Hand Grip Power Research Articles

Influence of blood flow occlusion on the development of peripheral and central fatigue during small muscle mass handgrip exercise.

Critical power represents an important threshold for neuromuscular fatigue development and may, therefore, dictate intensities for which exercise tolerance is determined by the magnitude of fatigue accrued. Peripheral fatigue appears to be constant across O2 delivery conditions for large muscle mass exercise, but this consistency is equivocal for smaller muscle mass exercise. We sought to determine the influence of blood flow occlusion during handgrip exercise on neuromuscular fatigue development and to examine the relationship between neuromuscular fatigue development and W '. Blood flow occlusion influenced the development of both peripheral and central fatigue, thus providing further evidence that the magnitude of peripheral fatigue is not constant across O2 delivery conditions for small muscle mass exercise. W ' appears to be related to the magnitude of fatigue accrued during exercise, which may explain the reported consistency of intramuscular metabolic perturbations and work performed for severe-intensity exercise. The influence of the muscle metabolic milieu on peripheral and central fatigue is currently unclear. Moreover, the relationships between peripheral and central fatigue and the curvature constant (W ') have not been investigated. Six men (age: 25 ± 4 years, body mass: 82 ± 10 kg, height: 179 ± 4 cm) completed four constant power handgrip tests to exhaustion under conditions of control exercise (Con), blood flow occlusion exercise (Occ), Con with 5 min post-exercise blood flow occlusion (Con + Occ), and Occ with 5 min post-exercise blood flow occlusion (Occ + Occ). Neuromuscular fatigue measurements and W ' were obtained for each subject. Each trial resulted in significant peripheral and central fatigue. Significantly greater peripheral (79.7 ± 5.1% vs. 22.7 ± 6.0%) and central (42.6 ± 3.9% vs. 4.9 ± 2.0%) fatigue occurred for Occ than for Con. In addition, significantly greater peripheral (83.0 ± 4.2% vs. 69.0 ± 6.2%) and central (65.5 ± 14.6% vs. 18.6 ± 4.1%) fatigue occurred for Occ + Occ than for Con + Occ. W ' was significantly related to the magnitude of global (r = 0.91) and peripheral (r = 0.83) fatigue. The current findings demonstrate that blood flow occlusion exacerbated the development of both peripheral and central fatigue and that post-exercise blood flow occlusion prevented the recovery of both peripheral and central fatigue. Moreover, the current findings suggest that W ' may be determined by the magnitude of fatigue accrued during exercise.

Relationship between anthropometric variables, respiratory function and bio-motoric properties in Turkish flat water canoe athletes

The flatwater canoeing competition is held in lake or pond that flow rate is constant. The traction and thrust force are expected to be at high level as well as excellent technique. Also, the 1000-m event demands high levels of both aerobic and anaerobic fitness. Additionally, sportive performance is affected by anthropometric characteristics. Therefore, the aim of this study was to determine the relationship between anthropometric variables, respiratory function, bio-motoric properties and 1000-m canoe performance. Eight male canoe athletes volunteered to participate in this study (mean age: 17.125 ± 1.12 years; height: 171.86 ± 6.95 cm; weight: 61.262 ± 10.7 kg; BMI: 20.623 ± 2.41 kg/m 2 ). The canoe athletes underwent tests of anthropometric variables (height, weight, BMI, sitting height, arm span, sum of 8 skinfold, body fat percentage), respiratory function (FVC, FEV1, FEV1/FVC, PEF, FEF 25-75 and MVV), bio-motoric properties (right and left hand-grip strength, anaerobic power and isokinetic knee strength) and 1000-m canoe performance. Anaerobic power was estimated by using countermovement jump height. Bilateral concentric isokinetic strength of the knee extensors and flexors was evaluated at 60 0 /s and 240 0 /s using CSMI-Humac/NormTM-770 dynamometer (Humac Norm Testing and Rehabilitation System, USA). A Spirolab-III ergospirometer (Medical International Research, Italy) was used to measure pulmonary function. The results of the present study demonstrated that there were no significant relationship between anthropometric variables, respiratory function, bio-motoric properties and 1000-m canoe performance (p> 0.05). A limited number of investigations focused on Turkish canoe athletes encourage us to design this study. Lack of training experience of participants may affect the results. Moreover, the small sample size is limitation of the present study.

