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Isometric hand grip strength measured by the Nintendo Wii Balance Board - a reliable new method. BMC Musculoskelet Disord 2016; 17:56. [PMID: 26842966 PMCID: PMC4739099 DOI: 10.1186/s12891-016-0907-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low hand grip strength is a strong predictor for both long-term and short-term disability and mortality. The Nintendo Wii Balance Board (WBB) is an inexpensive, portable, wide-spread instrument with the potential for multiple purposes in assessing clinically relevant measures including muscle strength. The purpose of the study was to explore intrarater reliability and concurrent validity of the WBB by comparing it to the Jamar hand dynamometer. METHOD Intra-rater test-retest cohort design with randomized validity testing on the first session. Using custom WBB software, thirty old adults (69.0 ± 4.2 years of age) were studied for reproducibility and concurrent validity compared to the Jamar hand dynamometer. Reproducibility was tested for dominant and non-dominant hands during the same time-of-day, one week apart. Intraclass correlation coefficient (ICC) and standard error of measurement (SEM) and limits of agreement (LOA) were calculated to describe relative and absolute reproducibility respectively. To describe concurrent validity, Pearson's product-moment correlation and ICC was calculated. RESULTS Reproducibility was high with ICC values of >0.948 across all measures. Both SEM and LOA were low (0.2-0.5 kg and 2.7-4.2 kg, respectively) in both the dominant and non-dominant hand. For validity, Pearson correlations were high (0.80-0.88) and ICC values were fair to good (0.763-0.803). CONCLUSION Reproducibility for WBB was high for relative measures and acceptable for absolute measures. In addition, concurrent validity between the Jamar hand dynamometer and the WBB was acceptable. Thus, the WBB may be a valid instrument to assess hand grip strength in older adults.
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102
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Camina-Martín MA, de Mateo-Silleras B, Malafarina V, Lopez-Mongil R, Niño-Martín V, López-Trigo JA, Redondo-Del-Río MP. [Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group]. Rev Esp Geriatr Gerontol 2016; 51:52-57. [PMID: 26388249 DOI: 10.1016/j.regg.2015.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/09/2015] [Accepted: 07/19/2015] [Indexed: 06/05/2023]
Abstract
Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.
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Affiliation(s)
| | - Beatriz de Mateo-Silleras
- Área de Nutrición y Bromatología, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Vincenzo Malafarina
- Área de Geriatría, Clínica Los Manzanos, Grupo Viamed, Logroño, La Rioja, España.
| | | | | | | | - María Paz Redondo-Del-Río
- Área de Nutrición y Bromatología, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
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103
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Huang WC, Hsu YJ, Wei L, Chen YJ, Huang CC. Association of physical performance and biochemical profile of mice with intrinsic endurance swimming. Int J Med Sci 2016; 13:892-901. [PMID: 27994494 PMCID: PMC5165682 DOI: 10.7150/ijms.16421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/22/2016] [Indexed: 02/05/2023] Open
Abstract
We aimed to investigate the potential mediators and relationship affecting congenital exercise performance in an animal model with physical activity challenge from physiological and biochemical perspectives. A total of 75 male ICR mice (5 weeks old) were adapted for 1 week, then mice performed a non-loading and exhaustive swimming test and were assigned to 3 groups by exhaustive swimming time: low exercise capacity (LEC) (<3 hr), medium exercise capacity (MEC) (3-5 hr), and high exercise capacity (HEC) (>5 hr). After a 1-week rest, the 3 groups of mice performed an exhaustive swimming test with a 5% and 7.5% weight load and a forelimb grip-strength test, with a 1-week rest between tests. Blood samples were collected immediately after an acute exercise challenge and at the end of the experiment (resting status) to evaluate biochemical blood variables and their relation with physical performance. Physical activity, including exhaustive swimming and grip strength, was greater for HEC than other mice. The swimming performance and grip strength between groups were moderately correlated (r=0.443, p<0.05). Resting serum ammonium level was moderately correlated with endurance with a 7.5% weight load (r=-0.447, p<0.05) and with lactate level (r=0.598, p<0.05). The pulmonary morphology of the HEC group seemed to indicate benefits for aerobic exercise. Mice showed congenital exercise performance, which was significantly correlated with different physical challenges and biochemical variable values. This study may have implications for interference in intrinsic characteristics.
