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Anami K, Murata S, Nakano H, Nonaka K, Iwase H, Shiraiwa K, Abiko T, Goda A, Horie J. Physical performance in relation to preserved ratio impaired spirometry: a cross-sectional study of community-dwelling older Japanese adults. Sci Rep 2021; 11:17411. [PMID: 34465800 PMCID: PMC8408254 DOI: 10.1038/s41598-021-96830-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/17/2021] [Indexed: 11/09/2022] Open
Abstract
Preserved ratio impaired spirometry (PRISm) is associated with an increased mortality rate; however, its characteristics have not been clearly identified in Japan. This cross-sectional study of community-dwelling older adults compared physical function between people with PRISm and those with no respiratory issues, from 2014 to 2019. We collected demographic data through interviews and measured respiratory and physical functions. We included 668 older adults (male, 23.5%; mean age, 72.8 ± 5.6 years); the prevalence of PRISm was 12%, while the prevalence of obstruction was 6.9%. Propensity score matching was used to identify control subjects with normal spirometry (n = 80) while minimizing the effects of confounders during comparisons with the PRISm population (n = 80). Compared with community-dwelling older adults with normal lung capacity, older adults with PRISm had a lower forced vital capacity (%FVC; 68.7 ± 9.1% vs. 92.5 ± 12.7%, p < 0.001), lower core muscle endurance (sit-up test: 6.7 ± 5.8 vs. 8.7 ± 6.0, p = 0.032), and a longer one-leg stance duration (52.4 ± 41.1 s vs. 36.4 ± 34.1 s, p = 0.008). In multivariable logistic regression, %FVC and increased one-leg stance were independent predictors of PRISm status. The prevalence of PRISm among community-dwelling elderly Japanese exceeds that of obstructive lung disease and is associated with reduced %FVC and better performance on balance testing.
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Affiliation(s)
- Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1, Nakatomigaoka, Nara-shi, Nara, 631-8524, Japan.
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-15-1, Nakatomigaoka, Nara-shi, Nara, 631-8524, Japan
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe, 658-0032, Japan
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, 607-8175, Japan
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López-López L, Calvache-Mateo A, Rodríguez-Torres J, Granados-Santiago M, Ortiz-Rubio A, Valenza MC. A Feasibility and Efficacy Randomized Controlled Trial of Two Exercise Programs in Severe AECOPD Patients with Resting Hypoxemia. Healthcare (Basel) 2021; 9:healthcare9091102. [PMID: 34574876 PMCID: PMC8471268 DOI: 10.3390/healthcare9091102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.
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Instrumented and Standard Measures of Physical Performance in Adults With Chronic Kidney Disease. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2021. [DOI: 10.1097/jat.0000000000000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abo S, Ritchie D, Denehy L, Panek-Hudson Y, Irving L, Granger CL. Feasibility of early-commencing group-based exercise in allogeneic bone marrow transplantation: the BOOST study. Bone Marrow Transplant 2021; 56:2788-2796. [PMID: 34272484 DOI: 10.1038/s41409-021-01411-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/27/2021] [Accepted: 07/05/2021] [Indexed: 01/06/2023]
Abstract
Increasing evidence supports that individualised exercise is safe and beneficial for adults treated with allogeneic bone marrow transplantation (alloBMT), although this is not part of standard care and no research has investigated group-based interventions. This study aimed to determine safety, feasibility and exploratory effects of a supervised group-based inpatient and subsequent home-based exercise programme in alloBMT. This single-site prospective cohort study included consecutive adults treated with alloBMT for haematological disease. All participants received usual care in addition to the protocolised exercise programme pre-transplant until 60 days post transplant. The primary outcome was feasibility; secondary outcomes included exercise capacity, frailty, health-related quality of life and strength. Consent rate was 100% (n = 42); 83% (n = 35) completed all aspects of the intervention and outcome testing; of those, 83% (n = 29) attended ≥2 group-exercise sessions per week; no adverse events occurred. Emotional well-being significantly improved over time, which may highlight benefits of group-based intervention. Other outcomes significantly declined from pre-BMT to hospital discharge, with some improvement at 60 days post-BMT. Participants with early signs of frailty demonstrated the greatest decline in outcomes. Group-based exercise was safe and feasible; observations from this study highlight the importance of baseline identification of frailty to target intervention at those who need it most.
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Affiliation(s)
- Shaza Abo
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia. .,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, VIC, Australia.
| | - David Ritchie
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.,Department of Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Yvonne Panek-Hudson
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Parkville, VIC, Australia
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55
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Ebert JR, Edwards P, Preez LD, Furzer B, Joss B. Knee extensor strength, hop performance, patient-reported outcome and inter-test correlation in patients 9-12 months after anterior cruciate ligament reconstruction. Knee 2021; 30:176-184. [PMID: 33940305 DOI: 10.1016/j.knee.2021.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/23/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hop performance and isokinetic knee extensor strength (IKES) asymmetry are associated with re-injury after anterior cruciate ligament reconstruction (ACLR). This study investigated deficits after ACLR, and which hop tests are most correlated with IKES and patient-reported outcome measures (PROMs). METHODS 50 patients were assessed 9-12 months after ACLR using the International Knee Documentation Committee (IKDC) and ACL Return to Sport after Injury (ACL-RSI) scores. Peak IKES and eight hop tests were assessed: single (SHD), triple (THD) and triple crossover (TCHD) hop for distance, 6 m timed hop (6MTH), single medial (MHD) and single lateral (LHD) hop for distance, single countermovement jump (SLCMJ) and timed speedy hop (SHT). The percentage of patients with limb symmetry indices (LSIs) < 90% was reported. Pearson's correlations investigated the correlation between PROMs, IKES and hop LSIs. RESULTS The majority (80%) of patients had IKES LSIs < 90%. While 12-14% of patients demonstrated LSIs < 90% for the SHD, 6MTH, THD and TCHD, 52-80% demonstrated LSIs < 90% for the other hop tests. The IKES LSI was significantly different (p < 0.05) from all hop LSIs, besides the SLCMJ (p = 0.638). Large correlations were only observed between the IKES LSI and the SLCMJ (r = 0.82), MHD (r = 0.71) and LHD (r = 0.53). The SLCMJ, MHD and IKES LSIs demonstrated the largest significant correlations with the IKDC (r = 0.51-0.53) and ACL-RSI (r = 0.38-0.40). CONCLUSIONS Hop tests such as the MHD and SLCMJ may present a more practical alternative to quantifying peak IKES, especially in the absence of more sophisticated testing equipment. While not surrogates as such, these selective hop measures may better inform the clinician as to whether significant underlying quadriceps deficits are still present throughout the post-operative rehabilitation period.
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; HFRC, 117 Stirling Highway, Nedlands, Western Australia 6009, Australia.
| | - Peter Edwards
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Luke Du Preez
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Bonnie Furzer
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia
| | - Brendan Joss
- HFRC, 117 Stirling Highway, Nedlands, Western Australia 6009, Australia
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Dech S, Bittmann FN, Schaefer LV. Assessment of the Adaptive Force of Elbow Extensors in Healthy Subjects Quantified by a Novel Pneumatically Driven Measurement System with Considerations of Its Quality Criteria. Diagnostics (Basel) 2021; 11:diagnostics11060923. [PMID: 34063869 PMCID: PMC8224031 DOI: 10.3390/diagnostics11060923] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/14/2023] Open
Abstract
Adaptive Force (AF) reflects the capability of the neuromuscular system to adapt adequately to external forces with the intention of maintaining a position or motion. One specific approach to assessing AF is to measure force and limb position during a pneumatically applied increasing external force. Through this method, the highest (AFmax), the maximal isometric (AFisomax) and the maximal eccentric Adaptive Force (AFeccmax) can be determined. The main question of the study was whether the AFisomax is a specific and independent parameter of muscle function compared to other maximal forces. In 13 healthy subjects (9 male and 4 female), the maximal voluntary isometric contraction (pre- and post-MVIC), the three AF parameters and the MVIC with a prior concentric contraction (MVICpri-con) of the elbow extensors were measured 4 times on two days. Arithmetic mean (M) and maximal (Max) torques of all force types were analyzed. Regarding the reliability of the AF parameters between days, the mean changes were 0.31–1.98 Nm (0.61%–5.47%, p = 0.175–0.552), the standard errors of measurements (SEM) were 1.29–5.68 Nm (2.53%–15.70%) and the ICCs(3,1) = 0.896–0.996. M and Max of AFisomax, AFmax and pre-MVIC correlated highly (r = 0.85–0.98). The M and Max of AFisomax were significantly lower (6.12–14.93 Nm; p ≤ 0.001–0.009) and more variable between trials (coefficient of variation (CVs) ≥ 21.95%) compared to those of pre-MVIC and AFmax (CVs ≤ 5.4%). The results suggest the novel measuring procedure is suitable to reliably quantify the AF, whereby the presented measurement errors should be taken into consideration. The AFisomax seems to reflect its own strength capacity and should be detected separately. It is suggested its normalization to the MVIC or AFmax could serve as an indicator of a neuromuscular function.
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Hibbert JE, Kulas AS, Rider PM, Domire ZJ. Practice day may be unnecessary prior to testing knee extensor strength in young healthy adults. Int Biomech 2021; 7:58-65. [PMID: 33998382 PMCID: PMC8130721 DOI: 10.1080/23335432.2020.1766997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A practice session is common prior to strength testing. However, the benefits of practice have not been previously reported. The purpose of this study was to determine the effect of a practice session on peak torque, mean torque and between trial variability across three test days. We hypothesized that peak and mean torque would be higher and less variable the second and third test days than the first. Twenty-five healthy, young participants completed 3 maximal voluntary isometric and isokinetic knee extensions on three separate days. No difference in isometric torque was found between days 1 and 2, but there was a significant decrease in isokinetic torque (8.45 Nm). There was a significant decrease in both mean isometric and isokinetic torque from day 1 to day 3 (12.67 and 13.59 Nm). Contrary to our hypothesis, no benefit from a practice session was found. Healthy, young adults are able to produce peak knee extensor torques on the first day of testing and do not demonstrate any benefit from additional testing. Thus, a practice day preceding isometric and isokinetic knee extensor strength testing may not be necessary when testing healthy, young participants, and may, in fact, negatively impact subsequent strength measurements.
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Affiliation(s)
- Jamie E Hibbert
- Department of Kinesiology, East Carolina University , Greenville, NC, USA
| | - Anthony S Kulas
- Department of Kinesiology, East Carolina University , Greenville, NC, USA
| | - Patrick M Rider
- Department of Kinesiology, East Carolina University , Greenville, NC, USA
| | - Zachary J Domire
- Department of Kinesiology, East Carolina University , Greenville, NC, USA
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Kuriyama N, Ozaki E, Koyama T, Matsui D, Watanabe I, Tomida S, Nagamitsu R, Hashiguchi K, Inaba M, Yamada S, Horii M, Mizuno S, Yoneda Y, Kurokawa M, Kobayashi D, Fukuda S, Iwasa K, Watanabe Y, Uehara R. Evaluation of myostatin as a possible regulator and marker of skeletal muscle-cortical bone interaction in adults. J Bone Miner Metab 2021; 39:404-415. [PMID: 33044569 DOI: 10.1007/s00774-020-01160-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/21/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Bone mass was recently reported to be related to skeletal muscle mass in humans, and a decrease in cortical bone is a risk factor for osteoporosis. Because circulating myostatin is a factor that primarily controls muscle metabolism, this study examined the role of myostatin in bone mass-skeletal muscle mass interactions. METHODS The subjects were 375 middle-aged community residents with no history of osteoporosis or sarcopenia who participated in a health check-up. Cortical bone thickness and cancellous bone density were measured by ultrasonic bone densitometry in a health check-up survey. The subjects were divided into those with low cortical bone thickness (LCT) or low cancellous bone density (LBD) and those with normal values (NCT/NBD). Bone metabolism markers (TRACP-5b, etc.), skeletal muscle mass, serum myostatin levels, and lifestyle were then compared between the groups. RESULTS The percentage of diabetic participants, TRACP-5b, and myostatin levels were significantly higher, and the frequency of physical activity, skeletal muscle mass, grip strength, and leg strength were significantly lower in the LCT group than in the NCT group. The odds ratio (OR) of high myostatin levels in the LCT group compared with the NCT group was significant (OR 2.17) even after adjusting for related factors. Between the low cancellous bone density (LBD) and normal cancellous bone density (NBD) groups, significant differences were observed in the same items as between the LCT and NCT groups, but no significant differences were observed in skeletal muscle mass and blood myostatin levels. The myostatin level was significantly negatively correlated with cortical bone thickness and skeletal muscle mass. CONCLUSIONS A decrease in cortical bone thickness was associated with a decrease in skeletal muscle mass accompanied by an increase in the blood myostatin level. Blood myostatin may regulate the bone-skeletal muscle relationship and serve as a surrogate marker of bone metabolism, potentially linking muscle mass to bone structure.
