951
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Roi GS, Mosconi G, Totti V, Angelini ML, Brugin E, Sarto P, Merlo L, Sgarzi S, Stancari M, Todeschini P, La Manna G, Ermolao A, Tripi F, Andreoli L, Sella G, Anedda A, Stefani L, Galanti G, Di Michele R, Merni F, Trerotola M, Storani D, Nanni Costa A. Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients. World J Transplant 2018; 8:13-22. [PMID: 29507858 PMCID: PMC5829451 DOI: 10.5500/wjt.v8.i1.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/06/2017] [Accepted: 12/28/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the effect of a 12-mo supervised aerobic and resistance training, on renal function and exercise capacity compared to usual care recommendations.
METHODS Ninety-nine kidney transplant recipients (KTRs) were assigned to interventional exercise (Group A; n = 52) and a usual care cohort (Group B; n = 47). Blood and urine chemistry, exercise capacity, muscular strength, anthropometric measures and health-related quality of life (HRQoL) were assessed at baseline, and after 6 and 12 mo. Group A underwent a supervised training three times per week for 12 mo. Group B received only general recommendations about home-based physical activities.
RESULTS Eighty-five KTRs completed the study (Group A, n = 44; Group B, n = 41). After 12 mo, renal function remained stable in both groups. Group A significantly increased maximum workload (+13 W, P = 0.0003), V’O2 peak (+3.1 mL/kg per minute, P = 0.0099), muscular strength in plantar flexor (+12 kg, P = 0.0368), height in the countermovement jump (+1.9 cm, P = 0.0293) and decreased in Body Mass Index (-0.5 kg/m2, P = 0.0013). HRQoL significantly improved in physical function (P = 0.0019), physical-role limitations (P = 0.0321) and social functioning scales (P = 0.0346). No improvements were found in Group B.
CONCLUSION Twelve-month of supervised aerobic and resistance training improves the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Recommendations alone are not sufficient to induce changes in exercise capacity of KTRs. Our study is an example of collaborative working between transplant centres, sports medicine and exercise facilities.
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Affiliation(s)
- Giulio Sergio Roi
- Department of Education and Research, Isokinetic Medical Group, Bologna 40123, Italy
| | - Giovanni Mosconi
- Department of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
| | - Valentina Totti
- Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna 40121, Italy
- Associazione Nazionale Emodializzati, Dialisi e Trapianto, Milano 20121, Italy
| | - Maria Laura Angelini
- Department of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
| | - Erica Brugin
- Department of Cardiovascular, Sports Medicine, Noale 30033, Italy
| | | | - Laura Merlo
- Sports Medicine, ULSS Company 9, Treviso 31100, Italy
| | - Sergio Sgarzi
- Sports Medicine, Regional Hospital of Bologna, Bologna 40121, Italy
| | - Michele Stancari
- Sports Medicine, Regional Hospital of Bologna, Bologna 40121, Italy
| | - Paola Todeschini
- Department of Nephrology and Dialysis, S. Orsola Hospital, Bologna 40121, Italy
| | - Gaetano La Manna
- Department of Nephrology and Dialysis, S. Orsola Hospital, Bologna 40121, Italy
| | - Andrea Ermolao
- Sports Medicine Unit DIMED, Department of Medicine, University of Padua, Padua 35100, Italy
| | - Ferdinando Tripi
- Sports Medicine, Regional Hospital of Modena, Modena 41100, Italy
| | - Lucia Andreoli
- Sports Medicine, Regional Hospital of Modena, Modena 41100, Italy
| | - Gianluigi Sella
- Sports Medicine, Regional Hospital of Ravenna, Ravenna 48121, Italy
| | - Alberto Anedda
- Sports Medicine, Regional Hospital of Parma, Parma 43121, Italy
| | - Laura Stefani
- Department of Experimental and Clinical Medicine, School of Sports Medicine, University of Florence, Sports Medicine Centre, Florence 50100, Italy
| | - Giorgio Galanti
- Department of Experimental and Clinical Medicine, School of Sports Medicine, University of Florence, Sports Medicine Centre, Florence 50100, Italy
| | - Rocco Di Michele
- Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna 40121, Italy
| | - Franco Merni
- Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna 40121, Italy
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952
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Lera L, Albala C, Leyton B, Márquez C, Angel B, Saguez R, Sánchez H. Reference values of hand-grip dynamometry and the relationship between low strength and mortality in older Chileans. Clin Interv Aging 2018; 13:317-324. [PMID: 29503536 PMCID: PMC5826209 DOI: 10.2147/cia.s152946] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim This study was aimed to set reference values of hand-grip strength by age and sex and validate cut points for risk of functional limitation and mortality in older Chileans. Methods This was a pooled analysis of four studies including 6,426 people ≥60 years of nondependent community-dwelling Chileans. After exclusion criteria, the final sample included 5,250 subjects, from whom 2,193 were followed to study all-cause mortality associated with low hand-grip strength. Face-to-face interviews registering sociodemographic characteristics, self-reported chronic diseases, and functional limitations were conducted. Anthropometric measurements and observed mobility were performed by trained professionals. Hand-grip strength was measured with a hand dynamometer T-18 (Country Technology, Inc.) before 2008 or with JAMAR brand from 2008 onwards. Percentiles were calculated through descriptive analysis and quantile regression models for specific groups of age and sex. Adjusted Cox regression hazard models for mortality risk according to low dynamometry condition and covariates were developed. Results We deliver reference values of hand-grip strength for older Chileans proposing the 25th percentile as the cut-off point for low dynamometry risk: men ≤27 kg, women ≤15 kg. Low hand-grip strength was associated with Instrumental Activities of Daily Living limitations (p=0.001), and altered physical performance evaluated through the Timed Up and Go test (p=0.0001), grasping (p=0.001), bending (p<0.0001), and lifting (p<0.0001). After Cox proportional hazard regression models were assessed with a median follow-up of 9.2 years, the adjusted risk of all-cause mortality associated with a hand-grip strength lower than the 25th percentile in older Chileans showed a hazard ratio of 1.39 (95% confidence interval: 1.13–1.71). Conclusion The cut-off points of dynamometry validated for the older Chileans allow the incorporation in the geriatric evaluation in primary health care of an easy-to-use, inexpensive indicator to identify older adults at risk of sarcopenia, frailty, and dismobility. In addition this also helps to optimize the evaluation of intervention strategies focused on the maintenance of functionality.
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Affiliation(s)
- Lydia Lera
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Cecilia Albala
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Bárbara Leyton
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Carlos Márquez
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Bárbara Angel
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Rodrigo Saguez
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Hugo Sánchez
- Public Health Nutrition Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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953
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Selvamani Y, Arokiasamy P, Chaudhary M, Himanshu. Association of sleep problems and sleep duration with self-rated health and grip strength among older adults in India and China: results from the study on global aging and adult health (SAGE). J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0906-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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954
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Li D, Guo G, Xia L, Yang X, Zhang B, Liu F, Ma J, Hu Z, Li Y, Li W, Jiang J, Gaisano H, Shan G, He Y. Relative Handgrip Strength Is Inversely Associated with Metabolic Profile and Metabolic Disease in the General Population in China. Front Physiol 2018; 9:59. [PMID: 29459831 PMCID: PMC5807728 DOI: 10.3389/fphys.2018.00059] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 01/17/2018] [Indexed: 01/24/2023] Open
Abstract
Background: Absolute handgrip strength has been correlated with metabolic profile and metabolic disease. Whether relative handgrip strength is also associated with metabolic disease has not been assessed. This study aimed at assessing the association of relative handgrip strength with metabolic profile and metabolic disease in the general population in China. Methods: Data were derived from an ongoing cross-sectional survey of the 2013 National Physical and Health in Shanxi Province, which involved 5520 participants. Multiple linear regression or multiple logistic regression analysis were used to assess the association of absolute/relative handgrip strength with the metabolic profile, preclinical, and established stages of metabolic diseases. Results: This study revealed that relative handgrip strength, that is when normalized to BMI, was associated with: (1) in both genders for more favorable blood lipid levels of high-density lipoprotein cholesterol [males: b = 0.19 (0.15, 0.23); females: b = 0.22 (0.17, 0.28)], low-density lipoprotein cholesterol [males: b = −0.14 (−0.23, −0.05); females: b = −0.19 (−0.31, −0.18)], triglycerides [males: b = −0.58 (−0.74, −0.43); females: b = −0.55 (−0.74, −0.36)] and total cholesterol [males: b = −0.20 (−0.31, −0.10); females: b = −0.19 (−0.32, −0.06)]; and better serum glucose levels in males [b = −0.30 (−0.46, −0.15)]. (2) lower risk of impaired fasting glucose in males {third quartile [OR = 0.66 (0.45–0.95)] and fourth quartile [OR = 0.46 (0.30–0.71)] vs. first quartile} and dyslipidemia in both genders {third quartile [males: OR = 0.65 (0.48–0.87); females: OR = 0.68 (0.53–0.86)] and fourth quartile [males: OR = 0.47 (0.35–0.64); females: OR = 0.47(0.36–0.61)] vs. first quartile}. (3) lower risk of hyperlipidemia in both genders third quartile [males: OR = 0.66 (0.50–0.87); females: OR = 0.57 (0.43–0.75)] and fourth quartile [males: OR = 0.35 (0.26–0.47); females: OR = 0.51 (0.38–0.70)] vs. first quartile. However, contrary to relative handgrip strength, higher absolute handgrip strength was associated with unfavorable metabolic profiles and higher risk of metabolic diseases. These paradoxical associations were retained even after adjusted for BMI by employed a multivariate analysis. Conclusion: We conclude that measurement of relative handgrip strength can be used as a reasonable clinical predictor of metabolic health and disease.
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Affiliation(s)
- Dongxue Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Guanghong Guo
- Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, China
| | - Lili Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xinghua Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Biao Zhang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Liu
- Shanxi Provincial Disease Prevention and Control Center, Xi'an, China
| | - Jingang Ma
- Shanxi Provincial Disease Prevention and Control Center, Xi'an, China
| | - Zhiping Hu
- Shanxi Provincial Disease Prevention and Control Center, Xi'an, China
| | - Yajun Li
- Shanxi Provincial Disease Prevention and Control Center, Xi'an, China
| | - Wei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jiajia Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Herbert Gaisano
- Departments of Medicine and Physiology, University of Toronto, Toronto, ON, Canada
| | - Guangliang Shan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan He
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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955
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Abstract
The good news is that a growing body of evidence recognizes resistance training as foundational to long-term physical development. Original research and reviews published in 2017 conclude that early exposure to developmentally appropriate resistance training can improve markers of health, increase muscular fitness, enhance physical literacy, and reduce the risk of injury in young athletes. Although the papers discussed in the commentary add to our understanding of the pleiotropic benefits of youth resistance training, they also raise concerns. As measures of muscular strength and power have been found to track from childhood to adulthood, the bad news is that youth with low levels of muscular fitness tend to become weak adults who are at increased risk for functional limitations and adverse health outcomes. Furthermore, global participation in youth resistance training is falling far short of public health recommendations, and these ugly trends will likely impact the health and well-being of future generations. A change in current attitudes and common practices is urgently needed to educate parents, practitioners, and clinicians about the potential benefits of resistance training for all children and adolescents, not only young athletes.
