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Zhang C, Li J, Shi H, Liu Y, Cui J, Luo XM, Zeng LT, Fan GQ, Chang XM, Zhang PJ, Shen J. Independent and combined associations of upper and lower limb strength with all-cause mortality in community-based older adults: findings from the Chinese Longitudinal Healthy Longevity Survey. Public Health 2023; 220:57-64. [PMID: 37270853 DOI: 10.1016/j.puhe.2023.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE With the acceleration of aging progress, China is projected to have the largest older population globally. This study aimed to examine the association of upper limb strength (ULS) and lower limb strength (LLS) with all-cause mortality based on the Chinese Longitudinal Healthy Longevity Survey (2012-2018). STUDY DESIGN This is a prospective cohort study. METHODS Participants were 2442 older adults (aged 84.98 ± 11.94 years) recruited from eight longevity areas in China. Limb muscle strength was evaluated using handgrip strength and objective physical examinations. Cox proportional hazards regression was used to analyze the association of limb muscle strength with all-cause mortality. Demographic characteristics, health status, and biological markers were included as confounders. RESULTS Over a median follow-up period of 42.2 months, 993 older people died. After adjusting for all covariates, low ULS was associated with higher mortality risk (hazard ratio [HR] = 1.51, 95% confidence interval [CI] = 1.25-1.84), and the association of low LLS with all-cause mortality was only significant in women (HR = 1.36, 95% CI = 1.04-1.79). Participants with combined low ULS and low LLS had the highest risk of mortality than those with normal limb muscle strength (hazard ratio = 2.06, 95% confidence interval = 1.61-2.63). The combined association of ULS and LLS with mortality was robust in subgroup and sensitivity analyses. CONCLUSION Low ULS and low LLS were independently and synergistically associated with higher all-cause mortality risk. Considering the high prevalence of limb muscle weakness among Chinese older adults, especially the oldest-old, limb strength could be considered as a potential doable mortality predictor for community health care.
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Affiliation(s)
- C Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - J Li
- Department of Pharmacy, Children's Hospital Affiliated Capital Pediatric Research Institute, Beijing, China
| | - H Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Y Liu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - J Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - X M Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - L T Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - G Q Fan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - X M Chang
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - P J Zhang
- Department of Science Research, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - J Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
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Tatangelo T, Muollo V, Ghiotto L, Schena F, Rossi AP. Exploring the association between handgrip, lower limb muscle strength, and physical function in older adults: A narrative review. Exp Gerontol 2022; 167:111902. [PMID: 35878867 DOI: 10.1016/j.exger.2022.111902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/23/2022] [Accepted: 07/17/2022] [Indexed: 12/25/2022]
Abstract
Widely used in daily practice, handgrip strength (HGS) is a low cost, easy-to-use, and portable test to assess overall muscle and physical function. It can be used as a stand-alone or a first-line tool for evaluating muscle weakness, though controversy surrounds its use for assessing global or lower limb muscle function. Lower limb mobility and physical activity are reduced with advancing age. This decline is difficult to quantify with isokinetic or isometric devices in routine settings (hospital and nursing home). For this narrative review we explored and summarized the findings of studies that investigated the association between HGS, lower limb muscle strength, and physical performance in older adults. The review also provides directions for future research. We noted contrasting findings for an association between HGS, lower limb strength, and physical performance. We found insufficient evidence for endorsing the handgrip dynamometer as a definitive tool for measuring overall muscle strength and physical function. More evidence is needed from comparable studies involving larger samples of men and women and investigating other areas such as lifestyle, daily physical activity levels, and health-related disorders.
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Affiliation(s)
- Toni Tatangelo
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Laura Ghiotto
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Andrea P Rossi
- Division of Geriatrics, Department of Medicine, Ospedale Cà Foncello, Treviso, Italy; Healthy Aging Center, Department of Medicine, Division of Geriatric, University of Verona, 37126 Verona, Italy.
