Handgrip Strength Measurement Research Articles

Temporal Muscle Thickness and Sarcopenia Components in Healthy Adults, Validated through Allgeun Diagnostic Tool

Sarcopenia, characterized by progressive muscle loss and functional decline, poses significant risks, including falls, impaired daily activities, and increased mortality. We developed Allgeun, a novel device that measures handgrip strength, muscle mass, and physical performance. This study aimed to investigate whether temporal muscle thickness (TMT) could be used as a sarcopenia marker and to evaluate the usability of Allgeun. This prospective study enrolled 28 participants without medical or neurological disorders. They underwent three-dimensional T1-weighted imaging using a 3 Tesla magnetic resonance imaging scanner. TMT was measured based on T1-weighted images by a board-certified neuroradiologist. Allgeun was used to measure the following three key components of sarcopenia: muscle strength (handgrip strength), muscle mass (calf and thigh circumference), and physical performance (five times the chair stand test). Correlation analysis was conducted between TMT and the results of the handgrip strength, calf and thigh circumferences, and chair stand tests. There were moderate positive correlations between TMT and calf circumference (r = 0.413, p = 0.029), thigh circumference (r = 0.486, p = 0.008), and handgrip strength (r = 0.444, p = 0.018). However, no significant correlation was observed between TMT and physical performance (r = −0.000, p = 0.998). Our findings underscore TMT’s potential as an indicator of sarcopenia, particularly regarding muscle mass and strength. Additionally, we demonstrated that the new device, Allgeun, is useful for screening and diagnosing the severity of sarcopenia.

The relationship between muscle strength and epicardial fat in healthy adults

BackgroundMuscular strength and muscle mass are considered key factors for healthy ageing. Modification of body composition and redistribution of adipose tissue has been described in advanced age. Muscle strength has an important predictive role for health outcomes. However, little is known regarding the relationship between muscle strength and epicardial fat. Methods and materialsIn a cohort of healthy adults following physical capacity evaluations, anthropometric measurements, handgrip strength (HGS), echocardiography and bioimpedance analysis (BIA) were performed. Kruskal-Wallis test, Spearman's correlation and regression analysis adjusted for confounders were applied. ResultsA total population of 226 adults, age range 18–83 years, were included. Epicardial fat thickness resulted significantly associated with age p < 0.001, HGS (p < 0.001). Regression analysis adjusted for confounders revealed an independent relationship between handgrip strength and epicardial fat thickness: regression coefficient: -1.34; R2 = 0.27 and p = 0.044. ConclusionsThe relationship between epicardial fat and muscle strength is inverse and independent. Implementation of HGS measurement may be useful for the identification of subjects with excessive epicardial fat and cardiovascular risk. Measurement of epicardial fat could be helpful in the early detection of physical decline associated to ageing.

Comparison of Some Physical Characteristics of Young Judoka and Wrestlers

This research sought to assess and contrast the physical attributes of adolescent wrestlers and judo practitioners aged 13 to 16 in Çorum, aiming to identify key physical and motor skills that contribute to performance excellence in these sports. A total of 30 athletes were divided into wrestling (n=15) and judo (n=15) groups. These athletes train 4 to 6 days a week. In this study, body composition, forward jump test and hand grip strength of combat athletes were evaluated. Anthropometric measurements included parameters such as body weight and height, while bioelectrical impedance method and Tanita 418 BC instrument were used for body composition analysis. Forward jump test and hand grip strength measurement were performed with specific tests. Statistical analysis was conducted utilizing the SPSS 20.0 program. The normality of distribution was examined through the Shapiro-Wilk test, while comparisons of numerical data across two distinct groups were conducted using suitable statistical tests.Based on the results, the average age of the participants was calculated to be (13.7±1.2) for judo and (14.8±1.7) for wrestling, with their respective sports ages being (5.3±1.3) for judo and (5.6±1.2) for wrestling, and their heights being (161.1±10.7) for judo and (169.4±9.4) for wrestling. Although a significant difference was noted in the lean body mass percentage (p

