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PubMed1992

Priming doses of atracurium and vecuronium depress swallowing in humans.

The administration of low doses of muscle relaxant may cause peripheral muscular weakness including difficulty in swallowing. In the present study, the effect of priming doses of atracurium and vecuronium on swallowing was studied. Sixty patients undergoing elective surgery under general anesthesia were divided randomly into four groups of 15 patients and received as a priming dose either vecuronium (10 or 15 micrograms/kg) or atracurium (50 or 75 micrograms/kg). Swallowing muscle activity was measured by electromyography using submental surface electrodes. Swallowing was initiated by administration of 0.3 ml distilled water through an oral catheter. Swallowing reflex was determined by measuring the latency time (i.e., time from water administration to start of EMG activity of glossal muscles). Swallowing activity was determined by integration of the EMG of glossal muscles during swallowing. Peripheral muscle strength was determined by hand grip strength. Swallowing reflex activity and peripheral muscle strength were measured before and 3 and 6 min after administration of vecuronium or atracurium. Latency time remained unchanged after any of the priming doses. Integrated EMG decreased significantly (P < .001) 3 and 6 min after all priming doses tested (42-75% of baseline value). Only after atracurium 75 micrograms/kg was the hand grip strength significantly decreased (P < .01). These results suggest that owing to its effect on swallowing, the priming dose should be used with caution.

Adult↗
PubMed1992

Detection of extraordinary large bio-magnetic field strength from human hand during external Qi emission.

It is generally accepted that more than 10(-6) gauss order magnetism was not detected in normal human condition. However, we detected 10(-3) gauss (mGauss) order bio-magnetic field strength from the palm in special persons who emitted External Qi ("Chi" or "Ki"). This detection was possible by special arranged magnetic field detection system, consisted of a pair of 2 identical coils with 80,000 turns and a high sensitivity amplifier. Each of the coils were rolled 80,000 turns accurately, and were connected in series in opposite direction, actuating as a gradiometer. We measure bio-magnetic field strength in 37 subjects with this detection system. The only 3 subjects of them exhibited strong bio-magnetic field of 2 to 4 mGauss in frequency range of 4 to 10 Hz. This magnetic field strength was greater than that of normal human bio-magnetism by 1,000 times at least. A simultaneous measurement of bio-magnetic field strength and its corresponding bio-electric current was examined in one subject. During exhibiting such strong bio-magnetism, its corresponding electric current was not detectable. Therefore, the extra-ordinary large bio-magnetic field strength can not derive from internal body current alone, hence the origin of the large bio-magnetism is still unknown. We suppose that the extraordinary large bio-magnetic field strength might be originated from "Qi" energy in the oriental medicine or in the oriental traditional philosophy.

Electromagnetic Fields↗
PubMed2006

Body mass index, free insulin-like growth factor I, and physical function among older adults: results from the ilSIRENTE study.

The aim of the present study was to evaluate the mediating role played by obesity on the relationship of free insulin-like growth factor I (IGF-I) and IGF-binding protein-3 (IGFBP-3) with muscle strength and physical performance. Data were from baseline evaluation of the ilSIRENTE Study. Muscle strength was measured by hand grip strength. Physical performance was assessed using the walking speed and the 0-3 Short Physical Performance Battery (SPPB) score. Based on its median value, free IGF-I was categorized in the following two groups: low IGF-I (IGF-I <0.65 ng/ml; n = 174) and high IGF-I (IGF-I > or =0.65 ng/ml; n = 175). Similarly, IGFBP-3 was categorized in the following two groups: low IGFBP-3 (IGFBP-3 <4,319.9 ng/ml; n = 174) and high IGFBP-3 (IGFBP-3 > or =4,319.9 ng/ml; n = 175). Body mass index (BMI) was categorized as follows: <25 kg/m(2) (n = 160), 25-29.9 kg/m(2) (n = 133), > or =30 kg/m(2) (n = 56). Mean age of the 349 participants was 85.8 yr, and 234 (67%) were women. After adjusting for potential confounders, no significant association of IGF-I and IGFBP-3 with study outcomes was observed. After the study sample was stratified by BMI groups, compared with participants with low IGF-I level, those with high IGF-I level had a significantly better grip strength [35.2 +/- 1.6 vs. 29.2 +/- 2.0 (SE) kg, P = 0.03], walking speed (0.55 +/- 0.04 vs. 0.40 +/- 0.04 m/s, P = 0.01), and SPPB score (1.9 +/- 0.1 vs. 1.5 +/- 0.1 m/s, P = 0.01) but only in the group with BMI > or =30 kg/m(2) and not in other BMI groups. A statistically significant interaction between BMI and IGF-I level was observed on all study outcomes. By contrast, no association was observed between IGFBP-3 and study outcomes, independently of BMI. In conclusion, high IGF-I level is associated with better physical function in older persons with obesity, but not in nonobese subjects.

