Static and Dynamic Handgrip Strength Endurance: Test-Retest Reproducibility

Masticatory and Neck Muscles' Isometric Endurance and Their Relation to Upper Limb Isometric Grip Strength in Sport Climbers-Preliminary Investigation

Background and Objectives: Sport climbing's popularity has grown with its inclusion in the Olympics and increased accessibility. Understanding the relationship between hand dominance, grip strength, endurance, and the involvement of masticatory and neck muscles can provide valuable insights into the neuromuscular adaptations specific to sport climbing, potentially aiding performance optimization and injury prevention in intermediate and advanced climbers. This study analyzes if the dominant hand has greater isometric endurance and isometric manual grip strength parameters than the non-dominant one and examines its relation to the masticatory and neck muscles in intermediate and advanced sport climbers. Materials and Methods: The study was conducted on 41 participants who were divided into two groups according to the IRCRA classification. A level 2 (Lv2) group consisting of 18 climbers and a level 3 (Lv3) group consisting of 23 climbers were identified. First, isometric manual grip strength and isometric endurance were measured using a dynamometer following the protocol of the first three and the last three repetitions (PC3) and the first six and the last six repetitions (PC6). Next, masticatory and neck muscle activity was assessed using surface electromyography, following the same protocol. Results: Greater activity of the temporalis muscle was observed on the non-dominant side in the advanced climber's group (p = 0.045). The decrease in bioelectric activity was lower on the dominant side in group Lv3 compared to Lv2. In intermediate climbers, the bioelectrical activity of the masseter muscles in PC3 was greater on the non-dominant side, and in PC6, was greater on the dominant side. The digastric muscles showed a greater decrease in isometric endurance on the non-dominant side. Conclusions: Advanced climbers demonstrated greater isometric endurance and isometric manual grip strength parameters in both dominant and non-dominant hands compared to intermediate climbers. The masticatory muscles exhibited higher electromyographic activity on the non-dominant side in the masseter muscles and higher electromyographic activity on the dominant side in the temporalis muscles and digastric muscles.

Reliability, Objectivity, Validity, and Reference Levels of the Austrian Pole Climbing Test (APCT)-A Novel Monitoring Tool for Assessing General Fitness in Children, Adolescents, and Young Adults

Climbing is an activity involving many major muscle groups and, therefore, it is suitable for assessing general physical fitness. The Austrian pole climbing test (APCT) was developed as a reliable and valid test for the assessment of general fitness levels in children, adolescents, and young adults. In this cross-sectional pilot study, 677 participants (aged 6 to 19 years) were assessed via the APCT. Subsequently, test quality criteria (reliability and objectivity) were assessed, and the test's validity was evaluated through comparisons with other established fitness tests (hand grip strength, standing long jump, and pull- and push-ups). Additionally, age- and gender-specific reference values were generated. The reliability (ICC2.1 = 0.97, 95%CI 0.95 to 0.98) and objectivity (ICC2.1 = 0.99, 95%CI 0.99 to 0.99) of the APCT were found to be excellent. The APCT results correlated strongly with the hand strength per kilogram of body weight (right: r = 0.58; left: r = 0.53), number of pull-ups (with upper grip: r = 0.74; with lower grip: r = 0.69) and standing long jump (r = 0.61); a moderate correlation with the push-up test was observed (r = 0.44). The APCT is reliable, objective, and suitable for children, adolescents, and young adults with an affinity for sports. It offers a novel opportunity to assess fitness without time pressure, considering the anthropometric requirements.

Could BIA-derived phase angle predict health-related musculoskeletal fitness? A cross-sectional study in young adults

OBJECTIVES

To our knowledge, little evidence exists on the relationships between body composition and health-related physical fitness; in particular, musculoskeletal fitness. Bioimpedance index phase angle (bioelectrical impedance analysis raw variables) is a candidate predictor of health-related fitness, a marker of fat-free and body cell mass, respectively. The aim of this study was to evaluate body composition, raw bioelectrical impedance analysis variables, and health-related fitness in young adults and investigate their mutual relationships to identify predictors of muscle strength.

METHODS

The study included 229 young adults (115 men and 114 women; 24.2 ± 3 y; body mass index 19-30 kg/m²). Anthropometry was measured with standardized procedures. Whole-body BIA (50 kHz) was performed for impedance and phase angle. Predictive equations estimated fat-free mass and percentage body fat. The bioimpedance index was calculated as stature²/impedance. Musculoskeletal fitness was assessed by handgrip strength, standing broad jump, squat jump, and countermovement jump.

RESULTS

In both sexes, health-related fitness had stronger associations with body composition than stature or weight. Handgrip strength was related to fat-free mass and bioimpedance index, while an inverse association with percent body fat emerged for standing broad jump, squat jump and countermovement jump. Phase angle is directly correlated with handgrip strength, standing broad jump, squat jump, and countermovement jump. In multiple regression analysis phase angle was an independent predictor of all health-related fitness tests, along with fat-free mass (or bioimpedance index) for handgrip strength, and with sex and percent body fat for the three jump tests.