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956
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Strasser B, Volaklis K, Fuchs D, Burtscher M. Role of Dietary Protein and Muscular Fitness on Longevity and Aging. Aging Dis 2018; 9:119-132. [PMID: 29392087 PMCID: PMC5772850 DOI: 10.14336/ad.2017.0202] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/02/2017] [Indexed: 12/21/2022] Open
Abstract
Muscle atrophy is an unfortunate effect of aging and many diseases and can compromise physical function and impair vital metabolic processes. Low levels of muscular fitness together with insufficient dietary intake are major risk factors for illness and mortality from all causes. Ultimately, muscle wasting contributes significantly to weakness, disability, increased hospitalization, immobility, and loss of independence. However, the extent of muscle wasting differs greatly between individuals due to differences in the aging process per se as well as physical activity levels. Interventions for sarcopenia include exercise and nutrition because both have a positive impact on protein anabolism but also enhance other aspects that contribute to well-being in sarcopenic older adults, such as physical function, quality of life, and anti-inflammatory state. The process of aging is accompanied by chronic immune activation, and sarcopenia may represent a consequence of a counter-regulatory strategy of the immune system. Thereby, the kynurenine pathway is induced, and elevation in the ratio of kynurenine to tryptophan concentrations, which estimates the tryptophan breakdown rate, is often linked with inflammatory conditions and neuropsychiatric symptoms. A combined exercise program consisting of both resistance-type and endurance-type exercise may best help to ameliorate the loss of skeletal muscle mass and function, to prevent muscle aging comorbidities, and to improve physical performance and quality of life. In addition, the use of dietary protein supplementation can further augment protein anabolism but can also contribute to a more active lifestyle, thereby supporting well-being and active aging in the older population.
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Affiliation(s)
- Barbara Strasser
- Division of Medical Biochemistry, Biocenter, Medical University Innsbruck, Austria
| | | | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Medical University Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, Medical Section, University Innsbruck, Austria
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957
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Dor-Haim H, Barak S, Horowitz M, Yaakobi E, Katzburg S, Swissa M, Lotan C. Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial. PLoS One 2018; 13:e0188551. [PMID: 29377893 PMCID: PMC5788332 DOI: 10.1371/journal.pone.0188551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Exercise is considered a valuable nonpharmacological intervention modality in cardiac rehabilitation (CR) programs in patients with ischemic heart disease. The effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac patients' with reduced left ventricular function, post-myocardial infarction (MI) has not been thoroughly investigated. Aim of study to improve cardiac function with a novel method of combined aerobic-resistance circuit training in a randomized control trial by way of comparing the effectiveness of continuous aerobic training (CAT) to SCT on mechanical cardiac function. Secondary to compare their effect on aerobic fitness, manual strength, and quality of life in men post MI. Finally, to evaluate the safety and feasibility of SCT. Methods 29 men post-MI participants were randomly assigned to either 12-weeks of CAT (n = 15) or SCT (n = 14). Both groups, CAT and SCT exercised at 60%-70% and 75–85% of their heart rate reserve, respectively. The SCT group also engaged in intermittently combined resistance training. Primary outcome measure was echocardiography. Secondary outcome measures were aerobic fitness, strength, and quality of life (QoL). The effectiveness of the two training programs was examined via paired t-tests and Cohen's d effect size (ES). Results Post-training, only the SCT group presented significant changes in echocardiography (a reduction in E/e' and an increase in ejection fraction, P<0.05). Similarly, only the SCT group presented significant changes in aerobic fitness (an increase in maximal metabolic equivalent, P<0.05). In addition, SCT improvement in the physical component of QoL was greater than this observed in the CAT group. In both training programs, no adverse events were observed. Conclusion Men post-MI stand to benefit from both CAT and SCT. However, in comparison to CAT, as assessed by echocardiography, SCT may yield greater benefits to the left ventricle mechanical function as well as to the patient's aerobic fitness and physical QoL. Moreover, the SCT program was found to be feasible as well as safe.
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Affiliation(s)
- Horesh Dor-Haim
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
- * E-mail:
| | - Sharon Barak
- The Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Ramat Gan, Israel
- Kaye Academic College of Education, Beer-Sheba, Israel
| | - Michal Horowitz
- Department of Physiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eldad Yaakobi
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Sara Katzburg
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Moshe Swissa
- Cardiac Research Center, Kaplan Medical Center, Rehovot, Israel
| | - Chaim Lotan
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
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958
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High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure. Heart Vessels 2018; 33:752-759. [DOI: 10.1007/s00380-018-1120-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 01/05/2018] [Indexed: 12/25/2022]
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959
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Suwa M, Imoto T, Kida A, Yokochi T, Iwase M, Kozawa K. Association of body flexibility and carotid atherosclerosis in Japanese middle-aged men: a cross-sectional study. BMJ Open 2018; 8:e019370. [PMID: 29306892 PMCID: PMC5781189 DOI: 10.1136/bmjopen-2017-019370] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study examined the associations of body flexibility with carotid arterial remodelling, including intima-media thickness (IMT) and plaque formation in middle-aged men. METHODS The subjects of this cross-sectional study included 1354 Japanese men aged 35-59 years without histories of stroke or cardiac diseases. The arm extensibility test, which can estimate flexibility of the upper extremity (composed of shoulder external rotation and forearm supination), and the sit-and-reach test were performed. Common carotid IMT and plaque formation (≥1.1 mm) were estimated by ultrasound. RESULTS The proportion of subjects who fully completed the arm extensibility test was 55.0%, and who had plaques in the common carotid artery was 37.8%. IMT was associated with poor arm extensibility (β=-0.073, 95% CI -0.02224 to -0.00041, P=0.004), while plaque formation was associated with poor sit-and-reach (OR 0.98579, 95% CI 0.97257 to 0.99919, P=0.038) after adjustment by all covariates. CONCLUSIONS This study demonstrated that poor upper extremity and trunk flexibility were associated with characteristics of early onset of atherosclerosis. Furthermore, these associations were independent of covariates such as age, blood pressure, blood lipids glucose levels and abdominal fat accumulation, handgrip strength and lifestyle, including sleeping, drinking, exercise and smoking habits. Poor flexibility may reflect subclinical atherosclerosis in middle-aged men.
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Affiliation(s)
- Masataka Suwa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takayuki Imoto
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Akira Kida
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
| | - Takashi Yokochi
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
- Midtown Clinic Meieki, Nagoya, Japan
| | | | - Kenji Kozawa
- Health Support Center WELPO, Toyota Motor Corporation, Toyota, Japan
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960
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Melgaard D, Baandrup U, Bøgsted M, Bendtsen MD, Hansen T. Rehospitalisation and mortality after hospitalisation for orapharyngeal dysphagia and community-acquired pneumonia: A 1-year follow-up study. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2017.1417668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Dorte Melgaard
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Bøgsted
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Dahl Bendtsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Tina Hansen
- Department of Physical and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
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961
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Duchowny KA, Clarke PJ, Peterson MD. Muscle Weakness and Physical Disability in Older Americans: Longitudinal Findings from the U.S. Health and Retirement Study. J Nutr Health Aging 2018; 22:501-507. [PMID: 29582889 PMCID: PMC6472265 DOI: 10.1007/s12603-017-0951-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPORTANCE Muscle weakness is an important indicator of disability, chronic disease and mortality. While we recently proposed sex/race specific grip strength cutpoints for clinical muscle weakness in a diverse, nationally representative sample of older Americans, the extent to which these cutpoints predict physical disability remains unknown. OBJECTIVE To examine whether sex/race specific muscle weakness cutpoints predict physical disability status in a nationally representative sample of Americans age 65+. DESIGN We used data from the 2006-2010 Health and Retirement Study. Fully-adjusted, weighted multinomial logistic regression models were used to quantify the odds of experiencing the onset, progression or persistence of disability in activities of daily living (ADL) among weak versus non-weak individuals over a 2-year period. SETTING General community, nationally representative sample of older Americans. PARTICIPANTS Population-based, community dwelling sample of older American adults aged 65-years+; 57 percent were women, 91% were White and the mean age was 75 years. Main Outcome(s) and Measure(s): The primary outcome of interest was disability dynamics, defined by changes in ADL status across at 2- year period. The primary exposure was clinical muscle weakness as defined by previously identified cutpoints. Hypotheses were formulated before analyses were conducted. RESULTS In this nationally representative sample (n= 8,725), 44% of individuals were classified as weak at baseline. At follow-up, 55% remained independent with no change in their ADL status, 11% had an onset of disability and 4% progressed in their disability status. The odds of experiencing an onset of ADL disability was 54% higher among weak individuals compared those who were not weak at baseline (OR= 1.54, 95% CI= 1.54, 1.5, p<.0001); the odds of experiencing a progression in physical disability status was 2.16 times higher among those who were weak at baseline compared to non-weak individuals (OR= 2.16, 95% CI= 2.15, 2.16, p<.0001). CONCLUSIONS This is the first study to use grip strength weakness cut-points to identify those who may be at greatest risk for experiencing physical disability in later life. Results underscore the importance of using population-specific cutpoints for clinical weakness in order to identify individuals at greatest risk for adverse health outcomes.
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Affiliation(s)
- K A Duchowny
- Kate Duchowny, MPH, University of Michigan School of Public Health, Department of Epidemiology, Center for Social Epidemiology and Population health, 1415 Washington Heights, 3rd Flower Tower, Ann Arbor, Michigan 48109, Phone: (734) 615-9209,
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962
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Lameijer CM, ten Duis HJ, Vroling D, Hartlief MT, El Moumni M, van der Sluis CK. Prevalence of posttraumatic arthritis following distal radius fractures in non-osteoporotic patients and the association with radiological measurements, clinician and patient-reported outcomes. Arch Orthop Trauma Surg 2018; 138:1699-1712. [PMID: 30317380 PMCID: PMC6224009 DOI: 10.1007/s00402-018-3046-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Outcomes of non-osteoporotic patients who sustained a distal radius fracture (DRF) have not gained much attention in recent literature. The aims of this study were to determine the prevalence of posttraumatic arthritis (PA), to analyze associations of radiological measurements, clinician-reported and patient-reported outcomes (CROs and PROs) with PA and gain insight into employment changes after DRF in non-osteoporotic patients. METHODS Non-osteoporotic patients following a DRF were selected. Radiographs of both wrists were obtained at follow-up and the degree of PA was determined. Radiological measurements consisted of grading of PA, ulnar variance, radial length, radial inclination, dorsal tilt, distal radio-ulnar joint width, scapholunate dissociation, step-off and gap. Active range of motion and grip strength measurements were performed and all patients filled in four questionnaires to assess pain, upper extremity functioning, and health status (Disability of Arm, Shoulder and Hand; Patient Reported Wrist Evaluation; Michigan Hand Questionnaire; Short Form-36). RESULTS Seventy-three patients (32 women, 41 men) with a mean age of 33.5 (SD 9.2) years were included. Prevalence of PA was 32% at a median follow-up of 62.0 months. Patients with PA had statistically significant longer radial length (1.1 mm, 95% CI - 2.1; - 0.0, p = 0.045). Patients with PA had a statistically significant diminished flexion/extension arc of motion (12.0°, p = 0.008) and ulnar/radial deviation arc of motion (6.3°, p = 0.018). When corrected for dominance, all grip strength measurements were not statistically significantly different between patients with and without PA. Statistically significant poorer PROs in patients with PA were the MHQ subscales general functioning (65 versus 75, p = 0.018), esthetics (94 versus 100, p = 0.037), satisfaction (75 versus 92, p = 0.042) and total score of the MHQ (83 versus 91, p = 0.044), as well as the SF-36 subscale physical functioning (95 versus 100, p = 0.028). In regression analyses the DASH, PRWE function and PRWE total were statistically significantly associated with flexion/extension arc of motion. Seven patients (10%) changed or left their occupation because of the DRF. CONCLUSION Non-osteoporotic patients had a considerably high prevalence of PA following DRFs, despite a relatively short follow-up time. Patients with longer radial length more often had PA. Irrespective of AO/OTA fracture type, patients with PA had diminished range of motion, but no altered grip strength measurements. Non-osteoporotic patients following DRFs perceived diminished general functioning and dissatisfaction, which was impacted by the diminished active range of motion. Pain or impaired general health status was not reported. The PRO MHQ might be a valuable evaluation tool in this patient group. Change of occupation following DRFs should receive attention in further research.
