Handgrip Test Research Articles

Association between frailty and physical performance in older patients with heart failure.

Frailty is an issue in patients with heart failure (HF). A Korean version of the frailty scale (K-FRAIL) has been developed. We aimed to analyze the relationship between the K-FRAIL scale and physical performance in patients with HF. This study included 142 patients with HF aged ≥65 years from a single center. Muscular fitness was assessed using the handgrip test and knee extensor strength measurement. Aerobic capacity was assessed using the cardiopulmonary exercise test and 6-min walk test (6MWT). Frailty was assessed using the K-FRAIL questionnaire. Peak VO2 and 6MWT scores significantly decreased as frailty worsened, but handgrip and knee extensor strength did not. In the multivariate analysis, peak VO2 (β = -.31; p = .002) and 6MWT score (β = -.38; p < .001) showed significant inverse associations with the K-FRAIL score. Based on the receiver operating characteristic curve analysis, the cut-off values of peak VO2 (hazard ratio, 5.08; p = .023) and 6MWT (hazard ratio, 3.99; p = .020) were independent predictors of frailty. In older patients with HF, physical performance correlates with the degree of frailty. The K-FRAIL scale is correlated with the peak VO2 and 6MWT.

Parental History of Hypertension: A Risk for Autonomic Dysfunction and Metabolic and Vascular Derangement in Normotensive Male Offspring.

Children of hypertensive parents have an increased propensity of developing hypertension, at an age very much prior to their parents. Understanding the pathophysiology of hypertension in such young individuals, especially baroreflex sensitivity (BRS), is necessary. Reduced heart rate variability (HRV), insulin resistance (IR), dyslipidemia, and decreased vasodilatory adipokines, namely, apelin and relaxin, in normotensives may predispose to the onset of hypertension. Thus, this study compared autonomic functions, vascular markers, and metabolic profiles between normotensive male offspring with and without parental hypertension. This analytical cross-sectional study comprised 40 male normotensive offspring of hypertensive parents, aged 18-35 years, recruited as the study group and 40 age- and body mass index (BMI)-matched normotensive male offspring with non-hypertensive parents enrolled as controls. Cardiovascular autonomic functions, including BRS, HRV, diastolic blood pressure response to isometric handgrip test (ΔDBPIHG), Valsalva ratio, and metabolic and vascular markers, were assessed. The study group exhibited reduced BRS, HRV, and Valsalva ratio and higher ΔDBPIHG compared to controls, indicating impaired autonomic functions. The study group had higher IR and triglyceride levels and reduced apelin and relaxin levels. BRS showed significant correlations with HRV, Valsalva ratio, ΔDBPIHG, and metabolic and vascular markers. Normotensive male offspring of hypertensive parents exhibit impaired autonomic functions, as evidenced by reduced BRS, HRV, and Valsalva ratio. Additionally, they have higher IR, dyslipidemia, and decreased levels of vasodilatory adipokines, indicating an increased risk for future hypertension development. These findings signify that early identification of hypertensive potential in this high-risk population is warranted, which would enable taking necessary preventive measures.

Trends in muscular fitness performance among 9-12-year-olds: implications for monitoring and test selection

Background and Study Aim: Long-term trends in muscular fitness show a gradual decline, which has become even more intense due to the Covid-19 pandemic. Declines in muscular fitness are associated with deteriorated health and well-being parameters. It is crucial to monitor this decline and appropriate tests need to be selected and interpreted correctly. The aim of this research was to apply muscle fitness tests and compare the development of performance between 9 and 12-year-olds and, at the same time, to compare performance differences between boys and girls.&#x0D; Material and Methods: 225 girls and 259 boys aged 9 to 12 years (11.1 ± 0.9) took part in the studies. Seven tests were selected to assess muscular fitness: bent-arm hang (BAH), push-ups, sit-ups, standing broad jump (SBJ), medicine ball throw (MBT), handgrip dynamometry (handgrip), and pulling back-leg dynamometry (back-leg). Results: The results showed that the development curves of muscle tests are incomparable. A linear increase was recorded for the MBT test. The handgrip, back-leg, and MBT tests have similar development although they do not test the same type of force. A very different trend (stagnation, decline) was found for the BAH and push-up tests. Girls and boys showed a comparable trend in all tests, however, boys always had higher absolute performances. Conclusions: Our data are intended to contribute to the expert discussion on the choice of muscular fitness tests. Based on these results, the selection of multiple tests may be recommended for optimal assessment of muscular fitness. In future research, it would be advisable to follow up by testing a larger cohort.

