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PubMed2000

Depressed mood and body mass index as predictors of muscle strength decline in old men.

OBJECTIVE: To study depressed mood as a predictor of strength decline within body weight categories over a 3-year follow-up period. DESIGN: A prospective cohort study over 3 years. SETTING: Honolulu, Hawaii. PARTICIPANTS: The subjects were 2275 men participating in the Honolulu Heart Program with an average age of 77.1 years (range 71-92 years), who were not cognitively impaired at baseline (Exam 4), and who participated in maximal hand grip strength measurements at baseline and 3 years later (Exam 5). MEASUREMENTS: Hand grip strength was measured using a dynamometer. Depressive symptoms were studied using an 11-item version of Center for Epidemiologic Studies Depression Scale with 9 as a cutoff. Body weight categories were formed on the basis of body mass index (BMI) (BMI = weight/height2; underweight: BMI < 20; normal weight: BMI 20-24.99, overweight: BMI > or = 25). MAIN RESULTS: At baseline, 9.4% of the participants were rated as having depressed mood. The mean individual strength change over 3 years was - 6.9% (standard deviation 14.0). Steep strength decline was determined as losing > or = 14% (lowest quartile). The proportions of those with steep strength decline in the groups based on combined distributions of BMI and depressed mood were: underweight/ depressed (n = 22) 41%, underweight/not depressed (n = 200) 28%, normal weight/depressed (n = 127) 30%, normal weight/not depressed (n = 1181) 25%, overweight/depressed (n = 55) 31%, overweight/not depressed (n = 675, referent) 21%. After adjusting for baseline strength, age, height, sociodemographic variables and diseases, the odds ratio for steep strength decline was more than four times greater among those who were depressed and underweight, and twice as great among people who were depressed and normal weight compared with those who were nondepressed and overweight. The risks of nondepressed under- and normal weight people and depressed overweight people did not differ from the reference group. CONCLUSIONS: Depressed mood was associated with increased risk of steep strength decline, in particular in older men with low body weight. Low body weight in combination with depressed mood may be an indicator of frailty or severe disease status that leads to accelerated strength loss and disability.

Aged↗
PubMed1993

Sauvè-Kapandji operation for disorders of the distal radioulnar joint.

A series of 13 patients is reported in which a Sauvè-Kapandji procedure consisting of arthrodesis of the articulation between the radius and ulna combined with resection of the collum ulnae was used to treat posttraumatic caput ulnae syndrome. Among the nine female and four male patients whose median age was 42 years (range: 23 to 77 years), nine sustained a distal fracture that had healed with shortening of the radius or with subluxation of the caput ulnae. Median postoperative observation time was 16 months (range: six to 27 months). Preoperatively, all patients had persistent medial wrist pain and restricted pronation-supination. At follow-up, ten patients were without symptoms and three others had improved significantly. No patient suffered from pain from the site of the resection. A significant improvement in pronation-supination of 45 degrees and flexion-extension of 25 degrees were found. Hand grip strength improved significantly during rehabilitation. At follow-up, the average hand grip strength on the operated wrists was 69% compared to the uninjured side.

Adult↗
PubMed1995

Treatment of thumb ulnar collateral ligament ruptures with the Mitek bone anchor.

Complete thumb ulnar collateral ligament (UCL) injuries usually require primary repair. The ulnar collateral ligament is often torn from its insertion site and reattachment is difficult. Seven patients underwent repair with the Mitek bone anchor (Mitek Surgical Products, Norwood, MA) for complete ulnar collateral ligament disruptions. A Stener lesion was found in four patients. Follow-up examination was at approximately 1 year. All patients regained a stable metacarpophalangeal joint to valgus stress. X-ray films demonstrated accurate placement of the bone anchor with protraction of the metallic wings within cancellous bone. Range of motion revealed a 7% loss of metacarpophalangeal flexion-extension and a 21% loss of interphalangeal motion. Pinch strength in apposition averaged 98% and in opposition 97% of the uninvolved hand. Grip strength was 96% of the contralateral extremity.