Pronator teres transfer for forearm and wrist deformity in cerebral palsy children.

Forearm pronation and wrist flexion contracture can be a disability for daily living care and 2-hand function in cerebral palsy (CP) children. It may be beneficial to improve their posture and hand-grip power for better functional outcome. The purpose of our study was to investigate the outcome of pronator transfer in CP children. Seventeen spastic CP patients (14 hemiplegic, 3 diplegic; 14 male, 3 female; mean age, 12 y 5 mo) underwent pronator teres transfer for forearm pronation and wrist flexion contractures. The mean follow-up period was 46 months. We recorded Gross Motor Function Classification System level, modified Ashworth scale, forearm and wrist range of motion, forearm resting position, grip power, and 3 basic daily living skills preoperatively and postoperatively. Paired t test was used for statistical analysis. The average forearm active supination gained 80.9 degrees (P<0.05) and the active forearm pronation lost 22 degrees (P<0.05), with average postoperative total active forearm range of motion 130.9 degrees (P<0.05). The average active wrist extension gained 76.9 degrees (P<0.05) and the active wrist flexion lost 31.8 degrees (P<0.05). The average grip power gained 4.5 kg (P<0.05). The average forearm resting position improved to 10 degrees pronation (P<0.05). The basic daily living skills showed great improvement. Our procedure improved the functional outcome in wrist extension and decreased the forearm pronation. Therefore, significant grip-strength enhancement and better forearm posture was noted. It is an additional armamentarium in the management of upper extremity disability in CP children. Level IV-case series.

Validation of the brief pain inventory in patients with low back pain: a preliminary report

Purpose: This study sought to determine, among the measures that can be conveniently conducted in physical therapy practice, the factors differentiated fallers from nonfallers in a group of older adults with DM. Methods: Community-dwelling older adults (age > 60 years) with DM were referred by their primary physicians to participate in this study. Those who reported to have fallen within the past year were classified as faller. All the participants were measured for their body mass index (BMI) and waist-hip ratio (WHR), and underwent a series of physical function tests, including timed up-and-go, hand grip power, knee extension muscle strength, 30 s sit-to-stand and 2min stepping. In addition, the Mini Mental Status Examination and International Physical Activity Question were used to measure mental status and activity level, respectively. The level of blood sugar (HbA1c) within the past 3 months was also recorded from the medical charts. Betweengroup comparisons were made by independent t tests for continuous variables, chi square for categorical variables and Mann–Whitney test for ordinal data. Results: A total of 51 patients participated in this study and 15 of them reported to have fallen in the past year. Fallers did not differ from nonfallers in age, gender, blood sugar, BMI, mental status or activity level. Based on WHR, 86% of the fallers and 75% of the nonfallers were obese, and the former had a significantly greaterWHR (0.949± 0.069) than the latter (0.918± 0.132). In addition, fallers showed a trend of poorer physical functions, although the differences were nonsignificant. Conclusion(s): Obesity is common among people with diabetes and has been shown to be related to a higher rate of falls and fall-related injuries in postmenopausal, middleaged and older women. WHR is a measure of central obesity and has been proposed to be a better measure than BMI in predicting a number of obesity-related health problems. This study further found that, compared toBMI,WHRcould better differentiate fallers from nonfallers in a group of older adults with diabetes. Furthermore, it seems possible that problems related to obesity might play a more important role in falling than declined physical functions for older adults with DM. Implications: WHR could potentially help to predict falling in older adults with DM. Weight control may be considered to be included in falls prevention for this group of older adults. Further studies are needed.

