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Objective: Evaluate and correlate data between relevant cytokines, disease progression, and handgrip and quality of life among RA patients at different stages of disease progression. Method: Thirty-three RA patients were recruited for analysis, using comparisons and correlations, between levels of circulating cytokines (IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17, IL-1ß, and TNF receptors I and II), activity of the disease (evaluated using the DAS-28), handgrip (Hydraulic dynamometer), and quality of life (SF-36). Result: RA patients in different disease stages showed increases of IL-6 and IL-10 compared control group. Positive correlation between IL-6 with TNF-α, and IL-4 with IL-10 was found. Handgrip strength and quality of life were not related to cytokine levels. However, remission patients had better strength and quality of life indices compared to the active patients. In addition, handgrip of the non-dominant side, physical functions, role limitations physical health, pain, energy/fatigue and social functions have a negative correlation with the DAS28-PCR. Conclusion: High levels of IL-6 and IL-10 were observed in the chronic RA patients, but the values did not show correlation with disease activity, handgrip strength and quality of life. Disease activity show correlation with handgrip strength and quality of life. Furthermore, remission patients had better strength and quality of life indices compared to the active patients.
Objetivo: Avaliar e correlacionar dados entre citocinas relevantes, progressão da doença, preensão manual e qualidade de vida entre pacientes com AR em diferentes estágios de progressão da doença. Método: Trinta e três pacientes com AR foram recrutados para análise, por meio de comparações e correlações, entre níveis de citocinas circulantes (IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17, IL-1ß e receptores de TNF-I e -II), atividade da doença (avaliada pelo DAS-28), preensão manual (dinamômetro hidráulico) e qualidade de vida (SF-36). Resultado: Pacientes com doença ativa e inativa apresentaram aumento de IL-6 e IL-10 comparados ao grupo controle. Foi encontrada correlação positiva entre IL-6 com TNF-α e IL-4 com IL-10. A força de preensão e a qualidade de vida não relacionaram aos níveis de citocinas. Entretanto, pacientes em remissão apresentaram melhores índices de força e qualidade de vida comparados aos pacientes com doença ativa. Além disso, preensão manual do lado não dominante, e quesitos dos SF-36, apresentam correlação negativa com o DAS28-PCR. Conclusão: Foram observados níveis elevados de IL-6 e IL-10 nos pacientes com AR crônica, mas os valores não mostraram correlação com DAS-28, força de preensão manual e SF-36. A atividade da doença apresenta correlação com força de preensão manual e qualidade de vida. Além disso, os pacientes em remissão apresentaram melhores índices de força e qualidade de vida em comparação aos pacientes ativos.
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Humanos , Artrite Reumatoide , Força da MãoRESUMO
Objective:To examine the influence of handgrip strength(HGS)on the intrinsic capacity(IC)and explore the correlation between HGS and intrinsic capacity subdomains in elderly patients of varying genders.Methods:A cross-sectional study was conducted on 201 inpatients admitted to the Geriatric Department of Zhejiang Hospital from May 2020 to November 2021.The study collected data on the patients' general situation and intrinsic capacity assessment, which included physical function, nutritional status, visual and hearing status, cognitive function, and depressive mood.The patients were grouped based on the number of impaired subdomains of intrinsic capacity.Multivariate ordered Logistic regression analysis was performed to identify the factors influencing the impaired subdomains of intrinsic capacity.The patients were further divided into normal and decreased grip strength groups based on HGS thresholds of less than 26 kg for males and less than 18 kg for females.Binary Logistic regression analysis was then used to investigate the relationship between HGS and the different subdomains of intrinsic capacity among males and females.Results:Among the 201 inpatients, 68 were impaired in 0 to 1 subdomain(33.8%), 103 in 2 to 3 subdomains(51.2%), and 30 in more than 3 subdomains(14.9%).After adjusting for confounding factors using multivariate ordered Logistic regression analysis, the HGS of the 2 to 3 and more than 3 subdomain groups were found to be lower than the 0 to 1 subdomain group( OR=0.957, 95% CI: 0.924-0.993, P=0.019).Among the patients, 117(58.2%)had normal HGS, while 84(41.8%)had decreased HGS.In the binary Logistic regression analysis of older adults, adjusted for confounders, the results indicated that older men with decreased HGS had higher odds of experiencing cognition problems( OR=3.919, 95% CI: 1.301-11.804, P=0.015).Similarly, older women with decreased HGS had higher odds of having locomotion( OR=10.623, 95% CI: 2.374-47.536, P=0.002), vitality( OR=7.386, 95% CI: 1.875-29.095, P=0.004), and cognition( OR=4.835, 95% CI: 1.218-19.196, P=0.025)problems. Conclusions:The key population for intrinsic capacity screening should be elderly patients with decreased HGS.It is important to note that there are differences in the subdomains of impaired intrinsic capacity among elderly individuals with decreased HGS of different genders.As a result, it is crucial to prioritize the development of intervention programs to improve intrinsic capacity based on the specific needs of elderly individuals of different genders.