Adult↗
PubMed2006

Predictive value of grip strength for bone mineral density in males: site specific or systemic?

This study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD.

Adult↗
PubMed1998

Muscular performance in heart failure.

BACKGROUND: Some of the major symptoms in patients with chronic heart failure are muscle weakness and fatigue. However, not much is known about muscle performance in these patients compared to healthy controls. METHODS AND RESULTS: Activity level, gait speed, hand grip strength, muscle performance of the knee extensors and flexors along with the plantar and dorsal flexors of the foot were evaluated. Muscle biopsies from the lateral vastus lateralis were taken. Sixteen patients in New York Heart Association class II or III were tested and compared to 112 reference subjects. Compared to the reference subjects, there was a reduction in activity level, gait speed, isometric and isokinetic peak torque for knee extension at different velocities, hand grip strength, peak torque for plantar and dorsal flexion of the ankle and isometric and isokinetic endurance for the knee extension. Recovery was faster. There were small differences in fiber composition. 3-Hydroxy-acylCoA-dehydrogenase and citrate synthase were lower, and lactate dehydrogenase was increased. CONCLUSIONS: Muscle performance is affected in terms of both strength and endurance, which might affect performance in everyday activities. The more pronounced reduction in hand grip compared to the other muscles tested could be an indication of intrinsic abnormalities in the skeletal muscle.

Adult↗
PubMed2006

Age trajectories of grip strength: cross-sectional and longitudinal data among 8,342 Danes aged 46 to 102.

PURPOSE: The purpose is to study the age trajectory of hand-grip strength after the age of 45 years. METHODS: In this study, we use data from three large nationwide population-based surveys of Danes aged 45 to 102 years with a total of 8342 participants with grip-strength measurements and up to 4 years of follow-up. Grip strength was measured by using a portable hand dynamometer. RESULTS: Grip strength declines throughout life for both males and females, but among the oldest women, the longitudinal curve reaches a horizontal plateau. The course of the decline is estimated by using full information in the longitudinal data and is found to be almost linear in the age span of 50 to 85 years. In this age span, mean annual grip-strength loss is estimated to be 0.59 (0.02) (SE) kg for men and 0.31 (0.01) kg for women. CONCLUSION: This study confirms the previously reported grip-strength decline with increasing age. Estimates were obtained by using full-information methods from large population-representative studies. Equations of expected grip strength, as well as tables with sex-, age-, and height-stratified reference data, provide an opportunity to include grip-strength measurement in clinical care in similar populations.

Aged↗
PubMed1999

Physical capacity in relation to present and past physical load at work: a study of 484 men and women aged 41 to 58 years.

BACKGROUND: A negative association has previously been reported between long-lasting physically heavy work and some measures of physical capacity. This relationship was further investigated in a 24-year follow-up study of 484 middle-aged men and women from the general population. METHODS: A questionnaire was administered in 1993 concerning retrospective recall of physical work loads and physical training in the time span between 1970 and 1993. Laboratory tests performed in 1993 included tests of muscle function (maximal isometric strength and dynamic endurance) and aerobic power (submaximal ergometer test). RESULTS: Consistent with the hypothesis, but mainly among the women, associations between long-lasting physically heavy demands and low trunk flexion strength, squatting endurance, and aerobic power were observed. In contrast, low isometric hand grip strength and low weight lifting endurance were seldom seen among those with high physical work loads, indicating a possible maintaining or training effect on the hand/arm/shoulder muscle groups. CONCLUSIONS: Physically heavy work seems to have a different impact on different parts of the musculoskeletal system, an effect that is also different between men and women.

Adult↗
PubMed2002

A preliminary study on the reliability of physical performance measures in older day-care center clients with dementia.

