Muscle Strength Of Upper Limbs Research Articles

Feasibility and safety of high-intensity interval training for the rehabilitation of geriatric inpatients (HIITERGY) a pilot randomized study

BackgroundHigh-intensity interval training (HIIT) has been shown to be more effective than moderate-intensity continuous training (MICT) for the physical rehabilitation. However, data on its suitability for older hospitalized patients is scarce.MethodsRandomized controlled trial in a hospital setting. Inclusion of 100 patients, ≥65 years old, hospitalized for rehabilitation after an acute medical condition, in a two-week rehabilitation program of either four HIIT or three MICT sessions per week. Completion was defined as participation in all but two planned sessions accomplishing ≥50% of each session. We assessed: upper-limb muscle strength (handgrip isometric strength test), lower-limb muscle strength (quadriceps and ankle flexion and extension tests); gait speed and spatio-temporal parameters (instrumented walkway), and exercise capacity (6-min walk test). All adverse events were recorded as safety endpoints.ResultsAn intention-to-treat analysis showed a 44% completion rate for the HIIT group (95% CI, 30–59) and 77% for MICT (95% CI, 55–82). A modified intention-to-treat analysis restricted to patients who participated in ≥1 session showed an 88% completion rate in the HIIT group (95%CI, 69–97) and an 80% completion rate in MICT (95%CI, 65–90). The exercises most frequently undertaken were the pedal exerciser (54%) and the NuStep (32%). There were no significant differences in the various measures. No serious adverse events occurred.ConclusionA HIIT rehabilitation program for this population was feasible, safe and had a high adherence rate.Trial registration numberClinicatrials.gov ID: NCT02318459.Trial registration date: November 7th, 2014. Retrospectively registered.This study adheres to the CONSORT guidelines.

Case Report: Central Nervous System Tuberculosis Immune Reconstitution Inflammatory Syndrome in a Non-HIV Patient

Tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) is an abnormal, excessive immune response against live or dead Mycobacteria tuberculosis that may occur during or even after completion of anti-TB therapy, commonly in HIV-infected patients. However, this has also been reported amongst HIV negative patients. We report a case of CNS TB-IRIS in a 57-year-old HIV negative man with miliary TB and tuberculoma. He first presented with 4 months of chronic constitutional symptoms. His symptoms improved on standard anti-TB (isoniazid, rifampicin, ethambutol, pyrazinamide) initially, but he developed worsening left hemiparesis after 1 month of treatment. He was restarted on tapering dose of dexamethasone, and anti-TB was intensified with intramuscular streptomycin for 2 months. His gained full muscle power 4 months later. Serial brain imaging subsequently showed slow treatment response with partial resolution of brain lesions. However, he developed another episode of left hemiparesis with facial asymmetry and slurred speech after 16 months of anti-TB treatment. Repeated MRI brain showed 2 large frontal ring enhancing lesions and lesions in cerebellar hemispheres and vermis regions. Due to diagnostic uncertainties and compressive nature of the brain lesions, craniotomy and excision biopsy of the right frontal lesion were performed. There were no evidence of drug resistant TB and no other brain pathologies were found. Moxifloxacin was added post operatively to achieve better CNS penetration. Patient eventually recovered and achieved full muscle strength of left upper and lower limbs.

Risk factors for decreased upper-limb muscle strength and its impact on survival in maintenance hemodialysis patients.