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Affiliation(s)
- C. M. Lameijer
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Postbox 30.001, Huispostcode BA51, 9700 RB Groningen, The Netherlands
| | - H. J. ten Duis
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Postbox 30.001, Huispostcode BA51, 9700 RB Groningen, The Netherlands
| | - D. Vroling
- Rehabilitation Center ‘Revalidatie Friesland’, Leeuwarden, The Netherlands
| | - M. T. Hartlief
- Rehabilitation Center ‘Revalidatie Friesland’, Leeuwarden, The Netherlands
| | - M. El Moumni
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Postbox 30.001, Huispostcode BA51, 9700 RB Groningen, The Netherlands
| | - C. K. van der Sluis
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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963
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Rossi VA, Schmied CM, Niederseer D. [Sports in Patients with Heart Disease: What Should Be Recommended?]. PRAXIS 2018; 107:585-591. [PMID: 29788848 DOI: 10.1024/1661-8157/a002993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sports in Patients with Heart Disease: What Should Be Recommended? Abstract. Sports is recommended in the European guidelines for the prevention and initial treatment of many cardiovascular diseases as well as the metabolic syndrome. However, the individually recommended intensity and duration of physical activity that unfolds the maximal protective effects in terms of prevention, largely differs. Indeed, a J-curve relationship with regard to exercise training has been postulated, with the assumption that too much sports is equally harmful or potentially even more harmful than too little sports. In this review, we try to answer the question of how much and which sports is optimal for cardiac patients.
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Affiliation(s)
- Valentina Alice Rossi
- 1 Universitäres Herzzentrum Zürich, Klinik für Kardiologie, Universitätsspital Zürich
| | - Christian M Schmied
- 1 Universitäres Herzzentrum Zürich, Klinik für Kardiologie, Universitätsspital Zürich
| | - David Niederseer
- 1 Universitäres Herzzentrum Zürich, Klinik für Kardiologie, Universitätsspital Zürich
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964
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Shai O. Is retirement good for men's health? Evidence using a change in the retirement age in Israel. JOURNAL OF HEALTH ECONOMICS 2018; 57:15-30. [PMID: 29179026 DOI: 10.1016/j.jhealeco.2017.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/09/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
This study examines the effect of employment on elderly men's health. A typical OLS analysis yields a positive relationship between employment and health for individuals in their sixties. Causality, however, is difficult to infer because healthier individuals are more capable of working than others. To overcome this endogeneity problem, this paper exploits the increase in the full retirement age for men in Israel from sixty-five to sixty-seven in 2004. After this change, the employment rate of men in this age bracket jumped significantly compared to the last cohort that was able to retire at sixty-five. Using the new retirement law as an exogenous source of variation in the employment status of elderly men, a significant causal relationship in the opposite direction of the correlation is found: employment at older ages impairs health. These findings are found across a broad array of datasets and health outcomes. The results are significantly stronger among less-educated workers, suggesting that employment in physically demanding occupations is more detrimental to health. Placebo analyses using the years preceding the new retirement regime and other health measures unrelated to employment (e.g., dentist visits) reinforce a causal interpretation of my main findings.
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Affiliation(s)
- Ori Shai
- Department of Economics, The Hebrew University of Jerusalem, Mount Scopus Campus, Jerusalem, 91905 Israel.
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965
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Bertoni M, Maggi S, Weber G. Work, retirement, and muscle strength loss in old age. HEALTH ECONOMICS 2018; 27:115-128. [PMID: 28512845 DOI: 10.1002/hec.3517] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 06/07/2023]
Abstract
Reduced muscle strength is an accurate predictor of functional limitations, disability, and mortality. Hence, understanding which socio-economic factors contribute to preserve muscle strength in old age is central to the design of social policies that help reducing these health risks. Using data on handgrip strength collected by the Survey of Health, Ageing and Retirement in Europe for the population of Europeans aged 50+ and the exogenous variation in pension eligibility age across countries over time, we estimate that the retirement transition has a short-term positive causal effect on muscle strength. However, this protective effect is not persistent, as retirement speeds up the age-related trend in muscle strength loss, especially for blue-collar workers and males. The "holy grail" of early retirement may not be such a good deal for retirees' longevity and physical functioning late in life.
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Affiliation(s)
- Marco Bertoni
- Department of Economics and Management "Marco Fanno", University of Padua, Padua, Italy
| | - Stefania Maggi
- Institute of Neuroscience, Italian National Research Council, Padua, Italy
| | - Guglielmo Weber
- Department of Economics and Management "Marco Fanno", University of Padua, Padua, Italy
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966
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Keevil VL, Luben R, Hayat S, Sayer AA, Wareham NJ, Khaw KT. Physical capability predicts mortality in late mid-life as well as in old age: Findings from a large British cohort study. Arch Gerontol Geriatr 2018; 74:77-82. [PMID: 29040888 PMCID: PMC5701965 DOI: 10.1016/j.archger.2017.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Low physical capability predicts mortality, perhaps by association with co-morbidity. However, few studies include participants <70years old with lower co-morbidity burdens compared to older adults. We examined relationships between usual walking speed (UWS), timed chair stands speed, grip strength, standing balance and all-cause mortality in 8477 participants aged 48-92years enrolled in the European Prospective Investigation of Cancer-Norfolk study. METHODS Participants (55.1% female) were followed up for 6.0 years (inter-quartile range 4.6, 7.5). Associations were examined using Cox proportional hazards regression by age-group (<70years versus ≥70years) and then in the whole cohort adjusted for age, sex, anthropometry, history of diabetes/stroke/myocardial infarction/cancer, smoking, alcohol intake, socioeconomic status, television viewing time and physical activity. RESULTS Age and sex adjusted associations were similar in younger and older participants (Pinteraction all >0.05) and those with lower physical capability had higher mortality risk. For example, in those <70years old hazard ratios (95% confidence interval) for mortality in the third, second and lowest sex-specific quartiles of UWS compared to the highest were 1.21 (0.75, 1.96), 2.11 (1.35, 3.28) and 2.91 (1.84, 4.62) and in participants ≥70years old were 1.19 (0.73, 1.95), 2.09 (1.35, 3.24) and 2.64 (1.73, 4.02) respectively. In the whole cohort, strong associations between all physical capability tests and mortality persisted after multivariable adjustment and after excluding participants with co-morbidity. CONCLUSIONS Physical capability was independently predictive of future mortality risk with similar associations in late mid-life, when co-morbidity burden is lower, as at older age.
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Affiliation(s)
- Victoria L Keevil
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, CB1 8RN, UK; Medicine for Older People, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK.
| | - Robert Luben
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, CB1 8RN, UK
| | - Shabina Hayat
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, CB1 8RN, UK
| | - Avan A Sayer
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, UK; AGE Research Group, Institute of Neuroscience and Institute for Ageing, Newcastle University, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Addenbrooke's Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge, CB1 8RN, UK
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967
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Ordan MA, Mazza C, Barbe C, Perrier M, Botsen D, Renard Y, Moreau J, Brasseur M, Taillière B, Bertin É, Bouché O. Feasibility of systematic handgrip strength testing in digestive cancer patients treated with chemotherapy: The FIGHTDIGO study. Cancer 2017; 124:1501-1506. [PMID: 29278424 DOI: 10.1002/cncr.31207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/06/2017] [Accepted: 11/28/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Handgrip strength (HGS) is a widely studied noninvasive test. Weak strength (dynapenia) seems to be associated with high morbidity and mortality in different populations, notably oncology populations. Despite this, HGS testing is not used in daily practice in oncology. The study was aimed at evaluating the feasibility and acceptability of HGS testing in patients with digestive cancer treated with ambulatory chemotherapy. METHODS In this prospective, single-center study, enrolled patients were followed for 6 months. Two consecutive bilateral measures were performed with a Jamar dynamometer during each patient's appointments in the unit for intravenous treatment. A questionnaire was completed by patients and medical team members. RESULTS There were 203 consecutive patients, and 201 were recruited. In all, 1704 of 1716 measurements (99.3%) were performed, and 201 patients (99.0%) performed at least 1 measure; 190 (94.5%) performed all expected measures. One hundred sixty-four of 171 participating patients (95.9%) found the test easy to perform, and 167 (97.7%) did not find the test restrictive. All of the 14 medical team members found the test easy to perform, unrestrictive, and undisruptive in their daily practice. CONCLUSIONS HGS testing is routinely feasible, inexpensive, and well accepted by patients and medical teams in an ambulatory digestive cancer unit. Cancer 2018;124:1501-6. © 2017 American Cancer Society.
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Affiliation(s)
| | - Camille Mazza
- Ambulatory Care Unit, Reims University Hospital, Reims, France
| | - Coralie Barbe
- Department of Biostatistics, Reims University Hospital, Reims, France
| | - Marine Perrier
- Ambulatory Care Unit, Reims University Hospital, Reims, France
| | - Damien Botsen
- Ambulatory Care Unit, Reims University Hospital, Reims, France
| | - Yohann Renard
- Department of General and Digestive Surgery, Reims University Hospital, Reims, France
| | - Johanna Moreau
- Ambulatory Care Unit, Reims University Hospital, Reims, France
| | - Mathilde Brasseur
- Ambulatory Care Unit, Reims University Hospital, Reims, France.,Department of Biostatistics, Reims University Hospital, Reims, France
| | | | - Éric Bertin
- Department of Nutrition, Endocrinology, and Diabetology, Reims University Hospital, Reims, France
| | - Olivier Bouché
- Ambulatory Care Unit, Reims University Hospital, Reims, France.,Department of Gastroenterology and Digestive Oncology, Reims University Hospital, Reims, France
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968
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Nutrition and Liver Disease. Nutrients 2017; 10:nu10010009. [PMID: 29295475 PMCID: PMC5793237 DOI: 10.3390/nu10010009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 12/13/2022] Open
Abstract
Malnutrition in children and adults with advanced liver disease represents a tremendous challenge as the nutritional problems are multifactorial. This Editorial comments the articles appearing in this special issue of Nutrients, “Nutrition and Liver disease” dealing with multiple diagnostic and therapeutic features that relate the outcomes of liver disease to nutrition. To improve quality of life and prevent nutrition-related medical complications, patients diagnosed with advanced liver disease should have their nutritional status promptly assessed and be supported by appropriate dietary interventions. Furthermore specific food supplements and/or restriction diets are often necessary for those with hepatic conditions associated with an underlying metabolic or nutritional or intestinal disease.