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Affiliation(s)
- Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Reo Nagamitsu
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kanae Hashiguchi
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shinsuke Yamada
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Motoyuki Horii
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeto Mizuno
- Department of Endoscopy, Kindai University Nara Hospital, Ikoma City, Nara Prefecture, Japan
| | - Yutaro Yoneda
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masao Kurokawa
- Department of Orthopaedics, Saiseikai Suita Hospital, Osaka, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Shinpei Fukuda
- Department of Health Promoting and Geriatric Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Kyoto, Japan
| | - Koichi Iwasa
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ritei Uehara
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Abstract
BACKGROUND Research examining the measurement of trunk muscle strength after stroke is limited and diverse. This review, therefore, was undertaken to summarize research addressing what is known about measurements of trunk muscle strength after stroke. METHODS Potentially relevant research was identified via 3 electronic database searches and a hand search. The research was examined for information on patients, measurement procedures and study findings. Findings regarding measurement properties (ie, validity, reliability, and responsiveness) were of particular interest. RESULTS Searches identified 260 potentially relevant articles of which 28 met inclusion and exclusion criteria. Research involving diverse populations and measurement procedures demonstrates that trunk muscle strength is impaired after stroke. Many studies show that measurements of trunk muscle strength have known-groups/conditions and convergent validity with balance and performance of functional activities. The literature also supports the reliability of measurements of trunk strength after stroke. Little is known regarding the responsiveness of the measurements. CONCLUSIONS Trunk strength is commonly impaired after stroke. As weakness of the trunk muscles can affect balance and function, it may warrant routine measurement.
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Brown C, Marinko L, LaValley MP, Kumar D. Quadriceps Strength After Anterior Cruciate Ligament Reconstruction Compared With Uninjured Matched Controls: A Systematic Review and Meta-analysis. Orthop J Sports Med 2021; 9:2325967121991534. [PMID: 33889639 PMCID: PMC8040575 DOI: 10.1177/2325967121991534] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background: The limb symmetry index may overestimate the recovery of quadriceps muscle strength after anterior cruciate ligament reconstruction. Comparison of individuals who have had anterior cruciate ligament reconstruction with age-, sex-, and activity-matched individuals might be more appropriate to guide rehabilitation interventions. Purpose: To compare the quadriceps strength between the injured limb of people with anterior cruciate ligament reconstruction and the limb of an age-, sex-, and activity-matched control group. Study Design: Systematic review; Level of evidence, 3. Methods: MEDLINE, CINAHL, EMBASE, SCOPUS, and SPORTDiscus were searched between inception and April 2019. Studies were included if they reported the peak quadriceps strength for persons with anterior cruciate ligament reconstruction and age-, sex-, and activity-matched control groups measured using isometric or isokinetic dynamometry. Risk of bias was assessed, and meta-analyses and metaregression (for effect of time since surgery) were performed. Results: A total of 2759 studies were identified and 21 were included for analyses. Quadriceps strength was lower in the limbs with anterior cruciate ligament reconstruction compared with the limb from matched controls within 6 months of anterior cruciate ligament reconstruction (standardized mean difference [SMD], –1.42; 95% CI, –1.62 to –1.23), 6 to 18 months after anterior cruciate ligament reconstruction (SMD, –0.92; 95% CI, –1.18 to –0.66), and >18 to 48 months after anterior cruciate ligament reconstruction (SMD, –0.38; 95% CI, –0.79 to 0.03). Results of the metaregression were significant, with the difference between anterior cruciate ligament reconstruction and matched controls decreasing with time since surgery (P < .001). Conclusion: In people with anterior cruciate ligament reconstruction, the injured limb had lower quadriceps strength compared with the limb of age-, sex-, and activity-matched controls up to 4 years after surgery. Clinicians should consider comparison with matched cohorts for return to sports decision making.
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Affiliation(s)
- Conlan Brown
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Lee Marinko
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Michael P LaValley
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA.,Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Deepak Kumar
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA.,Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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Arhos EK, Capin JJ, Buchanan TS, Snyder-Mackler L. Quadriceps Strength Symmetry Does Not Modify Gait Mechanics After Anterior Cruciate Ligament Reconstruction, Rehabilitation, and Return-to-Sport Training. Am J Sports Med 2021; 49:417-425. [PMID: 33373534 PMCID: PMC7863565 DOI: 10.1177/0363546520980079] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND After anterior cruciate ligament (ACL) reconstruction (ACLR), biomechanical asymmetries during gait are highly prevalent, persistent, and linked to posttraumatic knee osteoarthritis. Quadriceps strength is an important clinical measure associated with preoperative gait asymmetries and postoperative function and is a primary criterion for return-to-sport clearance. Evidence relating symmetry in quadriceps strength with gait biomechanics is limited to preoperative and early rehabilitation time points before return-to-sport training. PURPOSE/HYPOTHESIS The purpose was to determine the relationship between symmetry in isometric quadriceps strength and gait biomechanics after return-to-sport training in athletes after ACLR. We hypothesized that as quadriceps strength symmetry increases, athletes will demonstrate more symmetric knee joint biomechanics, including tibiofemoral joint loading during gait. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Of 79 athletes enrolled in the ACL-SPORTS Trial, 76 were participants in this study after completing postoperative rehabilitation and 10 return-to-sport training sessions (mean ± SD, 7.1 ± 2.0 months after ACLR). All participants completed biomechanical walking gait analysis and isometric quadriceps strength assessment using an electromechanical dynamometer. Quadriceps strength was calculated using a limb symmetry index (involved limb value / uninvolved limb value × 100). The biomechanical variables of interest included peak knee flexion angle, peak knee internal extension moment, sagittal plane knee excursion at weight acceptance and midstance, quadriceps muscle force at peak knee flexion angle, and peak medial compartment contact force. Spearman rank correlation (ρ) coefficients were used to determine the relationship between limb symmetry indexes in quadriceps strength and each biomechanical variable; alpha was set to .05. RESULTS Of the 76 participants, 27 (35%) demonstrated asymmetries in quadriceps strength, defined by quadriceps strength symmetry <90% (n = 23) or >110% (n = 4) (range, 56.9%-131.7%). For the biomechanical variables of interest, 67% demonstrated asymmetry in peak knee flexion angle; 68% and 83% in knee excursion during weight acceptance and midstance, respectively; 74% in internal peak knee extension moment; 57% in medial compartment contact force; and 74% in quadriceps muscle force. There were no significant correlations between quadriceps strength index and limb symmetry indexes for any biomechanical variable after return-to-sport training (P > .129). CONCLUSION Among those who completed return-to-sport training after ACLR, subsequent quadriceps strength symmetry was not correlated with the persistent asymmetries in gait biomechanics. After a threshold of quadriceps strength is reached, restoring strength alone may not ameliorate gait asymmetries, and current clinical interventions and return-to-sport training may not adequately target gait.
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Affiliation(s)
- Elanna K. Arhos
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Jacob J. Capin
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Department of Physical Therapy, University of Delaware, Newark, DE, USA,Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO,Eastern Colorado Veterans Affairs (VA) Geriatric Research Education and Clinical Center (GRECC), Aurora, CO
| | - Thomas S. Buchanan
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Department of Mechanical Engineering, University of Delaware, Newark, DE, USA,Department of Biomedical Engineering, University of Delaware, Newark, DE, USA,Delaware Rehabilitation Institute, University of Delaware, Newark, DE, USA
| | - Lynn Snyder-Mackler
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA,Department of Physical Therapy, University of Delaware, Newark, DE, USA,Department of Biomedical Engineering, University of Delaware, Newark, DE, USA,Delaware Rehabilitation Institute, University of Delaware, Newark, DE, USA
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Lee MY, Sung KS, Ham H, Yi YG, Shin HI. Knee Extensor Strength Measurement in Patients With Limited Physical Activity Using a Supine Dynamometer Anchoring Frame. Ann Rehabil Med 2021; 44:502-509. [PMID: 33440098 PMCID: PMC7808794 DOI: 10.5535/arm.20056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/27/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the reliability of knee extensor strength measurements using a supine hand-held dynamometer (HHD) anchoring frame in patients with limited physical activity. Although an HHD is suitable for bedside use, its inter-rater reliability is low because measurements can be influenced by tester strength. METHODS Maximal knee extensor isometric strength was measured using an HHD anchored to the supine frame. Three trials of three maximal contractions were assessed by two raters. RESULTS A total of 33 inpatients who were non-ambulatory due to acute illness participated in the study. The intraclass correlation coefficients were 0.974 (inter-rater) and 0.959 (intra-rater). The minimal detectable changes in intra- and inter-observer measurements were 29.46 N (24.10%) and 36.73 N (29.26%), respectively. The limits of agreement ranged from -19.79% to 24.81% for intra-rater agreement and from -21.45% to 37.07% for inter-rater agreement. CONCLUSION The portable dynamometer anchoring system can measure the isometric strength of the knee extensor reliably in the supine position, and could be used for measurements in patients who have difficulty visiting the laboratory and maintaining a seated posture.
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Affiliation(s)
- Min-Yong Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwan-Sik Sung
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyungsuk Ham
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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van Bakel SIJ, Gosker HR, Langen RC, Schols AMWJ. Towards Personalized Management of Sarcopenia in COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:25-40. [PMID: 33442246 PMCID: PMC7800429 DOI: 10.2147/copd.s280540] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
The awareness of the presence and consequences of sarcopenia has significantly increased over the past decade. Sarcopenia is defined as gradual loss of muscle mass and strength and ultimately loss of physical performance associated with aging and chronic disease. The prevalence of sarcopenia is higher in chronic obstructive pulmonary disease (COPD) compared to age-matched controls. Current literature suggests that next to physical inactivity, COPD-specific alterations in physiological processes contribute to accelerated development of sarcopenia. Sarcopenia in COPD can be assessed according to current guidelines, but during physical performance testing, ventilatory limitation should be considered. Treatment of muscle impairment can halt or even reverse sarcopenia, despite respiratory impairment. Exercise training and protein supplementation are currently at the basis of sarcopenia treatment. Furthermore, effective current and new interventions targeting the pulmonary system (eg, smoking cessation, bronchodilators and lung volume reduction surgery) may also facilitate muscle maintenance. Better understanding of disease-specific pathophysiological mechanisms involved in the accelerated development of sarcopenia in COPD will provide new leads to refine nutritional, exercise and physical activity interventions and develop pharmacological co-interventions.
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Affiliation(s)
- Sophie I J van Bakel
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Harry R Gosker
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Ramon C Langen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, Department of Respiratory Medicine, Maastricht, The Netherlands
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Nepomuceno Júnior BRV, Menezes MPDS, Santos KRBD, Gomes Neto M. COMPARISON OF METHODS FOR EVALUATING UPPER LIMB STRENGTH BY HAND-HELD DYNAMOMETRY. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127012020_0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction The upper limbs are segments of the human body responsible for primary activities of daily life, and the muscles are essential structures for performing these activities. There have been few studies on intra- and inter-examiner reliability of the hand-held dynamometer (HHD) in healthy subjects, and none have been published that compare dynamometric evaluation methods in the main muscles in this segment. Objective Evaluate intra-examiner and inter-examiner assessment reliability of the hand-held dynamometry of upper limb muscles in healthy individuals, as well as comparing the assessment reliability between fixed and non-fixed methods. Methods Healthy subjects aged over 18 years were recruited for the study. The isometric contraction for ten muscle groups of the dominant upper limb was tested. For the fixed method, we used a system of suction cups, connected to the HHD by an inelastic belt. For the non-fixed method, the examiner supported the device by hand. The isometric contraction was sustained for three seconds. Each measurement was repeated three times, considering the highest value obtained. The reliability was calculated using the intraclass correlation coefficient (ICC). The dispersion between measurements was expressed by a Bland-Altman plot. Results The sample consisted of 25 volunteers, all right-handed. The intra-examiner ICC was 0.89-0.99 for the non-fixed method, and 0.43 to 0.85 for the fixed method. Inter-examiner reliability showed equivalent behavior. This study showed that evaluation of upper limb muscle strength using an isometric dynamometer has excellent intra-examiner and inter-examiner reliability. The supine position was chosen due to the need to propose a feasible protocol for clinical practice that could be replicated for the majority of publics and in different environments. The non-fixed method showed better reliability overall, demonstrating the feasibility of this tool without the need for adaptations, additional devices, or increased operating costs for this evaluation. Conclusion Comparison between the fixed and non-fixed HHD methods demonstrated superiority of the non-fixed method in terms of reliability. Level of evidence II; Investigation of a diagnostic exam - Development of diagnostic criteria with consecutive patients.
