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PubMed2005

Cognitive status, muscle strength, and subsequent disability in older Mexican Americans.

OBJECTIVES: To examine the association between Mini-Mental State Examination (MMSE) score and subsequent muscle strength (measured using handgrip strength) and to test the hypothesis that muscle strength will mediate any association between impaired cognition and incident activity of daily living (ADL) disability over a 7-year period in elderly Mexican Americans who were initially not disabled. DESIGN: A 7-year prospective cohort study (1993-2001). SETTING: Five southwestern states (Texas, New Mexico, Colorado, Arizona, and California). PARTICIPANTS: Two thousand three hundred eighty-one noninstitutionalized Mexican-American men and women aged 65 and older with no ADL disability at baseline. MEASUREMENTS: In-home interviews in 1993/1994, 1995/1996, 1998/1999, and 2000/2001 assessed social and demographic factors, medical conditions (diabetes mellitus, stroke, heart attack, and arthritis), body mass index (BMI), depressive symptomatology, handgrip muscle strength, and ADLs. MMSE score was dichotomized as less than 21 for poor cognition and 21 or greater for good cognition. Main outcomes measures were mean and slope of handgrip muscle strength over the 7-year period and incident disability, defined as new onset of any ADL limitation at the 2-, 5-, or 7-year follow-up interview periods. RESULTS: In mixed model analyses, there was a significant cross-sectional association between having poor cognition (MMSE<21) and lower handgrip strength, independent of age, sex, and time of interview (estimate=-1.41, standard error (SE)=0.18; P<.001). With the introduction of a cognition-by-time interaction term into the model, there was also a longitudinal association between poor cognition and change in handgrip strength over time (estimate=-0.25, SE=0.06; P<.001), indicating that subjects with poor cognition had a significantly greater decline in handgrip strength over 7 years than those with good cognition, independent of age, sex, and time. This longitudinal association between poor cognition and greater muscle decline remained significant (P<.001) after controlling for age, sex, education, and time-dependent variables of depression, BMI, and medical conditions. In general estimation equation models, having poor cognition was associated with greater risk of 7-year incident ADL disability (odds ratio=2.01, 95% confidence interval (CI)=1.60-2.52); the magnitude of the association decreased to 1.66 (95% CI=1.31-2.10) when adjustment was made for handgrip strength. CONCLUSION: Older Mexican Americans with poor cognition had steeper decline in handgrip muscle strength over 7 years than those with good cognition, independent of other demographic and health factors. A possible mediating effect of muscle strength on the association between poor cognition and subsequent ADL disability was also indicated.

Activities of Daily Living↗

PubMed2004

Oral health status and change in handgrip strength over a 5-year period in 80-year-old people.

OBJECTIVE: The number of remaining teeth may indicate the extent of life-long exposure to inflammation, a known risk factor for muscle loss and consequent disability. The aim was to study dental health status as a risk factor for muscle strength loss in very old people. DESIGN: Cross-sectional and prospective cohort study over a 5-year follow-up. SETTING: Research laboratory. PARTICIPANTS: One hundred and ninety-three 80-year-old people participated in the baseline examinations. Five years later, 79 survivors were retested. MAIN OUTCOME MEASURES: Number of remaining teeth, presence of periodontitis and handgrip strength. RESULTS: At baseline, grip strength of men correlated positively with number of teeth but not with the presence of periodontitis. In women, the cross-sectional associations were not statistically significant. In the prospective analyses, the presence of periodontitis at baseline showed a clear association with a steeper decline in handgrip over the 5-year follow-up in both sexes. The values adjusted for gender, height, weight, number of chronic conditions and physical activity were -28.3% (SE 5.7) among those with periodontitis vs. -11.9% (SE 3.1, p = 0.015) among those with healthy gingiva. No association between the number of teeth at baseline and change in grip strength over 5 years was observed. CONCLUSIONS: The presence of oral inflammation may lead to loss in muscle strength increasing the risk of disability. Therefore, good dental care throughout the life span may decrease risk of disability in old age.