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Introduction: In critically ill patients on mechanical ventilation, the loss of inspiratory and peripheral muscle strength is associated with prolonged mechanical ventilation and failed weaning. Objective: To determine the relationship between handgrip strength and inspiratory muscle strength with the success of the Spontaneous Breathing Trial in adults with ventilatory support greater than 48 hours. Methodology: Prospective observational cross-sectional study performed at a tertiary hospital in Colombia. Handgrip strength and Maximal Inspiratory Pressure were measured once a day before Spontaneous Breathing Trial testing. Pearson's test and Cohen's D test were used to analyze correlations. Results: A total of 51 patients were included, 57% male, with a mean age of 51.9±20 years. A positive correlation was identified between Maximal Inspiratory Pressure and grip strength; and a negative correlation between grip strength and Maximal Inspiratory Pressure with the days of stay in the intensive care unit, (r -0.40; p<0.05) and (r -0.45; p<0.05). Conclusions: Handgrip strength and Maximal Inspiratory Pressure were positively correlated with Spontaneous Breathing Trial success. The importance of these measures to guide ventilator disconnection processes is highlighted.
Introducción: En el paciente críticamente enfermo con ventilación mecánica, la pérdida de la fuerza de los músculos inspiratorios y periféricos se asocia con ventilación mecánica prolongada y destete fallido. Objetivo: Determinar la relación entre la fuerza de prensión manual y la fuerza de músculos inspiratorios con el éxito de la prueba de respiración espontánea en adultos con soporte ventilatorio mayor a 48 horas. Metodología: Estudio prospectivo observacional de corte transversal realizado en un hospital de tercer nivel en Colombia. La fuerza de prensión manual y la presión inspiratoria máxima se midieron una vez al día antes de la prueba de prueba de respiración espontánea. Se utilizaron la prueba de Pearson y la prueba D de Cohen para analizar las correlaciones. Resultados: Se incluyeron 51 pacientes, 57 % de sexo masculino, con una edad promedio de 51,9 ± 20 años. Se identificó una correlación positiva entre Presión Inspiratoria Máxima y fuerza de la mano; y una correlación negativa entre la fuerza de la mano y la Presión Inspiratoria Máxima con los días de estancia en la Unidad de Cuidados Intensivos, (r -0,40; p < 0,05) y (r -0,45;p < 0,05). Conclusiones: La fuerza de prensión manual y la Presión Inspiratoria Máxima se correlacionaron positivamente con el éxito de la Prueba de Respiración Espontánea. Se destaca la importancia de estas mediciones para guiar procesos de desconexión del ventilador.
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Introducción: Algunos estudios han encontrado relación entre exceso de peso y baja fuerza de prensión relativa. En países de ingresos socioeconómicos medianos y bajos hay pocas evidencias que evalúen la fuerza prensil y su relación con la composición corporal en población pediátrica. Objetivo: Evaluar la correlación entre la fuerza prensil y la composición corporal de escolares de Bucaramanga, Colombia. Materiales y métodos: Se realizó un estudio piloto de corte transversal, analítico, correlacional. Participaron niños en edad escolar de Bucaramanga, Colombia. Las principales variables dependientes fueron masa muscular, agua corporal total, proteínas (kg) y el porcentaje de grasa corporal. La variable independiente correspondió a la fuerza prensil. Se usó el coeficiente de correlación de Spearman para explorar la relación entre variables. Resultados: El promedio de la fuerza prensil en el total de la muestra fue de 13,8 ± 3,2 Newton. Se encontraron correlaciones positivas y estadísticamente significativas entre la fuerza prensil y la masa musculoesquelética (r = 0,73), agua corporal total (r = 0,73) y proteínas (r = 0,74). Discusión: Nuestros resultados son consistentes con evidencias previas que identifican a la fuerza prensil como un indicador de la composición corporal, específicamente en las variables de masa musculoesquelética y proteínas. Conclusión: Los niños en el tercil más alto de fuerza prensil presentan los terciles más altos de masa musculoesquelética, agua corporal total y proteínas.
