Non-dominant Handgrip Strength Research Articles

Investigating the relationship between non-pathological neck pain and hand grip strength: A cross-sectional study

Background: Non-pathological neck pain (NPNP) is neck pain without a known cause. It might weaken the hand grip strength (HGS) by affecting the neck, shoulder, and upper extremity muscles. Head-neck positions (HNPs) can have a significant impact on neck pain. However, no previous study investigated the effect of NPNP and different HNPs on the HGS among healthcare professionals (HCPs). Objective: To determine how HNPs influence the HGS of medical personnel with NPNP. Method: A cross-sectional study recruited 46 healthcare professionals: 21 (45.7%) with and 25 (54.3%) without NPNP. A dynamometer, cervical range of motion, and visual analogue scale measured HGS, HNPs, and NPNPs, respectively. Participants were instructed to squeeze the handgrip dynamometer handle in 90-degree elbow flexion as much as possible from a seated position to measure HGS from the neutral head position (NHP), 40° head neck flexion (HFP40°), and 30° head neck extension (HEP30°). Data differences were analysed using ANOVA. The significance level was set at p < 0.05. Results: The mean HGS for the dominant hand in NHP, HFP40°, and HEP30° was 29.27 (±9.03), 27.24 (±9.08), and 26.37 (±9.32), respectively, while for the non-dominant hand it was 27.45 (±9.62), 25.23 (±9.36), and 24.61 (±10.17). There was no significant correlation between HNPs and HGS. However, the only significant difference was between dominant HGS in the NHP and non-dominant HGS in the HEP30° (P = 0.018). Furthermore, NPNP had no significant effect on the HGS (P = 0.325). Conclusion: NPNP had no significant influence on HGS in any of the three HNPs for either hand. Future studies should include other HNPs and other potential variables such as age, gender, weight, and pain intensity.

Normative values of grip and pinch strength and their predictor factors: PERSIAN cohort study of healthcare staff.

The present study aims to provide normative values for Hand Grip Strength (HGS) and Hand Pinch Strength of healthcare staff and evaluate key body anthropometric predictors of these strengths. This cross sectional study was conducted on 2,337 healthcare staff. HGS and pinch strength were assessed for both hands using a hydraulic hand dynamometer and pinch gauge. Descriptive data were reported for dominant and non-dominant HGS and pinch strength, after stratification by gender, age, and height. Multivariatelinear regression analysis was performed to assess predictor variables. The maximum HGS values were identified in men aged 35 to 40, measuring 38.00 ± 7.81kg, and in women aged 50 to 55, measuring 22.20 ± 4.13kg. The highest pinch strength values were recorded in men aged 45 to 50, with measurements of 7.16 ± 1.48kg, and in women aged 35 to 40, with measurements of 4.24 ± 1.15kg. The predictor variables for dominant HGS and pinch strength exhibited 59% and 51% prediction for variations in dominant HGS and pinch strength, respectively, using gender, height, and wrist circumference as predictors. Height (for grip: dominant hand: β = 0.33, CI [0.28, 0.37]; for pinch: dominant hand: β = 0.04, CI [0.02, 0.05]) was the most effectively correlated anthropometric variable. The findings demonstrate differences in HGS and pinch strength among different gender and age groups. Multiple linear regression analysis highlights the crucial role of anthropometric variables in evaluating hand strength. These results can provide guidance for future research and clinical assessments. Not applicable. Level III (analytical cross-sectional study on big sample size).

Non-dominant handgrip strength is associated with higher cardiorespiratory endurance and elevated NT-proBNP concentrations in ambulatory male adult outpatients with stable HFrEF.