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Domingues VL, Pompeu JE, de Freitas TB, Polese J, Torriani-Pasin C. Physical activity level is associated with gait performance and five times sit-to-stand in Parkinson's disease individuals. Acta Neurol Belg 2022; 122:191-196. [PMID: 34689319 DOI: 10.1007/s13760-021-01824-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physical activity (PA) level is decreased in individuals with Parkinson´s disease (PD). To increase the PA level improves both motor and non-motor symptoms of this population. It is known that gait performance and five times sit-to-stand (FTSTS) are associated with PA level; therefore, it is of great relevance for rehabilitation purposes to understand whether these variables may predict PA level of individuals with PD. OBJECTIVE To investigate whether gait performance and FTSTS are predictors of PA level. METHODS Cross-sectional study with individuals with idiopathic PD modified Hoehn and Yahr staging scale between 1.0 and 3.0. The gait performance was measured by Functional Gait Assessment (FGA) and PA level was measured by an accelerometer for one week, during day and night through their time spend in locomotion (locomotion time-LT). Multiple linear regression was conducted with gait performance and FTSTS as independent variables and PA level (LT) as dependent variable. RESULTS Twenty-two participants were included, mean age 64.82 (8.39) and the mean storage of accelerometer time was 9.866 min (0.33). Both gait performance and FTSTS have moderate significant correlation with PA level (r = - 0.538 p < 0.01 and r = 0.625 p < 0.001, respectively). The linear regression model with FGA and FTSTS was significant (p < 0.05) and predicted 41% of LT. CONCLUSION Gait performance and FTSTS have important interaction with PA level measured by LT in individuals with PD, and it provides insights on the importance of these variables in predicting the PA level of its population.
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Affiliation(s)
- Vitória Leite Domingues
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil.
| | - José Eduardo Pompeu
- Laboratory of Studies in Technology, Functionality and Aging of the Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Tatiana Beline de Freitas
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
| | - Janaine Polese
- Department of Physical Therapy, Medical Sciences College of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Camila Torriani-Pasin
- Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, SP, Brazil
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Ebert JR, Edwards P, Yi L, Joss B, Ackland T, Carey-Smith R, Buelow JU, Hewitt B. Strength and functional symmetry is associated with post-operative rehabilitation in patients following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2018; 26:2353-2361. [PMID: 28916871 DOI: 10.1007/s00167-017-4712-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/08/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate strength and functional symmetry during common tests in patients after anterior cruciate ligament reconstruction (ACLR), and its association with post-operative rehabilitation. METHODS At a median 11.0 months post-surgery (range 10-14), 111 ACLR patients were assessed. A rehabilitation grading tool was employed to evaluate the duration and supervision of rehabilitation, as well as whether structured jumping, landing and agility exercises were undertaken. Patients completed the Noyes Activity Score (NSARS), maximal isokinetic knee extensor and flexor strength assessment, and a 4-hop test battery. Limb Symmetry Indices (LSIs) were calculated, presented for the entire group and also stratified by activity level. ANOVA evaluated differences between the operated and unaffected limbs across all tests. Correlations were undertaken to assess the relationship between post-operative rehabilitation and objective test LSIs. RESULTS The unaffected limb was significantly better (p < 0.0001) than the operated limb for all tests. Only 52-61 patients (47-55%) demonstrated LSIs ≥ 90% for each of the hop tests. Only 34 (30.6%) and 61 (55.0%) patients were ≥ 90% LSI for peak quadriceps and hamstring strength, respectively. Specifically in patients actively participating in jumping, pivoting, cutting, twisting and/or turning sports, 21 patients (36.8%) still demonstrated an LSI < 90% for the single hop for distance, with 37 patients (65.0%) at < 90% for peak knee extension strength. Rehabilitation was significantly associated with the LSIs for all tests. CONCLUSION Rehabilitation was significantly correlated with limb symmetry, and lower limb symmetry was below recommended criterion for many community-level ACLR patients, including those already engaging in riskier activities. It is clear that many patients are not undertaking the rehabilitation required to address post-operative strength and functional deficits, and are being cleared to return to sport (or are returning on their own accord) without appropriate evaluation and further guidance. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (M408), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,HFRC, 117 Stirling Highway, Nedlands, WA, 6009, Australia.
| | - Peter Edwards
- School of Human Sciences (M408), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.,HFRC, 117 Stirling Highway, Nedlands, WA, 6009, Australia
| | - Luke Yi
- School of Human Sciences (M408), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Brendan Joss
- HFRC, 117 Stirling Highway, Nedlands, WA, 6009, Australia
| | - Timothy Ackland
- School of Human Sciences (M408), The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Richard Carey-Smith
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram Street, West Perth, WA, 6005, Australia.,School of Surgery (Orthopaedics), University of Western Australia, Crawley, WA, 6009, Australia.,Sir Charles Gairdner Hospital (Orthopaedic Surgery Department), Nedlands, WA, 6009, Australia
| | - Jens-Ulrich Buelow
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram Street, West Perth, WA, 6005, Australia
| | - Ben Hewitt
- Orthology, Suite 1, 48 Outram Street, West Perth, WA, 6005, Australia
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Rouissi M, Chtara M, Bragazzi NL, Haddad M, Chamari K. Data concerning isometric lower limb strength of dominant versus not-dominant leg in young elite soccer players. Data Brief 2018; 17:414-418. [PMID: 29876411 PMCID: PMC5988318 DOI: 10.1016/j.dib.2018.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 11/28/2022] Open
Abstract
The present data article describes the isometric lower limb strength of dominant leg versus not-dominant leg measured with handheld dynamometer (HHD) in a sample of 31 young elite soccer players (age 16.42 ± 0.45 years; height 169.00 ± 0.50 cm; leg length 94.80 ± 3.32 cm; body-mass 67.04 ± 5.17 kg).
