Peripheral Muscle Strength Research Articles

Maximal exercise capacity, peripheral muscle strength, sleep quality, and quality of life in adult patients with stable asthma

ABSTRACT Objective The prevalence of asthma is increasing gradually worldwide. The pathophysiological process of asthma causes some alterations in the respiratory system and decreases oxygen-carbon dioxide exchange and respiration volume. These alterations may affect maximal exercise capacity, peripheral muscle strength, sleep quality, and disease-specific quality of life but have yet to be comprehensively investigated. To compare maximal exercise capacity, pulmonary function, peripheral muscle strength, dyspnea, sleep quality, and quality of life in adult patients with asthma, healthy controls were aimed. Methods Forty-one adult stable asthmatic patients (GINA I-III) and 41 healthy subjects were compared. Exercise capacity (cardiopulmonary exercise test [CPET]), pulmonary function (spirometry), peripheral muscle strength (dynamometer), dyspnea (modified Medical Research Council [mMRC] dyspnea scale), quality of life (Asthma Quality of Life Questionnaire [AQLQ]) and sleep quality (Pittsburgh Sleep Quality Index [PSQI]) were evaluated. Results Peak VO2, VO2kg, MET, VE, HR, %VE, %HR, VCO2 parameters of CPET, FVC, FEV1, FEF25-75%, and FEV1/FVC and quadriceps femoris, shoulder abductors, and hand grip muscles strength were significantly decreased in patients with asthma (p < 0.05). MMRC dyspnea scale score was increased, and AQLQ and PSQI scores decreased in asthma patients (p < 0.05). Conclusions Cardiac and pulmonary system responses to peak exercise worsened, and maximal exercise capacity and peripheral muscle strength decreased in adult patients with stable asthma. In addition, dyspnea during daily activities increases, and quality of life and sleep quality are impaired. A variety of exercise training that would benefit asthmatic patients' outcomes should be investigated.

Exploring frailty: muscle strength, functional capacity, activities of daily living and cognition in adult congenital heart disease

Purpose The study aimed to assess frailty in adults with congenital heart disease (ACHD) and to compare muscle strength, functional capacity, activities of daily living (ADL), and cognition between frail and non-frail ACHD patients. Materials and methods A cross-sectional study design was used. Sixty people with ACHD aged between 18 and 45 years were included. Frailty was determined according to the Fried criteria. Peripheral muscle strength was assessed with a digital dynamometer, functional capacity with the 6-min walk test (6MWT), ADL with the Glittre ADL test, and cognition with the Montreal Cognitive Assessment (MoCA) test. Results Frailty was seen in 38.33% (frail = 23 and non-frail = 37) of the participants. In the frail patients, dominant knee extensor strength (p = 0.002), shoulder abductor strength (p = 0.005), 6MWT distance (p = 0.021), and MoCA score (p = 0.005) were significantly lower than those in the non-frail patients. Glittre ADL test (p = 0.002) was significantly higher in the frail patients. Conclusions Muscle strength, functional capacity, ADL, functional mobility, and cognition were lower in the frail participants with ACHD. Early assessment of frailty in ACHD and planning individualized exercise training programs for frail individuals may be a strategy to reduce the impact of frailty on adverse clinical outcomes.

The Impact of Different Telerehabilitation Methods on Peripheral Muscle Strength and Aerobic Capacity in COPD Patients: A Randomized Controlled Trial.

Lung diseases have profound effects on the aging population. We aimed to hypothesize and investigate the effect of remote pulmonary telerehabilitation and motor imagery (MI) and action observation (AO) methods on the clinical status of elderly chronic obstructive pulmonary disease (COPD) patients. Twenty-six patients were randomly assigned to pulmonary telerehabilitation (PtR) or cognitive telerehabilitation (CtR) groups. The programs were carried out 3 days a week for 8 weeks. The 6-min walk test (6MWT), modified Medical Research Council dyspnea score, blood lactate level (BLL), measurement of peripheral muscle strength (PMS), and electromyography activation levels of accessory respiratory muscles were the main outcomes. There was a statistically significant improvement (p < 0.05) in both groups in the 6MWT distance and in secondary results, except for BLL. Generally, in the mean muscle activity obtained from the electromyography measurement after the program, there were statistically significant increases in the PtR group and decreases in the CtR group (p < 0.05). There was a statistically significant increase in PMS in both groups. An active muscle-strengthening program has the same benefits as applying the muscle-strengthening program to the patient as MI and AO. CtR can be a powerful alternative rehabilitation method in respiratory patients who cannot tolerate active exercise programs.