Understanding the significance of handgrip strength is essential for identifying frailty in heart failure patients. The aim of this study was to identify the association between handgrip strength and cardiorespiratory endurance while highlighting the importance of the musculoskeletal system in cardiac rehabilitation for patients with heart failure. An observational cross-sectional study was conducted at Harapan Kita Hospital, Jakarta, Indonesia, from April 2022 to April 2023, among patients with heart failure with reduced ejection fraction (HFrEF) attributed to cardiomyopathy or coronary artery disease. Patients were classified by a 6-minute walk test (6MWT) distance into <400 meters (low endurance) or ≥400 meters (high endurance). The short physical performance battery (SPPB), handgrip strength, ultrasonographic forearm muscle thickness, left ventricle ejection fraction, tricuspid annular plane systolic excursion, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured. Results indicated significant differences in non-dominant handgrip strength, gait speed, and sit-to-stand SPPB scores between patients achieving a 6MWT distance of ≥400 meters and those below this threshold, with values of 31.11 ± 6.88 kg vs 27.66 ± 6.66 kg (p = 0.049), 0.52 ± 0.08 m/s vs 0.61 ± 0.13 m/s (p = 0.001), and 10.71 ± 2.47 seconds vs 12.85 ± 4.11 seconds (p = 0.014), respectively. Stronger non-dominant handgrip strength (>30 kg) was associated with higher endurance (odds ratio (OR): 3.80; 95%CI: 1.35-10.67; p = 0.010) and thicker forearm muscles (>1.9 cm) as measured by ultrasonography (AUC: 0.713; 95%CI: 0.585- 0.840, p = 0.001). In conclusion, a cut-off of ≤30 kg for non-dominant handgrip strength could effectively stratify the male patients into a lower endurance group (6MWT ≤400 meters), which is associated with elevated NT-proBNP levels and reduced forearm muscle thickness.

Impact of the Combination of Anamorelin and Rehabilitation on Functional and Nutritional Outcomes in Patients with Cancer Cachexia

Cancer cachexia, characterized by the progressive loss of skeletal muscle mass, leads to functional impairment and poor prognosis. Anamorelin is approved for treating cancer cachexia in Japan; however, the factors influencing its discontinuation and the impact of combining anamorelin with rehabilitation remain unclear. Therefore, we retrospectively analyzed 82 patients with cancer cachexia to identify factors associated with anamorelin discontinuation and assess changes in nutritional status and motor function using non-dominant handgrip strength after 12 wk. Patients received outpatient rehabilitation, combining resistance and aerobic training every two weeks, alongside anamorelin therapy. Our findings indicate that patients with an ECOG performance status of 1 or 2 were less likely to continue anamorelin therapy for 12 wk compared to those with a performance status of 0 (odds ratio 2.71; 95% CI 1.05 − 7.00; p = 0.040). Significant improvements were observed in body weight (48.8 to 53.7 kg, p < 0.001), skeletal muscle mass (6.4 to 6.9 kg/m2, p < 0.001), FAACT score (11.5 to 18.0, p < 0.001), and non-dominant handgrip strength (20.5 to 21.7 kg, p = 0.018) after 12 wk. Early initiation of anamorelin with regular rehabilitation is recommended to enhance nutritional status and motor function in patients with cancer cachexia.

Assessment of Dynamic Balance, Muscle Strength and Pain in Young Women with Generalized Joint Hypermobility

This research aims to assess dynamic balance, muscle strength, and pain in young women with generalized jointhypermobility.Research methods: A cross-sectional research design was used in this study. The Beighton scale was used toassess joint hypermobility; the Y test was performed to assess injury risk; a hand-held dynamometer was applied toassess upper extremities’ muscle strength; the McGill tests were used for evaluation of the endurance of trunk muscles’ strength; a numeric analog scale and pain map were used to assess pain intensity and localization.Participants: Twenty-fve young females (age: 22(18–28; 21,16) years; body mass index: (23, 19,2–24, 23,2)kg/m²) participated in this study.Results: The median Beighton score value was 7 (4-9;7.48) points. The Y balance test revealed that 36% (n=9)of the participants were at risk of injury when standing on the dominant leg, and 64% (n=16) when standing on thenon-dominant leg. 64% (n=16) of the young women had a normal grip strength of the dominant hand, and 56%(n=14) had normal non-dominant handgrip strength. Only 20% (n=5) of young women with joint hypermobility hadan abdominal-to-back muscle strength endurance ratio within the normal range and lateral muscle endurance ratiowas within the normal range only in 16% of women.Conclusions: Our pilot study showed that young women with joint hypermobility have reduced hand musclestrength, an imbalance in trunk muscle static endurance and an increased risk of injury in more than half of the subjects. As many as 76% of the young women in this study reported experiencing pain in different areas of the body.Keywords: increased range of movement, fitness, injury risk .