Protein-energy wasting, characterized by decreased muscle mass, is one of the strongest predictors of mortality in patients on maintenance hemodialysis (MHD). As people get older, their muscle strength usually declines faster than muscle mass. However, the association between lower-limb muscle strength and all-cause mortality remains unclear. We aimed to evaluate risk factors for decreased upper-limb muscle strength in MHD patients and its impact on patient survival. The cross-sectional part of the study included 174 MHD patients. Subsequently, they were followed up for 52weeks. Biceps muscle strength, anthropometry, body composition, dietary intake, daily steps, and biochemical indicators of malnutrition and inflammation were evaluated. Risk factors for muscle weakness were screened by multiple linear regression analysis, and patient survival was analyzed by Kaplan-Merier and Cox multivariate analysis. The 174 MHD patients (93 men; 63.05 ± 12.29years) were classified as a young (< 65years, n = 97) group and an elderly group (≥ 65years, n = 77). Gender, daily steps, muscle mass, 25(OH)D level and IL-6 in young group, and muscle mass, 25(OH)D, daily steps, and NT-proBNP in elderly group were associated with the decreased biceps muscle strength. The survival rate in high muscle strength group was significantly higher than that in low muscle strength group (P = 0.002). The association between low muscle strength and high mortality risk remained strong in the fully adjusted model. Risk factors of muscle weakness were different between young and elderly MHD patients. There was a strong correlation between strong biceps muscle strength and high patient survival.

Photobiomodulation therapy increases functional capacity of patients with chronic kidney failure: randomized controlled trial.

Photobiomodulation (PBM) has been used in different populations as a strategy to attenuate muscle fatigue and improve exercise performance. Recent findings demonstrated that a single session with specific PBM doses during hemodialysis (HD) increased the upper limb muscle strength of chronic kidney failure (CKF) patients. Now, the primary objective of this study was to evaluate the chronic effect of PBM on the functional capacity of this population. Secondarily, we aimed at investigating the effects of PBM on the patients' strength, muscle thickness and echogenicity, perception of pain, fatigue, and quality of life. A randomized controlled trial was conducted in which the intervention group (IG, n = 14) received 24 sessions of PBM (810nm, 5 diodes × 200mW, 30J/application site) on lower limb during HD. The control group (CG, n= 14) did not receive any physical therapy intervention, it only underwent HD sessions. As a result, there was an increase in the functional capacity (assessed through the six-minute walk test) for the IG compared with the CG [50.7m (CI95% 15.63; 85.72), p = 0.01, large effect size, d = 1.12], as well as an improvement on lower limb muscle strength (assessed through the sit-and-stand test) [- 7.4s (CI95% - 4.54; - 10.37), p = 0.00, large effect size, d = 1.99]. For other outcomes evaluated, no significant difference between-group was observed. Finally, PBM applied as monotherapy for 8weeks in the lower limb improves functional capacity and muscle strength of CKF patients.

Effectiveness of Early Rehabilitation Combined With Virtual Reality Training on Muscle Strength, Mood State, and Functional Status in Patients With Acute Stroke: A Randomized Controlled Trial.

Early rehabilitation has been shown to enhance functional outcomes. Whether the addition of virtual reality (VR) training could further improve muscle strength, mood state, and functional status for patients with acute stroke is unknown. To investigate the effectiveness of VR training on muscle strength, mood state (depression, anxiety), and functional status in patients following acute stroke. A randomized controlled trial was conducted. Patients with acute ischemic stroke (N=152) were selected and randomly assigned with a 1:3 randomization ratio to either experimental group (EG) or comparison group (CG). Both groups received early rehabilitation. The EG received an extra 5days of VR training (15min of time, two times a day), started 24hr to 3days poststroke. Muscle strength, mood state, and functional status were collected at admission and at the day of discharge. Generalized estimating equations were applied to examine the intervention effects. A total of 143 participants (94%) completed the study, and 145 were included in the intention-to-treat analysis. Participants in the EG reported increased muscle strength of upper and lower limbs in both affected and unaffected sides, decreased depression and anxiety, and increased functional status at discharge. When the group-time interaction was examined, the EG had greater increased upper limb muscle strength of the unaffected side (ß=0.34, p<.001) and decreased depression and anxiety scores (ß=-2.31, p=.011; ß=-1.63, p=.047) at discharge compared with the CG. However, there was no difference in the functional status change scores from baseline between EG and CG. A poststroke program that includes both early rehabilitation and VR training has greater benefit in relation to mood state and muscle strength at discharge than early rehabilitation alone. Therefore, an early physical rehabilitation program that includes VR training for acute stroke inpatients should be considered for implementation in clinical settings.

