Dynapenia and sarcopenia: association with the diagnosis, duration and complication of type 2 diabetes mellitus in ELSA-Brasil / Dinapenia e sarcopenia: associação com o diagnóstico, duração e complicações de diabetes mellitus tipo 2 no ELSA-Brasil / Dinapenia y sarcopenia: asociación con el diagnóstico, duración y complicaciones de la diabetes mellitus tipo 2 en ELSA-Brasil

Abstract: Sarcopenia (the loss of muscle mass, strength and skeletal muscle function) increases mortality and the risk of hospitalization in the older population. Although it is known that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of dynapenia and sarcopenia, few studies have investigated these conditions in middle-aged populations. The objective of this study was to investigate whether T2DM, its duration, the presence of albuminuria, and glycemic control are associated with sarcopenia and its components in adults. The cross-sectional analysis was based on data from visit 2 of the Brazilian Longitudinal Study of Adult Health (2012-2014). The 2018 European Working Group on Sarcopenia in Older People criteria were used to define dynapenia, low appendicular muscle mass (LAMM), and sarcopenia (absent/probable/confirmed). The explanatory variables were: T2DM; duration of T2DM; T2DM according to the presence of albuminuria; and glycemic control (HbA1C < 7%) among people with T2DM. A total of 12,132 participants (mean age = 55.5, SD: 8.9 years) were included. The odds ratio for LAMM was greater among those with T2DM, T2DM duration from 5 to 10 years, and T2DM without albuminuria. Chances of dynapenia were higher among those with T2DM, T2DM duration > 10 years, and T2DM with and without albuminuria. The variables T2DM, T2DM ≥ 10 years, and T2DM with albuminuria increased the odds of probable sarcopenia, and T2DM duration from 5 to 10 years increased the odds of confirmed sarcopenia. The results support the importance of frequently monitoring the musculoskeletal mass and strength of individuals with T2DM to prevent sarcopenia and related outcomes.

Resumo: A sarcopenia (perda de massa muscular, força e função muscular esquelética) aumenta a mortalidade e o risco de hospitalização em idosos. Idosos com diabetes mellitus tipo 2 (DMT2) apresentam risco elevado de desenvolver dinapenia e sarcopenia, mas poucos estudos investigaram populações de meia-idade. O objetivo foi investigar se DMT2, sua duração, a presença de albuminúria e o controle glicêmico estão associados à sarcopenia e seus componentes em adultos. Análise transversal baseada nos dados da segunda visita do Estudo Longitudinal de Saúde do Adulto (2012-2014). Os critérios do European Working Group on Sarcopenia in Older People [Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas] de 2018 foram usados para definir dinapenia, baixa massa muscular apendicular e sarcopenia (ausente/provável/confirmada). As variáveis explicativas foram: DMT2; duração do DMT2; DMT2 de acordo com a presença de albuminúria; e controle glicêmico (HbA1c < 7%) entre pessoas com DMT2. Foram incluídos 12.132 participantes (idade média de 55,5; DP: 8,9 anos). A razão de chances para baixa massa muscular apendicular foi maior entre pessoas com DMT2, duração do DMT2 entre 5 e 10 anos e DMT2 sem albuminúria. As chances de dinapenia foram maiores entre pessoas com DMT2, duração do DMT2 > 10 anos e DMT2 com e sem albuminúria. DMT2, DMT2 ≥ 10 anos e DMT2 com albuminúria aumentaram as chances de sarcopenia provável e duração do DMT2 entre 5 e 10 anos aumentaram as chances de sarcopenia confirmada. Os resultados reforçam a importância do monitoramento frequente da massa e da força muscular em indivíduos com DMT2 para prevenir a sarcopenia e desfechos relacionados.

Resumen: La sarcopenia (pérdida de masa muscular, fuerza y función muscular esquelética) aumenta la mortalidad y el riesgo de hospitalización en ancianos. Los ancianos con diabetes mellitus tipo 2 (DMT2) presentan un mayor riesgo de sufrir dinapenia y sarcopenia, pero pocos estudios han investigado poblaciones de mediana edad. El objetivo fue investigar si la DMT2, su duración, la presencia de albuminuria y el control glucémico están asociados con la sarcopenia y sus componentes en adultos. Análisis transversal basado en los datos de la visita 2 del Estudio Longitudinal de Salud del Adulto en Brasil (2012-2014). Se utilizaron los criterios del European Working Group on Sarcopenia in Older People [Grupo de Trabajo Europeo sobre Sarcopenia en Personas Mayores] del 2018 para definir dinapenia, baja masa muscular apendicular y sarcopenia (ausente/probable/confirmada). Las variables explicativas fueron las siguientes: DMT2; duración de la DMT2; DMT2 según la presencia de albuminuria; y control glucémico (HbA1c < 7%) entre personas con DMT2. Se incluyeron 12.132 participantes (edad media = 55,5, DE: 8,9 años). La razón de probabilidades de masa muscular apendicular baja fue mayor entre personas con DMT2, duración de la DMT2 entre 5 y 10 años y DMT2 sin albuminuria. Las probabilidades de dinapenia fueron mayores entre las personas con DMT2, duración de la DMT2 > 10 años y DMT2 con y sin albuminuria. Las condiciones de DMT2, DMT2 ≥ 10 años y DMT2 con albuminuria aumentaron las probabilidades de sarcopenia probable y la duración de la DMT2 entre 5 y 10 años las probabilidades de sarcopenia confirmada. Los resultados refuerzan la importancia del monitoreo frecuente de la masa y de la fuerza musculoesquelética en individuos con DMT2 para prevenir la sarcopenia y los desenlaces relacionados.

