Arm Muscle Strength Research Articles

Shoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer

Aims: The purpose of this study was to examine the outcome of shoulder–arm morbidity in patients with breast cancer after various axillary staging procedures. We used a new specific summation score to compare conventional axillary node dissection (AD) and sentinel node only biopsy for postoperative shoulder–arm morbidity.Methods: Eighty-five patients undergoing conventional AD and 66 patients undergoing sentinel node biopsy were evaluated both subjectively (questionnaire) and objectively (clinical examination) for reduced muscle strength, limited range of motion, lymphedema and pain, dysesthesias and loss of sensitivity. The symptoms elicited were rated by their severity with a single summation score describing all symptoms reported.Results: Subjective evaluation of patients undergoing breast conserving surgery showed a highly significant difference in favor of SNB only (P≤0.002). On clinical examination the outcome of patients with SNB only was also significantly or highly significantly better (difference in arm volume:P =0.007; difference in arm muscle strength: P=0.016; loss of sensitivity: P<0.001). Of a total score of 100 (=no symptoms), the mean for AD patients was 80.2 vs 92.8 for SNB patients (P=0.001). In patients undergoing total mastectomy the difference was only significant for pain sensations and total scores.Conclusions: SNB appears to reduce morbidity. Summation scores are a suitable and practicable tool for describing the symptoms associated with axillary surgery.

Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment – A Prospective 2-year Study

Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment – A Prospective 2-year Study

Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment ? A Prospective 2-year Study

Arm lymphoedema and impaired shoulder mobility and muscle strength are well known side-effects to breast cancer treatment. The aim of this prospective study was to follow closely and describe the arm volume, range of motion of the shoulder and muscle strength of the shoulder and hand after breast cancer treatment in order to form a basis for further studies in the area including physiotherapy intervention. Sixty-one women treated for breast cancer with axillary dissection, with or without postoperative radiotherapy, were examined preoperatively and monthly until 6 months after the operation with 1- and 2-year follow-ups. 1 month after the operation, results revealed decrease in range of motion, after 2 months increase in arm volume difference and after the first 6 months decrease in muscle strength of shoulder adductors, flexors and internal rotators. A greater increase in arm volume difference and decrease in shoulder abduction, flexion and external rotation were noted throughout the follow-up period for...

Hand grip dynamometry does not correlate with anthropometric measures of nutritional status in survivors of prolonged critical illness

Prolonged critical illness results in malnutrition and functional impairment. Impaired muscle function has several possible explanations in these patients such as reduced muscle mass, myopathy and neuropathy. There are no data regarding the relation between anthropometric measures and measures of muscle strength following critical illness. In other populations mid arm muscle circumference (MAMC, a measure of lean body mass) and muscle strength measured by hand grip dynamometry (HGD, a simple measure of muscle function) correlate. We have investigated the relation between anthropometric measures of nutritional status and muscle strength using HGD in patients attending our Intensive Care follow up clinic. Thirty patients who spent more than 4 days in Intensive Care (median stay 9.25 days (range 4.4–58.9)) were studied 3 months following ICU discharge. Height, weight, body mass index (BMI), triceps skinfold thickness (TSF), mid arm circumference (MAC) and MAMC were measured using standard anthropometric techniques. Pre-illness weight and BMI were determined retrospectively from patient records or recollection. HGD was measured with a single spring hand grip dynamometer. Quality of life was assessed using the SF-36 questionnaire. A total of 64% of patients had failed to regain the weight recorded prior to admission to ICU; 39% had a persistent weight loss of >10% (mean pre-illness BMI 24.3 (SEM 0.60), 3 month BMI 23.3 (0.51),P Our findings demonstrate marked loss of muscle mass and functional ability using established methods in about one third of patients 3 months following prolonged critical illness. However, unlike other populations MAMC did not correlate with HGD. This may be because (1) factors other than muscle mass contribute to functional impairment following critical illness such as neuropathy and myopathy (2) HGD is too insensitive or effort-dependent in this population. Evaluation of neuromuscular physiology should be included in studies of functional recovery from critical illness. More rigorous measures of functional ability are needed in order to understand and improve recovery from prolonged critical illness.

