laboratory findings, and body temperatures of the patients were recorded. The relationship between the patient's hand grip muscle strength and the recorded data was evaluated. Myalgia severity was evaluated in kg by using the Numerical Rating Scale (NRS), physical fatigue by the Visual Analog Scale (VAS), and muscle strength by kg using a CAMRY digital hand dynamometer. Results: The negative relationship between hand grip strength, focal muscle pain, and physical fatigue in pregnant COVID-19 patients was found to be statistically significant (P=0.010 and p=0.020 for focal muscle pain and physical fatigue, respectively). In laboratory data, a positive relationship was detected with the neutrophil/lymphocyte ratio (NLR) and neutrophil percentage, and a negative relationship was detected with lymphocyte percentage at a statistically significant level (P=0.042, p=0.027, p=0.037 for NRL, percentage of neutrophils and percentage of lymphocytes, respectively). (Statistical significance level was accepted as p&lt;0.05). Conclusion: We think that the evaluation of hand grip strength in pregnant women infected with COVID-19 will provide useful information for diagnosis, treatment, and prognosis.

Hand grip strength, vitamin D status, and diets as predictors of bone health in 6–12 years old school children

BackgroundVitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children.PurposeThis study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6–12 years old schoolchildren.MethodsThis study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6–12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.

High-intensity interval training prevents muscle mass loss in overweight Chilean young adults during a hypocaloric-Mediterranean diet: a randomized trial.

The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.

Mid-term effects of two different Kinesio tape treatments in female patients with subacromial impingement syndrome: Randomized controlled ultrasonographic study

Randomized controlled study. To evaluate the effect of Kinesio Tape (KT) applied differently in patients diagnosed with Subacromial Impingement Syndrome (SIS) on acromiohumeral distance (AHD) and supraspinatus tendon (SsT) thickness using ultrasound (US) and its effect on pain, upper limb functional status and hand grip muscle strength in the short and mid-term. The 90 patients diagnosed with unilateral SIS by clinical examination were randomized into 3 groups. In addition to exercise therapy, the deltoid in group 1 and the supraspinatus muscle in group 2 were taped from insertion to origin. Group 3, which was the control group, was applied 9 sessions of sham taping for 3 weeks. Cases were evaluated for AHD and SsT thickness, pain was evaluated with the Visual Analog Scale (VAS), function with the Disabilities of the arm, shoulder and hand (DASH) and the Western Ontario Rotator Cuff Index (WORC), and hand grip strength (HGS) using a dynamometer before, and 3rd week and 3rd month after the KT application. There was a significant improvement in all parameters in the short and mid-term intra group comparisons in Group 1 and 2 after taping (P < .05). In intergroup comparisons, significant improvement was achieved in all parameters in Group 1 and Group 2 in the mid and short term compared to the control group (P < .05). In comparison of Group 1 and Group 2, HGS in the short term (p: 0.07) and the SsT thickness in the short and mid-term (p: 0.36, p: 0.85) did not exhibit any difference. The improvement in all other parameters in group 1 was statistically significant. The findings of our study provide definitive evidence for the effectiveness of KT treatment depending on the method of tape application employed.

Muscle strength, balance and upper extremity function are not predictors of cervical proprioception in healthy young subjects

Purpose/Aim: The aim of this study is to examine the relationship between cervical proprioception sense and balance, hand grip strength, cervical region muscle strength and upper extremity functionality in healthy young subjects. Methods: A total of 200 people with a mean age of 20.8 ± 1.8 participated in the study. Cervical proprioception sense of the participants was evaluated with Cervical Joint Position Error Test (CJPET), balance with Biodex Stability System, hand grip strength with hand dynamometer, and upper extremity functionality with Perdue Pegboard test. The relationship of variables with cervical proprioception was evaluated with Pearson Correlation analysis. Results: According to this study results, there was no significant relationship between CJPET (extension, left rotation, right rotation) and sub-parameters of dynamic balance (anteroposterior, mediolateral, overall), cervical muscle strength and hand grip strength (p > 0.05). There was a significant correlation between CJPET flexion and static balance variables (p < 0.05). Conclusion: According to this study, there is no relationship between cervical proprioception and balance, hand grip muscle strength, cervical region muscle strength and upper extremity functionality in healthy young subjects.