Estado nutricional, força muscular e capacidade funcional em portadores de mieloma múltiplo / Nutritional status, muscle strength and functional capacity in patients with multiple myeloma

O mieloma múltiplo é uma neoplasia maligna caracterizada pela proliferação clonal de plasmócitos na medula óssea. O objetivo deste trabalho foi avaliar as possíveis associações entre o estado nutricional, força muscular e capacidade funcional de pacientes ambulatoriais portadores de mieloma múltiplo. Trata-se de estudo transversal realizado em amostra não probabilística de pacientes com mieloma múltiplo atendidos no Hospital das Clínicas, em Goiânia. Os dados foram coletados entre agosto e dezembro de 2015, utilizando-se de entrevistas e informações dos prontuários. O estado nutricional foi avaliado aplicando-se a Avaliação Subjetiva Global Produzida pelo Próprio Paciente; a força muscular medida por meio da Força do Aperto de Mão e a capacidade funcional, pela Escala de Performance de Karnofsky. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do referido hospital. Foram avaliados 52 pacientes, em que 48,1% estavam desnutridos, 30,8% apresentavam baixa força muscular e 73,1%, comprometimento da capacidade funcional. A força muscular e a capacidade funcional foram menores nos desnutridos. Observou-se que aqueles que utilizavam corticoides apresentaram 18% menos chance de se tornarem desnutridos (OR=0,18; IC=0,05-0,62; p=0,011) porém, é importante considerar as possíveis causas de viés; por outro lado, os pacientes com baixa força muscular ou faziam quimioterapia apresentaram, aproximadamente, quatro vezes mais chances de desnutrição, respectivamente (OR=3,46; IC=0,99-12,08; p=0,047) (OR=3,64; IC=1,13-11,69; p=0,027). Concluiu-se que a desnutrição é comum nos pacientes portadores de mieloma múltiplo, indicando a necessidade premente de intervenção nutricional apropriada e precoce.

Multiple myeloma is a malignant neoplasm characterized by the clonal proliferation of plasma cells in the bone marrow. The objective of this study was to evaluate possible associations between nutritional status, muscle strength and functional capacity of outpatients with multiple myeloma. This is a cross-sectional study carried out on a non-probabilistic sample of patients with multiple myeloma treated at Hospital das Clínicas, in Goiânia. Data were collected between August and December 2015, using interviews and information from medical records. Nutritional status was assessed using the Patient Generated Subjective Global Assessment; muscular strength measured using Hand Grip Strength and functional capacity, using the Karnofsky Performance Scale. The study was approved by the Ethics and Research Committee of that hospital. 52 patients were evaluated, of which 48.1% were malnourished, 30.8% had low muscle strength and 73.1% had impaired functional capacity. Muscle strength and functional capacity were lower in malnourished individuals. It was observed that those who used corticosteroids were 18% less likely to become malnourished (OR=0.18; CI=0.05-0.62; p=0.011), however, it is important to consider the possible causes of bias; on the other hand, patients with low muscle strength or undergoing chemotherapy were approximately four times more likely to be malnourished, respectively (OR=3.46; CI=0.99-12.08; p=0.047) (OR=3.64; CI=1.13-11.69; p=0.027). It was concluded that malnutrition is common in patients with multiple myeloma, indicating the pressing need for appropriate and early nutritional intervention.

Evaluation of the Association Between Carrying Angle, Hand Grip Strength, Lateral Pinch Strength, and Hand Functional Index in Nursing Students / Evaluación de la Asociación entre el Ángulo de Carga, la Fuerza de Agarre de la Mano, la Fuerza de Pellizco Lateral y el Índice Funcional de la Mano en Estudiantes de Enfermería

SUMMARY: Health professionals especially nurses have ongoing contact with patients and they may have a high incidence of musculoskeletal problems. For this reason, grip strength and carrying angle are important parameters for all health professionals to succeed in their job and avoid injuries. It was aimed to determine the effects of the hand grip, and pinch strength, carrying angle of dominant, and non-dominant hands as well as the association of the hand functional index with morphometric measurements in 193 nursing students. The means of the carrying angle of dominant and non-dominant sides were 169.11±4.21° and 168.16±4.30°, respectively. The means of the dominant and, non-dominant sides of hand grip strength were 45.99±11.24 kg and 45.89±11.34 kg, respectively. The lateral pinch strength means were measured as 19.55±3.75 kg and 19.31±3.45 kg, respectively. This paper's findings may be important for some experts such as anatomists, clinicians, surgeons, forensic scientists, anthropologists, and nurses- healthcare professionals keep in touch with patients. Also, we believe that appropriate and effective knowledge of carrying angle, hand grip and lateral pinch strength has created an opportunity to research in terms of reducing work-related risk factors.