REPETITIVE SENSORIMOTOR TRAINING FOR ARM AND HAND IN A PATIENT WITH LOCKED-IN SYNDROME

The locked-in syndrome is characterized by quadriplegia, preserved consciousness and inability to respond to the outside world. In recent years, the repetitive execution of identical movements has been demonstrated to be crucial for the recovery of arm and hand function in stroke patients. The present study aimed at investigating the efficiency of repetitive training in a patient suffering from locked-in syndrome due to an occlusion of the basilar artery. Seven months after the brainstem lesion and after a 15-week period of standard inpatient therapy, the repetitive training was applied to the (most affected) right upper extremity in addition to usual therapy. After 42 weeks of the repetitive training for the right arm, it was applied to the left arm. The ranges of active motion as well as functional motor capacity and muscle tone were regularly assessed. During those phases when the repetitive sensorimotor training was applied to the right or left arm, the ranges of active motion, muscle strength and functional motor capacity of the trained arm increased significantly accompanied by a continuous normalization of muscle tone in the flexor muscle groups. Since the prominent functional improvements of the right and left arms were observed during those phases when the repetitive training was applied, these effects were likely to be due to the training rather than to the standard rehabilitation program or extraneous influences. The repetitive sensorimotor training, therefore, appears to be appropriate to improve motor function of the arm and hand and to accelerate the time course of recovery even in patients with almost complete central paralysis of both arms.

Low serum calcidiol concentration in older adults with reduced muscular function.

To examine the association between muscular function and the serum concentrations of 25-hydroxyvitamin D (calcidiol) and 1,25-dihydroxyvitamin D (calcitriol). A randomized population survey. Baseline measurements of serum calcidiol and calcitriol concentrations and assessment of muscular function (hand grip strength, ability to climb stairs, outdoor activity, and fall occurrence). The Medical department, Aker University Hospital, Oslo, and subjects' homes. Two hundred forty-six recently hospitalized older patients and 103 randomly selected older people living at home. Serum concentration of calcidiol and calcitriol in relation to muscle function. Reduced muscle function was associated with low calcidiol levels. In both the hospital group and the home group, calcidiol concentrations correlated positively to arm muscle strength (r = .22, P < .001; r = .37, P < .001), ability to climb stairs (r = -.16, P < .05; r = -.42, P = < .001), physical activity (r = -.27, P < .001; r = -.31, P < .001), and the absence of fall occurrences (r = -.27, P < .001; r = -.31, P = .004). Calcitriol showed an association with physical activity in the hospital group (r = -.19, P < .05), and with fall last month in the home group (r = -.22, P < .05). Older people with reduced muscle function often had reduced levels of calcidiol serum concentration. Low levels of calcidiol were not associated with signs of general undernutrition, such as low body mass, or with reduced arm-muscle circumference or triceps skinfold thickness. This finding may suggest a physiological role for calcidiol in muscle function. Reduced muscle strength increased disability in our older subjects, which may be improved by vitamin D supplementation in vitamin D-deficient subjects.

Power output for wheelchair driving on a treadmill compared with arm crank ergometry.

OBJECTIVES: The limiting factors with regard to power output available for wheelchair ambulation have not been identified. The aim of the present study was to correlate power output during wheelchair...

Physical Fitness and Psychological Benefits of Strength Training in Community Dwelling Older Adults.