Physical Activity, Fitness, and Body Composition After a 5-yr Exercise Counseling Intervention

ABSTRACT Introduction Physical activity (PA) is recommended to optimize health after bariatric surgery. However, there is limited evidence on how to deliver these interventions and whether they are effective long-term. The present study aimed to examine PA levels, body composition, and physical fitness outcomes up to 5 yr after bariatric surgery following engagement in a PA intervention, with a focus on whether dose and/or timing of delivery impacts postoperative outcomes. Methods Individuals (n = 80) who completed a 6-month randomized treatment study to increase PA (phase 1) were invited to receive up to six exercise counseling sessions from 1 to 5 yr after operation (phase 2). Phase 2 participants (n = 64) completed assessments at 1, 1.5, 2, 3, 4, and 5 yr after operation. Results Five years after surgery, participants (84.4% female; mean age, 52.9 (standard deviation, 11.5); mean body mass index, 33.8 (standard error, 1.1)) increased minutes of moderate-to-vigorous physical activity (MVPA; P = 0.001) but not steps per day, exercise bouts per week, or bout minutes per week. Participants experienced significant cardiovascular endurance improvements but decreased strength (P &lt; 0.05). Greater intervention dose (i.e., greater number of counseling visits attended 1–5 yr after surgery) was significantly associated with steps per day (P = 0.003), weight (P = 0.03), and nondominant handgrip strength (P = 0.002). Those who started counseling preoperatively (i.e., randomized to counseling in phase 1) versus 1 yr after surgery (i.e., beginning in phase 2) had greater steps per day (P = 0.04), exercise bouts per week (P = 0.006), and exercise bout minutes per week (P = 0.002). No other associations were significant. Conclusions Participants increased MVPA 5 yr after bariatric surgery and experienced improvements in cardiovascular functioning after engagement in a PA intervention. In general, individuals experienced modestly better outcomes with more treatment. Beginning exercise counseling preoperatively, instead of 1 yr postoperatively, improved PA but not body composition or physical fitness.

Does the Effect of Mental Fatigue Created by Motor Imagery on Upper Extremity Functions Change with Diaphragmatic Breathing Exercises? A Randomized, Controlled, Single-Blinded Trial.

Background and Objectives: This study focused on the impact of mental fatigue induced by motor imagery on upper limb function, an area with limited research compared to lower limb performance. It aimed to explore how diaphragmatic breathing exercises influence these effects. Materials and Methods: This study included 30 participants, and Group 1 participated in 12 sessions of diaphragmatic breathing exercises under the supervision of a physiotherapist; Group 2 did not receive any intervention. For all the participants, mental fatigue was induced with motor imagery before and after the intervention, and evaluations were performed before and after mental fatigue. Upper extremity functions were evaluated using isometric elbow flexion strength, hand grip strength, upper extremity reaction time and endurance, finger reaction time, the nine-hole peg test, shoulder position sense, light touch-pressure threshold, and two-point discrimination. Results: The study results showed that after mental fatigue, there was a decrease in isometric elbow flexion strength, nondominant hand grip strength, and nondominant upper extremity endurance, and an increase in nondominant tactile sensation (p < 0.05). No changes were found in two-point discrimination, nine-hole peg test time, and position sense on either side (p > 0.05). The effect of mental fatigue on isometric elbow flexion strength and nondominant grip strength showed significant improvement following diaphragmatic breathing exercises (p < 0.05). Conclusions: This study found that mental fatigue from motor imagery can impact elbow flexion, hand grip strength, upper extremity endurance, and tactile sensitivity. Breathing exercises may help improve strength parameters affected by mental fatigue. It is crucial to consider these effects on upper extremity functions in rehabilitation programs.