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969
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Makiura D, Ono R, Inoue J, Fukuta A, Kashiwa M, Miura Y, Oshikiri T, Nakamura T, Kakeji Y, Sakai Y. Impact of Sarcopenia on Unplanned Readmission and Survival After Esophagectomy in Patients with Esophageal Cancer. Ann Surg Oncol 2017; 25:456-464. [PMID: 29214454 DOI: 10.1245/s10434-017-6294-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although sarcopenia increases postoperative complications following esophagectomy, its effects on prognosis remain unclear. This study was performed to identify the effect of sarcopenia on 90-day unplanned readmission and overall survival (OS) after esophagectomy. METHODS Ninety-eight patients with esophageal cancer who underwent esophagectomy were enrolled in this study. Unplanned readmission was defined as any emergent hospitalization within 90 days after discharge. Sarcopenia, defined as low muscle mass plus low muscle strength and/or low physical performance according to the Asian consensus definition, was assessed prior to esophagectomy. Multivariate logistic regression analysis was performed to identify factors that contributed to 90-day unplanned readmission. OS was estimated using the Kaplan-Meier method, and a Cox proportional hazards model was used to assess the relationship between sarcopenia and OS. RESULTS Thirty-one patients (31.6%) were diagnosed with sarcopenia. The 90-day unplanned readmission rate was significantly higher in patients with sarcopenia than those without (42.9% vs. 16.4%, respectively; p = 0.01). Multivariable logistic regression analysis showed that sarcopenia was an independent predictor of 90-day unplanned readmission [odds ratio 3.71, 95% confidence interval (CI) 1.29-11.05; p = 0.02], and the log-rank test showed that sarcopenia was associated with OS (p = 0.01). Moreover, sarcopenia was a significant predictor of OS after adjustment for age, sex, and pathological stage (hazard ratio 2.35, 95% CI 1.21-4.54; p = 0.01). CONCLUSIONS Sarcopenia is a risk factor for 90-day unplanned readmission and OS following esophagectomy. Assessment of sarcopenia could help to identify patients at higher risk of a poor prognosis after esophagectomy.
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Affiliation(s)
- Daisuke Makiura
- Division of Rehabilitation, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Junichiro Inoue
- Division of Rehabilitation, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Akimasa Fukuta
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Miyuki Kashiwa
- Division of Rehabilitation, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yasushi Miura
- Division of Rehabilitation, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.,Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.,Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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970
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Predicting Age Using Neuroimaging: Innovative Brain Ageing Biomarkers. Trends Neurosci 2017; 40:681-690. [DOI: 10.1016/j.tins.2017.10.001] [Citation(s) in RCA: 386] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 11/16/2022]
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971
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Grøntved A, Hu FB. Walking pace and handgrip strength: simple measures of fitness and mortality risk? Eur Heart J 2017; 38:3241-3243. [PMID: 29020272 DOI: 10.1093/eurheartj/ehx497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Anders Grøntved
- Department of Sport Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Center of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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972
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Lameijer CM, Ten Duis HJ, Dusseldorp IV, Dijkstra PU, van der Sluis CK. Prevalence of posttraumatic arthritis and the association with outcome measures following distal radius fractures in non-osteoporotic patients: a systematic review. Arch Orthop Trauma Surg 2017; 137:1499-1513. [PMID: 28770349 PMCID: PMC5644687 DOI: 10.1007/s00402-017-2765-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The objective of this systematic review was to analyze (1) prevalence of radiological posttraumatic arthritis (PA), (2) associations of PA with outcome measures and (3) predictors of PA following distal radius fractures in non-osteoporotic patients. MATERIALS AND METHODS Nineteen studies were included (10 open source data). RESULTS In total, 733 patients were described with a weighted mean age of 37 years (range 25-54) at the time of the injury. Follow-up ranged from 13 months to 38 years. Overall prevalence of PA was 50% and 37% in the open source data. Radial deviation was significantly worse in patients with PA (N = 49, mean 14°, SD 6° versus N = 55, mean 17°, SD 6°, p = 0.037). No analysis could be performed regarding patient reported outcome measures, because of limited data. Articular incongruence was a significant predictor for PA. CONCLUSIONS A high prevalence of PA was found in non-osteoporotic patients following a distal radius fracture. PA following a distal radial fracture was associated with a limited radial deviation and flexion, but not with grip strength. Articular incongruence predicted PA. Patient reported outcome measures should be investigated more thoroughly to be able to understand the value of using these instruments in interpreting outcome in follow-up of non-osteoporotic patients following a distal radius fracture. LEVEL OF EVIDENCE Level of evidence 3 (Phillips et al. Levels of Evidence-Oxford Centre for Evidence-based Medicine, 1).
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Affiliation(s)
- C M Lameijer
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, 30.001, Huispostcode BA51, 9700 RB, Groningen, The Netherlands.
| | - H J Ten Duis
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, 30.001, Huispostcode BA51, 9700 RB, Groningen, The Netherlands
| | - I van Dusseldorp
- Medical Center Leeuwarden, MCL Academy, Leeuwarden, The Netherlands
| | - P U Dijkstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C K van der Sluis
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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973
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Martinez CH, Diaz AA, Meldrum CA, McDonald MLN, Murray S, Kinney GL, Hokanson JE, Curtis JL, Bowler RP, Han MK, Washko GR. Handgrip Strength in Chronic Obstructive Pulmonary Disease. Associations with Acute Exacerbations and Body Composition. Ann Am Thorac Soc 2017; 14:1638-1645. [PMID: 29090990 PMCID: PMC5711268 DOI: 10.1513/annalsats.201610-821oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/24/2017] [Indexed: 01/26/2023] Open
Abstract
RATIONALE Handgrip strength (HGS) predicts mortality in the elderly, but its determinants and clinical significance in chronic obstructive pulmonary disease (COPD) has not been defined. OBJECTIVES We tested associations of HGS with pectoralis muscle area (PMA), subcutaneous adipose tissue (SAT), imaging characteristics, and lung function in smokers with COPD, and evaluated the cross-sectional and longitudinal associations of HGS with acute respiratory events. METHODS We analyzed demographic, clinical, spirometry, HGS, and imaging data of 272 subjects with COPD, obtaining measures of airway thickness, emphysema, PMA, and SAT from chest computed tomography scans. We tested associations of lung function and imaging characteristics with HGS, using linear models. HGS association to acute respiratory events at enrollment and during follow-up (mean, 2.6 years) was analyzed using adjusted logistic models. RESULTS HGS correlated with PMA, SAT, forced expiratory volume, and airway thickness, but not with body mass index or emphysema severity. In adjusted regression models, HGS was directly (β, 1.5; 95% confidence interval [CI], 0.1-3.0) and inversely (β, -3.3; 95% CI, -5.1 to -0.9) associated with one standard deviation of PMA and SAT, respectively, independent of body mass index and emphysema. In regression models adjusted for age, sex, body mass index, race, pack-years smoked, current smoking, chronic bronchitis, FEV1% predicted, emphysema, and airway metrics, HGS was associated with exacerbation risk; in cross-sectional analyses, there was an increment of 5% in the risk of exacerbations for each 1-kg decrement in HGS (risk ratio, 1.05; 95% CI, 1.01-1.08), and there was a similar risk during follow-up (risk ratio, 1.04; 95% CI, 1.01-1,07). CONCLUSIONS In ever-smokers with COPD, HGS is associated with computed tomography markers of body composition and airway thickness, independent of body mass index and emphysema. Higher HGS is associated with lower exacerbation frequency.
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Affiliation(s)
- Carlos H. Martinez
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Catherine A. Meldrum
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | - Merry-Lynn N. McDonald
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan Murray
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | | | - John E. Hokanson
- School of Public Health, University of Colorado, Aurora, Colorado
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and
| | - Jeffrey L. Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | - Russell P. Bowler
- Division of Pulmonary Medicine, National Jewish Health, Denver, Colorado
| | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - for the COPDGene Investigators
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- School of Public Health, University of Michigan, Ann Arbor, Michigan
- School of Public Health, University of Colorado, Aurora, Colorado
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and
- Division of Pulmonary Medicine, National Jewish Health, Denver, Colorado
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974
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Granic A, Davies K, Jagger C, M. Dodds R, Kirkwood TBL, Sayer AA. Initial level and rate of change in grip strength predict all-cause mortality in very old adults. Age Ageing 2017; 46:970-976. [PMID: 28541466 PMCID: PMC5860048 DOI: 10.1093/ageing/afx087] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/11/2017] [Indexed: 01/12/2023] Open
Abstract
Objective to investigate the associations between initial level and rate of change in grip strength (GS) and all-cause mortality in very old adults (≥85 years) over a 9.6-year follow-up. Methods prospective mortality data from 845 participants in the Newcastle 85+ Study were analysed for survival in relation to GS (kg, baseline and 5-year mean change) using Cox proportional hazards models. Results during the follow-up, 636 (75.3%) participants died. Higher baseline GS was associated with a decreased risk of mortality in all participants [hazard ratio (HR) = 0.95, 95% confidence interval (CI): 0.93-0.98, P < 0.001], men (HR = 0.97, 95% CI: 0.95-0.99, P = 0.009) and women (HR = 0.96, 95% CI: 0.94-0.99, P = 0.007) after adjustment for health, lifestyle and anthropometric factors. Overall GS slope had a downward trajectory and was determined in 602 participants: 451 experienced constant decline (negative slope) and 151 had increasing GS (positive slope) over time. Men and women with a negative slope had a 16 and 33% increased risk of mortality, respectively, with every kg/year decline in GS (P ≤ 0.005), and participants with a positive slope had a 31% decreased risk of mortality (P = 0.03) irrespective of baseline GS and key covariates. Conclusion higher baseline GS and 5-year increase in GS were protective of mortality, whilst GS decline was associated with an increased risk of mortality in the very old over 9.6 years, especially in women. These results add to the biological and clinical importance of GS as a powerful predictor of long-term survival in late life.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- Institute of Health and Society, Newcastle University, Newcastle University, Newcastle upon Tyne, UK
| | - Richard M. Dodds
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Thomas B L Kirkwood
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- Institute for Cell and Molecular Biosciences, Newcastle University, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University Institute for Ageing, Newcastle upon Tyne, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care, Wessex, University of Southampton, Southampton, UK
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975
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Kamada M, Shiroma EJ, Buring JE, Miyachi M, Lee IM. Strength Training and All-Cause, Cardiovascular Disease, and Cancer Mortality in Older Women: A Cohort Study. J Am Heart Assoc 2017; 6:e007677. [PMID: 29089346 PMCID: PMC5721806 DOI: 10.1161/jaha.117.007677] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/26/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Few data exist on the association between strength training and mortality rates. We sought to examine the association between strength training and all-cause, cardiovascular disease, and cancer mortality. METHODS AND RESULTS Beginning in 2001 to 2005, 28 879 women throughout the United States (average baseline age, 62.2 years) from the Women's Health Study who were free of cardiovascular disease, diabetes mellitus, and cancer reported their physical activities, including strength training. During follow-up (average, 12.0 years) through 2015, investigators documented 3055 deaths (411 from cardiovascular disease and 748 from cancer). After adjusting for covariables, including aerobic activity, time in strength training showed a quadratic association with all-cause mortality (P=0.36 for linear trend; P<0.001 for quadratic trend); hazard ratios across 5 categories of strength training (0, 1-19, 20-59, 60-149, and ≥150 min/wk) were 1.0 (referent), 0.73 (95% confidence interval, 0.65-0.82), 0.71 (0.62-0.82), 0.81 (0.67-0.97), and 1.10 (0.77-1.56), respectively. A significant quadratic association was also observed for cardiovascular disease death (P=0.007) but not cancer death (P=0.41). Spline models also indicated a J-shaped nonlinear association for all-cause mortality (P=0.020); the point estimates of hazard ratios were <1.00 for 1 to 145 min/wk of strength training, compared with 0 min/wk, whereas hazard ratios were >1.00 for ≥146 min/wk of strength training. However, confidence intervals were wide at higher levels of strength training. CONCLUSIONS Time in strength training showed a J-shaped association with all-cause mortality in older women. A moderate amount of time in strength training seemed beneficial for longevity, independent of aerobic activity; however, any potential risk with more time (≈≥150 min/wk) should be further investigated.