BACKGROUND: Decline in physical functional ability is an intrinsic component of the dementia syndrome. Reductions in muscle mass and strength represent a major factor in the loss of functional ability Although resistance exercise has been studied as a method for maintaining/recovering function in populations of frail older adults, people with dementia have been systematically excluded because of uncertainty about the reliability of outcome measurements. OBJECTIVE: The purpose of this study was to determine the test-retest reliability of a battery of established performance-based measures of strength and function among subjects with dementia. SETTING: A hospital-affiliated adult day-care facility. SUBJECTS: Twelve of 28 older subjects with dementia of various etiologies were available for two assessments prior to implementation of a resistance-exercise intervention. METHODS: Subjects underwent an assessment of lower extremity strength and physical function consisting of two recorded trials of bilateral isometric strength of the knee extensor, hip flexor, and dorsiflexor muscles, as well as hand grip strength; repeated chair stands, evaluation of usual- and maximal safe-gait speed over a 6-m course, and the Timed-Up-and-Go Test. The entire assessment was repeated approximately 1 week later. An average of the trials for each measurement was computed for each of the two assessment periods, and intraclass correlation coefficients (ICCs) for these paired measurements were estimated using STATA. RESULTS: ICCs ranged from .56 for left iliopsoas to .77 for left dorsiflexors among the strength measures whereas measures of function ranged from .80 for number of steps in usual gait to .95 for time of fast gait. CONCLUSIONS: Performance-based measures of strength and function can be reliably assessed in older people with dementia, although measures of function appear to be more reliable than measures of strength.

Activities of Daily Living↗
PubMed2003

The aging hand.

Hand function decreases with age in both men and women, especially after the age of 65 years. A review is presented of anatomical and physiological changes in the aging hand. The age-related changes in prehension patterns (grip and pinch strength) and hand dexterity in the elderly population are considered. Deterioration in hand function in the elderly population is, to a large degree, secondary to age-related degenerative changes in the musculoskeletal, vascular, and nervous systems. Deterioration of hand function in elderly adults is a combination of local structural changes (joints, muscle, tendon, bone, nerve and receptors, blood supply, skin, and fingernails) and more distant changes in neural control. These age-related changes are often accompanied by underlying pathological conditions (osteoporosis, osteoarthritis, rheumatic arthritis, and Parkinson's disease) that are common in the elderly population. Assessment of hand function and prehension patterns is needed in order to determine specific treatment approaches.

Activities of Daily Living↗
PubMed2000

Diurnal variation in the P300 component of human cognitive event-related potential.

Diurnal variation in the P300 component of the human cognitive event-related potential (ERP) was examined. The P300 component is considered to be a measure of neuroelectric activity related to cognitive functions such as attention allocation and information processing. Nine diurnally active healthy male subjects whose sleep-wake rhythms were synchronized prior to the experiment were studied. The P300 components oral temperature, heart rate, left- and right-hand grip strength, reaction time, subjectively rated sleepiness, attention level, and fatigue were measured at 08:00, 11:00, 14:00, 17:00, and 20:00. Significant diurnal variations in P300 latency, P300 amplitude, oral temperature, heart rate, left- and right-hand grip strength, subjectively rated sleepiness, and attention level were observed. The P300 latency at 08:00 was significantly longer than at 11:00, 17:00, and 20:00, while the P300 amplitude at 08:00 was significantly greater than at 17:00 and 20:00. The P300 latency was correlated positively with subjectively rated sleepiness and negatively correlated with subjectively rated attention level. These results suggest the existence of diurnal variation in human cognitive functions.

Adult↗
PubMed1993

Posture and reaching in chimpanzees (Pan troglodytes) and orangutans (Pongo pygmaeus).

Hand preference in reaching was assessed under 2 postural adjustment conditions in 40 chimpanzees (Pan troglodytes) and 9 orangutans (Pongo pygmaeus). The postural conditions were quadrupedal and upright, during which reaching for food was scored on a minimum of 50 trials. Results indicated no population preference during quadrupedal reaching but a right-hand population preference was found during upright reaching. There were no significant effects of age or sex on either the direction or strength of hand preference. Early rearing history affected the strength of hand preference but not direction. The results suggest that posture is an important factor in the assessment of hand preference in great apes and may have important evolutionary consequences.