Exploring the feasibility of a combined exercise program for patients with advanced lung or pancreatic cancer

ObjectiveThis study aims to assess the safety, feasibility, and potential benefits of a combined aerobic and resistance exercise intervention for patients diagnosed with advanced pancreatic or lung cancer. MethodsA prospective, single-arm study was conducted, enrolling patients with advanced lung or pancreatic cancer. Participants engaged in a 12-week exercise intervention comprising personalized bi-weekly aerobic and resistance training tailored to individual baseline conditions. The primary study outcomes focused on safety (absence of serious adverse events) and feasibility. Secondary outcomes included assessments of functional capacity using the "Six minutes walking test", strength measured through handgrip and leg press tests, anthropometric measures including body mass index and waist–hip ratio, quality of life (QoL), and changes in blood parameters. ResultsThe study involved twelve patients (mean age 57.66 ​± ​7.40 years), with seven having pancreatic cancer and five having lung cancer. The recruitment rate was 50%, and assessment adherence was 100%, with an 84% adherence to the exercise program and no dropouts. No exercise-related adverse events were recorded, while three non-severe, non-exercise-related adverse events were observed: treatment-related dermatitis (Grade 2), axillary lymphadenopathy (Grade 2), and migraine (Grade 1). Significant enhancements in functional capacity, emotional well-being, and social functioning within the QoL domains were observed. Anthropometric measures, specifically waist–hip ratio and body mass index, remained stable. ConclusionsThe findings suggest that a tailored 12-week exercise intervention is both feasible and safe for patients with advanced lung or pancreatic cancer. This intervention appears to enhance functional capacity, specific aspects of QoL, and contribute to maintaining body weight.

Functional training improves peak oxygen consumption and quality of life of individuals with heart failure: a randomized clinical trial

BackgroundFunctional training may be an effective non-pharmacological therapy for heart failure (HF). This study aimed to compare the effects of functional training with strength training on peak VO2 and quality of life in individuals with HF.MethodsA randomized, parallel-design and examiner-blinded controlled clinical trial with concealed allocation, intention-to-treat and per-protocol analyses. Twenty-seven participants with chronic HF were randomly allocated to functional or strength training group, to perform a 12-week physical training, three times per week, totalizing 36 sessions. Primary outcomes were the difference on peak VO2 and quality of life assessed by cardiopulmonary exercise testing and Minnesota Living with Heart Failure Questionnaire, respectively. Secondary outcomes included functionality assessed by the Duke Activity Status Index and gait speed test, peripheral and inspiratory muscular strength, assessed by hand grip and manovacuometry testing, respectively, endothelial function by brachial artery flow-mediated dilation, and lean body mass by arm muscle circumference.ResultsParticipants were aged 60 ± 7 years, with left ventricular ejection fraction 29 ± 8.5%. The functional and strength training groups showed the following results, respectively: peak VO2 increased by 1.4 ± 3.2 (16.9 ± 2.9 to 18.6 ± 4.8 mL.kg−1.min−1; p time = 0.011) and 1.5 ± 2.5 mL.kg−1.min−1 (16.8 ± 4.0 to 18.6 ± 5.5 mL.kg−1.min−1; p time = 0.011), and quality of life score decreased by 14 ± 15 (25.8 ± 14.8 to 10.3 ± 7.8 points; p time = 0.001) and 12 ± 28 points (33.8 ± 23.8 to 19.0 ± 15.1 points; p time = 0.001), but no difference was observed between groups (peak VO2: p interaction = 0.921 and quality of life: p interaction = 0.921). The functional and strength training increased the activity status index by 6.5 ± 12 and 5.2 ± 13 points (p time = 0.001), respectively, and gait speed by 0.2 ± 0.3 m/s (p time = 0.002) in both groups.ConclusionsFunctional and strength training are equally effective in improving peak VO2, quality of life, and functionality in individuals with HF. These findings suggest that functional training may be a promising and innovative exercise-based strategy to treat HF.Trial registrationNCT03321682. Registered date: 26/10/2017.

