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Raghavan P. Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke. Phys Med Rehabil Clin N Am 2024; 35:235-257. [PMID: 38514216 DOI: 10.1016/j.pmr.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Stroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early closure of the sensitive period and downstream changes in muscles, such as sarcopenia, muscle stiffness, and reduced cardiovascular capacity, and blood flow that impede recovery.
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Affiliation(s)
- Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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2
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Hoekstra C, Swart M, Bautmans I, Melis R, Peeters G. Association between Muscle Fatigability, Self-Perceived Fatigue and C-Reactive Protein at Admission in Hospitalized Geriatric Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6582. [PMID: 37623168 PMCID: PMC10454850 DOI: 10.3390/ijerph20166582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/28/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
Background: The capacity to perceived vitality (CPV) ratio is a novel measure for intrinsic capacity or resilience based on grip work and self-perceived fatigue. CPV has been associated with pre-frailty in older adults and post-surgery inflammation in adults. To better understand the utility of this measure in a frail population, we examined the association between CPV and inflammation in geriatric inpatients. Methods: Data were obtained from 104 hospitalized geriatric patients. The average age of participants was 83.3 ± 7.5 years, and 55.8% of participants were women. In the cross-sectional analyses, associations between C-reactive protein (CRP), grip work (GW), self-perceived fatigue (SPF) and the CPV ratio (higher values indicate better capacity) were examined using linear regression adjusted for confounders. Results: The adjusted association between CRP (abnormal vs. normal) and the CPV ratio was not statistically significant (B = -0.33, 95% CI = -4.00 to 3.34). Associations between CRP and GW (B = 25.53, 95% CI = -478.23 to 529.30) and SPF (B = 0.57, 95% CI = -0.64 to 1.77) were also not statistically significant. Similar results were found in unadjusted models and analyses of cases with complete data. Conclusions: In this frail group of geriatric inpatients, inflammation, routinely assessed with CRP, was not associated with CPV or its components, GW and SPF. Further research is needed to explore whether CPV is a useful indicator of frailty or recovery capacity in hospitalized geriatric patients.
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Affiliation(s)
- Carmen Hoekstra
- Department of Geriatric Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10 (Route 696), Postbus 9101, 6500 HB Nijmegen, The Netherlands; (C.H.)
| | - Myrthe Swart
- Department of Geriatric Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10 (Route 696), Postbus 9101, 6500 HB Nijmegen, The Netherlands; (C.H.)
| | - Ivan Bautmans
- Gerontology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Frailty in Ageing Research (FRIA) Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - René Melis
- Department of Geriatric Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10 (Route 696), Postbus 9101, 6500 HB Nijmegen, The Netherlands; (C.H.)
| | - Geeske Peeters
- Department of Geriatric Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10 (Route 696), Postbus 9101, 6500 HB Nijmegen, The Netherlands; (C.H.)
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Shokri-Mashhadi N, Moradi S, Heidari Z, Saadat S. Association of circulating C-reactive protein and high-sensitivity C-reactive protein with components of sarcopenia: A systematic review and meta-analysis of observational studies. Exp Gerontol 2021; 150:111330. [PMID: 33848566 DOI: 10.1016/j.exger.2021.111330] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Sarcopenia, a multi-faceted skeletal muscle disorder in the older population, has poor health outcomes. Some previous observational studies investigated the association between circulating inflammatory markers and sarcopenia components to evaluate chronic inflammation as a risk factor for sarcopenia in the elderly population. Nevertheless, the association between circulating C-reactive protein (CRP) and hs-CRP, as the recognized markers of systemic inflammation and components of sarcopenia, is unclear. This meta-analysis aimed to investigate the association of muscle strength, muscle mass, and muscle function with two serum inflammatory markers, circulating C-reactive protein (CRP) and high-sensitive CRP (hs-CRP). METHODS We assessed all observational studies across different electronic databases including PubMed, Scopus, and Google Scholar using keywords such as "muscle strength", "muscle mass", "muscle function", CRP and hs-CRP from inception until the 30th of July 2019. Only studies that investigated the association between components of sarcopenia and CRP or hs-CRP levels were included. Participants' country, age, sex, BMI, and screening tool for sarcopenia were retrieved. The correlations between muscle strength, muscle mass, and muscle function with CRP, and hs-CRP were expressed as the correlation coefficient (r) with 95% confidence intervals (CIs). Begg's test and Egger's test were conducted to evaluate risk of publication bias in this study. RESULTS Initially, we found fifty-nine studies for the qualitative synthesis. Ultimately, nineteen adult cross-sectional studies comprising 14,650 subjects were included in the meta-analysis. Of them, fourteen studies measured the correlation between CRP or hs-CRP and muscle strength. There were significant inverse correlation between CRP and hs-CRP concentrations with muscle strength (ES (z) = -0.22; 95% CI = -0.34 to -0.09; P < 0.001), (ES (z) = -0.22; 95% CI = -0.34 to -0.09; P < 0.001), respectively. No publication bias was found between muscle strength and CRP (P = 0.53) or hs-CRP (P = 0.62) respectively. CONCLUSION Among diagnostic components of sarcopenia, impairment of muscle strength was independently associated with both inflammatory biomarkers. However, future cohort studies are essential to clarify the causal correlation.