Strength and Electromyographic Responses of Upper and Lower Limbs During Maximal Intermittent Contractions in Males and Females.

Carr, JC and Ye, X. Strength and electromyographic responses of upper and lower limbs during maximal intermittent contractions in males and females. J Strength Cond Res 36(9): 2403-2409, 2022-This study examined the strength and electromyographic (EMG) responses of upper vs. lower limb muscles during intermittent maximal contractions in both sexes. Twenty subjects ( n = 7 women) performed a fatiguing protocol (6, 30-second intermittent maximal isometric contractions with a 50% duty cycle) with either the elbow flexors or the knee extensors on separate visits. Bipolar surface EMG signals were detected from the biceps brachii and vastus lateralis muscles ( n = 5 women retained). Women maintained more of their maximal force than men (Δforce: men vs. women = -55.0 ± 12.8% vs. -43.3 ± 9.9%, p = 0.042). Although force loss was similar between the elbow flexors and knee extensors, the EMG responses showed greater reductions for the biceps brachii than those for the vastus lateralis (Δamplitude: biceps brachii vs. vastus lateralis: -32.0 ± 22.3% vs. -18.9 ± 28.9%; Δmedian frequency: biceps brachii vs. vastus lateralis: -31.1 ± 14.5% vs. -10.3 ± 17.0%). During a series of maximal intermittent isometric contractions with 30 seconds of recovery between work bouts, women are more fatigue resistant than men. In addition, the greater electrophysiological fatigue exhibited by the biceps brachii than that by the vastus lateralis suggests that high-intensity contractions involving elbow flexion will have a greater rate of fatigue progression than those involving knee extension.

Comprehensive metabolic flux analysis to explain skeletal muscle weakness in COPD.

Metabolic characterization of a well-defined group of patients could be a powerful tool in revealing metabolic signatures to explain limb muscle weakness in chronic diseases. Studies are currently limited in Chronic Obstructive Pulmonary Disease (COPD) to the identification of differential amino acid concentrations but lack comprehensive analysis of the flux through relevant muscle function related metabolic pathways. In 23 stable patients with moderate to very severe COPD and 19 healthy controls, a comprehensive metabolic flux analysis was conducted by administering an intravenous pulse and primed constant infusion of multiple stable tracers of amino acids known to play a role in muscle health. Blood samples were obtained to calculate production (WBP) and interconversion rates, and plasma concentrations of these amino acids. Lower and upper limb muscle strength, muscle mass, lung function, physical activity level, and disease history and characteristics were assessed. The COPD group was characterized by lower and upper limb muscle weakness (P<0.01) despite preserved muscle mass. Higher values were found in COPD for plasma glutamine, WBP of leucine (P<0.001), 3-methylhistidine (P<0.01) (marker of enhanced myofibrillar protein breakdown), citrulline (P<0.05), and arginine to citrulline conversion (P<0.05) (reflecting enhanced nitric oxide synthesis). Plasma concentration of β-hydroxy β-methylbutyrate (HMB with anticatabolic, anabolic and contractile properties), WBP of glycine (precursor of creatine and glutathione), and transcutaneous O2 saturation explained up to 79% and 65% of the variation in strength of the lower and upper limb muscles, respectively, in COPD. Comprehensive metabolic flux analysis revealed a homogenous metabolic signature in stable patients with COPD and a specific metabolic profile in those with skeletal muscle weakness. ClinicalTrials.gov; No. NCT01787682; URL: www.clinicaltrials.gov.