Beetroot Supplementation and Small Muscle Mass Handgrip Exercise

Beetroot (BR) supplementation has previously been shown to elicit improvements in aerobic exercise performance and more recently to alter the contractile properties of mouse and human skeletal muscle. However, these studies were conducted using only maximal voluntary contractions (MVC), leaving a gap in the understanding of the influences of BR on the development of central and peripheral fatigue during rhythmic exercise. PURPOSE: To determine the relationship between BR and human muscle contractile properties after a bout of rhythmic exercise. METHODS: 5 healthy male subjects (age 23.8 ± 1.3 yrs, weight 79.4 ± 9.5 kg) completed constant power handgrip exercise tests at 40 and 85% peak power for 10 min and to exhaustion, respectively. Trials were completed in both placebo (PLA) and BR conditions. Peripheral and central fatigue was assessed via potentiated doublet twitch force (Qtw), MVC, contraction time (CT), 1/2 relaxation time (1/2RT), and voluntary activation (%VA). RESULTS: There were no significant differences between pre and post exercise in the 40% trials for Qtw, MVC, CT, or %VA in either condition, although 1/2RT was significantly reduced post exercise (0.0664 ± 0.0039 vs. 0.0626 ± 0.0037 s, p=0.043) for PLA. There were no significant differences in time to exhaustion at 85% peak power between PLA and BR (314.6 ± 47.1 vs. 307.2 ± 61.0 s). Qtw was significantly lower post exercise for 85% PLA (181.1 ± 30.1 vs. 145.2 ± 40.1 N, p=0.025) and 85% BR (165.5 ± 49.5 vs. 127.9 ± 31.8 N, p=0.021) and there were no significant differences between conditions. MVC was significantly lower post exercise for 85% PLA (473.5 ± 38.0 vs. 348.5 ± 42.0 N, p=0.003) and 85% BR (438.3 ± 68.2 vs. 350.6 ± 76.8 N, p=0.013) and there were no significant differences between conditions. There were no significant differences between or within conditions for CT, %VA, and 1/2RT for the 85% trials. CONCLUSION: The current findings suggest that BR has no significant effect on indices of central and peripheral fatigue when measured after small muscle mass handgrip exercise at 85% peak power.

Increased pulse wave velocity and augmentation index after isometric handgrip exercise in patients with coronary artery disease.

BackgroundArterial stiffness of patients with coronary artery disease (CAD), which is expected to be increased due to a generalized atherosclerotic process of human body, may be more evident after the acute increase of blood pressure (BP) or peripheral vascular resistance. Isometric handgrip exercise is a simple and easily applicable method to achieve this goal. We investigated the changes of hemodynamic parameters and arterial stiffness indexes after handgrip exercise in patients with CAD.MethodsForty-two subjects, who underwent coronary angiography (CAG), were enrolled. After CAG, baseline arterial waveforms were traced at the aortic root and external iliac artery using right coronary catheters. Arterial waveforms were recorded at 1, 2, and 3 min in the aortic root and at 3 min in the external iliac artery after isometric handgrip exercise at 30% ~ 40% of the maximal handgrip power. Augmentation pressure (AP) and augmentation index (AIx) were measured at aortic pressure waveforms. Pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and the distance between the aortic root and the external iliac artery.ResultsThirty patients had CAD (CAD group), and others showed no significant coronary stenosis (non-CAD group). Baseline hemodynamic parameters including AIx and PWV were not different between both groups. After isometric handgrip exercise, central systolic blood pressure (BP), central diastolic BP, central pulse pressure, peripheral systolic BP, and peripheral pulse pressure were increased in all patients. AIx inclined significantly from 1 min after exercise only in patients with CAD (before 17.7% ± 9.7% vs. 3 min after exercise 22.3% ± 10.7%, p < 0.001). PWV also increased significantly after exercise only in patients with CAD (before 10.03 ± 1.99 m/s vs. 3 min after 11.09 ± 2.45 m/s, p < 0.001).ConclusionsArterial stiffness indexes at rest were not different between patients with and without CAD. After isometric handgrip exercise, increased arterial stiffness became evident only in patients with CAD.

Influence of Ischemia on Peripheral and Central Fatigue During Handgrip Exercise

We hypothesized that both ischemic exercise and recovery would significantly increase peripheral and central fatigue. Subjects performed constant power handgrip exercise tests to exhaustion (TTE) at 80% peak power under control blood flow (Con), control blood flow + 5 min post-exercise occlusion (Con + Occ), occluded blood flow (Occ), and occluded blood flow + 5 min post-exercise occlusion (Occ + Occ) condtions. Peripheral and central fatigue was assessed via potentiated doublet twitch force (Qtw), MVC, and voluntary activation (%VA). TTE was significantly different between Con and Occ exercise conditions, but was not significantly different within each exercise condition (Con: 480 ± 143 s; Con + Occ: 446 ± 165 s; Occ: 142 ± 25 s; Occ + Occ: 134 ± 25 s). Pre-exercise Qtw, MVC, and %VA were not significantly different across conditions. Qtw and MVC were significantly lower post-exercise in all conditions. Post-exercise Qtw and MVC were significantly lower for Con + Occ, Occ, and Occ + Occ compared to post-exercise Con Qtw. %VA was significantly reduced post-exercise for Occ and Occ + Occ. The current findings suggest that ischemic exercise and recovery augment both peripheral and central fatigue.