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Affiliation(s)
- Nafiseh Shokri-Mashhadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sajjad Moradi
- Halal Research Center of IRI, FDA, Tehran, Iran; Nutritional Sciences Department, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Science, Isfahan, Iran
| | - Saeed Saadat
- Department of Computer Sciences, Faculty of Mathematics and Natural Sciences, Heinrich Heine Universität, Düsseldorf, Germany
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Kositsawat J, Kuo CL, Barry LC, Melzer D, Bandinelli S, Ferrucci L, Wu R, Kuchel GA. Interaction Between Vitamin D and Interleukin 6 on Slow Gait Speed: 6-Year Follow-up Data of Older Adults From InCHIANTI. J Gerontol A Biol Sci Med Sci 2021; 75:1161-1166. [PMID: 31282535 DOI: 10.1093/gerona/glz165] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Whereas the independent effects of biomarkers, including 25-hydroxy vitamin D (25(OH)D), insulin-like growth factor 1, C-reactive protein, and interleukin 6 (IL-6), on gait speed in older adults have been evaluated, their joint effects on gait speed are not well understood. METHODS Study subjects aged at least 65 at baseline (N = 970) were enrolled in the population-based Invecchiare in Chianti (InCHIANTI) study from 1998 to 2000 and were followed up at 3 and 6 years. All above biomarkers and gait speed data were measured at each of the three time points. Using a generalized estimating equation approach, we determined if slow gait speed (<0.8 m/s) was associated with the biomarkers. Further investigation was conducted for interactions between high IL-6 (≥.87 pg/mL) and other biomarkers focusing on low 25(OH)D (<20 ng/mL). RESULTS After controlling for other biomarkers and potential confounders, IL-6 emerged as the only biomarker independently associated with gait speed. The association between high IL-6 and slow gait speed was enhanced by low 25(OH)D, with significant interaction between high IL-6 and low 25(OH)D (p = .038). The odds ratio of slow gait speed for low 25(OH)D and high IL-6 was 1.63 (95% confidence interval [CI]: 1.15, 2.32) compared with the reference groups with both biomarker levels at the other ends. CONCLUSION The association of low vitamin D with slow gait speed statistically interacts with high IL-6. Coexisting vitamin D insufficiency and inflammation may provide a better biomarker for identifying those at risk of developing impairments in gait speed than either factor alone.
