Muscle Strength Of Upper Extremities Research Articles

Identifying Factors for Predicting Postoperative Segmental Motor Paralysis in Patients Undergoing Anterior Cervical Spine Surgery: A Multicenter Study.

Retrospective cohort study. To investigate the incidence of and risk factors for segmental motor paralysis after anterior cervical spine surgery. Segmental motor paralysis is a potential complication following both anterior and posterior cervical decompression procedures; however, previous studies investigating risk factors for segmental motor paralysis after anterior cervical spine surgery were limited by small sample sizes. Consequently, the exact pathogenesis and risk factors for this complication remain poorly understood, highlighting the need for larger-scale investigations focused exclusively on anterior cervical spine surgeries. We retrospectively reviewed the clinico-demographic and operative factors and postoperative outcomes of 1,428 patients undergoing anterior cervical spine surgery at three spine centers in Japan. Postoperative segmental motor paralysis was defined as deterioration of upper extremity muscle strength by ≥1 grade; recovery was defined as a return to preoperative muscle strength levels. Univariate and multivariate analyses were performed to identify risk factors. Ninety-nine patients (6.9%) developed segmental motor paralysis, mostly involving the C5 segment (81.8%), the incidence being highest in patients with ossification of the posterior longitudinal ligament (OPLL) and those undergoing anterior cervical corpectomy and fusion or hybrid fusion (discectomy + corpectomy). Older age, male sex, higher body mass index, OPLL, and cervical corpectomy were independent risk factors for paralysis, with these patients having significantly worse clinical outcomes at 1 year postoperatively. Most patients (74/99, 79.6%) regained preoperative muscle strength levels an final follow up. This study identified important clinico-demographic and operative risk factors for segmental motor paralysis after anterior cervical spine surgery. Patients undergoing corpectomy, with or without OPLL, were found to be at particularly high risk. While most patients recover well, worse outcomes with segmental motor paralysis highlight the importance of preventing this complication, particularly for OPLL patients and corpectomy procedures. III.

Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise.

This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury. Pilot randomized clinical trial. Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences. The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status. This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.

A systematic review and meta-analysis on effect of different exercise training on grip strength and upper extremity muscle strength in patients with type 2 diabetes mellitus.

Individuals with type 2 diabetes mellitus (T2DM) are prone to musculoskeletal complications, particularly in the upper extremities (UE), which can significantly impair their grip strength and UE muscle strength. This review will provide valuable insights for developing optimized exercise interventions aimed at enhancing upper limb functionality and improving patient outcomes. To determine the effect of different exercise training on grip strength & UE muscle strength in patients suffering from T2DM. A comprehensive search from electronic databases was performed based on the selection criteria and 13 randomized controlled trials (RCT's) were included in the study. Mean changes in grip strength and UE muscle strength were the primary outcome measures. Included studies ranked high on the PEDro rating scale and eta-analysis was performed by Rev Man 5.4 software. Meta-analysis results indicated that there was a statistically significant improvement in UE muscle strength of experimental group when compared to control group (mean differences [MD]=2.91, 95% confidence interval=0.12, 5.71; p=0.04) with moderate heterogeneity (I2=49%, p<0.07). Grip strength improved significantly in the experimental group when compared to the control group with (MD=2.93, 95% CL=-0.00, 5.86; p=0.05) and moderate heterogeneity (I2=66%, p<0.08). This review indicated a positive role of supervised resistance & aerobic exercises on UE muscle strength in patients with T2DM. Due to lack of RCT's, grip strength needs to be explored by further investigations in these patients.

Upper Extremity Function and Neuromuscular Parameters in Primary Headaches: A Cross-Sectional Study