Association of handgrip strength asymmetry and weakness with cognitive function: a nationally representative cohort study

ObjectiveTo describe the association of handgrip strength asymmetry and weakness with cognitive function among Chinese middle-aged and older adults. Study designWe used data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study. Handgrip strength was measured at baseline. Handgrip strength asymmetry was defined on the basis of the ratio of handgrip strength of the non-dominant hand to that of the dominant hand (i.e. non-dominant/dominant): a ratio of <0.9 defined as dominant handgrip strength asymmetry and >1.1 as non-dominant handgrip strength asymmetry. Weakness was defined as a handgrip strength of <28 kg for males or <18 kg for females. Main outcome measuresCognitive function with its two core dimensions (episodic memory and mental status) at each wave was assessed and standardized. Results9333 participants (48.3 % female, age 58.2 ± 9.0 years) were included. Non-dominant but not dominant handgrip strength asymmetry was significantly associated with poorer cognitive function at baseline (β = −0.121, −0.092, and −0.132 for mental status, episodic memory, and global cognition, respectively). In longitudinal analyses over 2 years, dominant handgrip strength asymmetry significantly slowed cognitive decline (β = −0.078 and −0.069 for mental status and global cognition, respectively), and non-dominant handgrip strength asymmetry accelerated cognitive decline (β = 0.053 and 0.043 for episodic memory and global cognition, respectively). Weakness was associated with poorer cognitive function at baseline and cognitive decline over 2, 4, and 7 years (all P < 0.05). ConclusionsIn middle-aged and older adults, non-dominant handgrip strength asymmetry and weakness were associated with poorer cognitive function and predicted accelerated cognitive decline. Dominant handgrip strength asymmetry may be beneficial for maintaining cognitive function.

Anamorelin for the Treatment of Cancer Anorexia-Cachexia Syndrome.

The following review will highlight the development of anamorelin to treat cancer anorexia-cachexia syndrome (CACS) including the potential benefits, limitations, and future directions. Ghrelin, a 28-amino acid peptide hormone, is secreted by the stomach mucosa and regulates appetite, promotes lipogenesis, increases body weight, improves gastric motility, reduces catabolic wasting and inflammation. Several randomized, double-blind, placebo-controlled clinical trials evaluating anamorelin, a ghrelin agonist, for the treatment of CACS have reported improvement in appetite and body composition including both lean body and fat mass; however, most studies noted no improvement in physical function as assessed by measuring non-dominant hand-grip strength. Common adverse effects of anamorelin include the development of diabetes mellitus, hyperglycemia, and less frequently, hepatic abnormalities and cardiovascular events including conduction abnormalities, hypertension, and ischemic cardiomyopathy. Anamorelin has the potential to stimulate appetite, improve gastric movement, and may have anti-inflammatory effects on patients with CACS. In patients with cancer, studies involving anamorelin combined with other multimodal treatments including nutrition counseling (branched chain amino acids, omega 3 fatty acids, and other nutrients), exercise, treatment of hormonal abnormalities including hypogonadism and hypovitaminosis D, and anti-inflammatory agents are needed. Compliance with multimodality treatment has been a barrier and future studies may need to incorporate motivational counseling to promote adherence.

Associations of Handgrip Strength Weakness and Asymmetry with Lower Cognitive Function: Results from the National Health and Nutrition Examination Survey (2011-2014).

The joint associations of handgrip strength (HGS) weakness and asymmetry with cognitive decline remain understudied in older adults. To investigate the associations between HGS weakness, asymmetry, and lower cognitive function in a nationally representative sample of older Americans. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2011-2014. Weakness was defined as HGS <26 kg for men and <16 kg for women. Asymmetry was determined by calculating the ratio of dominant to non-dominant HGS. Participants with an HGS ratio <0.90 or >1.10 were classified as having any HGS asymmetry. Those with an HGS ratio >1.10 exhibited dominant HGS asymmetry, while those with an HGS ratio <0.90 displayed nondominant HGS asymmetry, respectively. Lower cognitive functioning was defined as global cognitive composite scores more than 1 standard deviation below the mean. Covariate-adjusted logistic regression models were used to analyze the associations between HGS asymmetry/weakness and lower cognitive functioning. Compared to individuals with non-weak and symmetric HGS, those with any HGS asymmetry alone and weakness alone had 1.017 (95% confidence interval [CI]: 0.707-1.463) and 1.391 (95% CI: 0.542-3.571) greater odds for cognitive decline, while co-occurrence of both HGS asymmetry and weakness was associated with 3.724 (95% CI: 1.711-8.107) greater odds for lower cognitive function after controlling for confounders. Individuals exhibiting both diminished and asymmetrical HGS demonstrated an elevated susceptibility to cognitive impairment, thereby implying that the inclusion of HGS asymmetry assessment in conjunction with weakness evaluation may enhance the accuracy of prognosticating cognitive decline.