Comparison of two electronic dynamometers for measuring handgrip strength

Comparison of two electronic dynamometers for measuring handgrip strength

Sex differences of the association between handgrip strength and health-related quality of life among patients with cancer

The purpose of this study is to investigate the association between handgrip strength (HGS) and health-related quality of life (HRQoL), demonstrating HGS as an effective indicator for evaluating HRQoL of patients with cancer. Analyzing 1657 Korean adult cancer patients (644 males, 1013 females) aged ≥ 20 years from the Korea National Health and Nutrition Examination Survey (2014–2019), HGS was standardized based on body mass index and categorized by sex. HRQoL was assessed using the Euro Quality of Life-5-Dimension 3-Level version (EQ-5D-3L) Index. Lower relative HGS was associated with decreased HRQoL in female patients, while no significant association was found in male patients. The lowest quartile of relative HGS exhibited a 2.5-fold decrease in HRQoL compared to the highest quartile (OR 2.50, 95% CI 1.59–3.95, p < 0.001). Both male and female patients with cancer were affected by age, subjective health perception, and stress recognition regarding HRQoL. This study suggests that HGS may be associated with the HRQoL of female patients with cancer, emphasizing that the HGS measurement can be effectively utilized as a pivotal tool for evaluating HRQoL in female patients with cancer.

Use of a novel bluetooth-connected device to measure handgrip strength: A practical tool to help healthcare professionals identify adults at nutritional risk

Background and AimsLow muscle strength is strongly tied to poor nutrition status, and nutritional interventions are likewise linked to maintenance and restoration of muscle strength and functional status. Nutrition plays a vital role in muscle mass, strength, and function, and losses in muscle (strength, function, and mass) are associated with poor health outcomes and added costs for healthcare services. For this study of outpatients, the main objective was to identify those at risk for low muscle strength, as evidenced by low handgrip strength (HGS) measures with risk stratified by age and sex. MethodsThis was a two-part study on HGS measures in adults attending outpatient clinics in India. In part one, we conducted HGS tests on dominant and non-dominant hands of patients who qualified for the study. For HGS measures, we used a validated tool, the SQUEGG device, a smart handgrip trainer, along with its companion Bluetooth-connected app, the Muscle Strength Assessment Tool (MSAT) app. In part two, we collected Healthcare Practitioners’ (HCP) feedback via a short digital survey on the use of the SQUEGG device + the MSAT app to do HGS risk screening as an indicator of needed nutritional intervention. ResultsNearly a third of community-living adults in India exhibited low HGS among the 3036 sampled. At each age stratum, dominant-hand HGS in women was lower by 25% to 35% compared to men. Among 353 HCPs, 293 (83%) provided insights via survey, and 85% of surveyed HCPs (n=249) strongly agreed or agreed that the SQUEGG device + MSAT app helped them identify HGS issues among their patients, and 85% (n=248) agreed or strongly agreed they would like to continue using the SQUEGG device + MSAT app to inform their practice. Nearly all surveyed HCPs (98%, n=288) recommended an oral nutritional supplement (ONS) to their patients with identified low HGS. ConclusionsOur findings demonstrate that HCPs would like to continue use of the SQUEGG device + MSAT app as it helped them identify adult patients who had decreased HGS (about 30% of the study population), in turn identifying opportunities to use nutritional interventions such as ONS to address nutrition shortfalls and to restore functional status.

Collective Weakness Is Associated With Time to Mortality in Americans.

McGrath, R, McGrath, BM, Jurivich, D, Knutson, P, Mastrud, M, Singh, B, and Tomkinson, GR. Collective weakness is associated with time to mortality in Americans. J Strength Cond Res XX(X): 000-000, 2024-Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg·kg-1 (body mass normalized), or <1.05 kg·kg-1·m-2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg·kg-1, or <0.79 kg·kg-1·m-2. Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all-cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (CI: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging.