Age Factors↗
PubMed1998

Effect of forward rapidly rotating shift work on circadian rhythms of arterial pressure, heart rate and oral temperature in air traffic controllers.

Twenty-four-hour records of arterial pressure (AP), heart rate (HR), oral temperature (OT) and physical and mental performance were obtained in air traffic controllers during morning (n = 16), afternoon (n = 17) and night (n = 19) shifts. Data were analyzed by the cosinor method. The results obtained during the morning shift were as follows (mesor/amplitude/acrophase): systolic AP (mm Hg)--113.6/10.0/16:03 h; diastolic AP--71.1/8.2/15:19 h; mean AP--85.6/8.8/15:41 h; HR (beats/min)--77.5/8.9/16:00 h; OT (dg C)--36.71/0.21/15:49 h; right-hand grip strength (kg)--49.8/2.0/17:43 h; left-hand grip strength--46.1/2.0/16:08 h; mental performance (calculations/min)--14.9/1.1/16:39 h. During the night shift either no change of the circadian acrophases (HR, right-hand grip strength) or acrophase delays ranging from about 2 h (systolic AP, OT, mental performance) up to 3 h (diastolic and mean AP, left-hand grip strength) were observed. Our data suggest that the shift system studied does not significantly alter the circadian rhythms, and does not induce a desynchronization, particularly as concerns arterial pressure and oral temperature.

Adult↗
PubMed2006

Motor unit synchronization measured by cross-correlation is not influenced by short-term strength training of a hand muscle.

The purpose of the study was to quantify the strength of motor unit synchronization and coherence from pairs of concurrently active motor units before and after short-term (4-8 weeks) strength training of the left first dorsal interosseous (FDI) muscle. Five subjects (age 24.8 +/- 4.3 years) performed a training protocol three times/week that consisted of six sets of ten maximal isometric index finger abductions, whereas three subjects (age 27.3 +/- 6.7 years) acted as controls. Motor unit activity was recorded from pairs of intramuscular electrodes in the FDI muscle with two separate motor unit recording sessions obtained before and after strength training (trained group) or after 4 weeks of normal daily activities that did not involve training (control group). The training intervention resulted in a 54% (45.2 +/- 8.3 to 69.5 +/- 13.8 N, P = 0.001) increase in maximal index finger abduction force, whereas there was no change in strength in the control group. A total of 163 motor unit pairs (198 single motor units) were examined in both subject groups, with 52 motor unit pairs obtained from 10 recording sessions before training and 51 motor unit pairs from 10 recording sessions after training. Using the cross-correlation procedure, there was no change in the strength of motor unit synchronization following strength training (common input strength index; 0.71 +/- 0.41 to 0.67 +/- 0.43 pulses/s). Furthermore, motor unit coherence z scores at low (0-10 Hz; 3.9 +/- 0.3 before to 4.4 +/- 0.4 after) or high (10-30 Hz; 1.7 +/- 0.1 before to 1.9 +/- 0.1 after) frequencies were not influenced by strength training. These motor unit data indicate that increases in strength following several weeks of training a hand muscle are not accompanied by changes in motor unit synchronization or coherence, suggesting that these features of correlated motor unit activity are not important in the expression of muscle strength.

Action Potentials↗
PubMed1988

Musculoskeletal capacity of middle-aged women and men in physical, mental and mixed occupations. A 3.5-year follow-up.

The musculoskeletal capacity of 44 women and 39 men, mean age 55.0 +/- 3.4 years, was studied at the beginning and end of a 3.5 year period. The measurements included anthropometrics, maximal isometric trunk flexion and extension strength, maximal isometric hand grip strength and back mobility. According to a job analysis the subjects were divided into three dominating work groups: physical, mental and mixed groups. The results showed significant changes in anthropometrics, maximal isometric muscle strength and in mobility. The body weight and body mass index among women and the body mass index among men increased significantly during the period. The body height and sum of the skinfolds had on the other hand decreased significantly for both women and men. Women showed significant decreases of 9% and 10% (p less than 0.05 and p less than 0.01) in isometric trunk flexion and extension strength, and an increase of 9% in back mobility (p less than 0.05). In mental work, most of the significant changes occurred among women. Men had significant decreases in isometric trunk flexion and extension, 22% and 16% respectively (p less than 0.001) and an increase of 13% in back mobility (p less than 0.001). The men doing physical work had most of the significant changes in musculoskeletal capacity. The results revealed accelerated changes in musculoskeletal capacity in middle-aged employees.