Increased Cardiometabolic Risk in Dynapenic Obesity: Results from the Study of Workers' Health (ESAT).

Background: The coexistence of obesity and low muscle strength-denoted dynapenic obesity (DO)-has been associated with an unhealthy metabolic profile and increased risk for metabolic syndrome. However, there is a lack on studies investigating if DO exhibits higher cardiometabolic risk than non-dynapenic obesity. Objectives: To assess if individuals with DO exhibit elevated cardiometabolic risk compared to non-dynapenic obesity. Methods: a cross-sectional study that analyzed the data of workers from a quaternary care hospital collected between November 2018 and March 2020. Participants were stratified into the following anthropometrical and peripheral muscle strength profiles: non-obese/non-dynapenic (NOND), non-obese/dynapenic (NOD), obese/non-dynapenic (OND), and obese dynapenic (OD). Cardiovascular risk was evaluated by Atherogenic Index (AI), Plasma Atherogenic Index (PAI), Hypertriglyceridemic Waist (HW), A Body Shape Index (ABSI), Atherogenic Dyslipidemia (AD), Castelli Indices I and II, and Framingham Score (FS). Results: the OD group had significantly lower HDL compared to all others (p = 0.009), and despite exhibited lower prevalence of HW compared to OND (p < 0.01), a higher cardiometabolic risk compared to OND profile was observed assessing AI (p = 0.05), Castelli I (p < 0.05) and Castelli II (p < 0.05) scores. Conclusions: in the studied population, individuals with DO exhibit elevated cardiometabolic risk compared to other anthropometrical and peripheral muscle strength profiles.

Conservative treatment of adolescent idiopathic scoliosis (AIS): A narrative review of current evidence and implications for clinical practice

Introduction and purpose: Adolescent idiopathic scoliosis (AIS) is characterized by lateral curvature, vertebral rotation, and disruption of physiological curvature of the spine with the Cobb angle ≥10°. AIS affects 1-3% of children aged 10-16 years, representing the most common form of idiopathic scoliosis. Diagnosis of AIS is by exclusion and can be suspected based on Adams forward bend test and scoliometer. Untreated AIS can lead to serious consequences, such as progression of the deformity, back pain, reduced respiratory and cardiovascular function. The aim of this review is to update overview of conservative treatment options. Description of the state of knowledge: AIS treatment guidelines from the Scoliosis Research Society (SRS) and the Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) advocate for observation, bracing, or surgery depending on curve severity, with a focus on avoiding spinal fusion when possible. Additionally, SOSORT recommends scoliosis-specific physiotherapy exercises for smaller curves or as an adjunct to bracing. Conservative treatment aims to prevent curve progression, manage respiratory and spinal complications, and improve quality of life. Conclusions: AIS can significantly impair the physical and psychosocial well-being of young patients, with potential long-term consequences extending into adulthood Individualized treatment plans and patient/parent education are crucial for optimal outcomes. Schroth exercises are superior to Core Stabilization (CS) exercises in reducing Cobb angle, trunk rotation and improving spinal mobility, cosmetic trunk deformities and quality of life. CS exercises are more effective in increasing peripheral muscle strength, reducing pain and correcting vertebral rotation.

