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Neurological signs and psychomotor performance in patients with schizophrenia, their relatives and healthy controls.

Schizophrenic patients (DSM-III-R) were consecutively recruited and 39 were included. Twenty-one were first-episode and 18 were chronic schizophrenic patients. Thirty of the patients were on neuroleptic medication. Thirty-three parents were included, of whom nine were classified as 'family history positive' and 22 as 'family history negative' of a disposition to psychosis. Fifty-five healthy controls volunteered. The subjects were investigated according to a protocol divided into neurological signs and psychomotor performance (finger-tapping rate, Purdue pegboard test, pronation-supination test, gait and hand-grasp strength). Seventy-eight percent of the patients and 7% of the controls were classified as globally aberrant in signs. The patients and their parents, classified as 'family history positive', exhibited a similar laterality pattern in a finger-tapping test improving performance with the preferred hand, significantly different from the performance of the 'family history negative' parents and normal subjects. Duration of illness, neuroleptic medication and negative symptoms were not related to the occurrence of neurological signs and psychomotor performance. These findings indicate that neurological aberrations are present at the onset of illness and that hereditary factors are associated with motor laterality.

Acute Disease↗

Association of muscle strength with functional status of elderly people.

We have studied the association of muscle strength (quadriceps, biceps, handgrip), measured by a portable chair technique, with functional status (Barthel Index, manual dexterity, Mental Test Score, history of falls, fracture, prescribed drugs), in a sample of 92 elderly subjects attending a Local Authority Day Centre and Day Hospital. Anthropometric measurements and hand-grip strength were also measured in 30 young controls. Muscle area, mass and strength were significantly greater in young controls. Elderly men had significantly greater muscle area, mass and strength than elderly women. Muscle strength correlated with several measures of functional status. Using stepwise multiple regression, an independent association of muscle strength with manual dexterity, Barthel Index and receipt of domiciliary services is demonstrated.

Aged↗

Associations between grip strength change and axial postmenopausal bone loss--a 10-year population-based follow-up study.

The aim of the present study was to investigate the associations between grip strength change and postmenopausal bone loss. The study population, 622 peri- and postmenopausal women, was a random sample of the OSTPRE-study cohort (n=13,100) in Kuopio, Finland. Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual X-ray absorptiometry and grip strength with a pneumatic squeeze dynamometer at baseline in 1989-1991, at the 5-year follow-up in 1994-1997 and at the 10-year follow-up in 1999-2001. Women were divided into three groups according to the change in age-grouped grip strength quartile they belonged to in each measurement (n in 5-year/10-year follow-up): "decreased" (n=150/n=140), "maintained" (n=314/n=320) and "improved" (n=158/n=162). Women within the improved group had significantly lower bone loss at both FN and LS in comparison to the other two groups after 10 years of follow-up (P<0.01). Furthermore, in HRT non-users (n=305) the difference between the improved group and maintained group was only modest (P=0.04). In contrast, in HRT users (n=310) the mean annual BMD change among the improved group was positive (bone gain 0.11%/year) and differed significantly in comparison to modest bone loss in the decreased and maintained groups in both LS and FN (P<0.01). The linear trend between grip strength quartile change and LS/FN bone loss was significant in HRT users (P<0.001) in contrast to HRT non-users (P=NS) in the linear regression model. Any of these differences were not affected by adjustments for age, weight, height and other potential confounders. In conclusion, the present study suggests that improvement in age-grouped grip strength quartile is strongly associated with axial bone loss among postmenopausal women. This effect seemed to interact positively with estrogen repletion status. These results encourage performing further clinical studies on associations between muscle strength changes and bone loss.

Absorptiometry, Photon↗

Sensitivity of cortical movement representations to motor experience: evidence that skill learning but not strength training induces cortical reorganization.

The topography of forelimb movement representations within the rat motor cortex was examined following forelimb strength training. Adult male rats were allocated to either a Power Reaching, Control Reaching or Non-Reaching Condition. Power Reaching rats were trained to grasp and break progressively larger bundles of dried pasta strands with their preferred forelimb. Control Reaching animals were trained to break a single pasta strand and Non-Reaching animals were not trained. Power Reaching animals exhibited a progressive increase in the maximal size of the pasta bundle that could be retrieved during a 30-day training period. Kinematic analyses showed that this improvement was not due to a change in reaching strategy. Intracortical microelectrode stimulation was used to derive maps of forelimb movement representations within the motor cortex of all animals following training. In comparison to Non-Reaching animals, both Power Reaching and Control Reaching animals exhibited a significant increase in the proportion of motor cortex occupied by distal forelimb movement representations (wrist/digit) and a decrease in the proportion of proximal representations (elbow/shoulder). These results demonstrate that the development of skilled forelimb movements, but not increased forelimb strength, was associated with a reorganization of forelimb movement representations within motor cortex.

