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PubMed2004

The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women's Health Across the Nation.

Women may experience a decline in physical function during menopause. Whether this decline is due to aging or to changes in hormonal status is unknown. The authors performed a longitudinal data analysis on data collected between 1996 and 2001 to determine the effects of menopausal status, age, race, and use of hormone replacement therapy (HRT) on 3-year changes in grip and pinch strength. Participants were 563 women from the Chicago, Illinois, site of the Study of Women's Health Across the Nation. According to adjusted analyses, women who became postmenopausal showed a 1.04-kg decline in grip strength (p = 0.10) and a 0.57-kg decline in pinch strength (p = 0.002) relative to women who remained premenopausal. Women who became early perimenopausal showed a 0.20-kg decline in pinch strength (p = 0.04), whereas women who transitioned to late perimenopause showed a 0.93-kg decline in grip strength (p = 0.07). Effects of menopausal status on grip and pinch strength did not vary by race. A significant HRT-by-race interaction for grip strength was found; African-American HRT users had greater grip strength during the study, whereas Caucasian HRT users did not (p = 0.05). Greater physical activity was the strongest predictor of grip and pinch strength (p < 0.0001). Results indicate that transition through menopause is associated with a decline in grip and pinch strength.

Adult↗
PubMed2006

Developmental origins of midlife grip strength: findings from a birth cohort study.

BACKGROUND: There is growing evidence that the prenatal environment has long-term effects on adult grip strength, but little is known about the effects of the postnatal environment. We tested whether prepubertal growth, pubertal growth, or the development of motor and cognitive capabilities was associated with midlife muscle strength independently of other determinants of grip strength. METHODS: Handgrip strength and body size were measured in a representative British sample of 1406 men and 1444 women 53 years old with prospective childhood data. Normal regression models were used to examine the effects of birth weight, postnatal height and weight gain before 7 years and between 7 and 15 years, motor milestones and cognitive ability on grip strength at age 53, taking account of lifetime social class, current physical activity, and health status. RESULTS: Birth weight and prepubertal height gain were associated with midlife grip strength, independently of later weight and height gain and other determinants. Pubertal growth was also independently associated with midlife grip strength; for men weight gain during puberty was beneficial, whereas for women it was height gain. Those participants with earlier infant motor development had better midlife grip strength, which was partly confounded by the growth trajectory. CONCLUSIONS: This study showed that components of prenatal, prepubertal, and pubertal growth have long-term effects on midlife grip strength. To the extent that these associations are modifiable, interventions in childhood that help to build muscle mass and strength, such as increased physical exercise, may have long-term beneficial effects on adult muscle strength and may help to prevent sarcopenia, disability, and frailty in later life.

Adolescent↗
PubMed2000

Muscular strength and physical function.

PURPOSE: The purpose of this study was to evaluate the potential association of muscular strength and endurance at baseline with the prevalence of functional limitations at follow-up. METHODS: Study participants were 3,069 men and 589 women (30-82 yr) who received a clinical examination including a strength evaluation at the Cooper Clinic between 1980 and 1989 and responded to a 1990 mail-back survey. Participants also had to achieve at least 85% of their age-predicted maximal heart rate on a maximal exercise treadmill test and have no history of heart attack, stroke, diabetes, high blood pressure, cancer, or arthritis at their first visit. A strength index composite score (0-6) was calculated using age- and sex-specific tertiles from bench press, leg press, and sit-up tests. Those scoring 5 or 6 were categorized in the high strength group. Functional health status was assessed by responses to questions about the participant's ability to perform light, moderate, and strenuous recreational, household, daily living, and personal care tasks. RESULTS: After an average follow-up of 5 yr, 7% of men and 12% of women reported at least one functional limitation. A logistic regression model including age, aerobic fitness, body mass index, and new health problems at follow-up found that, relative to those with lower levels of strength, the odds of reporting functional limitations at follow-up in men and women categorized as having higher levels of strength were 0.56 (95%CI = 0.34, 0.93) and 0.54 (95%CI = 0.21, 1.39), respectively. CONCLUSIONS: These findings, if replicated in other populations, suggest that maintenance of strength throughout the lifespan may reduce the prevalence of functional limitations.