Gender differences and relationships between upper extremity muscle strength, lower limb power and shuttle velocity in forehand smash and jump smash in badminton

The aim of the study was to investigate the relationships between shuttlecock velocity during a badminton forehand smash with and without jump (VmaxWJ and VmaxNJ), strength of upper limb muscles, vertical jump height and to analyze differences in these parameters for each gender. The study examined members of the Polish National Badminton Team seven women and seven men. A special torque meter was used to assess the strength of the upper limb muscles. Vertical jumps were performed on an AMTI force plate. Shuttlecock velocity was measured using Vicon motion capture system. Differences between the right and left limbs were observed in all muscle groups except shoulder flexion for both genders. The results of all measured parameters: torques, height of countermovement and spike jump (HACMJ, HCMJ, HSPJ), VmaxWJ and VmaxNJ, were greater for men than for women. No statistically significant differences were found between VmaxWJ (men: 83.27 ± 4.83 m/s; women: 67.57 ± 4.21 m/s) and VmaxNJ (men: 84.19 ± 6.05 m/s; women: 69.70 ± 6.53 m/s) within the same gender. Positive correlations were found between both HCMJ and HSPJ regarding VmaxWJ in men; the height of shuttlecock impact in jump smash (HWJ) and HSPJ in women; proving the importance of jumping ability in badminton. Negative correlations were found between HWJ and VmaxWJ for both genders. The jump before smash is not used in order to hit the shuttle from the highest point, but to gain time to correctly prepare the phase of stroke while being in the air.

Effect of flapping-meridians combined with thunder-fire moxibustion on upper limb dysfunction after stroke

Objective: The objective of the study is to explore the effect of flapping-meridians combined with thunder-fire moxibustion in the treatment of upper limb dysfunction after stroke.Materials and Methods: This randomized, single-blind, controlled trial included 140 patients with stroke. According to the random number table, the patients were divided into four groups: the control group (receiving conventional nursing alone), the intervention group 1 (receiving conventional nursing combined with flapping-meridians), the intervention group 2 (receiving conventional nursing combined with thunder-fire moxibustion), and the intervention group 3 (receiving conventional nursing, flapping-meridians, and thunder-fire moxibustion). All four groups were intervened 4 weeks, 6 days a week. The outcome indicators (Fugl-Meyer Assessment of the upper extremity and body mass index of shoulder abduction, elbow extension, and wrist flexion) were assessed at the beginning and the end of treatment.Results: The effect of the intervention group 3 was better than that of the intervention group 2, intervention group 1, and control group (P < 0.05).Conclusion: The flapping-meridians combined with thunder-fire moxibustion can significantly improve the upper limb motor function and muscle strength of stroke patients with hemiplegia, and its effect is better than that of single treatment.

Association between muscle strength and health-related quality of life in a Chinese rural elderly population: a cross-sectional study

ObjectiveTo investigate the relationship between upper and lower limb muscle strength and the health-related quality of life (HRQoL) of a Chinese rural, elderly population.DesignA population-based, cross-sectional study.SettingMiyun, Beijing, China.ParticipantsThe participants...

Muscle strength and functional capacity of elderly people engaged in two types of strength training

Abstract Introduction: Regular physical activity is one of the main ways of avoiding compromised functional capacity and gaining muscle mass. Objective: investigate the differences in muscle strength and functional capacity of elderly people engaged in two types of strength exercises. Method: a cross-sectional study of 80 seniors of both sexes, 40 of whom engaged in weight training and 40 from the Fitness Zone in the city of Maringá, Paraná, state. A sociodemographic questionnaire, the sitting-rising and elbow flexion tests, and the functional capacity tests of the Latin American Development Maturity Group (GDLAM) were applied. The data were analyzed using the Shapiro-Wilk, Mann-Whitney “U” and Spearman’s correlation tests (p&lt;0.05). Results: Most seniors who performed well in the sitting and rising test, rising from a chair and moving around the house and rising from the dorsal decubitus position engaged in weight training (p=0.001). Those engaged in weight training exhibited better upper limb strength and functional capacity in all the tests performed (p &lt;0.05). Muscle strength is inversely related to functional capacity, that is, the better the result in the upper and lower limb muscle strength tests, the better the functional capacity of the elderly engaged in weight training. Conclusion: According to the results obtained, older people who engage in weight training display better upper limb strength and functional capacity than seniors from the Fitness Zone.