Previous studies concerning psychological benefits of exercise among the elderly has focused predominantly on the effects of aerobic exercise. In the present study, psychological and behavioral adaptations in response to 12-weeks of strength training were examined in medically healthy but sedentary 42 older adults (mean age = 68 years). The purpose of this study was to evaluate the effects of high and low intensity resistance training intensity on a) muscular fitness, b) psychological affect, and c) neurocognitive functioning. Subjects were randomly assigned to high intensity/low volume (EXH: 2 sets of 8 to 10 repetitions for 75 to 85% of 1 RM), low intensity/high volume (EXL: 2 sets of 14 to 16 repetitions for 55 to 65% of 1 RM), or no exercise control programs. Prior to and following the 12-week program, subjects underwent comprehensive physiological and psychological evaluations. Physiological assessment included measurements of blood pressure, heart rate, arm and leg muscle strength, body composition, and oxygen consumption (VO2max). Psychological measures included evaluations of mood, anxiety, and physical self-efficacy as well as cognitive functioning. The results of this study indicated that both high and low intensity strength programs were associated with marked improvements in physiological fitness and psychological functioning. Specifically, subjects in the strength training programs increased overall muscle strength by 38.6% and reduced percent body fat by 3.0%. Favorable psychological changes in the strength-trained subjects included improvements in positive and negative mood, trait anxiety, and perceived confidence for physical capability. The treatment effects of neurocognitive functioning were not significant. In summary, this study demonstrated that participation in 12-weeks of high or low intensity strength training can improve overall physical fitness, mood, and physical self-efficacy in older adults while cognitive functioning remains constant.

The relations between physical ability and bone mass in women aged over 65 years

In this cross-sectional study of 55 women (mean age 73.54 +/- 5.87), the magnitude of the relation between different indices of physical ability and confounding factors to bone density were determined. Physical fitness was assessed by direct measurement of maximal oxygen consumption (VO2 max), isokinetic muscle strength, and quadriceps and psoas muscle surfaces and densities using computed tomography. Anthropometry, chronological and gynecological ages, and dietary calcium intake were also recorded. The bone mineral density (BMD) was evaluated at the axial level (lumbar spine and proximal femur) and at the peripheral level (radius and tibia, cancellous and cortical compartments). Parameters related to physical ability proved to be the best predictors of BMD in radial and tibial cancellous compartments, spine, femoral neck, and trochanter, accounting for 15-27.5% of the total variance. The VO2 max was a major determinant of the femoral mineral density and one of the predictors of radial and tibial cancellous compartments. Psoas parameters were strongly related to spine mineral density and also constituted a predictor of radius (cancellous) and tibia mineral densities. The arm muscle strength could predict, though weakly, the BMD of axial skeleton, whereas thigh muscle strength only predicted the BMD of inferior limbs. No correlation was observed between current dietary calcium intake and BMD. Age-postmenopause and fertile life remained predictive of BMD at mostly cancellous sites, whereas anthropometry exerted important effects on radial and tibial cortices. The study suggests distinct sets of relations between physical ability and the BMD variables. Subjects with greater and denser psoas muscles had greater spine BMD, and those with higher VO2 max had greater proximal femur BMD.

Clinical use of neck isometric strength measurement in rehabilitation

The purpose of this study was to evaluate for diagnostic purposes the isometric strength of the neck flexor and extensor muscles in 56 patients with neck and shoulder pain and to quantify the effect of a specific rehabilitation program. An isometric measurement protocol was performed at the beginning and at the end of a 3-week rehabilitation program that included physiotherapy, stretching, aerobic exercises, and circuit training to improve arm, shoulder, and neck muscle strength. In the beginning, mean neck flexor muscle isometric strength was 83N (+/- 48 SD) and extensor muscle strength 158N (+/- 76 SD), whereas after rehabilitation the strength measurements were 117N (+/- 43 SD) and 207N (+/- 84 SD) respectively. There was a significant increase in the ability to push forward and backward, which correlated with the lessening of neck pain and disability found at the end of the program (p < .05). Isometric strength measurement is a useful and practical method of objectively showing a functional improvement in response to rehabilitation.

Assessment of regional body composition changes by dual-energy X-ray absorptiometry.