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Affiliation(s)
- Masamitsu Kamada
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Physical Activity Research, National Institute of Health and Nutrition NIBIOHN, Shinjuku-ku, Tokyo, Japan
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Science, Intramural Research Program of the National Institutes of Health, National Institute on Aging, Bethesda, MD
| | - Julie E Buring
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition NIBIOHN, Shinjuku-ku, Tokyo, Japan
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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976
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Peterson MD, Duchowny K, Meng Q, Wang Y, Chen X, Zhao Y. Low Normalized Grip Strength is a Biomarker for Cardiometabolic Disease and Physical Disabilities Among U.S. and Chinese Adults. J Gerontol A Biol Sci Med Sci 2017; 72:1525-1531. [PMID: 28329157 PMCID: PMC5861974 DOI: 10.1093/gerona/glx031] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/15/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Evidence highlights the importance of muscular strength as a protective factor for health and function across aging populations. The purpose of this study was to examine the extent to which low normalized grip strength (NGS) serves as a biomarker for both cardiometabolic disease and physical disability in U.S. and Chinese adults. METHODS Middle aged and older adults from the U.S. National Health and Nutrition Examination Survey 2011-2012 and 2013-2014 combined surveys (n = 4,544), and the 2011 wave of the China Health and Retirement Longitudinal Study (n = 6,030) were included. Strength was assessed using a handgrip dynamometer, and was normalized to body mass. Weighted logistic regression models were used to assess the association between NGS and diabetes, hyperglycemia, hypertriglyceridemia, low HDL-cholesterol, hypertension, and physical disability status, while controlling for age, sex, and sociodemographic characteristics. RESULTS Every 0.05 lower NGS was independently associated with a 1.49 (95% confidence interval [CI]: 1.42-1.56) and 1.17 (95% CI: 1.11-1.23) odds for diabetes; a 1.46 (95% CI: 1.39-1.53) and 1.11 (95% CI: 1.07-1.15) odds of hyperglycemia; a 1.15 (95% CI: 1.07-1.25) and 1.11 (95% CI: 1.08-1.14) odds of hypertriglyceridemia; a 1.22 (95% CI: 1.17-1.27) and 1.15 (95% CI: 1.12-1.18) odds of low HDL-cholesterol; a 1.19 (95% CI: 1.14-1.24) and 1.10 (95% CI: 1.07-1.14) odds of hypertension; and a 1.36 (95% CI: 1.29-1.42) and 1.10 (95% CI: 1.05-1.15) odds for physical disability status in U.S. and Chinese adults, respectively. CONCLUSIONS NGS was robustly associated with both cardiometabolic disease risk and physical disabilities in U.S. and Chinese aging adults.
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Affiliation(s)
- Mark D Peterson
- Department of Physical Medicine & Rehabilitation, University of Michigan Health System, Ann Arbor
- Global REACH, University of Michigan Medical School, Ann Arbor
| | - Kate Duchowny
- School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor
| | | | | | | | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
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977
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Toigo M, Flück M, Riener R, Klamroth-Marganska V. Robot-assisted assessment of muscle strength. J Neuroeng Rehabil 2017; 14:103. [PMID: 29020968 PMCID: PMC5637351 DOI: 10.1186/s12984-017-0314-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/03/2017] [Indexed: 11/14/2022] Open
Abstract
Impairment of neuromuscular function in neurological disorders leads to reductions in muscle force, which may lower quality of life. Rehabilitation robots that are equipped with sensors are able to quantify the extent of muscle force impairment and to monitor a patient during the process of neurorehabilitation with sensitive and objective assessment methods. In this article, we provide an overview of fundamental aspects of muscle function and how the corresponding variables can be quantified by means of meaningful robotic assessments that are primarily oriented towards upper limb neurorehabilitation. We discuss new concepts for the assessment of muscle function, and present an overview of the currently available systems for upper limb measurements. These considerations culminate in practical recommendations and caveats for the rational quantification of force magnitude, force direction, moment of a force, impulse, critical force (neuromuscular fatigue threshold) and state and trait levels of fatigue.
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Affiliation(s)
- Marco Toigo
- Laboratory for Muscle Plasticity, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
| | - Martin Flück
- Laboratory for Muscle Plasticity, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology ETH Zurich, Zurich, Switzerland.,Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Verena Klamroth-Marganska
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology ETH Zurich, Zurich, Switzerland. .,Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
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978
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Chasing the top quartile of cross-sectional data: Is it possible with resistance training? Med Hypotheses 2017; 108:63-68. [DOI: 10.1016/j.mehy.2017.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/21/2017] [Accepted: 08/06/2017] [Indexed: 02/02/2023]
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979
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Marques-Vidal P, Vollenweider P, Waeber G, Jornayvaz FR. Grip strength is not associated with incident type 2 diabetes mellitus in healthy adults: The CoLaus study. Diabetes Res Clin Pract 2017; 132:144-148. [PMID: 28863331 DOI: 10.1016/j.diabres.2017.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/05/2017] [Accepted: 08/08/2017] [Indexed: 12/21/2022]
Abstract
AIMS We examined the association of grip strength with incident type 2 diabetes mellitus (T2DM) in healthy subjects initially aged 50 to 75years after a follow-up of 5.5years and 10.7years. METHODS This was a prospective, population-based study derived from the CoLaus (Cohorte Lausannoise) study including 2318 participants (aged 60.2y; 1354 women) free from T2DM at baseline. Grip strength was assessed using a handheld dynamometer. The effect of grip strength on the incidence of T2DM was analyzed by logistic regression. RESULTS After a follow-up of 5.5years, 190 (8.2%) T2DM cases were identified. In bivariate analysis, participants who developed T2DM had a higher absolute grip strength (35.3±10.6 versus 33.2±10.7kg, P=0.013). Analysis between grip strength expressed in 5kg increment and incident TD2M showed a negative association when adjusted for age and sex [ORs (95% CI): 0.88 (0.79, 0.98)], or for age, sex and body mass index (BMI) [ORs (95% CI): 0.87 (0.78, 097)]. After a follow-up of 10.7years, 131 supplemental (7.3%) T2DM cases were identified, but there was no association between grip strength and incident T2DM in bivariate and multivariable analysis, potentially due to a lack of statistical power. CONCLUSIONS In non elderly healthy adults, the risk of incident T2DM is overall not associated with grip strength over a maximum follow-up of 10.7years. Future studies are warranted to better assess the association between grip strength and incident T2DM in bigger and even younger cohorts.
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Affiliation(s)
- Pedro Marques-Vidal
- Service of Internal Medicine, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Peter Vollenweider
- Service of Internal Medicine, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Gérard Waeber
- Service of Internal Medicine, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - François R Jornayvaz
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
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980
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Silva DAS, Pelegrini A, de Castro JAC, de Lima TR, de Sousa GR, de Lima Silva JMF, Petroski EL. Low handgrip strength levels among adolescents in a city in southern Brazil. J Bodyw Mov Ther 2017; 21:884-889. [DOI: 10.1016/j.jbmt.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/30/2017] [Accepted: 02/27/2017] [Indexed: 01/30/2023]
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981
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Kim ES, Kawachi I, Chen Y, Kubzansky LD. Association Between Purpose in Life and Objective Measures of Physical Function in Older Adults. JAMA Psychiatry 2017; 74:1039-1045. [PMID: 28813554 PMCID: PMC5710461 DOI: 10.1001/jamapsychiatry.2017.2145] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Higher purpose in life is hypothesized to reduce the likelihood of developing weak grip strength and slow walking speed because purpose has been linked with a range of positive health behaviors and biological processes that are potentially protective against declining physical function. However, the association between purpose in life and objective physical function has not been examined. OBJECTIVE To assess whether higher purpose in life among adequately functioning older adults is associated with lower risk of developing weak grip strength and slow walking speed over time. DESIGN, SETTING, AND PARTICIPANTS Data for a longitudinal cohort study were collected in 2006 and again in 2010 from the Health and Retirement Study, a nationally representative study of US adults older than 50 years. Data analysis was conducted from November 23, 2016, to June 2, 2017. MAIN OUTCOMES AND MEASURES The risk of developing weak grip strength (assessed as a binary yes or no outcome) or slow walking speed (yes or no) during the 4-year follow-up period. Grip strength was assessed using Smedley spring-type hand dynamometers, and walking speed was assessed by asking respondents to walk 2.5 m at their normal walking pace. RESULTS In this study, 4486 adults had grip scores at baseline indicating adequate function (2665 women and 1821 men; mean [SD] age, 63.0 [8.2] years) and 1461 adults had walking scores at baseline indicating adequate function (801 women and 660 men; mean [SD] age, 70.8 [6.5] years). After controlling for sociodemographic factors, each 1-SD increase in purpose was associated with a 13% decreased risk (95% CI, 1%-23%) of developing weak grip strength and a 14% decreased risk (95% CI, 8%-20%) of developing slow walking speed. Associations with walking speed were maintained in all covariate models (fully adjusted model: risk ratio, 0.89; 95% CI, 0.83-0.95), but associations with grip strength did not reach conventional levels of statistical significance after additionally adjusting for relevant baseline health factors, depressive symptoms, and health behaviors (fully adjusted model: risk ratio, 0.91; 95% CI, 0.80-1.04). CONCLUSIONS AND RELEVANCE Purpose in life was prospectively associated with a decreased risk of developing weak grip strength and slow walking speed, although the findings were more robust for walking speed than for grip strength. These findings suggest that a sense of purpose in life, a modifiable factor, may play an important role in maintaining physical function among older adults.
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Affiliation(s)
- Eric S. Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ying Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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982
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Booth FW, Roberts CK, Thyfault JP, Ruegsegger GN, Toedebusch RG. Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms. Physiol Rev 2017; 97:1351-1402. [PMID: 28814614 PMCID: PMC6347102 DOI: 10.1152/physrev.00019.2016] [Citation(s) in RCA: 341] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 03/06/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022] Open
Abstract
This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.