Adults born preterm have lower peripheral skeletal muscle area and strength

Prematurity is associated with lower exercise capacity, which relies on the integrity of the cardiovascular, pulmonary, and skeletal muscle systems. Our animal model mimicking prematurity-associated conditions showed altered muscle composition and atrophy in adulthood. This study aimed to compare muscle composition and strength in adults born preterm versus full-term controls. This observational cohort study recruited 55 adults born preterm, ≤ 29 weeks’ of gestation and 53 full-term controls who underwent musculoskeletal ultrasound imaging to assess morphology of the rectus femoris at rest and during a maximal voluntary contraction. Maximal voluntary contraction of the hands and legs were measured by manual dynamometry. In adults born preterm, there was lower muscle strength (handgrip: − 4.8 kg, 95% CI − 9.1, − 0.6; knee extensor: − 44.6 N/m, 95% CI − 63.4, − 25.8) and smaller muscle area (− 130 mm2, 95% CI − 207, − 53), which was more pronounced with a history of bronchopulmonary dysplasia. Muscle stiffness was increased in the preterm versus term group (0.4 m/s, 95% CI 0.04, 0.7). Prematurity is associated with alterations in skeletal muscle composition, area, and function in adulthood. These findings highlight the necessity to implement preventive and/or curative approaches to improve muscle development and function following preterm birth to enhance overall health in this population.

Evaluation of upper extremity functional capacity and activities of daily living in patients with heart failure: A cross-sectional study

BackgroundConsidering the limitations in activities of daily living (ADL) and the impact of improvements in patients with heart failure (HF), appropriate assessment of upper extremity functional capacity and ADL is important. ObjectivesTo evaluate upper extremity functional capacity and ADL in patients with HF and compare them with healthy controls. MethodsThis study included 30 HF patients and healthy controls. Upper extremity functional capacity was assessed with the 6-Minute Pegboard Ring Test (6PBRT), ADL by the Londrina protocol, exercise capacity by 6-Minute Walk Test (6MWT), peripheral muscle strength by hand dynamometer, and dyspnea by Modified Medical Research Council Scale (MMRC). For performance tests, pre-test (resting) and post-test (after performance) values ​​were also measured. ResultsPatients with HF with ejection fraction ≤50 % and controls were similar in terms of age (52.63±6.2 and 50.03±6.5 years, respectively) and gender (25 females for each group) (p > 0.05). Patients showed a statistically significant increase in total test time in the Londrina protocol and fewer rings moved in 6PBRT (p < 0.0001). The post-test dyspnea (p = 0.03) and pre-test arm fatigue (p < 0.0001) were observed to be higher in patients in the Londrina protocol. There was a statistically significant group by time interaction in the patients’ pre- and post-test lower heart rate (F= 4.80, p = 0.03), post-test dyspnea (p < 0.0001), and post-test arm fatigue (p = 0.005) were observed to be higher in patients in 6PBRT. ConclusionsThe evidence showed a decrease in upper extremity functional capacity in patients with HF. Patients required more time to perform their ADLs compared with healthy controls.

Impact of peripheral muscle strength on extubation success after cardiac surgery

Impact of peripheral muscle strength on extubation success after cardiac surgery

Relation of functional independence to balance, exercise capacity, and peripheral muscle strength in individuals with chronic stroke: A cross-sectional study

PurposeThis cross-sectional study determined the relationship between functional independence and balance, functional exercise capacity, and knee extensor strength in individuals with chronic stroke. Material and methodsThe study included fifty-four individuals with chronic stroke. A single physiotherapist evaluated clinical features. Assessments included the Functional Independence Measure (FIM), the Tinetti Performance Oriented Mobility Assessment (POMA), the Timed-Up and Go Test (TUG), the 6-min Walk Test (6MWT), and Knee Extensor Strength (KES). ResultsPatients' mean age and body mass index were 60.5 ± 7.13 years and 27.08 ± 4.65 kg/m2. FIM was significantly associated with the POMA (r = 0.644, p = 0.000), TUG (r = -0.723, p = 0.000), and 6MWT (r = 0.569, p = 0.000). FIM was not significantly associated with KES of the paretic side (r = 0.264, p = 0.054), and KES of the non-paretic side (r = 0.207, p = 0.133). However, mFIM was significantly associated with KES of the paretic side (r = 0.432, p = 0.001), and KES of the non-paretic side (r = 0.348, p = 0.010). OutcomesIt was established that there was no relationship between KES and FIM, but that a relationship existed between KES and mFIM. Functional independence is associated with balance ability and functional exercise capacity.

Exploring Balance Impairment and Determinants in Chronic Obstructive Pulmonary Disease: A Comparative Study with Healthy Subjects.

Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, "Postural Stability Test" (PST), "Limits of Stability Test" (LOST), "Clinical Test of Sensory Integration of Balance" (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = -0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = -0.472, p = 0.023; r = -0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD.

The impact of iron deficiency on patients under evaluation for colorectal cancer, a prospective cross-sectional study

Background and objective Iron deficiency affects more than 60% of colorectal cancer patients at the time of diagnosis. Iron deficiency ultimately leads to anemia, but additionally, iron deficiency might impact other domains of colorectal cancer patients’ health and well-being. The aim of this study was to evaluate the impact of iron deficiency on fatigue, quality of life, cognition, and physical ability in patients undergoing evaluation for colorectal cancer. Methods Multicenter, prospective, observational cross-sectional study (2021–2023). Fatigue was the primary outcome, measured using the Focused Assessment of Cancer Treatment-Anemia questionnaire (FACT-An). Quality of Life, Cognition, Aerobe capacity, mobility, and peripheral muscle strength were tested as secondary outcomes. Multivariate analysis was performed to estimate the impact of iron deficiency on all outcomes. Results Two hundred and one patients were analyzed, 57% being iron deficient. In multivariate regression analysis, iron deficiency was not associated with fatigue: FACT-An (r = −1.17, p = 0.57, 25% CI: −5.27 to 2.92). Results on quality of life, cognition, and mobility were non-significant and with small regression coefficients. Iron deficiency showed a nearly significant association with reduced hand-grip-strength (r = −3.47 kg, p = 0.06, 25%CI −7.03 to 0.08) and reduced 6 min walking distance (r = −40.36 m, p = 0.07, 25%CI: −84.73 to 4.00). Conclusion Iron deficiency in patients undergoing evaluation for colorectal cancer was not associated with fatigue, quality of life, or cognition, but might affect aerobic endurance and peripheral muscle strength to a degree that is clinically relevant.

Clinical and Physiological Variables in Patients with Post-COVID-19 Condition and Persistent Fatigue.

Background/Objectives: Post-COVID-19 condition can manifest through various symptoms such as dyspnea, cognitive disturbances, and fatigue, with mechanisms related to these symptoms, particularly those related to fatigue, still requiring further clarification. Therefore, our aim was to assess the clinical and physiological variables in patients with post-COVID-19 condition and persistent fatigue. Methods: After one year post-COVID-19 infection, the patients underwent a comprehensive evaluation, including a complete blood count, a metabolic panel, complete spirometry, and assessments of dyspnea, quality of life, anxiety and depression, physical capacity, body composition, muscle strength, comorbidities, and medications. The participants were categorized into two groups: G1-fatigue and G2-non-fatigue. Results: Seventy-seven patients (53% female; 55 ± 11.8 years) were included, 37 in G1 and 40 in G2. As for clinical markers and symptoms of illness, in those with persistent fatigue symptoms, a greater sensation of dyspnea [BDI score: 7.5 (6-9) vs. 12 (9-12), p < 0.001; mMRC score: 1 (1-2) vs. 0 (0-1), p = 0.002], worse quality of life [SGRQ total score: 1404 (1007-1897) vs. 497 (274-985); p < 0.001], higher levels of anxiety [HADS-A score: 8 (5-9) vs. 3 (0.5-4); p < 0.001], and a reduction in peripheral and inspiratory muscle strength [handgrip strength: 34 (28-40) vs. 40 (30-46.5) kgf, p = 0.044; MIP: -81 ± 31 vs. -111 ± 33 mmHg, p < 0.001)] were observed. Conclusions: Those with persistent fatigue exhibited a greater sensation of dyspnea, higher levels of anxiety, reduced peripheral and inspiratory muscle strength, and a greater impairment of quality of life. The severity of fatigue was influenced by the worsening quality of life, heightened anxiety levels, and decreased peripheral muscle strength. Additionally, the worse quality of life was associated with a higher sensation of dyspnea, lower muscle strength, and reduced physical capacity.