Activities of Daily Living↗
PubMed2005

Weight loss, muscle strength, and angiotensin-converting enzyme inhibitors in older adults with congestive heart failure or hypertension.

OBJECTIVES: To determine whether angiotensin-converting enzyme (ACE) inhibitor use may be associated with weight maintenance and sustained muscle strength (measured by grip strength) in older adults. DESIGN: Data from the Cardiovascular Health Study (CHS), a community-based prospective cohort study of 5,888 older adults, were used. SETTING: Subjects were recruited from four U.S. sites beginning in 1989; this analysis included data through 2001. PARTICIPANTS: CHS participants with congestive heart failure (CHF) or treated hypertension. MEASUREMENTS: The exposure, current ACE inhibitor use, was ascertained by medication inventory at annual clinic visits; the outcomes were weight change and grip-strength change during the following year. Multivariate linear regression was used, accounting for correlations between observations on the same participant over time. RESULTS: The average annual weight change was -0.38 kg in 2,834 participants (14,443 person-years) with treated hypertension and -0.62 kg in 342 participants (980 person-years) with CHF. ACE inhibitor use was associated with less annual weight loss after adjustment for potential confounders: a difference of 0.17 kg (95% confidence interval (CI)=0.05-0.29) in those with treated hypertension and 0.29 kg (95% CI=-0.25-0.83) in those with CHF. There was no evidence of association between ACE inhibitor use and grip-strength change. CONCLUSION: ACE inhibitor use may be associated with weight maintenance, but not maintenance of muscle strength, in older adults with treated hypertension.

Aged↗
PubMed2002

Body composition of 80-years old men and women and its relation to muscle strength, physical activity and functional ability.

OBJECTIVE: To measure body composition and analyse the relation to muscle strength, physical activity and functional ability in healthy, old subjects, and to relate the results to an optimal BMI level for the elderly. SETTING: Subjects aged 80 years living at home from the 1914-population in Glostrup, Denmark. SUBJECTS AND METHOD: 121 men and 113 women had their height and weight measured. Body fat mass and fat-free mass were assessed by bioelectrical impedance. Muscle strength was measured as handgrip, elbow flexion, knee extension, body flexion and body extension. Physical activity was self reported and functional ability was assessed by the Physical Performance Test (PPT) and self reported mobility including information about tiredness and help. RESULTS: After dividing BMI into three groups: BMI < 24, BMI 24-29 and BMI > 29 no relationship was seen between a BMI interval of 24-29 kg/m2, and physical activity and functional ability. BMI was related to body fat mass, and FFM was related to muscle strength. Muscle strength was related to mobility and PPT. Mobility and PPT were mutually related and were related to physical activity. CONCLUSION: Our cross sectional study did not support newly proposed guidelines for the elderly of an optimal BMI interval of 24-29 kg/m2. We found relations between body composition, muscle strength, physical activity and functional ability.

Adipose Tissue↗
PubMed1998

Evidence for a phase transition in the early development of prehension.

A longitudinal study was conducted to examine the hypothesis that the development of prehension during the first 5 months of life is characterized by the presence of a discontinuous phase transition. Ten infants were observed weekly from 8 to 24 weeks of age. Video recordings were made of movements toward an attractive object which were classified according to two behavioral categories: reaching without grasping and reaching with grasping. The time evolution of the relative incidence of these behavioral categories was analyzed statistically. Evidence was found for a sudden jump from a (developmental) state in which reaching without grasping is predominant to a state in which reaching with grasping is predominant. Evidence was also found for bimodality, inaccessibility, and anomalous variance. In combination, these findings support the hypothesis that the investigated behavioral change constitutes a discontinuous phase transition. The behavioral change in question occurred at the moment in developmental time at which the attractor strength of reaching for objects as such relative to that of other behavioral activities appeared to be increased.