Tracking handgrip strength in Kendo athletes from university to middle and older adulthood.

This study aimed to compare the current handgrip strength (HGS) of Kendo athletes with their HGS when they were in university (up to 50 years). Eighty male graduates who were Kendo club members during their university days performed anthropometric and HGS measurements, and these HGS were compared with those measured during their university days (mean age of 19.5 years old). There was no evidence of a statistical difference in HGS between the current measurement and the measurement taken during university [-0.64 (-1.9, 0.67) kg, p = .336]. There was, however, evidence that the difference in HGS depended upon the current age of the individual (t = -6.43, p < .001). When probing the interaction, there were statistical differences between the ages of 24.6 and 38.2 years and between the ages of 47.4 and 69.9 years. Strength increased across time in the younger participants and decreased for those who were older. Between the ages of 38.9 and 46.1 years, there was no evidence of a statistical difference indicating a maintenance of strength. The HGS of Kendo club graduates, which they acquired during their formative years, continued to increase even after they graduated from university and entered their 30s. However, their HGS decreased from age 50, even though they practiced Kendo.

Role of handgrip strength in predicting the quality of life in older adults: A cross-sectional study

BACKGROUND: Quality of life (QOL) is a vital component in assessing the standard of living for seniors. Hand grip strength (HGS) is a widely used measure to diagnose muscle strength decline that often occurs due to age-related loss of skeletal muscle mass and function. This study focuses on the HGS in predicting the QOL of older adults who are referred to retirement centers in Guilan Province. MATERIALS AND METHODS: In 2021, a cross-sectional analytical study was conducted among 115 older adults who were residing in retirement centers located in Guilan Province, Northern Iran. The participants were selected using a two-stage sampling method, where three retirement centers were randomly chosen followed by convenience sampling from each center. The selected retirement centers were situated in Langrod, Sowme’eh Sara, and Rasht cities in the east, west, and center of the province, respectively. The data were collected through a demographic information questionnaire, QOL scale (CASP-19), and HGS measurement using a dynamometer. RESULTS: Of the participants, 57.4% were male, 51.3% had middle income, and 96.5% were categorized as young elderly. The mean overall QOL score was found to be 37.026 ± 6.123, while the mean HGS level was 31.74 ± 7.45 and 18.48 ± 5.13 among males and females, respectively. There was a significant association between the level of education and QOL (P = 0.002). Moreover, there was a positive and significant correlation between HGS and QOL (r = 0.54, P = 0.001). The results of the multiple linear regression identified HGS as a predictor of QOL (Adj R2 = 0.44, βHGS = 0.79). CONCLUSION: Given that HGS has been identified as a predictor of QOL in older adults, improving this factor through exercise can lead to enhancement in their QOL. Therefore, regular sports exercises can be recommended as a means of improving HGS and subsequently enhancing the QOL of older adults.

Association of Handgrip Strength and Cardiovascular Disease Risk Among Middle-Aged Postmenopausal Women: An Analysis of the Korea National Health and Nutrition Examination Survey 2014-2019.

Handgrip strength is an indicator of overall muscle strength and has been associated with an increased risk of cardiovascular disease. Evidence suggests that menopause is a risk factor for cardiovascular disease in women, and muscle strength decreases progressively after menopause. Despite the prognostic importance of the decline in muscle strength and increased cardiovascular disease risk among postmenopausal women, evidence of their association is limited. This study aimed to investigate the relationship between handgrip strength and cardiovascular disease risk among postmenopausal, middle-aged Korean women. Using pooled cohort equations, we calculated the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among postmenopausal women (N = 2019) aged 50-64 years without cardiovascular disease history from the 2014-2019 Korea National Health and Nutrition Examination Survey. Relative grip strength was defined as measured grip strength divided by body mass index. Logistic regression analysis of a complex sampling design was performed to evaluate the association between relative grip strength and a predicted 10-year ASCVD risk ≥7.5%. The average handgrip strength was 24.8 kg, and 5.2% of women were considered for sarcopenia (<18 kg). The quartile-stratified relative grip strength was negatively associated with 10-year ASCVD risk (p < 0.001). In the multiple logistic regression analysis, the adjusted odds ratio for the highest relative grip strength quartile was 0.53 (95% confidence interval [CI]: 0.36-0.78), and that of the group who breastfed for more than 12 months was 1.75 (95% CI: 1.36-2.25) for 10-year ASCVD risk. Increased handgrip strength may be associated with lower cardiovascular disease risk among middle-aged postmenopausal women in Korea. Our findings provide critical evidence regarding the importance of increasing handgrip strength among postmenopausal, middle-aged women to reduce cardiovascular disease risk. Handgrip strength measurement might be a valuable screening tool for cardiovascular disease prevention.