Los profesionales de la salud, especialmente las enfermeras, se mantienen en contacto con los pacientes y pueden tener una alta incidencia de problemas musculo-esqueléticos. En consecuencia, la fuerza de agarre y el ángulo de carga son parámetros importantes para que todos los profesionales de la salud tengan éxito en su trabajo y eviten las lesiones. El objetivo de este estudio fue determinar los efectos de la fuerza de prensión y pinzamiento de la mano, el ángulo de carga de las manos dominantes y no dominantes, así como la asociación del índice funcional de la mano con medidas morfométricas en 193 estudiantes de enfermería. Las medias del ángulo de carga de los lados dominante y no dominante fueron 169,11±4,21° y 168,16±4,30°, respectivamente. Las medias de los lados dominante y no dominante de la fuerza de prensión manual fueron 45,99 ± 11,24 kg y 45,89 ± 11,34 kg, respectivamente. La media de la fuerza de pellizco lateral se midió como 19,55 ± 3,75 kg y 19,31 ± 3,45 kg, respectivamente. Los hallazgos de este artículo pueden ser importantes para algunos expertos, como anatomistas, médicos clínicos, cirujanos, científicos forenses, antropólogos y enfermeras y profesionales de la salud que se mantienen en contacto con los pacientes. Además, creemos que el conocimiento apropiado y efectivo del ángulo de carga, el agarre de la mano y la fuerza de pellizco lateral ha creado una oportunidad para investigar en términos de reducción de los factores de riesgo relacionados con el trabajo.

Correlation of body mass index with handgrip strength and blood pressure indices among young adults

Objectives: Hand grip strength (HGS) is an important quantitative measure to evaluate the overall muscle strength of an individual. It is affected by factors such as age, sex, body mass index (BMI) and cardiovascular risk factors such as obesity and hypertension. This study aims to find out the correlation of BMI with HGS and blood pressure indices among young adults. Materials and Methods: Three hundred and eighty-two medical students between the age group of 18–20 years with no history of systemic illness, musculoskeletal disorder, hand pain or deformity were selected. Informed consent was obtained. Biodata and anthropometric measurements were documented in a proforma. HGS and endurance of the dominant hand were measured using a hand-held dynamometer. Blood pressure was recorded using a mercury sphygmomanometer. Data on BMI was sub grouped into underweight, normal weight, overweight and obese participants to compare the HGS among them. Results: There was a statistically significant negative correlation between BMI and HGS (r = ?0.513; P < 0.01), BMI and grip strength ratio (r = ?0.750; P < 0.01), and between BMI and handgrip endurance (r = ?0.359; P < 0.01). Statistically significant decrease in HGS was found among underweight (29.36 ± 7.01), overweight (26.18 ± 5.45) and obese participants (20.48 ± 3.12) with Kruskal–Wallis value ?2 = 14.231. Furthermore, a statistically significant positive correlation was found between BMI and systolic blood pressure (r = 0.603; P < 0.01), BMI and diastolic blood pressure (r = 0.514; P < 0.01), BMI and pulse pressure (r = 0.228; P < 0.01) and between BMI and mean arterial pressure (r = 0.572; P < 0.01). Conclusion: BMI was found to be negatively correlated with HGS and positively correlated with blood pressure indices. This can influence the compatibility of medical students with the physical and emotional stress of course. Determinants such as grip span, hand span, skeletal muscle bulk, and arm and calf muscle circumference are to be considered for further research to improve the endurance of young adults.

Correlação entre resistência de preensão manual e resistência muscular escapular em indivíduos assintomáticos / Correlation between hand grip endurance and scapular muscle endurance in asymptomatic individuals

INTRODUÇÃO: A atividade de preensão é uma ação diária essencial em casa e no local de trabalho, onde muitas vezes é necessário levantar e segurar cargas com uma preensão relativamente estática usando contração isométrica. A força e resistência muscular no aspecto proximal das extremidades superiores influenciam na função da mão, e indivíduos com força e resistência reduzidas são mais propensos a desenvolver distúrbios musculoesqueléticos relacionados ao trabalho. Uma boa resistência de preensão pode ser influenciada pela estabilização fornecida pelos músculos do ombro. Este estudo tem como objetivo determinar a extensão da correlação entre resistência de preensão manual e resistência muscular da escápula em jovens assintomáticos. MÉTODO: O tamanho da amostra para este estudo foi n = 62, com base em estudos anteriores. Indivíduos saudáveis, com idade entre 18 e 25 anos, de ambos os sexos, foram incluídos. Uma avaliação objetiva da resistência da preensão foi realizada usando um dinamômetro manual hidráulico, e a resistência escapular foi avaliada usando o teste muscular escapular. RESULTADOS: A análise de dados foi realizada usando o SPSS versão 20. Houve correlações positivas significativas entre as medidas de resistência escapular e a resistência de preensão palmar para ambos os lados (teste de correlação de Pearson, r = 0,612 (p < 0,001) e r = 0,524 (p < 0,001), respectivamente, para resistência de preensão da mão não dominante e dominante). CONSIDERAÇÕES FINAIS: Os achados preliminares deste estudo sustentam que a resistência do músculo escapular exibe uma relação com a resistência da preensão palmar, sugerindo que o treinamento de resistência escapular pode ser um complemento eficaz no processo de reabilitação das funções da extremidade superior.

