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Alotaibi R, Aladel A, Alshammari SA, Abulmeaty MMA, Alhamdan AA. Association of Nutritional Status and Diet Diversity with Skeletal Muscle Strength and Quality of Life among Older Arab Adults: A Cross-Sectional Study. Nutrients 2023; 15:4382. [PMID: 37892457 PMCID: PMC10609555 DOI: 10.3390/nu15204382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/01/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
There is little research evaluating skeletal muscle strength, nutritional status, and quality of life in older Arab adults. This study examined the association of nutritional status with skeletal muscle strength and quality of life among older adults living in Saudi Arabia. A cross-sectional study was conducted among older adults (n = 166 older adults; 57.8% females) who visited primary outpatient clinics at King Khalid University Hospital in Riyadh City. Sociodemographic data, Mini Nutritional Assessment short-form (MNA-SF), diet variety score (DVS), and health-related quality of life (HR-QoL) were assessed. Furthermore, handgrip strength (HGS) and knee extension strength (KES) were measured to evaluate skeletal muscle strength. Malnourishment and risk of malnutrition were found in 16.9% of our sample. Nutritional status was significantly associated with muscle strength and HR-QoL (p < 0.05). The well-nourished group had higher HGS, KES, and total HR-QoL scores compared to the at risk of malnutrition or malnourished group. Moreover, there was a moderate positive correlation between MNA-SF and total HR-QoL scores (r = 0.40). The percentage of individuals in the well-nourished group categorized with a high or moderate DVS was significantly higher than those at risk of malnutrition or are malnourished; however, DVS was not associated with muscle strength and HR-QoL. The MNA-SF score had a significant positive correlation with HGS (r = 0.30) and KES (r = 0.23). An increase in the MNA-SF score was significantly associated with higher odds of being moderate/high (HGS and HR-QoL) in the crude and adjusted models. In conclusion, maintaining adequate nutritional status is beneficial for preserving skeletal muscle strength and promoting better HR-QoL among older individuals. Therefore, applications of appropriate nutritional and muscle strength assessments in geriatric care institutions are recommended.
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Affiliation(s)
- Rahaf Alotaibi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Alanoud Aladel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Sulaiman A. Alshammari
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Mahmoud M. A. Abulmeaty
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
| | - Adel A. Alhamdan
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (R.A.); (A.A.); (M.M.A.A.)
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Xiang Q, Li Y, Xia X, Deng C, Wu X, Hou L, Yue J, Dong B. Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis. BMC Geriatr 2022; 22:327. [PMID: 35428245 PMCID: PMC9012026 DOI: 10.1186/s12877-022-03036-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/07/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Objective
Standard modalities recommended for sarcopenia diagnosis may be unavailable in primary care settings. We aimed to comprehensively evaluate and compare associations of some better popularized nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis in community-dwelling middle-aged and elderly adults, including geriatric nutrition risk index (GNRI), albumin (ALB), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST) and body mass index (BMI).
Methods
Based on the West China Health and Aging Trend study, the current study included participants aged 50 or older who were recruited in 2018. Sarcopenia-related assessment and diagnosis were in line with Asian Working Group for Sarcopenia 2019. For each single index, we assessed its association with sarcopenia presence by univariate and multivariate logistic regression analysis; we also computed diagnostic measures including the area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, accuracy at the optimal cut-off value determined according to Youden’s index.
Results
A total of 3829 subjects were included, consisting of 516 and 3313 subjects in the sarcopenia and non-sarcopenia groups, respectively. Regarding the risk for sarcopenia presence, the fully adjusted odds ratios of GNRI, ALB, CC, MAC, TST and BMI per standard deviation decrease were 2.95 (95% CI 2.51–3.47, P < 0.001), 1.01 (95% CI 0.90–1.15, P = 0.816), 4.56 (95% CI 3.82–5.44, P < 0.001), 4.24 (95% CI 3.56–5.05, P < 0.001), 1.67 (95% CI 1.92–1.45, P < 0.001) and 4.09 (95% CI 3.41–4.91, P < 0.001), respectively. Regarding the value in sarcopenia diagnosis in the entire study population, their AUCs could be ordered as MAC (0.85, 95% CI 0.83–0.86) > GNRI (0.80, 95% CI 0.78–0.82), CC (0.83, 95% CI 0.81–0.85), BMI (0.81, 95% CI 0.79–0.83) > TST (0.72, 95% CI 0.70–0.74) > ALB (0.62, 95% CI 0.60–0.65). At the relevant optimal cut-off values, the sensitivity was the highest for CC (0.83, 95% CI 0.80–0.87) and MAC (0.80, 95% CI 0.77–0.84), while GNRI showed the highest specificity (0.79, 95% CI 0.78–0.81) and accuracy (0.78, 95% 0.76–0.79).