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Affiliation(s)
- Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Christian K Roberts
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - John P Thyfault
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Gregory N Ruegsegger
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
| | - Ryan G Toedebusch
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri; Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri; Geriatrics, Research, Education and Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, California; Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas; and Cardiovascular Division, Department of Medicine, University of Missouri, Columbia, Missouri
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983
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Bhanji RA, Carey EJ, Yang L, Watt KD. The Long Winding Road to Transplant: How Sarcopenia and Debility Impact Morbidity and Mortality on the Waitlist. Clin Gastroenterol Hepatol 2017; 15:1492-1497. [PMID: 28400317 DOI: 10.1016/j.cgh.2017.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 03/13/2017] [Accepted: 04/03/2017] [Indexed: 02/07/2023]
Abstract
Frailty and sarcopenia are common complications of cirrhosis. Frailty has been described as an increased susceptibility to stressors secondary to a cumulative decline in physiologic reserve; this decline occurs with aging or is a result of the disease process, across multiple organ systems. Sarcopenia, a key component of frailty, is defined as progressive and generalized loss of skeletal muscle mass and strength. The presence of either of these complications is associated with increased morbidity and mortality, as these are tightly linked to decompensation and increased complication rates. Recognition of these entities is critical. Studies have shown improvement in muscle strength and function lead to reduced mortality, suggesting both frailty and sarcopenia are modifiable risk factors. In this review we outline the prevalence of frailty and sarcopenia in cirrhosis and the impact on clinical outcomes such as decompensation, hospitalization, and mortality. Existing and potential novel therapeutic approaches for frailty and sarcopenia are also reviewed.
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Affiliation(s)
- Rahima A Bhanji
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Elizabeth J Carey
- Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, Arizona
| | - Liu Yang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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984
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McCoy SM, Campbell KL, Lassemillante ACM, Wallen MP, Fawcett J, Jarrett M, Macdonald GA, Hickman IJ. Changes in dietary patterns and body composition within 12 months of liver transplantation. Hepatobiliary Surg Nutr 2017; 6:317-326. [PMID: 29152478 DOI: 10.21037/hbsn.2017.01.12] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Cardiometabolic risk factors are increasing in liver transplant recipients (LTR). Influencing dietary factors have not been assessed. The aim of this observational study was to assess changes in weight, metabolic function, dietary intake and eating behaviours in the first year after orthotopic liver transplantation (OLT). Methods Consecutive recruitment of 17 patients (14 males) awaiting OLT at a single tertiary hospital. Dietary intake, food behaviours and anthropometry were recorded at baseline, and 6 and 12 months post-transplant. Results By 12 months, patients had gained on average 7.3% of body weight. The prevalence of overweight or obesity increased from baseline 53% to 77% (P=0.001). By 6 months, 65% (n=11/17) of patients had altered glucose metabolism. Dietary intake was consistent with a Western-style dietary pattern with high saturated fat. Over half of the patients (69%, n=11/16) reported low to no depressive feelings and rated their self-esteem as good (53%, n=9/16). The Power of Food Scale increased between pre and post-transplant, indicating a stronger appetitive drive. Conclusions Weight gain occurs early post-transplant, with significant metabolic dysfunction present within 6 months, however is not associated with significant psychological distress. Early dietary intervention designed to limit weight gain and target cardiometabolic health is recommended for this unique patient population.
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Affiliation(s)
- Simone M McCoy
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Katrina L Campbell
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | | | - Matthew P Wallen
- School of Human Movement and Nutrition Sciences, the University of Queensland, St Lucia, QLD, Australia
| | - Jonathan Fawcett
- Queensland Liver Transplant Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Maree Jarrett
- Queensland Liver Transplant Service, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Graeme A Macdonald
- Department of Hepatology and Gastroenterology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
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985
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Fraser BJ, Huynh QL, Schmidt MD, Dwyer T, Venn AJ, Magnussen CG. Childhood Muscular Fitness Phenotypes and Adult Metabolic Syndrome. Med Sci Sports Exerc 2017; 48:1715-22. [PMID: 27128670 DOI: 10.1249/mss.0000000000000955] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE The objective of this study is to determine whether childhood muscular fitness phenotypes (strength, endurance, and power) are independently associated with adult metabolic syndrome (MetS). METHODS We conducted a longitudinal study including 737 participants who had muscular fitness measures in 1985 when age 9, 12, or 15 yr and attended follow-up in young adulthood 20 yr later when measures of MetS were collected. Childhood measures of muscular fitness included strength (right and left grip, leg, and shoulder extension and flexion), endurance (number of push-ups in 30 s), and power (distance of a standing long jump). A muscular fitness score was created using all individual muscular fitness phenotypes. In adulthood, waist circumference, blood pressure, HDL cholesterol, triglycerides, and glucose were measured. Adult outcomes were MetS defined using the harmonized definition and a continuous MetS risk score. RESULTS Participants with childhood muscular strength, muscular power, and combined muscular fitness score in the highest third had significantly lower relative risk (RR) for MetS and a lower continuous MetS score in adulthood independent of cardiorespiratory fitness than those in the lowest third (strength: RR = 0.21 (0.09, 0.49) β = -0.46 (-0.59, -0.34) power: RR = 0.26 (0.12, 0.60), β = -0.36 (-0.49, -0.23) fitness score: RR = 0.20 (0.09, 0.47), β = -0.45 (-0.58, -0.33)). However, adjustment for childhood waist circumference reduced the effect sizes for both adult outcomes by 17%-60%. CONCLUSION Phenotypes of childhood muscular fitness can be used to predict adult MetS independent of cardiorespiratory fitness. Although a large proportion of the effect of childhood muscular fitness on adult MetS is potentially being mediated by child waist circumference, these data suggest that promotion of muscular fitness among children might provide additional protection against developing adult MetS.
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Affiliation(s)
- Brooklyn J Fraser
- 1Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, AUSTRALIA; 2Department of Kinesiology, University of Georgia, Athens, GA; 3George Institute for Global Health, Oxford Martin School and Nuffield Department of Obstetrics and Gynaecology, Oxford University, Oxford, England, UNITED KINGDOM; and 4Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FINLAND
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986
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Springstroh KA, Gal NJ, Ford AL, Whiting SJ, Dahl WJ. Evaluation of Handgrip Strength and Nutritional Risk of Congregate Nutrition Program Participants in Florida. J Nutr Gerontol Geriatr 2017; 35:193-208. [PMID: 27559854 DOI: 10.1080/21551197.2016.1209146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to determine if handgrip strength (HGS) is a predictor of nutritional risk in community-dwelling older adults. A cross-sectional study was carried out to determine the relationship between HGS and nutritional risk using SCREEN 1. The setting was Congregate Nutrition program meal sites (n = 10) in North Central Florida and included community-dwelling older adults participating in the Congregate Nutrition program. Older adults (n = 136; 77.1 ± 8.9 y; 45 M, 91 F) participated in the study. Nutritional risk was identified in 68% of participants, with 10% exhibiting clinically relevant weakness (men, HGS < 26 kg; women, HGS < 16 kg), suggesting a vulnerable population. HGS was weakly associated with nutritional risk as assessed by SCREEN 1 (AUC = 0.59), but alternate cutpoints, 33 kg for men (mean of both hands) and 22 kg for women (highest of either hand), provided the best comparison to nutritional risk. In community-dwelling older adults, HGS was weakly associated with nutritional risk assessed using traditional screening. However, as existing research supports the inclusion of HGS in malnutrition screening in acute care, further research into the usefulness of HGS and possibly other measures of functional status in nutrition risk screening of community-dwelling older adults may be warranted.
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Affiliation(s)
- Kelly A Springstroh
- a Food Science and Human Nutrition Department , University of Florida , Gainesville , Florida , USA
| | - Nancy J Gal
- b Marion County Cooperative Extension , University of Florida , Gainesville , Florida , USA
| | - Amanda L Ford
- a Food Science and Human Nutrition Department , University of Florida , Gainesville , Florida , USA
| | - Susan J Whiting
- c College of Pharmacy and Nutrition , University of Saskatchewan , Canada
| | - Wendy J Dahl
- a Food Science and Human Nutrition Department , University of Florida , Gainesville , Florida , USA.,c College of Pharmacy and Nutrition , University of Saskatchewan , Canada
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987
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Morimoto A, Suga T, Tottori N, Wachi M, Misaki J, Tsuchikane R, Isaka T. Association between hand muscle thickness and whole-body skeletal muscle mass in healthy adults: a pilot study. J Phys Ther Sci 2017; 29:1644-1648. [PMID: 28932005 PMCID: PMC5599838 DOI: 10.1589/jpts.29.1644] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/15/2017] [Indexed: 11/29/2022] Open
Abstract
[Purpose] Handgrip strength is a surrogate indicator for assessing disease-related and
age-related skeletal muscle loss. Clinical utility as such a surrogate can be at least
partially explained by the close relationship between handgrip strength and whole-body
skeletal muscle mass. The handgrip strength is related to hand muscle size. Thus, the
present study examined whether hand muscle thickness is associated with whole-body
skeletal muscle mass. [Subjects and Methods] Thirty healthy male adults participated in
this study. All subjects were right-hand dominant. Two muscle thicknesses (lumbrical and
interosseous muscles) in the right hand were measured using ultrasonography. Whole-body
and appendicular skeletal muscle masses were assessed using dual-energy X-ray
absorptiometry. [Results] Although lumbrical muscle thickness was not correlated with
whole-body skeletal muscle mass, there was a significant correlation with appendicular
skeletal muscle mass. Furthermore, interosseous muscle thickness was significantly
correlated with both whole-body and appendicular skeletal muscle masses. [Conclusion] The
present findings suggest that two muscle thicknesses in the hand are related to whole-body
and/or appendicular skeletal muscle mass in healthy adults. Therefore, we propose that
despite being smaller than other limb muscles, hand muscle thickness may be useful as
surrogate indicator for assessing disease-related and age-related skeletal muscle
loss.
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Affiliation(s)
- Akio Morimoto
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Tadashi Suga
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Nobuaki Tottori
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Michio Wachi
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan.,Kanazawa Orthopaedic & Sports Medicine Clinic, Japan
| | - Jun Misaki
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Ryo Tsuchikane
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University: 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
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988
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Grip Strength on the Unaffected Side as an Independent Predictor of Functional Improvement After Stroke. Am J Phys Med Rehabil 2017; 96:616-620. [DOI: 10.1097/phm.0000000000000694] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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989
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Özkan S, Claessen FMAP, Eberlin KR, Lee SGP, Ring DC, Vranceanu AM. The Effect of Priming With Questionnaire Content on Grip Strength in Patients With Hand and Upper Extremity Illness. Hand (N Y) 2017; 12:484-489. [PMID: 28832217 PMCID: PMC5684937 DOI: 10.1177/1558944716681975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Grip strength is a performance-based measure of upper extremity function that might be influenced by priming (the influence of a response to a stimulus by exposure to another stimulus). This study addressed the influence of questionnaire content on performance measurements such as grip strength between patients who complete the standard Pain Catastrophizing Scale (PCS) compared with patients who complete a positively adjusted PCS. METHODS Between June 2015 and August 2015, we enrolled 122 patients who presented to 3 hand surgeons at 3 outpatient offices. They were randomized to 2 groups: the control group, which completed the PCS, and the intervention group, which completed a positively phrased version of the PCS. Before and after completion of the questionnaire, we measured each patient's grip strength 3 times by alternating between hands. Two patients were excluded after participation. We calculated both the preintervention and postintervention mean and maximum grip strengths. RESULTS There was no significant difference between groups on mean or maximum grip strength before completion of the questionnaires. There was a greater improvement in mean grip strength of both hands in the intervention group compared with the PCS group. This improvement was statistically significant in the affected hand. The maximum grip strength showed a statistically significant greater improvement in both hands in the positive PCS group compared with the control group. CONCLUSIONS Positive priming through a questionnaire leads to an increase in mean and maximum grip strength when compared with the standard questionnaire that uses negative terms rather than positive.