Animals↗

Three mouse models of muscular dystrophy: the natural history of strength and fatigue in dystrophin-, dystrophin/utrophin-, and laminin alpha2-deficient mice.

To optimize and evaluate treatments for muscular dystrophy, it is important to know the natural history of the disease in the absence of therapeutic intervention. Here we characterized disease progression of three mutant mouse strains of muscular dystrophy: mdx mice, which lack dystrophin; mdx:utrn-/- mice, which also lack utrophin; and dy/dy mice, which are deficient in laminin alpha2. Normal mice show a marked increase in forelimb strength over the first 10 weeks of life and little fatigue (<5%) over five consecutive strength trials. Mdx and mdx:utrn-/- mice demonstrate less strength then normal mice and approximately 40% fatigue at each age. Mdx mice become obese but mdx:utrn-/- mice do not. Dy/dy mice remain small and are much weaker than mdx and mdx:utrn-/- mice at all ages even when normalized to weight; however, they show only minimal fatigue (10%). This work demonstrates a distinct pattern of disease progression in each model and provides a foundation for assessing strategies for improving strength in each model.

Aging↗

Modelling handgrip strength in the presence of confounding variables: results from the Allied Dunbar National Fitness Survey.

Differences in handgrip strength, caused by risk factors such as physical inactivity, will be influenced by 'confounding' variables, e.g. age, body size. The aims of the study were to identify the confounding variables associated with handgrip strength and to assess the benefit that physical activity plays in maintaining grip strength within a population, having adjusted for differences in these confounding variables. The most appropriate linear body size dimension associated with grip strength was height rather than demispan. Non-linear associations with age and body mass were also identified. Handgrip strength peaked in the age group 25 - 34 years for male subjects and in the age group 35 - 44 years for female subjects. Similarly, handgrip strength increased with body mass until it peaked at a body mass of approximately 100 kg for male and 90 kg for female subjects; thereafter a rapid decline in grip strength was observed. Differences in handgrip strength were found to be significantly associated with levels of physical activity even having controlled for differences in age and body size (height, mass and percentage body fat), but the observed association was not linear. The level of physical activity necessary to maintain an optimal level of handgrip strength was found to be a balance of moderate or vigorous occasions of physical activity.

Adult↗

Strength, power and related functional ability of healthy people aged 65-89 years.

This cross-sectional study was designed to examine the effects of healthy ageing on muscle strength, power, and potentially related functional ability. Subjects were recruited through local and national newspapers and inclusion was based on strict health criteria, by questionnaire. Isometric knee extensor, isometric elbow flexor and handgrip strength, leg extensor power, timed rise from a low chair, lifting a weighted bag on to a surface, and stepping unaided on to boxes of different heights were measured in 50 men and 50 women, evenly distributed over the age range 65-89 years. The differences in isometric strength and leg extensor power over the age range were equivalent to 'losses' of 1-2% per annum and approximately 3 1/2% per annum, respectively. The decline of explosive power was faster than the decline of knee extensor strength in men (p = 0.0001), but not significantly so in women (p = 0.08). Power standardized for body weight influenced chair rise time and step height. Isometric knee extensor strength standardized for body weight influenced chair rise time.

Aged↗

Relevance of assessing quadriceps endurance in patients with COPD.

The aims of this study were to investigate whether the impairment in endurance of limb muscles is a general finding in chronic obstructive pulmonary disease (COPD) patients, affecting even those with mild-to-moderate disease or relatively normal physical activity. In addition, this study aimed to determine the physiopathology of exhaustion in local endurance tests and whether the reduction in quadriceps endurance can be predicted from muscle strength measurements. A total of 75 volunteers were assigned to one of two groups according to pulmonary function tests: COPD patients or healthy age-matched controls. Functional assessment included both quadriceps strength (maximum voluntary contraction (QMVC)), and quadriceps endurance (contractions against a load equivalent to 10% QMVC until task failure or for up to a limiting time of 30 min (QTlim)). COPD patients showed a decrease of approximately 43%, in QMVC and approximately 77% in QTlim compared with controls. Task failure occurred only in COPD patients and was due to muscle fatigue, since limiting symptoms were associated with a decrease in the median frequency of quadriceps electromyographical signal and a reversible decrease in QMVC. The impairment in skeletal muscle endurance was present even in patients with mild-to-moderate airflow obstruction and individuals with relatively normal physical activity, and was irrespective of lung function variables, anthropometrical data or quadriceps strength. Peripheral muscle endurance was impaired in chronic obstructive pulmonary disease patients, even in those with relatively normal physical activity and mild-to-moderate airflow obstruction. This impairment associated with an early onset of muscle fatigue and could not be predicted from the severity of the disease or the reduction in quadriceps strength.