CONCLUSIONS

The present study provided consistent information on the relationships between body composition and health-related fitness in young adults. Phase angle emerged as a significant predictor of all health-related fitness measures and might be useful for a more consistent assessment of musculoskeletal fitness.

Creatine supplementation and resistance training to preserve muscle mass and attenuate cancer progression (CREATINE-52): a protocol for a double-blind randomized controlled trial

BACKGROUND

Muscle mass is important for metastatic prostate cancer survival and quality of life (QoL). The backbone of treatment for men with metastatic castration sensitive prostate cancer (mCSPC) is androgen deprivation therapy (ADT) with an androgen signaling inhibitor. ADT is an effective cancer treatment, but it facilitates significant declines in muscle mass and adverse health outcomes important to mCSPC survivors, such as fatigue, and reductions in physical function, independence, insulin sensitivity, and QoL. In non-metastatic CSPC survivors, resistance training (RT) preserves muscle mass and improves these related health outcomes, but the biggest barrier to RT in CSPC survivors of all stages is fatigue. Creatine monohydrate supplementation coupled with RT (Cr + RT) may address this barrier since creatine plays a critical role in energy metabolism. Cr + RT in cancer-free older adults and other clinical populations improves muscle mass and related health outcomes. Evidence also suggests that creatine supplementation can complement cancer treatment. Thus, Cr + RT is a strategy that addresses gaps in survivorship needs of people with mCSPC. The purpose of this parallel, double-blind randomized controlled trial is to test the effects of 52-weeks of Cr + RT compared with placebo (PLA) and RT (PLA + RT) on muscle mass, other related health outcomes, and markers of cancer progression.

METHODS

We will carry out this trial with our team's established, effective, home-based, telehealth RT program in 200 mCSPC survivors receiving ADT, and evaluate outcomes at baseline, 24-, and 52-weeks. RT will occur twice weekly with elastic resistance bands, and an established creatine supplementation protocol will be used for supplementation delivery. Our approach addresses a major facilitator to RT in mCSPC survivors, a home-based RT program, while utilizing a supervised model for safety.

DISCUSSION

Findings will improve delivery of comprehensive survivorship care by providing a multicomponent, patient-centered lifestyle strategy to preserve muscle mass, improve health outcomes, and complement cancer treatment (NCT06112990).

Characterization of the Sideritis scardica Extract SidTea+TM and Its Effect on Physiological Profile, Metabolic Health and Redox Biomarkers in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Study

This study aimed to characterize a Sideritis scardica extract (SidTea+TM) and investigate its effect on the physiological profile, metabolic health and redox status in healthy individuals. The chemical profile and antioxidant potential of the SidTea+TM extract were evaluated by UPLC-HRMS analysis and in vitro cell-free methods. Twenty-eight healthy adults participated in this randomized, double-blind, placebo-controlled study. Participants consumed 1500 mg/day of SidTea+TM or a placebo for 4 weeks. At baseline and post-supplementation, participants were assessed for their anthropometric and physiological profile and provided a resting blood sample. SidTea+TM decreased (p < 0.05) systolic blood pressure (-10.8 mmHg), mean arterial pressure (-4.5 mmHg), resting heart rate (-3.1 bpm) and handgrip strength of the non-dominant limb (-0.8 kg) whereas the placebo decreased (p < 0.05) handgrip strength of the dominant (-5.8 kg) and non-dominant (-3.2 kg) limb. SidTea+TM also resulted in an increase (p < 0.05) in estimated VO2max (+1.1 mL/kg/min) and a reduction (p < 0.05) in γ-GT and SGPT enzymatic activity in serum (-3.7 and -3.3 U/L, respectively). Finally, SidTea+TM increased (p < 0.001) total antioxidant capacity and decreased (p < 0.05) lipid peroxidation levels in plasma. These results indicate that SidTea+TM is a potent and safe to use antioxidant that can elicit positive changes in indices of blood pressure, cardiorespiratory capacity, liver metabolism, and redox status in healthy adults over a 4-week supplementation period.

EFFECT OF WRIST WRAP IN HANDGRIP STRENGTH IN CROSSFIT

Objectives

Analyze wrist wrap influence on the values of maximum handgrip strength and dynamic resistance.

Methods

A controlled randomized cross-over trial including 54 Crossfit participants randomly assigned to two groups. Group 1 began the series of tests with control wrapping, and Group 2 started with functional wrapping. Alternate series of four dynamic grip strength resistance tests were performed, and the resistance and fatigue values were calculated.

Results

The values obtained from the grip tests did not indicate any effect from the wrist wrap for an increase in maximum grip strength (35.7 vs. 35.6 kg; p=0.737) or greater endurance (78.2 vs. 77.8%; p=0.549). Fatigue was also equal in both groups (mean differences between the groups: 0.1 kg, CI= -0.7-0.8; p=0.779).

Conclusion

The hypothesis that using a wrist wrap increases maximum strength and dynamic handgrip endurance was rejected in this study. Evidence Level I; Randomized control trial .