Introduction: Some studies have found a relationship between excess weight and low relative grip strength. In countries with medium and low socioeconomic income, there is little evidence evaluating grip strength and its relationship with body composition in the pediatric population. Objective: To evaluate the correlation between grip strength and body composition of schoolchildren from Bucaramanga, Colombia. Materials and Methods: A cross-sectional, analytical, correlational pilot study was conducted. Schoolchildren from Bucaramanga, Colombia participated. The main dependent variables were muscle mass, total body water, protein (kg), and percentage of body fat. The independent variable corresponded to the prehensile force. Spearman's Correlation Coefficient was used to explore the relationship between variables. Results: The average prehensile force in the total sample was 13.8±3.2 Newton. Positive and statistically significant correlations were found between grip strength and musculoskeletal mass (r=0.73), total body water (r=0.73), and protein (r=0.74). Discussion: Our results are consistent with previous evidence that identifies grip strength as an indicator of body composition, specifically in the variables of musculoskeletal mass and protein. Conclusion: Children in the highest tertile of prehensile strength present the highest tertiles of skeletal muscle mass, total body water, and protein.
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Introduction: The change in handgrip strength (HGS) is an indicator of the emergence of some chronic diseases, such as diabetes mellitus (DM) and systemic arterial hypertension (SAH). Objective: Analyze the relationship between HGS and body composition and laboratory indicators of diabetic and hypertensive patients assisted in Primary Health Care. Methods: The sample consisted of 185 users of a Basic Health Unit in the city of Santarém, Pará, distributed into two groups: control (CTL) users without a diagnosis of DM and/or SAH (n=66); and DM/SAH (n=119) users with DM or SAH or both diseases. Data collection involved sociodemographic, clinical, anthropometric, biochemical, and HGS information. Data were analyzed using descriptive and inferential statistics, adopting p<0.05. Results: It was noted that low HGS in the DM/SAH group was associated with high values of body mass index, abdominal circumference, fat percentage, fat mass, total cholesterol, and triglycerides and with more factors for metabolic syndrome (p<0.05). The CTL group, in relation to DM/SAH for the same HGS classification, demonstrated significance for lower blood pressure values, body mass index, abdominal circumference, fat percentage, and fat mass, as well as a lower chance of developing metabolic syndrome (p<0.05). Conclusion: According to the study proposal, it is concluded that the evaluation and follow-up of HGS in individuals with chronic diseases, especially DM and SAH, is relevant to monitor body adiposity and dyslipidemia and avoid the aggravation of existing diseases or the emergence of new ones (AU).
Introdução: A alteração na força de preensão (FP) manual é indicador para surgimento de algumas doenças crônicas, como a diabetes mellitus (DM) e hipertensão arterial sistêmica (HAS). Objetivo: Analisar a relação da FP com a composição corporal e indicadores laboratoriais de diabéticos e hipertensos assistidos na Atenção Primária à Saúde. Métodos: A amostra foi composta por 185 usuários de uma Unidade Básica de Saúde na cidade de Santarém, Pará, sendo distribuídos em dois grupos: controle (CTL) usuários sem o diagnóstico para DM e/ou HAS (n=66); e DM/HAS (n=119) usuários com DM ou HAS ou as duas doenças. A coleta de dados envolveu informações sócio-demográficas, clínicas, antropométricas, bioquímicas e FP. Os dados foram analisados por estatística descritiva e inferencial, adotando-se p<0,05. Resultados: Notou-se que a FP baixa no grupo DM/HAS apresentou associação com valores elevados do índice de massa corporal, circunferência abdominal, percentual de gordura, massa gorda, colesterol total, triglicerídeos e com mais fatores para a síndrome metabólica (p<0,05). Já o grupo CTL, em rela-ção do DM/HAS para uma mesma classificação de FP, demonstrou significância para menores valores pressóricos, do índice de massa corporal, da circunferência abdominal, percentual de gordura, massa gorda, bem como menor chance para o desenvolvimento da síndrome metabólica (p<0,05). Conclusão: Conclui-se, conforme a proposta do estudo, que é relevante a avaliação e acompanhamento da FP em indivíduos com doenças crônicas, em especial a DM e a HAS, a fim de monitorar a adiposidade corporal e a dislipidemia, evitando o agravo das doenças instaladas ou o surgimento de novas (AU).
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Humanos , Força da Mão , Diabetes Mellitus , HipertensãoRESUMO
Objective: To verify the development of fatigue and sex-influence on the handgrip during dynamic contractions in typical children. Methods: Cross-section study. Fifty-eight children, distributed into two groups according to sex (30 boys), aged 8 to 12 years, of both sexes, performed successive dynamic contractions with a bulb dynamometer until they reached maximum perceived effort. The values from the first, the last contractions of the fatigue test, and the measure after 30-s of the last contraction (recovery contraction) were recorded and compared using the linear regression model with mixed effects. T-Student test was used to compare the perceived effort scores and time-to-fatigue between groups. Results: The handgrip values significantly decreased, and perceived effort scores significantly increased in the final measure in relation to the initial measure of the fatigue test. After the fatigue handgrip test, 30-sec of recovery was insufficient to restore the baseline handgrip values. There were no differences between the female and male groups for all variables. Conclusion: The handgrip fatigue test using dynamic contractions showed it efficiently induces motor and perceived fatigue in children, without differences between sexes.