Evaluating performance on the Glittre-ADL test in men with long COVID 3 years after a SARS-CoV-2 infection

Background/objectiveMany COVID-19 survivors, especially those who have been hospitalized, have been suffering numerous complications that limit their activities of daily living, although changes that persist 3 years after infection are still not known. We aimed to investigate the impact of long COVID on the Glittre-ADL test (TGlittre) 3 years after acute infection in men who needed hospitalization and explore whether the performance on the TGlittre is associated with impairments in lung function, muscle strength, physical function and quality of life (QoL). MethodsCross-sectional study with 42 men with long COVID who took the TGlittre. They underwent pulmonary function tests and measurements of handgrip strength and quadriceps strength (QS). Additionally, they also completed the Saint George Respiratory Questionnaire (SGRQ) and Functional Independence Measure (FIM). ResultsThe mean age was 52 ± 10.6 years, while the mean time after diagnosis of COVID-19 was 37 ± 3.5 months. The mean TGlittre time was 3.3 (3.1–4.1) min, which was 10% greater than the time expected for normal individuals to complete it. The TGlittre time was correlated significantly with the QS (rs = −0.397, p = 0.009), pulmonary diffusion (rs = − 0.364, p = 0.017), FIM (rs = −0.364, p = 0.017) and the “activity” domain score of the SGRQ (rs = 0.327, p = 0.034). ConclusionFunctional capacity on exertion as measured by the TGlittre time is normal in most men with long COVID 3 years after hospitalization. However, this improvement in functional capacity does not seem to be reflected in muscle strength or QoL, requiring continued monitoring even after 3 years.

Muscle strength during pregnancy and postpartum in adolescents and adults.

Adolescent childbirth is associated with worse physical function over the long-term. Differential loss of muscle strength during pregnancy and postpartum for adolescents compared to adults may be one explanation for this, but research examining these differences is lacking. The objective of this study as to assess hand grip strength and hip adduction muscle strength in adolescents and adults during pregnancy and postpartum. A prospective cohort study was carried out with adolescent (13 to 18 years) and adult (23 to 28 years) primigravid women. Assessments were performed at three timepoints: before the 16th gestational week, during the third trimester, and between the fourth and sixth week postpartum. Hand grip strength (continuous and muscle weakness if ≤ 20.67 kgf) and hip adductor measures (continuous and muscle weakness if ≤ 13.8 kgf) were assessed using dynamometry. Generalized estimating equations modelled longitudinal relationships between muscle weakness and age group. More adolescents had hip adductor weakness than adults in the third trimester of pregnancy (62.5% vs. 31.8%, p < 0.005), which was corroborated by the longitudinal analyses. For all women, there were higher odds of hip adductor weakness in the third trimester (OR = 4.35; p< 0.001) and postpartum (OR = 9.45; p < 0.001) compared to the 16th gestational week. No significant difference in HGS was observed between age groups or across the different timepoints. The higher proportion of hip adductor weakness among adolescents may indicate a need for resistance training during and after pregnancy and physical therapy if weakness or injury is noted.

Ultrasonographically Measured Rectus Femoris Cross-sectional Area might Predict Osteosarcopenia.