INTRODUCTION: Gripping activity is an essential daily activity at home and at the workplace, where lifting and holding loads with a relatively static grip using isometric contraction is often required. Muscle strength and endurance in the proximal aspect of the upper extremities influence hand function, and individuals with reduced strength and endurance are more prone to developing work-related musculoskeletal disorders. Good grip endurance might be influenced by the stabilization provided by shoulder muscles. This study aims to determine the correlation between hand grip endurance and scapula muscle endurance among young asymptomatic individuals. METHOD: The sample size for this study is n = 62, based on previous studies. Healthy individuals of both genders, aged between 18 and 25 years, were included. An objective assessment of grip endurance was performed using a hydraulic hand dynamometer, while scapular endurance was evaluated using the scapular muscle test. RESULTS: Data analysis was performed using SPSS version 20. There were significant positive correlations between scapular endurance measures and the hand grip endurance on both sides (Pearson correlation test, r = 0.612 (p < 0.001) and r = 0.524 (p < 0.001), respectively, for non-dominant and dominant hand grip endurance). FINAL CONSIDERATIONS: The preliminary findings of this study support the notion that scapular muscle endurance is related to hand grip endurance, suggesting that scapular endurance training may be an effective adjunct in the rehabilitation process for upper extremity functions.

Frailty prevalence and its associations in a subacute geriatric ward in Singapore

INTRODUCTION@#Our aim was to study the prevalence of frailty and its associated factors in a subacute geriatric ward.@*METHODS@#This was a cross-sectional study of 167 participants between June 2018 and June 2019. Baseline demographics and participants' Mini Nutritional Assessment, Geriatric Depression Scale, Mini Mental State Examination, Charlson's Comorbidity Index and LACE index scores were obtained. Functional measurements such as modified Barthel's Index scores and hand grip strength (HGS) were taken. Frailty was assessed using the Clinical Frailty Scale (CFS) and the FRAIL scale. Data on history of healthcare utilisation, medications, length of stay, selected blood investigations and presence of geriatric syndromes were also collected.@*RESULTS@#The prevalence of pre-frailty (CFS 4) and frailty (CFS ≥ 5) was 16.2% and 63.4%, respectively. There were significant associations between CFS and age (pre-frail vs. non-frail: odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04-1.25, P = 0.006; frail vs. non-frail: OR 1.08, 95% CI 1.01-1.15, P = 0.021), HGS at discharge (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.025), serum albumin (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.035) and the presence of urinary incontinence (frail vs. non-frail: OR 3.03, 95% CI 1.19-7.77, P = 0.021).@*CONCLUSION@#Frailty is highly prevalent in the subacute geriatric setting and has many associated factors. In this study, independent factors associated with frailty were age, HGS at discharge, serum albumin and urinary incontinence. This has implications for future resource allocation for frail older inpatients and may help direct further research to study the effectiveness of frailty-targeted interventions.

Effect of task-oriented training on hand dexterity, grip strength, and function among institutionalized geriatric population

Background: The hand is the most active and important part of the upper extremity with complex functional biomechanics and anatomy. The decline in hand grip strength and dexterity with age can adversely affect functional activities. Task?oriented training (TOT) is a treatment approach focused on functional activities of daily life. Aim: To investigate the effect of TOT on hand dexterity, grip strength, and hand function in the geriatric population. Subjects and Methods: Sixteen institutionalized geriatric participants were recruited based on the inclusion and exclusion criteria and assigned to Group A experimental group (nine participants) who received TOT for 4 weeks, 3 days/week along with routine activities and Group B control group (seven participants) who were involved in routine activities only. Gross dexterity was assessed using the box and block test, fine dexterity with nine?hole peg board, hand grip strength with hand dynamometer, and hand function with the Michigan hand outcome questionnaire. The statistical analysis with Student’s t?test was performed using the SPSS software. The significance level kept as P ? 0.05. Results: The analysis expressed significant improvement in gross and fine hand dexterity and grip strength among the experimental group. The hand function did not reveal a statistically significant change. Conclusion: A 4?week TOT program is an effective measure to improve gross and fine dexterity, and muscle grip strength in the geriatric population. For improvement in hand function, a longer training may be required

Prevalence of the palmaris longus and its impact on grip strength in elite gymnasts and non-athletes / Prevalencia del músculo palmar largo y el impacto en la fuerza de agarre en gimnastas de elite y no atletas

In elite athletes, the palmaris longus (PL) presence has a potential contribution to hand strength, smaller reaction time, better shooting speed and power. The aim of this study was to investigate the prevalence of PL in elite competitive artistic gymnasts and its impact on grip strength compared to a control group of moderately active non-athletes. This prospective study included 370 subjects divided in two groups (170 elite artistic gymnasts and 200 moderately active non-athletes, students of medicine). The study consisted of two clinical sets of examination: a search for the clinical presence of PL was initially conducted followed by the assessment of maximal grip strength. Standard and six additional tests were performed to confirm PL tendon absence. Maximal grip strength was measured bilaterally with an electronic hand dynamometer. Bilateral absence was more common than unilateral, predominately noted on left side in both study groups. Unilateral PL absence was correlated to decreased grip strength in students, while the opposite was found in gymnasts. The mean value of grip strength in some age groups was higher on the side where the PL was absent. The results of our study show that the presence of the PL doesn`t affect the hand grip strength in gymnasts. Due to the low incidence of unilateral PL absence, further large-sampled research is warranted to assess PL contribution to hand grip strength and to other hand functions that could be of significant importance for athletes and non-athletes.