Pengaruh Latihan Range Of Motion (ROM) Menggenggam Bola Terhadap Kekuatan Otot Ekstremitas Atas Pasien Stroke Iskemik

Stroke causes motor hemiparise disorders or weakness. Nursing intervention to overcome this is by doing range of motion (ROM) exercises grasping the ball. The purpose of the study was to identify the effect of ROM-grasping ball exercises on the strength of limb muscles for ischemic stroke patients. Quasi-experimental research type, one group pre-post test design. Research in the Neuro Ward Dr. M. Djamil Padang Hospital. The time of the research is October to December 2017. The intervention is ROM gripping ball exercises, namely rubber balls for 3 days followed by tennis balls for 2 days. Hold the ball firmly for 5 seconds then relax 10 seconds, practice repeated 10 times, frequency 3 times a day. The study population were all stroke patients in the Neuro Ward Dr. M. Djamil Padang Hospital. A sample of 10 people was obtained by purposive sampling that met the inclusion criteria. Data collection by measurement of muscle strength using Manual Muscle Testing (MMT). Data were computerized, analyzed by descriptive statistics and Wilcoxon test. The results of the study showed differences in upper limb muscle strength before and after the ROM exercise held the ball on the patient's shoulder (p value = 0.004), on the elbow of the patient (p value = 0.000), on the patient's hand (p value = 0.000), and on the patient's finger (p value = 0.000). It is recommended to nurses to implement the practice of grasping the ball to increase muscle strength of ischemic stroke patients and make it as a procedure for nursing intervention to patients to muscle strength.&#x0D; &#x0D; &#x0D;

10 Quality of Live and Muscle Strength in Adults with Low and Moderate to High Risk of Osteoporotic Fracture

Abstract Osteoporotic fracture is known contributor to decline quality of life (QoL) and muscle strength. We aimed to examine the association between quality of life and muscle strength in adults at risk of osteoporotic fracture. A cross-sectional study was conducted among 105 adults aged 50 years and above (69.3 ± 8.5 years) at a spine orthopaedic clinic. Upper and lower limb muscle strength were measured using dominant hand grip strength test (HGS) and 5-sit to stand test (5STS). Quality of life and osteoporotic fracture risk were assessed using EQ5DVAS questionnaire and fracture risk calculator (FRAX®). Approximately 38% of the participants had moderate to high risk of major osteoporotic fracture. Although lower, the total mean score of EQ5DVAS in adults with low (80.54 ± 13.20) and moderate to high (76.88 ± 16.90) risk of osteoporotic fracture was not significantly different (p = 0.77). Adults with risk of osteoporotic fracture had slight to severe problems in EQ5D subdomains (mobility: 30%, self-care:10%, usual activities: 14%, pain discomfort: 60%, anxiety/depression: 46%). After adjusting for femoral neck bone mineral density and education level, higher HGS score (ß = 0.79, 95% C.I: 0.07-1.52, p &amp;lt; 0.05) and shorter time to complete 5STS (ß =-1.02, 95% C.I:-1.86 - -0.19, p &amp;lt; 0.05) were associated with higher QoL scores. Our study results suggest that muscle strength is positively associated with QoL among adults at risk of osteoporotic fracture. Muscle strength training should be emphasised among adults with risk of osteoporotic fracture in view of improving QOL.