The Influence of Team Invasion Sports’ Participation in the Phase Angle of Youth Athletes

Team invasion sports are characterized as ball games, played by two opponents, aiming to score points or goals. The aim intended to verify which team invasion sport presents a greater probability to obtain a higher phase angle (PhA) value, considering the age, time of practice, vertical jump tests and handgrip strength of young athletes. A total of 248 young athletes were evaluated. After performing the correlations between the PhA and categorical variables (sport and sex) and covariables (age, time of practice- t, squat jump- SJ, countermovement jump- CMJ, and handgrip strength left or right- HGSl or HGSr), we developed an equation from a logistic regression model, aiming to better interpret the probability to obtain a higher PhA. Our findings showed a significant correlation (p&lt; 0.05) ranging from weak to moderate between the PhA and age (r=0.268), t (r =0.206), SJ (r=0.330), CMJ (r= 0.277), HGSr (r=0.537), and HGSl (r=0.523). Considering the median value of the PhA (7.7o) as a cut-off point, youth soccer players were the most likely to have 2.2 more chances to reach a higher PhA, followed by Futsal (2.13), and Rugby (2.01) players. Considering our equation, we suggested that higher PhA values predisposed the Soccer, Futsal and Rugby players to express greater jumping capacity or handgrip tests. Considering the advantage of using PhA as a marker of a healthy body composition profile, the magnitude of these probabilities to reach higher values of strength performance in young athletes may depend on the sport practiced and their exposure to specific training.

Handgrip fatigue test using dynamic contractions in typical children

Objective: To verify the development of fatigue and sex-influence on the handgrip during dynamic contractions in typical children. Methods: Cross-section study. Fifty-eight children, distributed into two groups according to sex (30 boys), aged 8 to 12 years, of both sexes, performed successive dynamic contractions with a bulb dynamometer until they reached maximum perceived effort. The values from the first, the last contractions of the fatigue test, and the measure after 30-s of the last contraction (recovery contraction) were recorded and compared using the linear regression model with mixed effects. T-Student test was used to compare the perceived effort scores and time-to-fatigue between groups. Results: The handgrip values significantly decreased, and perceived effort scores significantly increased in the final measure in relation to the initial measure of the fatigue test. After the fatigue handgrip test, 30-sec of recovery was insufficient to restore the baseline handgrip values. There were no differences between the female and male groups for all variables. Conclusion: The handgrip fatigue test using dynamic contractions showed it efficiently induces motor and perceived fatigue in children, without differences between sexes.

Phase angle as a key marker of muscular and bone quality in community-dwelling independent older adults: A cross-sectional exploratory pilot study

