Validity and feasibility of a seated push-up test to indicate skeletal muscle mass in well-functioning older adults

The determination of sarcopenia in older adults using a practical measure

BACKGROUND

Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management.

OBJECTIVE

To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling older adults.

METHODS

Older adults (n= 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT.

RESULTS

Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia.

CONCLUSION

The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness.

The Use of Practical Measures to Determine Body Composition of Older People

Background

Older adults frequently experience body composition changes-decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)-which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults.

Methods

Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition.

Results

The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370-0.781; P < 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340-0.614; P < 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%.

Conclusion

The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.

Seated push-up tests: Reliable and valid measures for older individuals when used by primary healthcare providers

BACKGROUND

Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals.

OBJECTIVE

To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers.

METHODS

Older participants (n= 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers.

RESULTS

The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p< 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r, rp⁢b=-0.270 to 0.758, p< 0.05).

CONCLUSION

SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people's hospital access.