La presencia del músculo palmar largo (MPL) en atletas de élite tiene el potencial de aportar mayor fuerza a la mano, un tiempo de reacción menor, mejor velocidad de tiro y potencia. El objetivo de este estudio fue investigar la prevalencia de MPL en las gimnastas artísticas competitivas de élite y su impacto en la fuerza de agarre en comparación con un grupo control de no atletas moderadamente activos. El estudio incluyó 370 sujetos divididos en dos grupos (170 gimnastas artísticas de élite y 200 no atletas moderadamente activos, estudiantes de medicina). El estudio consistió en dos series clínicas de examen: inicialmente se realizó una búsqueda de la presencia clínica de MPL, seguido de la evaluación de la fuerza máxima de agarre. Se realizaron pruebas estándar y seis pruebas adicionales para confirmar la ausencia del tendón del MPL. La máxima fuerza de agarre se midió bilateralmente con un dinamómetro de mano electrónico. La ausencia bilateral fue más común que unilateral, predominantemente observada en el lado izquierdo en ambos grupos de estudio. La ausencia unilateral de MPL se correlacionó con una menor fuerza de agarre en los estudiantes, mientras que en gimnastas se encontró lo contrario. El valor medio de la fuerza de agarre en algunos grupos de edad fue mayor en el lado donde el MPL estaba ausente. Los resultados de nuestro estudio muestran que la presencia de MPL no afecta la fuerza de agarre de la mano en gimnastas. Debido a la baja incidencia de ausencia unilateral de MPL, se justifica una investigación adicional de gran tamaño para evaluar la contribución de MPL a la fuerza de agarre de la mano y otras funciones de la mano que podrían ser de gran importancia para los atletas y no atletas.

Descriptive Study Of Hand Grip Strength And Factors Associated With It In A Group Of Young Undergraduate Students In University Of Peradeniya, Sri Lanka Who Are Not Participating In Regular Physical Training

Background: Handgrip strength (HGS) not only reflects the strength of the upper limb muscles; it also reflects the overall strength of the skeletal muscles and physical fitness. Further, it is being used as an indicator of nutritional status too. Undergraduate students have been described as having low physical fitness due to their sedentary lifestyle in many studies. Therefore, this study describes the HGS and its association with gender, hand dominance, Body Mass Index (BMI), hand and forearm anthropometries in a group of young undergraduate students of the University who do not participate in regular physical training. Methods: This is a cross-sectional descriptive study, and was conducted among healthy first-year residential undergraduate student population (n= 524, 350 females, 174 males, mean age= 21.31 ± 0.93). Main outcome measures were HGS, gender, hand dominance, BMI, hand length, hand span, handbreadth, forearm length, forearm girth, and wrist circumference. Results: HGS of the dominant hand of male students was 35.27 ± 5.91 kg, which is significantly higher (p< 0.05) than that of the females (19.52 ± 4.34 kg). However, it has a significant but weakly positive correlation with other variables measured except for forearm length. Conclusion: This study has provided an insight into the association of low HGS with physical inactivity in an academically oriented group where the BMI is within the normal range and the association of higher HGS with hand dominance and male gender.

Grip Strength as a Predictor of Cerebrovascular Disease / 보건행정학회지

BACKGROUND: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. METHODS: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. RESULTS: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963–0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342–0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. CONCLUSION: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.

Effect of Decreased Skeletal Muscle Index and Hand Grip Strength on Functional Recovery in Subacute Ambulatory Stroke Patients

OBJECTIVE: To investigate the effect of decreased Skeletal Muscle Index (SMI) and hand grip strength on functional recovery in subacute ambulatory stroke patients. METHODS: Subacute stroke patients who were referred to the rehabilitation center were recruited. Decreased SMI and hand grip strength were diagnosed according to the Asian Working Group on Sarcopenia. Diagnostic criteria were decreased SMI and decreased unaffected hand grip strength. SMI was measured by bioelectrical impedance analysis. Unaffected hand grip strength was measured with a hand dynamometer. Patients were divided into two groups, decreased group (DG) and not-decreased group (NDG), according to the presence of decreased SMI and hand grip strength. Both groups received conventional stroke rehabilitation for 3 weeks. All patients were evaluated at the baseline and at 3 weeks after treatment. Functional status was evaluated with 4-meter walk test (4MWT), 6-minute walk test (6MWT), Timed Up and Go test (TUG), and Modified Barthel Index (MBI). RESULTS: Both groups showed improvement in 4MWT, TUG, and MBI. NDG showed improvement in 6MWT. Comparing improvements between the two groups, NDG showed more improvement in 6MWT and TUG than DG. CONCLUSION: The presence of decreased SMI and hand grip strength had negative effects on functional recovery in subacute ambulatory stroke patients.