Exercise capacity in COVID-19 surviving patients: impact of physical rehabilitation

Background: At least 65 million individuals worldwide have Long COVID and despite efforts to explain the effects of exercise prescription on the recovery of these individuals, there is a need to explore its effects on exercise tolerance and cardiorespiratory fitness. Therefore, our main objective was to evaluate the effect of the Physical Rehabilitation Program (PRP) on muscle strength and physical exercise capacity of COVID-19 survivors. Methods: The cohort included 28 patients post COVID-19, each participant performed a comprehensive and multisystem evaluation in two visits, in the pre- and post-PRP: 1st visit = clinical evaluation periods (maximal inspiratory pressure (MIP); maximal expiratory pressure (MEP) and Duke Activity Status Index (VO2peak). 2nd visit= physical evaluation [6-minute Step Test (6MST) and Handgrip Strength (HGS)]. The PRP consisted of breathing exercises, muscle strength exercises for upper and lower limbs and aerobic exercise, 2 or 3 times/week for 03 months. Results: The post-PRP we found: improvement in peripheral [95%CI 2.7 (2.0-3.4), p=0.001, Huge] and respiratory [MIP 95%CI 1.6 (0.9-2.3), p&lt;0.001, Very large) and MEP 95%CI 2.7 (2.0-3.4), p=0.001, Huge)] muscle strength; increase in cardiorespiratory fitness according to estimated-VO2peak [95%CI 2.3 (1.5-3.1), p&lt;0.001, Huge] and the number of steps climbed in the 6MST [95%CI 1.6 (0.9-2.3), p&lt;0.001, Very large]; adaptations resulting lower resting heart rate (HR), higher peak HR, good modulation of HR resulting from stress caused by 6MST; linear and positive association between peripheral and respiratory muscle strength and the number of steps climbed 6MST and greater HR recovery especially post-PRP; recovery-first minute HR remained unchanged post-PRP. Conclusion: In patients post COVID19, we emphasize the great effect of individualized and supervised PRP on the increase in peripheral and respiratory muscle strength/ quality and cardiorespiratory fitness. Despite the gains obtained in PRP, the risk of death based on HR recovery did not change.

Comparison of peripheral muscle strength, functional capacity and activities of daily living in frail and non-frail adult individuals with congenital heart disease

Comparison of peripheral muscle strength, functional capacity and activities of daily living in frail and non-frail adult individuals with congenital heart disease

Effects of different inspiratory muscle training protocols on functional exercise capacity and respiratory and peripheral muscle strength in patients with chronic kidney disease: a randomized study

BackgroundPathological changes were observed in the diaphragm due to abnormal renal function in chronic kidney disease (CKD). Inspiratory muscle training (IMT) has been suggested for patients with CKD; however, the most appropriate intensity for IMT has not been determined. Therefore, this study aimed to investigate the effects of different IMT protocols on respiratory muscle strength, quadriceps femoris muscle strength (QMS), handgrip muscle strength (HGS), functional exercise capacity, quality of life (QoL), pulmonary function, dyspnoea, fatigue, balance, and physical activity (PA) levels in patients with CKD.MethodsThis randomized, controlled, single-blind study included 47 patients and they were divided into three groups: Group 1 (n = 15, IMT with 10% maximal inspiratory pressure (MIP)), Group 2 (n = 16, IMT with 30% MIP), and Group 3(n = 16; IMT with 60% MIP). MIP, maximal expiratory pressure (MEP), 6-min walking test (6-MWT), QMS, HGS, QoL, pulmonary function, dyspnoea, fatigue, balance, and PA levels were assessed before and after eight weeks of IMT.ResultsIncreases in MIP, %MIP, 6-MWT distance, and %6-MWT were significantly higher in Groups 2 and 3 than in Group 1 after IMT (p < 0.05). MEP, %MEP, FEF25-75%, QMS, HGS, and QoL significantly increased; dyspnoea and fatigue decreased in all groups (p < 0.05). FVC, PEF, and PA improved only in Group 2, and balance improved in Groups 1 and 2 (p < 0.05).ConclusionsIMT with 30% and 60% MIP similarly improves inspiratory muscle strength and functional exercise capacity. IMT with 30% is more effective in increasing PA. IMT is a beneficial method to enhance peripheral and expiratory muscle strength, respiratory function, QoL and balance, and reduce dyspnoea and fatigue. IMT with %30 could be an option for patients with CKD who do not tolerate higher intensities.Trial registrationThis study was retrospectively registered (NCT06401135, 06/05/2024).