The aim of the present cross-sectional exploratory pilot study was to analyze the ability of the Phase Angle (PhA) to predict physical function, muscle strength and bone indicators, upon adjusting for potential confounders [age, sex, lean mass, and body mass index (BMI)]. This study included 56 physically independent older adults (age, 68.29 ± 3.01 years; BMI, 28.09 ± 4.37 kg/m2). A multi-frequency segmental bioelectrical impedance analysis was used to measure PhA at 50 KHz. Additionally, physical function was assessed through four functional capacity tests [30-sec chair‐stand; seated medicine ball throw (SMBT); timed up & go; and 6-min walking test (6 MWT)], muscle strength through the handgrip test (dominant side) and maximal isokinetic strength of the dominant knee flexor and extensor. Moreover, bone indicators and body composition were assessed through the dual energy X-ray absorptiometry.PhA was significantly associated with SMBT (r = 0.375, effect size (ES) = moderate); 6 MWT (r = 0.396, ES = moderate); 30-sec chair‐stand (rho = 0.314, ES = moderate); knee extension (rho = 0.566, ES = large) and flexion (r = 0.459, ES = moderate); handgrip (rho = 0.432, ES = moderate); whole-body bone mineral content (BMC) (r = 0.316, ES = moderate); femoral neck BMC (r = 0.469, ES = moderate); and femoral neck bone mineral density (BMD) (rho = 0.433, ES = moderate). Additionally, the results of multiple regression analysis demonstrated that PhA is significantly associated with SMBT (p < 0.001; R2 = 0.629), 6 MWT (p = 0.004; R2 = 0.214), knee extension (p < 0.001; R2 = 0.697), knee flexion (p < 0.001; R2 = 0.355), handgrip test (p < 0.001; R2 = 0.774), whole-body BMC (p < 0.001; R2 = 0.524), femoral neck BMC (p = 0.001; R2 = 0.249), and femoral neck BMD (p = 0.020; R2 = 0.153). The results of the preliminary analysis suggested that PhA is linked to muscle strength and some factors related to physical function and bone quality in community-dwelling older adults.

Sub-Anesthetic Dose of Ketamine Improves Cognitive Function and Motor Responses in Wistar Rats

Background: The cognitive and motor effects of sub-anesthetic doses of ketamine remain controversial. The aim of this study was to investigate the effects of ketamine administration under anesthesia on cognitive function and motor responses in Wistar rats.&#x0D; Methods: Twenty-five Wistar rats were randomized into five groups of five rats each (n=5): group 1 (normal control), group 2 (1mg/kg ketamine), group 3 (2mg/kg ketamine), group 4 (3mg/kg ketamine) and group 5 (0.5ml/100g celecoxib). Treatment for each group lasted 3 weeks. Rats from each group were subjected to a total of nine (9) trials of cognitive-motor tests, including; the Barnes maze test (memory based on visual scenes), hand grip test (motor response to foreleg strength), rotarod test (coordination ability). The neurobehavioral ability displayed by the animals was recorded and analyzed using analysis of variance (ANOVA).&#x0D; Results: Observations from the cognitive function study showed a significant improvement (p&lt;0.05) from week 1 to week 3. The quality of motor task performance also improved from week 1 to week 3 compared to control and celecoxib-treated groups.&#x0D; Conclusions: Sub-anesthetic doses of ketamine improved cognitive function and motor responses in Wistar rats.

Uncovering the Relationship Between Statins and Muscle Problems in the ELSA-Brasil MSK Cohort.

To investigate the association between statins and muscle problems in a highly diverse sample of Brazilian civil servants. We conducted a cross-sectional data analysis at baseline of the ELSA-Brasil MSK cohort. Pain was identified through self-reported symptoms in large muscle groups (lower back and/or hips/thighs). Muscle strength was assessed using the five-times-sit-to-stand (FTSTS) and handgrip tests, with weakness defined as the lowest and highest quintiles of age- and sex-stratified handgrip strength and FTSTS performance time, respectively. Multivariable logistic regression analyses were conducted to investigate the association between statin use and muscle pain and weakness. Secondary analyses explored the impact of different types of statins and their duration of use on the response variables. A total of 2156 participants (mean age 55.6 ± SD 8.9, 52.8% women) were included, of whom 21.1% were taking statins and 25.1% reported muscle pain. We found no significant association between statin use and muscle problems. Secondary analysis on different types of statins revealed an association between atorvastatin and muscle weakness, as measured by the five-times-sit-to-stand test (OR 1.94, 95% CI 1.12-3.37), but not by the handgrip test (OR 0.75, 95% CI 0.29-1.42). No evidence was found to support a link between the duration of statin treatment and muscle problems. This study challenges previous claims of an efficacy-effectiveness gap between experimental and observational literature on statins. The findings indicate that statin use does not contribute to muscular problems.