Feasibility and acceptability of an mHealth, home-based exercise intervention in colorectal cancer survivors: A pilot randomized controlled trial

OBJECTIVE

To determine the feasibility and acceptability of an mHealth, home-based exercise intervention among stage II-III colorectal cancer (CRC) survivors within 5-years post-resection and adjuvant therapy.

METHODS

This pilot randomized controlled trial of a 12-week mHealth, home-based exercise intervention, randomly assigned CRC survivors to a high-intensity interval training (HIIT) or moderate-intensity continuous exercise (MICE) prescription. The following assessments were carried out at baseline and end-of-study (EOS): handgrip strength, short physical performance battery (SPPB), PROMIS physical function, neuropathy total symptom score-6 (NTSS-6), Utah early neuropathy scale (UENS), cardiopulmonary exercise testing, anthropometrics, and body composition via BOD POD, modified Godin leisure-time activity questionnaire. Feasibility, as defined by number of completed prescribed workouts and rate of adherence to individualized heart rate (HR) training zones, was evaluated at EOS. Acceptability was assessed by open-ended surveys at EOS. Descriptive statistics were generated for participant characteristics and assessment data.

RESULTS

Seven participants were included in this pilot study (MICE: n = 5, HIIT: n = 2). Median age was 39 years (1st quartile: 36, 3rd quartile: 50). BMI was 27.4 kg/m2 (1st quartile: 24.5, 3rd quartile: 29.7). Most participants had stage III CRC (71%, n = 5). We observed an 88.6% workout completion rate, 100% retention rate, no adverse events, and qualitative data indicating improved quality of life and positive feedback related to ease of use, accountability, motivation, and autonomy. Mean adherence to HR training zones was 95.7% in MICE, and 28.9% for the high-intensity intervals and 51.0% for the active recovery intervals in HIIT; qualitative results revealed that participants wanted to do more/work-out harder.

CONCLUSION

An mHealth, home-based delivered exercise intervention, including a HIIT prescription, among stage II-III CRC survivors' post-resection and adjuvant therapy was tolerable and showed trends towards acceptability.

A Chair-Based Music-Kinetic Combined Exercise Program as an Alternative Approach for Increasing Health, Functional Capacity, and Physical Fitness Indices in Middle-Aged Pre-Menopausal Women

Lately, chairs have been widely used as a cheap, easily accessible, safe, and effective training means in different settings (e.g., in gyms, the house, workplaces, and in rehabilitation). This study investigated the effectiveness of a 10-week chair-based music-kinetic integrated combined exercise program on health, functional capacity, and physical fitness indicators of middle-aged pre-menopausal women. A total of 40 healthy women (40-53 years) were assigned to two groups: exercise (EG) and control (CG). The EG followed a 10-week (3 times/weekly; 30 training sessions) chair-based exercise program including aerobic dance, flexibility, coordination, and strength exercises with body weight or auxiliary means. Selected indicators of health, functional capacity, and physical fitness were evaluated before and after the 10 weeks. Following the program, the EG significantly reduced their body fat (-2.5%), blood pressure (by -4.5 to -5.5%), the time during the timed up-and-go (TUG) test (by -10.27%), heart rate (by -6.35 to -13.78%), and the rate of perceived exertion (by -24.45 to -25.88%), while increasing respiratory function (3.5-4%), flexibility (12.17%), balance (50.38-51.07%), maximal handgrip strength (10-12.17%), and endurance strength (43.87-55.91%). The chair-based combined music-kinetic exercise program was effective and could be safely used in different settings to improve health, functional capacity, and physical fitness in middle-aged women.

Does Obesity Affect Neuromuscular and Cardiovascular Adaptations after a 3-Month Combined Exercise Program in Untrained Premenopausal Middle-Aged Women?

Previous studies indicated different acute adaptations between obese and lean individuals, while there is limited information with conflicting results regarding long-term adaptations. The aim of this study was to compare the efficacy of a 3-month integrated combined training between obese and lean middle-aged untrained premenopausal women. In total, 72 women (36 obese/36 lean) were divided into four groups: (a) obese exercise (OB-EG), (b) obese control (OB-CG), (c) lean exercise (L-EG), and (d) lean control (L-CG). The exercise groups followed a 3-month (3 times/week) integrated combined aerobic and strength training program. Health indices (body composition, body circumferences, blood pressure, respiratory function), functional capacity (flexibility, balance), and physical fitness (strength, aerobic capacity) were measured before and after the 3-month time period. Participants' enjoyment was also assessed following the program. OB-EG and L-EG significantly improved (p < 0.05) similarly across all functional capacity and physical fitness indices (10-76%; depending on the evaluation index), except balance and strength indices of the non-preferred limb where OB-EG showed greater improvement (reducing the existing pre-training strength/balance asymmetries) than L-EG. Furthermore, both obese and lean individuals showed similarly high levels of enjoyment. This program could be effectively used in fitness settings causing similar neuromuscular and cardiovascular adaptations in obese and lean women.