Age Factors↗
PubMed1985

Skeletal muscle function in man: force, relaxation rate, endurance and contraction time-dependence on sex and age.

Two different methods for estimating muscle function were compared; hand grip strength (HGS) and adductor pollicis muscle function after electrical stimulation of the ulnar nerve. Fifty-two 'normal' subjects, who were divided into four groups, according to sex and age, were investigated. Technical modifications of the latter method are presented for the measurement of human skeletal muscle function, independent of the motivation of the subject. Maximal voluntary force, as measured with a hand dynamometer, was higher in males than in females. Young males were stronger than males over 50 years old, and young females were stronger than old women. The statistical analysis of the muscle function variables after electrical stimulation showed that young females developed relatively more force at low stimulating frequencies than females over 50 years old. Females had a significantly longer contraction time to tetany compared to males. The relaxation rate after tetanic stimulation was independent of sex and age. Endurance was reduced in old males compared to females in the same age-group and to young males.

Adult↗
PubMed2004

Changes in key pinch strength after excision of the trapezium and total joint arthroplasty.

Key pinch force was measured preoperatively and at follow-up (mean 25 months) in patients treated for basal joint arthritis by either trapziectomy with ligament reconstruction and tendon interposition (n=26) or total joint arthroplasty (n=27). There was a significant increase in key pinch strength with both treatments, but no difference between the two treatments. Total joint arthroplasty does not appear to produce stronger key pinch than trapziectomy with ligament reconstruction and tendon interposition.

Adult↗
PubMed2006

Prevalence of nutritional depletion in a large out-patient population of patients with COPD.

OBJECTIVE: The present study focuses on the prevalence of nutritional depletion in relation to functional performance, airflow limitation, experienced dyspnoea and health status in a large multi-center out-patient population with chronic obstructive pulmonary disease (COPD). METHODS: In 39 out-patient centers in The Netherlands, 389 patients with moderate to severe COPD (217 men) were recruited. The study evaluated on the baseline characteristics of the COSMIC study. Measurements included body composition by bioelectrical impedance analysis, dyspnoea by MRC-score, peripheral muscle function by isometric handgrip strength and disease-specific health status by St. George Respiratory Questionnaire. RESULTS: The prevalence of nutritional depletion (defined as body mass index (BMI)<or=21 kg/m2 and/or fat-free mass index (FFMI)<or=15 (females) or <or=16 (males) kg/m2) was high (27%). Prevalence of normal BMI and low FFMI was 15%, and of low BMI and low FFMI 11%. The prevalence of low BMI as well as low FFMI was significantly higher in female than in male COPD patients, 18% and 40% vs. 10% and 20%, respectively (both P<0.01). No differences in FEV1%predicted, dyspnoea score and health status were observed between depleted and non-depleted COPD patients. Multiple linear regression analysis in the total group showed that handgrip strength correlated with FFMI after correction for sex distribution and age, but not FEV1%predicted. CONCLUSIONS: The prevalence of nutritional depletion was high in a large out-patient COPD population in The Netherlands, especially in female COPD patients. Depletion of FFM was associated with impaired peripheral muscle strength, independent of disease severity.

Adult↗
PubMed1999

Osteoporosis in hemiplegic stroke patients as studied with dual-energy X-ray absorptiometry.