We have aimed to investigate the role of ultrasonographic muscle parameters (UMP) in predicting osteosarcopenia in bedridden patients in a palliative care center. The role of ultrasound has not been evaluated in predicting osteosarcopenia. Reduced muscle thickness (MT) and cross-sectional area (CSA) have often been observed in individuals with sarcopenia, reflecting muscle loss and atrophy. Meanwhile, the potential role of muscle ultrasound has not been evaluated in predicting osteosarcopenia. We have conducted a prospective, observational study between January 2021 and 2022. We have recorded the demographics, comorbidities, and nutritional status by using the mini nutritional assessment-short form. We measured handgrip strength with a hand dynamometer and the muscle mass with dual X-ray absorptiometry. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People 2 criteria. Osteoporosis was diagnosed according to the World Health Organization criteria. We have categorized the body phenotypes into four groups: "non-sarcopenic non-osteoporotic," "sarcopenic alone," "osteoporotic alone," and "sarcopenic osteoporotic." We have measured the subcutaneous fat thickness (SFT), MT, and CSA of the rectus femoris (RF) and biceps brachii (BB) via ultrasonography. A multivariate regression analysis was performed and area under curve (AUC) values were used to evaluate the accuracy of UMPs. We included 31 patients (mean age: 74.6±12.1 years, 54.8%: male). The prevalences of sarcopenia, osteoporosis, and sarcopenic osteoporosis were 71%, 48.4%, and 41.9%, respectively. Only the "sarcopenic osteoporotic" phenotype was negatively correlated with all UMPs. In the regression analysis, only the "sarcopenic osteoporotic" phenotype was independently associated with RFCSA (ß=-0.456, p= 0.024). The AUC for all patients was >0.700. RFCSA measurement might be useful in the screening for osteosarcopenia. This has been the first study investigating the relationship between UMPs and body phenotypes. Multi-center and large-scale studies are, however, needed.

Combination of neuromuscular block monitoring and hand grip strength assessment for patients undergoing emergency abdominal surgery

Relevance. The hand grip strength measurement together with neuromuscular block monitoring played an important role during surgery. They both helped in losing less time during surgery and also facilitate the task of the surgeon. The aim of this study was to reduce time on intubation, facilitate the task of the surgeon and to limit post-surgical pain. In rehabilitation, hand grip strength helps in determining further recuperation measures after asurgery. There are three fundamental principles for an anesthesiologist to ensure that the patient after combined endotracheal anesthesia can be extubated, the first one is to ask the patient to move his head forward, the second one is to ask the patient whether the intubation tube is disturbing him in his mouth and the third most important one is to make the patient hold his wrist very firmly. Materials and Methods. Monitoring of muscle relaxant on induction, intra and post-surgery is carried out using aTOF Watch SX in coordination with handgrip strength measurement on 46 patients aged from 18 to 60 years of BMI of 18-30 kg/m² 15min before endotracheal intubation and 15min, 45min and 210min post extubation by using adynamometer “MEGEON 34090” to help us understand whether after extubation muscle strength changes and to what extent. Also, pre-anesthesiology protocol, combined endotracheal protocol, Microsoft excel advanced, monitoring of hemodynamics, ECG, PEEP, PCO2, PO2, respiratory volume using Drager Fabius. Results and Discussion. The results showed that to reach deep muscle relaxation both atracurium benzilate (FKP Kursk Biofabric company, Kursk, Russia) at TOF 0 took 258.5± 83.5 secs and Cisatracurium benzilate (ZAO Obninsk Chemical pharmaceutical company, Obninsk, Russia) at TOF0-252.4±100.1 secs in emergency patients and basically hand grip strength also was lesser as compared to planned cholecystectomy patients. Conclusion. Rehabilitation was necessary for patients undergoing massive abdominal emergency surgeries underlying the fact that on apain scale 10/10 post surgery, further treatments should be implemented to reduce pain, reduce residual neuromuscular block and muscle weakness after extubation at TOF 90-95%.

Evaluation of factors influencing handgrip strength asymmetry in elderly Peruvians.

Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. From a total of 1468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (aPR = 1.08, 95% CI = 1.01 - 1.15), falls risk (aPR = 1.08, 95% CI = 1.02 - 1.16), and an altered Lawton index (aPR = 0.92, 95% CI = 0.84 - 0.99) were associated with HGS asymmetry. Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.

Association between oxidative balance score and sarcopenia in older adults

Sarcopenia is a progressive skeletal muscle disease in which oxidative stress has been proposed as one of the primary markers. The oxidative balance score (OBS) represents the oxidative balance of a person's dietary pattern using the merged intake of anti-oxidants and pro-oxidants. Therefore, the present study assessed the association between OBS and sarcopenia in Iranian older adults. In the current study, 80 people with sarcopenia and 80 without it were considered the case and control groups, respectively. All controls were matched by sex with cases. To confirm sarcopenia, skeletal muscle mass index (SMI), handgrip strength (HGS) measurement, and gait speed were used. Also, body composition was measured by bioelectrical impedance analysis (BIA). A valid and reliable food frequency questionnaire (FFQ) was used to assess all participants' dietary intake of pro-oxidants and anti-oxidants. Conditional logistic regression was applied to assess the association between OBS and sarcopenia. In the bivariate model, we observed lower odds of sarcopenia in the second and last tertile of OBS in comparison to the first tertile (T) (T2 – odds ratio (OR) = 0.414, 95% confidence interval (CI) : 0.186–0.918 and T3 – OR = 0.101, 95% CI: 0.041–0.248). After adjusting for potential confounders, the association was not significant in second and last tertile of OBS in comparision to the first one. The present study's findings demonstrated that overcoming exposure to anti-oxidants over pro-oxidants, as illustrated by a higher OBS, is not related to lower odds of sarcopenia in older adults.

Reduced calf muscle pump function is not explained by handgrip strength measurements

ObjectiveReduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between handgrip strength (HGS) and CPF. MethodsPatients referred to the Gonda Vascular Laboratory for noninvasive venous studies were identified and consented. Patients underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cutoff for reduced CPF (rCPF) was defined as an ejection fraction of <45%. Maximum HGS bilaterally was obtained (three trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated. Results115 patients (mean age, 59.2 ± 17.4 years; 67 females, mean body mass index, 30.83 ± 6.46) were consented and assessed for HGS and CPF. rCPF was observed in 53 right legs (46%) and 67 left legs (58%). CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) patients. HGS was reduced bilaterally in 74 (64.3%), unilaterally in 23 (20%), and normal in 18 (15.7%) patients. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side. ConclusionsThere is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF, indicating different pathophysiological mechanisms for each process.

Completion of a Nutrition-Focused Physical Exam with hospitalized adults and pediatric patients: Secondary analysis of a prospective cohort study.

Nutrition-Focused Physical Exam (NFPE) feasibility is not well-studied. We describe registered dietitian nutritionist (RDN)-reported NFPE completion for hospitalized adult and pediatric patients overall and by assessment parameters. Trained RDNs systematically conducted NFPEs for hospitalized adult and pediatric patients during the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Indicators to diagnose Malnutrition multisite cohort study (ClinicalTrials.gov: NCT03928548). RDNs reported their ability to evaluate assessment sites for subcutaneous fat and muscle loss, fluid accumulation, and micronutrient status and to complete handgrip strength (adults and children ≥6 years) and mid-upper arm circumference measurements (children). RDNs noted if they could complete the full NFPE; if not, they noted challenges. We descriptively summarized results and used multilevel logistic regression models to examine relationships between patient characteristics and NFPE completion. RDNs from 39 adult and 29 pediatric US hospitals conducted NFPEs for 327 adults and 214 children aged 1 month to 17.9 years. RDNs reported completing the examination for 44% (n = 145) of adults and 15% (n = 33) of children. They successfully evaluated 25 of 27 and 19 of 26 unique NFPE components in >80% of adults and children, respectively. Common reasons the full NFPE was not completed were limited mobility in adults and patient refusal in children. RDNs had lower odds of completing NFPEs in adults with lower vs higher education levels or higher vs lower nutrition complexity and in younger vs older children. RDNs evaluated NFPE components for a high proportion (>80%) of hospitalized patients.