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Portable fixed dynamometry: towards remote muscle strength measurements in patients with motor neuron disease. J Neurol 2020; 268:1738-1746. [PMID: 33355879 PMCID: PMC8068646 DOI: 10.1007/s00415-020-10366-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022]
Abstract
Background We aimed to determine (1) the test–retest reliability of a newly developed portable fixed dynamometer (PFD) as compared to the hand-held dynamometer (HHD) in patients with motor neuron disease (MND) and (2) the PFD’s ability to reduce possible examiner-induced ceiling effects. Methods Test–retest reliability of isometric muscle strength of the quadriceps was measured in patients with MND and non-neurological controls using the HHD and PFD. Reliability was estimated by the intraclass correlation coefficient (ICC) and standard error of measurement (SEM) using linear mixed effects models, and the Bland–Altman method of agreement. Results In total, 45 patients with MND and 43 healthy controls were enrolled in this study. The ICC of the PFD was excellent and similar in both patients and controls (ICC Patients 99.5% vs. ICC Controls 98.6%) with a SEM of 6.2%. A strong examiner-induced ceiling effect in HHD was found when the participant’s strength exceeded that of examiner. Employing the PFD increased the range of muscle strength measurements across individuals nearly twofold from 414 to 783 N. Conclusions Portable fixed dynamometry may significantly reduce examiner-induced ceiling effects, optimize the standardization of muscle strength testing, and maximize reliability. Ultimately, PFD may improve the delivery of care due to its potential for unsupervised, home-based assessments and reduce the burden to the patient of participating in clinical trials for MND or other neuromuscular diseases.
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Mackney J, Harrold M, Jenkins S, Fehlberg R, Thomas L, Havill K, Jacques A, Hill K. Survivors of Acute Lung Injury Have Greater Impairments in Strength and Exercise Capacity Than Survivors of Other Critical Illnesses as Measured Shortly After ICU Discharge. J Intensive Care Med 2020; 37:202-210. [PMID: 33334223 DOI: 10.1177/0885066620981899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare the physical function on ICU discharge in adults who survived an ICU admission for acute lung injury (ALI) with those admitted for a critical illness other than ALI. MATERIALS AND METHODS Two groups were recruited, (i) those who survived an ICU admission for ALI and, (ii) those who survived an ICU admission for a critical illness other than ALI. Within 7 days of discharge from ICU, in all participants, measures were collected of peripheral muscle strength, balance, walking speed and functional exercise capacity. RESULTS Recruitment was challenging and ceased prior to achieving the desired sample size. Participants with ALI (n = 22) and critical illness (n = 33) were of similar median age (50 vs. 57 yr, p = 0.09), sex proportion (males %, 45 vs. 58, p = 0.59) and median APACHE II score (21.5 vs. 23.0, p = 0.74). Compared with the participants with critical illness, those with ALI had lower hand grip (mean ± SD, 18 ± 9 vs. 13 ± 8 kg, p = 0.018) and shoulder flexion strength (10 ± 4 vs. 7 ± 3 kg, p = 0.047), slower 10-meter walk speed (median [IQR], 1.03 [0.78 to 1.14] vs. 0.78 [0.67 to 0.94] m/s, p = 0.039) and shorter 6-minute walk distance (265 [71 to 328] vs. 165 [53 to 220] m, p = 0.037). The Berg balance scores were similar in both groups. CONCLUSIONS Compared with survivors of a critical illness that is not ALI, those with ALI are likely to have greater physical impairment when measured shortly after discharge to the ward.
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Affiliation(s)
- Jennifer Mackney
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia.,School of Health Sciences, Faculty of Health and Medicine, 5982The University of Newcastle, Callaghan, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, 37024John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Meg Harrold
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia
| | - Sue Jenkins
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia.,Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia
| | - Rachel Fehlberg
- School of Health Sciences, Faculty of Health and Medicine, 5982The University of Newcastle, Callaghan, New South Wales, Australia
| | - Lauren Thomas
- Physiotherapy Department, 37024John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Ken Havill
- Department of Intensive Care, 37024John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia.,Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Australia
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The validity of the sphygmomanometer for shoulder strength assessment in amateur rugby union players. Phys Ther Sport 2020; 47:59-65. [PMID: 33197874 DOI: 10.1016/j.ptsp.2020.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To determine the concurrent validity of a sphygmomanometer for assessing shoulder strength in the I, Y and T positions during the athletic shoulder test (ASH test). Force platforms were used as the gold standard measurement tool for this purpose. DESIGN Shoulder strength was assessed using force platforms and a sphygmomanometer, both placed on the floor and the participant positioned prone. One rater assessed strength, taking three measurements in each of the I, Y and T positions, using the sphygmomanometer and force platforms. Concurrent validity was calculated using the force platforms as the gold standard device. SETTING Data was collected within the treatment room of an amateur rugby club. PARTICIPANTS Twenty male amateur rugby players (25.15 years old ± 3.27 years) were recruited for this study. MAIN OUTCOME MEASURES Peak force across the shoulder girdle was assessed using the force platforms and sphygmomanometer which provided values in Newtons (N) and millimetres of mercury (mmHg) respectively. RESULTS Results showed high concurrent validity (Pearsons r = 0.76-0.81) between the sphygmomanometer and the force platform. Coefficient of determination (r2 = 0.59-0.67) showed the sphygmomanometer to have a valid predictive model in the I, Y and T positions. CONCLUSIONS The sphygmomanometer is suitable for monitoring force transfer across the shoulder during the ASH test, and is able to quantify peak force in mmHg. The sphygmomanometer enables coaches and clinicians to accurately quantify force production across the shoulder girdle in order to screen and monitor players at a low cost.
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McCarney L, Andrews A, Henry P, Fazalbhoy A, Selva Raj I, Lythgo N, Kendall JC. Determining Trendelenburg test validity and reliability using 3-dimensional motion analysis and muscle dynamometry. Chiropr Man Therap 2020; 28:53. [PMID: 33076947 PMCID: PMC7570029 DOI: 10.1186/s12998-020-00344-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 10/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background The hip abductor muscle group stabilises the pelvis during gait to prevent excessive pelvic drop. Hip abductor weakness has been linked to musculoskeletal conditions such as chronic low-back pain. As such, it is important that practitioners can correctly diagnose hip abductor weakness in a clinical setting. Although the Trendelenburg test is commonly used by practitioners, the validity of this test to assess hip abductor weakness in the absence of musculoskeletal injury remains questionable. The aim of this study was to determine the validity of the Trendelenburg test, as observed by a practitioner, to assess frontal plane pelvic motion and hip abductor strength in a population without intra-articular hip disorders. Methods This study was performed between June 14th and October 16th 2019. Eighteen participants were recruited for this study. Peak normalised isometric and isokinetic hip abductor torque were measured bilaterally (n = 36) using the Biodex System 4 isokinetic dynamometer. Each participant performed the Trendelenburg test bilaterally (n = 36) while a graduate year chiropractic practitioner assessed for a “positive” or “negative” sign. The test was simultaneously recorded using Vicon 3-Dimensional motion capture to measure frontal plane pelvic motion and elevation. Correlation analyses were performed between the measures of peak hip abductor torque and pelvic motion to determine if any relationship existed. Agreement between the practitioner and 3-Dimensional analysis was calculated using the kappa (κ) statistic. Results Weak, non-significant correlations were found between hip abductor strength and pelvic motion before outlier removal. Significant (p < 0.05) yet weak correlations were found after outlier removal, except for isometric hip abductor strength. Weak agreement was found between the chiropractic practitioner and 3-Dimesnional analysis for the Trendelenburg test assessment (κ = 0.22–0.25). Conclusions This study found no significant relationship between normalised peak isometric and isokinetic hip abductor torque and frontal plane pelvic motion during the Trendelenburg test in a healthy young adult population. There was also poor agreement between the practitioner and pelvic motion assessments. Caution should be used when using this test, in the absence of intra-articular hip pathology, to assesses hip abductor weakness. Before any definitive conclusion can be made, studies with a larger sample size should be performed.
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Affiliation(s)
- Luke McCarney
- Osteopathy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Alexander Andrews
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Phoebe Henry
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Azharuddin Fazalbhoy
- Osteopathy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Isaac Selva Raj
- Exercise and Sports Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Noel Lythgo
- Exercise and Sports Sciences, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Julie C Kendall
- Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
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Anami K, Murata S, Nakano H, Nonaka K, Iwase H, Shiraiwa K, Abiko T, Goda A, Horie J. The Association between Health Literacy and Gait Speed in Community-Dwelling Older Adults. Healthcare (Basel) 2020; 8:healthcare8040369. [PMID: 32998262 PMCID: PMC7712768 DOI: 10.3390/healthcare8040369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/24/2020] [Indexed: 01/19/2023] Open
Abstract
The association between gait speed, a vital health outcome in older adults, and health literacy, an important health promotion aspect, is unclear. This study examined the relationship of gait speed with health literacy, physical function, and cognitive function in community-dwelling older adults. The subjects were 240 older adults (52 men, mean age 73.8 ± 6.0 years). Gender, age, and education were self-reported, while height and weight were measured directly. Health literacy was evaluated using Communicative and Critical Health Literacy (CCHL). Grip strength, knee extension strength, toe-grip strength, sit-up test, sit-and-reach test, one-leg stance test time, 30-s chair-stand test (CS-30), and normal gait speed were measured. Subjects were divided into two groups based on normal gait speed—fast (speed ≥ 1.3 m/s) and slow (<1.3 m/s). In the logistic regression analysis, the dependent variable was normal gait speed (fast/slow). Four logistic regression models were utilized to determine whether health literacy affects gait speed. Height and CCHL were found to independently affect gait speed. That health literacy influences gait speed is a new discovery.
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Affiliation(s)
- Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan;
- Correspondence: ; Tel.: +81-742-93-5427
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan;
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan;
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (A.G.); (J.H.)
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Goda A, Murata S, Nakano H, Shiraiwa K, Abiko T, Nonaka K, Iwase H, Anami K, Horie J. Subjective and Objective Mental and Physical Functions Affect Subjective Cognitive Decline in Community-Dwelling Elderly Japanese People. Healthcare (Basel) 2020; 8:healthcare8030347. [PMID: 32962150 PMCID: PMC7551000 DOI: 10.3390/healthcare8030347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using the Kihon Checklist: Cognitive Function. Other parameters were evaluated using the Mini-Mental State Examination (MMSE) and the five-item version of the Geriatric Depression Scale (GDS-5), for an objective mental function other than SCD. A timed up-and-go test (TUG) and knee extension strength were used to test objective physical function, and the Mental Component Summary (MCS) and Physical Component Summary (PCS) in the Health-Related Quality of Life survey eight-item short form (SF-8) were used for subjective mental and physical functions. The results of the MMSE, GDS-5, TUG, knee extension strength, and MCS were significantly worse in the SCD group. In addition, logistic regression analysis showed that GDS-5 and MCS were associated with SCD onset. Depressive symptoms and decreased subjective mental function contribute to SCD among community-dwelling Japanese adults. These findings will be useful for planning dementia prevention and intervention programs for older Japanese adults.