OBJECTIVES: To compare bone mineral densities (BMDs) of the affected and unaffected limbs in stroke patients at multiple sites; to study longitudinal changes during a 3-month rehabilitation program; and to relate BMDs to demographic, impairment, and disability variables. DESIGN: Descriptive study. SETTING: Tertiary rehabilitation center. PATIENTS: One hundred four consecutive hemiplegic inpatients, 69 men, age 56.5 +/- 13.2 yrs, 47 with left-sided brain lesion. Median days from onset to admission and median length of stay days were 83 and 105.5, respectively. MAIN OUTCOME MEASURES: BMDs of proximal humerus, distal radius, femoral neck, and calcaneus bilaterally, and third lumbar vertebra, measured with dual-energy x-ray absorptiometry (DXA), were compared between affected and unaffected sides at admission and discharge. RESULTS: Stroke Impairment Assessment Set (SIAS) motor scores, Functional Independence Measure (FIM) scores, grip strength, and awake/sleep heart rate counts (activity index) improved significantly at discharge. Affected/unaffected BMD ratios were 88.3% to 98.4% at admission and 79.6% to 98.8% at discharge, lowest for the humerus. Discharge/admission ratios were 89.1% to 97.8% for the affected and 97.4% to 100% for the unaffected side. All BMDs were intercorrelated (R = .438 to .873). They correlated significantly with age, body weight, grip strength, FIM scores, and activity index. Factors selected to explain BMD with multiple regression analysis differed according to the site and timing of the measurement. CONCLUSIONS: BMDs of the affected side were lower and most marked in the humerus. Longitudinally, not only the affected but the unaffected BMDs decreased. Age, sex, duration of stroke, anthropometric measurements, motor paralysis, muscle strength, and activity level contributed differently to bone loss according to the site and timing of the measurement.

Absorptiometry, Photon↗
PubMed2002

Handgrip strength and mortality in older Mexican Americans.

OBJECTIVES: To examine the association between handgrip strength and mortality in older Mexican American men and women. DESIGN: A 5-year prospective cohort study. SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. MEASUREMENTS: Maximal handgrip strength, timed walk, and body mass index were assessed at baseline during 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. RESULTS: Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Average handgrip strength +/- standard deviation was significantly higher in men (28.4 kg +/- 9.5) than in women (18.2g +/- 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quartile, the hazard ratio of death was 2.10 (95% confidence interval (CI) = 1.31-3.38) compared with those in the highest handgrip strength quartile, after controlling for sociodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95%I = 1.05-2.93) compared with those in the highest handgrip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. CONCLUSION: Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors.

Aged↗
PubMedDate not supplied

Exercise training in COPD: how to distinguish responders from nonresponders.

PURPOSE: Pulmonary rehabilitation programs consistently have improved exercise capacity, quality of life, and symptoms over the past decade. Although training has been shown to be an essential component of the rehabilitation program, individual patients do not always benefit to the same extent. The present study was designed to investigate which patients were achieving significant benefit of exercise training. METHODS: Forty-nine stable outpatients with moderate to severe COPD (FEV1 37 (15)%pred) were evaluated before and after 12 weeks of exercise training (3 times per week). Responders in exercise capacity were defined as having 15% increase in maximal workload and/or 25% increase in walking distance, while responders in quality of life showed an improvement of at least 10 points on the chronic respiratory disease questionnaire. With multivariate discriminant analysis, responders were distinguished from nonresponders based upon their initial characteristics. RESULTS: Thirty-two patients were responders in terms of improved exercise capacity. Ventilatory reserve (VE/MVV), inspiratory muscle strength (Plmax), and peripheral muscle strength (handgrip force and quadriceps force) were significant predictors of the training response (P < 0.05) (accuracy 80% P < 0.001). Although the explained variance was modest, patients that were clearly ventilatory limited and had normal skeletal muscle strength were not likely to benefit from exercise training in terms of exercise capacity. No physiologic variables predicted whether a patient would increase quality of life after exercise training. CONCLUSION: Patients with reduced exercise capacity who experience less ventilatory limitation to exercise and more reduced respiratory and peripheral muscle strength are more likely to improve with exercise training. Improvements in quality of life after exercise training were significant but remained unpredictable with variables included in the present trial.

Aged↗
PubMed2006

Vascular endothelium-derived factors and arterial stiffness in strength- and endurance-trained men.