A comprehensive wellness profile in sedentary office employees: Health, musculoskeletal pains, functional capacity, and physical fitness indices

BACKGROUND

One of the most important steps for the successful designing, execution, and sustainability of a workplace wellness program is the evaluation stage.

OBJECTIVES

The purpose of this research was to create a comprehensive wellness profile through selected and reliable testing protocols used for the evaluation of health, functional capacity, and physical fitness in office employees.

METHODS

One hundred office employees (32-55year-old) were evaluated to create a comprehensive wellness profile. Health indices (body composition, blood pressure, respiratory function, lipidemic profile), musculoskeletal pains, functional capacity, physical fitness (cervical, handgrip, back, leg strength, cardiorespiratory fitness), and lifestyle behaviors (physical activity levels, viewing habits, smoking, alcohol consumption) were measured.Thirty of the participants performed two assessment sessions to examine the reliability of functional capacity and physical fitness indices.

RESULTS

A significant proportion of employees were overweight (40.7%) and obese (18.5%). The largest percentage of employees (78%) presented musculoskeletal problems in various areas of the body (higher rates in lower back, neck, and/or hip). A large percentage of the employees (40-65%) showed low-moderate levels in selected indices of health, physical activity (<6000 steps/day), functional capacity and physical fitness, and high levels of unhealthy lifestyle behaviors. The test-retest reliability for the assessment of functional capacity and physical fitness profile was high for all testing variables (ICC = 0.92-0.99;SEM%  = 2.5-4.5).

CONCLUSION

The testing protocols are reliable and can be used in conjunction with the reference values created to evaluate selected health and wellness indicators in office-employees.

Grip endurance in patients with rheumatoid arthritis: Its relationship between clinical characteristics, upper extremity functional disability, and quality of life

AIM

The study's aim was to investigate the relationship of grip strength and endurance with clinical characteristics, upper extremity functional disability, and quality of life in rheumatoid arthritis (RA) patients.

METHOD

We included 45 RA patients and 37 healthy controls in this cross-sectional study. All participants were evaluated using the maximal gripping test, static and dynamic grip endurance test, the Disability of Arm, Shoulder Hand Questionnaire, and Short Form-36, and sociodemographic and clinical characteristics were recorded.

RESULTS

Moderate to strong correlations were found between functional disability and all of the grip-related variables. Physical, emotional, and social function sub-scores were correlated with grip strength on both sides and dynamic endurance on the dominant side.

CONCLUSION

The study highlights grip-related variables associated with disability of the upper extremity. The grip strength was related to hand-wrist pain but not other clinical characteristics. Furthermore, grip strength on both sides and dynamic grip endurance on the dominant side were associated with some quality of life sub-scores. While therapists create a rehabilitation plan for RA patients, based on our findings, it may be beneficial to maximize therapeutic benefits on daily life and quality of life.

Grip strength, functional range and anthropometric dimensions, and indication on fulfilling occupations in the home and workplace: A cross-sectional study

Introduction

Little is known about the relationship between the types of grip strength, functional range, anthropometric measures, and function in the home and workplace. The study aimed to determine their relationships and explore their contributions to performing usual work duties and overall function in participants with and without hand and wrist injury.

Method

Forty-four participants were measured on Maximal Voluntary Isometric Grip Strength, Rapid Exchange Grip Contractions and Isometric Endurance, Forearm Length and Volumetry, and the Dart Thrower’s Motion (DTM) measure. They completed the Patient Rated Wrist and Hand Evaluation and the Disabilities of the Arm, Shoulder and Hand Work Module.

Results

The grip measures significantly correlated with Volumetry (r = 0.62–0.74) in participants with and without hand and wrist injury. The Isometric Endurance and DTM measure of the non-injured hand were found to be contributing factors for participants with hand and wrist injury when returning to usual work duties and overall function.

Conclusion

The non-injured hand function plays a role in the overall function for participants with hand and wrist injuries. Isometric Endurance and DTM measure could assist clinicians in determining suitable rehabilitation targets, resulting in a better function required for occupations in the home or workplace.

Workplace exercise program in a hospital environment: an effective strategy for the promotion of employees physical and mental health. A randomized controlled study

PURPOSE

The demanding and exhausting working hours, as well as the bad and unsuitable working conditions that prevail in several hospitals, affect employees' physical and mental health. The purpose of this study was to examine the effectiveness of a daily 6-week supervised workplace exercise program on health indices, functional capacity, overall fitness, subjective vitality, and life satisfaction in health professionals.

METHODS

A randomized controlled study was used. 50 health professionals (40-55 years), working in a hospital environment, were divided into two groups: exercise (EG) and control group (CG). EG performed a 6-week supervised concurrent chair-based exercise program (stretching, strength, balance exercises, aerobic dance; 5 days/week, 30-40 min/day, 2 workouts/day lasted 15-20 min) in the hospital. Health indices (body composition, blood pressure, respiratory function), functional capacity (flexibility, balance), physical fitness (strength, cardiorespiratory fitness), subjective vitality, and life satisfaction were measured before and after the completion of the program. Additionally, after the completion of the program, EG participants' enjoyment was assessed.