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Affiliation(s)
- Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
- Correspondence: ; Tel.: +81-75-574-4313
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan;
| | - Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
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Ogawa M, Satomi-Kobayashi S, Yoshida N, Tsuboi Y, Komaki K, Nanba N, Izawa KP, Sakai Y, Akashi M, Hirata KI. Relationship between oral health and physical frailty in patients with cardiovascular disease. J Cardiol 2020; 77:131-138. [PMID: 32819801 DOI: 10.1016/j.jjcc.2020.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/20/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Oral health is important for maintaining general health and is associated with components of physical frailty among the elderly. Oral health problems are common in hospitalized patients; however, no reports on oral health problems pertain to patients with cardiovascular diseases (CVD). The present study aimed to evaluate the association between oral health and physical frailty in these patients. METHODS In this retrospective cohort study, we included consecutive patients admitted for CVD to our hospital between May 2014 and December 2018. Physical frailty was assessed using the Short Physical Performance Battery (SPPB). Oral health characteristics, such as the number of remaining teeth, denture use, occlusal support, and periodontal status, were assessed. RESULTS In our cohort (n = 457), 111 (24.3%) patients had physical frailty. Univariate linear regression showed that the number of teeth present and the prevalence of occlusal support were significantly lower in patients with than without physical frailty. Pearson correlation indicated that the number of teeth significantly correlated with the nutritional status (r = 0.27) and SPPB score (r = 0.24), grip strength (r = 0.33), and 6-minute walking distance (r = 0.26). Multiple linear regression analysis showed that the number of teeth was independently associated with physical frailty after adjusting for confounders. CONCLUSIONS Oral health was closely associated with physical frailty, and nutritional status in patients with CVD; thus, it could be an important screening marker for early frailty symptoms and a predictor of future malnutrition risk.
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Affiliation(s)
- Masato Ogawa
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Seimi Satomi-Kobayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Naofumi Yoshida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasunori Tsuboi
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Kodai Komaki
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Nagisa Nanba
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Rodacki ALF, Boneti Moreira N, Pitta A, Wolf R, Melo Filho J, Rodacki CDLN, Pereira G. Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women? Clin Interv Aging 2020; 15:1045-1056. [PMID: 32636619 PMCID: PMC7335282 DOI: 10.2147/cia.s253262] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/29/2020] [Indexed: 01/15/2023] Open
Abstract
Aim This study aimed to determine the association of handgrip strength with isometric and isokinetic strength (hip, knee and ankle extensor/flexor muscles), and functional capacity in older women. Methods The handgrip strength and lower limb strength of 199 older women (60–86 years) were measured using JAMAR and BIODEX dynamometers, respectively. Time Up and Go, Five-times-sit-to-stand and 6m-walk functional tests were evaluated. Pearson correlations were used to determine the relationship between variables. Regression analysis was applied to identify if HS was able to predict TUG performance. The effect of age was analyzed by splitting the participants in a group of older women (OLD; from 60 to 70 years old) and very old women (from 71 to 86 years old). Results The HS and isometric/isokinetic strength correlations were negligible/low and, in most cases, were non-significant. The correlation between handgrip strength and functional tests also ranged predominantly from negligible (r=0.0 to 0.3) to low (r=0.3 to 0.5), irrespective of the group age. The handgrip strength was not able to explain the variance of the TUG performance. Conclusion Generalizing handgrip strength as a practical and straightforward measure to determine lower limbs and overall strength, and functional capacity in older women must be viewed with caution. Handgrip strength and standard strength measures of the lower limbs and functional tests present a negligible/low correlation.
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Affiliation(s)
| | - Natália Boneti Moreira
- Department of Physiotherapy Prevention and Rehabilitation, Federal University of Parana, Curitiba, Brazil
| | - Arthur Pitta
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Renata Wolf
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Jarbas Melo Filho
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Cintia de Lourdes Nahhas Rodacki
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil.,Department of Physical Education, Paraná Technological Federal University, Paraná, Curitiba, Brazil
| | - Gleber Pereira
- Department of Physical Education, Federal University of Parana, Curitiba, Brazil
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Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review. PARKINSONS DISEASE 2020; 2020:9748091. [PMID: 32566123 PMCID: PMC7270996 DOI: 10.1155/2020/9748091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/09/2020] [Indexed: 11/26/2022]
Abstract
Parkinson disease (PD) is a chronic neurodegenerative condition that leads to progressive disability. PD-related reductions in muscle strength have been reported to be associated with lower functional performance and balance confidence with an increased risk of falls. Progressive resistance training (PRT) improves strength, balance, and functional abilities. This umbrella review examines the efficacy of PRT regarding muscular strength in PD patients. The PubMed, PEDro, Scopus, and Cochrane Library databases were searched from January 2009 to August 2019 for systematic reviews and meta-analyses conducted in English. The populations included had diagnoses of PD and consisted of males and females aged >18 years old. Outcomes measured were muscle strength and enhanced physical function. Eight papers (six systematic reviews and meta-analyses and two systematic reviews) were considered relevant for qualitative analysis. In six of the eight studies, the reported severity of PD was mild to moderate. Each study analyzed how PRT elicited positive effects on muscle strength in PD patients, suggesting 10 weeks on average of progressive resistance exercises for the upper and lower limbs two to three times per week. However, none of the studies considered the postworkout follow-up, and there was no detailed evidence about the value of PRT in preventing falls. The possibility of PRT exercises being effective for increasing muscle strength in patients with PD, but without comorbidities or severe disability, is discussed. Overall, this review suggests that PRT should be included in rehabilitation programs for PD patients, in combination with balance training for postural control and other types of exercise, in order to preserve cardiorespiratory fitness and improve endurance in daily life activities.
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Padulo J, Trajković N, Cular D, Grgantov Z, Madić DM, Di Vico R, Traficante A, Alin L, Ardigò LP, Russo L. Validity and Reliability of Isometric-Bench for Knee Isometric Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124326. [PMID: 32560400 PMCID: PMC7345336 DOI: 10.3390/ijerph17124326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 01/18/2023]
Abstract
There is a strong need for a new, probably cheaper, smaller, and more portable isometric dynamometer. With this aim, we investigated the concurrent validity and reliability of a low-cost portable dynamometer to measure the isometric strength of the lower limb. Seventeen young participants (age 16.47 ± 0.51 years) were randomly assessed on three different days for knee flexion and extension isometric forces with two different devices: a commonly used isokinetic dynamometer (ISOC) and a portable isometric dynamometer prototype (ISOM). No significant differences were observed between the ISOC and the ISOM (all comparisons p > 0.05). Test–retest comparison showed the ISOM to have high reliability (ICC 0.879–0.990). This study showed that measurements with the ISOM could be performed without systematic bias and with high reliability. The ISOM is a device that is able to assess knee isometric strength with excellent concurrent validity and reliability.
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Affiliation(s)
- Johnny Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy;
| | - Nebojša Trajković
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (N.T.); (D.M.M.)
| | - Drazen Cular
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (D.C.); (Z.G.)
- “Einstein” Craft for Research, Development, Education, Trade and Services, 21000 Split, Croatia
| | - Zoran Grgantov
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (D.C.); (Z.G.)
| | - Dejan M. Madić
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (N.T.); (D.M.M.)
| | - Rosa Di Vico
- Italian Society of Posture and Gait Research, 8100 Caserta, Italy;
| | - Alfonso Traficante
- Department of Biotechnology and Applied Clinical Science, University of L’Aquila, 67100 L’Aquila, Italy; (A.T.); (L.R.)
| | - Larion Alin
- Faculty of Physical Education, Ovidius University of Constanta, 900029 Constanta, Romania;
| | - Luca Paolo Ardigò
- School of Exercise and Sport Science, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37131 Verona, Italy
- Correspondence:
| | - Luca Russo
- Department of Biotechnology and Applied Clinical Science, University of L’Aquila, 67100 L’Aquila, Italy; (A.T.); (L.R.)
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75
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Kong SH, Kim JH, Park YJ, Lee JH, Hong AR, Shin CS, Cho NH. Low free T3 to free T4 ratio was associated with low muscle mass and impaired physical performance in community-dwelling aged population. Osteoporos Int 2020; 31:525-531. [PMID: 31784788 DOI: 10.1007/s00198-019-05137-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/16/2019] [Indexed: 10/25/2022]
Abstract
UNLABELLED In aged population, the association of thyroid hormones on physical performance, especially within their normal range, has yet to be elucidated. In this study, individuals with low serum free T3/free T4 were likely to have low muscle mass and impaired physical performance. PURPOSE We aimed to evaluate the associations of muscle mass, strength, and physical performance with thyroid hormone in an aged euthyroid population from a community-based cohort. METHODS We examined 918 men aged over 60 years and 1215 postmenopausal women from the Ansung cohort study. Appendicular skeletal muscle mass divided by square of height (ASM/ht2) was used as the muscle mass index. Hand grip strength was measured using a hydraulic dynamometer. Physical performance was assessed using the short physical performance battery (SPPB). RESULTS Participants with higher tertiles of free T3 and free T3/free T4 were younger and had higher ASM/ht2, stronger hand grip strength, and higher SPPB scores than those in the lower tertiles. In adjusted models, men within higher tertiles of free T3 had higher ASM/ht2 compared with those within lower tertiles (p = 0.033), whereas subjects with higher tertiles of free T4 had lower ASM/ht2 compared with those within lower tertiles (p = 0.043). Subjects within higher tertiles of free T3/free T4 had higher ASM/ht2 (p < 0.001) and better physical performance (p = 0.048) than those within lower tertiles after adjustments. However, free T3, free T4, or free T3/free T4 was not related to hand grip strength after adjustment for covariates. CONCLUSION Our results thus indicate that in an aged euthyroid population, low serum free T3/free T4 was a better index for low muscle mass and impaired physical performance than serum free T3 or free T4 alone.
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Affiliation(s)
- S H Kong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - J H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - J H Lee
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea
| | - A R Hong
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam, South Korea
| | - C S Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - N H Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, 443-721, Republic of Korea.
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76
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Almeida JN, Prado WL, Terra CM, Oliveira MG, Garcia RA, Pinfildi CE, Botero JP. Effects of photobiomodulation on muscle strength in post-menopausal women submitted to a resistance training program. Lasers Med Sci 2020; 35:355-363. [PMID: 31197508 DOI: 10.1007/s10103-019-02822-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/29/2019] [Indexed: 01/17/2023]
Abstract
The aim of this study was to compare the effects of resistance training of low volume and high intensity with or without photobiomodulation (PBM) on muscle strength and functional performance in post-menopausal women. Thirty-four post-menopausal women were randomized into resistance training (RTG, n = 17) or resistance training plus PBM (PBMG, n = 17). Individuals from both groups received the same RT protocol consisting of leg-press 45°, front lat pulldown, leg curl, chest press, and squat performed in two sets of 10 repetitions with a workload of 75% of one repetition maximum (1RM), twice per week, during 8 weeks. PBMG individuals also received, prior to the exercise session, PBM through a cluster containing 7 visible diodes (630 nm) and 7 infrared diodes (850 nm) with power of 100 mW each and energy of 4 J per diode, applied to the quadriceps femoris muscle; individuals from RTG received placebo PBM prior to the sessions, applied with the same device switched off. Muscle strength (1RM; isometric dynamometer), functional performance (Time Up and Go; Berg Balance Scale; 6-min walk test), and quality of life (World Health Organization Quality of Life-Bref) were performed before and after 8 weeks. Both groups increased muscle strength (p < 0.001) for all exercises, without group differences (p = 0.651). Quality of life (p = 0.015) and balance (p = 0.006) increased only in the RTG. The results suggest that PBM were not able for inducing additional benefits to RT to improve muscle strength in post-menopausal women.