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Affiliation(s)
- Mehdi Rouissi
- Tunisian Research Laboratory "Sport Performance Optimization", National Center of Medicine and Science in Sports Tunisia
- Corresponding author.
| | - Moktar Chtara
- Tunisian Research Laboratory "Sport Performance Optimization", National Center of Medicine and Science in Sports Tunisia
| | - Nicola Luigi Bragazzi
- Department of Mathematics (DIMA), University of Genoa, Genoa, Italy
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Monoem Haddad
- Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Karim Chamari
- Athlete Health and Performance Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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Godfrey A, Lara J, Del Din S, Hickey A, Munro CA, Wiuff C, Chowdhury SA, Mathers JC, Rochester L. iCap: Instrumented assessment of physical capability. Maturitas 2015; 82:116-22. [PMID: 25912425 PMCID: PMC4551273 DOI: 10.1016/j.maturitas.2015.04.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/03/2015] [Accepted: 04/05/2015] [Indexed: 11/05/2022]
Abstract
Instrumented testing of five physical capability tasks with a single accelerometer. Evaluated on a large cohort of older adults. iCap provides robust quantitative data about physical capability. iCap captures gait and postural control data known as sensitive to ageing/pathology. Methodology may have practical utility in a wide range of surveys and studies.
Objectives The aims of this study were to (i) investigate instrumented physical capability (iCap) as a valid method during a large study and (ii) determine whether iCap can provide important additional features of postural control and gait to categorise cohorts not previously possible with manual recordings. Study design Cross-sectional analysis involving instrumented testing on 74 adults who were recruited as part of a pilot intervention study; LiveWell. Participants wore a single accelerometer-based monitor (lower back) during standardised physical capability tests so that outcomes could be compared directly with manual recordings (stopwatch and measurement tape) made concurrently. Main outcome measures Time, distance, postural control and gait characteristics. Results Agreement between manual and iCap ranged from moderate to excellent (0.649–0.983) with mean differences between methods low and deemed acceptable. Additionally, iCap successfully quantified (i) postural control characteristics which showed sensitivity to distinguish between 5 variations of the standing balance test and (ii) 14 gait characteristics known to be sensitive to age/pathology. Conclusions Our findings show that iCap can provide robust quantitative data about physical capability during standardised tests while also providing sensitive (age/pathology) postural control and gait characteristics not previously quantifiable with manual recordings. The methodology which we propose may have practical utility in a wide range of clinical and public health surveys and studies, including intervention studies, where assessment could be undertaken within diverse settings. This will need to be tested in further validation studies in a wider range of settings.
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Affiliation(s)
- A Godfrey
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - J Lara
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - S Del Din
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - A Hickey
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - C A Munro
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - C Wiuff
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - S A Chowdhury
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - J C Mathers
- Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Human Nutrition Research Centre, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
| | - L Rochester
- Institute of Neuroscience, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK; Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne, UK.
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Abstract
Objective To assess the effect of lower limb strength on falls and balance in community-dwelling elderly persons by a health status questionnaire, evaluation of lower limb strength and balance. Method A total of 86 subjects (age 69.8±5.3) were categorized into one of two groups, "Fallers" and "Non-fallers". Thirty one participants who had reported the experience of having fallen unexpectedly at least once in the past year were assigned into the group "Fallers", and the remaining 55 subjects having no fall history in the past year, "Non-fallers". A self-assessment questionnaire was taken. Lower limb strength was measured by a "Chair stand test". Balance was measured by the stability index of the fall risk test protocol of Balance System SD® (Biodex, New York, USA). The differences between the two groups were compared and the correlation between lower limb strength and balance were analyzed. Results The questionnaire demonstrated no significant differences between two groups. The "Chair stand test" showed a significantly less for the "Fallers" (p<0.05). The stability index was significantly greater in the "Fallers" group (p<0.05). There was a moderate negative correlation between the "Chair stand test" and the "Stability index" (R=-0.576, p<0.01). Conclusion This study suggests that the "Chair stand test" is a useful screening process for lower limb strength which correlates to risk for falls and balance in the elderly.
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Affiliation(s)
- Kang Hee Cho
- Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon 301-721, Korea
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