Objectives: To investigate the upper extremity function, muscle strength, endurance, and proprioception in patients with primary headache compared to healthy controls. Materials and Methods: The study was completed with 37 patients with primary headache (22 patients with tension-type headache and 15 patients with migraine) and 36 healthy controls with matched age and gender. Headache severity was evaluated with the Visual Analog Scale (VAS); upper extremity function with Nine-Hole Peg Test (9-HPT); upper extremity isometric muscle strength of shoulder flexor, extensor, and elbow flexor with a hand-held dynamometer; upper extremity endurance with 6-Minute Pegboard and Ring Test (6PBRT); and upper extremity proprioception with shoulder reposition tests using Dualer IQTM digital inclinometer. Intergroup differences were examined using the Mann-Whitney U Test, and the Spearman correlation analysis was used to ascertain the relationship between the variables in headache groups. Results: There was a significant difference between the results for the 9-HPT, some upper extremity isometric muscle strength tests, 6PBRT, and shoulder reposition tests between patients with tension-type headache, migraine, and healthy controls (p&amp;lt;0.05). Except for the 9-HPT and 6PBRT (r between -0.518 and -0.645; p&amp;lt;0.05 for all), there was no significant relationship between the results for patients with tension type and migraine (p&amp;gt;0.05). Conclusion: Upper extremity function, some upper extremity muscle strength parameters, endurance, and proprioception were decreased in patients with tension-type headache and migraine compared to healthy controls, and upper extremity function was found to be associated with upper extremity endurance in these patients.

Plantar Plate Increase Upper Extremity Muscle Strength in Patients with Flat Foot

Plantar Plate Increase Upper Extremity Muscle Strength in Patients with Flat Foot

Comparison of the Effect of Online Physical Exercise and Computerized Cognitive Stimulation in Patients with Alzheimer’s Disease during the Covid-19 Pandemic

IntroductionTo investigate the effect of physical exercise alone and in combination with cognitive stimulation on cognition, physical function, and quality of life in patients with Alzheimer’s Disease (PwAD). MethodsThe study was a randomized controlled, single-blinded trial with pre-and post-treatment and follow-up assessments conducted at the private hospital and home environment in PwAD. Seventy-five (N=75) participants diagnosed with AD were enrolled, but sixty (N=60) participants (mean age 77.8 years, standard deviation (SD) 6.7) were randomized as physical exercise group (PEG) (n=20), physical exercise and cognitive stimulation group (PE+CSG) (n=20) and control group (CG) (n=20). Participants in PEG and PE+CSG performed an online supervised physical exercise program (SPEP) given biweekly for 12 weeks. Additionally, the cognitive stimulation (CS) program was offered for at least three or five days for 12 weeks for PE+CSG. No treatment was given for the CG. The primary outcome measures were cognition, balance, functional mobility (FM), upper extremity muscle strength (UEMS) and lower extremity muscle strength (LEMS), and quality of life (QoL). Furthermore, depression, basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were measured secondarily. ResultsPE+CSG demonstrated significant improvement in cognition, balance, FM, UEMS, IADL and reduction in depression compared to the CG (p<0.05). Besides, participants in the PE+CSG had statistically superior QoL and IADL than the PEG (p<0.05). ConclusionsThe addition of CS to the SPEP was a safe and effective method to gain statistically significant improvements in cognition, balance, FM, UEMS, IADL, and reduction in depression in PwAD.

The Effectiveness of Blood Flow Restriction Training on Upper Extremity Muscle Strength: A Systematic Review

Abstract Objective This systematic review aims to investigate the effect of blood flow restriction training (BFRT) on upper extremity muscle strength in pathological conditions of the upper extremity musculoskeletal system or in healthy individuals. Materials and Methods This study was conducted in accordance with the PRISMA guideline statement. The randomized controlled studies which published from January 2000 to May 2022 were searched in the PubMed, Web of Science, MEDLINE, Scopus, and Cochrane Library databases. Inclusion criteria were healthy clinical population or musculoskeletal pathology related to the upper extremity, participants aged 18 and above, application of blood flow restriction to the arm, a randomized controlled study design, and publication in English. Additionally, the presentation of upper extremity muscle strength as an outcome measurement was required. The quality of the studies was evaluated using The Physiotherapy Evidence Database (PEDro) scale. Articles that were non-randomized, inaccessible in full text, and scored 4 or below on the PEDro scale were excluded. Results Five studies were included with 219 participants. The included studies had PEDro scores ranging from 5 to 8, with an average score of 6.4. This review demonstrated a positive or neutral effect of BFRT on grip strength and shoulder strength. Conclusion Although some studies have reported positive effects of BFRT on upper extremity muscle strength, there is no conclusive evidence regarding the protocol to be used for increasing upper extremity muscle strength.