THU-446 - Poor performance at five times sit-to-stand test, but not at handgrip test, is related to significant liver fibrosis and correlates with major cardiovascular events in non-alcoholic fatty liver disease patients

THU-446 - Poor performance at five times sit-to-stand test, but not at handgrip test, is related to significant liver fibrosis and correlates with major cardiovascular events in non-alcoholic fatty liver disease patients

Safety and feasibility of a randomized controlled trial testing a personalized exercise program in patients with cancer: The CHOiCE trial.

e24045 Background: Growing evidence suggests that physical exercise (EX) may reduce mortality and recurrence risk in patients (pts) with cancer, as well as help in managing cancer treatment side effects and improve quality of life (QoL). Despite these well-recognized benefits, most pts are insufficiently active, and compliance with the EX intervention is often challenging. This pilot study aimed to evaluate the safety, feasibility, and preliminary efficacy of a 3-month EX-intervention in pts with cancer. Methods: A pilot, two-center randomized controlled trial was conducted on pts with different cancers at early stages. Pts allocated in the 3-month EX intervention participated in bi-weekly aerobic and resistance training tailored to the patient's baseline condition and preferences. The duration of aerobic training progressively increased over weeks, whereas the resistance component consisted of body weight or elastic-bands exercises performed in 2-3 sets of 8-12 repetitions. EX intensity was moderate and monitored using the 10-point Borg Rating of the Perceived Exertion Scale. Pts randomized to control received usual care. Primary study endpoints were safety, monitored through the Common Terminology Criteria for Adverse Events (AEs), and feasibility, evaluated through recruitment rate, adherence, and withdrawals. Secondary endpoints included functional capacity, using the Six minutes walking test, and muscle strength, with the handgrip and leg press test. European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire (EORTC- QLQ-C30) was used to assess the QoL. Descriptive statistics was applied, and repeated-measures analysis of variance was used to evaluate within- and between-group differences. Results: With a 38% recruitment rate, 57 pts were randomized (56 years; 68% breast, 14% colorectal) to the EX-intervention (n = 37) and controls (n = 20). Five dropouts occurred, n = 3 in the EX-group (leukemia onset n = 1, psychiatric disorder n = 1, gonarthrosis n = 1), and n = 2 in the controls (lack of interest n = 2). Adherence to EX-sessions was high, 93%. Concerning safety, three AEs were reported: worsening in the lymphedema, Grade 1 (n = 2), and elbow inflammation, Grade 1. Compared to the controls, EX-group reported a significant increase in functional capacity (within group, p &lt; 0.01), and lower limb strength (within and between group, p &lt; 0.01). Regarding QoL, EX produced enhancements in social function (within group, p &lt; 0.05), fatigue (within group, p &lt; 0.05), nausea and vomiting (within group p &lt; 0.01), dyspnea (within group, p &lt; 0.05), insomnia (within group, p &lt; 0.05), and loss of appetite (within group, p &lt; 0.01). Conclusions: Preliminary findings support the feasibility of a combined aerobic and resistance EX in pts with cancer with minimal AEs. Moreover, improvements in physical parameters and some domains of QoL were detected. Clinical trial information: NCT04226508 .

HEMODIALYSIS EFFECTS ON AUTONOMIC FUNCTION: RESULTS OF LINEAR AND NON-LINEAR ANALYSIS OF HEART-RATE-VARIABILITY AT REST AND IN RESPONSE TO PHYSICAL AND MENTAL STRESS TESTS