Exercises Training Program: Its Effect on Muscle Strength and Activity of Daily Living among Elderly People

&#x0D; &#x0D; &#x0D; Context: Aging is associated with the loss of muscle strength and difficulties in functional activities. Research evidence has identified that regular exercises in the elderly have been shown to enhance gait, balance, and muscle strength, leading to a reduction in seniors’ dependency. Aim: This study aimed to evaluate the effect of an exercise training program on muscle strength and activity of daily living among elderly people.&#x0D; Methods: A quasi-experimental research design used in the current study. A purposive sample of 92 male and female elder adults distributed in three geriatric homes collected through a period of one year. This study carried out at three geriatric homes in Minia city (Dar Omar Bn El-Khattab, Dar El- Qedesa Hena, and Dar El- Raee El-Saleh), Egypt. Three tools utilized in collecting the data; Structured Interview Questionnaire; Muscle Strength Scale for upper and lower limbs; Katz and Akpom Scale used to assess activities of daily living.&#x0D; Results: The current study findings revealed that the level of independence of elderly clients at the end of the program became (87.5%) compared to zero at the first observation. There was a highly statistically significant difference in muscle strength in upper limbs between first and tenth observation as (37.5%) have normal muscle strength compared to none at first observation. Also, a highly statistically significant difference in lower limb strength between the first and tenth observation that (58.75%) have normal muscle strength in the lower limb compared to none at first observation.&#x0D; Conclusions: The study findings concluded that the regular performance of exercises for an extended period enhances the performance of the daily living activity and strength body muscles, which improves general health. Recommendations: Active exercise training programs should be recommended by evaluating its effect on the quality of life for the elderly, particularly those at the elderly home.&#x0D; &#x0D; &#x0D;

Intraspinal metastasis of alveolar rhabdomyosarcoma: A case report

This paper reported a case of cervical intraspinal metastasis of alveolar rhabdomyosarcoma (ARMS). The clinicopathological features, surgical treatment, chemotherapy and prognosis were introduced and the current literature was reviewed. The diagnosis, differential diagnosis, treatment, molecular features and prognosis of the disease were comprehensively analyzed to improve clinicians' knowledge of this rare disease. The primary lesion appeared about 1 year ago which was painless mass of left hand whose size was about 2 cm×2 cm. After conservative treatment, the mass gradually enlarged and the mass was resected. Postoperative pathology revealed embryonic rhabdomyosarcoma. Postoperative chemotherapy with recombinant human endostatin, liposomal doxorubicin and ifosfamide was performed. The left neck mass was found about 3 months ago, and then the left neck mass was resected under general anesthesia. Postoperative pathological examination showed small round cell malignant tumors. Severe left upper extremity pain began about 2 weeks ago with nocturnal pain and supine pain. Non-steroidal anti-inflammatory drugs were needed to relieve pain which was accompanied by numbness and weakness of the left upper extremity. MRI showed a intraspinal tumor at C5. The left thumb and index finger were absent. Hypoesthesia, muscle atrophy and hypotonia of the left upper limb were confirmed. The muscle strength of biceps brachii and deltoid muscle of the left upper limb was grade 0, the muscle strength of extensor carpus and interphalangeal muscle was grade II, the muscle strength of intrinsic muscles of hands was grade I. The tendon reflex of the left upper limb disappeared. Intraspinal mass was removed and the pain was relieved. But there was no significant change in the muscle strength of the left upper limb. Pathological examination revealed small cell malignancies which were poorly differentiated with diffuse patchy distribution and disordered arrangement. The tumor cells had round, oval or irregular nuclei, and few cytoplasms were positive for Myogenin and MyoD1. FISH test of FOXO1 gene was positive. More than 50% of nuclei showed redgreen signal separation, and the distance between redgreen signals was larger than double diameter of the signal points, which supported ARMS. Total resection of intraspinal tumors was achieved and postoperative chemotherapy was admitted. But intraspinal disseminated metastasis occurred rapidly. ARMS was rare, aggressive tumor with poor prognosis. Subdural metastasis was rare. Correct diagnosis and classification can be made only with help of modern molecular diagnostic methods, which is effective to guide the treatment.