The Effect of N‐acetylcysteine on Peripheral Hemodynamics and Fatigue during Exercise

We hypothesized that oral N‐acetylcysteine (NAC) would lead to higher exercising arm blood flow and a delayed onset of peripheral fatigue. Thus far, three healthy men have completed constant power handgrip exercise tests at 80% peak power to exhaustion. Subjects orally consumed either placebo (PLA) or NAC (70mg/kg) 60 min before exercise. Brachial artery blood flow (BABF) was measured via Doppler ultrasound and flexor digitorum superficialis oxygenation characteristics were measured via near infrared spectroscopy. Peripheral and central fatigue were assessed via potentiated doublet twitch force (Qtw), MVC, and voluntary activation (%VA). The mean time to exhaustion was similar (p=0.83) with NAC (368.8±37.5s) and PLA (353.9±90.9s). Mean resting BABF was similar (p=0.68) with NAC (92.7±12.0mL/min) and PLA (112.3±37.2mL/min). Mean peak exercising BABF was similar (p=0.77) between NAC (550.5±73.1mL/min) and PLA (527.5±94.3mL/min). Mean deoxy‐[Hb+Mb] was not different between NAC and PLA from rest to exercise (p=0.63). Mean total‐[Hb+Mb] was similar (p=0.08) between NAC and PLA at rest (NAC: 101.6±2.2 µM; PLA: 90.8±1.8 µM) and during exercise. % change in MVC from pre to post exercise was not different (p=0.18) between NAC (‐43.9±16.6%) and PLA (‐32.5±13.2%). % change from pre to post exercise in Qtw was similar (p=0.29) with NAC (‐34.6±20.4%) and with PLA (24.8±18.6%). Change (%) from pre to post exercise in %VA was less (p=0.019) with NAC (‐8.0±8.9%) than PLA (‐13.8±9.0%). These preliminary data suggest NAC does not affect exercising BA blood flow, but may increase microvascular hematocrit at rest and during exercise. Also, NAC may reduce central fatigue during exercise.

Efficacy of Mechano-Acoustic Vibration on Strength, Pain, and Function in Poststroke Rehabilitation: A Pilot Study

Background: Vibration therapy may be used to help cortical reorganization after stroke as it can cause different adaptive metabolic and mechanical effects. Objective: This study examined whether the application of mechano-acoustic vibration on upper limb muscles could induce changes in range of motion (ROM), function, pain, and grip strength in individuals with chronic stroke. Methods: Out of 52 individuals post stroke with upper limb spasticity who were eligible,16 received mechano-acoustic vibration therapy (ViSS device) 3 times weekly for 12 sessions. The frequency of vibration was set to 300 Hz for 30 minutes. The treated muscles were the extensor carpi radialis longus and brevis and triceps brachii during voluntary contraction. All participants were evaluated in both upper limbs before (T0) and at the end (T1) of treatment with a dynamometer (hand grip strength), Modified Ashworth Scale, QuickDASH, FIM score, Fugl-Meyer scale, Verbal Numerical Rating Scale of pain, and Jebsen-Taylor Hand Function Test. Results: After 4 weeks, hand grip power had improved and pain and spasticity had decreased. Improvements were recorded for all parameters and were considered statistically significant. Conclusions: Application of vibratory stimuli to a muscle can increase the motor-evoked potential recorded from the muscle, suggesting an enhancement of corticospinal excitability. Low amplitude, high-frequency vibration treatment (300 Hz) can significantly decrease tone and pain and improve strength in upper limb of hemiplegic individuals, when applied for 30 minutes, 3 times a week over 4 weeks.