Age Distribution↗

Alternating hemiplegia of childhood: a study of neuropsychological functioning.

Alternating hemiplegia of childhood (AHC) is a rare chronic neurological disorder characterized by alternating transient attacks of hemiplegia. Evidence from recent studies suggests the disorder is characterized by tonic fits, dystonic posturing, and ocular motor abnormalities. Although widely observed, deficits in cognitive functioning are among one of the least described features of AHC. Most studies describe global deficits, however, no study has provided a comprehensive neuropsychological assessment of a child with AHC. This study presents neuropsychological findings from a comprehensive assessment of a single child with AHC. Results showed significant deficits in intellectual, academic, memory, attention, and executive functioning. Additional deficits in language, psychomotor abilities, and psychosocial functioning were noted. Preliminary longitudinal data are also offered to examine the progressive nature of this disorder. Cognitive strengths and weaknesses are discussed at length as well as recommendations for the classroom and future research.

Child↗

[The locomotor system in adolescents in relation to the type of an educational establishment].

A hundred and eight-two Uzbek girls aged 15-17 years who went to general educational schools, academic lycees, and vocational technical colleges were examined in 1999-2001. The parameters characterizing their locomotor system were studied. The rate of formation of force capacities was ascertained to vary in the girls going to different types of educational establishments. The slightly increased muscular force and the significantly decreased muscular strength in the college students are indicative of their deteriorated functional parameters of the musculomotor system during 3-year study.

Adaptation, Physiological↗

Comparison of Rolyan and Jamar dynamometers for measuring grip strength.

This study compared the Jamar and Rolyan hydraulic dynamometers to determine their concurrent validity with known weights as well as their inter-instrument reliability and concurrent validity for measuring grip strength in a clinical setting. Thirty females and 30 males were tested on these two grip strength measurement devices using a repeated measure design. Results showed that the Jamar and Rolyan dynamometers have acceptable concurrent validity with known weights (that is, correlation coefficients were r > or = 0.9994), excellent inter-instrument reliability (that is, intraclass correlation coefficients ranged from 0.90 to 0.97) and strong concurrent validity (that is, no significant differences between dynamometers' scores). Data indicate that Jamar and Rolyan dynamometers measure grip strength equivalently and can be used interchangeably. Thus, therapists using the Rolyan dynamometer are justified in using published normative data, which were collected with the Jamar dynamometer.

Adult↗

The reproductive and neural toxicities of acrylamide and three analogues in Swiss mice, evaluated using the continuous breeding protocol.

Acrylamide is a known genetic, reproductive, and neural toxicant, although it is not known if one effect is predominant. The toxicities of several structural analogues of acrylamide have been incompletely characterized, and the relative sensitivity of the second generation is not known. The present studies were designed to explore the relationship between neurotoxicity and reproductive toxicity, to further characterize the toxicities of three acrylamide analogues, and to evaluate the relative sensitivity of a second generation to these compounds. For the F0 generation, male and female Swiss CD-1 mice were provided drinking water containing acrylamide (ACR; 3, 10, 30 ppm), N,N'-methylenebisacrylamide (MBA; 10, 30, 60 ppm), N-(hydroxymethyl)acrylamide (HMA; 60, 180, 360 ppm), or methacrylamide (MACR; 24, 80, 240 ppm) during and after a 14-week cohabitation. The last litter was reared and dosed after weaning until mating at 74 +/- 10 days of age with the same level of compound given to the parents Neurotoxicity was assessed at several times in both generations by measuring forelimb and hindlimb grip strength. In the F0 generation, ACR caused an 11% decrease in pup number without measurable neurotoxicity; female fertility was not affected. Although both generations consumed the same amount of ACR, there were larger changes in the fertility-related endpoints in the F1 mice than in the F0's, with no concomitant change in organ weights or sperm parameters. In F0 mice, MBA reduced the number of live pups and their adjusted weight, with no neurotoxicity and no change in F0 female reproduction. MBA caused greater adverse effects in the second generation, concomitant with increased consumption. In the F0 generation, HMA caused the largest decrease in pup number during cohabitation (26%) together with a small effect on grip strength. Female reproduction was not affected. The second generation consumed more HMA and showed slightly greater toxic effects. In both generations, MACR was negative for both neurotoxicity and reproductive toxicity. Dominant-lethal studies showed that the fertility effects for ACR, MBA, and HMA could be explained by a male-mediated increase in postimplantation loss. These studies found that dominant lethality occurred without structural effects on the reproductive system in the presence of only minor effects on grip strength and without detectable neural histopathology. Female reproduction was not significantly affected by these compounds at the doses used. Thus, these data confirm the male as the affected gender and that the reproductive toxicity was greater than motoneuron toxicity when measured as grip strength.