Effects of Ving Tsun sticking-hand training on upper-limb sensorimotor performance in community-dwelling middle-aged and older adults: A randomized controlled trial

ObjectiveTo evaluate the effects of Ving Tsun (VT) sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults. MethodsThirty-three adults were randomly allocated to either a VT group or a control group. The VT group received VT sticking-hand training twice per week for 3 months. Measurements were taken before and after the intervention period. The primary outcome was elbow-joint repositioning error, which was measured by an elbow-joint passive positioning and active repositioning test using a universal goniometer. Secondary outcomes were upper-limb muscles’ peak force and time taken to reach peak force as measured by a hand-held dynamometer. ResultsNo significant time, group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force outcomes. Shoulder flexor time to peak force decreased by 33.8% from pre-test to post-test in the VT group (P = 0.007). Shoulder abductor, internal and external rotator, and elbow extensor times to peak force decreased by 30.0%–35.9% in the VT group (P < 0.05) and by 30.4%–37.1% in the control group (P < 0.05). ConclusionsVT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older adults. However, VT can improve shoulder flexor muscles’ time to reach peak force in these populations. VT had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.

Physical Condition, Glycemia, Liver Function, and Quality of Life in Liver Transplant Recipients After a 12-Month Supervised Exercise Program

Background and aimsDespite the excellent long-term outcomes in liver transplant (LT) recipients, several medical complications related to lifestyle still represent an issue. This study examined the effects of a 12-month supervised aerobic and strength training program on the aerobic capacity, muscle strength, metabolic profile, liver function, and quality of life of a cohort of LT recipients. MethodsLT recipients with stable liver function were assigned to interventional exercise (group A) or usual care (group B). Aerobic capacity, muscle strength, metabolic profile, liver and kidney function, and health-related quality of life were assessed at baseline and after 6 and 12 months. Group A attended supervised training sessions 3 times per week for 12 months. Group B received general recommendations about home-based exercise. ResultsForty patients from 6 Italian LT centers were randomized. Twenty-nine (72.5%, men-to-women ratio 23:6, mean age, 52 ± 8 years) LT recipients completed the study. Baseline characteristics were similar between groups except for body mass index and time from LT. No episode of acute rejection nor increase of transaminases occurred. Maximum workload and body mass index increased in both groups over time, but fasting glucose significantly decreased in group A (94.0 ± 15.0 mg/dL vs 90.0 ± 17.0 mg/dL; P = .037) and increased in controls (95.0 ± 24.0 mg/dL vs 102.0 ± 34.0 mg/dL, P = .04). Upper limb muscle strength increased only in supervised LT recipients. Vitality and general and mental health domains significantly improved after physical exercise. ConclusionsSupervised combined training was safe and effective in increasing aerobic capacity, muscle strength, and quality of life and in improving glucose metabolism in stable LT recipients.

Effectiveness of Chair Yoga for Improving the Functional Fitness and Well-being of Female Community-Dwelling Older Adults With Low Physical Activities

Objective: This study investigated the effect of a 12-week chair yoga program on functional fitness and well-being in community-dwelling older women with low physical activities. Methods: A total of 31 community-dwelling older women with low physical activity participated in this quasi-experimental study. Two communities of the elderly were allocated to 2 groups through lot drawing. Subjects were randomly assigned to control or intervention groups by community to avoid contamination—the experimental group of 16 people and the control group of 15 people. The participants in the experimental group trained chair yoga exercise for 12 weeks with 2 sessions per week, 110 minutes per session, whereas the control group maintained its regular daily activities. Data collection from multiple variables was conducted using questionnaire (well-being) and examination on functional fitness (handgrip strength, lower limb muscle strength, upper limb muscle strength, static balance, agility and dynamic balance, lower limb flexibility, upper limb flexibility). Results: The results showed a significant improvement for the experimental group in the handgrip strength (P = .001), upper limb muscle strength (P = .047), lower limb muscle strength (P = .007), static balance (P = .016), agility and dynamic balance (P = .009), and in the well-being (P = .003) after the intervention. The control group reveals deteriorated result in upper limb muscle strength (P = .016). Among other functional fitness and well-being variables, there is no significant difference. Conclusion: The chair yoga training provides a simple and inexpensive exercise program that improves the functional fitness and well-being effectively.