Muscle Strength and Quality of Life in Malaysian Adults with Low and Moderate to High Risk of Osteoporotic Fractures / Jurnal Sains Kesihatan Malaysia

@#Reduced muscle strength and quality of life (QoL) has an impact on adults at risk of osteoporotic fractures. Muscle strength and QoL among Malaysian adults at risk of osteoporotic fractures is not known. The aim of our study was to examine muscle strength and QoL status and its relationship among adults at low and moderate to high risk of osteoporotic fractures. In this cross-sectional study, we recruited 27 men and 78 women with mean age 69.3 ± 8.5 years from Orthopaedic Clinic, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia. A 10-year probability of major osteoporotic fractures were calculated according to WHO fracture risk assessment tool (FRAX) with femoral neck BMD (cut-point 10%). Participants were categorized as low and moderate to high risk of osteoporotic fractures based on FRAX results. Back extensor muscle strength (BES) and dominant hand grip strength (HGS) was measured using a load cell system and a hand dynamometer respectively. European QoL questionnaire (EQ5Dvas) was used to measure QoL. Multiple linear regression was performed with QoL as a dependent variable and back extensor muscle strength and hand grip strength as the independent variables. Approximate 40% of adults were categorized into moderate to high risk of osteoporotic fractures. The mean values among the low and moderate to high risk of osteoporotic fractures for QoL was 80.5 ± 13.2 and 76.9 ± 16.9 (p = 0.77); hand grip strength was 25.7 ± 17.3 and 20.6 ± 5.5 kg (p < 0.001) and back extensor strength was 25.0 ± 7.0 and 18.9 ± 9.5 Newton (p < 0.01) respectively. Hand grip muscle strength appeared to be a determinant of QoL and accounted for 5.8% of the total variance. Improved muscle strength may lead in better QoL among adults at risk of osteoporotic fractures.

Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI

The purpose of this study was to report age- and gender-specific distribution of the hand grip strength (HGS) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-3 (2015) survey and determine cut-off values for low muscle strength of HGS of Koreans. Of a total of 7,380 participants, 4,553 were subjected to measurements of HGS, including 1,997 men and 2,556 women with a mean age of 49.3 years (range, 19–80 years). The mean ages of men and women were 49.0 and 49.5 years, respectively. HGS was measured using a digital hand dynamometer. It was defined as maximal measured grip strength of the dominant hand. The cut-off value for low muscle strength was defined as the lower 20th percentile of HGS of the study population. Maximum grip strength of men was significantly higher than that of women (40.2 kg in men vs. 24.2 kg in women, P < 0.001). The mean HGS was increased from the age of 19 to 39 years. It was peaked in the age of 35 to 39 years range for both men and women. It was then decreased after 39 years. The cut-off values of HGS in male and female elderly healthy populations were 28.6 and 16.4 kg, respectively. These data might be used as reference values when evaluating sarcopenia and assessing hand injuries.

Comparative study of sympathetic function changes in normal and moderately hypertensive patients

Introduction: Hypertension is one of the leading disorders contributing to significant morbidity and mortality in the world today. Today’s stressful life and modern life styles including the food habits have increased the incidence, acquiring a status of modern day epidemic along with diabetes mellitus. The onset and severity of complication in a system is said to be dependent on the duration of hypertension and the degree of its control. Autonomic dysfunction is drawing more and more attention of the medical fraternity for its supposed role in sudden deaths observed in hypertensive and diabetics. Aim of the study: Our aim is to Hand grip test and Cold presser test in normotensive and moderately hypertensive patients. Materials and methods: A comparative study of cardiovascular autonomic function tests in hypertensive and normotensive individuals was conducted in the Department of Physiology, Department of Community Medicine, RMMCH-Urban Health Centre, Chidambaram on 25 hypertensive patients in the age group of 30-40 years and age matched control group of 25 normotensive individuals. The study was programmed to assess sympathetic nerve functions based on cardiovascular parameters like blood pressure and heart rate measurement. Among the autonomic function tests discussed in the review of literature. Results: In HGT this is an indicator for sympathetic insufficiency. Rise in DBP of > 16 mmHg is taken as normal. In autonomic disorder the rise is < 10 mmHg.

Correlation between thumb length on handgrip strength, hand dexterity and musculoskeletal problem among dental professional / Correlação entre comprimento do polegar sobre a força de preensão manual, destreza manual e problemas musculoesqueléticos entre profissionais da odontologia

Objective: The key factor for potency of the teeth is their muscular strength. The dominant hand plays an important role in most of the daily muscular activities involving dental procedure. There are many factors, which may affect the grip strength, and very few studies especially in India have shown their correlation with grip strength. Work related musculoskeletal disorders (WRMSD) are an important occupational health problem affecting dental practitioners. This study assessed the prevalence of WRMSD in dental interns in relation to the thumb length and hand grip strength. Material and Methods: Thumb length template, jammer dynamometer, nine-hole peg board, and RULA assessment. Methods: Thumb length was measured by thumb length template. Grip strength was measured by jammer dynamometer, unilateral hand finger dexterity was measured by ninehole pegboard, and work related musculoskeletal disorder was assessed by RULA. Results: Thumb length was positively correlated with grip strength and work related musculoskeletal disorder. Thumb length was negatively correlated with unilateral hand finger dexterity among dental professionals. Conclusion: Thumb length is a better predictor for measuring hand grip strength and work related musculoskeletal disorder, than unilateral hand finger dexterity.