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Affiliation(s)
- Johny N Almeida
- Health Science Graduation Program, Federal University of São Paulo, Santos, Brazil.
| | - Wagner L Prado
- Department of Human Movement Science, Federal University of São Paulo, Silva Jardim, 136, Santos, São Paulo, 11015-020, Brazil
- Human Movement Science and Rehabilitation Graduation Program, Federal University of São Paulo, Santos, Brazil
| | - Caio M Terra
- Health Science Graduation Program, Federal University of São Paulo, Santos, Brazil
| | - Matheus G Oliveira
- Health Science Graduation Program, Federal University of São Paulo, Santos, Brazil
| | - Renato A Garcia
- Health Science Graduation Program, Federal University of São Paulo, Santos, Brazil
| | - Carlos E Pinfildi
- Department of Human Movement Science, Federal University of São Paulo, Silva Jardim, 136, Santos, São Paulo, 11015-020, Brazil
- Human Movement Science and Rehabilitation Graduation Program, Federal University of São Paulo, Santos, Brazil
| | - João P Botero
- Department of Human Movement Science, Federal University of São Paulo, Silva Jardim, 136, Santos, São Paulo, 11015-020, Brazil
- Human Movement Science and Rehabilitation Graduation Program, Federal University of São Paulo, Santos, Brazil
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77
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Hirano M, Katoh M, Gomi M, Arai S. Validity and reliability of isometric knee extension muscle strength measurements using a belt-stabilized hand-held dynamometer: a comparison with the measurement using an isokinetic dynamometer in a sitting posture. J Phys Ther Sci 2020; 32:120-124. [PMID: 32158074 PMCID: PMC7032982 DOI: 10.1589/jpts.32.120] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/04/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine the validity and reliability of isometric knee
extension muscle strength measurements using a belt-stabilized hand-held dynamometer
compared to that using an isokinetic dynamometer with the participant in a sitting
posture. [Participants and Methods] Forty-two university students participated. The
isometric knee extension muscle strength was measured using a hand-held dynamometer and an
isokinetic dynamometer. For both measurements, the participants were in the similar
sitting posture. The sitting posture maintained trunk stability, with the hands on the
bed, and the non-measurement-side toe touching the floor or table. The intra-class
correlation coefficient and the relevance were verified. [Results] Intra-rater correlation
coefficient (1, 1) of the two measurements was ≥0.75. A significant difference was found
in the measurement value between males and females. No significant difference was found
between the measurements value of the two devices. A significant positive correlation was
found in the measurement value of two devices in the male participants. [Conclusion] When
compared to the standard method of isometric knee extension muscle strength measurements
using an isokinetic dynamometer with the participant in the sitting posture, measurements
using the belt-stabilized hand-held dynamometer were considered valid and highly reliable
in the male participants.
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Affiliation(s)
- Masahiro Hirano
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Munenori Katoh
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Masahiro Gomi
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Saori Arai
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
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Hogrel JY, Benveniste O, Bachasson D. Routine monitoring of isometric knee extension strength in patients with muscle impairments using a new portable device: cross-validation against a standard isokinetic dynamometer. Physiol Meas 2020; 41:015003. [PMID: 31935703 DOI: 10.1088/1361-6579/ab6b49] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Muscle strength is a critical clinical hallmark in both health and disease. The current study introduces a novel portable device prototype (MyoQuad) for assessing and monitoring maximal voluntary isometric knee extension torque (MVIT). APPROACH Fifty-six patients with inclusion body myositis were studied. Knee extension weakness is a key feature in this inflammatory muscle disease. Cross-validation with an isokinetic dynamometer (Biodex System 3 Pro) was performed. Between-day reproducibility and ability to monitor changes in muscle strength over time compared to the gold standard method as a reference, were also investigated. MAIN RESULTS The measurement was feasible even in the weakest patients. Agreement between methods was excellent (standard error of measurement (SEM) was 3.8 Nm and intra-class correlation coefficient (ICC) was 0.973). Least significant difference (LSD) was 4.9 and 5.3 Nm for the MyoQuad and the Biodex, respectively Measurements using the MyoQuad exhibited excellent between-day reproducibility (SEM was 2.4 Nm and ICC was 0.989 versus 2.6 Nm and 0.988 using the Biodex). Changes in MVIT at 6 and 12 months were similar between methods (timepoint × method interaction was not significant; all p > 0.19); strength changes classified according to LSD at 6 and 12 months were consistent between methods (>70% consistent classification)). SIGNIFICANCE The measurement of MVIT using the MyoQuad offers a cost-effective, portable and immediate alternative for the routine measurement of maximal voluntary isometric strength of the quadriceps. The MyoQuad offers a comfort and stability that cannot be provided by standard hand-held dynamometers. These results support quantitative muscle strength assessment using fixed yet flexible dynamometry within clinical routine and multicenter trials.
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Affiliation(s)
- Jean-Yves Hogrel
- Institute of Myology, Neuromuscular Investigation Center, Pitié-Salpêtrière University Hospital, Paris, France. Author to whom any correspondence should be addressed
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Preoperative hand-grip strength can be a predictor of stair ascent and descent ability after total knee arthroplasty in female patients. J Orthop Sci 2020; 25:167-172. [PMID: 30904204 DOI: 10.1016/j.jos.2019.03.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/17/2018] [Accepted: 03/02/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND Hand-grip strength was reported to be important predictor of functional limitation and disability related to low muscle strength in old people. The purpose of this study was to determine whether preoperative hand-grip strength predicts stair ascent and descent ability after total knee arthroplasty (TKA). METHODS A total of 83 female patients (mean age 75.6 ± 7.2 years) who underwent unilateral TKA were included in this study. We measured body mass index, range of motion of both knees, bilateral quadriceps strength and hand-grip strength before and one year after TKA. One year after TKA, we had the subjects ascend and descend some stairs and recorded the gait pattern (step-to-step or step-over-step) and pain in both knees using a numerical rating scale. We divided the subjects into two groups according to gait pattern. These factors were compared between groups. Receiver Operating Characteristics (ROC) analysis was performed to estimate the preoperative hand-grip strength cut off point for the stair gait pattern. RESULTS Pre- and postoperative mean hand-grip strengths were 20.1 ± 5.0 kg and 20.7 ± 5.4 kg, respectively, and there was a strong positive correlation between them (r = 0.82, P < 0.001). Quadriceps strength of both limbs significantly improved after TKA (P < 0.001). After TKA, all patients were able to perform both stair ascent and descent. The gait patterns of 27 patients were step-to-step, and 56 patients were step-over-step. Preoperative and postoperative quadriceps strength of both limbs and preoperative and postoperative hand-grip strength were significantly different between the groups. According to the ROC curve, the optimal cut off values of preoperative hand-grip strength for which female patients could ascend and descend the stairs by step-over-step after TKA was set at 19 kg. CONCLUSION Preoperative hand-grip strength can be used in preoperative screening for stair ascent and descent ability after TKA.
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80
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Katoh M, Hiiragi Y, Hirano M, Gomi M, Tozawa R, Sakai Y, Tanaka M. Isometric knee muscle strength measurement using a belt-stabilized hand-held dynamometer and an isokinetic dynamometer with and without trunk fixation: investigation of agreement of measurement values and factors influencing measurement. J Phys Ther Sci 2019; 31:878-883. [PMID: 31871370 PMCID: PMC6879403 DOI: 10.1589/jpts.31.878] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the agreement between the values
obtained by using a hand-held dynamometer with a belt (belt-HHD) and an isokinetic
dynamometer (IKD) for the measurement of isometric knee flexion and extension muscle
strength. We also studied the factors influencing the measurement. [Participants and
Methods] Overall, 26 healthy young adults (16 males, 10 females) participated in the
study; the mean age was 21 years. Knee flexion and extension muscle strength were measured
by three methods: 1) belt-HHD, 2) conventional IKD with the participant sitting on an
attached chair (conv-IKD), and 3) modified IKD with the participant sitting on the same
mat table as HHD (mod-IKD). [Results] In the measurement of knee extension, mod-IKD and
conv-IKD showed a fixed bias and a proportional bias, conv-IKD and belt-HHD showed a fixed
bias, and belt-HHD and mod-IKD showed a fixed bias. In the measurement knee flexion,
conv-IKD and mod-IKD showed a proportional bias, belt-HHD and conv-IDK showed a fixed
bias, and mod-IKD and belt-HHD showed a fixed bias. In each combination, the measured
values were larger in the latter due to errors. However, the types and values of errors
differed when analysis was conducted based on gender. [Conclusion] In order to increase
the agreement between the values, it is necessary to revise the fixing method of the
trunk, and the fixing method of the belt and the sensor pad in belt-HHD.
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Affiliation(s)
- Munenori Katoh
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Yukinobu Hiiragi
- Department of Physical Therapy, Faculty of Health, Fukuoka International University of Health and Welfare, Japan
| | - Masahiro Hirano
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Masahiro Gomi
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Ryosuke Tozawa
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University: 5-8-1 Akemi, Urayasu-shi, Chiba 279-8567, Japan
| | - Yoshihito Sakai
- Department of Physical Therapy, Toyama Medical and Human Services Institute, Japan
| | - Masaru Tanaka
- Department of Physical Therapy, Toyama Medical and Human Services Institute, Japan
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Moukarzel M, Guillot A, Di Rienzo F, Hoyek N. The therapeutic role of motor imagery during the chronic phase after total knee arthroplasty: a pilot randomized controlled trial. Eur J Phys Rehabil Med 2019; 55:806-815. [PMID: 31615192 DOI: 10.23736/s1973-9087.19.05136-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There is now ample evidence that motor imagery contributes to enhance motor learning and promote motor recovery in patients with motor disorders. Whether motor imagery practice is likely to facilitate mobility in patients suffering from knee osteoarthritis, at 6-months after total knee arthroplasty, remains unknown. AIM This trial was designed to evaluate the therapeutic effectiveness of implementing motor imagery into the classical course of physical therapy at 6-months after total knee arthroplasty. DESIGN Randomized controlled trial. POPULATION Twenty-four patients with unilateral total knee arthroplasty were assigned to a motor imagery or control group in a test-retest procedure, following a rehabilitation program as outpatients. METHODS During both the pre- and post-test, a set of strength and functional mobility measures were assessed: quadriceps strength, peak knee flexion during the swing phase, performance at the timed up and go test, stair climbing test, and 6-minute walk test, and finally Oxford knee score. In addition to a common physical therapy program, the motor imagery group practiced additional motor imagery exercises, while participants of the control group were subjected to a period of neutral activities for an equivalent amount of time. RESULTS Data provided evidence that motor imagery enhanced the quadriceps muscle strength of the operated knee (F (1, 22)=10.36, P=0.003), improved the peak knee flexion during the swing phase (F (1, 22)=31.52, P<0.001), and increased the speed to climb and descend stairs (F (1, 22)=14.28, P=0.001). CONCLUSIONS This study demonstrated the effectiveness of motor imagery exercises in gait performance and functional recovery in a small sample of individuals who underwent total knee arthroplasty. However, before drawing final conclusions sample size calculation should be conducted in the future. CLINICAL REHABILITATION IMPACT While waiting for further research, our findings encourage incorporating motor imagery exercises into classical physical therapy protocols at 6-months after total knee arthroplasty.
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Affiliation(s)
- Marcel Moukarzel
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Jounieh (USEK), Kaslik, Lebanon
| | - Aymeric Guillot
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France.,Institut Universitaire de France (IUF), Paris, France
| | - Franck Di Rienzo
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France
| | - Nady Hoyek
- Inter-University Laboratory of Human Movement Biology (LIBM, EA7424), Claude Bernard Lyon 1 University, Lyon, France -
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Bui KL, Mathur S, Dechman G, Maltais F, Camp P, Saey D. Fixed Handheld Dynamometry Provides Reliable and Valid Values for Quadriceps Isometric Strength in People With Chronic Obstructive Pulmonary Disease: A Multicenter Study. Phys Ther 2019; 99:1255-1267. [PMID: 30939198 DOI: 10.1093/ptj/pzz059] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 01/09/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Quadriceps weakness is associated with poor clinical outcomes in chronic obstructive pulmonary disease (COPD). However, quadriceps isometric strength assessment has not been routinely adopted in clinical practice because of the lack of homogeneity in the devices and protocols and the lack of reliability studies. OBJECTIVE The objectives of this study were to determine the test-retest reliability and the criterion validity of a commercially available handheld dynamometer for evaluating the quadriceps isometric maximal voluntary contraction (iMVCquad) using a standardized protocol and to investigate the relationship between iMVCquad and functional capacity in people with COPD. DESIGN This was a prospective, observational, multicenter trial. METHODS Participants with mild to severe COPD from 4 Canadian sites were tested on 2 separate days. Five iMVCquad measurements were obtained following a standardized procedure with a fixed handheld dynamometer (iMVCquad-HHD), and then 5 iMVCquad measurements were obtained with a computerized dynamometer (iMVCquad-CD; the gold standard). Functional capacity was assessed with the Short Physical Performance Battery. Intraclass correlation coefficients, standard errors of measurement, Bland-Altman plots, and Spearman correlation coefficients were used for analyses. RESULTS Sixty-five participants (mean age = 69 years [SD = 8]; forced expiratory volume in 1 second = 48% of predicted value [SD = 21]) completed the study. The mean iMVCquad-HHD values on visits 1 and 2 were 102.7 (SD = 51.6) and 105.6 (SD = 58.8) N·m, respectively; the standard error of measurement was 11.4 N·m. The between-visits intraclass correlation coefficient for iMVCquad-HHD was 0.95 (95% confidence interval = 0.92-0.97), with a mean bias of 2.0 (Bland-Altman plot). There was a strong correlation between iMVCquad-HHD and iMVCquad-CD (Spearman correlation coefficient = 0.86). There was no correlation between iMVCquad-HHD and Short Physical Performance Battery total score. LIMITATIONS Participants had stable COPD with few comorbidities and were more physically active than the general population of people with COPD; results might not be applicable to patients with acute exacerbations of the disease or more comorbidities. Assessment order between handheld and computerized dynamometers has not been randomized, but analyses did not highlight any systematic bias or learning effect. CONCLUSIONS Quadriceps strength assessment can be implemented in a reliable and valid way in people with COPD using a fixed handheld dynamometer and standardized procedure. This protocol should be established in clinical practice to facilitate the assessment of muscle strength in people with COPD.