Comparison of Hand Grip Strength in Hypertensive and Non-Hypertensive Middle-Aged People

Background: Hypertension is a leading risk factor for cardiovascular diseases, affecting millions globally. Previous studies have suggested an inverse relationship between hand grip strength (HGS) and hypertension, indicating the potential of HGS as a non-invasive marker for cardiovascular health. However, research exploring this relationship within the middle-aged population of Pakistan remains limited. Objective: This study aims to compare hand grip strength between hypertensive and non-hypertensive middle-aged individuals and to assess the potential of HGS as a predictive marker for hypertension. Methods: A comparative cross-sectional study was conducted over six months, from August 2022 to February 2023, involving 220 participants (110 hypertensive and 110 non-hypertensive), aged 35-45 years, at PSRD and Jinnah Hospitals in Lahore, Pakistan. Hand grip strength was measured using a CAMRY digital dynamometer, and blood pressure was assessed with a Certeza sphygmomanometer. Participants were excluded if they had wrist joint problems, neurological disorders, a history of frozen shoulders, limb fractures, cognitive impairments, diabetes, or were pregnant. Data were analyzed using SPSS version 25, employing independent sample t-tests with a significance level set at p&lt;0.05. Results: The mean age of participants was 39.81±3.16 years. Hypertensive individuals showed significantly lower hand grip strength compared to non-hypertensive individuals, with mean dominant HGS at 34.10±8.75 kg for hypertensives and 39.40±7.37 kg for non-hypertensives. Non-dominant HGS followed a similar pattern, with hypertensives at 31.87±8.75 kg and non-hypertensives at 36.97±7.57 kg. Additionally, a higher proportion of males was observed in the hypertensive group compared to the non-hypertensive group. Conclusion: The study found a significant association between lower hand grip strength and hypertension among middle-aged individuals, supporting the potential of HGS as a screening tool for hypertension risk. This finding underscores the importance of incorporating hand grip strength assessment into routine health evaluations to identify individuals at higher risk of hypertension.

RACE AND SEX DIFFERENCES IN RELATIONS OF DIABETES BIOMARKERS WITH PHYSICAL FUNCTIONING BEFORE DIABETES ONSET

Abstract It remains unclear if declines in physical functioning linked to Type 2 diabetes (T2DM) occur even before T2DM onset. We examined the longitudinal associations of T2DM biomarkers with upper and lower extremity strength among adults without T2DM at baseline. Participants were 1,572 African American (AA) and White adults (M(SD) age at baseline = 47.3 (9.7) years, 55% female, 53% AA) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, assessed on up to 3 time points between 2004-2017. Participants provided blood samples for measurement of fasting glucose and glycosylated hemoglobin (HbA1c), and completed dominant and nondominant handgrip strength assessment, and a chair stands task to assess upper and lower extremity strength, respectively. Linear mixed effects regression models estimating relations of HbA1c on age-related change and adjusting for race, sex, literacy, and poverty status revealed significant four-way interactions of HbA1c, race, sex, and age (B = -.2.59, t(2853) = -2.0 p = 0.04), and to a lesser extent of fasting glucose, race, sex, and age (B = -.07, t(2863) = -1.84 p = 0.06) on change in the chair stands task, but not on handgrip strength (ps &amp;gt; 0.29). Among younger AA and White men, and younger White women, increasing HbA1c was related to worse lower extremity strength. However, among AA women, and older White women, increasing HBA1c was related to better lower extremity strength. Our findings suggest differential relations of worse glucose regulation on physical functioning amongst African American and White men and women.