RESULTS

EG significantly increased (p < 0.001) lean body mass and respiratory function (range of mean increase 3.5-4.5%, depending on the variable), functional capacity (range of mean increase 18-40%, depending on the variable), lower and upper libs maximal strength (range of mean increase 10-25%, depending on the variable), subjective vitality (41.3%) and life satisfaction (21.5%); while significantly decreased (p < 0.001) heart rate during submaximal test (- 14%), body fat and blood pressure (range of mean decrease - 3.5% to - 5.5%, depending on the variable). In CG, all the above variables did not change. Furthermore, a great percentage of employees (95%) reported high levels of enjoyment.

CONCLUSION

A workplace exercise program may be safely used for the promotion of employees' physical and mental health.

Impairments in grip and pinch force accuracy and steadiness in people with osteoarthritis of the hand: A case-control comparison

BACKGROUND

Symptomatic hand osteoarthritis (OA) is severely disabling condition. Limited evidence has focused on force control measures in this population.

OBJECTIVES

It was the aim of the present study to determine whether force matching accuracy and steadiness are impaired in people with hand OA. In addition, the relationship between force control measures (accuracy and steadiness) and measures of hand function and pain in people with symptomatic hand OA was explored.

DESIGN

Case-control study.

METHOD

Sixty-two participants with symptomatic hand OA and 26 healthy pain-free controls undertook an isometric grip and pinch force matching task at 50 % of their maximum voluntary contraction. Average pain hand pain was recorded. In addition, the Disability of the Arm Shoulder and Hand Questionnaire (DASH), and the Functional Index of Hand Osteoarthritis were collected.

RESULTS

Grip force-matching accuracy and steadiness were significantly impaired in the hand OA group compared to controls (P < 0.05). Pinch force-matching error was greater in people with hand OA (P < 0.05), however, pinch force steadiness was not different between groups. There was a learning effect in people with hand OA, with resolution of force matching impairments with task repetition. A small positive correlation was identified between grip force control and the DASH. No association was found between other measures of force control and self-reported measures of function or pain.

CONCLUSIONS

People with hand OA presented with greater impairments in measures of submaximal force control. These were correlated with self-reported hand function but not pain. Future studies may wish to examine whether objective measures of functional performance are related to force-matching error and steadiness.

Dynapenia is highly prevalent in older patients with advanced idiopathic pulmonary fibrosis

Body composition and muscle strength are emerging aspects in idiopathic pulmonary fibrosis (IPF) clinical assessment. We aimed to study the relationships of handgrip strength (HGS) with anthropometric variables, body composition, and disease staging, and to evaluate the prevalence of dynapenia in 102 clinically stable IPF patients (70 M; mean age: 69.4 years). Fat-free mass (FFM), skeletal muscle (SM) were estimated with bioimpedance analysis. HGS was measured with a digital handle dynamometer for both dominant and non-dominant body sides. Dynapenia was identified according to six recognized criteria sets. Mean body mass index (BMI) was 28.2 ± 4.7 kg/m², with a prevalence of overweight (BMI > 25 and < 30 kg/m²) and obesity (BMI ≥ 30 kg/m²) of 35% and 37%, respectively. FFM and SM were greater in males, whereas percentage body fat was higher in women. HGS was higher and declined with age slightly more rapidly in men, showing a stronger correlation with FFM and SM. Dynapenia prevalence ranged from 20.6 to 56.9%, depending on the criteria used, and was more frequent in older patients and advanced disease. Dynapenia is highly prevalent in IPF. HGS is a promising proxy marker of muscle function to be used in clinical evaluation and follow-up programs.

A new visual feedback-based system for the assessment of pinch force, endurance, accuracy and precision. A test-retest reliability study

Introduction

Given that pinch is a precision grip involved in sustained submaximal activities, a Sustained Contraction (SC) task could be associated to Maximal Voluntary Contraction (MVC). To better evaluate the thumb-index system, the test-retest reliability of pinch MVC and SC, measured by a visual feedback-based pinch gauge was assessed.

Methods

26 healthy participants performed MVC and SC in two separate sessions. SC required to maintain 40%MVC as long as possible and it was evaluated in terms of time, accuracy (Mean Distance between force trace and target force, MD), precision (Coefficient of Variability of force trace, CV). MD and CV analyses were conducted dividing the SC task into three equivalent time stages (beginning, middle, exhaustion). Relative Reliability (RR) was measured by Intraclass Correlation Coefficient, and Absolute Reliability (AR) was measured by Standard Error of Measurement and by Bland-Altman plot.

Results

MVC and Time showed high RR and AR in both hands. RR of MD and CV in right hand was excellent in the beginning and middle stages, and fair in the exhaustion one, showing decreasing reliability as fatigue increases. In the left hand RR of MD and CV was generally lower. MD showed excellent reliability in the beginning stage and good reliability in the other stages. CV showed fair relative reliability at both beginning and middle stages, excellent in the last one. Conversely, it was observed high AR of MD and CV in all stages in both hands.

Conclusions

All indices are reliable to assess motor control of thumb-index pinch in both hands.