Effect of Vitamin D analog supplementation on levator ani strength and plasma Vitamin D receptor expression in uterine prolapse patients

Uterine prolapse is a pathological condition that can negatively impact women's quality of life. It is caused by weakening of the pelvic floor muscles. Function of levator ani muscle and other striated muscles is thought to be influenced by Vitamin D levels. Vitamin D exerts its biological effects by adhering to Vitamin D receptors (VDRs) present in striated muscles. We aim to analyze the effect of Vitamin D analog supplementation on levator ani muscle strength in uterine prolapse patients. This was a quasi-experimental study with a pre-post design on 24 postmenopausal women diagnosed with grade III and IV uterine prolapse. Vitamin D levels, VDR, levator ani muscle, and hand grip muscle strength were measured before and after three months of Vitamin D analog supplementation. We found that Vitamin D level, VDR serum level, levator ani muscle strength, and hand grip muscle strength all significantly increase (p < 0.001) following Vitamin D analog supplementation. The correlation coefficient between levator ani muscle and handgrip muscle strength was 0.616 and with p value of 0.001. To conclude, Vitamin D analog supplementation can significantly increase levator ani muscle strength in uterine prolapse patients. We propose that determining Vitamin D level in postmenopausal women and replenishing its deficiency with Vitamin D analog supplementation might aid in preventing POP progression.

Accuracy of handgrip and respiratory muscle strength in identifying sarcopenia in older, community-dwelling, Brazilian women

Certain cut-off points for sarcopenia screening and diagnosis are arbitrary and based on European populations, with normative references often obtained from healthy young adults. Although respiratory skeletal muscle strength tests represent low-cost clinical measures commonly performed in clinical practice by health professionals, a gap remains regarding whether respiratory skeletal muscle strength tests are adequate and sensitive measures for sarcopenia screening. This study aimed to verify the value of handgrip and respiratory muscle strength as possible discriminators to identify sarcopenia and to establish cut-off points for sarcopenia screening in community-dwelling, Brazilian women. In a cross-sectional study, 154 community-dwelling, Brazilian women (65–96 years) were assessed for appendicular skeletal muscle mass, handgrip (HGS), and respiratory muscular strength, including maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). The data were analyzed using the ROC curve and the Youden Index determined cut-off points. Statistical significance was set at 5%. 88 participants (57%) were sarcopenic. MEP (OR 0.98 [95%CI 0.97, 1.00], p = 0.023) and HGS (OR 0.82 [95% CI 0.75, 0.90], p < 0.001) were independent factors for sarcopenia in older. The optimal cut-off points for identifying sarcopenia were ≤ 77 cmH2O for MEP (AUC = 0.72), and ≤ 20 kg for HGS (AUC = 0.80). Simple muscular strength tests, including HGS and MEP, may be considered in the identification of sarcopenia in older, community-dwelling, Brazilian women. Future work is still needed to assess external validation of the proposed cut-offs before the clinical application.

Handgrip muscle strength – Its association with blood pressure in healthy young adults

Handgrip muscle strength – Its association with blood pressure in healthy young adults

Association of handgrip strength and depression in medical undergraduate students during COVID-19 pandemic