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Affiliation(s)
| | - Chia-Ling Kuo
- Connecticut Institute for Clinical and Translational Science, Farmington
| | - Lisa C Barry
- Center on Aging, University of Connecticut Health Center, Farmington
| | - David Melzer
- Center on Aging, University of Connecticut Health Center, Farmington.,Epidemiology and Public Health, University of Exeter Medical School, Devon, UK
| | | | | | - Rong Wu
- Connecticut Institute for Clinical and Translational Science, Farmington
| | - George A Kuchel
- Center on Aging, University of Connecticut Health Center, Farmington
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5
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Hartley P, Romero-Ortuno R, Wellwood I, Deaton C. Changes in muscle strength and physical function in older patients during and after hospitalisation: a prospective repeated-measures cohort study. Age Ageing 2021; 50:153-160. [PMID: 32902637 DOI: 10.1093/ageing/afaa103] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Indexed: 01/11/2023] Open
Abstract
AIM to investigate changes in knee-extension strength and physical function in older adults during and after acute hospital admission, and the contributions of illness severity, frailty and sedentary activity to changes in knee-extension strength. METHODS prospective repeated-measures cohort study on a sample of participants aged ≥75 recruited within 24 hours of acute hospital admission. Knee-extension, grip strength and functional mobility (de Morton Mobility Index, DEMMI) were measured at recruitment, day 7 (or discharge if earlier), and at follow-up 4-6 weeks later. During the first 7 days, continuous measurement of physical activity and daily measurements of muscle strength were taken. Participants recalled the functional ability they had 2-weeks before admission and self-reported it at follow-up (Barthel Index, BI). RESULTS sixty-five of 70 participants (median age 84 years) had at least one repeated measure of muscle strength in hospital. Knee-extension strength declined during hospitalisation by 11% (P < 0.001), but did not change post-hospitalisation (P = 0.458). Grip strength did not change during hospitalisation (P = 0.665) or from discharge to follow-up (P = 0.508). General functional ability (BI) deteriorated between 2 weeks before admission and follow-up (P < 0.001). Functional mobility (DEMMI) improved during hospitalisation (P < 0.001), but did not change post-hospitalisation (P = 0.508). A repeated-measures mixed model showed that greater loss in knee-extension strength during hospitalisation was associated with increased sedentary time, frailty and baseline strength and lower baseline inflammatory levels. CONCLUSIONS our observations add to a growing body of evidence on potential risk factors for hospital-associated deconditioning.
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Affiliation(s)
- Peter Hartley
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, Trinity College Dublin, Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
| | - Ian Wellwood
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Christi Deaton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Karlsen A, Mackey AL, Suetta C, Kjaer M. What is the impact of acute inflammation on muscle performance in geriatric patients? Exp Gerontol 2020; 138:111008. [DOI: 10.1016/j.exger.2020.111008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 01/08/2023]
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Beckwée D, Lefeber N, Bautmans I, Cuypers L, De Keersmaecker E, De Raedt S, Kerckhofs E, Nagels G, Njemini R, Perkisas S, Scheys E, Swinnen E. Muscle changes after stroke and their impact on recovery: time for a paradigm shift? Review and commentary. Top Stroke Rehabil 2020; 28:104-111. [PMID: 32588773 DOI: 10.1080/10749357.2020.1783916] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In stroke rehabilitation there is a growing body of evidence that not all patients have the same potential to recover. Understanding the processes that give rise to the heterogeneous treatment responses in stroke survivors will lay foundations for any conceivable advance in future rehabilitation interventions. This review was set out to shine new light on the debate of biomarkers in stroke rehabilitation by linking fundamental insights from biogerontological sciences to neurorehabilitation sciences. In particular, skeletal muscle changes and inflammation are addressed as two potential constructs from which biomarkers for stroke rehabilitation can be derived. Understanding the interplay between these constructs as well as their relation to recovery could enhance stroke rehabilitation in the future. The rationale for the selection of these constructs is three-fold: first, recent stroke literature emphasizes the importance of identifying muscle wasting (also called stroke-induced muscle wasting) in stroke patients, a concept that is widely investigated in geriatrics but less in the stroke population. Second, insights from transdisciplinary research domains such as gerontology have shown that inflammation has severe catabolic effects on muscles, which may impede rehabilitation outcomes such as gait recovery. Last, it has been proven that (high-intensity) muscle strengthening exercises have strong anti-inflammatory effects in a non-stroke population. Therefore, an evidence-based rationale is presented for developing research on individual changes of muscle and inflammation after a stroke.