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Affiliation(s)
- Wen-Ching Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Li Wei
- Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei 11696, Taiwan
| | - Ying-Ju Chen
- Department of Food and Nutrition, Providence University, Taichung City 43301, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
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104
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Lindskov S, Sjöberg K, Hagell P, Westergren A. Weight stability in Parkinson's disease. Nutr Neurosci 2015; 19:11-20. [DOI: 10.1179/1476830515y.0000000044] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Susanne Lindskov
- The PRO-CARE group, School of Health and Society, Kristianstad University, Sweden
- Department of Geriatrics and Neurology, Central Hospital Kristianstad, Northeast Skåne Health Care District, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Klas Sjöberg
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Gastroenterology and Nutrition, Skåne University Hospital, Malmö, Sweden
| | - Peter Hagell
- The PRO-CARE group, School of Health and Society, Kristianstad University, Sweden
| | - Albert Westergren
- The PRO-CARE group, School of Health and Society, Kristianstad University, Sweden
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105
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Abstract
PURPOSE OF REVIEW Grip strength measured by dynamometry is well established as an indicator of muscle status, particularly among older adults. This review was undertaken to provide a synopsis of recent literature addressing the clinical and prognostic value of hand-grip dynamometry. RECENT FINDINGS Numerous large-scale normative grip strength projects have been published lately. Other recent studies have reinforced the concurrent relationship of grip strength with measures of nutritional status or muscle mass and measures of function and health status. Studies published in the past few years have confirmed the value of grip strength as a predictor of mortality, hospital length of stay, and physical functioning. SUMMARY As a whole, the recent literature supports the use of hand-grip dynamometry as a fundamental element of the physical examination of patients, particularly if they are older adults.
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Affiliation(s)
- Richard W Bohannon
- Physical Therapy Program of the Department of Kinesiology, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, Connecticut, USA
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106
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Camina-Martín MA, de Mateo-Silleras B, Malafarina V, Lopez-Mongil R, Niño-Martín V, López-Trigo JA, Redondo-del-Río MP. Nutritional status assessment in geriatrics: Consensus declaration by the Spanish society of geriatrics and gerontology nutrition work group. Maturitas 2015; 81:414-9. [DOI: 10.1016/j.maturitas.2015.04.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 04/29/2015] [Indexed: 12/23/2022]
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107
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No strong correlations between serum cytokine levels, CMV serostatus and hand-grip strength in older subjects in the Berlin BASE-II cohort. Biogerontology 2015; 17:189-98. [PMID: 25906063 DOI: 10.1007/s10522-015-9577-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 04/11/2015] [Indexed: 01/22/2023]
Abstract
Hand-grip strength is strongly correlated with measures of muscle mass and can be taken to predict morbidity and mortality. The aim of this study was to investigate the relationship between hand-grip strength and other markers associated with immune ageing, such as Cytomegalovirus (CMV) infection, leukocyte telomere length and serum levels of inflammatory and anti-inflammatory markers in the elderly. We have assessed grip strength with the Smedley Dynamometer in younger (22-37 years) and older (60-85 years) men and women in a sample of people living in Berlin (the BASE-II study). Serum cytokine levels were determined by flow-cytometry, CMV serostatus via ELISA and leukocyte telomere length by quantitative PCR. IL-1β levels tended to be negatively associated with grip strength, but we did not find a significant association with IL-6 levels. CMV-seropositivity was not associated with higher levels of IL-1β, IL-6 or TNF, nor with weaker grip strength in men or women at any age. A putative general measure of organismal ageing, overall leukocyte telomere length, was also found not to be associated with lower grip strength in the elderly. Hand-grip strength remains an important biomarker independent of CMV infection or shorter telomere lengths, and poorly reflected in peripheral pro-inflammatory cytokine levels, all of which have been associated in some studies with frailty and mortality.
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108
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Dowhan L, DeChicco R, Welsh R, Wehner R, Habib M, Hipskind P, Cresci G. Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients. JPEN J Parenter Enteral Nutr 2015; 40:951-8. [PMID: 25855578 DOI: 10.1177/0148607115580647] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 02/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients. METHOD Patients admitted to the heart failure service on the cardiac stepdown units at the Cleveland Clinic Main Campus in Cleveland, Ohio, were eligible for the study, and those who met the inclusion criteria underwent handgrip strength (HGS) testing and evaluation of nutrition status using the Academy/ASPEN Characteristics Recommended for the Identification of Adult Malnutrition. MMT was then performed within 24 hours by a different study investigator blinded to the HGS and malnutrition assessment results. RESULTS It was found that HGS and MMT overall were in agreement for 84% of patients and that MMT had a high sensitivity (98%) but low specificity (13%). CONCLUSION This study shows feasibility for RDs to perform MMT on patients to determine muscle strength and functioning. Future practice application may be to incorporate MMT into screening criteria for patients being evaluated for malnutrition and reserve HGS testing only for patients with an abnormal MMT.