Aged↗

PubMed2000

Pool exercise combined with an education program for patients with fibromyalgia syndrome. A prospective, randomized study.

OBJECTIVE: To evaluate the effects of 6 months of pool exercise combined with a 6 session education program for patients with fibromyalgia syndrome (FM). METHODS: The study population comprised 58 patients, randomized to a treatment or a control group. Patients were instructed to match the pool exercises to their threshold of pain and fatigue. The education focused on strategies for coping with symptoms and encouragement of physical activity. The primary outcome measurements were the total score of the Fibromyalgia Impact Questionnaire (FIQ) and the 6 min walk test, recorded at study start and after 6 mo. Several other tests and instruments assessing functional limitations, severity of symptoms, disabilities, and quality of life were also applied. RESULTS: Significant differences between the treatment group and the control group were found for the FIQ total score (p = 0.017) and the 6 min walk test (p < 0.0001). Significant differences were also found for physical function, grip strength, pain severity, social functioning, psychological distress, and quality of life. CONCLUSION: The results suggest that a 6 month program of exercises in a temperate pool combined with education will improve the consequences of FM.

Adult↗

PubMed2002

Relations of Body Mass Index, body fat, and power of various muscles to sport injuries.

The aim of the present study was to estimate associations of Body Mass Index, body fat, and muscle power on sport injuries. In injured and noninjured athletes during a sport season of four months, the differences in Body Mass Index, the percent body fat, and back, leg, and right- and left-hand muscle strength were examined. The subjects were 329 men and 127 women attending classes in the departments of Physical Training and Sport of Atatürk University (Erzurum, Erzincan, and Ağri in Turkey). Body Mass Index was higher in injured athletes than in noninjured ones, but there was no difference in percent body fat between injured and noninjured athletes. The back and leg muscle power were higher for noninjured athletes than for injured ones. The right- and left-hand power was higher for injured athletes in some sports. Because the back and leg muscles function in control of equilibrium, the power of these muscles may be important for control related to avoidance of sport injuries.

Adipose Tissue↗

PubMed2004

Palmar midcarpal instability: the results of treatment with 4-corner arthrodesis.

PURPOSE: Palmar midcarpal instability (PMCI) is one type of nondissociative carpal instability. The optimal treatment for PMCI is uncertain. The purpose of this investigation was to evaluate the results of capitate-lunate-triquetrum-hamate (4-corner) arthrodesis for PMCI. METHODS: Over a 10-year period 8 patients were treated with 4-corner arthrodesis for PMCI. The instability was diagnosed clinically and confirmed with cineradiography. The symptomatic instability began in all patients after a notable trauma; 6 of the patients were injured at work and 2 were injured in a motor vehicle accident. Patients were evaluated at an average of 34 months after surgery. RESULTS: Seven of the 8 patients were satisfied with the surgery and 6 of 8 patients had no pain or mild pain. Both patients injured in motor vehicle accidents returned to all preinjury activities. Four of the 6 workers' compensation patients returned to work, 3 at full duty and 1 in a restricted position. Two patients, both with workers' compensation, did not return to their pre-injury jobs. One had occasional moderate pain and the other had chronic pain. The average wrist flexion/extension arc of motion decreased with surgery from 135 degrees to 75 degrees. The average grip strength increased significantly with surgery from 20 kg to 32 kg; however, grip strength remained significantly lower than the opposite side strength of 54 kg. CONCLUSIONS: Four-corner arthrodesis is a reasonable option for PMCI. Compared with previous reports of soft tissue reconstruction 4-corner arthrodesis may provide a more reliable solution for this difficult problem.

Adult↗

PubMed2006

A protein farnesyltransferase inhibitor ameliorates disease in a mouse model of progeria.