Objective: Cardiac arrhythmias are the most common cause of death in hemodialysis. Autonomic dysfunction plays a central role in this arrhythmogenic background. Previous studies on hemodialysis-related changes in heart-rate-variability(HRV) give contradictory results. This study investigated HRV indices both at rest and in response to physical and mental stimulation maneuvers at multiple time-points around and during the hemodialysis procedure. Design and method: Autonomic function was assessed by linear and non-linear HRV indices at pre-dialysis, during-dialysis(3 equal time-periods), post-dialysis, and on the non-dialysis day in 36 hemodialysis patients. Continuous measurement of beat-by-beat heart-rate was recorded with Finometer-PRO(The Netherlands) at rest and after orthostatic, sit-to-stand, handgrip and mental-arithmetic test. Results: The RMSSD, SD1, and SD2 indices significantly increased during dialysis(early-HD, mid-HD, late-HD periods) compared with the pre-dialysis levels(p&lt;0.05) and returned to baseline post-dialysis(RMSSD: 54.39±83.73 vs 137.98±109.53* vs 119.85±97.34* vs 144.47±88.74* vs 85.82±121.43msec, *p&lt;0.05 vs pre-dialysis and post-dialysis). No differences were detected in the above indices between the pre-dialysis and non-dialysis day. However, post-dialysis, the HRV responses to orthostatic and sit-to-stand tests were more exaggerated than in the pre-dialysis measurements (p&lt;0.05). The HRV responses both at resting and physical tests in the non-dialysis day were similar to the pre-dialysis levels. HRV indices in mental-arithmetic test during hemodialysis were much higher than at the non-dialysis day(RMSSD: 77.05 (180.41) vs 19.75 (105.47)msec; p = 0.031) were detected. Conclusions: Hemodialysis causes marked changes in autonomic function. Resting HRV indices return to baseline post-dialysis, but HRV responses to physical stress remain exaggerated and return to baseline on the non-dialysis day. Detecting patients with significant autonomic dysfunction may help towards reduction of arrhythmia risk through individualized approaches.

Radiofrequency Echographic Multi Spectrometry (REMS) for the assessment of muscle strength

Objective: Due to the limitations of available methods for muscle strength evaluation, there is a need to develop more effective ways to quantify muscle function and performance in individuals suffering from musculoskeletal diseases. This study investigated the relationship between handgrip strength and a novel parameter derived from ultrasound scans of the forearm obtained using Radiofrequency Echographic Multi Spectrometry (REMS) technology. Estimations of muscle strength were performed in two study groups: healthy subjects and individuals affected by sarcopenia. Methods: A total of 58 Caucasian volunteers (30 healthy individuals and 28 subjects affected by sarcopenia) were recruited. A handgrip strength test was used to measure the Maximum Voluntary Contraction (MVC) of each subject’s dominant arm. Transversal echographic scans of the forearm were performed using an EchoStation device (Echolight S.p.a., Lecce, Italy) equipped with a 40 mm linear probe. A dedicated segmentation algorithm was designed and optimized for automatic identification of the ulnar and radius muscle profiles. The correlation between MVC values and REMS-based estimations of MVC (MVCREMS) was established using a linear regression approach. Results: MVCREMS showed excellent correlation with the MVC taken as ground truth. A high correlation value (r=0.95) was found in the overall population, and the corresponding values in the healthy and pathological subgroups were r=0.90 and r=0.83, respectively (p&lt;0.0001). Conclusion: This technique allows reliable estimation of muscle strength in both pathological and healthy subjects, and is a valid alternative to conventional handgrip tests for use in primary care. In the future, this technique might help to enhance the assessment, screening and prevention of musculoskeletal diseases.

Reversed Mirror Therapy (REMIT) after Stroke—A Proof-of-Concept Study

In mirror training (MIT), stroke patients strive to move their hands while looking at the reflected image of the unaffected one. The recruitment of the mirror neurons and visual-proprioceptive conflict are expected to facilitate the paretic voluntary movement. Here, a reversed MIT (REMIT) is presented, which requires moving hands while looking at the reflected image of the paretic one, giving the illusion of being unable to move the unimpaired hand. This study compares MIT and REMIT on post-stroke upper-limb recovery to gain clues on the mechanism of action of mirror therapies. Eight chronic stroke patients underwent two weeks of MIT and REMIT (five sessions each) in a crossover design. Upper-limb Fugl-Meyer, Box and Block and handgrip strength tests were administered at baseline and treatments end. The strength of the mirror illusion was evaluated after each session. MIT induced a larger illusory effect. The Fugl-Meyer score improved to the same extent after both treatments. No changes occurred in the Box and Block and the handgrip tests. REMIT and MIT were equally effective on upper-limb dexterity, challenging the exclusive role of mirror neurons. Contrasting learned nonuse through an intersensory conflict might provide the rationale for both forms of mirror-based rehabilitation after stroke.