Objetivo: Verificar o desenvolvimento da fadiga e a influência do sexo na preensão manual durante contrações dinâmicas em crianças típicas. Métodos: Estudo transversal. Cinquenta e oito crianças, distribuídas em dois grupos de acordo com o sexo (30 meninos), com idades entre 8 e 12 anos, de ambos os sexos, realizaram sucessivas contrações dinâmicas com um dinamômetro de bulbo até atingirem o esforço máximo percebido. Os valores da primeira, da última contração do teste de fadiga e da medida após 30 segundos da última contração (contração de recuperação) foram registrados e comparados usando o modelo de regressão linear com efeitos mistos. O teste T-Student foi usado para comparar os escores de esforço percebido e o tempo até a fadiga entre os grupos. Resultados: Os valores de preensão palmar e os escores de esforço percebido diminuíram significativamente durante o teste de fadiga. Não houve diferenças entre os grupos para todas as variáveis. Conclusão: O teste de fadiga de preensão palmar utilizando contrações dinâmicas mostrou-se eficaz na indução da fadiga motora e percebida em crianças, sem diferenças entre os sexos.
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Abstract Objective: To investigate the relationship between Handgrip Strength (HGS), dysphagia classification, nutritional aspects, and Pharyngeal Transit Time (PTT) in subjects with Chronic Obstructive Pulmonary Disease (COPD). Methods: Study based on the analysis of secondary data from a database. The sample comprised 15 COPD patients of both sexes and a mean age of 65.7 years. We collected information on HGS, videofluoroscopic swallowing study, Volume-Viscosity Swallow Test (V-VST), and Body Mass Index (BMI). We applied correlation, effect size, and logistic regression tests at the 5% significance level. Results: Most individuals had severe COPD (66.7%), mean dominant HGS of 28.2, and non-dominant HGS of 25.3. Five subjects were malnourished, five were well-nourished, and five were obese. Most of them had normal swallowing (40%), normal V-VST results (60%), and PTT of 0.89 s (liquid) and 0.81 s (pudding-thick). There was no significant correlation between the swallowing classification and the other variables. We obtained a significant correlation (p = 0.015), though weak (r = -0.611), between non-dominant HGS and PTT. Regarding the binary logistic regression, HGS variables and HGS asymmetry were not enough to be considered a risk to clinically abnormal swallowing (V-VST). Conclusion: Subjects with COPD in this study had a longer PTT than reported in the literature for normal subjects and a weak correlation between PTT and non-dominant HGS. The variables related to muscle condition were not considered predictors for abnormal swallowing. Level of evidence: 3.
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Objetivo: investigar a associação entre força de preensão manual e características sociodemográficas e clínicas de idosos condutores de veículos automotores. Método: estudo transversal, realizado em clínicas de medicina de tráfego na cidade de Curitiba/Paraná, com 421 idosos (≥ 60 anos). Realizou-se análise estatística pelo modelo de Regressão Logística e Teste de Wald, considerando intervalo de confiança de 95% e valores de p <0,05 como significativos. Resultados: oitenta e quatro (20%) idosos apresentaram força de preensão manual reduzida. A força de preensão manual reduzida foi associada à faixa etária (p=0,001) e à hospitalização no último ano (p=0,002). Conclusão: houve associação significativa entre a força de preensão manual de idosos motoristas e as variáveis idade e hospitalização no último ano. Dessa forma, torna-se essencial a inclusão de avaliações específicas, centradas nas variáveis sociodemográficas e clínicas próprias da pessoa idosa, durante o exame de aptidão para dirigir veículos automotores.(AU)
Objective: to investigate the association between handgrip strength and sociodemographic and clinical characteristics of elderly automobile drivers. Method: cross-sectional study, carried out in traffic medicine clinics in the city of Curitiba/Paraná, with 421 elderly people (≥ 60 years old). Statistical analysis was performed using the Logistic Regression model and the Wald Test, considering a 95% confidence interval and p values <0.05 as significant. Results: eighty-four (20%) seniors had reduced handgrip strength. Reduced handgrip strength was associated with age group (p=0.001) and hospitalization in the last year (p=0.002). Conclusion: there was a significant association between the handgrip strength of elderly drivers and the variables age and hospitalization in the last year. Thus, it is essential to include specific assessments, centered on sociodemographic and clinical variables specific to the elderly person, during the aptitude test to drive automobiles.(AU)