There is little information on the differential catabolism of ann and leg tissue during intensive work by healthy individuals in a hypocaloric setting (e.g. wrestlers during their competitive season, soldiers on a long-range mission, and refugees fleeing their homes). Most available information about tissue catabolism comes from studies of hospitalized patients where this information is of prognostic importance. In severely ill patients the extreme weight loss transcends more subtle differences of which extremities dematerialize most rapidly. In this case, anthropometric indices such as an upper arm girth corrected for subcutaneous fat are useful indicators of a patient’s overall fat-free mass and/or protein nutritional status.1 In healthy individuals with weight loss severe enough to include a significant portion of the fat-free mass, regional changes may be less suitable predictors of overall fat-free mass or muscular strength deficits. The 1950 Minnesota study of semistarvation (in a relatively sedendary state) demonstrated differences in the loss of tissue between arms and legs, with the largest relative change in circumference and cross-sectional area of the arm, even though the largest absolute change occurred in the thigh.2 Presumably, it would be adaptive for hunter-gatherers in lean times to preferentially sacrifice strength of arm muscles over that of the leg muscles.KeywordsHypocaloric DietArmy Research InstituteLarge Relative ChangeExtreme Weight LossTissue CatabolismThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

The influence of handedness on the distribution of muscular weakness of the arm in facioscapulohumeral muscular dystrophy.

The strength of 10 muscle groups in both arms was measured using hand-held myometry to determine the influence of handedness on left-right differences of muscle strength in facioscapulohumeral muscular dystrophy (FSHD). Two groups of subjects were studied: 24 healthy volunteers (19 right-handed), and 53 patients (42 right-handed) with autosomal dominant FSHD. An opposite left-right difference of strength of shoulder and arm muscles was found: right-handed volunteers were stronger on the right side, right-handed patients were stronger on the left side. This opposite left-right difference was statistically significant for the supraspinatus muscle, the wrist extensors and the shoulder internal rotators. The number of left-handed subjects was too small for statistical analysis. The relation between handedness and increased muscle weakness in right-handed FSHD patients suggests that mechanical factors may play a distinct role in the progression of muscle weakness in FSHD.

The effects of resistance training on muscle area and strength in prepubescent age.

The purpose of this study was to determine the effect of strength training in prepubescent boys and girls on muscle strength and cross-sectional area of upper arm. Subjects were ninety-nine healthy elementary school children who belonged to 1st, 3rd and 5th grades and they were assigned to two groups of training (N = 52) and control (N = 47). Training group participated in strength training program for 12 weeks which consisted of maximum sustained isometric contraction of elbow flexion for ten sec, whereas control group did not participate in special training program in this period. In orger to determine the changes due to training, cross-sectional areas of the tissues in upper arm, such as muscle, fat and bone, were measured by the ultrasonic method. Maximum isometric and isokinetic muscle strength of elbow flexion and extension were measured by means of isokinetic cybex dynamometer. In order to assess the development of physiological maturity, TW2 method was used to estimate the skeletal age in each subject by taking the hand-wrist X-ray photograph. After 12-week training period, the whole cross-sectional areas increased in both training and control groups. This increment was due to significant increases in muscle and bone area in the training group and, on the other hand, due to the increase in fat area in the control. The increment of muscle area of training group was about 50% of that derived from the study on adults (Fukunaga, T., 1978). The increment in cross-sectional area of muscle with training was significantly correlated with the skeletal age.(ABSTRACT TRUNCATED AT 250 WORDS)

Functional electrical stimulation for upper limb strengthening in traumatic quadriplegia.

The hypothesis of this study was that the functional electrical stimulation (FES)-assisted exercise of partially paralyzed arm muscles would result in significantly greater muscle strength in the arms of spinal cord injured quadriplegics than equal periods of conventional isotonic exercise. Single muscles were studied in seven subjects in a crossover design consisting of equal periods of FES-assisted exercise and conventional exercise. It was concluded that for these subjects using this exercise regime, neither FES-assisted exercise nor conventional exercise produced improvements in maximum voluntary force that were either statistically or functionally significant. The results, although disappointing, have helped these subjects to be more realistic about the potential therapeutic benefits of FES.