Clinical usefulness of indoor life-space assessment in community-dwelling older adults certified as needing support or care.

This study aimed to develop a questionnaire to evaluate indoor life-space mobility and assess its validity in community-dwelling older adults certified as needing support or care. The participants included 37 community-dwelling older adults undergoing home-visit rehabilitation (mean age: 78.5±7.0 years). We developed a questionnaire to assess the degree of indoor life-space mobility (home-based life-space assessment (Hb-LSA)), evaluating the functional status (life-space assessment (LSA), time spent away from bed, functional independence measure (FIM), bedside mobility scale (BMS)), physical function (hand grip power (HGP), 30-second chair stand (CS-30), one-leg standing (OLS)) and cognitive status (mental status questionnaire (MSQ)). The average Hb-LSA score was 56.3±24.3 (minimum 4 to maximum 102.5). The test-retest reliability was high (intraclass correlation coefficients: (1, 1)=0.986, (1, 2)=0.993). The Hb-LSA scores were significantly associated with the LSA (r=0.897), time spent away from bed (r=0.497), FIM (r=0.786), BMS (r=0.720), HGP (r=0.388), CS-30 (r=0.541) and OLS (r=0.455). There were no significant associations between the Hb-LSA scores and the FIM cognitive subscores (r=0.180) or MSQ scores (r=-0.240). The Hb-LSA scores were significantly higher among the participants able to move independently indoors (75.8±18.8 points) than in those who required help to move (45.7±20.2 points). The Hb-LSA is a useful, reliable and valid tool for assessing the degree of indoor physical mobility in the life-space. The Hb-LSA score is related to the degree of independence of indoor mobility.

Effect of Longstanding Diabetes Mellitus Type II on Hand Grip Strength and Pinch Power of Females in the City of Hail-KSA

Background: Diabetes mellitus type II is the most common endocrine disorder all over the world, which is characterized by metabolic abnormal conditions and many long term illness. These complications can lead to social threatening problems due to loss of jobs. Objectives: This study aimed at measuring the effects of Type II diabetes mellitus on hand grip and Pinch power of adult females in the city of Hail-KSA Methods: A cross-sectional study was carried out in the outpatient clinics of the King Khalid Hospital. Forty Female patient represented the sample of the study. A JAMAR dynamometer and a pinch gauge were used to measure the participants' hand holding action and Pinch power. Results: Statistical analysis showed a significant decrease (P≤ 0,05) of the hand grip and pinch power strength among patient with long standing diabetes as compared to healthy matched group. Conclusion :The results of the current study concluded that the hand muscles strength represented in grip and pinch power which are important parameters of hand function is significantly affected by long standing type 2 diabetes mellitus.

Differences in Muscle Power Between the Dominant and Nondominant Upper Limbs of Baseball Players

We examined the differences in muscle power between the dominant and nondominant upper limbs of 33 healthy, right-handed, university baseball players (mean age, 20.4 ± 1.1 years) with an average baseball experience >11 years. After measuring maximal voluntary contraction (MVC) of hand grip, elbow flexion, and shoulder internal rotation in both upper limbs, the muscle power of each joint was measured at 40%, 50%, and 60% MVC. No significant differences were observed in the main factors affecting MVC and elbow flexion power loads between dominant and nondominant upper limbs. For handgrip power, load factors at 40% MVC in the dominant hand were lower than those at 60% MVC in the same hand and those at 50% and 60% MVC in the nondominant hand. Significant differences were observed in shoulder internal rotation power between dominant and nondominant upper limbs, with the dominant limb having greater power at all loads. Correlations between muscle power of both upper limbs for handgrip and elbow flexion were significant and moderately high at all loads. For shoulder internal rotation power, the degree of correlation was significant and moderately high at 40% MVC but low to moderate at 50% and 60% MVC. Therefore, baseball players have marked lateral dominance in shoulder internal rotation power unlike handgrip and elbow flexion power, although the relationship between shoulder internal rotation muscle powers of both upper limbs becomes lower with increasing load. The dominance of muscle power of each joint varied even in the same upper limb. It is thus beneficial for baseball players to train with even loads on both arms or adopt simultaneous workout of both arms after adjusting for strength differences.