Case report: a rare combination of diffuse idiopathic skeletal hyperostosis and cervical septic spondylodiscitis

Ossification of the anterior longitudinal ligament of the spine is a rare pathology with still unclear etiopathogenesis, although some authors associate it with metabolic diseases such as diabetes. Another rare disorder whose etiopathogenesis is also closely related to immunological disorders in diabetes is spinal epidural empyema. We present a case of a 62-year-old man with comorbidities of arterial hypertension and type II diabetes mellitus, with complaints of dysphagia and throat discomfort one and a half years prior to hospitalization. About a month before hospitalization, the patient reports pain with limited cervical mobility, followed by episodes of fever up to 38°C, with developing upper extremity muscle weakness and self-care incapacity. After imaging and laboratory studies, the patient was diagnosed with Forestier disease according to Resnick and Niwayama criteria, with ossification of the anterior longitudinal ligament and spondylodiscitis with epidural empyema in the cervical compartment. The patient was started on empiric antibiotic therapy and emergency surgery was undertaken for osteophytectomy, median corpectomy with medullar decompression and vertebrodesis. Postoperatively, the patient had improvement in dysphagia and upper extremity muscle strength - MRC 5/5 at the 6-month follow-up. Timely diagnosis and operative treatment with adequate decompression, anterior vertebrodesis and subsequent targeted antibiotic therapy are essential for a good outcome in the management of patients with this combined pathology.

The Effect of Two-Handed Overhead Medicine Ball Throwing Exercises on Upper Extreme Muscle Strength and Kinematic Movement in Soccer Throw-ins

This study aims to analyze the effect of two-handed overhead medicine ball (THOMBT) training on upper extremity muscle strength and kinematic movement. This research utilized an experimental method with a pre-test and post-test design. Sample collection used a random sampling technique. The sampling results were then divided into a control group (CTRL) and an experimental group (THOMBT). The Shapiro-Wilk test and Levene's test were used as prerequisite tests. Paired t-tests and independent sample t-tests were used to compare improvements within and between groups. Statistical significance was set at p &lt; 0.05. Cohen's effect size (ES) was used to measure group differences. A total of 15 players were in the experimental group with an average age of 16.20 ± 0.77 years, while 15 other players were in the control group with an average age of 16.13 ± 0.83. Before and after the four-week trial period, upper extremity muscle strength testing was conducted using push-ups, sit-ups, and kinematic movement tests, which included throwing distance, arm angular speed, and release angle tests. The result is the THOMBT group showed significant improvements in push-ups (p = .000, Δ% = 22.44), sit-ups (p = .000, Δ% = 9.33), distance throws (p = .000, Δ% = 8.20), and arm angular velocity (p = .000, Δ% = 14.98). Meanwhile, the CTRL group did not have a significant increase. The conclusion is that THOMBT training for four weeks is effective in increasing upper extremity strength ability and movement kinematics, but not variable angle of release. Keywords: throws, medicine ball, muscle strength, kinematics movement.

Case Report of Cylindrical Grip on Improving Upper Limb Muscle Strength of SNH Patient

Non-hemorrhagic stroke patients who do not get optimal treatment will experience disability or physical weakness such as paralysis and weakened muscle strength, which results in a lack of joint range of motion, limb function, and decreased daily life activities. One of the ROM techniques to help recover the upper extremities to stimulate the hands, can be done with cylindrical grip exercises which are functional hand exercises by grasping a cylindrical object in the palm of the hand which aims to support the recovery of the ability to move and function of the hand. Objective: This case repost aims to determine the effect of giving cylindrical grip to stroke ptients to increase muscle strengt in the upper extremities. Method: The method used is a descriptive case report design based on Evidance Based Nursing (EBN) conducted on two subjects with non-hemorrhagic stroke. Results: After the implementation of ROM exercise nursing: cylindrical grip for 3 days in each patient starting from 18-22 September 2023 which was carried out for 5 minutes and repeated 7 times, changes were obtained in the muscle strength of Mrs.M's right hand which was originally 3 to 4 and Mr.W which was originally left hand muscle strength 2 to 4. Conclusions: ROM Exercise: Cylindrical grip can improve upper extremity muscle strength in non-hemorrhagic stroke patients.