Progerias are rare genetic diseases characterized by premature aging. Several progeroid disorders are caused by mutations that lead to the accumulation of a lipid-modified (farnesylated) form of prelamin A, a protein that contributes to the structural scaffolding for the cell nucleus. In progeria, the accumulation of farnesyl-prelamin A disrupts this scaffolding, leading to misshapen nuclei. Previous studies have shown that farnesyltransferase inhibitors (FTIs) reverse this cellular abnormality. We tested the efficacy of an FTI (ABT-100) in Zmpste24-deficient mice, a mouse model of progeria. The FTI-treated mice exhibited improved body weight, grip strength, bone integrity, and percent survival at 20 weeks of age. These results suggest that FTIs may have beneficial effects in humans with progeria.

Animals↗

PubMed2005

Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players.

OBJECTIVE: To quantify the acute effect of whole body vibration (WBV) training on arm countermovement vertical jump (ACMVJ), grip strength, and flexibility performance. METHODS: Eighteen female elite field hockey players each completed three interventions of WBV, control, and cycling in a balanced random manner. WBV was performed on a Galileo machine (26 Hz) with six different exercises being performed. For the control, the same six exercises were performed at 0 Hz, whilst cycling was performed at 50 W. Each intervention was 5 min in duration with ACMVJ, grip strength, and flexibility measurements being conducted pre and post intervention. RESULTS: There was a positive interaction effect (intervention x pre-post) of enhanced ACMVJ (p<0.001) and flexibility (p<0.05) parameters following WBV; however no changes were observed after the control and cycling interventions. There was no interaction effect for grip strength following the three interventions. CONCLUSIONS: Acute WBV causes neural potentiation of the stretch reflex loop as shown by the improved ACMVJ and flexibility performance. Additionally, muscle groups less proportionally exposed to vibration do not exhibit physiological changes that potentiate muscular performance.

Adolescent↗

PubMed1999

Contested claims in carpal tunnel surgery: outcome study of worker's compensation factors.

UNLABELLED: We retrospectively analyzed the importance of factors relating to worker's compensation for 273 wrists in 211 consecutive patients who underwent primary carpal tunnel release. Patients were divided into three groups: non-work related, worker's compensation-uncontested, and worker's compensation-contested. Contested claims were those in which the worker's compensation carrier denied authorization for surgery, and in which such authorization was given following intervention by a plaintiff's attorney. RESULTS: there were no statistically significant differences in postoperative return of grip strength and in postoperative return to work intervals in comparing groups I and II. However, the contested worker's compensation patients were much less likely (and much slower) to return to light duty and to return to full duty work. Return of grip strength was slower and less complete in this group as well. Within worker's compensation, a contested claim portends a poorer prognosis. Uncontested worker's compensation claimants have nearly as good a prognosis as non-compensation patients.

Adult↗

PubMed1997

The effects of 6 weeks training on the physical fitness of female recruits to the British army.

The purpose of this study was to evaluate the influence of British army recruit training on the physical fitness and strength of female recruits. A total of 73 females (aged 17-23 years) of a single intake of Women's Royal Army Corps (WRAC) recruits were tested at the beginning and end of their 6-week recruit training programme at the WRAC training centre, Guildford. The battery of tests comprised the maximal cycle time for a standard NATO test as an indirect method of determination of maximal oxygen intake (VO2 max) using a cycle ergometer; maximal isometric hand grip strength (Max Grip); maximal isometric 38 cm upright pull strength (Max 38) and maximal incremental dynamic lift to 152 cm (IDL 152). In addition, body-weight and the sum of biceps, triceps, suprailiac and subscapular skinfold thicknesses were measured in order to assess alterations in fat-free mass and percentage of body fat (BF). The recruits responded to training with significant increases in mean VO2 max from 45.7 ml kg-1 min-1 (SD = 5.2) to 46.7 ml kg-1 min-1 (SD = 4.4) or 2.2% (p < .05), mean Max Grip from 263.1 N (SD = 52.2) to 304.9 N (SD = 54.0) or 15.9% (p < 0.001) and mean IDL 152 from 328.0 N (SD = 78.1) to 361.2 N (SD = 74.6) or 10.1% (p < 0.001). There was a significant increase in the mean body-weight of 0.61 kg or 1% (p < 0.05), mean fat-free mass of 1.05 kg or 2.4% (p < 0.001), and a significant reduction in the mean % BF by 3.3% (p < 0.001). It is concluded that female recruit training in the British army is effective in terms of increasing aerobic fitness, physical strength and fat-free mass and in reducing the percentage of body fat.