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Affiliation(s)
- Kim-Ly Bui
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Gail Dechman
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - François Maltais
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval
| | - Pat Camp
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada; and Department of Physical Therapy, University of British Columbia
| | - Didier Saey
- Centre de Recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 Chemin Ste-Foy, Quebec City, Quebec, Canada, G1V 4G5
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83
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Oh TJ, Kang S, Lee JE, Moon JH, Choi SH, Lim S, Jang HC. Association between deterioration in muscle strength and peripheral neuropathy in people with diabetes. J Diabetes Complications 2019; 33:598-601. [PMID: 31129004 DOI: 10.1016/j.jdiacomp.2019.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/03/2019] [Accepted: 04/07/2019] [Indexed: 12/14/2022]
Abstract
AIMS Diabetic peripheral neuropathy (DPN) is a major risk factor for sarcopenia or frailty in older patients with diabetes. In this study, we investigated the association between DPN and muscle strength in type 2 diabetes. METHODS DPN was assessed using the Michigan Neuropathy Screening Instrument Questionnaire (MNSI-Q) and Physical Examination (MNSI-PE) in 230 subjects with type 2 diabetes. Handgrip strength (HGS) was measured using an electronic grip strength dynamometer. RESULTS The prevalence of DPN was 26.4% in men and 34.7% in women. HGS was significantly lower in men with DPN compared with men without DPN (27.0 ± 9.4 vs. 29.7 ± 8.4 kg, p = 0.036). This effect was not seen in women. In men, multivariate regression analysis showed that HGS was negatively associated with the MNSI-Q (β = -1.200, p = 0.003) and MNSI-PE scores (β = -0.937, p = 0.046) and resulted in an abnormal 10-gram monofilament test score (β = -10.895, p < 0.001). However, HGS was not significantly associated with neuropathy in women. CONCLUSIONS Muscle strength was lower in men with DPN than in those without DPN. Assessment of muscle function may have clinical implications in the prevention of sarcopenia and frailty in men with DPN.
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Affiliation(s)
- Tae Jung Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sunyoung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jie-Eun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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84
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Almeida GPL, Albano TR, Melo AKP. Hand-held dynamometer identifies asymmetries in torque of the quadriceps muscle after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2019; 27:2494-2501. [PMID: 30377716 DOI: 10.1007/s00167-018-5245-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 10/17/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To verify the validity and diagnostic accuracy of the hand-held dynamometer (HHD) with the isokinetic dynamometer for evaluating the quadriceps strength of subjects who have undergone ACL reconstruction (ACLR). METHODS This validity and diagnostic accuracy study was conducted prospectively by examining 70 consecutive participants who had undergone ACLR at least 6 months previously. All participants performed strength evaluation of the quadriceps muscle using the HHD and isokinetic dynamometer. RESULTS The HHD presented high test-retest reliability [intraclass correlation coefficient (ICC) = 0.98], moderate to good validity with the isokinetic dynamometer when compared for the quadriceps strength (r = 0.62), 100% perfect specificity [LR + infinity, 95% confidence interval (CI) 81.4%-100%] to identify those with LSI > 10%, and a sensitivity of 63.4% (48.9%-76.3%). CONCLUSION The HHD is an instrument valid and reliable of low cost and easy handling compared to the isokinetic dynamometer to evaluate the quadriceps torque and the limb symmetry index after the ACLR with high diagnostic accuracy. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Gabriel Peixoto Leão Almeida
- Physical Therapy Department, School of Medicine, Federal University of Ceará, Alexandre Baraúna Street, 949 - 1° andar - Rodolfo Teófilo, Fortaleza, CE, 60430-160, Brazil.
- Knee Research Group, University of Ceará, Fortaleza, CE, Brazil.
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85
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Sung KS, Yi YG, Shin HI. Reliability and validity of knee extensor strength measurements using a portable dynamometer anchoring system in a supine position. BMC Musculoskelet Disord 2019; 20:320. [PMID: 31286912 PMCID: PMC6615264 DOI: 10.1186/s12891-019-2703-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Muscle strength measurements using hand-held dynamometry (HHD) can be affected by the inadequate strength of the tester and lack of stabilization of the participants and the device. A portable HHD anchoring system was designed that enabled the measurement of isometric knee extensor muscle strength in a supine position. This can be used with individuals who are unable to assume the sitting position required for the measurement of knee extensor strength in conventional isokinetic dynamometry (IKD). The aim of this study was to evaluate the reliability and validity of knee extensor strength measurements using this device. Methods The maximal knee extensor isometric strength of the dominant leg in healthy adults aged 20 to 40 years was tested. Three trials of three contractions were assessed by two raters using the portable dynamometer anchoring system whilst the participant was in the supine position. After the three measurement trials, peak knee extensor torque was evaluated using IKD. The intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) for intra- and inter-rater reliability were obtained. Results Thirty-nine participants (19 male and 20 female, aged 30.08 ± 4.16 y), completed the three measurement trials. The ICC for intra-rater reliability was 0.98 for the maximum measurements of knee extensor strength (95% confidence interval [CI]: 0.96–0.98) and 0.98 (95% CI: 0.96–0.99) for inter-rater reliability. The mean difference (%) between the maximum knee extensor strength measurements of each trial was 1.02% (LOA range: − 11.13 to 13.16%) for intra-rater and − 1.44% (LOA range: − 13.98 to 11.08%) for inter-rater measurements. The Pearson correlation coefficient of the maximum voluntary peak torque measurements with the portable dynamometer anchoring system and IKD was 0.927. Conclusions The portable dynamometer anchoring system is a reliable and valid tool for measuring isometric knee extensor strength in a supine position. Future clinical feasibility studies are needed to determine if this equipment can be applied to people with severe illness or disabilities. Trial registration KCT0003041. Electronic supplementary material The online version of this article (10.1186/s12891-019-2703-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kwan-Sik Sung
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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86
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Lees MJ, Wilson OJ, Hind K, Ispoglou T. Muscle quality as a complementary prognostic tool in conjunction with sarcopenia assessment in younger and older individuals. Eur J Appl Physiol 2019; 119:1171-1181. [PMID: 30806780 PMCID: PMC6469623 DOI: 10.1007/s00421-019-04107-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/20/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE This pilot study investigated differences in lean tissue mass, muscle strength, muscle quality (strength per unit of muscle mass; MQ), and functional performance in healthy younger and older individuals. The most robust predictors of appendicular lean mass (ALM) were then determined in each group. METHODS Fifty younger (18-45 years) and 50 older (60-80 years) participants completed tests of upper and lower body strength alongside body composition by dual-energy X-ray absorptiometry from which upper- and lower-body MQ were estimated. Available cut-points for older people were used to determine low upper-body MQ in both groups. Low lower-body MQ was determined as at least two standard deviations below the mean of the younger group. Functional performance was assessed by gait speed. Sarcopenia was identified using two established definitions. RESULTS Upper and lower body strength, ALM, lower-body MQ and gait speed were significantly higher in the younger group (all p < 0.002). Sarcopenia was identified in 2-4% of the older group. Low upper-body MQ was evident in 32% and 42% of the younger and older group, respectively. Low lower-body MQ was observed in 4% of younger participants, and 50% of older participants. In both groups, the most robust predictors of ALM were upper and lower body strength (young R2 = 0.74, 0.82; older R2 = 0.68, 0.72). CONCLUSIONS Low MQ despite low prevalence rates of sarcopenia in both groups suggests a need for age-specific MQ cut-points. Muscle quality assessments might be useful complementary prognostic tools alongside existing sarcopenia definitions.
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Affiliation(s)
- Matthew J Lees
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK.
| | - Oliver J Wilson
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
| | - Karen Hind
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Theocharis Ispoglou
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Fairfax Hall, Headingley Campus, Leeds, West Yorkshire, LS6 3QS, UK
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Soccer Footedness and Between-Limbs Muscle Strength: Systematic Review and Meta-Analysis. Int J Sports Physiol Perform 2019; 14:551-562. [PMID: 30975008 DOI: 10.1123/ijspp.2018-0336] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: Limb dominance and consequent between-limbs muscle strength in soccer players should be explored to determine a standard musculoskeletal profile to maintain and establish during screening protocols and postinjury rehabilitation. The primary aim of this review was to identify dominant- vs non-dominant-lower-extremity muscle-strength characteristics of healthy soccer players, with secondary aims to consider available between-limbs outcome measures and directions for future research. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Five electronic databases were used for study identification with guidance from a medical librarian. Inclusion criteria consisted of studies employing a cross-sectional design assessing soccer players of all ages, genders, and levels of play that identified limb dominance and associated lower-extremity muscle strength as a main purpose of the experiment. Results: The literature search identified 3471 articles. After screening titles, abstracts, and full texts, 17 articles were included in the review. Peak torques and hamstring-to-quadriceps ratios via isokinetic dynamometry were commonly used, and subsequent meta-analyses were conducted to yield remarkable between-limbs symmetry. Additional results of individual studies also demonstrate symmetry, except 1 article of velocity-dependent measures that reported greater strength in the dominant limb. Conclusions: In soccer, between-limbs muscle strength measured by maximal isokinetic dynamometry demonstrates symmetry across ages, genders, and levels of play. Future testing using alternative measures that more specifically replicate the movement demands of soccer players may further classify between-limbs characteristics.
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88
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Daun F, Kibele A. Different strength declines in leg primary movers versus stabilizers across age-Implications for the risk of falls in older adults? PLoS One 2019; 14:e0213361. [PMID: 30845168 PMCID: PMC6405087 DOI: 10.1371/journal.pone.0213361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/20/2019] [Indexed: 11/19/2022] Open
Abstract
This study investigated differences in the declines of isometric strength in hip abductors and adductors versus knee extensors across four different age groups (n = 31: 11.2 ± 1.0 y, n = 30: 23.1 ± 2.7 y, n = 27: 48.9 ± 4.4 y, and n = 33: 70.1 ± 4.2 y) with a total of 121 female subjects. As a starting point, we assumed that, during their daily activities, elderly people would use their leg stabilizers less frequently than their leg primary movers as compared to younger people. Given that muscle strength decreases in the course of the aging process, we hypothesized that larger strength declines in hip abductors and hip adductors as compared to knee extensors would be detected across age. Maximal isometric force for these muscle groups was assessed with a digital hand-held dynamometer. Measurements were taken at 75% of the thigh or shank length and expressed relative to body weight and lever arm length. Intratester reliability of the normalized maximal torques was estimated by using Cronbach’s alpha and calculated to be larger than 0.95. The obtained results indicate a clearly more pronounced strength decline in hip abductors and hip adductors across age than in the knee extensors. Therefore, a particular need for strength training of the lower extremity stabilizer muscles during the aging process is implied.