Conclusion
Overall diagnostic performance was the best for MAC, followed by GNRI, CC, BMI, and the worst for TST, ALB in distinguishing sarcopenia from non-sarcopenia in middle-aged and elderly adults in community-based settings. CC or MAC might do better in reducing missed diagnosis, while GNRI was superior in reducing misdiagnosis.
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Cigarán-Méndez M, Úbeda-D'Ocasar E, Arias-Buría JL, Fernández-de-Las-Peñas C, Gallego-Sendarrubias GM, Valera-Calero JA. The hand grip force test as a measure of physical function in women with fibromyalgia. Sci Rep 2022; 12:3414. [PMID: 35233066 PMCID: PMC8888740 DOI: 10.1038/s41598-022-07480-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 11/09/2022] Open
Abstract
Previous studies have reported the presence of muscle weakness in women with fibromyalgia syndrome (FMS) which is considered a risk factor for developing earlier disability and dependence during activities of daily life (ADL). We aimed to assess the relationship between hand grip force with sociodemographic, clinical, disease-specific, cognitive, and physical function variables in women with FMS. One hundred twenty-six women with FMS completed demographic (age, gender, height, weight, body mass index), pain-related (pain history, pain intensity at rest and during ADL), disease-specific severity (Fibromyalgia Impact Questionnaire -FIQ-S-, Fibromyalgia Health Assessment Questionnaire -FHAQ-, EuroQol-5D, Pain Catastrophizing Scale -PCS-, Pittsburgh Sleep Quality Index-PSQI-, Pain Vigilance and Awareness Questionnaire -PVAQ-, and Central Sensitization Inventory -CSI-), psychological (Tampa Scale for Kinesiophobia, TKS-11; Pain Vigilance and Awareness Questionnaire, PVAQ; Pain Catastrophizing Scale, PCS), and physical function (hand grip force, and Timed Up and Go Test, TUG). Hand grip force was associated with height (r = −0.273), BMI (r = 0.265), worst pain at rest (r = −0.228), pain during ADL (r = −0.244), TUG (r = −0.406), FHAQ (r = −0.386), EuroQol-5D (r = 0.353), CSI (r = −0.321) and PSQI (r = −0.250). The stepwise regression analysis revealed that 34.4% of hand grip force was explained by weight (6.4%), TUG (22.2%), and FHAQ (5.8%) variables. This study found that hand grip force is associated with physical function indicators, but not with fear-avoidance behaviors nor pain-related features of FMS. Hand grip force could be considered as an easy tool for identifying the risk of fall and poorer physical health status.
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Affiliation(s)
| | - Edurne Úbeda-D'Ocasar
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain
| | - José Luis Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Gracia María Gallego-Sendarrubias
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain
| | - Juan Antonio Valera-Calero
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Calle Castillo de Alarcón 49, 28692, Villanueva de la Cañada, Madrid, Spain. .,VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, Madrid, Spain.
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Xu ZY, Gao DF, Xu K, Zhou ZQ, Guo YK. The Effect of Posture on Maximum Grip Strength Measurements. J Clin Densitom 2021; 24:638-644. [PMID: 33526316 DOI: 10.1016/j.jocd.2021.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION/BACKGROUND The purpose of this study was to compare the grip strength values obtained under 4 postures, and to identify the position providing the maximum grip strength value. We also explored the effects of different body positions on grip strength measurements and the significance of the selection of measurement position for guiding the screening and diagnosis of sarcopenia. METHODOLOGY A total of 764 people (409 males and 355 females) participated in this study. Grip strength was measured in 4 positions: (1) standing with the elbow fully extended; (2) standing with arms raised; (3) sitting with the elbow flexed 90°; and (4) sitting with the elbow extended. Multiple linear regression model was used to compare the grip strength measurements obtained from these 4 positions by each hand when considering the influence of age, gender, body mass index, and other factors. RESULTS Both male and female grip strength values in the standing position with the elbow fully extended were significantly greater than those in other positions. In addition, the grip strength measured by standing posture was generally greater than measured by sitting posture. In contrast, grip strength values in the 2 sitting positions did not differ significantly. The grip strength of men was generally greater than that of women. CONCLUSIONS The findings reveal that grip strength measured while standing with the elbow fully extended is greater than that measured while sitting, which is the posture currently recommended in clinical practice. Clinicians and researchers should choose the appropriate and optimal postures to measure grip strength.