Age Factors↗
PubMed2005

Objective and subjective upper body function six months following diagnosis of breast cancer.

Whether based on self-reported disability or direct physical measurements, studies of upper body function (UBF) among women with breast cancer consistently reveal high prevalence of limitation. Unfortunately, limited research and conflicting results undermine the ability to identify those factors that contribute to these UBF problems. This study describes the influence of selected personal and treatment characteristics on UBF, six-months following treatment for unilateral breast cancer, in a population-based sample of women residing in Southeast Queensland, Australia (n = 214). UBF was assessed by three objective measures (upper body strength and endurance, flexibility and hand grip strength) and two subjective measures (Disability of the Arm, Shoulder and Hand questionnaire and arm morbidity scale of the Functional Assessment of Cancer Treatment, Breast questionnaire). Modest correlations between the various UBF measures suggest that each captures a somewhat different dimension of physical function and disability. Advancing age, being treated on the non-dominant side, more childcare responsibilities, lower socioeconomic status, more extensive lymph node removal, having lymphoedema, and UBF scores of the untreated side emerged as significant correlates depending on whether UBF was assessed objectively or subjectively. There also was evidence that the relationships between the UBF measure of flexibility and (i) radiation treatment and (ii) side of treatment were modified depending on dominance. These results highlight the necessity of taking dominance into account when assessing functional impairment among breast cancer survivors. The findings also highlight the importance of considering whether subjective or objective UBF measures are more relevant in the design of future studies.

Activities of Daily Living↗
PubMed2005

The effects of five-year growth hormone replacement therapy on muscle strength in elderly hypopituitary patients.

OBJECTIVE: Little is known of the long-term effects of GH replacement therapy on muscle strength in elderly adults with adult onset GH deficiency (GHD). In this study, the effects of 5 years of GH replacement therapy on muscle function were determined in adults over 60 years of age with adult onset GHD. DESIGN: A prospective, open-label, single-centre study. Patients Twenty-six (12 male and 14 female) consecutive hypopituitary adults with adult onset GHD, mean age 65.0 (range 61-74) years. MEASUREMENTS: Upper leg muscle strength was measured using a Kin-Com dynamometer. Right and left handgrip strength were measured using an electronic grip force instrument. RESULTS: The mean insulin-like growth factor-I (IGF-I) SD score increased from -1.10 at baseline to 1.21 at end of the study. Body weight was unchanged during the 5-year study. A sustained increase in lean body mass and a sustained reduction of body fat was observed as measured using dual-energy X-ray absorptiometry (DEXA). The GH replacement therapy induced a sustained increase in isometric (60 degrees ) knee flexor strength. After statistical correction for age and sex variables using observed/predicted value ratios, a sustained increase was also observed in concentric knee flexor strength at an angular velocity of 60 degrees /s, concentric knee extensor strength at 60 degrees /s and 180 degrees /s, and peak right handgrip strength. At baseline, knee flexor strength was 90-96% of predicted, knee extensor strength was 85-87% of predicted, and hand-grip strength was 74-80% of predicted values. At study end, knee flexor strength was 98-106% of predicted, knee extensor strength was 90-100% of predicted, and hand-grip strength was 80-87% of predicted values. CONCLUSION: Elderly patients with adult onset GH deficiency had decreased baseline muscle strength also after correction for age and sex. The 5-year GH replacement therapy normalized knee flexor strength and improved, but did not fully normalize, knee extensor strength and handgrip strength.

Absorptiometry, Photon↗
PubMed1988

Muscular strength at 5 years of children with a birthweight under 1500 g.

The hand-grip strength was measured as part of the 5-year neurodevelopmental assessment of 24 very low birthweight (VLBW) and 18 normal birthweight (NBW) children. Hand-grip strength was significantly lower in the VLBW children for left and right hands tested individually and for both hands used concurrently. Increasing hand-grip strength was significantly related to 5-year weight percentiles and to being in the NBW group. More of the VLBW children weighed less than the 10th percentile. After adjusting for the 5-year weight percentile, the hand-grip strength of VLBW children was still significantly lower than that for NBW children. This is another aspect of development in which VLBW children are disadvantaged.

Body Weight↗
PubMed1996

The efficacy and tolerability of aceclofenac compared to indomethacin in patients with rheumatoid arthritis.