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Affiliation(s)
- Franziska Daun
- Institute for Sports and Sport Science, University of Kassel, Germany
| | - Armin Kibele
- Institute for Sports and Sport Science, University of Kassel, Germany
- * E-mail:
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89
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Eika F, Blomkvist AW, Rahbek MT, Eikhof KD, Hansen MD, Søndergaard M, Ryg J, Andersen S, Jorgensen MG. Reference data on hand grip and lower limb strength using the Nintendo Wii balance board: a cross-sectional study of 354 subjects from 20 to 99 years of age. BMC Musculoskelet Disord 2019; 20:21. [PMID: 30636625 PMCID: PMC6330568 DOI: 10.1186/s12891-019-2405-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/04/2019] [Indexed: 01/11/2023] Open
Abstract
Background Accurate assessment of isometric hand grip strength (HGS) and isometric lower limb strength (LS) are often limited to specialized clinics due to high costs and need for specialized equipment and personnel. A mobile and user-friendly device would facilitate a wider use of these measures in the clinical setting. The Nintendo Wii Balance Board (WBB) is a novel and pragmatic tool that has been validated for measuring muscle strength and other clinically relevant physiological variables. However, reference data for HGS and LS are lacking. The purpose of the current study is to establish reference data for HGS and LS in individuals ≥20 years of age using the WBB method, and to characterize the effects of age in these measurements. Method Healthy participants were recruited at various locations and their HGS and LS were tested by six assessors using the WBB. Reference data were analysed and presented in age-groups, while the age-related change in HGS and LS was tested and characterized with linear regression models. Results Three hundred and fifty-four participants between 20 and 99 years of age were tested. Data are presented separately according to gender and the following age categories: 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80+, and presented in absolute values as well as percentiles. The main findings were; (1) Significantly higher HGS and LS among males compared to females and for the dominant limb compared to the non-dominant limb, (2) a significant decline in strength with increasing age, and (3) the rate of decline increased significantly (i.e. it was non-linear) with age for HGS, but not for LS. Conclusion This study reported reference data with percentiles for a novel method for assessing HGS and LS. Data were consistent with previously known effects of age and gender on HGS and LS. The presented data may supplement future trials using the WBB in research or in the clinical setting.
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Affiliation(s)
- F Eika
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
| | - A W Blomkvist
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - M T Rahbek
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - K D Eikhof
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - M D Hansen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - M Søndergaard
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
| | - J Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - S Andersen
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - M G Jorgensen
- Department of Geriatric and Internal Medicine, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark
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Stasi S, Papathanasiou G, Chronopoulos E, Dontas IA, Baltopoulos IP, Papaioannou NA. The Effect of Intensive Abductor Strengthening on Postoperative Muscle Efficiency and Functional Ability of Hip-Fractured Patients: A Randomized Controlled Trial. Indian J Orthop 2019; 53:407-419. [PMID: 31080280 PMCID: PMC6501618 DOI: 10.4103/ortho.ijortho_183_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hip fractures are common in the elderly and many patients fail to regain prefracture hip abductor strength or functional status. The purpose of this clinical trial was to compare the effects of an intensive abductor muscle exercise program versus a standard physiotherapy intervention in hip-fractured patients. MATERIALS AND METHODS Ninety six femoral neck-fractured patients were randomized into equal-sized groups. A 12-week standard physiotherapy program was implemented in the control group(S-PT) whereas an intensive exercise program, emphasizing on abductors' strengthening, was implemented in the research group(I-PT). Abductors' isometric strength of the fractured hip, abductor ratio% in the fractured compared to contralateral hip, and functional level were assessed at the 3rd (postintervention) and 6th (followup) months. RESULTS Postintervention, abductors' isometric strength was 35.7% greater (P < 0.0005) and abductor ratio% was 2.5% higher (P < 0.0005) in I-PT group, compared to S-PT group. With regard to functional assessments, I-PT group was 29.1% faster during Timed Up and Go (TUG) test and achieved a 26.7% higher Lower Extremity Functional Scale Greek version's (LEFS-Greek) total score, compared to S-PT group (P < 0.0005). At followup, abductors' isometric strength was 37.0% greater (P < 0.0005) and abductor ratio% was 7.1% higher (P < 0.0005) in I-PT group, compared to S-PT group. In addition, I-PT group was 45.9% faster during TUG test (P < 0.0005) and achieved an 11.2% higher LEFS-Greek total score, compared to S-PT group (P = 0.013). CONCLUSIONS Compared to the standard physiotherapy intervention, the intensive abductor-strengthening program significantly increased both abductors' isometric strength of the fractured hip and abductor ratio% and resulted in patients' enhanced functional level. CLINICAL TRIAL IDENTIFIER ISRCTN30713542.
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Affiliation(s)
- Sophia Stasi
- Department of Physiotherapy, Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece,Laboratory for Research of the Musculoskeletal System (LRMS), National and Kapodistrian University of Athens Medical School, Athens, Greece,Address for correspondence: Dr. Sophia Stasi, 30 Ouranias Street, 14121 Heraklion, Athens, Greece. E-mail:
| | - George Papathanasiou
- Department of Physiotherapy, Faculty of Health and Caring Sciences, University of West Attica, Athens, Greece
| | - Efstathios Chronopoulos
- 2nd Department of Orthopaedic, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ismene A Dontas
- Laboratory for Research of the Musculoskeletal System (LRMS), National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Nikolaos A Papaioannou
- Laboratory for Research of the Musculoskeletal System (LRMS), National and Kapodistrian University of Athens Medical School, Athens, Greece
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91
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Chopp-Hurley JN, Wiebenga EG, Gatti AA, Maly MR. Investigating the Test-Retest Reliability and Validity of Hand-Held Dynamometry for Measuring Knee Strength in Older Women with Knee Osteoarthritis. Physiother Can 2019; 71:231-238. [PMID: 31719719 PMCID: PMC6830419 DOI: 10.3138/ptc-2018-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose: Hand-held dynamometry (HHD) can be used to evaluate strength when gold-standard isokinetic dynamometry (IKD) is not feasible. HHD is useful for measuring lower limb strength in a healthy population; however, its reliability and validity in individuals with knee osteoarthritis (OA) has received little attention. In this research, we examined the test-retest reliability and validity of HHD in older women with knee OA. We also examined the associations between reliability and symptom and disease severity. Method: A total of 28 older women with knee OA completed knee extension and flexion exertions measured using HHD and IKD. Intra-class correlation coefficients (ICC2,3), standard error of measurement, and minimal detectable change were calculated. Correlation coefficients and regressions evaluated the relationships between inter-trial differences and symptom and disease severity. Results: High test-retest reliability was demonstrated for both exertions with each device (ICC2,3 = 0.83-0.96). Variance between trials was not correlated with OA symptoms. Criterion validity was good (ICC2,3 = 0.76), but extension yielded lower agreement than flexion. Regression analysis demonstrated that true strength can be predicted from HHD measurements. Conclusions: HHD is a reliable tool for capturing knee extension and flexion in individuals with OA. Because of lower agreement, HHD might be best suited for evaluating within-subject strength changes rather than true strength scores. However, gold-standard extension strength magnitudes may reasonably be predicted from regression equations (r 2 = 0.82).
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Affiliation(s)
- Jaclyn N. Chopp-Hurley
- School of Rehabilitation Science
- School of Kinesiology and Health Science, York University, Toronto
| | - Emily G. Wiebenga
- School of Rehabilitation Science
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
| | | | - Monica R. Maly
- School of Rehabilitation Science
- Department of Kinesiology, McMaster University, Hamilton
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
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de Almeida AC, Pedroso MG, Aily JB, Gonçalves GH, Pastre CM, Mattiello SM. Influence of a periodized circuit training protocol on intermuscular adipose tissue of patients with knee osteoarthritis: protocol for a randomized controlled trial. BMC Musculoskelet Disord 2018; 19:421. [PMID: 30497420 PMCID: PMC6267088 DOI: 10.1186/s12891-018-2325-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The objective of this study is to analyze the influence of a 14-week periodized circuit training protocol on patients with knee osteoarthritis (OA), in randomized intervention groups, on thigh intermuscular adipose tissue (interMAT), body composition, systemic inflammation, cartilage degradation, and its repercussion on pain, functional performance and quality of life. METHODS This study presents a protocol for a randomized controlled trial. Sixty selected participants diagnosed with knee OA grades II and III, 40-65 years old and BMI < 30 kg/m2, will be randomly divided into three groups:periodized circuit training, strength training, and educational protocol. The circuit training and strength training protocols consist of 14-week training protocols conducted 3 times a week. The circuit training group will perform selected exercises previously stratified as light, moderate, and intense, arranged progressively in a circuit model, the strength group will perform regular strength exercises, and the educational protocol group will participate in a 14-week protocol with lectures twice a month about healthy lifestyles. Baseline and follow-up evaluations will be conducted for thigh interMAT (computed tomography), body composition (DXA), inflammation (IL-1β, IL-6, IL-10, TNF-α, leptin, and adiponectin), and joint degradation biomarkers (uCTX-II and sCOMP), performance-based tests (30s Chair Stand Test, 40 m Fast-paced Walk Test and Stair Climb Test), quadriceps and hamstring maximal isometric voluntary contraction (MIVC), and questionnaires (WOMAC and pain catastrophizing scale). Repeated measures ANOVA will be used to compare differences between groups (circuit training X strength training X educational protocol) at the different times of assessment (baseline x follow-up or baseline x during protocol x follow-up) for each of the dependent variables. When significant main effects were found, the pots hoc Bonferroni test will be used to identify statistical differences. A significance level of 5% (p < 0.05) will be adopted. DISCUSSION This will be the first randomized controlled trial to assess the effects of a circuit training protocol on patients with knee OA on thigh intermuscular adipose tissue (interMAT). Given the prevalence and impact of OA and the widespread availability of this intervention, assessing the efficacy of a low-cost, non-pharmacological, and non-invasive treatment for knee OA patients has the potential for immediate and high clinical impact. TRIAL REGISTRATION ClinicalTrials.gov, NCT02761590 , registered in May 4, 2016.
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Affiliation(s)
- Aline Castilho de Almeida
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Km 235,Rod. Washington Luís–SP310, Postal code, São Carlos, (SP) 13565-905 Brazil
| | - Maria Gabriela Pedroso
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Km 235,Rod. Washington Luís–SP310, Postal code, São Carlos, (SP) 13565-905 Brazil
| | - Jessica Bianca Aily
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Km 235,Rod. Washington Luís–SP310, Postal code, São Carlos, (SP) 13565-905 Brazil
| | - Glaucia Helena Gonçalves
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Km 235,Rod. Washington Luís–SP310, Postal code, São Carlos, (SP) 13565-905 Brazil
| | - Carlos Marcelo Pastre
- Department of Physical Therapy, São Paulo State University (UNESP) - School of Sciences and Technology, 305, Roberto Simonsen St., Presidente Prudente, (SP) 19060-900 Brazil
| | - Stela Marcia Mattiello
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Km 235,Rod. Washington Luís–SP310, Postal code, São Carlos, (SP) 13565-905 Brazil
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93
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López-López L, Torres-Sánchez I, Romero-Fernández R, Granados-Santiago M, Rodríguez-Torres J, Valenza MC. Impact of Previous Physical Activity Levels on Symptomatology, Functionality, and Strength during an Acute Exacerbation in COPD Patients. Healthcare (Basel) 2018; 6:healthcare6040139. [PMID: 30501112 PMCID: PMC6316170 DOI: 10.3390/healthcare6040139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/21/2018] [Accepted: 11/28/2018] [Indexed: 11/16/2022] Open
Abstract
The main objective of this study is to determine the relationship between physical activity (PA) level prior to hospitalization and the pulmonary symptomatology, functionality, exercise capacity, and strength of acute exacerbated chronic obstructive pulmonary disease (COPD) patients. In this observational study, all data were taken during the patient’s first day in hospital. Patients were divided into two groups (a PA group, and a physical inactivity (PI) group), according to the PA level evaluated by the Baecke questionnaire. Cough status was evaluated by the Leicester Cough Questionnaire (LCQ), and dyspnea was assessed using the modified Medical Research Council dyspnea scale (mMRC). Functionality was measured by the Functional Independence Measure (FIM) and the London Chest Activity of Daily Living scale (LCADL). Exercise capacity was evaluated by the two-minute step-in-place (2MSP) test, and strength assessed by dynamometry. A total of 151 patients were included in this observational study. Patients in the PI group obtained worse results compared to the PA group, and significant differences (p < 0.05) were found in all of the variables. Those COPD patients who regularly perform PA have less dyspnea and cough, as well as better functionality, exercise capacity and strength during an exacerbation, without relationship to the severity of the pathology.
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Affiliation(s)
- Laura López-López
- Faculty of health of Sciences, University of Granada, Granada 18016, Spain.