Objetivo: investigar la asociación entre la fuerza de prensión de la mano y las características sociodemográficas y clínicas de los ancianos conductores de vehículos automotores. Método: estudio transversal, realizado en clínicas de medicina de tránsito de la ciudad de Curitiba/Paraná, con 421 ancianos (≥ 60 años). El análisis estadístico fue realizado por el modelo de Regresión Logística y Test de Wald, considerando intervalo de confianza de 95% y valores de p <0,05 como significativos. Resultados: 84 (20%) sujetos ancianos presentaron reducción de la fuerza de prensión de la mano. La reducción de la fuerza de prensión de la mano se asoció al grupo de edad (p=0,001) y a la hospitalización en el último año (p=0,002). Conclusión: hubo una asociación significativa entre la fuerza de prensión de la mano de los conductores ancianos y las variables edad y hospitalización en el último año. Así pues, es esencial incluir evaluaciones específicas, centradas en las variables sociodemográficas y clínicas de los ancianos, durante el examen de aptitud para conducir vehículos automotores.(AU)
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Humanos , Idoso , Condução de Veículo , Automóveis , Saúde do Idoso , Força da Mão , Fatores Sociodemográficos , Fatores Socioeconômicos , Exame para Habilitação de Motoristas , Modelos LogísticosRESUMO
Objective: This study aimed to characterize the muscle strength and skeletal muscle mass of patients with heart failure by investigating hand-grip strength, five times sit-to-stand (5STS) results, and skeletal muscle mass index (SMI).Materials and Methods: Muscle strength was assessed based on hand-grip strength and 5STS, while skeletal muscle mass was assessed using a bioelectrical impedance analyzer. Hierarchical logistic regression analysis was performed to explore the association between patients with heart failure and healthy elderly individuals.Results: Hierarchical logistic regression analysis was performed to examine the muscle strength and skeletal muscle mass characteristics in patients with heart failure. Hand-grip strength and 5STS responses but not SMI outcomes differed significantly between the two groups. The results of the hierarchical logistic regression analysis revealed that the hand-grip strength and 5STS were significant predictors of heart failure. The odds ratios for hand-grip strength and 5STS were 1.44 and 0.53, respectively.Conclusion: Our results suggested that upper and lower limb muscle strengths (handgrip strength and 5STS) in elderly patients with heart failure worsened significantly without a decrease in skeletal muscle mass.
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Objective:To explore the correlation between serum creatinine/cystatin C(Scr/CysC)ratio and sarcopenia, and search for serum markers specific to sarcopenia.Methods:A retrospective case-control study of 142 hospitalized patients in the Department of Geriatrics, Xiangya Second Hospital, Central South University from November 2020 to February 2022 were collected, including 43 sarcopenia cases and 99 non sarcopenia cases.The correlation between Scr/CysC ratio and sarcopenia was analyzed and explored.Results:The Scr/CysC ratio of 71.5±12.5 in the sarcopenia group was significantly lower than that of 81.9±15.8 in the non-sarcopenia group( t=3.823, P<0.001), and Scr/CysC was positively correlated with muscle mass and grip strength( r=0.52, 0.69, both P<0.001).The results of the analysis of receiver operating characteristic curves of the subjects showed that in male inpatients, the area under the curve(AUC)of the Scr/CysC ratio in the diagnosis of sarcopenia was 0.770(95% CI: 0.655 to 0.886, P<0.001), with a diagnostic reference value of 80.97, which gave a sensitivity of 72.2% and a specificity of 68.4%.In female inpatients the AUC was 0.621(95% CI: 0.474 to 0.768, P=0.099), with a diagnostic reference value of 65.20, giving a sensitivity of 77.8% and a specificity of 58.3%. Conclusions:The serum Scr/CysC ratio may be a serum marker for male sarcopenia patients, and sarcopenia may be considered when it is below 80.97; The diagnostic value in female sarcopenia needs further research.
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Objective@#To explore the relationship between handgrip strength (HGS) and pulmonary function (PF) in college students with sedentary lifestyle, so as to provide a reference for taking HGS as an essential factor of PF.@*Methods@#In March 1-5, 2023, a total of 44 college students were recruited and were divided into the sedentary group (22) and exercise group (22) according to the International Physical Activity Questionaire (IPAQ), with 22 students in each group. Independent sample t-test was used to compare the indexes between groups, pearson correlation coefficient was used to determine the correlation between HGS and PF. Multiple linear regression analysis was used to determine the predictive model of PF.@*Results@#There were statistical significance of the correlations between HGS and FVC, MEP, PEF, FEV1, FIVC, MIP, and PIF ( r=0.79, 0.47, 0.44, 0.60, 0.72, 0.53 , 0.49, P <0.01). When gender, physical activity, age, height, weight, and HGS were included as predictors in the regression model, height and HGS had significant effects on FVC ( R 2=0.75, F= 60.55 , P <0.01), weight and HGS had a good predictive effect on FIVC ( R 2=0.67, F=41.77, P <0.01).@*Conclusion@#HGS is significantly associated with PF in college students with sedentary lifestyle. Therefore, HGS can be used as an important indicator to predict the PF status of habitual sedentary college students.