Physical frailty recovery is slower than mental frailty recovery after non-cardiac surgery in older adult patients.

Frailty is characterized by fragility and decline in physical, mental, and social activities; it is commonly observed in older adults. No studies have reported frailty status changes between the preoperative and postoperative periods, including mental and cognitive factors. Therefore, this study investigated frailty factors, including mental and cognitive functions, that change after non-cardiac surgery in older adults. Patients aged ≥ 75years who underwent non-cardiac surgery were surveyed using five tools (Eastern Cooperative Oncology Group-Performance Status (PS); handgrip strengths; Japan-Cardiovascular Health Study index (J-CHS index); Mini-Mental State Examination (MMSE); and Geriatric Depression Scale) for comprehensive evaluation of perioperative functions. The results before surgery, at discharge, and during follow-up at the outpatient clinic were compared. Fifty-three patients with a median age of 80 (IQR, 77-84) years were evaluated. MMSE scores did not change during the perioperative period. The PS and J-CHS index worsened significantly at discharge and did not improve at the outpatient clinic follow-up. The dominant handgrip strength decreased after surgery (p < 0.001) but improved during follow-up. Additionally, nondominant handgrip strength decreased after surgery (p < 0.001) but did not recover as much as the dominant handgrip strength during follow-up (p = 0.015). Changes in physical frailty and mental and cognitive functions were not identical perioperatively in older adult patients undergoing non-cardiac surgery. Physical frailty did not improve 1month after surgery, mental function recovered early, and cognitive function did not decline. This study may be important for frailty prevention in older adult patients.

Evaluation of the Effectiveness of Using Handgrip Strength in Determining Malnutrition in Adolescents

We aimed to evaluate the effectiveness of using handgrip strength (HGS) in determining malnutrition in adolescents. Sixty-two participants (10–18 years of age), 33 malnourished and 29 healthy participants, were recruited. A questionnaire was administered, and anthropometric parameters and HGS were measured. Dominant HGS was different in children with (11.6 ± 5.8 nkgF) or without (21.6 ± 5.7 kgF) malnutrition (P &lt; .001). Body mass index, triceps/biceps skinfold, neck/waist/wrist circumferences, and arm muscle area were correlated with HGS. According to receiver operating characteristic analysis, dominant (area under the curve [AUC]: 85.9%), and nondominant HGSs (AUC: 83.9%) were possible predictors for malnutrition. HGS may be used as a tool for malnutrition assessment in adolescents.

The efficacy and safety of anamorelin for patients with cancer-related anorexia/cachexia syndrome: a systematic review and meta-analysis

Cancer-related anorexia/cachexia syndrome (CACS) is characterized by anorexia and loss of body weight. Evidence is insufficient to strongly endorse any pharmacologic agent for the treatment of CACS. In this systematic review, we assessed the efficacy of oral anamorelin treatment for patients with CACS. On July 6, 2022, we systematically searched the following databases for randomized controlled trials (RCTs) of adults with CACS comparing oral anamorelin versus placebo: CENTRAL, PubMed, EMBASE, and ICHUSHI. The primary outcomes were total body weight (TBW), patient-reported quality of life (QOL), and adverse events (AEs). Secondary outcomes included lean body mass (LBM), overall survival (OS), non-dominant hand grip strength (HGS), and appetite. We included seven RCTs with a total of 1944 CACS patients. Anamorelin significantly increased TBW (mean difference (MD) 1.73, 95% confidence interval (CI) 1.34–2.13, p < 0.00001), LBM (MD 1.06, 95% CI 0.30–1.81, p = 0.006), and QOL (standardized mean difference (SMD) 0.16, 95% CI 0.04–0.27, p = 0.006) compared with placebo without a significant difference in all AEs, severe AEs, OS, HGS or appetite. Anamorelin may be an effective treatment for CACS patients; however, further studies are needed to confirm the efficacy and safety of this drug.

Comparing Acute Responses Between Single Session Circuit Training and Fireground Suppression Tasks.