The efficacy and tolerability of aceclofenac (100 mg bid; n = 109), a new non-steroidal anti-inflammatory agent, was compared to that of indomethacin (50 mg bid; n = 110) in a multi-centre, 12-week, randomized, double-blind clinical trial in patients with rheumatoid arthritis. The efficacy of aceclofenac, on the basis of several clinical features characteristic for rheumatoid arthritis, was comparable to that of indomethacin. Patients in both treatment groups showed a notable and significant improvement during the study. Under aceclofenac treatment, the number of painful and swollen joints decreased by a median of six and nine, respectively, morning stiffness was shortened by 1 h, and the grip strength of both hands increased by a median of 8 mmHg. Pain at rest was relieved in 65.3% of aceclofenac-treated patients and in 67.1% of those treated with indomethacin (n.s.). With regard to safety, aceclofenac tended to be better tolerated than indomethacin. Among the 109 aceclofenac-treated patients, 26 incidents of adverse effects due to the drug were noted in 20 patients (18.4%). Sixty-four incidents of adverse events were documented in 32 (29.1%) of the 110 patients treated with indomethacin. The most common adverse events reported during treatment with aceclofenac were heartburn (four patients) and vertigo (three patients).

Alanine Transaminase↗
PubMed2004

Late reconstruction of neglected metacarpal shaft defects due to gunshot wound.

We evaluated eight patients after delayed treatment of nine metacarpal bone defects due to gunshot injuries. The mean length of the metacarpal defects was 3 cm and the average time between the gunshot injury and the reconstruction surgery was 10 months. Although all of the patients had been treated with wound irrigation and debridement immediately following injury, no attempt had been made to repair the metacarpal defect or to maintain metacarpal length. As a result, serious shortening had occurred. After the original length of the metacarpal had been restored by distraction of the soft tissues (1 mm/day), a tri-cortical iliac bone graft was inserted into the bone defect. The average follow-up time was 15 months. Clinical and radiological union was established in all cases after an average of 12 weeks. The mean grip strength of the hand and the mean range of motion of the metacarpophalangeal joint increased by 24% and 60%, respectively.

Adult↗
PubMed2004

Genetic and environmental sources on familial transmission in Biscayan families. III. The dynamometric strength.

The present research analyses a cross-sectional sample of 284 individuals (86 fathers, 86 mothers, 54 sons and 58 daughters) in 86 nuclear families living in the province of Biscay (Basque Country, Spain), with the aim of estimating both transmissible and non-transmissible components acting on familial resemblance for the maximum dynamometric strength of both hands, by means of a path analysis. Standardised data of each generation and sex were adjusted to a BETA model of path analysis independent of sex effects, allowing nevertheless the possibility to differentiate between transmissible (genetic and cultural) and non-transmissible (environmental) components acting on the observed phenotypic variance in Biscayan offspring. The results supported the full model of familial transmission for the two variables, in addition to other reduced models that gave rise to transmission effects regardless of any influence from the siblings' shared environment on the environmental transmitted component from their parents (b = 0), and without social homogamy between mates (u = 0). The most parsimonious model created, based on the previous ones, was accepted for both traits. The total transmissible variance (t2) explained between 21% (right hand) and 44% (left hand) of the observed phenotypic variation. These values are close to those from the literature (t2 = 37%). However, we should take into account that these kinds of estimations are specific for each group or population.

Adult↗
PubMed1994

Fusion of the first metacarpophalangeal joint for post-traumatic conditions.

Fusion of the metarcarpophalangeal joint of the thumb is an accepted treatment in the management of instability or osteoarthritis following trauma to this joint. A review was made of the literature and 30 of the senior author's (RH) patients who had had this operation, in order to determine what effect the operation had on the pain in their thumb, any symptoms of instability, interference with work and daily activities, and strength in the hand. All of the patients achieved bony union and the average angle of fusion was 7.6 degrees of flexion. All of the patients were either satisfied or very satisfied with the results of the operation, and had an average increase of 6.3 points on a 12 point rating scale. However, 48% of patients had some mild intermittent pain and 43% complained of some difficulty with fine motor tasks. Twelve patients were able to attend for formal evaluation including the Jebson and Crawford Hand Function Tests which revealed some decrease in hand function in all of those tested. It was concluded that this method of arthrodesis of the metacarpophalangeal joint of the thumb gives reliable results, with high patient acceptance, but does not result in an entirely normal thumb or hand function.