Comparative analysis of health-related fitness in patients with acute versus chronic Chagas disease.

Although Chagas disease causes high levels of morbidity, the muscle function and tolerance to physical activity in Chagas disease patients are still not completely understood. To compare health-related fitness of patient groups with acute Chagas disease versus chronic Chagas disease. We conducted a cross-sectional study involving 18 patients. The data were obtained from patient´s records, and functional capacity was measured with the sixminute walk test, the peripheral muscle strength with handgrip strength, and respiratory muscle strength using the maximum inspiratory pressure and the maximum expiratory pressure. The 18 patients were divided in two groups: acute Chagas disease (n=9) and chronic Chagas disease (n=9). The distance walked in the six-minute walk test was lower than the predicted distance walked in both groups (p < 0.0001). The maximum expiratory pressure was lower than the predicted one (p = 0.005), and statistically significant for chronic Chagas disease patients (p = 0.02). Heart rate increased faster in the chronic Chagas disease group within the first two minutes of the six-minute walk test (p = 0.04). The sixminute walk test in the acute Chagas disease group presented a strong correlation with peripheral muscle strength (p = 0.012) and maximum inspiratory pressure (p = 0.0142), while in the chronic Chagas disease group, only peripheral muscle strength and maximum inspiratory pressure were correlated (p = 0.0259). The results suggest lowered functional capacity and reduced respiratory and peripheral muscle strength in patients with Chagas disease, although no differences were observed between groups. The early increase in heart rate during exercise in the chronic Chagas disease group implies a greater myocardial overload.

Impact of cystic fibrosis on blood lactate level, respiratory muscle function, peripheral strength and nutritional status in children and adolescents

Introduction: Individuals with cystic fibrosis (CF) have digestive, pulmonary and muscular system manifestations, resulting in functional and clinical repercussions, such as changes in the nutritional status, in the strength and endurance of the respiratory muscles and in the oxidative capacity. The objective of this study was to compare blood lactate level, respiratory muscle strength and endurance, peripheral strength and nutritional status among children and adolescents with CF and healthy ones, as well as to correlate the lactate level with respiratory and peripheral muscle forces and respiratory muscle endurance of children and adolescents with CF. Methods: In an observational, analytical and cross-sectional study, 22 children and adolescents (11 healthy and 11 with CF) were divided into two groups according to the diagnosis of CF. Blood lactate level, inspiratory and expiratory muscle strength, respiratory muscle endurance, peripheral muscle strength and nutritional status were evaluated. Data analysis was performed using Students t test, Mann-Whitney, Pearson and Spearman correlations, with SPSS (25.0), adopting a significance level of 5%. Results: Children and adolescents with CF presented high levels of blood lactate (p=0.000), decreased maximum inspiratory pressure (p=0.006), deterioration of nutritional status (p=0.000) and also they did not show any difference in peripheral strength (p=0.365) and respiratory endurance (p=0.716). Conclusions: Individuals with CF have high levels of blood lactate, with significant impairment of nutritional status and respiratory muscle function compared to healthy individuals. However, the high lactate levels are not related to respiratory and peripheral muscle strength and respiratory endurance.

Association between peripheral and respiratory muscle strength and gait speed in the elderly is not mediated by peripheral muscle blood flow

BackgroundThe aging process affects different systems, including the musculoskeletal and respiratory systems. Both systems seem to be interconnected in relation to functional capacity deterioration in the elderly. Therefore, this study aimed to evaluate the association between peripheral and respiratory muscle strength with gait speed and its possible mediation by leg muscle blood flow (LBF) in the elderly. MethodsPeople aged over 65 years, of both sexes and clinically stable were evaluated. Gait speed was evaluated by the 4.6 m walking test. Maximal inspiratory pressure (MIP) and expiratory pressure (MEP) by manuvacuometry, Handgrip strength by a dynamometer (Jamar®) and LBF by venous occlusion plethysmography. ResultsWe included 110 patients with mean age 76.9 ± 7.2 years, 56 (50.9 %) were women, 72 (67.9 %) were classified as frail by Fried criteria and 22 (20.0 %) reported the regular practice of exercise. Baseline mean values of MIP was 59.5 ± 23.8 and MEP 68.2 ± 23.8. The median gait speed was 0.88 m/s, handgrip strength 19.5 Kg/f and LBF 2.7 ml/min/100 ml. Further analysis showed a significant association between gait speed and handgrip strength with MIP (p = 0.005, p = 0.013, respectively). However, no mediation by LBF were found. ConclusionThere is a strong association between gait speed and handgrip strength with MIP without mediation by LBF.