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China has already entered the aging society.Cardiovascular and cerebrovascular diseases, chronic obstructive pulmonary diseases, chronic kidney disease, type 2 diabetes and other chronic diseases showed a high prevalence in the elderly.Polypharmacy and multimorbidity also represent a major problem for elderly patients.Physical function, as a key factor in the maintainence of intrinsic capabilities for older adults, is increasingly valued by clinicians.Studies at home and abroad show that early decline in physical function may be an early sign of preclinical disease status.Early functional assessment for older adults is helpful to identify disease risk and disease-related adverse events, as well as optimizing health management for this population.
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ABSTRACT Objectives: Analyze wrist wrap influence on the values of maximum handgrip strength and dynamic resistance. Methods: A controlled randomized cross-over trial including 54 Crossfit participants randomly assigned to two groups. Group 1 began the series of tests with control wrapping, and Group 2 started with functional wrapping. Alternate series of four dynamic grip strength resistance tests were performed, and the resistance and fatigue values were calculated. Results: The values obtained from the grip tests did not indicate any effect from the wrist wrap for an increase in maximum grip strength (35.7 vs. 35.6 kg; p=0.737) or greater endurance (78.2 vs. 77.8%; p=0.549). Fatigue was also equal in both groups (mean differences between the groups: 0.1 kg, CI= -0.7-0.8; p=0.779). Conclusion: The hypothesis that using a wrist wrap increases maximum strength and dynamic handgrip endurance was rejected in this study. Evidence Level I; Randomized control trial .
RESUMO Objetivos: Analisar a influência do uso da munhequeira no valor máximo de força e na resistência dinâmica de preensão palmar. Métodos: Foi feito um ensaio controlado randomizado cruzado (cross-over) incluindo 54 praticantes de Crossfit. Os participantes foram alocados em dois grupos de forma aleatorizada. O grupo 1 iniciou a bateria de testes com enfaixamento placebo e o grupo 2 iniciou com enfaixamento funcional. Séries alternadas de quatro testes dinâmicos de resistência foram realizadas e os valores de resistência e fadiga foram calculados. Resultados: Os resultados apontaram para uma ausência de efeito do enfaixamento do punho tanto para um suposto aumento da força máxima de preensão (35,7 vs 35,6 kg; p=0,737) quanto para uma maior resistência (78,2 vs 77,8%; p=0,549). A fadiga também foi igual entre os dois grupos (média das diferenças entre os grupos: 0,1kg, CI: -0,7 - 0,8; p=0,779). Conclusão: A hipótese de que o uso da munhequeira aumenta o valor máximo de força e a resistência dinâmica de preensão palmar foram rejeitadas neste estudo. Nível de evidência I; Estudo clínico randomizado .
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ABSTRACT Objective Neck circumference is a simple anthropometric measurement that may be linked to chronic diseases, physical activity, and muscle strength. We sought to verify the association of moderate and vigorous physical activity levels and relative muscle strength with neck circumference in a community in southern Brazil. Methods We cross-sectionally analyzed data from 2,488 participants (51% women), aged 20-79 years old from the Study of Health in Pomerode (SHIP-Brazil) conducted in Pomerode, Santa Catarina, Brazil. Increased neck circumference was defined with cutoff points of >39cm for men and >35cm for women. The independent variables were the level of moderate and vigorous physical activity using the short International Physical Activity Questionnaire, and relative muscle strength using the handgrip test and body mass. Univariate and multiple Poisson regression models were used to determine the association between variables (p≤0.05). Results The prevalence of increased neck circumference was 48.2% (60.4% in men, 39.6% in women) and was associated with low relative muscle strength (PR=1.26, 95%CI: 1.17-1.35) in men, insufficient moderate and vigorous physical activity levels (PR=1.23, 95%CI: 1.14-1.32), and relative muscle strength (PR=1.73, 95%CI: 1.61-1.87) in women. After adjusting for covariates, no significant associations were observed between insufficient moderate and vigorous physical activity levels in men (PR=1.02, 95%CI: 0.95-1.07). Conclusion Increased neck circumference seems to be an important predictor of low moderate and vigorous physical activity and relative strength loss in adults, and more pronounced in women.