Arterial stiffness is higher in strength-trained humans and lower in endurance-trained humans. However, the mechanisms underlying these different adaptations are unclear. Vascular endothelium-derived factors, such as endothelin-1 (ET-1) and nitric oxide (NO), play an important role in the regulation of vascular tonus. We hypothesized that endogenous ET-1 and NO participate in the adaptation of arterial stiffness in different types of exercise training. The purpose of this study was to investigate plasma ET-1 and NO concentrations and arterial stiffness in strength- and endurance-trained men. Young strength-trained athletes (SA; n = 11), endurance-trained athletes (EA; n = 12), and sedentary control men (C; n = 12) participated in this study. Maximal handgrip strength in SA and maximal oxygen uptake in EA were markedly greater than in C. Aortic pulse-wave velocity, which is an established index of arterial stiffness, was higher in SA and lower in EA than in C. Additionally, we measured systemic arterial compliance (SAC) using carotid artery applanation tonometry and Doppler echocardiography, because arterial stiffness is a primary determinant of the compliance. SAC was lower in SA and higher in EA compared with that in C. Plasma ET-1 concentrations were higher in SA compared with C and EA. We did not find significant differences in plasma NO concentrations (measured as the stable end product of NO, i.e., nitrite/nitrate). The relationships of plasma ET-1 concentrations to aortic pulse-wave velocity and SAC were linear. These results suggest that differences in endogenous ET-1 may partly participate in the mechanism underlying different adaptations of arterial stiffness in strength- and endurance-trained men.

Adaptation, Physiological↗
PubMed1998

Steroid-responsive myopathy with deficient chondroitin sulfate C in skeletal muscle connective tissue.

A 71-year-old man developed severe limb, bulbar, and respiratory weakness over 18 months. A muscle biopsy showed only a moderate degree of type 2 atrophy, but immunocytochemistry showed absence of chondroitin sulfate C glycosaminoglycan in the endomysium. Prednisone produced a marked increase in strength. Diffuse loss of endomysial chondroitin sulfate C was a feature of this treatable myopathy with severe weakness, but few pathologic changes.

Aged↗
PubMed2002

Fitness levels of firefighter recruits before and after a supervised exercise training program.

Federal law prohibits pre-employment physical examination of firefighter recruits, but these workers must perform intense exercise in arduous environments. Components of physical fitness of rookie firefighters (n = 115; 104 men, mean +/- SD: age = 28.3 +/- 4.3 years; height = 1.76 +/- 0.07 m; weight = 83.2 +/- 13.9 kg; percent body fat = 17 +/- 8%) were measured upon being hired and following a 16-week exercise training program (1 h.d(-1), 3 d.wk(-1)) designed to improve physical fitness. Maximum aerobic capacity (VO2max) was estimated from submaximal cycle ergometry, body composition from skinfold tests, flexibility from a sit and reach test, strength by hand grip dynamometry, and muscle endurance by a push-up test. The results are as follows (*, p <or= 0.007 vs. pretraining): VO2max increased by 28% (35 +/- 7 to 45 +/- 6* ml.kg(-1).min(-1), 88 +/- 20 to 113 +/- 17%* of predicted increase); muscle endurance increased (41 +/- 13 to 51 +/- 14* push-ups); flexibility increased (0.34 +/- 0.07 to 0.35 +/- 0.07* m); muscle strength tended to increase (102.9 +/- 18.7 to 105.4 +/- 18.7 kg, p = 0.06); body weight tended to decrease (83.2 +/- 13.9 to 82.7 +/- 13.2 kg, p = 0.06); lean tissue weight increased (68.8 +/- 9.9 to 69.9 +/- 9.5* kg); and fat weight decreased (14.6 +/- 8.0 to 13.0 +/- 7.1* kg). We concluded that aerobic capacity was 20% lower before training than that deemed sufficient for safe performance of fire suppression duties; that training improved aerobic capacity by 28%, decreased fat and increased lean tissue weight, and increased/tended to increase other components of physical fitness. Prior to initiation of this training program, aerobic capacity of these firefighters was below that deemed appropriate for performing fire suppression duties. Training resulted in a large increase in aerobic capacity, so that the trainees ended the program with an aerobic capacity considered appropriate for fighting fires. It is hoped that the results of this study will encourage those who oversee workers who are responsible for the public's safety to mandate assessment of physical fitness of new hires, with mandatory participation in exercise training for those new hires who are found to possess less than appropriate aerobic capacity.