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Affiliation(s)
| | | | | | | | - David C. Ring
- The University of Texas at Austin, TX, USA,David C. Ring, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, 1400 Barbara Jordan Boulevard, Suite 2.834; MC: R1800, Austin, TX 78723, USA.
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990
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Oksuzyan A, Demakakos P, Shkolnikova M, Thinggaard M, Vaupel JW, Christensen K, Shkolnikov VM. Handgrip strength and its prognostic value for mortality in Moscow, Denmark, and England. PLoS One 2017; 12:e0182684. [PMID: 28863174 PMCID: PMC5580990 DOI: 10.1371/journal.pone.0182684] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 07/21/2017] [Indexed: 12/02/2022] Open
Abstract
Background This study compares handgrip strength and its association with mortality across studies conducted in Moscow, Denmark, and England. Materials The data collected by the Study of Stress, Aging, and Health in Russia, the Study of Middle-Aged Danish Twins and the Longitudinal Study of Aging Danish Twins, and the English Longitudinal Study of Ageing was utilized. Results Among the male participants, the age-standardized grip strength was 2 kg and 1 kg lower in Russia than in Denmark and in England, respectively. The age-standardized grip strength among the female participants was 1.9 kg and 1.6 kg lower in Russia than in Denmark and in England, respectively. In Moscow, a one-kilogram increase in grip strength was associated with a 4% (hazard ratio [HR] = 0.96, 95% confidence interval [CI]: 0.94, 0.99) reduction in mortality among men and a 10% (HR = 0.90, 95%CI: 0.86, 0.94) among women. Meanwhile, a one-kilogram increase in grip strength was associated with a 6% (HR = 0.94, 95%CI: 0.93, 0.95) and an 8% (HR = 0.92, 95%CI: 0.90, 0.94) decrease in mortality among Danish men and women, respectively, and with a 2% (HR = 0.98, 95%CI: 0.97, 0.99) and a 3% (HR = 0.97, 95%CI: 0.95, 0.98) reduction in mortality among the English men and women, respectively. Conclusion The study suggests that, although absolute grip strength values appear to vary across the Muscovite, Danish, and English samples, the degree to which grip strength is predictive of mortality is comparable across national populations with diverse socioeconomic and health profiles and life expectancy levels.
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Affiliation(s)
- Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
- * E-mail:
| | - Panayotes Demakakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Maria Shkolnikova
- Scientific Institute of Pediatry at the Pirogov Moscow Medical University, Moscow, Russian Federation
| | - Mikael Thinggaard
- The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Max Planck Odense Center on the Biodemography of Aging, Institute of Public Health, Odense, Denmark
| | - James W. Vaupel
- Max Planck Institute for Demographic Research, Rostock, Germany
- Max Planck Odense Center on the Biodemography of Aging, Institute of Public Health, Odense, Denmark
| | - Kaare Christensen
- The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Max Planck Odense Center on the Biodemography of Aging, Institute of Public Health, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Vladimir M. Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- National Research University Higher School of Economics, Moscow, Russian Federation
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991
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Kim Y, Wijndaele K, Lee DC, Sharp SJ, Wareham N, Brage S. Independent and joint associations of grip strength and adiposity with all-cause and cardiovascular disease mortality in 403,199 adults: the UK Biobank study. Am J Clin Nutr 2017; 106:773-782. [PMID: 28793990 PMCID: PMC6101209 DOI: 10.3945/ajcn.117.156851] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/30/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Higher grip strength (GS) is associated with lower mortality risk. However, whether this association is independent of adiposity is uncertain.Objective: The purpose of this study was to examine the associations between GS, adiposity, and mortality.Design: The UK Biobank study is an ongoing prospective cohort of >0.5 million UK adults aged 40-69 y. Baseline data collection (2006-2010) included measurements of GS and adiposity indicators, including body mass index (BMI; in kg/m2). Age- and sex-specific GS quintiles were used. BMI was classified according to clinical cutoffs.Results: Data from 403,199 participants were included in analyses. Over a median 7.0-y of follow-up, 8287 all-cause deaths occurred. The highest GS quintile had 32% (95% CI: 26%, 38%) and 25% (95% CI: 16%, 33%) lower all-cause mortality risks for men and women, respectively, compared with the lowest GS quintile, after adjustment for confounders and BMI. Obesity class II (BMI ≥35) was associated with a greater all-cause mortality risk. The highest GS quintile and obesity class II category showed relatively higher all-cause mortality hazards (not statistically significant in men) than the highest GS quintile and the normal weight category; however, the increased risk was relatively lower than the risk for the lowest GS quintile and obesity class II category. All-cause mortality risks were generally lower for obese but stronger individuals than for nonobese but weaker individuals. Similar patterns of associations were observed for cardiovascular mortality.Conclusions: Lower grip strength and excess adiposity are both independent predictors of higher mortality risk. The higher mortality risk associated with excess adiposity is attenuated, although not completely attenuated, by greater GS. Interventions and policies should focus on improving the muscular strength of the population regardless of their degree of adiposity.
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Affiliation(s)
- Youngwon Kim
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom;
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, UK CB2 0QQ
| | - Duck-chul Lee
- Department of Kinesiology, Iowa State University, 251 Forker Building, 534 Wallace Road, Ames, Iowa, USA 50011-4008
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, UK CB2 0QQ
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, UK CB2 0QQ
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, Cambridgeshire, UK CB2 0QQ
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992
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Hamasaki H. The association between handgrip strength and sleep duration in Japanese patients with type 2 diabetes. DIABETES & METABOLISM 2017; 45:306-307. [PMID: 28847680 DOI: 10.1016/j.diabet.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/15/2017] [Indexed: 12/24/2022]
Affiliation(s)
- H Hamasaki
- Hamasaki clinic, 2-21-4 Nishida, Kagoshima 860-0046, Japan; Department of internal medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan.
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993
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Dysmobility Syndrome and Risk of Mortality for Community-Dwelling Middle-Aged and Older Adults: The Nexus of Aging and Body Composition. Sci Rep 2017; 7:8785. [PMID: 28821868 PMCID: PMC5562709 DOI: 10.1038/s41598-017-09366-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/24/2017] [Indexed: 01/05/2023] Open
Abstract
Dysmobility syndrome is a newly proposed concept to comprehensively consider bone-muscle-adiposity as a whole to associate with mortality and other adverse outcomes in the older adults. Little was known in Asian populations since the body composition was highly related to ethnicity. The study aimed to evaluate the association between dysmobility syndrome and mortality and to explore the most optimal operational definition for dysmobility syndrome. The prevalence of dysmobility syndrome was 3.9–10.1% based on different operational definitions of adiposity and skeletal muscle index. Subjects with dysmobility syndrome were older, more often to be women, having higher adiposity, lower lean body mass and bone mineral density. Multivariate Cox proportional hazard model showed that dysmobility and pre-dysmobility syndrome had higher risk of mortality than the robust group (Hazard ratio (HR): 11.3, 95% confidence interval (CI): 1.2–109.1; and HR 8.7, 95% CI 1.1-67.3, respectively). Overall, the modified operational definition of dysmobility syndrome in Asian populations using FNIH-adjusted skeletal muscle mass and waist circumference-defined adiposity may be the most optimal model for mortality prediction. Taking the nexus of body composition as a whole to evaluate the mortality risk of older adults is an important improvement beyond sarcopenia and osteoporosis.
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994
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Filteau S, PrayGod G, Woodd SL, Friis H, Heimburger DC, Koethe JR, Kelly P, Kasonka L, Rehman AM. Nutritional status is the major factor affecting grip strength of African HIV patients before and during antiretroviral treatment. Trop Med Int Health 2017; 22:1302-1313. [PMID: 28712113 DOI: 10.1111/tmi.12929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Low grip strength is a marker of frailty and a risk factor for mortality among HIV patients and other populations. We investigated factors associated with grip strength in malnourished HIV patients at referral to ART, and at 12 weeks and 2-3 years after starting ART. METHODS The study involved HIV-infected Zambian and Tanzanian participants recruited to the NUSTART trial when malnourished (body mass index <18.5 kg/m2 ) and requiring ART. The relationship of grip strength to nutritional, infectious and demographic factors was assessed by multivariable linear regression at referral for ART (n = 1742) and after 12 weeks (n = 778) and 2-3 years of ART (n = 273). RESULTS In analyses controlled only for sex, age and height, most nutrition and infection-related variables were associated with grip strength. However, in multivariable analyses, consistent associations were seen for fat-free mass index, mid-upper arm circumference, haemoglobin and systolic blood pressure, and a variable association with fat mass index in men. C-reactive protein and CD4 count had limited independent effects on grip strength, while receiving tuberculosis treatment was associated with weaker grip strength. CONCLUSIONS In this population of originally malnourished HIV patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of HIV patients should incorporate nutritional assessment and management and could use grip strength as a functional indicator of improving nutrition.
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Affiliation(s)
- S Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - G PrayGod
- Mwanza Medical Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - S L Woodd
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - H Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - D C Heimburger
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J R Koethe
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P Kelly
- Barts & the London School of Medicine, Queen Mary University of London, London, UK.,University of Zambia School of Medicine, Lusaka, Zambia
| | - L Kasonka
- University Teaching Hospital, Lusaka, Zambia
| | - A M Rehman
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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995
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Jeong M, Kang HK, Song P, Park HK, Jung H, Lee SS, Koo HK. Hand grip strength in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2017; 12:2385-2390. [PMID: 28848339 PMCID: PMC5557109 DOI: 10.2147/copd.s140915] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Hand grip strength (HGS) is a simple way of predicting the risk of cardiovascular disease and all-cause mortality in the general population. However, the practical significance of grip strength in patients with COPD is uncertain. The aim of this study was to compare HGS between subjects with and without COPD and to evaluate its clinical relevance in patients with COPD by using a national survey. METHODS Data were collected from the Korean National Health and Nutrition Examination Survey. The study included 421 adults with COPD and 2,542 controls who completed questionnaires, spirometry, and a HGS test. HGS was compared between subjects with and without COPD, and the association between grip strength, lung function, and quality of life (QoL) was evaluated. RESULTS The mean HGS was 33.3±9.1 kg in the COPD group and 29.9±9.5 kg in the non-COPD group; adjusted HGS was 30.9±0.33 kg and 30.9±0.11 kg, respectively (P=0.99). HGS was not related to forced vital capacity (β=0.04, P=0.70) or forced expiratory volume in 1 second (β=0.11, P=0.24) in multivariable analysis. HGS was independently associated with the EQ-5D index, but the relationship was stronger in the COPD group (β=0.30, P<0.001) than in the non-COPD group (β=0.21, P<0.001). The results were similar for each component of the EQ-5D, including mobility (β=-0.25, P<0.001), daily activity (β=-0.19, P=0.01), pain/discomfort (β=-0.32, P<0.001), and anxiety/depression (β=-0.16, P=0.01). CONCLUSION HGS was not different between subjects with and without COPD, but was associated with QoL - including mobility, daily activity, pain/discomfort, and anxiety/depression - in patients with COPD. The HGS test could be used as a marker of QoL in patients with COPD and could assist risk stratification in clinical practice.