Efficacy of Repetitive Transcranial Magnetic Stimulation (r-TMS) Therapy on Improving Motor Strength in Storke Patients at Dr. Moewardi Surakarta

Background: Stroke, an acute neurological dysfunction, poses a health challenge with potential fatality, emerging as a leading cause of long-term disability. This study explores the efficacy of repetitive Transcranial Magnetic Stimulation (r-TMS) with medical rehabilitation in enhancing stroke patients' motor strength, comparing it with standard therapy, focusing on the Medical Research Council score. Objective: Stroke is an acute manifestation resulting from neurological dysfunction, persisting for ≥24 hours or leading to death due to blood vessel disorders. The study aims to determine the effectiveness of r-TMS therapy in improving stroke patients' motor strength, comparing it with standard therapy based on the Medical Research Council score. Methods: A quasi-experimental study with a pre-post control group design involved 30 respondents selected through consecutive sampling in stroke units and outpatient clinics. Upper extremity muscle strength, measured with the Medical Research Council score, was analyzed using the Mann-Whitney U test, with a significance level set at p &lt; 0.05. Result: The post-test ranking value of the r-TMS group (20.56) exceeded that of the Non r-TMS group (10.46). The Mann-Whitney U test indicated a significant difference in the average ranking of the Medical Research Council scores between the two groups (p &lt; 0.05, 0.001), highlighting the efficacy of r-TMS therapy in enhancing motor strength. Conclusion: This study shows that stroke patients receiving standard therapy and transcranial magnetic stimulation exhibit improvements in extremity motor strength compared to those undergoing medical rehabilitation alone. The r-TMS group notably showed a significant increase in extremity motor strength.

Physiotherapy Assessment and Intervention for Hirayama Disease: A Case Report

Hirayama Disease (HD) is a type of localised amyotrophy that mostly affects motor neurons. It is benign, self-limiting, and does not progress. It is not the same as distal limb juvenile muscular atrophy, which is a symptom of motor neuron disease. Together with other immunological and physical variables, cervical cord compression, particularly during cervical flexion, is one cause of HD. Over three to five years, the illness usually worsens progressively, resulting in wasting and distal weakness in one or both upper extremities. In addition, patients may experience cold paralysis, coarse finger tremors, and non specific sensory loss. Hereby, the authors present a case report of a 22-year-old male who had been steadily developing right upper extremity weakness for three years was evaluated in the Outpatient Department. The physical examination revealed atrophy of the right forearm muscle, reduced range of motion in right wrist flexion and extension, weak wrist extensors, finger extensors, supinator muscles of the forearm, and shoulder flexors. As HD does not have a well-defined physiotherapy protocol, tailor-made treatment was given for four weeks aimed at improving upper extremity muscle strength and overall hand function. The present case report will aid the physiotherapists understand the assessment and treatment of HD.

Physical exercise and chicken egg white supplementation increase muscle mass of stable COPD patients.

Patients with chronic obstructive pulmonary disease (COPD) commonly exhibit muscle atrophy and dysfunction due to a reduction in muscle mass; and protein supplements such as chicken egg whites have been reported to improve muscle mass. The aim of this study was to evaluate the impact of physical exercise and egg white supplementation on the muscle mass of COPD patients. An experimental study was conducted among stable COPD patients at Universitas Sumatra Utara Hospital Medan, Indonesia, between August and October 2022. The patients were divided into two groups, control and interventional groups, with each patient subjected to a pre- and post-muscle mass assessment. All the patients performed respiratory endurance and upper extremity muscle strength training three times/week for a total of 12 weeks. In addition, the patients in the intervention group were also given egg white supplementation (10 eggs/day) during the period of intervention in addition to the physical training. The Wilcoxon and Mann-Whitney tests were performed to identify the significance of the difference between pre- and post-intervention and between the control and intervention groups, respectively. A total of 38 COPD patients were included in the study, 19 from each group. Our data suggested no significant difference in muscle mass of the patients in the control group before and after 12 weeks of physical exercise (pre-intervention 27.37±4.54% and post-intervention 27.68±4.5% with p=0.174). However, there was a significant muscle mass increment of patients in the intervention group upon 12 weeks of physical training and egg white supplementation (pre-intervention 27.18±4.15%, post-intervention 29.95±3.76%, p<0.001). A significant difference in muscle mass was observed between patients in the control and the intervention groups (p=0.046) after the intervention. The study highlights that physical exercise in combination with egg white supplementation may serve as potential and effective non-pharmacological treatment for muscle mass restoration in COPD patients as compared to physical exercise alone.