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Affiliation(s)
- Lindsay Dowhan
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robert DeChicco
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Renee Welsh
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Rebecca Wehner
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Monica Habib
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Peggy Hipskind
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Gail Cresci
- Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas 2015; 81:17-27. [PMID: 25782627 DOI: 10.1016/j.maturitas.2015.02.009] [Citation(s) in RCA: 251] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 12/23/2022]
Abstract
Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full extent of its metabolic functions is not known in detail. One of the main roles assigned to albumin is as an indicator of malnutrition. There are many factors, in addition to nutrition, that influence levels of albumin in plasma. The main aim of this review is to assess the clinical significance of albumin in elderly people in the community, in hospital and in care homes. Following the review, it can be stated that age is not a cause of hypoalbuminemia. Albumin is a good marker of nutritional status in clinically stable people. Significant loss of muscle mass has been observed in elderly people with low albumin levels. Hypoalbuminemia is a mortality prognostic factor in elderly people, whether they live in the community or they are in hospital or institutionalized. Low levels of albumin are associated to worse recovery following acute pathologies. Inflammatory state and, particularly, high concentrations of IL-6 and TNF-alpha, are two of the main influencing factors of hypoalbuminemia. In elderly patients with a hip fracture, albumin levels below 38 g/L are associated to a higher risk of post-surgery complications, especially infections. Further research is needed on the impact of nutritional intervention upon albumin levels and on the outcomes in elderly people in the community, in hospital and in care.
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Affiliation(s)
- Sonia Cabrerizo
- Nutrition Service, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain
| | - Daniel Cuadras
- Servei d'Assessorament Metodològic i Estadístic a la RecercaUnitat de Recerca i Desenvolupament, Parc Sanitari Sant Joan de Déu - Fundació Sant Joan de Déu, Dr. Antoni Pujades 42, 08830 Sant Boi de Llobregat (Barcelona), Spain
| | - Fernando Gomez-Busto
- Geriatric Department, Residencia San Prudencia, Calle Francia 35, 01002 Vitoria-Gasteiz, Spain
| | - Iñaki Artaza-Artabe
- Geriatric Department, Orue Centro Socio Sanitario, Grupo Igurco, B° San Miguel Dudea s/n, 48340 Amorebieta, Spain
| | - Fernando Marín-Ciancas
- Geriatric Department, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain
| | - Vincenzo Malafarina
- Geriatric Department, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain.
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Guerra RS, Amaral TF, Sousa AS, Pichel F, Restivo MT, Ferreira S, Fonseca I. Handgrip strength measurement as a predictor of hospitalization costs. Eur J Clin Nutr 2014; 69:187-92. [PMID: 25369830 DOI: 10.1038/ejcn.2014.242] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 09/16/2014] [Accepted: 09/27/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Undernutrition status at hospital admission is related to increased hospital costs. Handgrip strength (HGS) is an indicator of undernutrition, but the ability of HGS to predict hospitalization costs has yet to be studied. OBJECTIVE To explore whether HGS measurement at hospital admission can predict patient's hospitalization costs. SUBJECTS/METHODS A prospective study was conducted in a university hospital. Inpatient's (n=637) HGS and undernutrition status by Patient-Generated Subjective Global Assessment were ascertained. Multivariable linear regression analysis, computing HGS quartiles by sex (reference: fourth quartile, highest), was conducted in order to identify the independent predictors of hospitalization costs. Costs were evaluated through percentage deviation from the mean cost, after adjustment for patients' characteristics, disease severity and undernutrition status. RESULTS Being in the first or second HGS quartiles at hospital admission increased patient's hospitalization costs, respectively, by 17.5% (95% confidence interval: 2.7-32.3) and 21.4% (7.5-35.3), which translated into an increase from €375 (58-692) to €458 (161-756). After the additional adjustment for undernutrition status, being in the first or second HGS quartiles had, respectively, an economic impact of 16.6% (1.9-31.2) and 20.0% (6.2-33.8), corresponding to an increase in hospitalization expenditure from €356 (41-668) to €428 (133-724). CONCLUSIONS Low HGS at hospital admission is associated with increased hospitalization costs of between 16.6 and 20.0% after controlling for possible confounders, including undernutrition status. HGS is an inexpensive, noninvasive and easy-to-use method that has clinical potential to predict hospitalization costs.
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Affiliation(s)
- R S Guerra
- 1] Departamento de Bioquímica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal [2] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [3] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
| | - T F Amaral
- 1] UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - A S Sousa
- 1] Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal [2] Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - F Pichel
- Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
| | - M T Restivo
- UISPA-IDMEC, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
| | - S Ferreira
- Serviço de Informação de Gestão, Centro Hospitalar do Porto, Porto, Portugal
| | - I Fonseca
- Unidade de Nutrição, Centro Hospitalar do Porto, Porto, Portugal
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111
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Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF. Handgrip strength cutoff values for undernutrition screening at hospital admission. Eur J Clin Nutr 2014; 68:1315-21. [DOI: 10.1038/ejcn.2014.226] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/01/2014] [Accepted: 09/16/2014] [Indexed: 01/04/2023]
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112
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Body symmetry and physical strength in human males. Am J Hum Biol 2014; 26:697-700. [DOI: 10.1002/ajhb.22584] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 06/20/2014] [Accepted: 06/22/2014] [Indexed: 11/07/2022] Open
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