Clinical Outcomes Associated With Malnutrition Diagnosed by the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Indicators of Malnutrition: A Systematic Review of Content Validity and Meta-Analysis of Predictive Validity

BackgroundThe Academy of Nutrition and Dietetics-American Society for Parenteral and Enteral Nutrition Indicators of Malnutrition (AAIM) is a tool that uses nutrition assessment parameters to diagnose patients with malnutrition. Evaluation of the content validity of AAIM relative to the Subjective Global Assessment (SGA) or Patient Generated-Subjective Global Assessment (PG-SGA) is needed. Predictive validity of malnutrition diagnosed by AAIM for clinical outcomes in hospitalized adults is also important. ObjectiveThe purpose of this systematic review of the published literature was to evaluate the content validity of the AAIM approach relative to SGA/PG-SGA and to determine whether malnutrition diagnosed by AAIM at or near hospital admission is associated with increased mortality, length of stay, hospitalization cost, or readmissions. MethodsObservational studies of hospitalized adult patients published in English during 5/1/2012-6/1/2023 were identified using Pubmed, CINAHL, EMBASE or Cochrane Library. The risk of bias of outcome studies was evaluated by the National Institutes of Health quality assessment tool for observational studies. Effect sizes from three or more studies were combined into forest plots using Review Manager 5.0 to produce effect sizes expressed as odds ratios or mean differences with 95% confidence intervals (CI) using the inverse variance method with a random effects model, and computation of the I2 statistic to indicate heterogeneity. Visual examination of funnel plots was used to assess likelihood of publication bias. ResultsEighteen studies with data from 14,794 patients were included. In the nine studies that provided content validation data, five did not measure hand grip strength. Nonetheless, AAIM demonstrated 89% sensitivity, 84% specificity, and substantial agreement with the SGA/PG-SGA. Sixteen studies reported clinical outcomes. Malnutrition diagnosed by AAIM was associated with greater OR (95% CI) hospital mortality of 2.37(1.58 to 3.55) and increased OR (95% CI) 30-day readmissions of 2.26 (1.97 to 2.58) than patients without malnutrition. While a specific effect size was not established due to study heterogeneity, longer length of stay was confirmed in five adjusted models. Two studies reported significantly increased costs of hospitalization in patients with malnutrition. ConclusionsThe AAIM criteria are valid in content relative to SGA/PG-SGA. Malnutrition diagnosed by AAIM identifies patients with greater odds of hospital mortality, and 30-day readmissions as well as longer hospital length of stay.

Obstacles to the Early Diagnosis and Management of Sarcopenia: Current Perspectives.

Research in sarcopenia has grown exponentially over the last 15 years in geriatrics and gerontology, as well as other specialties, including oncology and hepatology. There is now strong evidence for the role of resistance exercise to prevent declines in muscle strength and function, especially when combined with nutritional optimization with protein supplementation. However, there remains a disparity between research evidence and clinical practice. There are multiple factors for this, which relate to the current diagnostic criteria for sarcopenia, practical and logistical aspects of diagnosis of sarcopenia, clinician knowledge of both diagnosis and management, and the availability of pathways for interventions. Sarcopenia is currently defined based on the identification of muscle strength, in combination with muscle size or quality, below cut-off thresholds at a single timepoint. This defines sarcopenia as a binary process of either present or not present, thus early diagnosis can be challenging. In this article, we summarize current obstacles to early diagnosis and management of sarcopenia in clinical practice, and make recommendations to how these might be overcome. This includes our recommendation of incorporation of handgrip strength measurement into standard care, to enable dynamic assessment and identification of early declines in handgrip strength, so that interventions can be implemented to prevent disability.