Adolescent↗

PubMed1992

Military operations at moderate altitude: effects on physical performance.

The purpose of this study was to examine changes in select anaerobic and aerobic dependent physical performance tasks in U.S. Marines exposured to field operations at moderate altitude. The subjects (N = 16) completed Wingate anaerobic power, submaximal aerobic cycle ergometry, hand grip strength, and push-up tests on three separate occasions. Testing sessions occurred at sea level, at altitude after a 10-day acclimatization period (immediately before field operations), and at altitude immediately after 4.5 days of field operations. Anaerobic power was significantly (p < 0.05) reduced after the field operations at altitude. In contrast, the aerobic cost of doing submaximal exercise was slightly elevated (p < 0.05) after the altitude field operations. No physiologically significant effect was noted for hand grip or push-up results. The findings of this study indicate that field operations at moderate altitude do result in slight, but significant, anaerobic-aerobic performance decrement in U.S. Marines.

Adult↗

PubMed1997

Changes in body composition after gastrectomy: results of a controlled, prospective clinical trial.

To elucidate mechanisms involved in weight development after gastrectomy we have prospectively determined changes in body composition during the first year after similar operations. A total of 75 patients were enrolled who had a "curative operation" for gastric carcinoma; 42 were randomized to have a total gastrectomy, 23 total gastrectomy with a gastric substitute, and 10 subtotal gastrectomy. All reconstructions were done with a Roux-en-Y loop of the jejunum. Body composition was assessed preoperatively and at 6 and 12 months after gastrectomy by determining total body potassium and total body water. From these estimates, body cell mass, extracellular water, fat-free extracellular solids, and body fat were calculated with knowledge of the actual body weight and length. Triceps skinfold, arm muscle circumference, and grip strength were also measured. Weight loss (10% of preoperative weight) occurred early after the operations, after which body weight stabilized. Body cell mass remained essentially unchanged over the entire study period in contrast to body fat, which decreased by 40% during the first 6 months after gastrectomy. In accordance with the selective loss of body fat, we recorded a significant decrease in triceps skinfold figures and only a minor decrease of arm muscle circumference without obvious deterioration in hand grip strength. Weight loss after gastrectomy seems to be characterized by selective loss of body fat in contrast to other known clinical situations associated with impaired nutritional intake. Our observations form a basis for future clinical research aimed at preventing weight loss after these operations.

Aged↗

PubMedDate not supplied

The effect of use of a wrist orthosis during functional activities on surface electromyography of the wrist extensors in normal subjects.

Wrist orthoses are advocated for patients with lateral epicondylitis on the assumption that use of the orthosis decreases muscle activity of the wrist extensors during activities. The purpose of this study was to compare the amount of electrical activity, root mean square (RMS) calculated from surface EMG recorded over the wrist extensors, during activities when applying four conditions of wrist orthoses: dorsal; volar; semicircular; and no orthosis. Thirteen normal subjects (mean age 27.7 years) performed three lifting and two gripping tasks, repeated on three consecutive days under four orthotic conditions. Measured were RMS and maximum voluntary grip strength. Repeated measures ANOVA's indicated a significant decrease of RMS using the semicircular design during lifting (p < .0005). Grip strength decreased significantly using all three orthotic designs, but RMS recorded during gripping did not. It was concluded that application of a wrist orthosis reduces electrical activity of the wrist extensors less than anticipated and only during lifting.

Adult↗

PubMed2005

Associations between self-estimated and measured physical fitness among 40-year-old men and women.