The impact of a hospital-based exercise oncology program on cancer treatment-related side effects among rural cancer survivors

Purpose

To assess the impact of the Personal Optimism With Exercise Recovery (POWER) program on cancer treatment–related side effects among rural cancer survivors.

Methods

In this retrospective study of data collected between 2016 and 2019, we assessed change in cardiorespiratory fitness, whole-body muscular endurance, physical function and strength, anthropometrics, fatigue, and quality of life (QoL), after participation in POWER. Descriptive statistics were calculated for demographic and clinical variables. Univariate analysis of variance was carried out with age and BMI at initial assessment as covariates.

Results

A total of 239 survivors, 78% rural residents, completed a follow-up assessment. Among rural cancer survivors, the most prevalent cancer sites were breast (42.5%), prostate (12.4%), and lymphoma (5.9%). The majority of survivors were female (70%), non-Hispanic (94.6%), and white (93.5%), with average age and BMI of 62.1 ± 13.2 years and 28.4 ± 6.7 kg/m², respectively. Rural cancer survivors with cancer stages I–III exhibited significant improvements in fitness (+ 3.07 ml/kg/min, 95% CI 1.93, 4.21; + 0.88 METS, 95% CI 0.55, 1.20), physical function (30-s chair stand: + 2.2 repetitions, 95% CI 1.3, 3.1), muscular endurance (10-repetition maximum: chest press + 4.1 kg, 95% CI 2.0, 6.3; lateral pulldown + 6.6 kg, 95% CI 4.4, 8.9), self-reported fatigue (FACIT-Fatigue score: + 4.9, 95% CI 1.6, 8.1), and QoL (FACT-G7 score + 2.1, 95% CI, 0.9, 3.4). Among stage IV rural and urban cancer survivors, significant improvements were observed in muscular endurance and physical function.

Conclusion

Participation in POWER was associated with attenuation of cancer treatment–related side effects and may serve as a model exercise oncology program for rural cancer survivors.

Can maximal handgrip strength and endurance be improved by an 8-week specialized strength training program in older women? A randomized controlled study

Maximal handgrip strength and endurance are important indicators of upper limb function in older adults. Up to now, there is insufficient information regarding the efficacy of specialized strength training programs for improving handgrip strength. The purpose of this study was to investigate the effectiveness of an 8-week specialized handgrip strength training program on maximal handgrip strength and endurance in healthy older women. A randomized controlled trial was performed. Thirty-six healthy older women (>65 years) were randomly divided into a training group (TG) (n = 18) and a control group (CG) (n = 18). The TG participated in an 8-week specialized handgrip strength training program using rubber balls and hand grippers (2 training sessions/week, 10-15 min, 8-15 repetitions/set, 4-6 total sets/session). Prior to and after the completion of the program, maximal handgrip strength and dynamic endurance (indices: repeated maximal repetitions and percentage change in handgrip strength between first and last 6 repetitions) were assessed in both hands. Repeated measures MANOVA results indicated that maximal handgrip strength (+9.3%-10.4%) and strength values during repeated maximal repetitions (+14% to 27%) significantly increased in TG (p < 0.001), while the percentage change in handgrip strength between the first and last 6 repetitions decreased significantly (-6%) (p < 0.05), irrespective of the tested hand. The results of this study showed that an 8-week specialized handgrip strength training program can be used effectively by athletic trainers, physical and hand therapists to counteract the detrimental effects of the aging process on maximal handgrip strength and endurance in older adults.

Dynamic Handgrip Strength Endurance: A Reliable Measurement in Older Women

BACKGROUND AND PURPOSE

Dynamic handgrip strength endurance is essential for daily activities that require repetitive gripping movements for a sustained period. At this time, there is no information about the reliability of measurement of dynamic handgrip strength endurance in older individuals. Thus, the purpose of this study was to investigate the test-retest reliability of dynamic handgrip strength endurance in older women.

METHODS

A cross-sectional study was performed. Thirty older women aged 70.5 (3.6) years performed 2 assessment sessions (test and retest), separated by 3 days. During these sessions, the dynamic handgrip strength endurance was evaluated using a testing protocol consisted of 12 repeated maximal isometric contractions for 3 seconds, with a 5-second rest between contractions (repetitions). The maximal handgrip strength at each repetition (repeated maximal repetitions) was evaluated in both hands (preferred and nonpreferred hand) using an hydraulic dynamometer Jamar; while the percentage change (using the mean of the first and the last 3 repetitions as well as the mean of the first and the last 6 repetitions) and the fatigue index were calculated.

RESULTS

The test-retest reliability for the assessment of repeated maximal repetitions (intraclass correlation coefficient [ICC] = 0.82-0.95, standard error of measurement [SEM] = 0.76-1.22 kg, SEM 95% confidence interval [CI] = 0.53-1.69 kg, SEM% = 3.6-8.6) and of percentage change (ICC = 0.81-0.87, SEM = 3.26%-4.40%, SEM 95% CI = 2.23-6.33%, SEM% = 3.4-4.7) was found to be high, whereas fatigue index exhibited lower reliability (ICC = 0.69-0.84, SEM% = 10.9-11.8).