Clinical and functional outcomes associated with pulmonary complications after coronary artery bypass grafting

IntroductionCoronary artery bypass grafting(CABG) is a surgical treatment for coronary artery disease aiming at improving symptoms and life expectancy. Despite this, there are pulmonary and functional complications that may arise during the postoperative period due to invasive mechanical ventilation(IMV), cardiopulmonary bypass and immobility, leading to longer hospital stays.ObjectiveTo evaluate the clinical and functional outcomes related to pulmonary complications in the postoperative period of CABG.MethodsProspective cohort. During the ICU stay the patients were divided into: Non Complicated Group(NCG) who did not present complications and Complicated Group(CG) who presented complication. Functional variables were applied as the six-minute walk test(6MWT), gait speed, sit up and stand up test, Timed Up and Go, peripheral muscle strength, ventilatory, pulmonary function and Functional Independence Measure. These tests were applied preoperatively, at ICU discharge, hospital discharge and six months after surgery.ResultsThe study evaluated 90 patients, 59 in the NCG and 31 CG. In the 6MWT there was a 2%(p = 0.43) decrease in the NCG, while the decrease was 13%(p < 0.01) in the CG. In the MRC the drop was 2%(p = < 0.01) in the CNG, while in the CG the drop was 14%(p = < 0.01). In MIP the NCG had a 6%(p = 0.67) decrease, while the CG had a 16%(p = < 0.01) decrease.ConclusionPatients with postoperative complications of CABG may have reduced functional performance, muscle strength, and pulmonary function at hospital discharge and after six months.

Respiratory Muscle Strength Is Related to Handgrip Performance in Community-Dwelling Persons Aged 80+ from the BUTTERFLY Study

Introduction: This study aimed to evaluate the association of respiratory muscle strength with sarcopenia and its indicators in the oldest old. Methods: Maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and sarcopenia-related factors (handgrip strength and appendicular lean mass) were evaluated in a cohort of n = 286 (45.5% female) non-frail, community-dwelling persons aged 83.6 ± 3.0 years (age range 80–97 years). Results: The sample presented a sarcopenia prevalence of 32.2%. Sarcopenic subjects showed comparable MIP and MEP as non-sarcopenic ones (female: MIP 43.9 ± 18.9 vs. 50.3 ± 19.5, p = 0.053; MEP 63.0 ± 23.0 vs. 69.2 ± 19.1, p = 0.067; male: MIP, 65.1 ± 24.4 vs. 64.4 ± 23.9, p = 0.433; MEP 87.7 ± 33.3 vs. 93.8 ± 30.9, p = 0.124). Statistically significant but very low associations were found between grip strength and MIP (r = 0.193 for male, p < 0.05 and r = 0.257 for female participants, p < 0.01) and MEP (r = 0.200 for male, p < 0.01 and r = 0.191 for female participants, p < 0.05). Lean mass was significantly correlated to MIP and MEP in female (r = 0.253, p < 0.01 and r = 0.343, p < 0.01, respectively), whereas this association was not found in male participants. Grip strength was the only statistically significant predictor of MEP (r2 = 0.212, p < 0.001), while MIP was independently predicted by age, male sex, and grip strength (r2 = 0.177, p < 0.001). Conclusions: Peripheral muscle strength is a statistically significant, albeit weak predictor for respiratory muscle strength in well-functioning, community-dwelling persons aged 80+. When confronted to a low grip strength, one should be aware of concomitant respiratory muscle weakness, as this is a known risk factor for atelectasis and pneumonia. Given the relatively low association with handgrip strength, respiratory muscle strength testing might be indicated.