The aim was to evaluate whether 40-year-old men and women are able to estimate their level of fitness compared with actual measured physical fitness. Twenty-nine men and 35 women first completed a questionnaire at home and then their physical fitness was measured at laboratory. The index of self-estimated physical fitness was calculated by summing up the scores of self-estimated endurance, strength, speed and flexibility. The index of self-estimated endurance was calculated by summing up the scores of self-estimated endurance and those of the self-estimated distance they could run, cycle, ski and walk. The index of measured physical fitness was calculated by summing up the z-scores of a submaximal bicycle ergometer test, ergojump tests (counter-movement jump and jumping in 15 s), a 30-s sit-up test, hand-grip tests and a sit-and-reach test. The correlation (Spearman) between the indices of self-estimated and measured physical fitness was 0.54 for both sexes, and that between self-estimated endurance and measured endurance was 0.53 for both sexes. Maximal oxygen uptake estimated based on submaximal ergometer test was higher among those with longer self-estimated distance of running, cycling, skiing and walking (P for linear trend <0.001). Our study shows that 40-year-old adults can estimate at group level their fitness according to different categories moderately well. They can also estimate at group level their endurance moderately well by estimating the distance they can run, cycle, ski or walk. However, in some individuals self-estimation of fitness is not in agreement with the results of fitness tests.

Adult↗

PubMed2004

The muscle strength and bone density relationship in young women: dependence on exercise status.

AIM: Numerous studies report an association between muscle strength and bone mineral density (BMD) in young and older women. However, the participants are generally non-athletes, thus it is unclear if the relationship varies by exercise status. Therefore, the purpose was to examine the relationships between BMD and muscle strength in young women with markedly different exercise levels. METHODS EXPERIMENTAL DESIGN: cross-sectional. SETTING: a University research laboratory. PARTICIPANTS: 18 collegiate gymnasts and 22 age- and weight-matched recreationally active control women. MEASURES: lumbar spine, femoral neck, arm, leg and whole body BMD (g/cm(2)) were assessed by dual X-ray absorptiometry. In addition, lumbar spine and femoral neck bone mineral apparent density (BMAD, g/cm(3)) was calculated. Handgrip strength and knee extensor and flexor torque (60 degrees /s) were determined by dynamometry, and bench press and leg press strength (1-RM) using isotonic equipment. RESULTS: BMD at all sites and bench press, leg press and knee flexor strength were greater in gymnasts than controls (p<0.001). In controls, knee extensor torque was significantly correlated to femoral neck, limb and whole body BMD (r=0.47-0.55, p<0.05), leg press strength was associated with limb and whole body BMD (r=0.52-0.74, p<0.05), and bench press strength with arm BMD (r=0.50, p=0.019). In partial correlations controlling for weight, leg press strength was related to leg and whole body BMD (r=0.46-0.63, p<0.05). There was no association between muscle strength and BMD in gymnasts. CONCLUSION: These results suggest that the association between muscle strength and BMD in young women is dependent on exercise status. The osteogenic effect of increased mechanical loading associated with gymnastics training likely contributes to the dissociation of the relationship in gymnasts.

Absorptiometry, Photon↗

PubMed2006

Pilot trial of etanercept in the treatment of inclusion-body myositis.

Inclusion-body myositis (IBM) is an inflammatory muscle disease that has proven resistant to treatment. Tumor necrosis factor molecules have been detected in muscle biopsies from patients with IBM. Etanercept is a TNFalpha receptor fusion protein that binds and inactivates tumor necrosis factor. Nine patients were treated with etanercept at a dose of 25 mg, two times a week for an average of 17 +/- 6.1 months. Each patient was evaluated using quantitative strength testing. Their data were compared to two different control groups. The first control group consisted of patients who participated in trials of beta-interferon-1A and had received placebo. There was no significant difference. The second control group was a natural history cohort of IBM patients. There was no statistically significant difference between the treated group and the natural history group at 6 and 12 months when looking at elbow flexors, or 6 months when looking at hand grip. In the treated patients there was a small but significant improvement (p = 0.002) in handgrip at 12 months.

Cohort Studies↗

PubMed2003

Carotenoid and vitamin E status are associated with indicators of sarcopenia among older women living in the community.