Adaptation, Physiological↗
PubMed2003

Quantitative forearm muscle strength influences radial bone mineral density in osteoporotic and healthy males.

Fractures are not rare in male osteoporosis and bone mineral density (BMD) measurement is used in the diagnosis and monitoring, preventing and/or treating the disease. Muscle strength and BMD are highly related to each other. The distal radius is one of the most common sites of osteoporotic fractures. The relationship of quantitative muscle strength and BMD of the forearm has not yet been established. The objective of this study was to assess forearm muscle strength and grip strength in relation to BMD in 46 osteoporotic and randomly selected 45 healthy male participants. Forearm muscle strength and BMD were quantitatively measured using an isokinetic dynamometer and dual-energy-X-ray-absorptiometry (DEXA), respectively. Significant correlation was found among the muscle strength and dominant forearm BMD in 60 and 120 deg/s velocities. In the non-dominant arm, the 120 deg/s velocity was only significantly positively correlated to forearm BMD. Pearson's Product coefficient presented a moderate correlation between muscle strength and BMD at the dominant arms of both groups, whereas, the difference in the non-dominant forearm came from the difference of usage frequency. In conclusion, quantitative forearm muscle strength and BMD is moderately correlated and exercise can be advised to prevent distal radius fractures in male osteoporosis.

Absorptiometry, Photon↗
PubMedDate not supplied

Effectiveness of a community based low intensity exercise program for older adults.

OBJECTIVE: The aim of this study was to assess the effectiveness of a community-based, low-intensity exercise programme in older adults from socio-economically and historically disadvantaged communities. DESIGN: Three community centres were selected: two were allocated to the same 20-week, twice-weekly exercise program (EX1, n=38; EX2, n=32); and a third to relaxation classes (control/CTL; n=21). Measurements at baseline, 10 and 20 weeks included field tests for anthropometry, static and dynamic balance, gait, upper and lower body strength, 6-minute walk test, blood pressure, activities of daily living (ADL), instrumental activities of daily living (IADL), physical activity recall and self perceived health status. RESULTS: Exercise training significantly improved dynamic balance in both groups (75.1+/-31.5 vs 55.3+/-13.6 s, and 53.3+/-17.0 vs 37.0+/-10.4 s, for EX1 and EX2, respectively, p < 0.001 compared to CTL (57+/-27 vs 53+/-15 s). Lower body strength, as measured by the number of sit-to-stand repetitions in 10 s was also significantly improved in both EX1 and EX2 (p<0.001). No significant changes occurred in the CTL group. Systolic blood pressure decreased in both EX1 and EX2 from baseline to 20 weeks (147.8+/-12.8 vs 143.9+/-3.3 mmHg and 143.0+/-13.9 vs 137.4+/-14.5 mmHg, respectively, p<0.009, compared to CTL (147+/-13 to 150+/-16 mmHg). Furthermore, in a sub sample of subjects who were hypertensive at the outset, exercise intervention was associated with a significant decrease in systolic blood pressure (n=26; 146+/-14 mmHg to 140+/-14 mmHg; p=0.005). Variables unaffected by exercise training were upper body strength, body composition and fat distribution, 20 m walk, cardiovascular endurance, time spent in recreational activities, self perceived health status and ADL. CONCLUSION: A community-based, low intensity exercise programme improved dynamic balance and lower body strength in community dwelling older adults and improved blood pressure, particularly in those who were hypertensive.

Activities of Daily Living↗