Sarcopenia parameters in active older adults – an eight-year longitudinal study

BackgroudSarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population.MethodsThe 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants’ overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements.ResultsIn the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and − 48.5%; p < .001, respectively).ConclusionsDespite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature.Trial registrationThe clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.

Effects of SARS-CoV-2 on Pulmonary Function and Muscle Strength Testing in Military Subjects According to the Period of Infection: Cross-Sectional Study.

Pulmonary function can be impaired as a long-term consequence of SARS-CoV-2 infection. The aim of this study was to evaluate the effect of SARS-CoV-2 infection on pulmonary function, exercise tolerance, and muscle strength in healthy middle-aged military outpatients according during the period of infection. A cross-sectional study was carried out from March 2020 to November 2022 at the Military Hospital "Celio" (Rome, Italy). If someone had a diagnosis of SARS-CoV-2 infection certified by molecular nasal swab and if they performed pulmonary function tests, diffusion of carbon monoxide (DL'co), a six Minute Walk Test (6MWT), a Handgrip (HG) Test, and a One Minute Sit to Stand Test (1'STST). The included subjects were divided into two groups, A and B, according to the period of infection: A) from March 2020 to August 2021 and B) from September 2021 to October 2022. One hundred fifty-three subjects were included in the study: 79 in Group A and 74 in Group B. Although the values were within the normal range, Group A had smaller FVC, FEV1, and DL'co compared to Group B. Group A also walked a shorter distance at the 6MWT and performed fewer repetitions in the 1'STS test compared to Group B. In both groups, the DL'co (%predicted) correlated with the 6MWT distance (R2 = 0.107, p < 0.001), the number of repetitions of the 1'STST (R2 = 0.086, p = 0.001), and the strength at the HG test (R2 = 0.08, p < 0.001). This study shows that the SARS-CoV-2 infection in healthy middle-aged military outpatients was more severe in the first waves than in the later ones and that, in healthy and physically fit individuals, even a marginal reduction in resting respiratory test values can have a major impact on exercise tolerance and muscles strength. Moreover, it shows that those infected more recently had symptoms related to the upper respiratory tract infection compared to those of the first waves.

Cardiac dysfunction mediators CXCL-9 and chemotaxis of phagocytes characterized patients with long-term pulmonary dysfunction after COVID-19.

Abstract Severe COVID-19 is characterized by marked cytokine release and pulmonary dysfunction; however, it is still unknown which mediators support post-COVID-19 pulmonary dysfunction. Our aim was to determine the signaling pathways associated with long-term pulmonary dysfunction in patients with COVID-19. Our cohort of 60 patients with COVID-19 were followed up at 4- and 12-months post infection. Pulmonary sequelae were analyzed by computed tomography (CT), diffusing capacity of carbon monoxide (DLCO), spirometry, 6-minute walk test (6MWT) and handgrip test. Cytokines, chemokines and blood tests parameters were also analyzed. Furthermore, signaling pathways associated with pulmonary dysfunction were identified by serum proteomics analysis using TimsTOF-Pro and ingenuity pathway analysis. Fourteen patients with CT and abnormal DLCO were classified as patients with long-term pulmonary dysfunction (LTPD), who also presented impaired spirometry tests, 6MWT and handgrip strength than patients without sequelae or patients with CT only. We observed that only CXCL-9 was significantly increased in LTPD patients in comparison with other groups. In addition, the main signaling pathways identified by proteomics in LTPD patients were associated with an immunothrombotic state related to cardiac dysfunction, migration of dysfunctional monocytes and reduced IFN-signaling. In summary, patients with LTPD presented a restrictive lung condition, with greater fatigue, lower aerobic capacity and muscle strength 4-months post-COVID-19. Our data suggest that patients with previous cardiac dysfunction who had severe o moderate COVID-19 are more susceptible to develop LTPD. PROYECTO COVID1005, ACT210085 y Fondecyt Regular 1211480.