SARCOPENIA AND SEVERITY OF NON-ALCOHOLIC FATTY LIVER DISEASE.

Non-alcoholic fatty liver disease is characterized by deposition of lipids in the hepatic parenchyma exceeding 5% of liver weight in the absence of other conditions, such as viral or alcoholic hepatitis and metabolic disease. Non-alcoholic fatty liver disease is the most common form of chronic liver disease in several countries. In addition to liver complications, recent studies have shown a relation between liver fat and sarcopenia. Determine the association between sarcopenia and the severity of non-alcoholic hepatic steatosis diagnosed by abdominal ultrasonography. A clinical, cross-sectional study was conducted with a sample of male and female adults (18 to 70 years of age) submitted to ultrasonography for the investigation of non-alcoholic hepatic steatosis. Evaluations were also performed for the determination of upper and lower limb muscle strength. Data analysis was performed with the aid of the SPSS 22.0 program and involved ANCOVA and the Bonferroni post hoc test, with P-value <0.05 considered indicative of statistical significance. One hundred two patients were submitted to abdominal ultrasonography, 57.8% of whom presented some degree of non-alcoholic hepatic steatosis. The presence and degree of fatty liver infiltration were significantly associated with the sarcopenic index, determined by the ratio between upper and lower limb strength and BMI (P=0.009 and post-test P=0.028 for upper limbs; P=0.006 and post-test P=0.013 for lower limbs). In the present study, an association was found between the sarcopenic index and non-alcoholic hepatic steatosis, with an inversely proportional relation between this index and the severity of fatty infiltration. This finding offers further evidence of the metabolic interaction of the liver, adipose tissue and muscle.

Evaluation of isokinetic muscle strength of upper limb and the relationship with pulmonary function and respiratory muscle strength in stable COPD patients.

BackgroundUpper limb muscle strength plays an important role in respiratory and pulmonary function, and limited research focuses on the role of strength and endurance of the elbow extensor and flexor. This study was conducted to accurately assess upper limb muscle function and quantified associations with pulmonary function and respiratory muscle strength in patients with stable chronic obstructive pulmonary disease (COPD).MethodsIn this cross-sectional study, patients with stable COPD treated in Yue-Yang Integrative Medicine Hospital from March 2014 to March 2016 were recruited. All participants underwent a pulmonary function test (forced expiratory volume in first second/forced vital capacity, FEV1/FVC; percentage value of predicted FEV1, FEV1%pred), a respiratory muscle strength test (maximal inspiratory pressure, MIP; maximal expiratory pressure, MEP), and an isokinetic test of dominant upper limb after a 24-hr interval (peak torque, PT; PT/body weight, PT/BW; total work, TW; endurance ratio, ER).ResultsA total of 88 patients with stable COPD (age: 65.5±8.7 years) were recruited, of which 73% (64 patients) were male. In the multiple stepwise regression analysis, sex remained as significant impactors in the final model for FEV1%pred (adjusted R2=0.243, P<0.001). Elbow flexor PT/BW and ER, sex, and BMI remained as significant impactors in the final model for FEV1/FVC (adjusted R2=0.255, P<0.01). Elbow flexor TW remained as significant impactors for MIP (adjusted R2=0.112, P=0.001), while elbow extensor PT and PT/BW and sex remained as significant impactors for MEP (adjusted R =0.385, P<0.01).ConclusionIn stable COPD, pulmonary function and respiratory muscle strength are associated with upper limb muscle strength. In particular, elbow flexor endurance is likely an important impactor for pulmonary function and inspiratory muscle strength, while elbow extensor strength is of importance for expiratory muscle strength.