Loewen, B, Melton, B, Maupin, D, and Ryan, G. Comparing acute responses between single session circuit training and fireground suppression tasks. J Strength Cond Res 37(8): 1667-1678, 2023-The purpose of this study was to compare the cardio-metabolic and perceived demands of task-specific circuit training to fireground suppression tasks (FST). Twenty-three career, structural firefighters performed three separate testing days (i.e., FST, CT, and CTW). FST consisted of performing seven common occupational tasks in full gear (∼22.5kg). The weighted (CTW: 18.9kg vest) and unweighted (CT) circuit utilized seven exercises designed to mimic the FST's. Measurements included relative heart rate (%HRmax), post-training blood lactate (Lapost), change in countermovement jump height (▵CMJ), change in dominant and non-dominant handgrip strength (▵DHG and ▵NDHG), total training time, rating of perceived exertion (RPE), and job-specific rating of relevance. A repeated measure analysis of variance (ANOVA), with Bonferroni post-hoc, was performed for each variable, excluding RPE and rating of relevance. Friedman's ANOVA was used to assess differences in RPE and rating of relevance, with Wilcoxen Signed Rank tests follow-up. Significant mean differences were found in %HRmax between CT and FST (∼8.6%, p < 0.01, d = 1.12) and CTW and FST (∼5.3%, p < 0.01, d = 0.75), ▵CMJ between CT and FST (p < 0.01, d = 1.35) and CTW and FST (p < 0.01, d = 1.09), ▵NDHG between CTW and FST (p = 0.01, d = 0.79), training time between CT and FST (p < 0.01, d = 1.00) and CTW and FST (p < 0.01, d = 1.81), and rating of relevance between CT and FST (PSdep = 0.67). In conclusion, CT and CTW were able to elicit similar metabolic and perceived demands as FST, while producing a lower cardiovascular response. Therefore, while circuit training may be a beneficial training tool for firefighters, it cannot replicate FST.

Preoperative low handgrip strength (HGS) with HGS asymmetry is associated with adverse outcomes among older adults with gastric cancer

IntroductionThis study aimed to explore the associations of low hand grip strength (HGS), HGS asymmetry, their combinations, and frailty on hospital readmissions, total complications, and prolonged length of stay (PLOS) among older adults with gastric cancer. Materials and MethodsThis study included 342 patients with gastric cancer aged ≥60 years who were scheduled to undergo radical surgery. The Tilburg Frailty Indicator (TFI) was used to collect information on frailty. HGS was measured twice for each hand using an electronic handgrip dynamometer. The highest HGS readings on each hand were used for calculating the HGS asymmetry ratio: non-dominant HGS (kg)/dominant HGS (kg). The Fine and Gray proportional subdistribution hazard model and the logistic regression model were used for the analyses, with covariates adjusted. ResultsLow HGS (subdistribution hazard ratios [SHR] = 2.10, 95% confidence interval [CI] = 1.05–3.93, P = 0.036) and low HGS with HGS asymmetry (SHR = 3.95, 95% CI = 1.50–10.36, P = 0.005) were significantly associated with hospital readmissions. Frailty was associated with total complications (odds ratio [OR] = 2.87, 95% CI = 1.61–5.13, P < 0.001) and PLOS (OR = 1.98, 95% CI = 1.19–3.29, P < 0.001). Low HGS, HGS asymmetry, and their combinations were not significantly associated with total complications and PLOS. DiscussionPreoperative low HGS and low HGS with HGS asymmetry were associated with hospital readmissions, while frailty was associated with total complications and PLOS among older adults with gastric cancer. In the future, more rigorously designed studies are needed to verify our results further to improve preoperative clinical assessment and frailty evaluation among older adults with gastric cancer.