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ABSTRACT Objective: to analyze handgrip strength as a predictor of the inability to drive in older adults. Method: a cross-sectional study conducted in traffic clinics with 421 older adults in Curitiba-Paraná from January 2015 to December 2018. A sociodemographic and clinical questionnaire, handgrip strength test, and queries from the National Registry of Qualified Drivers form were applied. Results: Reduced handgrip strength was not a predictor of inaptitude for vehicular driving (p=0.649). The predictors of inaptitude were: low education (p=0.011), incomplete elementary education (p=0.027), and cognition (p=0.020). Conclusion: reduced handgrip strength was not shown to predict for loss of driving skills in older adults. Low education level and reduced cognition level are conditions that were shown to be predictors for loss of vehicular driving license.
RESUMEN Objetivo: analizar la fuerza de prensión manual como factor predictivo de inaptitud para la conducción vehicular de adultos mayores. Método: se trata de un estudio transversal llevado a cabo en clínicas de tránsito de Curitiba, Paraná, entre 421 adultos mayores, de enero de 2015 a diciembre de 2018. Se aplicaron los cuestionarios sociodemográfico y clínico, la prueba de fuerza de prensión manual y se consultó el formulario del Registro Nacional de Conductores Habilitados. Resultados: la fuerza de prensión manual reducida no fue un factor predictivo de la incapacidad para conducir (p=0,649). Los predictores de inaptitud fueron: baja educación (p=0,011), estudios primarios incompletos (p=0,027) y cognición (p=0,020). Conclusión: la fuerza de prensión manual reducida no demostró ser predictora de la pérdida de habilidades de conducción vehicular en adultos mayores. El nivel de escolaridad bajo y el nivel cognitivo reducido despuntaron como predictores de la pérdida de habilitación en la conducción vehicular.
RESUMO Objetivo: analisar a força de preensão manual como preditora de inaptidão para condução veicular de idosos. Método: estudo transversal realizado em clínicas de trânsito com 421 idosos em Curitiba-Paraná de janeiro de 2015 a dezembro de 2018. Aplicaram-se questionários sociodemográfico e clínico, teste de força preensão manual e consultas ao formulário de Registro Nacional de Condutores Habilitados. Resultados: A força de preensão manual reduzida não se mostrou preditora de inaptidão para a direção veicular (p=0,649). Os preditores de inaptidão foram: baixa escolaridade (p=0,011), ensino primário incompleto (p=0,027) e cognição (p=0,020). Conclusão: a força de preensão manual reduzida não se mostrou preditora para perda da habilitação na condução veicular de idosos. O baixo nível de escolaridade, o nível de cognição reduzida, são condições que se mostraram preditoras para a perda da habilitação na condução veicular.
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ABSTRACT Objective: To evaluate handgrip strength (HGS) as a diagnostic tool for frailty risk in elderly patients with asthma, as well as to investigate the prevalence of frailty in this population. Methods: This was a cross-sectional study including 96 patients ≥ 60 years of age diagnosed with moderate to severe asthma and treated at a tertiary referral center in Brazil. We measured HGS using a calibrated hydraulic hand dynamometer. We used a frailty scale and the AUC to assess the diagnostic accuracy of the HGS test. Results: The median age of participants was 67 years. Most (78%) were women and non-White (91%) of low socioeconomic status. HGS identified those at risk for frailty, with an AUC of 71.6% (61.5-80.4%; p < 0.002), as well as a sensitivity of 73.58% and a specificity of 67.53%, on the basis of a cutoff of ≤ 19 kgf. Conclusions: HGS appears to be a simple, reliable tool for clinicians to determine frailty risk in older asthma patients in a point-of-care setting.
RESUMO Objetivo: Avaliar a força de preensão manual (FPM) como ferramenta diagnóstica de risco de fragilidade em pacientes idosos com asma e investigar a prevalência de fragilidade nessa população. Métodos: Estudo transversal com 96 pacientes com idade ≥ 60 anos e diagnóstico de asma moderada a grave, atendidos em um centro terciário de referência no Brasil. Medimos a FPM com um dinamômetro hidráulico manual calibrado. Usamos uma escala de fragilidade e a ASC para avaliar a precisão diagnóstica do teste de FPM. Resultados: A mediana da idade dos participantes foi de 67 anos. A maioria eram mulheres (78%) não brancas (91%) cujo nível socioeconômico era baixo. O ponto de corte de FPM ≤ 19 kgf identificou os participantes que apresentavam risco de fragilidade, com ASC = 71,6% (61,5-80,4%; p < 0,002), sensibilidade = 73,58% e especificidade = 67,53%. Conclusões: A FPM parece ser uma ferramenta simples e confiável para determinar, no próprio local de atendimento médico, o risco de fragilidade em pacientes idosos com asma.