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Affiliation(s)
- Zheng-Yang Xu
- Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Deng-Fa Gao
- Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ke Xu
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zi-Qi Zhou
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Ying-Kun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
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Ling CHY, Meskers CGM, Maier AB. Can anthropometric measures be used as proxies for body composition and physical function in geriatric outpatients? Arch Gerontol Geriatr 2021; 94:104379. [PMID: 33610124 DOI: 10.1016/j.archger.2021.104379] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The study aimed to evaluate the associations between anthropometric measures with body composition, in particular skeletal muscle mass, and with physical function in a cohort of geriatric outpatients. METHODS We included 572 outpatients who attended geriatric clinics at Amsterdam UMC, location VUmc, Netherlands from January 2014 to December 2015. Anthropometric measures (height, weight, body circumferences, body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR)), and physical function measures (handgrip strength (HGS), Short Physical Performance Battery (SPPB) and Timed Up and Go test (TUG)) were obtained. Body composition was analysed using bioimpedance analysis (BIA) in a subgroup of 78 patients. Gender-stratified regression analyses were performed to test associations between anthropometric measures with body composition and physical function, adjusted for age. RESULTS In females, BMI, WHtR and all measured body circumferences were positively associated with body fat mass (BFM) (all β≥0.64, all p≤0.001). BMI and mid-upper arm circumference were also associated with fat-free mass (FFM) (β=0.49, p=0.001; β=0.53, p=0.01), skeletal muscle mass (SMM) (β=0.39, p=0.01; β=0.44, p=0.02) and skeletal muscle index (SMI) (β=0.44, p=0.003; β=0.44, p=0.02). In males, BMI, WHR, WHtR and waist circumference were positively associated with BFM (all β≥0.54, all p≤0.02). Calf circumference was associated with FFM (β=0.46, p=0.01), SMM (β=0.47, p=0.01) and SMI (β=0.50, p=0.01). BMI and central fat anthropometric measures were inversely associated with physical function. CONCLUSIONS Mid-upper arm circumference and calf circumference could serve as practical proxy measures for skeletal muscle mass in geriatric outpatient setting, but their associations with physical function were weak.
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Affiliation(s)
- Carolina H Y Ling
- Internal Medicine Department, The Prince Charles Hospital, Queensland, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
| | - Carel G M Meskers
- Amsterdam UMC, Department of Rehabilitation medicine, VU University, Amsterdam Movement Sciences, @AgeAmsterdam, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.
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Garkisch A, Mittlmeier T, Kalpen A, Mühldorfer-Fodor M, Fischer DC, Wichelhaus A. Dynamic Manugraphy as a Promising Tool to Assess the Outcome of Limited Aponeurectomy in Patients With Dupuytren's Contracture. Front Med (Lausanne) 2021; 7:604891. [PMID: 33511143 PMCID: PMC7835140 DOI: 10.3389/fmed.2020.604891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Dupuytren's contractures interfere with physiological gripping. While limited aponeurectomy is an accepted treatment modality to restore finger mobility, methods to objectify functional outcome beyond determination of the range of motion are scarce. Methods: Patients with Dupuytren's contracture being scheduled for unilateral limited aponeurectomy were invited to participate. Clinical data were gathered prospectively by chart review and interview. The DASH-score and flexion contracture for fingers were registered prior to surgery, 3 and 6 months afterwards. At the same time, dynamic manugraphy for simultaneous recording of the grip pattern and forces generated by the affected hand and anatomic areas (i.e., thumb, index finger, middle finger, ring finger, little finger and palm) were performed. All findings obtained during the follow-up period were compared to the situation at baseline. Comparison between paired samples was done using Wilcoxon rank test. All p-values are two-sided and p < 0.05 was considered to be significant. Results: Out of 23 consecutively enrolled patients, 19 (15 men, 4 women) completed follow-up examinations. Manugraphy confirmed the impairment of physiological gripping with concomitant pathological load distribution at base line. Limited aponeurectomy significantly reduced flexion contractures. However, the DASH-score remained at an excellent level in one patient, indicated improvement in 11 and worsening in seven patients. Six patients had lower grip force at t6 compared to the preoperative condition, although the preoperative flexion contracture (≥110°) was considerably improved in all of them. In four of those, the DASH-score improved while it turned worse in two of them. The force of surgically treated fingers remained unchanged in three patients while it was improved and worsened in half of the remaining patients, respectively. Manugraphy revealed physiological gripping by enlargement of contact area and higher force transmission by the fingertips in 10 of 12 patients with constant or even improved DASH-score and in three of seven patients with a worsened DASH-score. Conclusions: Assessing the reduction of flexion contracture and grip force alone is not sufficient to comprehensively reflect the functional outcome of aponeurectomy for Dupuytren's disease. Visualizing physiological grip pattern provides an additional tool to objectify the success of surgical treatment.
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Affiliation(s)
- Angelina Garkisch
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
| | - Axel Kalpen
- Novel Biomechanics Laboratory, Munich, Germany
| | | | - Dagmar-C Fischer
- Department of Pediatrics, Rostock University Medical Centre, Rostock, Germany
| | - Alice Wichelhaus
- Department of Traumatology, Hand- and Reconstructive Surgery, Rostock University Medical Centre, Rostock, Germany
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Felício DC, Elias J, de Queiroz BZ, Diz JBM, Pereira DS, Pereira LSM. Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study. SAO PAULO MED J 2021; 139:77-80. [PMID: 33656127 PMCID: PMC9632498 DOI: 10.1590/1516-3180.2020.0182.r1.30102020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Handgrip and knee extension strengths have each been used to characterize disability. However, it has been reported that the association between handgrip and knee extension strengths is weak. OBJECTIVE To evaluate the influence of knee extensor and handgrip muscle strength on Timed Up and Go (TUG) test results among elderly women with worse (≥ 10 seconds) and better (< 10 seconds) performance, after controlling for confounders. DATA AND SETTING Cross-sectional study on a sample selected according to convenience, carried out in a federal public institution of higher education. METHODS Assessment of handgrip was carried out using the Jamar dynamometer (Lafayette Instrument Company, Inc., Lafayette, United States). Knee extensor muscle performance was measured using an isokinetic dynamometer (Biodex System 3 Pro; Biodex Medical Systems, Inc., United States), The confounding factors were education, age, comorbidities, body mass index and Geriatric Depression Scale and Human Activity Profile scores. Functional performance was assessed through the TUG test. A backward linear regression model was used. RESULTS 127 elderly women performed the TUG test in more than 10 seconds and 93 in less than 10 seconds. However, regardless of test performance, handgrip strength and knee extension strength comprised the reduced final model. CONCLUSIONS Knee extension strength and handgrip strength might be particularly useful indicators for measuring disability.
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Affiliation(s)
- Diogo Carvalho Felício
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil; Postgraduate Program on Rehabilitation Sciences and Functional-Physical Performance, School of Physiotherapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - José Elias
- PT, MSc. Physiotherapist, Postgraduate Program on Rehabilitation Sciences and Functional-Physical Performance, School of Physiotherapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
| | - Bárbara Zille de Queiroz
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Juliano Bergamaschine Mata Diz
- PT, MSc. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Daniele Sirineu Pereira
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
| | - Leani Souza Máximo Pereira
- PT, PhD. Physiotherapist, Postgraduate Program on Rehabilitation Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.
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Lee J, Jo K, Ha J, Lim DJ, Lee JM, Chang SA, Kang MI, Kim MH. A Significant Association of Upper Limb Muscle Strength with Thyroid Function in Overweight and Obese Population: A Study of the Sixth Korea National Health and Nutrition Examination Survey (KNHANES 2014-2015). Int J Endocrinol 2020; 2020:7195846. [PMID: 33343661 PMCID: PMC7732406 DOI: 10.1155/2020/7195846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/20/2020] [Accepted: 11/18/2020] [Indexed: 01/05/2023] Open
Abstract
Background. As skeletal muscle is one of main targets of thyroid hormone signalling, an association of thyroid function and muscle strength could be expected. The aim of study is to evaluate the association of free thyroxine (FT4) and thyrotropin (TSH) with upper limb muscle strength, measured by hand grip strength, in subjects with normal FT4 from national representative data. The study utilized the sixth edition of the Korea National Health and Nutrition Examination Survey. After exclusion of subjects with FT4 level out of normal range, a history of thyroid disease or cerebral disease, restricted activity, and incomplete data, a total of 3503 were recruited (age range 19-80 years, 51% male). FT4 positively correlated with upper limb muscle strength (β coefficient = -12.84, p < 0.001), while TSH did negatively (β coefficient = -0.37, p=0.002). After adjusting for confounding factors, statistical significance disappeared. However, among subjects with BMI above 23 kg/m2, a negative correlation of TSH with upper limb muscle strength was found in a younger age group (19-39 years old) (β coefficient = -0.56, p=0.021), while FT4 positively correlated with upper limb muscle strength (β coefficient = 3.24, p=0.019) in an older group (above 40 years old). In overweight and obese subjects, a significant association of thyroid function with upper limb muscle strength was observed in nation-wide representative data. High TSH in a younger group and low FT4 in an older group could be risk factors for decreased upper limb muscle strength in obese population.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Kwanhoon Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Jung Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Sang-Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Moo Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
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Neidenbach RC, Oberhoffer R, Pieper L, Freilinger S, Ewert P, Kaemmerer H, Nagdyman N, Hager A, Müller J. The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S187-S197. [PMID: 31737527 DOI: 10.21037/cdt.2019.09.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background In patients with congenital heart disease (CHD), there is little data on the diagnostic and prognostic relevance of hand grip strength (HGS) for clinical assignment, while in the general population the loss of muscle strength and mass is an important risk factor in cardiovascular disease which is conversely associated with morbidity and all-cause mortality. This study aimed to assess the degree of muscle dysfunction using HGS as a biomarker in a large group of patients with CHD who often develop muscle dysfunction. Methods In total, 385 patients (27.6±13.1 years, 43% female) were included and assigned to 5 diagnostic groups: complex anomalies (n=131), left heart anomalies/aortopathies (n=107), right heart/pulmonary artery anomalies (n=92), primary left to-right-shunts (n=42) and miscellaneous CHD (n=13). Patients with Fontan circulation, chronic cyanosis, morphologic right systemic ventricle, arterial switch operation, or Ebstein's anomaly were analyzed separately. A control group (CG) consisted of 124 healthy individuals (30.1±12.1 years, 42% female). HGS was measured with a Jamar Hydraulic Hand Dynamometer. Results HGS was reduced in CHD patients compared to controls (35.2±14.6 versus 43.7±14.4 kg). Most impairments were present in females (26.1±7.6 kg). Patients with cyanosis had lower HGS values compared to acyanotic CHD patients (P=0.03). Patients with left heart lesions had the highest HSG values (40.7±14.7 kg), while patients with primary left-to-right shunt lesions had the lowest HSG values (30.9±11.3 kg). Within specific groups of cardiac anomalies, patients with Fontan circulation showed the lowest (P=0.033) and patients with a morphologic right system ventricle showed higher results (P=0.004). The late mid-term survival was favorable, and 7 patients (1.8%) died in a median interval of 422 days (range, 206-1,824 days) after HGS-testing. Conclusions This study provides the most comprehensive data on the use of HGS in CHD to date. Grip strength is an easily applicable, repeatedly usable and a cost-effective diagnostic tool to gain a quick, quantifiable assessment of the patient's current muscle function as an expression of cardiac fitness. Considering the low number of patients who died in the observation period, HGS may not be a suitable tool for survival assessment or identification of patients at risk. However, HGS is well suited to determine muscle function and strength and thereby to identify and to follow-up patients who have an increased cardiovascular risk.
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Affiliation(s)
- Rhoia Clara Neidenbach
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Renate Oberhoffer
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany.,Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Lars Pieper
- Department of Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Peter Ewert
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Alfred Hager
- Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | - Jan Müller
- Institute of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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10
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Noack Segovia JP, Sánchez López A, García-García I, Rodríguez-Blanque R, León Ríos XA, Aguilar Cordero MJ. Physical Exercise and Grip Strength in Patients Intervened through Bariatric Surgery. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: This work sought to evaluate a physical exercise program of moderate intensity in patients operated of bariatric surgery and its influence on muscle strength. Method: Randomized clinical trial, with an intervention group and a control group. Forty-three patients were operated of bariatric surgery. The intervention group was applied a program of moderate physical activity during six months. Grip strength and bioimpedance were measured at their baseline form, at one month, and six months after surgery. A bivariate study was conducted to observe variable changes. Results: Upon conducting Student´s t for independent samples in all the variables (weight, body mass index, grip strength, lean mass, fat mass, and metabolism), the result is that no significant differences exist between the intervention group and the control group with p > 0.05. Conclusion: A program of moderate physical activity lasting six months in patients intervened of bariatric surgery has no significant result in the development of muscle mass evaluated through manual dynamometry and bioimpedance.
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11
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Kang S, Yoo S, Baek H, Lee J, Choi Y, Kim H, Yi H, Yang EJ. Potentials of Smart dynamometer use for clinical and self-management of rehabilitation in breast cancer survivors: a feasibility study. Biomed Eng Lett 2019; 9:211-219. [PMID: 31168426 DOI: 10.1007/s13534-019-00101-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/23/2019] [Accepted: 01/28/2019] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to examine the feasibility of the Smart dynamometer as a rehabilitation exercise device in a daily care by comparing with the existing medical devices. We used and analyzed clinical and measurement data of breast cancer survivors who have used Smart dynamometer during their rehabilitation after breast cancer surgery. The Smart dynamometer was compared with the two existing devices of Takei dynamometer and surface electromyography (sEMG) that were used in routine care, respectively. Three key components of the rehabilitation exercise devices were analyzed to validate the feasibility of the Smart dynamometer: grip strength, reaction time, and grip endurance time. Pearson's correlation analysis was performed to compare the statistical significance between the devices. The data of 12 and 15 female breast cancer patients were analyzed for comparing the Smart dynamometer with Takei dynamometer and sEMG, respectively. There was a very weak correlation between the maximum values from the Takei and the Smart dynamometers in the affected and non-affected arms of breast cancer patients (r = 0.5321, 0.4733). Comparisons of 3 features between the Smart dynamometer and sEMG showed that there were strong positive correlations for both reaction time and endurance time in the affected and non-affected arms (r > 0.9). The feasibility of the Smart dynamometer for the possible use in a daily rehabilitation exercise was partially verified. Moreover, since the Smart dynamometer was highly correlated with time-related variables, it was important and significant to measure both grip strength and time-related information.
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Affiliation(s)
- Seungjin Kang
- 1Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sooyoung Yoo
- 1Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyunyoung Baek
- 1Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Junheon Lee
- 2Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, 173, Gumi-ro, Bundang-gu, Seongnam-si, 13620 Republic of Korea
| | - Younggeun Choi
- 3Department of Applied Computer Engineering, Dankook University, Yongin, Gyeonggi Republic of Korea
| | | | - Hyoseok Yi
- NEOFECT, Yongin, Gyeonggi Republic of Korea
| | - Eun Joo Yang
- 2Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, 173, Gumi-ro, Bundang-gu, Seongnam-si, 13620 Republic of Korea
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12
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Cai A, Pingel I, Lorz D, Beier JP, Horch RE, Arkudas A. Force distribution of a cylindrical grip differs between dominant and nondominant hand in healthy subjects. Arch Orthop Trauma Surg 2018; 138:1323-1331. [PMID: 29992376 DOI: 10.1007/s00402-018-2997-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Grip strength and load distribution of the hand are important parameters for evaluating hand function. The purpose of this study was to analyze and compare grip force and load distribution of dominant and nondominant hands in right-handed healthy subjects. METHODS Gripping measurements were performed on 40 healthy right-handed subjects using a cylindrical gripping device. Two different cylinders with circumferences of 150 mm (small cylinder) and 200 mm (large cylinder), respectively, were used for the measurements. Subjects were assigned to either the small or the large cylinder with respect to their hand size. Maximum and mean force applied during three intervals of gripping as well as the percent contribution of each digit, thenar, and hypothenar in relation to the total load applied were acquired. Values of dominant and nondominant hands were compared. RESULTS Percent contribution of mean grip strength differed for the thumb (p = 0.007), ring finger (p < 0.001), little finger (p = 0.047), and palm (p < 0.001). Comparing the dominant and nondominant side, the dominant hand showed a lower contribution of the thumb, ring finger, and little finger, but a higher contribution of the palm. When analyzing maximum grip, percent contribution of the small fingers was equal between dominant and nondominant side (p = 0.1). Differences between dominant and nondominant thumb, ring finger, and palm persisted (p = 0.007, p = 0.001, p = 0.005, respectively). No differences could be shown for the index finger, middle finger, thenar, and hypothenar when analyzing both mean and maximum force. DISCUSSION AND CONCLUSION Percent contribution of the thumb and the fingers to total grip strength differed between dominant and nondominant hands with a change in distribution when assessing maximum grip force. In right-handed subjects, thumb and ring finger have important roles during gripping.
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Affiliation(s)
- Aijia Cai
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany.
| | - I Pingel
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany
| | - D Lorz
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany
| | - J P Beier
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany
- Department of Plastic Surgery, Hand Surgery and Burn Center, Medical Faculty, RWTH Aachen University Hospital, Aachen, Germany
| | - R E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany
| | - A Arkudas
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Krankenhausstr. 12, 91054, Erlangen, Germany
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