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Affiliation(s)
- David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium.,Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp , Wilrijk, Belgium
| | - Nina Lefeber
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium
| | - Lotte Cuypers
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Emma De Keersmaecker
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Sylvie De Raedt
- Universitair Ziekenhuis Brussel , Neurology Department, Jette, Belgium
| | - Eric Kerckhofs
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
| | - Guy Nagels
- Universitair Ziekenhuis Brussel , Neurology Department, Jette, Belgium
| | - Rose Njemini
- Frailty in Ageing Research Department, Vrije Universiteit Brussel , Brussels, Belgium
| | - Stany Perkisas
- University Center of Geriatrics, University of Antwerp , Antwerp, Belgium
| | - Ellen Scheys
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium
| | - Eva Swinnen
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel , Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel , Brussels, Belgium.,Human Robotic Research Center (Brubotics), Vrije Universiteit Brussel , Brussels, Belgium
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McNicholl T, Curtis L, Dubin JA, Mourtzakis M, Nasser R, Laporte M, Keller H. Handgrip strength predicts length of stay and quality of life in and out of hospital. Clin Nutr 2019; 39:2501-2509. [PMID: 31757485 DOI: 10.1016/j.clnu.2019.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 09/30/2019] [Accepted: 11/03/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Handgrip strength (HGS) is a practical measure of strength and physical function that can be used to identify frailty among hospitalized patients, but its utility in this setting is unclear. To be considered useful, any functional measure needs to provide pertinent information on the patient and predict relevant outcomes such as health-care utilization (e.g., length of stay (LOS)) and patient-reported quality of life (QOL). The purpose of this study was to determine if HGS predicted LOS and QOL. A second aim was to examine the best sensitivity (SE) and specificity (SP) for predicting length of stay (>7 or >13 days) using previously published cut-points for HGS. METHODOLOGY HGS was measured on 1136 medical patients shortly after admission with a Lafayette dynamometer. QOL was assessed with the self-reported SF-12 completed with an interviewer during hospitalization and 30- days after discharge via telephone. Physical (PCS) and mental (MCS) component scores of SF-12 were calculated. A variety of covariates were assessed (e.g., nutritional status). Multivariate analyses stratified by sex were completed. RESULTS The mean LOS was 12.71 days (median = 8.00; SD = 13.20), 12.88 days (SD = 13.82) for males, and 12.58 days (SD = 12.68) for females. Lower admission HGS scores were associated with longer LOS (male X2 = 7.85, p < 0.05; female X2 = 14.9, p < 0.0001). The average quality of life scores were as follows: in hospital PCS: 34.66, MCS: 46.49; post discharge PCS: 36.17; MCS: 51.22. HGS predicted PCS during hospitalization (male X2 = 36.22, p < 0.0001; female X2 = 19.87, p < 0.0001) and post hospitalization (male X2 = 6.98, p < 0.01; female X2 = 10.99, p < 0.01). Various reference cut-points for HGS were tested against LOS, with none being considered appropriate (e.g., SE and SP both < 70) when adjusting for age and sex. CONCLUSION Admission HGS adds predictive value for both LOS and physical components of QOL and is worth pursuing in practice to identify potential frailty and the need for proactive steps to mitigate further functional decline during hospitalization. However, HGS cut-points for LOS specific to acute care patients need to be defined and tested.
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Affiliation(s)
- Tara McNicholl
- University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
| | - Lori Curtis
- University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
| | - Joel A Dubin
- University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
| | - Marina Mourtzakis
- University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
| | - Roseann Nasser
- Pasqua Hospital, 101 Dewdney Avenue, Regina, SK, S4T 1A5, Canada.
| | - Manon Laporte
- Réseau de santé Vitalité Health Network, Campbellton Regional Hospital, 189 Lily Lake Road, Campbellton, NB, E3N 3H3, Canada.
| | - Heather Keller
- University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada; Schlegel-Univeristy of Waterloo Research Institute for Aging, Waterloo, ON, N2J 0E2, Canada.