Acrylamide↗

Results from a degradable TMC joint Spacer (Artelon) compared with tendon arthroplasty.

PURPOSE: A new spacer for the trapeziometacarpal joint (TMC) based on a biological and tissue-preserving concept for the treatment of TMC osteoarthritis (OA) has been evaluated. The purpose was to combine a spacing effect with stabilization of the TMC joint. METHODS: Artelon (Artimplant AB, Sweden) TMC Spacer is synthesized of a degradable polyurethaneurea (Artelon), which has been shown to be biocompatible over time and currently is used in ligament augmentation procedures. Fibers of the polymer were woven into a T-shaped device in which the vertical portion separates the bone edges of the TMC joint and the horizontal portion stabilizes the joint. Fifteen patients with disabling pain and isolated TMC OA were included in the study. Ten patients received the spacer device and the remaining 5 (control group) were treated with a trapezium resection arthroplasty with abductor pollicis longus (APL) stabilization. The median ages of the 2 groups were 60 and 59 years, respectively. Pain, strength, stability, and range of motion were measured before and after surgery. Radiographic examination was performed in all patients before and after surgery. At follow-up evaluation 3 years after surgery an unbiased observer evaluated all patients. Biopsy specimens were obtained from 1 patient 6 months after surgery. RESULTS: All patients were stable clinically without signs of synovitis. In both groups all patients were pain free. The median values for both key pinch and tripod pinch increased compared with before surgery in the spacer group but not in the APL group. The biopsy examinations showed incorporation of the device in the surface of the adjacent bone and the surrounding connective tissue. No signs of foreign-body reaction were seen. CONCLUSIONS: This study showed significantly better pinch strength after Artelon TMC Spacer implantation into the TMC joint compared with APL arthroplasty.

Absorbable Implants↗

Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis.

OBJECTIVE: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care. DESIGN: Two physiotherapists assessed independently, and in randomized order, the severity of complaints scored on an 11-point numeric rating scale, pain-free grip strength, maximum grip strength, and pressure pain threshold. SETTING: Primary care center in the Netherlands. PARTICIPANTS: Fifty patients were assessed by both physiotherapists. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were calculated to assess interobserver reliability. The Bland and Altman method was used to assess interobserver agreement, which included calculation of the mean difference between the observers (d), the 95% CI for d, the standard deviation of the differences, and the 95% limits of agreement. Finally, the smallest detectable difference (SDD) was calculated. RESULTS: The ICC for the severity of complaints was.90. The ICCs for the pain-free grip strength and maximum grip strength were.97 and.98, respectively. The pressure pain threshold showed a lower reliability (ICC=.77). The interobserver agreement for all outcome measures was good, but systematic differences in assessment between the physiotherapists were found for the maximum grip strength and pressure pain threshold. For pressure pain threshold, the SDD was clearly larger than the predefined acceptable difference of 10% of the total range of measurement. CONCLUSIONS: The interobserver reliability of severity of complaints and grip strength was excellent, whereas the pressure pain threshold showed unsatisfactory reliability. Grip strength and overall assessment of the severity of complaints are useful and reliable measures for the assessment of lateral epicondylitis. Pain-free grip strength, in particular, is relatively easy to perform and has been shown to be associated with other measures of functional disability in patients with lateral epicondylitis. We, therefore, recommend the use of pain-free grip strength in both research and clinical practice.

Adult↗

Muscle strength and tibolone: a randomised, double-blind, placebo-controlled trial.