Urdu Translation and Psychometric Validation of Manual Ability Measure (MAM-36) in Patients with Neurological Disease

Background: The pathophysiological underpinnings of lifelong impairment in a variety of acute and chronic neurological illnesses include neuronal loss and destruction. Upon neuroaxonal injury, levels of neurofilament proteins rise in the blood and cerebrospinal fluid (CSF). The Manual Ability Measure (MAM-36) is a questionnaire about the perceived ease or difficulty individuals may experience when performing unilateral and bilateral ADL tasks. The objective o was to translate and validate the Urdu version of manual ability measure for patients with neurological disorders Methods: A standardized step by step forward and backward translation procedure was followed. Data was collected from 108 patients with neurological diseases. Researcher employed Urdu version of self-administered MAM-36 questionnaire for data collection. Data was analysed by using SPSS.25. in this study test retest reliability was found through alpha Cronbach and Intra class Coefficient and construct validity was assess in relation to MusiQOL Results: The reliability analysis of the Manual Ability Measure (MAM-36) questionnaire demonstrated a high level of internal consistency, with both readings having a Cronbach's alpha reliability coefficient of 0.987. The sample consisted of 45 males (41.7%) and 63 females (58.3%), and the majority had a middle socioeconomic status (66.7%). Descriptive statistics showed that the sample had a mean age of 56±4 years, a mean height of 1.68±0.1 meters, a mean weight of 86.5±11.0 kg, a mean body mass index of 30.7±4, a mean grip strength of dominant hand of 24.6±1.9, and a mean grip strength of non-dominant hand of 22.9±0.7. Practical Implication: The reliability statistics indicate that the MAM-36 questionnaire is a reliable and valid tool for measuring manual ability in individuals with neurological diseases. The strong positive correlation between the variable of interest and the reference variable supports the construct validity of the measure. Conclusion: Hence it was concluded that, the reliability statistics indicate that the MAM-36 questionnaire is a reliable and valid tool for measuring manual ability in individuals with neurological diseases. The strong positive correlation between the variable of interest and the reference variable supports the construct validity of the measure. Keywords: Psychometric validation, Manual Ability Measure (MAM-36), Neurological disease

Determinants of muscle function and health-related quality of life in patients with endogenous hypercortisolism: a cross-sectional study.

Prospective data on determinants of muscle strength impairment and quality of life in patients with various subtypes and severity of endogenous hypercortisolism are lacking. Single-center cross-sectional study, 2019 to 2022. Patients with Cushing syndrome (CS) and mild autonomous cortisol secretion (MACS) were assessed with clinical and biochemical severity scores, muscle function (nondominant hand grip strength and sit-to-stand test), and quality of life (Short Form-36 [SF36] and CushingQoL). Referent subjects were recruited from the local population undergoing abdominal imaging for reasons other than suspected adrenal disorder. Of 164 patients, 81 (49%) had MACS, 14 (9%) had adrenal CS, 60 (37%) had pituitary CS, and 9 (5%) had ectopic CS. Median age was 53 years (interquartile range: 42-63 years), and 126 (77%) were women. The SF36 mental component score was similarly low in patients with MACS vs CS, but physical component score was lower in CS when compared to MACS (mean of 34.0 vs 40.5, P = .001). Compared to MACS, patients with CS had lower scores on the standardized CushingQoL (mean of 47.1 vs 34.2, P < .001). Compared to referent subjects, patients with MACS demonstrated reduced muscle strength, similar to patients with CS (mean sit to stand Z-score of -0.47 vs -0.54, P = .822). Clinical severity (r = -0.22, P = .004) but not biochemical severity was associated with sit-to-stand test performance. Both patients with overt CS and MACS demonstrate reduced muscle strength and low quality of life. The clinical severity score utilized is associated with both physical and psychosocial components of CushingQoL and with the physical component of SF36.

Association between handgrip strength asymmetry and cognitive function across ethnicity in rural China: a cross-sectional study.

Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/non-dominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [β = -0.67, 95% confidence interval (CI): -1.26 ∼-0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(β = -0.60, 95% CI: -1.35 ∼ 0.15, P = 0.115) and asymmetric non-dominant HGS (β = -0.56, 95% CI: -1.42 ∼ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric non-dominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ∼ 1.74; OR per 5 kg decrease = 1.10, 95% CI: 1.01 ∼ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ∼ 1.78; OR per 5 kg decrease = 1.10, 95% CI: 1.02 ∼ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ∼ 1.67) and lower HGS (OR per 5 kg decrease = 1.21, 95% CI: 1.10 ∼ 1.32) were associated with impairment of visuoperception. HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups.