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Guo T, Zhang F, Xiong L, Huang Z, Zhang X, Wan J, Mo J. Association of Handgrip Strength with Hip Fracture and Falls in Community-dwelling Middle-aged and Older Adults: A 4-Year Longitudinal Study. Orthop Surg 2024; 16:1051-1063. [PMID: 38485456 PMCID: PMC11062856 DOI: 10.1111/os.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/13/2024] [Accepted: 02/20/2024] [Indexed: 05/03/2024] Open
Abstract
OBJECTIVE Hip fracture and falls are significant health concerns. Handgrip strength (HGS) is closely associated with overall muscle strength and physical health. However, the longitudinal relationship between HGS and the risk of hip fractures and falls remains unclear, particularly regarding gender differences. This longitudinal study aimed to investigate the association between HGS and the risk of hip fracture and falls in individuals aged 45 years and above, considering gender-specific differences over a 4-year period. METHODS This study included 10,092 participants (4471 men and 5621 women) aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS). Incidents of hip fractures and falls were recorded during a 4-year follow-up, along with various demographic and clinical factors. Participants were categorized into five groups based on their HGS quintiles. Logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between HGS and hip fracture/fall risk. RESULTS During the 4-year follow-up period, 223 cases of hip fracture (2.2%) and 1831 cases of falls (18.1%) were documented. Notably, higher HGS demonstrated a strong inverse association with the risk of hip fracture in both males and females (p < 0.05). In comparison to the lowest HGS quintile, the adjusted odds ratios (ORs) for hip fracture were 0.46 (0.27-0.78) for the total population, 0.4 (0.19-0.81) for males and 0.48 (0.23-0.98) for females in the highest HGS quintile. Furthermore, a profound and statistically significant negative correlation between HGS and falls was detected (p < 0.05). The adjusted ORs for falls in the highest HGS quintile, compared to the lowest quintile, were 0.62 (0.51-0.76) in the overall population, 0.59 (0.44-0.78) in males, and 0.78 (0.62-0.99) in females. CONCLUSION Our findings highlight the significant inverse association between HGS and the risk of hip fracture and falls in both males and females aged 45 years and above. Assessing handgrip strength may serve as a valuable tool for predicting fracture and fall risk.
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Affiliation(s)
- Tianting Guo
- Department of OrthopedicsGanzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital)GanzhouChina
| | - Fei Zhang
- Department of OrthopedicsThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
| | - Lijiao Xiong
- Department of Geriatrics, The Second Clinical Medical CollegeJinan University (Shenzhen People's Hospital)ShenzhenChina
| | | | - Xiaoan Zhang
- Department of OrthopedicsGanzhou Hospital of Guangdong Provincial People's Hospital (Ganzhou Municipal Hospital)GanzhouChina
| | - Junming Wan
- Department of OrthopaedicsThe Seventh Affiliated Hospital, Sun Yat‐sen UniversityGanzhouChina
| | - Jianwen Mo
- Department of OrthopedicsThe First Affiliated Hospital of Gannan Medical UniversityGanzhouChina
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Cutisque LP, Moreira NB, Silveira CC, Morozowski FW, Rodacki ALF. The role of ankle and knee muscle characteristics in spatiotemporal gait parameters at different walking speeds: A cross-sectional study. Gait Posture 2024; 108:77-83. [PMID: 38008035 DOI: 10.1016/j.gaitpost.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Understanding the intricate interplay between ankle and knee muscle characteristics and their impact on gait parameters is crucial for enhancing our comprehension of human locomotion, particularly in the context of varying walking speeds among healthy young adults. RESEARCH QUESTION The study aimed to identify the relative importance of ankle and knee flexor and extensor muscle characteristics (e.g., strength estimated by peak torque [PT] and rate of torque development [RTD]) in the spatiotemporal gait parameters and variability in self-selected (SSWS) and fast walking speeds (FWS) in healthy young adults. METHODS One hundred and thirty-nine adults (75 men - 54% and 64 women - 46%; 29.04 ± 9.55 years) were assessed about their muscle characteristics (PT and RTD by an isokinetic dynamometer) and spatiotemporal gait parameters at different walking speeds (SSWS and FWS by an instrumented walkway). RESULTS Data analysis indicated a weak relationship between the PT and RTD of the ankle and knee and spatiotemporal gait parameters and variability in both walking conditions (SSWS: R2 0.14-0.05; FWS: R2 0.40-0.05). The strength of the knee muscles was more relevant when walking at a self-selected speed, while the strength of the ankle muscles played a more prominent role when walking at a fast pace. SIGNIFICANCE The findings underscore the critical role of ankle muscles (plantar and dorsiflexors) at fast walking speeds. Therefore, targeted interventions for strength and optimization of these muscles are paramount.
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Affiliation(s)
| | - Natália Boneti Moreira
- Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Caio Corso Silveira
- Department of Physical Education, Federal University of Paraná, Curitiba, Paraná, Brazil
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Xia Q, Zhou P, Li X, Li X, Zhang L, Fan X, Zhao Z, Jiang Y, Zhu J, Wu H, Zhang M. Factors associated with balance impairments in the community-dwelling elderly in urban China. BMC Geriatr 2023; 23:545. [PMID: 37679669 PMCID: PMC10486131 DOI: 10.1186/s12877-023-04219-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/05/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Identification of factors relevant to balance performance impairments in the elderly population was critical for developing effective interventions and preventions. However, there have been very limited data available based on large scale studies. The present study identified factors that independently contributed to performance impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and individual items. METHODS A total of 1984 community-dwelling Chinese elderly from urban areas of Shanghai were recruited. Information on demographic characteristic, exercise, and health status were collected with a face-to-face interview. Balance performances were assessed on site by trained investigators based on the X16 balance testing scale. To identify the effectors, ordinal logistic regression analysis was applied for overall balance, static balance, postural stability, and dynamic balance. Binary logistic regression analysis was used for 16 items. RESULTS The community-dwelling elderly residents were aged from 60 to 97 years old. With increases of age, risks of impairments in overall balance increased gradually (ORs from 1.26 to 3.20, all P < 0.01). In the elderly with overweight and obesity, there was higher proportion of balance impairments compared to the elderly with normal BMI (OR = 1.26, P < 0.001). Regular exercise every week was associated with reduced risks of balance impairments (ORs from 0.63 to 0.73, all P < 0.001). Presences with vision lesion (ORs from 1.28 to 1.59, all P < 0.001), moderate hearing impairment (OR = 1.54, P < 0.001), somesthesis dysfunction (ORs from 1.59 to 13.26, all P < 0.001), and cerebrovascular disease (OR = 1.45, P = 0.001) were related to increased risks of balance impairments. Likewise, age, exercise, vision, hearing, somesthesis, and cerebrovascular disease were significantly associated with static balance, postural stability, and dynamic balance. Both overweight and obesity and underweight were associated with higher proportions of dynamic balance impairments. Regular exercise was significantly related to reduced risks of impairments in 15 out of the 16 items. CONCLUSIONS In the elderly, age, overweight and obesity, exercise, vision, hearing, somesthesia, and cerebrovascular disease were dominant factors associated with impairments in overall balance, domains of static balance, postural stability, and dynamic balance, and most individual items. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Qinghua Xia
- Changning Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Peng Zhou
- Changning Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Xia Li
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Xiaofen Li
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China
| | - Lei Zhang
- Changning Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Xuefei Fan
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China
| | - Zhoulan Zhao
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yu Jiang
- Changning Center for Disease Control and Prevention, Shanghai, 200051, China
| | - Jianhong Zhu
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China
| | - Hongmei Wu
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Mengdi Zhang
- Institute of Nutrition and Diseases, Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, 325035, China.
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Turimov Mustapoevich D, Kim W. Machine Learning Applications in Sarcopenia Detection and Management: A Comprehensive Survey. Healthcare (Basel) 2023; 11:2483. [PMID: 37761680 PMCID: PMC10531485 DOI: 10.3390/healthcare11182483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
This extensive review examines sarcopenia, a condition characterized by a loss of muscle mass, stamina, and physical performance, with a particular emphasis on its detection and management using contemporary technologies. It highlights the lack of global agreement or standardization regarding the definition of sarcopenia and the various techniques used to measure muscle mass, stamina, and physical performance. The distinctive criteria employed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGSOP) for diagnosing sarcopenia are examined, emphasizing potential obstacles in comparing research results across studies. The paper delves into the use of machine learning techniques in sarcopenia detection and diagnosis, noting challenges such as data accessibility, data imbalance, and feature selection. It suggests that wearable devices, like activity trackers and smartwatches, could offer valuable insights into sarcopenia progression and aid individuals in monitoring and managing their condition. Additionally, the paper investigates the potential of blockchain technology and edge computing in healthcare data storage, discussing models and systems that leverage these technologies to secure patient data privacy and enhance personal health information management. However, it acknowledges the limitations of these models and systems, including inefficiencies in handling large volumes of medical data and the lack of dynamic selection capability. In conclusion, the paper provides a comprehensive summary of current sarcopenia research, emphasizing the potential of modern technologies in enhancing the detection and management of the condition while also highlighting the need for further research to address challenges in standardization, data management, and effective technology use.
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Affiliation(s)
| | - Wooseong Kim
- Department of Computer Engineering, Gachon University, Sujeong-gu, Seongnam-si 461-701, Gyeonggi-do, Republic of Korea;
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Tapanya W, Maharan S, Amput P, Sangkarit N, Suwannakul B. The Influence of Knee Extensor and Ankle Plantar Flexor Strength on Single-Leg Standing Balance in Older Women. J Funct Morphol Kinesiol 2023; 8:jfmk8020067. [PMID: 37218863 DOI: 10.3390/jfmk8020067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023] Open
Abstract
Impaired balance is a significant risk factor for falls among older adults. The precise impact of lower-extremity muscles, including the proportion of muscle strength, on the performance of single-leg standing balance tests in older individuals is very interesting. The aim of this study is to examine the correlation between the knee extensor (KE), ankle plantar flexor (AP) muscle strength, and performance in single-leg standing balance tests in older females. Additionally, it aims to evaluate the combined proportion of KE and AP muscle strength in maintaining balance during single-leg standing. A total of 90 older females (mean age 67.83 ± 8.00 years) were recruited. All participants underwent maximum voluntary isometric contraction (MVIC) testing of the KE and AP muscles, as well as single-leg standing balance tests with eyes open (SSEO) and eyes closed (SSEC). To examine the influence of KE and AP muscle strength on balance performance, multiple regression analysis was conducted. Low correlations were found between SSEO and MVIC of KE and AP muscles, but moderate correlations were found with percentage of MVIC to body weight ratio (%MVIC/BW). The best model for SSEO included 0.99 times of the %MVIC/BW of AP and 0.66 times that of KE muscles as independent predictor variables (r = 0.682). In conclusion, AP muscle strength was found to have a greater impact on single-leg standing balance compared with KE muscle strength.
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Affiliation(s)
- Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Sinthuporn Maharan
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Patchareeya Amput
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence of Human Performance and Rehabilitations, University of Phayao, Phayao 56000, Thailand
| | - Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
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Wolff C, Steinheimer P, Warmerdam E, Dahmen T, Slusallek P, Schlinkmann C, Chen F, Orth M, Pohlemann T, Ganse B. Effects of age, body height, body weight, body mass index and handgrip strength on the trajectory of the plantar pressure stance-phase curve of the gait cycle. Front Bioeng Biotechnol 2023; 11:1110099. [PMID: 36873371 PMCID: PMC9975497 DOI: 10.3389/fbioe.2023.1110099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
The analysis of gait patterns and plantar pressure distributions via insoles is increasingly used to monitor patients and treatment progress, such as recovery after surgeries. Despite the popularity of pedography, also known as baropodography, characteristic effects of anthropometric and other individual parameters on the trajectory of the stance phase curve of the gait cycle have not been previously reported. We hypothesized characteristic changes of age, body height, body weight, body mass index and handgrip strength on the plantar pressure curve trajectory during gait in healthy participants. Thirty-seven healthy women and men with an average age of 43.65 ± 17.59 years were fitted with Moticon OpenGO insoles equipped with 16 pressure sensors each. Data were recorded at a frequency of 100 Hz during walking at 4 km/h on a level treadmill for 1 minute. Data were processed via a custom-made step detection algorithm. The loading and unloading slopes as well as force extrema-based parameters were computed and characteristic correlations with the targeted parameters were identified via multiple linear regression analysis. Age showed a negative correlation with the mean loading slope. Body height correlated with Fmeanload and the loading slope. Body weight and the body mass index correlated with all analyzed parameters, except the loading slope. In addition, handgrip strength correlated with changes in the second half of the stance phase and did not affect the first half, which is likely due to stronger kick-off. However, only up to 46% of the variability can be explained by age, body weight, height, body mass index and hand grip strength. Thus, further factors must affect the trajectory of the gait cycle curve that were not considered in the present analysis. In conclusion, all analyzed measures affect the trajectory of the stance phase curve. When analyzing insole data, it might be useful to correct for the factors that were identified by using the regression coefficients presented in this paper.
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Affiliation(s)
- Christian Wolff
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Patrick Steinheimer
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Elke Warmerdam
- Werner Siemens-Endowed Chair for Innovative Implant Development (Fracture Healing), Saarland University, Homburg, Germany
| | - Tim Dahmen
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Philipp Slusallek
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | | | - Fei Chen
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Marcel Orth
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Tim Pohlemann
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany
| | - Bergita Ganse
- Department of Trauma, Hand and Reconstructive Surgery, Saarland University, Homburg, Germany.,Werner Siemens-Endowed Chair for Innovative Implant Development (Fracture Healing), Saarland University, Homburg, Germany
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