Changes of central hemodynamics and pulse wave velocity after isometric handgrip exercise

Purpose: Dynamic changes of central hemodynamic parameters and arterial stiffness indexes after isometric handgrip exercise may be more sensitive indicators of the arterial stiffness. We investigated the changes of them after 3 min-handgrip exercise. Methods: Forty one subjects who underwent coronary angiography (CAG) were enrolled. After CAG, baseline arterial waveforms were traced at the aortic root and external iliac artery using right coronary catheters. Arterial waveforms were recorded at 1, 2 and 3 min in the aortic root and at 3 min in the external iliac artery after the isometric handgrip exercise at 30∼40% of the maximal handgrip power. AP and AI were measured at the central aortic waveforms. PWV was calculated using the ECG-gated time difference of the upstroke of the arterial waveforms and the distance between the aortic root and the common iliac artery measured by a catheter. Results: Central systolic BP (SBP), pulse pressure (PP), augmentation pressure (AP) and augmentation index (AI) increased from 1 min after exercise and reached peak values at 2 min after exercise. Changes of pulse wave velocity (PWV) showed a diverse pattern. PWV of 22 subjects (54%, 63.4±8.6 years) increased ≥0.5 m/sec, but 19 subjects (46%, 63.1±10.2 years) showed a little increase (<0.5 m/sec) or even decrease after exercise. SBP, PP, and forward pressure increased similarly after exercise, but AP and AI increased only in subjects with ΔPWV ≥0.5 m/sec after exercise. View this table: Conclusions: Isometric handgrip exercise was a simple and easy method to evaluate the dynamic changes of arterial stiffness indexes. Changes of central hemodynamic parameters were correlated with a change of PWV after handgrip exercise.

Effect of cardiac rehabilitation on muscle mass, muscle strength, and exercise tolerance in diabetic patients after coronary artery bypass grafting

BackgroundThe effects of cardiac rehabilitation (CR) on muscle mass, muscle strength, and exercise tolerance in patients with diabetes mellitus (DM) who received CR after coronary artery bypass grafting (CABG) have not been fully elucidated. MethodsWe enrolled 78 consecutive patients who completed a supervised CR for 6 months after CABG (DM group, n=37; non-DM group, n=41). We measured mid-upper arm muscle area (MAMA), handgrip power (HGP), muscle strength of the knee extensor (Ext) and flexor (Flex), and exercise tolerance at the beginning and end of CR. ResultsNo significant differences in confounding factors, including age, gender, ejection fraction, or number of CR sessions, were observed between the two groups. At the beginning of CR, the levels of Ext muscle strength and peak VO2 were significantly lower in the DM group than in the non-DM group. At the end of CR, significant improvement in the levels of muscle strength, HGP, and exercise tolerance was observed in both groups. However, the levels of Ext muscle strength, HGP, peak VO2, thigh circumference, and MAMA were significantly lower in the DM group than in the non-DM group. In addition, no significant improvement in thigh circumference and MAMA was observed in the DM group. At the end of CR, the levels of thigh circumference and MAMA correlated with Ext and Flex muscle strength as well as with HGP. Percent changes in the levels of Ext muscle strength were significantly correlated with those of MAMA and hemoglobin A1c. ConclusionsThese data suggest that improvement in muscle strength may be influenced by changes in muscle mass and high glucose levels in DM patients undergoing CR after CABG. A CR program, including muscle mass intervention and blood glucose control, may improve deterioration in exercise tolerance in DM patients after CABG.

大学生における26年間の体型と体力の推移とその関連性

The purpose of this study was to examine trends in the body mass index (BMI) and physical fitness of Japanese university students over a period of 26 years and the association between these parameters. We retrospectively collected data on 17,514 students aged 18-19 years attending a university in the years 1984, 1986, 1990, 1991, 1996, 1997, and 2004-2010. The subjects were classified into three body types on the basis of calculated BMI: underweight (BMI<18.5), normal (18.5≤BMI<25), and overweight (BMI≥25). We also calculated the physical fitness score on the basis of 4 fitness-test results (hand-grip power, handball throwing distance, 50-m running time, and 20-m shuttle run count). The time of assessment was categorized into three periods: 1980s (1984 and 1986), 1990s (1990, 1991, 1996, and 1997), and 2000s (2004-2010). The association of physical fitness with body type and period was analyzed using 2-factorial analysis of variance. Descriptive statistics showed that over the 26-year period, moderately increases in the prevalence of underweight and overweight individuals were observed, and the fitness score decreased for both sexes and all body types. A significant interaction between body type and period on physical fitness was observed in boys (P<0.05); underweight and overweight boys showed a greater decrease in physical fitness than normal-weight boys from the 1990s to the 2000s. These long-term data suggest that over 26 years, an increase in the prevalence of underweight and overweight individuals among university students resulted in a decrease in fitness levels to a greater extent in boys.