CONCLUSION

A dynamic protocol of 12 repeated maximal repetitions may be used for the evaluation of dynamic handgrip strength endurance, using the repeated maximal repetitions and the percentage change as the most reliable indicators for the determination of muscle endurance. However, the assessment of fatigue index should be interpreted with more caution.

Does the number of trials affect the reliability of handgrip strength measurement in individuals with intellectual disabilities?

The main objectives of this study were to examine which testing protocol (one/two/three trials) and method (best/average value) used for determining maximal handgrip strength is more reliable for individuals with intellectual disabilities (ID) and to compare the reliability and variability of maximal handgrip strength measurement between individuals with ID and healthy individuals. Twenty individuals with ID (18.7±3.3 years) and 20 healthy individuals (18.5±3.4 years) performed six separate sessions. During these sessions, the participants' maximal handgrip strength was evaluated using three protocols with different number of trials (one/two/three). In individuals with ID, the protocols with one and two trials were less reliable (ICC=0.78-0.95; SEM%=9-21) than the protocol with three trials (ICC=0.94-0.96; SEM%=8-10) whereas in healthy individuals all protocols were equally reliable (ICC=0.95-0.99; SEM%=1.9-4.9). In individuals with ID, the mean of three trials (ICC=0.96, SEM=1.19-1.35kg, SEM%=8.2-8.7) had slightly higher reliability than the best of three trials (ICC=0.94, SEM=1.47-1.75kg, SEM%=9.2-10.1). Furthermore, the variability of maximal handgrip strength measurement was about twofold higher in individuals with ID (CV=37-45%) vs. healthy individuals (CV=21-23%). Maximal handgrip strength can be measured reliably in young individuals with ID using the mean of three trials as the most reliable approach for the determination of maximal handgrip strength.

Health-Promoting Effects of a Concurrent Workplace Training Program in Inactive Office Workers (HealPWorkers): A Randomized Controlled Study

PURPOSE

To the best of our knowledge, no previous study has examined the health-promoting effects of a daily supervised concurrent workplace training program in inactive office workers. The main objective of this study was to examine the effectiveness of a 6-month workplace training program on health indices, musculoskeletal pains, functional capacity, and physical fitness in office workers.

DESIGN

Randomized controlled study.

SETTING

Four workplaces in the Region of Thessaly, Greece.

PARTICIPANTS

A total of 36 office workers (≥6 hours/d, 5 days/wk) were randomly assigned to either a training group (TG; n = 18) or a control group (CG; n = 18).

INTERVENTION

The TG participated, every working day, in a 6-month supervised concurrent (flexibility, strength, balance, aerobic) training program (120 training sessions, 2 workouts/d of 15-20 minutes) that was implemented, in small groups, at the workplace during the work shift. The CG did not participate in any training.

MEASURES

Health indices (body composition, blood pressure, respiratory function), musculoskeletal pains, functional capacity (flexibility, balance), and physical fitness (maximal strength, cardiorespiratory fitness) were measured before and after the completion of the program. After the completion of the program, participants' enjoyment was assessed.

ANALYSIS

Two-way analysis of variance (group × time) with repeated measures on the "time" factor.

RESULTS

The statistical power, for all parameters, ranged from 0.85 to 0.94. Training group significantly increased lean body mass (3.81%); respiratory function (4.20%-4.53%); cervical, handgrip, back, and leg maximal strength (8.75%-26.55%); and functional capacity (19.71%-188.20%; P < .001-.01; Cohen's effect size: 0.80-7.21), while significant reductions were observed on body fat (7.58%), blood pressure (4.99%-8.05%), heart rate (12.80%), and musculoskeletal pains (33.33%-100%; P < .001; Cohen's effect size: 0.81-6.21). In CG, all the above variables did not change. Furthermore, a great percentage of workers (94.4%) reported high levels of enjoyment.

CONCLUSION

The program "HealPWorkers" is an enjoyable exercise modality that may be safely and effectively used, to work settings, for the improvement of worker's health, overall fitness, and functional capacity.

Hand grip strength variability during serial testing as an entropic biomarker of aging: a Poincaré plot analysis

Background

The Poincaré plot method can be used for both qualitative and quantitative assessment of self-similarity in usually periodic functions, hence the idea of applying it to the study of homeostasis of living organisms. From the analysis of numerous scientific data, it can be concluded that hand functionality can be correlated with the state of the human body as a biological system exposed to various forms of ontogenetic stress.

Methods

We used the Poincaré plot method to analyze the variability of hand grip strength (HGS), as an entropic biomarker of aging, during 60 repetitive tests of the dominant and nondominant hand, in young and older healthy subjects. An observational cross-sectional study was performed on 80 young adults (18–22 years old, mean age 20.01 years) and 80 older people (65–69 years old, mean age 67.13 years), with a sex ratio of 1:1 for both groups. For statistical analysis, we applied univariate descriptive statistics and inferential statistics (Shapiro–Wilk test, Mann–Whitney U-test for independent large samples, with the determination of the effect size coefficient r, and simple linear regression. We calculated the effect of fatigue and the Poincaré indices SD₁, SD₂, SD₁/SD₂ and the area of the fitting ellipse (AFE) for the test values of each subject.