BACKGROUND AND AIMS: Oxidative stress may play a role in the pathogenesis of sarcopenia, and the relationship between dietary antioxidants and sarcopenia needs further elucidation. The aim was to determine whether dietary carotenoids and alpha-tocopherol are associated with sarcopenia, as indicated by low grip, hip, and knee strength. METHODS: Cross-sectional analyses were conducted on 669 non-disabled to severely disabled community-dwelling women aged 70 to 79 who participated in the Women's Health and Aging Studies. Plasma carotenoids and alpha-tocopherol were measured. Grip, hip, and knee strength were measured, and low strength was defined as the lowest tertile of each strength measure. RESULTS: Higher plasma concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, and lutein/zeaxanthin were associated with reduced risk of low grip, hip, and knee strength. After adjusting for potential confounding factors such as age, race, smoking, cardiovascular disease, arthritis, and plasma interleukin-6 concentrations, there was an independent association for women in the highest compared with the lowest quartile of total carotenoids with low grip strength [Odds Ratios (OR) 0.34, 95% Confidence Interval (CI) 0.20-0.59], low hip strength (OR 0.28, 95% CI 0.16-0.48), and low knee strength (OR 0.45, 95% CI 0.27-0.75), and there was an independent association for women in the highest compared with the lowest quartile of alpha-tocopherol with low grip strength (OR 0.44, 95% CI 0.24-0.78) and low knee strength (OR 0.52, 95% CI 0.29-0.95). CONCLUSIONS: Higher carotenoid and alpha-tocopherol status were independently associated with higher strength measures. These data support the hypothesis that oxidative stress is associated with sarcopenia in older adults, but further longitudinal and interventional studies are needed to establish causality.

Aged↗

PubMed2004

Reconstruction of C5 and C6 brachial plexus avulsion injury by multiple nerve transfers: spinal accessory to suprascapular, ulnar fascicles to biceps branch, and triceps long or lateral head branch to axillary nerve.

PURPOSE: In C5 and C6 brachial plexus avulsion lesions, elbow flexion, shoulder abduction, and external rotation are the functions that need to be restored. Because the proximal stumps are not available for grafting, surgical repair is based on nerve transfers. The purpose of this study was to describe and report the results of the use of multiple nerve transfers in the reconstruction of these avulsion injuries. METHODS: Ten patients had multiple nerve transfers: cranial nerve XI to the suprascapular nerve, ulnar nerve fascicles to the biceps motor branch, and triceps long or lateral head motor branch to the axillary nerve. Triceps branch transfer was performed through a posterior arm incision. RESULTS: Two years after surgery, all the patients had recovered full elbow flexion; 7 scored M4 and 3 scored M3+ according to Medical Research Council scoring. All the patients had recovered active abduction and external rotation. Abduction recovery averaged 92 degrees (range, 65 degrees-120 degrees) and external rotation, measured from full internal rotation, averaged 93 degrees (range, 80 degrees-120 degrees). Shoulder abduction strength was graded M4 in 3 patients and M3 in the remaining 7 patients. Shoulder external rotation strength was graded M4 in 2 patients, M3 in 5 patients, and M2 in 3 patients. No donor site deficits were observed. CONCLUSIONS: The proposed nerve transfers constitute a valid strategy in C5-C6 avulsion injury reconstruction.

Accessory Nerve↗

PubMed2005

Comparison between percutaneous transverse fixation and intramedullary K-wires in treating closed fractures of the metacarpal neck of the little finger.

We performed a non-randomized controlled clinical trial of 59 clinical cases to compare percutaneous transverse K-wire fixation and intramedullary K-wires in treating closed fractures of the metacarpal neck of the little finger. Twenty-nine patients were treated by percutaneous transverse K-wire fixation and 30 patients were treated with intramedullary K-wires. They were reviewed at a mean follow-up of 24 months for radiological and functional outcome in terms of union rate, union time, complication rate, pain, movement and grip strength. Radiographs did not show any significant differences in the union rate and union time. There was no statistical difference in complication rate, pain scores, total active motion and grip strength between the two groups. The authors suggest that both methods are comparable, good and safe methods of treating closed, displaced fractures of the metacarpal neck of the little finger, without significant complications.

Adolescent↗