Strength and Endurance of the Lower Arm Muscles.

Strength and Endurance of the Lower Arm Muscles.

Strength and Endurance of the Upper Arm Muscles.

Strength and Endurance of the Upper Arm Muscles.

Motor control of electromyographical signals with the biofeedback training.

Biofeedback method has been applied to the motor control training, of which aim is to keep a fixed constant surface EMG's signal during the flexor muscle contraction of the upper arm. The biofeedback method with the motor control has objected to make motor response with high sensibility and stability, and to give subjects the biofeedback training (BFT) in order to improve the covert sensory function. In the experiment, measuring items were as follows : integrated error values between the motor command and the controlled variable of suriace EMG (motor performance), the flexor muscle strength of the upper arm during an isometric contraction in the tracking (energy cost), and the spectrum analysis of error values (transfer function). The error spectrum should have been estimated to analyze the gain and the phase in the transfer function of the motor control. Adding the biofeedback training to the myoreflex control system, following results were obtained : 1) the gain in the motor control system increased efficiently, but the phase had no changes in the tracking after BFT. 2) the flexor muscle strength decreased with the low-cost energy of contraction after BFT. 3) motor performance had been improved with BFT significantly. 4) the covert sensory function might be elevated up to the overt sensory situation in the myoreflex control system.

Vertebral osteomyelitis and epidural abcess due to mucormycosis: A case report

A patient is described, with a history of pain in the neck, followed by a slowly progressive loss of muscle strength in both arms, followed by tetraplegia. Medical history included laryngectomy with partial hypopharyngectomy preceded by radiotherapy, because of carcinoma. X-ray of the cervical spine was suggestive for metastases. The patient died as a consequence of massive pulmonary embolism and at autopsy the cause of the neurological deficit turned out to be vertebral osteomyelitis and epidural abscess due to mucormycosis.

Comparison of Shoulder and Elbow Range of Motion and Arm Muscle Strength in Humerus Fractured Patients Treated with Operative and Non-operative at Dr. Soebandi Hospital

Humerus fracture is a disruption of normal architecture in humerus bone . This study was conducted to identify The Range Of Motion (ROM), muscle strength of arm and analyze the comparison of the ROM and muscle strength on humerus fracture patients between operative and non-operative treatment. This research used non-experimental study with cross-sectional design. Observed variables were Range of Motion and muscle strength each measured by goniometer and muscle strength scale, respectively. Comparing to these circumstances, there were significant difference in shoulder abduction, shoulder flexion, shoulder extension, elbow extension and elbow flexion between operative treatment patients and non-operative treatment patients at dr. Soebandi Hospital Jember. &#x0D; &#x0D; Keywords : humerus fracture, range of motion, muscle strength.

Physical work capacity as influenced by age.

Studies were carried out on 879 healthy soldiers of ages ranging from 18-46 years to assess the effect of age, if any, on physical work capacity. These subjects were in a fairly controlled state of nutrition and physical training. A battery of tests was administered under outdoor conditions as well as in the laboratory. It was found that all the physical functions tested, such as speed of running, abdominal muscle strength, agility, arm and shoulder muscle strength and capacity for short bursts of activity, started to show deterioration after 30 years, and the process was progressive thereafter. Judged from these performances the subjects seemed to fall into three distinct age groups, viz. 18-30, 31-37 and 38–43. The subjects above 43 years were too few to be considered for analysis. The mean maximum oxygen consumption was found to be 47.7 ml/kg/min in the 18-30 years group, and it was reduced to 45.8 and 42.1 ml/kg/min for the two higher age groups respectively. Excess lactic acid build-up due to a standard stepping exercise was also found to increase with age, and the tolerance time in endurance tasks was found to reduce with increasing age. Performance in the running test correlated highly with the values for maximum oxygen consumption and endurance stopping, thereby indicating that even simple outdoor tests like running can be effectively used for assessing the physical work capacity, especially under field conditions.