OBJECTIVE: To investigate the effects of tibolone, a tissue-specific compound with a mixed (estrogenic, progestogenic and androgenic) hormonal profile, on skeletal muscle strength in a group of healthy postmenopausal women. DESIGN: Randomised, parallel group, double-blind, placebo-controlled, single-centre trial conducted between August 1997 and July 1999. PARTICIPANTS: Eighty-five healthy women, between one and 15 years postmenopausal, (mean [SD] age, 54.2 [4.7] years) recruited from local paper advertisements. Participants were randomly assigned to 2.5 mg tibolone or to identically appearing placebo pills daily for 12 months, taken orally in the morning. METHODS: Both maximal handgrip strength, representing upper body strength, and maximal quadriceps strength, representing lower body strength, were measured isometrically. MAIN OUTCOME MEASURES: Treatment effect estimates (between group differences) in handgrip strength and isometric knee extension at last visit. RESULTS: Tibolone significantly (P = 0.04) increased handgrip strength compared with placebo (difference 0.99 kg, [95% CI 0.1-1.9]). No significant treatment effect (P = 0.61) was observed in isometric knee extension strength. Isometric strength adjusted for body mass index resulted in a trend favouring tibolone (P = 0.06). Individual trend analysis showed a significant difference in rate of change throughout the year (6.8% [95% CI 2.1-10.7]) favouring tibolone. CONCLUSIONS: Administration of tibolone increased handgrip strength in postmenopausal women compared with placebo. A trend indicating a positive effect in isometric knee extension strength adjusted for body mass index was observed. Tibolone seems to mitigate the menopause-related decline in muscle strength.

Administration, Oral↗

Serum albumin and muscle strength: a longitudinal study in older men and women.

OBJECTIVES: To examine whether low serum albumin is associated with low muscle strength and future decline in muscle strength in community-dwelling older men and women. DESIGN: Population-based cohort study. SETTING: The Longitudinal Aging Study Amsterdam. PARTICIPANTS: Six hundred seventy-six women and 644 men aged 65 to 88. MEASUREMENTS: Serum albumin was determined at baseline. Muscle strength was assessed using grip strength at baseline, after 3 (n=1,009), and 6 (n=741) years. The outcomes were continuous baseline muscle strength, 3- and 6-year change in muscle strength, and a dichotomous indicator for substantial decline (a decrease if > or =1 standard deviations for women=11 kg, for men=12 kg) in muscle strength. RESULTS: Mean serum albumin concentration+/-standard deviation was 45.0+/-3.3 g/L for women and 45.2+/-3.2 g/L for men. At baseline, adjusting for age, lifestyle factors, and chronic conditions, lower serum albumin was cross-sectionally associated with weaker muscle strength (P<.001) in women and men. After 3 years of follow-up, mean decline in muscle strength was -5.6+/-10.9 kg in women and -9.6+/-11.9 kg in men. After adjustment for potential confounders, lower serum albumin was associated with muscle strength decline over 3 years (P<.01) in women and men (beta=0.57, standard error (SE)=0.18; beta=0.37, SE=0.16, respectively). Lower serum albumin was also associated with substantial decline in muscle strength in women (per unit albumin (g/L) adjusted odds ratio (OR)=1.14, one-sided 95% confidence limit (CL)=1.07) and men (per unit albumin (g/L) adjusted OR=1.14, 95% CL=1.08). Similar but slightly weaker associations were found between serum albumin and 6-year change in muscle strength (P<.05). CONCLUSION: These results suggest that low serum albumin, even within the normal range, is independently associated with weaker muscle strength and future decline in muscle strength in older women and men.

Aged↗

Lack of association of anabolic hormone status and muscle strength with regional and whole body bone mineral density in healthy men aged 60-79 years.

This study investigated the capacity of muscle strength and anabolic hormone status to predict regional and whole body bone mineral density (BMD) in older men. Fifty-two healthy men aged 60-79 years served as subjects. BMD of the lumbar spine, proximal femur, upper and lower limbs, and whole body was assessed by dual X-ray absorptiometry. Dynamic muscle strength for several upper and lower body muscle groups was determined by the one-repetition maximum and isometric grip strength by dynamometry. Anabolic hormone status was assessed by the ratio of testosterone (T) to sex hormone binding globulin (SHBG), given as the free androgen index (FAI), and the ratio of insulin-like growth factor I (IGF-I) to IGF binding protein-3 (IGFBP-3). Age was associated with declines in dynamic strength and the log FAI. In stepwise regression analysis, only body mass was an independent predictor of whole body and upper limb BMD (R2 = 0.13), and hip adductor strength predicted the Ward's triangle (R2 = 0.14). For lumbar spine BMD, triceps extensor strength was significantly correlated (r = 0.36, p < 0.01), while no strength or hormonal variable was associated with the femoral neck, trochanter, or lower limb. The lack of association between muscle strength and BMD was generally unaltered after controlling for hormone status and body mass. There was no difference in BMD when analyzed by tertiles of log FAI or IGF-I/IGFBP-3 or by tertiles of muscle strength. These results suggest that in healthy community-dwelling men in the seventh and eighth decade, muscle strength and hormonal status are not significant contributors to regional or whole body BMD.

Aged↗