The Effect of Combination of Calcium Supplement and Physical Exercise on Increasing Muscle Strength in Chronic Ischemic Stroke

Background: Stroke causes muscle weakness which results in limitations in daily activities such as self-care, eating, walking, etc. Objective: This study aims to evaluate the effect of calcium supplement and physical exercise on increasing muscle strength in chronic ischemic stroke patients. Method: This research used a quasi-experimental pretest-posttest with control group design. This research was conducted at Dadi Makassar Hospital and Haji Hospital from March to May 2023. The sample obtained was 37 subjects based purposive sampling with an unpaired numerical comparative formula for two sample groups. Consisting of 18 people in the treatment group who were given calcium supplements at a dose of 500 mg per day and physical exercise (Both training, Proprioceptive Neuromuscular Facilitation (PNF) and strengthening) and 19 people in the control group who were only given physical exercise. The research was carried out for 6 weeks using a Manual Muscle Testing (MMT) measuring instrument for muscle strength. This research used the Wilcoxon and Mann Whitney test. (α&lt;0.05) Results: There is a significant of increasing lower extremity muscle strength between pretest and posttest in treatment group and control group (p=0.001; p=0.014, p&lt;0.05), There is an increasing of the upper extremity muscle strength between pretest and posttest in treatment group and control group (p=0.001; p=0.025). There is no significant difference of increasing muscle strength in the upper and lower limb between two groups (p=0.051). Conclusion: Calcium supplements and physical exercise were no more significant in increasing muscle strength than physical exercise only in chronic ischemic stroke patients.

Perbandingan Efektifitas Latihan Rom Aktif Dan Akupresur Terhadap Kekuatan Otot Ekstremitas Atas Pada Pasien Stroke Non Hemoragik Di Ruang Rawat Inap Rsud Dr. Haryoto Lumajang

Stroke is a clinical syndrome that begins suddenly, progressively, in the form of focal or global neurological deficits that lasts 24 hours or more and can cause death. This is caused by nontraumatic cerebral blood flow disorders. The purpose of this study was to compare the effectiveness of active ROM and acupressure exercises on upper limb muscle strength in non-hemorrhagic stroke patients in the inpatient room of RSUD Dr. Haryoto Lumajang.&#x0D; The research method used was a pre-experimental design with the type of pre-test and post-test one group design. With a sample of 36 respondents with the Accidental Sampling technique and the test used was the Wilcoxon test.&#x0D; From the results before being given the ROM treatment, 11 respondents (61.1%) had poor muscle tone and before being given the acupressure treatment, 15 respondents (83.3%) had poor muscle tone. From the results after being given ROM treatment, 13 respondents (72.2%) had moderately good muscle tone and after being given the acupressure treatment, 14 respondents (77.8%) had poor muscle tone. The results of the Mann-Whitney analysis test obtained α = 0.003, which means that there is a comparison of the effectiveness of active ROM exercises and acupressure on upper limb muscle strength in non-hemorrhagic stroke patients.&#x0D; It is expected that patients with stroke will always try to practice ROM independently which has been taught by health workers, for the patient's family to participate and motivate patients to do ROM exercises to accelerate the healing of stroke patients.&#x0D; &#x0D; Keywords: Active ROM Exercises, Acupressure, Upper Extremity Muscle Strength, Non Hemorrhagic Stroke

The relationships between upper extremity muscle strength and endurance with respiratory function, functional capacity and quality of life in children and adolescents with cystic fibrosis