Background: COVID-19 pandemic has affected the life of all individuals including medical undergraduate students, both physically as well as mentally. Handgrip muscle strength is the maximum force developed during maximal voluntary contraction under a given set of conditions using a handgrip dynamometer. Various studies have concluded that muscle strength can be a predictor of depressive symptoms among the elderly population. Not much attention has been given to assess similar correlation in younger generation. Aim and Objective: The aim of the study was to assess the correlation of maximal hand grip strength with depression among young population especially medical undergraduates during COVID-19 pandemic. Materials and Methods: The present study was conducted on 50 medical students in 18–24 years age group (25 male and 25 female) in North India. The grip strength of dominant as well as non-dominant hand was measured thrice at an interval of 1 min, and highest reading recorded was considered to be the maximum hand grip strength for each student. Depression, anxiety, and stress symptoms were assessed using DASS 21scale. Results: Data were analyzed on Microsoft excel. It was noted that handgrip strength in both male and female students were decreased. Overall students were having symptoms of depression, anxiety and stress. Conclusion: The present study suggests that there should be awareness of and sensitivity to student’s mental health during the COVID-19 pandemic. Handgrip strength can be a reliable method of identifying stressed individuals and is a safe, cheap, time economical, and easy to perform method for a large number of participants.

Respiratory and peripheral muscle strength influence recovery of exercise capacity after severe exacerbation of COPD? An observational prospective cohort study

BackgroundPatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have decreased exercise tolerance, which may persist for months. In this context, little is known about the associations between muscle strength and recovery of exercise capacity. ObjectiveTo assess whether respiratory and peripheral muscle strength influence recovery of exercise capacity in patients hospitalized due to AECOPD. MethodsTwenty-seven AECOPD patients (aged 69 ± 7 years, 56% male) were included. The following assessments were performed within 24 to 72 h of hospital admission: (i) respiratory muscle strength, measured by maximal inspiratory and expiratory pressures (MIP and MEP); (ii) peripheral muscle strength, assessed by handgrip and quadriceps muscle strength; and (iii) exercise capacity, measured by 6-min walking distance (6MWD). The 6MWD was reassessed 30 days later to determine the recovery of exercise capacity. ResultsAfter 30 days, while 63% of the patients showed clinically important improvement in the 6MWD (recovery ≥ 30 m), 37% showed no change (recovery < 30 m). During hospital stay, the non-recovered group had lower quadriceps muscle strength compared to the recovered group (15 ± 5 vs. 22 ± 6 kgf; P = 0.006), with no significant difference for MIP, MEP and handgrip strength. Only quadriceps muscle strength was associated with recovery of exercise capacity (r = 0.56; P = 0.003). ConclusionAECOPD patients with quadriceps muscle weakness during hospitalization have poor recovery of exercise capacity after 30 days. This finding suggests the importance of early rehabilitation to improve quadriceps strength and accelerate functional recovery after AECOPD.

Screening of osteoporosis and sarcopenia in individuals aged 50 years and older at different altitudes in Yunnan province: Protocol of a longitudinal cohort study.

Musculoskeletal system gradually degenerates with aging, and a hypoxia environment at a high altitude may accelerate this process. However, the comprehensive effects of high-altitude environments on bones and muscles remain unclear. This study aims to compare the differences in bones and muscles at different altitudes, and to explore the mechanism and influencing factors of the high-altitude environment on the skeletal muscle system. This is a prospective, multicenter, cohort study, which will recruit a total of 4000 participants over 50 years from 12 research centers with different altitudes (50m~3500m). The study will consist of a baseline assessment and a 5-year follow-up. Participants will undergo assessments of demographic information, anthropomorphic measures, self-reported questionnaires, handgrip muscle strength assessment (HGS), short physical performance battery (SPPB), blood sample analysis, and imaging assessments (QCT and/or DXA, US) within a time frame of 3 days after inclusion. A 5-year follow-up will be conducted to evaluate the changes in muscle size, density, and fat infiltration in different muscles; the muscle function impairment; the decrease in BMD; and the osteoporotic fracture incidence. Statistical analyses will be used to compare the research results between different altitudes. Multiple linear, logistic regression and classification tree analyses will be conducted to calculate the effects of various factors (e.g., altitude, age, and physical activity) on the skeletal muscle system in a high-altitude environment. Finally, a provisional cut-off point for the diagnosis of sarcopenia in adults at different altitudes will be calculated. The study has been approved by the institutional research ethics committee of each study center (main center number: KHLL2021-KY056). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders. http://www.chictr.org.cn/index.aspx, identifier ChiCTR2100052153.