Arthrodesis↗
PubMed1999

Surgery for suspected neurogenic thoracic outlet syndromes: a follow up study.

OBJECTIVES: To assess the outcome of surgical treatment for thoracic outlet syndrome (TOS), and to compare the outcome in patients with and without an underlying cervical rib. METHODS: a heterogeneous group of 40 patients (33 women, seven men; aged 22-62 years) were evaluated 3 months to 20 years after surgery for suspected neurogenic TOS. Forty nine operations had been performed: cervical ribs were removed in 23 patients, together with fibrous band excision in nine. In the 17 without a cervical rib the thoracic outlet was decompressed by resection of the first thoracic rib in nine, and by other operations in eight. RESULTS: After surgery patients reported improved pain (33/36), sensory disturbance (30/35), hand muscle strength (14/27), and hand function (23/34). Postoperatively TOS recurred in two, and symptoms continued to progress in three patients in whom other diagnoses eventually emerged. Surgical complications were recorded in 10 patients, but were transient and did not result in permanent symptomatic sequelae. CONCLUSIONS: Surgical treatment of suspected neurogenic TOS relieves pain and sensory disturbance (90%), but is less effective for muscle weakness (50%). Surprisingly, surgery relieved sensory and motor abnormalities to a similar degree in patients both with and without a cervical rib. Ideally, patients require early operation to forestall permanent hand muscle denervation, but, our retrospective analysis fails to identify any single preoperative diagnostic criterion for TOS, particularly in patients lacking a radiographic cervical rib.

Adolescent↗
PubMed1995

Inspiratory muscle weakness in chronic heart failure: role of nutrition and electrolyte status and systemic myopathy.

Inspiratory muscle weakness has been demonstrated in ambulatory, stable chronic heart failure (CHF) and may contribute to dyspnea during daily living. However, the mechanisms underlying this weakness are unknown. Malnutrition and electrolyte depletion are recognized complications of CHF that may impair skeletal muscle function, and limb muscle weakness and myopathic changes have also been demonstrated in CHF. We examined whether nutrition and electrolyte status contribute to the reduced skeletal muscle strength and whether inspiratory muscle weakness in CHF is part of general skeletal muscle weakness. We measured maximum inspiratory and expiratory mouth pressures as indices of respiratory muscle strength, maximum hand-grip strength as an index of limb muscle strength, anthropometric indices, serum albumin, and total lymphocyte count as indices of nutritional status, and serum electrolytes in 15 stable patients with chronic cardiac pump failure who had no evidence of primary lung disease, and in 15 age-and-sex-matched healthy controls. As compared with the matched controls, the CHF patients had reduced inspiratory muscle strength (p < 0.0025), but their expiratory and limb muscle strength were not significantly reduced. CHF patients were not malnourished; they were heavier than matched controls because of increased body fat (p < 0.05). Serum sodium was significantly lower in the CHF patients than in the controls (p < 0.01), but was within the normal range in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed2001

Baseline characteristics and the effects of five years of GH replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study.

The consequences of GH deficiency may differ if the disease is childhood onset or adulthood onset. In this single-center, prospective study, 21 consecutive adults with childhood onset GH deficiency and 21 adults with adulthood onset GH deficiency, matched for age, gender, body mass index, and number of anterior pituitary hormonal deficiencies, were included. Baseline differences and differences in the responses in body composition, muscle strength, bone mass, and metabolic indices during 5-yr GH replacement were determined. The duration of GH deficiency was longer and serum IGF-I level and body height were lower in the childhood onset patients than in the adulthood onset patients. Body fat (observed/predicted ratio) was increased, and lean mass and muscle strength were decreased, in the childhood onset patients. Total body and lumbar (L2-L4) bone mineral content and bone mineral density were lower in the childhood onset patients. Serum total cholesterol level was higher in the adulthood onset patients. The childhood onset and adulthood onset patients received a similar dose of GH. After adjustment for body weight, however, the dose of GH was higher in the childhood onset patients. The treatment responses were more marked in the childhood onset patients in lean mass, knee extensor strength, left-hand grip strength, and in total body and lumbar (L2-L4) bone mineral content and bone mineral density. The reduction in serum total cholesterol concentration was more marked in the adulthood onset patients. At study end, no differences remained between the two study groups after the correction for body height in the statistical analysis. In conclusion, the baseline analysis suggests more decreased lean mass, muscle strength, and bone mass in the childhood onset patients whereas the lipid profile was more disturbed in the adulthood onset patients. The 5-yr GH replacement eliminated all the anthropodometric and metabolic differences between the two groups.

Adolescent↗