Background/Aims The number of studies exploring isolated upper extremity muscle strength and endurance in paediatric patients with cystic fibrosis is limited. The aim of this study was to investigate the relationship between upper extremity muscle strength and endurance with respiratory functions, functional capacity and quality of life in children and adolescents with cystic fibrosis. Methods Children and adolescents with cystic fibrosis performed a flexed arm hang test to measure muscle endurance, movement against a dynamometer to measure muscle strength, a pulmonary function test and 6-minute walk test to measure functional capacity. The Cystic Fibrosis Questionnaire Revised was used to assess quality of life. Results A total of 29 children and adolescents with cystic fibrosis (15 girls, 14 boys) participated in the study. Biceps muscle strength moderately correlated with forced expiratory volume in 1 second predicted percentage, forced vital capacity predicted percentage and the ratio of forced expiratory volume in 1 second to forced vital capacity predicted percentage (r=0.306, P=0.035; r=0.405; P=0.029; r=0.367, P=0.048, respectively). Biceps muscle strength, shoulder abductors muscle strength, hand grip strength and flexed arm hang test correlated with the ratio of forced expiratory volume in 1 second to forced vital capacity predicted percentage. Biceps muscle strength, shoulder abductors muscle strength, hand grip strength and flexed arm hang test correlated with 6-minute walk test distance (r=0.678, p&lt;0.001; r=0.732, p&lt;0.001; r=0.512, P=0.005; r=0.375, P=0.045, respectively). Biceps muscle strength and shoulder abductors muscle strength moderately correlated with emotional functioning and eating disturbances in the Cystic Fibrosis Questionnaire Revised (r=0.451, P=0.014). Conclusions Specific assessment of upper extremity muscle strength and endurance in children and adolescents with cystic fibrosis may be helpful in informing physiotherapists of respiratory function, functional capacity and quality of life status.]

Omega-3 polyunsaturated fatty acids in sarcopenia management: A network meta-analysis of randomized controlled trials.

Sarcopenia frequently occurs with aging and leads to major adverse impacts on activities of daily living and quality of life in elderly individuals. Omega-3 polyunsaturated fatty acid (omega-3 PUFAs) supplements are considered promising therapeutic agents for sarcopenia management; however, the evidence remains inconsistent. We reviewed randomized controlled trials (RCTs) about omega-3 PUFA supplementation in patients with sarcopenia or in those at high risk for sarcopenia. Network meta-analysis (NMA) procedures were conducted using a frequentist model. The primary outcomes were (1) upper-extremity muscle strength and (2) lower-extremity physical function. The NMA of 16 RCTs showed that the high-dose (more than 2.5g/day omega-3 PUFAs) group yielded the greatest improvement in both upper-extremity muscle strength and lower-extremity physical function [compared to placebo/standard care groups, standardized mean difference (SMD)=1.68, 95% confidence interval (95%CI)=0.03-3.33, and SMD=0.73, 95%CI=0.16-1.30, respectively], and the effects were reaffirmed in subgroup analyses of placebo-controlled RCTs or those excluding concurrent resistance training programs. None of the investigated omega-3 PUFAs supplementation was associated with significantly increased skeletal muscle mass, fat mass, or overall body weight. Our findings provide a basis for future large-scale RCTs to investigate the dose effects and clinical application of omega-3 PUFA supplementation in sarcopenia management. TRIAL REGISTRATION: The current study was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (TSGHIRB No. B-109-29) and registered in PROSPERO (CRD42022347161).

Relationship between quantitative strength and functional outcomes in the phase 2 FORTITUDE-ALS trial

Objective To assess the relationship among measurements of strength, function, and quality of life in an amyotrophic lateral sclerosis (ALS) clinical trial. Methods In the FORTITUDE-ALS clinical trial (NCT03160898), 456 participants in the full-analysis set were treated with either reldesemtiv or placebo for 12 weeks; this post hoc analysis included all participants regardless of treatment assignments. Assessments included slow vital capacity (SVC), the ALS Functional Rating Scale-Revised (ALSFRS-R), and the 5-item ALS Assessment Questionnaire (ALSAQ-5). Muscle strength was measured quantitatively with hand-held dynamometry, and grip strength with a dedicated dynamometer. The relationship between strength and ALSFRS-R fine and gross motor domain scores, or responses to ALSAQ-5 questions on hand function and walking, was assessed with Spearman’s rank correlation. The relationship between mean upper- or lower-extremity muscle strength and specific ALSFRS-R domains was modeled using principal-components analysis. Results Upper-extremity muscle strength and hand grip were highly correlated with ALSFRS-R fine motor scores and the ALSAQ-5 hand function question. Similarly, lower-extremity strength correlated well with ALSFRS-R gross motor domain and the ALSAQ-5 walking question. For SVC, correlation was poor with the ALSFRS-R respiratory domain, but stronger with the total score, potentially reflecting the insensitivity of the respiratory questions in the scale. Upper- and lower-extremity strength were both strong predictors of ALSFRS-R domain scores. Conclusions In this analysis of data from an ALS clinical trial, muscle strength quantified by dynamometry was strongly correlated with functional capacity. These results suggest that muscle strength directly relates to specific functions of importance to people with ALS.