Results

The analysis of the differences between groups revealed statistically significant results for most HGS-derived indices (p ≤ 0.05), and the magnitude of the differences indicated, in most situations, a large effect size (r > 0.5). Our results demonstrate that the proposed repetitive HGS testing indicates relevant differences between young and older healthy subjects. Through the mathematical modeling of data and the application of the concept of entropy, we provide arguments supporting this new design of HGS testing.

Conclusions

Our results indicate that the variability of HGS during serial testing, which reflects complex repetitive biomechanical functions, represents an efficient indicator for differentiation between young and older hand function patterns from an entropic perspective. In practical terms, the variability of HGS, evaluated by the new serial testing design, can be considered an attractive and relatively simple biomarker to use for gerontological studies.

Cognitive and motor aspects of cancer-related fatigue

BACKGROUND

Cancer-related fatigue (CRF) is a debilitating symptom frequently reported by patients during and after treatment for cancer. CRF is a multidimensional experience and is often solely assessed by self-report measures. The goal of the study is to examine the physical and cognitive aspects of self-reported CRF using a cognitive function test and a physical fatigue index in order to provide objective measures that can characterize the CRF phenotype.

METHODS

A total of 59 subjects with nonmetastatic prostate cancer receiving external beam radiation therapy were included in the study. Fatigue was measured using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire. Cognitive characteristics of CRF was measured using the Stroop Color-Word Interference computerized test and the motor aspect of fatigue was measured using the static fatigue test using a handgrip dynamometer.

FINDINGS

Functional Assessment of Cancer Therapy-Fatigue scores significantly correlated with the Stroop Interference score, but not performance accuracy in all test conditions. Fatigued subjects exhibited a more rapid decline to 50% of maximal strength and increased static fatigue index in the handgrip test, whereas maximal grip strength was not affected.

CONCLUSIONS

The results suggest that CRF exhibits both cognitive and physical characteristics. Subjective fatigue was associated with increased time required to overcome cognitive interference, but not cognitive performance accuracy. Fatigued patients exhibited decreased physical endurance and the ability to sustain maximal strength over time. These objective measures may serve as valuable tools for clinicians to detect cognitive and physical impairment associated with CRF.

Hand grip endurance moderating the effect of grip force on functional ability and disease activity in rheumatoid arthritis patients: a cross-sectional study

To examine the effect of endurance on the relationship between grip force and measures of functional capacity and disease activity, we performed a cross-sectional study at the University Department of Rheumatology, Physical medicine and Rehabilitation from January 2017 to August 2018. Functional capacity of the hand was measured by ABILHAND-RA questionnaire and disease activity was assessed by the Disease Activity Score (DAS-28-CRP). All participants underwent dynamometric measurements of maximal grip force and hand grip endurance during repeated gripping. We analyzed the data from 34 RA patients at the median (IQR) age of 57 (51-61), 31 (91%) of them women, and 44 healthy participants at the age of 55 (50-59), 39 (89%) of them women. The moderating effect of endurance on the correlation between maximum grip force and the ABILHAND-RA score was not significant in healthy participants (b = 0.000, 95% CI - 0.005-0.004, p = 0.862), but it was in RA patients (b = 0.003, 95% CI 0.000-0.005, p = 0.027). In RA patients, the effect of maximum grip force on the ABILHAND-RA score increased with the increase in hand grip endurance. In RA patients, the interaction between endurance and grip force significantly explained the 15% more variance of the disease activity than main effects of these two measures, age, gender and body mass index alone. Hand grip endurance during repeated gripping affects the correlation between maximum grip force and the ABILHAND-RA score in a pattern that differs in RA patients and in the healthy population. In RA patients, hand grip endurance significantly moderates the correlation between maximum grip force and the DAS-28-CRP.

Effects of motor imagery and action observation on hand grip strength, electromyographic activity and intramuscular oxygenation in the hand gripping gesture: A randomized controlled trial

The aim of this study was to evaluate the effects of motor imagery and action observation combined with a hand grip strength program on the forearm muscles. Sixty subjects were selected and randomized into three groups: motor imagery (n = 20), action observation (n = 20), or a control group (n = 20). Outcome measures included hand grip strength, electromyographical activity and intramuscular oxygenation. The hand grip strength significantly increased in the motor imagery (p < .001) and action observation (p < .001) groups compared with the control group, although there were no differences between the both groups (p = .30). In the electromyographical activity, intra-group significant differences were found in motor imagery (p = .002) and action observation (p = .003) groups, although there were no differences between the both groups (p = 1.00) Intramuscular oxygenation results did not show any statistically significant differences between any of the study groups (p > .05). Our results suggest that both motor imagery and action observation training, combined with a hand grip strength program, present a significant strength gain and significant change in the strength and electromyographical activity of the forearm muscles, however no change was found in intramuscular oxygenation.