Effectiveness of Physiotherapeutic Group Education in Improving Quality of Life, Physical Performance and Back Extensor Muscle Strength among Postmenopausal Women with Osteoporosis

Introduction: Menopause associated symptoms may interrupt daily activities and wellbeing among postmenopausal women. Decline in muscle strength and bone mineral density may lead to bone fragility, increase osteoporotic fracture risk, decrease functional performance and quality of life (QOL) among postmenopausal women. The aim of this study was to investigate the effectiveness of 8-weeks physiotherapeutic education (an education session and home-based exercise) on back extensor muscle (BEM) strength, physical performance, balance and QOL in postmenopausal women. Methods: A single blinded, two-arm pilot randomize clinical trial consisting of 30 postmenopausal women with mean age of 68.90 (SD = 8.44) years were randomly assigned to the experimental (n=15) and control (n=15) groups. Experimental group received a group education and performed 8-weeks of home-based exercises. Participants in experimental group recorded exercises performed in their exercise diaries and a physiotherapist monitored their progress through phone calls every two weeks. Control group maintained their daily routine. Assessments were performed at baseline and after eight weeks of intervention for quality of life (QOL), physical performance, BEM strength, handgrip muscle strength and balance using Euro-EQ5D Questionnaire, Short Physical Performance Battery (SPPB) test, prone trunk extension test with a load cell, hand-held dynamometer and Activities-specific Balance Confidence (ABC) scale, respectively. Results: The adherence of exercise in experimental group was 86.67%. Mixed model ANOVA analysis showed that there was an interaction effect for BEM strength (p &lt; 0.01). Specifically, the self-perceived health status (EQVAS), EQ5D health Utility index, SPPB and ABC scale had more improvements from pre to post test (all p &lt; 0.05) among experimental compared to control group. Conclusion: Physiotherapeutic education (a group education combined with 8-weeks of therapeutic home-based exercises) provides an effective means to improve BEM strength and physical performance in postmenopausal women.

Zoledronic Acid for prevention of bone and muscle loss after BAriatric Surgery (ZABAS)-a study protocol for a randomized controlled trial

BackgroundBariatric surgery has adverse effects on the muscular-skeletal system with loss of bone mass and muscle mass and an increase in the risk of fracture. Zoledronic acid is widely used in osteoporosis and prevents bone loss and fracture. Bisphosphonates may also have positive effects on skeletal muscle. The aim of this study is to investigate the effects of zoledronic acid for the prevention of bone and muscle loss after bariatric surgery. Methods/designThis is a randomized double-blind placebo-controlled study. Sixty women and men with obesity aged 35 years or older will complete baseline assessments before randomization to either zoledronic acid (5 mg in 100 ml isotonic saline) or placebo (100 ml isotonic saline only) 3 weeks before surgery with Roux-en-Y-gastric bypass (RYGB) or sleeve gastrectomy (SG). Follow-up assessments are performed 12 and 24 months after surgery. The primary outcome is changes in lumbar spine volumetric bone mineral density (vBMD) assessed by quantitative computed tomography (QCT). Secondary bone outcomes are changes in proximal femur vBMD assessed by QCT. Changes in cortical and trabecular bone microarchitecture and estimated bone strength will be assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT). Cortical material bone strength at the mid-tibia diaphysis will be assessed using microindentation and fasting blood samples will be obtained to assess biochemical markers of bone turnover and calcium metabolism. Secondary muscle outcomes include whole body lean mass assessed using dual-energy X-ray absorptiometry. Dynamometers will be used to assess handgrip, shoulder, ankle, and knee muscle strength. Short Physical Performance Battery, 7.6-m walking tests, 2-min walking test, and a stair climb test will be assessed as biomarkers of physical function. Self-reported physical activity level is assessed using International Physical Activity Questionnaire (IPAQ).DiscussionResults from this study will be instrumental for the evidence-based care of patients undergoing bariatric surgery.Trial registrationClinicalTrials.gov NCT04742010. Registered on 5 February 2021.