Effects of an arteriovenous fistula stenosis prevention program in patients receiving hemodialysis.

To increase the efficiency of hemodialysis, an appropriate vascular pathway must be created, and its function must be maintained. This study aimed to identify the effects of an arteriovenous fistula (AVF) stenosis prevention program on upper muscular strength, blood flow, physiological indexes, and self-efficacy among patients receiving hemodialysis. The participants were patients receiving hemodialysis at Keimyung University Dongsan Medical Center in Daegu, Republic of Korea. They were divided into experimental and control groups based on the day of the week they received hemodialysis at the outpatient department and included 25 participants each. The study was conducted for 8 weeks. The AVF stenosis prevention program was effective in improving upper extremity muscle strength (F=15.23, p<0.001) and blood flow rate (F=36.00, p<0.001). As a result of the program, the phosphorus index level, which is a physiological indicator in hemodialysis patients, decreased (F=8.64, p<0.001). Encouragement and support through text messages and practice lists also resulted in an increase in self-efficacy (F=18.62, p<0.001). The AVF stenosis prevention program in this study resulted in an increase in upper extremity muscle strength through grip strength exercises and was effective in preventing AVF stenosis by increasing the blood flow rate.

Analisis Praktik Klinik Keperawatan pada Pasien Stroke Hemoragik dengan Terapi Inovasi Mobilisasi (Rom Pasif) dan Rangsangan Taktil Terhadap Pemulihan Anggota Gerak Atas di Ruang Hcu Rsud Prof. Dr. H. Aloei Saboe Kota Gorontalo

Background: Stroke is one of the main health problems for the community because stroke can cause damage to the brain that appears suddenly, progressively, and quickly due to non-traumatic brain blood circulation disorders.&#x0D; Purpose: To conduct an analysis of managed cases with a medical diagnosis of hemorrhagic stroke with innovative mobilization therapy (Passive ROM) and tactile stimulation for upper limb recovery in the HCU Room of Prof. Dr. H. Aloei Saboe City of Gorontalo&#x0D; Methods: This research is a quasi-experimental design with pre and post test. To determine the effect of providing innovative mobilization therapy (Passive ROM) and tactile stimulation to hemorrhagic stroke patients in the HCU Room of Prof. Dr. H. Aloei Saboe City of Gorontalo. The sample used in this study were 5 patients with the sample criteria being patients who had hemorrhagic strokes who were treated in the HCU Room at Prof. Hospital. Dr. H. Aloei Saboe Gorontalo City, patients who experience hemiparesa, patients have awareness of compos mentis.&#x0D; Results: Implementation of innovation in Mrs.FK On the first day the Ara test score was 0 until the third day there was no increase in the Ara test value which was still 0. Mr. RA on the first day the Ara test value was 1, on the third day the Ara test value increased enough to be 2. On Mr. UT on the first day the Ara test value was 0, on the third day the Ara Test value was 1. Mr. AH on the first day the Ara test value was 0, on the third day the Ara Test value was still 0. Mr. MH on the first day the Ara test value was 1, on the third day the Ara Test value increased to 2.&#x0D; Conclusion: Based on the research conducted, it was found that 5 respondents from the results of the study had the same complaint, namely experiencing weakness/hemiparesis of the upper extremities. The client's upper extremity muscle strength is 1/5, 3/4, 2/4, 4/2, 4/5, when the motor function test is carried out by holding the researcher's hand the client is unable to grip,