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94
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Physical Frailty and Cognitive Functioning in Korea Rural Community-Dwelling Older Adults. J Clin Med 2018; 7:jcm7110405. [PMID: 30384463 PMCID: PMC6262608 DOI: 10.3390/jcm7110405] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 01/16/2023] Open
Abstract
Cognitive frailty is a heterogeneous clinical manifestation characterized by the simultaneous presence of physical frailty and cognitive impairment. The objective of this study was to investigate the association between physical frailty and cognitive function in rural community-dwelling older Korean adults, taking four cognitive domains into account. We carried out a cross-sectional population-based study which enrolled 104 community-dwelling elderly. Physical frailty phenotype, as well as its individual criteria, were used. Cognitive functioning was examined in the four domains of memory, processing speed, cognitive flexibility, and working memory. Demographic data, lipid profile, muscle strength, physical function, and 25-hydroxyvitamin D (25[OH]D) concentration collected from questionnaire interviews and assessments were included. Of the 104 older adults (77% female), 24.3% were classified as robust, 49.6% as prefrail, and 16.5% as frail. Linear regression analyses showed that the severity of frailty index was associated with four cognitive domains Muscle strength (i.e., Grip strength, Knee extensor and flexor), physical function (i.e., SPPB and Gait speed), and 25[OH]D were associated with poorer cognitive function. Within our population of Korean rural community-dwelling older adults, physical frailty status, muscle strength, physical functions, and biochemical measurements were associated with poorer cognitive function. Synchronicity of physical frailty and cognitive dysfunction may contribute to the negative health-related effects associated with aging.
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95
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Forechi L, Silveira-Nunes G, Barbosa MA, Barbosa ÉG, Santos DLD, Vieira ER, Barbosa AC. Pain, balance, grip strength and gait parameters of older adults with and without post-chikungunya chronic arthralgia. Trop Med Int Health 2018; 23:1394-1400. [PMID: 30281868 DOI: 10.1111/tmi.13154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the levels of pain, grip strength, balance and gait in older adults with and without post-Chikungunya chronic arthralgia (PCCA). METHODS Sixty-two older adults, 30 with and 32 without PCCA participated in the study. Pain level was assessed using a Visual Analogue Scale (VAS). Gait during a 10-m walk was assessed using inertial sensors. Semi-static balance was assessed during an eyes-closed bipedal balance test on a force platform, and grip strength was assessed using a hand dynamometer. RESULTS Participants with PCCA presented severe levels of pain (VAS > 7.5), poorer balance, lower grip strength, walked slower, with lower cadence and stride length and higher stride time and stride length variability than participants without PCCA (P < 0.001 for all variables). CONCLUSIONS Older adults with PCCA had high levels of pain, impaired balance and gait and lower grip strength compared to older adults without PCCA.
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Affiliation(s)
- Ludimila Forechi
- Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Gabriela Silveira-Nunes
- Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Michelle Almeida Barbosa
- Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | | | | | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL, USA
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96
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Peos JJ, Helms ER, Fournier PA, Sainsbury A. Continuous versus intermittent moderate energy restriction for increased fat mass loss and fat free mass retention in adult athletes: protocol for a randomised controlled trial-the ICECAP trial (Intermittent versus Continuous Energy restriction Compared in an Athlete Population). BMJ Open Sport Exerc Med 2018; 4:e000423. [PMID: 30364484 PMCID: PMC6196972 DOI: 10.1136/bmjsem-2018-000423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction Reducing fat mass (FM) while retaining fat free mass (FFM) is a common goal of athletes. Evidence suggests that some-but not all-forms of intermittent energy restriction (IER) may be superior to the conventional method of continuous energy restriction (CER) for people with excess body fat that are sedentary, by reducing some of the adaptive responses to ER. However, it is yet to be established whether this dietary approach is effective for athletes. Methods and analysis A single-blind, parallel group, randomised controlled trial with a 1:1 allocation ratio is proposed. Sixty healthy athletes aged ≥18 years will be recruited from local sporting facilities and randomised to an intervention of either moderate CER (mCER) or moderate IER (mIER). Both interventions will consist of 12 weeks of moderate ER, plus 3 weeks in energy balance (EB). The mCER intervention will entail 12 weeks of continuous moderate ER, followed by 3 weeks in EB. The mIER intervention will entail 12 weeks of moderate ER, administered as 4×3 week blocks of moderate ER, interspersed with 3×1 week blocks of EB. The co-primary outcomes are changes in FM and FFM after 12 weeks of moderate ER. Secondary outcomes will be changes in FM and FFM at 15 weeks after intervention commencement, as well as muscle performance, physical activity, sleep quality, changes in resting energy expenditure, subjective drive to eat, circulating concentrations of appetite-regulating hormones, mood states and diet acceptability. Trial registration ACTRN12618000638235p.
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Affiliation(s)
- Jackson J Peos
- School of Human Sciences, The University of Western Australia (UWA), Crawley, Western Australia, Australia
| | - Eric R Helms
- Sports Performance Institute New Zealand (SPRINZ), Auckland University of Technology, at AUT Millennium, Auckland, New Zealand
| | - Paul A Fournier
- School of Human Sciences, The University of Western Australia (UWA), Crawley, Western Australia, Australia
| | - Amanda Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
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97
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Gellhorn AC, Stumph JM, Zikry HE, Creelman CA, Welbel R. Ultrasound measures of muscle thickness may be superior to strength testing in adults with knee osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2018; 19:350. [PMID: 30261863 PMCID: PMC6161398 DOI: 10.1186/s12891-018-2267-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022] Open
Abstract
Background Evaluation of muscle strength as performed routinely with a dynamometer may be limited by important factors such as pain during muscle contraction. Few studies have compared formal strength testing with ultrasound to measure muscle bulk in adults with knee osteoarthritis (OA). Methods We investigated the muscle bulk of lower limb muscles in adults with knee OA using quantitative ultrasound. We analyzed the relationship between patient reported function and the muscle bulk of hip adductors, hip abductors, knee extensors and ankle plantarflexors. We further correlated muscle bulk measures with joint torques calculated with a hand held dynamometer. We hypothesized that ultrasound muscle bulk would have high levels of interrater reliability and correlate more strongly with pain and function than strength measured by a dynamometer. 23 subjects with unilateral symptomatic knee OA completed baseline questionnaires including the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Lower Extremity Activity Scale. Joint torque was measured with a dynamometer and muscle bulk was assessed with ultrasound. Results Higher ultrasound measured muscle bulk was correlated with less pain in all muscle groups. When comparing muscle bulk and torque measures, ultrasound-measured muscle bulk of the quadriceps was more strongly correlated with measures of pain and function than quadriceps isometric strength measured with a dynamometer. Conclusions Ultrasound is a feasible method to assess muscle bulk of lower limb muscles in adults with knee OA, with high levels of interrater reliability, and correlates negatively with patient reported function. Compared with use of a hand held dynamometer to measure muscle function, ultrasound may be a superior modality.
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Affiliation(s)
- Alfred C Gellhorn
- Department of Rehabilitation Medicine, Weill Cornell Medicine, 525 E 68th Street, B16, New York, NY, 10065, USA.
| | | | - Hashem E Zikry
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carly A Creelman
- Department of Rehabilitation Medicine, Weill Cornell Medicine, 525 E 68th Street, B16, New York, NY, 10065, USA
| | - Rachel Welbel
- Department of Rehabilitation Medicine, Weill Cornell Medicine, 525 E 68th Street, B16, New York, NY, 10065, USA
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98
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Yeung SSY, Reijnierse EM, Trappenburg MC, Hogrel JY, McPhee JS, Piasecki M, Sipila S, Salpakoski A, Butler-Browne G, Pääsuke M, Gapeyeva H, Narici MV, Meskers CGM, Maier AB. Handgrip Strength Cannot Be Assumed a Proxy for Overall Muscle Strength. J Am Med Dir Assoc 2018; 19:703-709. [PMID: 29935982 DOI: 10.1016/j.jamda.2018.04.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/04/2018] [Accepted: 04/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Dynapenia, low muscle strength, is predictive for negative health outcomes and is usually expressed as handgrip strength (HGS). Whether HGS can be a proxy for overall muscle strength and whether this depends on age and health status is controversial. This study assessed the agreement between HGS and knee extension strength (KES) in populations differing in age and health status. DESIGN Data were retrieved from 5 cohorts. SETTING AND PARTICIPANTS Community, geriatric outpatient clinics, and a hospital. Five cohorts (960 individuals, 49.8% male) encompassing healthy young and older individuals, geriatric outpatients, and older individuals post hip fracture were included. MEASURES HGS and KES were measured according to the protocol of each cohort. Pearson correlation was performed to analyze the association between HGS and KES, stratified by sex. HGS and KES were standardized into sex-specific z scores. The agreement between standardized HGS and standardized KES at population level and individual level were assessed by intraclass correlation coefficients (ICC) and Bland-Altman analysis. RESULTS Pearson correlation coefficients were low in healthy young (male: 0.36 to 0.45, female: 0.45) and healthy older individuals (male: 0.35 to 0.37, female: 0.44), and moderate in geriatric outpatients (male and female: 0.54) and older individuals post hip fracture (male: 0.44, female: 0.57) (P < .05, except for male older individuals post hip fracture [P = .07]). Intraclass correlation coefficient values were poor to moderate in all populations (ie, healthy young individuals [0.41, 0.45], healthy older individuals [0.37, 0.41, 0.44], geriatric outpatients [0.54], and older individuals post hip fracture [0.54]). Bland-Altman analysis showed that within the same population of age and health status, agreement between HGS and KES varied on individual level. CONCLUSIONS At both population and individual level, HGS and KES showed a low to moderate agreement independently of age and health status. HGS alone should not be assumed a proxy for overall muscle strength.
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Affiliation(s)
- Suey S Y Yeung
- Department of Human Movement Sciences, AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Department of Medicine and Aged Care, AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Marijke C Trappenburg
- Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands; Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | | | - Jamie S McPhee
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Mathew Piasecki
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital Centre, Derby, United Kingdom
| | - Sarianna Sipila
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | | | | | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Helena Gapeyeva
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Marco V Narici
- Institute of Physiology, Department of Biomedical Sciences, University of Padova, Podavo, Italy
| | - Carel G M Meskers
- Department of Human Movement Sciences, AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Department of Medicine and Aged Care, AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.
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99
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Yeung SSY, Reijnierse EM, Trappenburg MC, Blauw GJ, Meskers CGM, Maier AB. Knee extension strength measurements should be considered as part of the comprehensive geriatric assessment. BMC Geriatr 2018; 18:130. [PMID: 29859054 PMCID: PMC5984755 DOI: 10.1186/s12877-018-0815-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/11/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Comprehensive geriatric assessment (CGA) generally includes handgrip strength (HGS) as a measure of overall muscle strength that is associated with various health characteristics in geriatric outpatients. Whether this is also true for knee extension strength (KES) is yet unknown. This study aims to compare the associations between health characteristics from the CGA with both HGS and KES in geriatric outpatients. METHODS Data were retrieved from a cross-sectional study. A total of 163 community-dwelling older adults referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Health characteristics included physical, nutritional, social, psychological, diseases, cognitive, and behavioural factors. HGS and KES were assessed three times for each limb and the best performance was used for analysis. Sex-specific z-scores of HGS and KES were used to allow comparison of effect estimates. Associations between health characteristics with standardized HGS and KES were analysed with linear regression adjusted for age, sex and further adjustment for standardized KES (for model of HGS) or standardized HGS (for model of KES). RESULTS Physical, nutritional and psychological health characteristics were positively associated with both HGS and KES after adjustment for age and sex, with overall stronger associations with KES compared to HGS. All significant associations with HGS were lost after further adjustment for KES; significant associations with KES remained after further adjustment for HGS, except for nutritional characteristics. CONCLUSIONS Stronger associations of health characteristics with KES compared to HGS indicate its additional value and therefore inclusion of KES in the CGA is recommended.
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Affiliation(s)
- Suey S. Y. Yeung
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Marijke C. Trappenburg
- Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands
- Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Gerard J. Blauw
- Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Geriatrics, Bronovo Hospital, The Hague, The Netherlands
| | - Carel G. M. Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
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100
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Reliability of Shoulder Rotators Isometric Strength Test using a Novel Pulley Electromechanical Dynamometer. Influence of the Assessment Position. Asian J Sports Med 2018. [DOI: 10.5812/asjsm.60406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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