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Affiliation(s)
- Moa Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Hyung Koo Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Pamela Song
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Hye Kyeong Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Hoon Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Sung-Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine
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996
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Cruz Estrada FDM, Tlatempa Sotelo P, Valdes-Ramos R, Hernández Murúa JA, Manjarrez-Montes-de-Oca R. Overweight or Obesity, Gender, and Age Influence on High School Students of the City of Toluca's Physical Fitness. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9546738. [PMID: 28845436 PMCID: PMC5563394 DOI: 10.1155/2017/9546738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/27/2017] [Indexed: 12/03/2022]
Abstract
MATERIAL AND METHOD This is a prospective, cross-sectional, and correlational study with a probabilistic sampling in which 150 teenagers from three different high schools from the city of Toluca, Mexico, aged 15-17, were assessed. OBJECTIVE To determine if weight, age, and gender have an influence on physical fitness evaluated with the EUROFIT and ALPHA-FITNESS batteries. RESULTS Women have a higher overweight and obesity rate than men (3 : 1). Adolescents who have normal weight have regular physical fitness (74.9%). When comparing genders we found that men have a higher mean than women in the tests, except for skinfold thickness and waist circumference. Age was only correlated with the plate tapping test (p = 0.001). There are significant differences in the standing broad jump test and the Course-Navette of the EUROFIT and ALPHA-FITNESS batteries (p = 0.000). CONCLUSIONS It is likely that regular physical activity, and not normal weight, helps generate healthy physical fitness. Male subjects had a higher mean than women, reporting a better physical fitness and more frequent physical activity.
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Affiliation(s)
| | - Patricia Tlatempa Sotelo
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, MEX, Mexico
- Facultad de Ciencias de la Conducta, Universidad Autónoma del Estado de México, Toluca, MEX, Mexico
| | - Roxana Valdes-Ramos
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, MEX, Mexico
| | | | - Rafael Manjarrez-Montes-de-Oca
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca, MEX, Mexico
- Facultad de Ciencias de la Conducta, Universidad Autónoma del Estado de México, Toluca, MEX, Mexico
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997
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Ong HL, Abdin E, Chua BY, Zhang Y, Seow E, Vaingankar JA, Chong SA, Subramaniam M. Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors. BMC Geriatr 2017; 17:176. [PMID: 28778190 PMCID: PMC5544979 DOI: 10.1186/s12877-017-0565-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 07/25/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Hand-grip strength (HGS) serves as a proxy measure for muscle function and physical health. Studies have shown that low HGS is associated with common age-related disorders including frailty and sarcopenia. The aim of the present study was to establish the normative values of HGS among older adults in Singapore and to compare it with data from Western and other Asian countries. The study also aimed to explore the sociodemographic and anthropometric correlates of HGS. METHODS Data were collected from 2043 men and women aged 60 years and above who took part in the Well-being of the Singapore Elderly study in 2013. HGS was obtained using a Jamar Plus + digital hand dynamometer. Normative data were stratified by; 5-year age groups, sex and ethnicity. Relationships between the HGS with various sociodemographic and anthropometric correlates were examined using multiple linear regression analysis. RESULTS The mean HGS demonstrate a decreasing trend with increased age across all ethnic groups and sexes. HGS among Singapore older adults were relatively low compared to Western and other Asian countries. Males in the youngest age group (60-64) and of Chinese ethnicity attained greater HGS values than their counterparts. When the regression analysis was stratified for sex, significant associations were found between height, upper arm circumference with HGS in the males sample, and between height, weight, waist circumference and HGS in the females sample. CONCLUSIONS Older adults in Singapore have a relatively weak HGS compared to other countries. Greater height and weight, and smaller waist circumference are independently associated with greater HGS in females but not males. These results facilitate the interpretation of HGS conducting using Jamar digital-type dynamometers among the older adults in Singapore.
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Affiliation(s)
- Hui Lin Ong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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998
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Lee SH, Kim SJ, Han Y, Ryu YJ, Lee JH, Chang JH. Hand grip strength and chronic obstructive pulmonary disease in Korea: an analysis in KNHANES VI. Int J Chron Obstruct Pulmon Dis 2017; 12:2313-2321. [PMID: 28831248 PMCID: PMC5552152 DOI: 10.2147/copd.s142621] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Muscle mass is known to be associated with mortality in elderly adults. Because hand grip strength (HGS) is known as a simple assessment tool for muscular strength, many researchers have studied the association between HGS and disease. However, empirical evidence for the relationship between chronic obstructive pulmonary disease (COPD) and HGS is still controversial. The aim of this study was to evaluate the association between COPD and HGS, using Korean population data. Methods This was a population-based cross-sectional study. Data were obtained from the sixth Korean National Health and Nutrition Examination Survey, which was conducted from 2013 to 2015. To reduce the effects of HGS-related factors and potential confounding factors, propensity score matching was used to match subjects with and without COPD. Results Among 14,930 subjects, 832 were enrolled in each group (non-COPD and COPD) after propensity score matching. COPD subjects did not have lower HGS than non-COPD subjects (non-COPD vs COPD, male, 38.0±7.0 vs 38.9±7.0 kg, P=0.044, female, 23.8±4.6 vs 24.2±4.9 kg, P=0.342). Lung function was classified by Global Initiative for Chronic Obstructive Lung Disease stages and was not significantly associated with HGS. For male COPD subjects, there was a significant correlation between HGS and the EuroQol Five-Dimension Questionnaire (EQ5D) utility score index, which is an indicator of quality of life that adjusts for age and body mass index (r=0.201, P<0.001). The correlation was absent for female subjects (r=0.098, P=0.170). Conclusion COPD subjects did not have lower HGS than non-COPD subjects. HGS did not associate with lung function. However, the HGS of male COPD subjects was positively associated with EQ5D utility score index, an indicator of quality of life. HGS may be helpful as an additional method to the evaluation of quality of life in male COPD patients.
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Affiliation(s)
- Su Hwan Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Soo Jung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeji Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yon Ju Ryu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jin Hwa Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Hyun Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
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999
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Lai JC, Covinsky KE, Dodge JL, Boscardin WJ, Segev DL, Roberts JP, Feng S. Development of a novel frailty index to predict mortality in patients with end-stage liver disease. Hepatology 2017; 66:564-574. [PMID: 28422306 PMCID: PMC5519430 DOI: 10.1002/hep.29219] [Citation(s) in RCA: 331] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/17/2017] [Accepted: 04/03/2017] [Indexed: 12/13/2022]
Abstract
UNLABELLED Cirrhosis is characterized by muscle wasting, malnutrition, and functional decline that confer excess mortality not well quantified by the Model for End-Stage Liver Disease (MELD) Sodium (MELDNa) score. We aimed to develop a frailty index to capture these extrahepatic complications of cirrhosis and enhance mortality prediction in patients with cirrhosis. Consecutive outpatients listed for liver transplantation at a single transplant center without MELD exceptions were assessed with candidate frailty measures. Best subset selection analyses with Cox regression identified subsets of frailty measures that predicted waitlist mortality (=death or delisting because of sickness). We selected the frailty index by balancing statistical accuracy with clinical utility. The net reclassification index (NRI) evaluated the %patients correctly reclassified by adding the frailty index to MELDNa. Included were 536 patients with cirrhosis with median MELDNa of 18. One hundred seven (20%) died/were delisted. The final frailty index consisted of: grip strength, chair stands, and balance. The ability of MELDNa and the frailty index to correctly rank patients according to their 3-month waitlist mortality risk (i.e., concordance-statistic) was 0.80 and 0.76, respectively, but 0.82 for MELDNa+frailty index together. Compared with MELDNa alone, MELDNa+frailty index correctly reclassified 16% of deaths/delistings (P = 0.005) and 3% of nondeaths/delistings (P = 0.17) with a total NRI of 19% (P < 0.001). Compared to those with robust frailty index scores (<20th percentile), cirrhotics with poor frailty index scores (>80th percentile) were more impaired by gait speed, difficulty with Instrumental Activities of Daily Living, exhaustion, and low physical activity (P < 0.001 for each). CONCLUSION Our frailty index for patients with cirrhosis, comprised of three performance-based metrics, has construct validity for the concept of frailty and improves risk prediction of waitlist mortality over MELDNa alone. (Hepatology 2017;66:564-574).
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Affiliation(s)
- Jennifer C. Lai
- Department of Medicine, Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, CA
| | - Kenneth E. Covinsky
- Department of Medicine, Division of Geriatrics, University of California-San Francisco, San Francisco, CA
| | - Jennifer L. Dodge
- Department of Surgery, Division of Transplant Surgery, University of California-San Francisco, San Francisco, CA
| | - W. John Boscardin
- Department of Medicine, Division of Geriatrics, University of California-San Francisco, San Francisco, CA,Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA
| | - Dorry L. Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - John P. Roberts
- Department of Surgery, Division of Transplant Surgery, University of California-San Francisco, San Francisco, CA
| | - Sandy Feng
- Department of Surgery, Division of Transplant Surgery, University of California-San Francisco, San Francisco, CA
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1000
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Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Sci Rep 2017; 7:7041. [PMID: 28765572 PMCID: PMC5539205 DOI: 10.1038/s41598-017-07438-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/28/2017] [Indexed: 12/25/2022] Open
Abstract
Handgrip strength is useful for the diagnosis of sarcopenia. We examined the associations of handgrip strength with all-cause mortality, cardiovascular events, and hospitalization in patients with type 2 diabetes. From April 2013 to December 2015, we conducted a retrospective cohort study to examine patients with type 2 diabetes whose handgrip strength was measured at our hospital. All patients were followed up until May 2016. A total of 1,282 patients (63.8 ± 13.9 years) were enrolled and followed up for 2.36 ± 0.73 years. During the follow-up period, 20 patients (1.6%) died, 14 (1.1%) experienced cardiovascular events, and 556 (43.4%) were admitted to our hospital for any diseases. Multiple regression analyses revealed that handgrip strength was favorably associated with abdominal obesity and renal function. Moreover, Cox proportional hazard analyses with adjustment for potential confounding variables revealed that handgrip strength was significantly associated with occurrence of CVD events and hospitalization in all subjects. In addition, handgrip strength was significantly associated with mortality and hospitalization in men and with hospitalization in women. Handgrip strength could be a prognostic indicator for health as well as a diagnostic marker of skeletal muscle mass loss in Japanese patients with type 2 diabetes.
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