Effects of Coenzyme Q10 Administration in Amyotrophic Lateral Sclerosis (ALS). Report of a Case and Review

Objective: Coenzyme Q10 (CoQ10) appears to be a promising agent in neurodegenerative disorders because they are associated with defects in the inner mitochondrial membrane and in oxidative phosphorylation. This report aims to highlight the role of CoQ10 in amyotrophic lateral sclerosis. Methods: A 75 year old medical scientist (1 st author TK) unbiased for treatment with CoQ10, volunteered for CoQ10 ad- ministration. He himself recorded his symptoms, mood, sensations, body weight, using limb Norris score, hand grip power for both hands. He received highly bioavailable CoQ10 in a dose of 500 mg twice daily initially followed by 200mg twice daily for treatment in 2005. (solubilized ubiquinol, Tishcon Corp. NY). His plasma CoQ10 level was ob- tained initially and after treatment with CoQ10. Results: He presented with weakness of left leg along with cramps in the left calf muscle with steppage gate in September 2000. He had wasting of muscles, fasciculations and exaggerated reflexes. He had rapid deterioration in hand grip power in the left hand and weakness in left lower limb followed by right limbs with inability in walking and routine activities. Treatment with ubiquinol in 2005, resulted in better hand grip power, mood and sensation within a month and in 2006, he reported that hand grip power and wasting of muscles are not progressing as rapidly as before administering CoQ10. Interpretations: Treatment with highly solubilized ubiquinol can provide benefit to patients with ALS. Further controlled trials would be necessary to confirm our findings.

Anthropometric Profile, Vertical Jump, and Throwing Velocity in Elite Female Handball Players by Playing Positions

Women's handball is a sport, which has seen an accelerated development over the last decade. Although anthropometric and physical characteristics have been studied for male sports teams, in women's handball, studies are scarce. The aim of this study was twofold: first, to describe the anthropometric characteristics, throwing velocity, hand grip, and muscular power of the lower limbs in female handball players and second, to identify the possible differences in these parameters in terms of individual playing positions (center, back, wing, pivot, and goalkeeper). A total of 130 elite female Spanish handball players participated in the study (age 25.74 ± 4.84 years; playing experience 14.92 ± 4.88 years). Anthropometric assessment was performed for all the subjects following the International Society for the Advancement of Kinanthropometry protocols. Furthermore, all the subjects performed a vertical jump test (squat jump and countermovement jump). Hand grip and throwing velocity in several situations were also assessed. A 1-way analysis of variance and a Tukey post hoc test were used to study the differences among individual playing positions. Wings were less heavy, shorter, and showed a smaller arm span than did goalkeepers, backs and pivots (p ≤ 0.001). Additionally, pivots were heavier than centers. Backs and pivots exhibited higher muscular mass than did wings. Total players' somatotype was mesomorphy endomorphy (3.89-4.28-2.29). Centers showed higher throwing velocity levels than did wings in 9-m throws from just behind the line, with a goalkeeper. Backs exhibited higher hand-grip values than did wings. Statistical differences have been established between wings and other specific playing positions, especially with pivot and backs. Coaches can use this information to select players for the different specific positions.