Objetivo: O fator chave para a potência do dentes é a força muscular dos mesmos. A mão dominante tem um papel importante nas atividades musculares diárias envolvendo procedimentos odontológicos. Há vários fatores que influenciam a força de preensão e poucos estudos, especialmente na Índia, mostra as correlações com a força de preensão. Desordens musculoesqueléticas relacionadas a trabalho (DMRT) são um importante problema ocupacional de saúde entre profissionais da Odontologia. Este trabalho verificou a prevalência de DMRTs em residentes de Odontologia e sua relação com o comprimento do polegar e a força de preensão manual. Material e Métodos: Materiais utilizados foram o gabarito de comprimento do polegar, um dinamômetro Jamar, um tabuleiro de 9 perfurações e o instrumento RULA. Métodos: O comprimento polegar foi medido pelo gabarito; a força de preensão foi medida no dinamômetro Jamer; a destreza manual unilateral foi verificada utilizando-se o tabuleiro perfurado e as desordens musculoesqueléticas associadas ao trabalhos foram determinadas pelo instrumento RULA. Resultados: O comprimento polegar apresentou correlação positiva com a força de preensão e com a presença de desordens musculoesqueléticas relacionadas ao trabalho. O comprimento polegar foi negativamente correlacionado com a destreza manual unilateral entre os profissionais da Odontologia. Conclusão: O comprimento polegar é melhor preditor para a força de preensão manual e presença de desordens musculoesqueléticas relacionas ao trabalho, do que a destreza manual unilateral.

Effect of longstanding Diabetes Mellitus II on handgrip strength: An observational study.

Introduction: Diabetes mellitus is a chronic metabolic condition characterized by persistent hyperglycemia, with resultant morbidity and mortality. Muscle weakness has been associated with type-II diabetes, even among subjects with high body mass indices. There is decremental effect of DM-II on skeletal muscles. Objective: The study was aimed to find the effect of longstanding DM-II on hand grip strength. Material and methods: 25 subjects with DM-11 diagnosed since more than 6 years aged between 35- 75 years (60.96±7.6) (Group A), with mean diabetic duration of 13.25±8.5 years and independent in their ADL were compared with 25 healthy non diabetic subjects (55.00±9.93) (Group B) for their hand grip strength of dominant hand using hand held dynamometer. Subjects with any upper limb amputation or with cervical spondylosis, cervical pott’s disease, 1 degree metastatic tumour or fracture or dislocation of cervical vertebra, Thoracic outlet syndrome, peripherls nerve injury, cervical neurofibromatosis and cervical rediculopathy in previous 6 month before commencement of study were excluded. Wilcoxon signed Rank test was used for with in group analysis and Mann- Whtney 'U' Test was used for between group analysis. Results: For group A, W=-3.009, p=0.003 and for group B, W= -3.909. The U value for between group analysis is U= 87.00, p=0.001. Conclusion: Grip strength was significantly redused in diabtic individuals as campared to non-diabetic individuals. There is also significant difference in dominant and non-dominant hand grip strength in diabetic group and non diabetic group.

Repercusión de la cirugía torácica y abdómino-pélvica en el estado funcional del anciano / Impact of thoracic and abdominopelvic surgery on the functional status in the elderly

La calidad de vida de los ancianos está determinada por su capacidad funcional, más que por el número o tipo de enfermedades que padecen. Se analizaron 43 pacientes mayores de 65 años sometidos a cirugías mayores. Se siguió longitudinalmente la evolución del estado funcional mediante el análisis de 6 variables, las actividades de la vida diaria (AVD), actividades instrumentales de la vida diaria (AIVD), la prueba de levántate y anda, prueba del alcance funcional del brazo, fuerza de prensión de la mano y velocidad de la marcha, medidas previas a la cirugía (medición basal) y a los 1, 2, 3 y 4 meses posteriores al alta. Los objetivos fueron: estimar la repercusión que la cirugía tiene en el estado funcional de ancianos, determinar el tiempo que cada una de las mediciones regresa a los valores del preoperatorio en el seguimiento a 4 meses, comparar las curvas de recuperación de los valores basales de AIVD, fuerza de prensión de la mano y velocidad en la marcha, entre 2 grupos definidos por la velocidad de la marcha basal, en lentos ( 0.8 m/s). La repercusión de la cirugía en la aptitud física presentó una disminución estadísticamente significativa en AVD, AIVD, la prueba de levántate y anda y velocidad en la marcha con recuperación en tiempo variable, más allá de la convalecencia. La evaluación del estado funcional permite planear estrategias tendientes a cubrir limitaciones y necesidades del paciente y su familia en el post operatorio mediato.