Prospective Observational Study of Prevalence, Assessment and Treatment of Pancreatic Exocrine Insufficiency in Patients with Inoperable Pancreatic Malignancy (PANcreatic Cancer Dietary Assessment-PanDA).

Pancreatic exocrine insufficiency (PEI) in patients with advanced pancreatic cancer (aPC) is well documented, but there is no consensus regarding optimal screening. Patients diagnosed with aPC referred for palliative therapy were prospectively recruited. A full dietetic assessment (including Mid-Upper Arm Circumference (MUAC), handgrip and stair-climb test), nutritional blood panel, faecal elastase (FE-1) and 13C-mixed triglyceride breath tests were performed. prevalence of dietitian-assessed PEI (demographic cohort (De-ch)); design (diagnostic cohort (Di-ch)) and validation (follow-up cohort (Fol-ch)) of a PEI screening tool. Logistic and Cox regressions were used for statistical analysis. Between 1 July 2018 and 30 October 2020, 112 patients were recruited (50 (De-ch), 25 (Di-ch) and 37 (Fol-ch)). Prevalence of PEI (De-ch) was 64.0% (flatus (84.0%), weight loss (84.0%), abdominal discomfort (50.0%) and steatorrhea (48.0%)). The derived PEI screening panel (Di-ch) included FE-1 (normal/missing (0 points); low (1 point)) and MUAC (normal/missing (>percentile 25) (0 points); low (2 points)) and identified patients at high-risk (2-3 total points) of PEI [vs. low-medium risk (0-1 total points)]. When patients from the De-ch and Di-ch were analysed together, those classified by the screening panel as "high-risk" had shorter overall survival (multivariable Hazard Ratio (mHR) 1.86 (95% CI 1.03-3.36); p-value 0.040). The screening panel was tested in the Fol-ch; 78.4% patients classified as "high-risk", of whom 89.6% had dietitian-confirmed PEI. The panel was feasible for use in clinical practice (64.8% patients completed all assessments), with high acceptability (87.5% would repeat it). Most patients (91.3%) recommended dietetic input for all patients with aPC. PEI is present in most patients with aPC; early dietetic input provides a holistic nutritional overview, including, but not limited to, PEI. This proposed screening panel may help to prioritise those at higher risk of PEI, requiring urgent dietitian input. Its prognostic role needs further validation.

Musculoskeletal Fitness for Identifying Low Physical Function in Older Women.

This cross-sectional study aimed to analyze the relevance of musculoskeletal fitness for identifying low physical functioning in community-dwelling older women. Sixty-six older women (73.62 ± 8.23 yrs old) performed a musculoskeletal fitness assessment of the upper and lower limbs. A handheld dynamometer was used to evaluate upper-limb muscle strength through a handgrip (HG) test. Lower-limb power and force were assessed from a two-leg countermovement vertical jump (VJ) on a ground reaction force platform. Physical functioning was assessed subjectively using the Composite Physical Function (CPF) questionnaire and objectively by daily step count measured by accelerometry and gait speed/agility assessed by the 8-Foot Up-and-Go (TUG) test. Logistic regressions and ROC curves were carried out to define odds ratios and ideal cutoff values for discriminatory variables. VJ power showed the ability to identify low physical functioning when evaluated through the CPF (14 W/kg, 1011 W), gait speed/agility (15 W/kg, 800 W), or daily accumulated steps (17 W/kg). Considering that VJ power was normalized for body mass, the increase of 1 W/kg corresponds to a decrease of 21%, 19%, or 16% in the chance of low physical functioning when expressed by these variables, respectively. HG strength and VJ force did not show a capacity to identify low physical functioning. The results suggest that VJ power is the only marker of low physical functioning when considering the three benchmarks: perception of physical ability, capacity for mobility, and daily mobility.