K teli kullanılarak volar yaklaşımla perilunat dislokasyon tedavisinin sonuçları

Objectives: We evaluated the functional results of traumatic perilunate dislocations treated with volar surgical approach and K-wire fixation technique. Methods: The study included 4 patients who were operated for perilunate dislocation since 5 years (range 6 to 60 months ) ago. The patients underwent open reduction and internal fixation with K-wire (size 1.5 mm) and K-wire was taken out at 6 th week.Clinical and radiological evaluations were made with use of Dash score, modified Mayo elbow score, VAS score, restart work, patient pleasure, wrist range of motion, hand grip power and post surgical radiologic scapho-lunate angle and gap at 6th months control. Results: The K-wires were taken at 6th week and than active-pasive wrist range of motion exergices were started at physical rehabilitation centers. At 6th months controls the mean flexion-extansion arc was 100° and %78 compared with the other wrist, the mean rotation arc was 140° and %81 to the other side, the mean radioulnar arc was 60° and %88.8 to the other side. The grip strength was 0.52 bar and %87.6 that of the uninjured arm. According to the Mayo modified wrist score, the functional result was excellent in 2 patients and good in 2 patients.The mean VAS score was 8.5 pre-operative and 2 was post-operative. According to clinical and radiologic evaluations the mean DASH score was 36, scapho-lunate interval was 2.0 mm, and scapho-lunate angle was 53°. Conclusion: Perilunate dislocations are rare and severe wrist injuries. Acute perilunate dislocations are usually relatively easy to reduce however carpal collaps and post-travmatic arthritis are seen usually during late period.Because of this open reduction and internal fixation technique is used to prevent carpal collaps and post-travmatic arthritis and to facilitate anatomic reduction.Our results show that open reduction and internal fixation with K-wire can restore affectively normal carpal relationship, providing acceptable grip strength and functional motion,also carpal collaps and post-travmatic arthritis were prevented.

Impact of diabetes on muscle mass, muscle strength, and exercise tolerance in patients after coronary artery bypass grafting

The impact of diabetes mellitus (DM) on muscle mass, muscle strength, and exercise tolerance in patients who had undergone coronary artery bypass grafting (CABG) has not been fully elucidated. We enrolled 329 consecutive patients who received cardiac rehabilitation (CR) after CABG (DM group, n=178; non-DM group, n=151) and measured lean body weight, mid-upper arm muscle area (MAMA), and handgrip power (HGP) at the beginning of CR. We also performed an isokinetic strength test of the knee extensor (Ext) and flexor (Flex) muscles and a cardiopulmonary exercise testing at the same time. No significant differences in risk factors, including age, gender, number of diseased vessels, or ejection fraction were observed between the 2 groups. The levels of Ext muscle strength, peak oxygen uptake, and anaerobic threshold were significantly lower in the DM group than in the non-DM group (all p<0.05). Both peak oxygen uptake and MAMA correlated with Ext and Flex muscle strength as well as HGP (all p<0.005). The MAMA, HGP, and Ext muscle strength were lower in patients who received insulin therapy than in those who did not. Interestingly, fasting glucose levels significantly and negatively correlated with Ext muscle strength. These data suggest that DM patients had a lower muscle strength and exercise tolerance than non-DM patients. Moreover, a high glucose level may affect these deteriorations in DM patients after CABG.

Sensorimotor impairments of paretic upper limb correlates with activities of daily living in subjects with chronic stroke

The main objective of this study was to investigate the correlations between sensorimotor impairments of paretic upper limb and the hand functions of activities of daily living (ADLs) scores in persons with chronic stroke.This is a cross-sectional study with 19 chronic stroke survivors. Hand function was measured by the Jebsen-Taylor Hand Function Test (JTHFT). Impairments in upper extremity motor function were measured by upper limb items of Fugl-Meyer Assessment (FMA-UE). Forearm muscles strength, handgrip and pinch grip power were assessed using handheld dynamo-meters. Tactile sensation threshold was measured by monofilaments.Significant differences were found between the affected and unaffected side in the total JTHFT scores, forearm muscle strength, handgrip and pinch grip (p≤0.017), but not the tactile sensa-tion threshold. The total JTHFT scores were found to be correlated with total score of FMA-UE (rs = -0.789), hand-grip power (rs = -0.588) and pinch grip power (rs = -0.657) on the affected side, but not the tactile sensation. The total JTHFT scores were correlated with FMA-UE scores, handgrip and pinch grip of the affected side. This is the first study in documenting the correlation between the sensorimotor impairments and JTHFT scores in persons with chronic stroke. Our findings highlights the importance of including upper limb and grip strength training in stroke rehabilitation program in order to improve hand functions in activities of daily living in patients with chronic stroke.