Animals↗
PubMed2004

Validity and reliability of the measurement of the quardriceps femoris muscle strength with a hand-held dynamometer on the affected side in hemiplegic patients.

The purpose of this study was to investigate validity and reliability of measuring the quadriceps femoris muscle strength on the affected side in hemiplegic patients with a hand-held dynamometer(HHD) to prepare for a multi-center cooperative study. Measurements of the known weights(8.972 and 18.665 kg) with HHD were 8.98 +/- 0.00 kg and 18.57 +/- 0.00 kg, respectively, and measurements with HHD were almost consistent with those with KIN-COM (gold standard), because the Pearson's product-moment correlation coefficient was 0.99 (P < 0.001). There were significant differences in measurements of the quadriceps femoris muscle strength on the affected side in a hemiplegic patient between just anterior to the face of the ankle and 7 cm proximal to the ankle, and on a chair with or without a backrest (t-test, P < 0.05), but no significant difference was found between the 90 degrees and 60 degrees flexed position of the knee (t-test, 0.1 > P > 0.05). There were also no significant differences in muscle strength measured by three different examiners and on four trials, but significant differences were found among three patients (General Linear Model, P < 0.001). Therefore, by using the standardized measuring procedure, the HHD is reliable to measure strength of the quadriceps femoris muscle on the affected side in hemiplegic patients.

Hemiplegia↗
PubMed2004

Tennis elbow--outcome following the Garden procedure: a retrospective study.

PURPOSE: From 1993 to 1999, 17 patients (18 elbows) underwent the Garden procedure for clinically diagnosed tennis elbow. Non-operative treatment was ineffective for these patients. METHODS: The study group consisted of 10 men and 7 women, with a mean age of 49.6 years. Follow-up duration ranged from 18 months to 6 years, with a mean of 37 months. Patients' pain, activity level, and hand grip strength were evaluated postoperatively. RESULTS: 14 (77.8%) elbows had an excellent or good result, 2 elbows had a fair result, and another 2 elbows had a poor result and required revision surgery. Most patients had immediate relief of elbow pain, returned to work early, and did not notice any weakness of hand grip strength or radial wrist extension. There were no significant complications. CONCLUSION: The Garden procedure produced good results for tennis elbow with minimal morbidity in an unselected group of patients. This retrospective study supports the view that the underlying lesion in tennis elbow is in the origin of extensor carpi radialis brevis.

Adult↗
PubMed2005

Basis for an FCE methodology for patients with work-related upper limb disorders.

A reported reduction in work-related functional capacity in Work-related Upper Limb Disorders (WRULD) patients is among the most common problems in WRULD. The extent to which this reduction in functional capacity can be objectified remains unknown. A validated instrument to test functional capacity in this patient group is unavailable. The objective of this study was to design a Functional Capacity Evaluation (FCE) for WRULD patients working with Visual Display Units (VDU) and provide evidence for content validity. A review to epidemiological literature was conducted to identify physical risk factors for VDU-related WRULD. The results indicate that physical risk factors were related to repetition, duration, working in awkward and static positions and forceful movements of the upper extremity and neck. An FCE was designed based on the risk factors identified. Eight tests were selected to cover all risk factors: the overhead lift, overhead work, repetitive reaching, handgrip strength, finger strength, wrist extension strength, fingertip dexterity, and a hand and forearm dexterity test. Content validity of this FCE was established by providing the rationale, specific objectives and operational definitions of the FCE. Further research is needed to establish reliability and other aspects of validity of the WRULD FCE.

Biomechanical Phenomena↗
PubMedDate not supplied

Associations between pain, grip strength, and manual tests in the treatment evaluation of chronic tennis elbow.

OBJECTIVE: The objective was to assess the associations between changes in pain and grip strength and manual tests among patients with chronic tennis elbow. DESIGN: Measurements for 45 consecutive patients with unilateral tennis elbow were made before and after an exercise intervention. SETTING: The setting was a physiatric outpatient clinic. PATIENTS: The patients were 45 persons with chronic unilateral tennis elbow: 32 women and 13 men. The mean age was 44 (31-54) years; mean duration of symptoms was 35 (10-66) weeks. OUTCOME MEASURES: Manual tests, pressure pain thresholds at three cubital points, a pain questionnaire, a pain drawing, and grip strength measurements were assessed. RESULTS: Grip strength became normal during the treatment. Pressure pain thresholds reached 66% of that of the healthy arm. Lowered pain thresholds and changes in pain thresholds of the lateral epicondyle were strongly associated with the findings in the manual tests. Mills test and resisted wrist extension tests were associated with perceived pain, and resisted wrist extension tests also were associated with decreased grip strength. Pain on palpation was associated with lowered pain thresholds at the lateral epicondylus and with perceived pain under physical load. After the treatment, for 13 patients all 4 manual tests were still positive; for 17 patients, 3 were still positive; and for 5 patients, all were negative. Positive clinical tests were associated with lowered pain thresholds, decreased grip strength, and high perceived pain scores. CONCLUSIONS: Pain thresholds at the lateral epicondyles are strongly associated with pain on palpation and with a positive Mills test. Resisted wrist extension test results reflect decreased grip strength. Impaired function of the hand is associated with the number of positive clinical tests. Pain threshold evaluation is a simple, easy, inexpensive method that provides useful additional quantitative data on pain and disability among patients with chronic tennis elbow.

Adult↗
PubMed1994

Partial radiocarpal arthrodesis.

Eight patients underwent partial radiocarpal arthrodesis for various wrist disorders. There were 5 men and 3 women, whose age at operation ranged from 33 to 59 years with an average of 44 years. The indications for operation included post-traumatic changes secondary to distal radius fracture in 5 cases, Kienböck's disease in 1, Madelung's deformity in 1, and rheumatoid arthritis in 1. Arthrodesis was performed at the radiolunate joint in 5 cases, and at the radioscapholunate joint in 3 cases. In all cases, bone union was obtained within 3 months postoperatively. Postoperative wrist pain disappeared in 6 cases, and decreased in 2 cases. The average postoperative flexion-extension arc of motion was 35 degrees in the radioscapholunate arthrodesis group, and 85 degrees in the radiolunate arthrodesis group. The postoperative grip strength compared with the unaffected hand averaged 51% in the radioscapholunate arthrodesis group, and 68% in the radiolunate arthrodesis group. One patient showed a deterioration in the osteoarthritic change in the midcarpal joint.

Adult↗
PubMed2001

Three days fast in sportsmen decreases physical work capacity but not strength or perception-reaction time.

This study investigates, in young nonobese healthy athletes, the consequences of a 3-day fast coupled, or not, to enhanced physical activity. Eight male subjects, aged 21+/-2 years, fasted for 3 days on two separate occasions, 4 weeks apart. On the first occasion, subjects continued their daily training activities. On the second occasion, a daily physical exercise program was added to these activities. Subjects were evaluated before and after 24 hours and 72 hours of fasting. Evaluation consisted of body composition, basal respiratory exchange ratio, plasma metabolic parameters, perception-reaction time (both simple and discriminant), hand grip strength, and physical work capacity at 170 beats per minute (PWC170). Fasting determined significant reductions in body weight, body fat, and muscle mass. These reductions were not affected by enhanced physical activity. Basal respiratory exchange ratio decreased with fasting but was not influenced by increased training activities. Fasting determined a significant decrease in blood glucose levels, while plasma proteins, urea, uric acid, and free fatty acids increased. Perception-reaction time and hand grip strength were unmodified during fasting. By contrast, PWC170 was significantly and progressively reduced during fasting, and this decrease was not reversed by an increase in training activities.

Adult↗