The quality of life of older people is determined by their functional capacity, rather than by the number or type of disease suffered. We analyzed 43 patients over 65 years undergoing major surgery. Longitudinally continued evolution of functional status by analyzing six variables, activities of daily living (ADLs), instrumental activities of daily living (IADL), the get up and walk test, functional reach test of arm, strength of handgrip and walking speed, measured before surgery (baseline measurement) and at 1, 2, 3 and 4 months after discharge. The objectives were to estimate the impact that surgery has on functional status in the elderly, determine how long each of the measurements returned to preoperative values at 4 months follow-up. Recovery curves compared the baseline AIVD, grip strength and hand speed on the fly, between two groups defined by baseline walking speed in slow ( 0.8 m/s). The impact of surgery on physical fitness showed a statistically significant decrease in ADL, IADL, and the get up and walk test and walking speed, with variable time recovery beyond convalescence. All return to baseline at 4 months except test walking speed that exceeded the baseline. Functional status can be evaluated quickly and should be included in the preoperative evaluation, since it allows planning strategies to meet the needs and limitations of patients and their families, in the immediate postoperative period.

DISCRIMINATION OF MOBILITY LIMITATION BY HAND-GRIP STRENGTH AMONG COMMUNITY-DWELLING OLDER ADULTS / 体力科学

The purpose of this study was to determine whether hand-grip strength (HGS) can be a significant discrimination factor of mobility limitation (ML) among older adults. Cross-sectional analysis was conducted on data from 939 community-dwelling older adults, aged 65-96 years (74.4 ± 6.4 yr, 266 men, 673 women). ML was defined as self-reported difficulty in walking 400 m, climbing 10 steps, and rising from a chair. Trained testers assessed standardized measurements of HGS and lower extremity performance score (LEPS) calculated by four tests (i.e., tandem stance, 5-chair sit-to-stand, alternate step, and timed up & go). Receiver operating characteristic (ROC) analysis was conducted to identify discrimination power of HGS and LEPS for ML. The areas under the ROC curves (AUCs) of HGS and LEPS for ML were 0.82 and 0.87 in men; 0.70 and 0.85 in women, respectively. No significant difference was detected between the AUCs of HGS and LEPS (<i>P</i> = 0.12) in men, whereas in women, the AUC was significantly lower in HGS than LEPS (<i>P</i> < 0.001). The optimal HGS cut-off values for ML were 31.0 kg (sensitivity 75%, specificity 81%) for men and 19.6 kg (sensitivity 73%, specificity 57%) for women. In men, the HGS test could be as useful as LEPS for identifying ML. In women, discrimination power for ML by HGS alone was considered acceptable; however, a combination of HGS and lower extremity performance tests could be more useful for monitoring the hierarchical levels of physical frailty.

Relationship of BODE Index to functional tests in chronic obstructive pulmonary disease

OBJECTIVE: To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease. MATERIALS AND METHODS: Ten men (aged 58 to 80 years old) with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (V•E), oxygen consumption (V•O2), and carbonic gas production (V•CO2) on the ADL assessment; Distance Walking (DW) in the Six Minute Walking Test (6MWT) and the Six Minute Walking Test on Treadmill (6MWTT); number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05). RESULTS: The mean of the total score for the BODE Index was 2.80 (±1.03), with three patients scoring in the first quartile (Q1) and seven scoring in the second quartile (Q2). This Index showed a negative correlation with the 6MWTT (r=-0.86), the Sit-to-Stand Test (r=-0.66), and the Hand Grip Strength Test (r=-0.83). CONCLUSIONS: Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index.

A study of the effect of low dose recombinant human growth hormone replacement therapy on bone mineral density, IGF-1, hand grip strength, body fat and serum lipid compositions in postmenopausal women / 대한산부인과학회지

OBJECTIVE: To determine the effect of low-dose growth hormone (GH) replacement therapy on bone mineral density at the lumbar spine and femur, IGF-1, hand grip, body fat and serum lipid compositions in postmenopausal women. METHODS: A total of 9 postmenopausal women were assigned to receive growth hormone with a daily dose 0.0095 IU/kg, six times a week. We compared the change of bone marrow density (BMD), bone marker (osteocalcin), IGF-1, hand grip strength, body fat and serum lipid compositions during therapy. Repeated measure ANOVA test was used for statistical analysis. RESULTS: The results were as follows. 1. Mean age of the patients was 62.2 +/- 2.7 years. 2. The bone marker, osteocalcin level at 3 and 6 months were increased by 28% and 35% respectively, compared to baseline (p0.05). 5. Hand grip strength at 6 months was increased by 7.8% compared to baseline (p0.05). 7. The total cholesterol, triglyceride and LDL cholesterol were decreased during GH treament, but not significance (p>0.05). The HDL cholesterol was increased with no statistical significance (p>0.05). CONCLUSION: Our study results suggest that low-dose GH replacement therapy in postmenopausal women have beneficial effect on increased BMD, hand grip strength and HDL cholesterol. The present findings provide useful information regarding the use of low-dose GH treament in elderly women with osteoporosis.