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Hartley P, Costello P, Fenner R, Gibbins N, Quinn É, Kuhn I, Keevil VL, Romero-Ortuno R. Change in skeletal muscle associated with unplanned hospital admissions in adult patients: A systematic review and meta-analysis. PLoS One 2019; 14:e0210186. [PMID: 30608987 PMCID: PMC6319740 DOI: 10.1371/journal.pone.0210186] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/18/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The primary objective of the review was to describe change that occurs in skeletal muscle during periods of unplanned hospitalisation in adult patients. The secondary objective was to examine the relationship between both physical activity and inflammation with the change in skeletal muscle. A further objective was to investigate the effect of interventions on change in skeletal muscle during periods of unplanned hospitalisation. DESIGN A systematic review and meta-analyses. Embase, MEDLINE, CINAHL, AMED, PEDro and the Cochrane Library were searched for studies that included any measures of skeletal muscle (excluding pulmonary function) at two time points during unplanned hospitalisation. Studies that were set in critical care, or included patients with acute or progressive neurological illness, were excluded. RESULTS Our search returned 27,809 unique articles, of which 35 met the inclusion criteria. Meta-analyses of change between baseline and follow-up in random effects models suggested that grip strength had an average increase: standardised mean difference (SMD) = 0.10 (95% CI: 0.03; 0.16); knee extension strength had an average reduction: SMD = -0.24 (95% CI: -0.33; -0.14); and mid-arm muscle circumference had an average reduction: SMD = -0.17 (95% CI: -0.22; -0.11). Inflammation appeared to be associated with greater loss of muscle strength. There was inconclusive evidence that the level of physical activity affects change in skeletal muscle. In regard to the effect of interventions, only exercise interventions were consistently associated with improved skeletal muscle outcomes. CONCLUSIONS Adult patients who undergo an unplanned hospital admission may experience a small reduction in knee extension strength and mid-arm muscle mass. Prospective research is needed to clarify the contribution of confounding factors underlying the observations made in this review, with particular attention to levels of physical activity, and possible contributions from environmental factors and processes of hospital care.
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Affiliation(s)
- Peter Hartley
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
- * E-mail:
| | - Patricia Costello
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Rachel Fenner
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Nathalie Gibbins
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Édáin Quinn
- Department of Physiotherapy, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Isla Kuhn
- Medical Library, University of Cambridge, Cambridge, United Kingdom
| | - Victoria L. Keevil
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Department of Medicine for the Elderly, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Roman Romero-Ortuno
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Department of Medicine for the Elderly, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
- Discipline of Medical Gerontology, Trinity College Dublin, Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
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Impact of drugs with anti-inflammatory effects on skeletal muscle and inflammation: A systematic literature review. Exp Gerontol 2018; 114:33-49. [PMID: 30367977 DOI: 10.1016/j.exger.2018.10.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/01/2018] [Accepted: 10/17/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Ageing-related low-grade inflammation is suggested to aggravate sarcopenia and frailty. This systematic review investigates the influence that drugs with anti-inflammatory effects (AIDs) have on inflammation and skeletal muscle. METHODS PubMed and Web of Science were systematically screened for articles reporting the effects of AIDs on inflammation on one hand and on muscle mass and/or performance on the other. RESULTS Twenty-eight articles were included. These articles were heterogeneous in terms of the subjects studied, intervention components, setting, and outcome measures. Articles on older humans with acute inflammation showed evidence that celecoxib and piroxicam could reduce inflammation and improve performance and that ibuprofen improves exercise-induced muscle hypertrophy and gains in strength. In younger humans, only the effects of AIDs combined with exercise were investigated; no significant benefits of non-selective COX-inhibitors were reported, but improved strength gains with etanercept and reduced muscle soreness with celecoxib were noted. Indomethacin increased acute exercise-induced inflammation and reduced satellite cell differentiation in exercising muscle. Most articles did not systematically report occurrences of side effects. CONCLUSIONS Although AIDs showed significant reduction in inflammation-induced muscle weakness in older hospitalised patients with acute inflammation, robust evidence is still lacking. When combined with exercise, AIDs presented a protective effect against age-related loss of muscle mass, thus enhancing muscle mass and performance. The mechanism regulating muscle strength and its mass seems to differ between individuals of old and young age. However, the effects seem drug-specific and dose-dependent and appear to be influenced by subjects' trainability and the clinical context. In addition, the balance between benefits and harm remains unclear.
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11
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Norheim KL. Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- K. L. Norheim
- Department of Health Science and Technology; Physical Activity and Human Performance Group; SMI; Aalborg University; Aalborg Denmark
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