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Resumo Objetivo Definir pontos de corte para os valores do teste de força máxima de preensão palmar (FMPP) em pessoas idosas longevas. Método Estudo transversal com amostra de pessoas idosas longevas, octogenárias e nonagenárias, saudáveis e independentes funcionais (grupo robusto) e frágeis (grupo frágil). O teste de FMPP foi realizado em triplicata, sendo considerado o maior valor obtido. Os valores de sensibilidade, especificidade e os pontos de corte foram calculados por meio da Curva Característica de Operação do Receptor (ROC). Foram utilizados os pontos de corte brasileiros e os do Consenso Europeu de Sarcopenia para estudo da comparação. Resultados Foram avaliadas 121 pessoas idosas, com idade média de 84,5±5,3 anos, 65 (53,7%) do sexo feminino, sendo 46 (38%) do grupo frágil e 75 (62%) do grupo robusto. Foram encontrados os pontos de corte para FMPP de 27 kgf para homens e 19 kgf para mulheres. Os valores de sensibilidade e especificidade para os pontos de corte masculinos foram 94,44 e 65,79, respectivamente. Para o sexo feminino foram de 85,71 e 67,57. A partir desses pontos de corte, 23 (38,3%) pessoas idosas do grupo robusto foram classificadas com força inadequada, e, portanto, com provável sarcopenia, ao passo que, de acordo com os pontos de corte brasileiros e europeus, o número é de 35 (44,3%) e 14 (33,3%), respectivamente. Conclusão O estudo definiu pontos de corte para a população longeva e mostrou que os pontos de corte definidos até o momento para a população idosa brasileira não se mostraram adequados para longevos.
Abstract Objective To define cut-off points for the values of the Maximum Handgrip Strength (MGS) test in long-lived elderly people. Method Cross-sectional study with a sample of long-lived elderly people, octogenarians and nonagenarians, healthy and functionally independent (robust group) and frail (fragile group). The MHS test was performed in triplicate, with the highest value obtained being considered. Sensitivity, specificity and cut-off values were calculated using the Receiver Operating Characteristic Curve (ROC). The Brazilian cut-off points and those of the European Consensus on Sarcopenia were used for the comparison study. Results 121 elderly people were evaluated, with a mean age of 84.5±5.3 years, 65 (53.7%) female, 46 (38%) from the frail group and 75 (62%) from the robust group. Cut-off points for MHS of 27 kgf for men and 19 kgf for women were found. Sensitivity and specificity values for men's cutoffs were 94.44 and 65.79, respectively. For woman, they were 85.71 and 67.57. Based on these cutoff points, 23 (38.3%) individuals from the robust group were classified as having competitive strength, and therefore with probable sarcopenia, while according to the Brazilian and European cutoff points, the number is 35 (44.3%) and 14 (33.3%). Conclusion The study defined cut-off points for the oldest-old population and showed that the cut-off points defined so far for the Brazilian elderly population were not adequate for the oldest-old.
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Abstract Background Neuromuscular diseases are acquired or inherited diseases that affect the function of the muscles in our body, including respiratory muscles. Objective We aimed to discover more cost-effective and practical tools to predict respiratory function status, which causes serious problems with patients with neuromuscular disease. Methods The Vignos and Brooke Upper Extremity Functional Scales were used to evaluate functional status for patient recruitment. The handgrip strength and dexterity of patients were measured using a dynamometer and nine-hole peg test. Respiratory function parameters: forced vital capacity, forced expiratory volume in one second, and peak expiratory flow were evaluated using spirometry. Results The mean age of the 30 patients was 11.5 ± 3.79 years old. Significant relationships were found between nine-hole-peg-test scores and respiratory function parameters on both sides. Significant correlations were found between both handgrip strength and respiratory function parameters (p< 0.05). In the linear regression analysis, it was seen that the forced expiratory volume in 1 second, and peak expiratory flow values could be explained in different percentages (p< 0.05). Conclusions Handgrip strength and dexterity measurements can be used as indicators for estimating respiratory function parameters in terms of cost and accessibility, although it is known that they will not replace respiratory function tests.
Resumo Antecedentes As doenças neuromusculares são doenças adquiridas ou hereditárias que afetam a função dos músculos do nosso corpo, incluindo os músculos respiratórios. Objetivo Nosso objetivo foi descobrir ferramentas mais práticas e econômicas para prever o estado da função respiratória, que causa sérios problemas em pacientes com doença neuromuscular. Métodos As Escalas Funcionais da Extremidade Superior de Vignos e Brooke foram utilizadas para avaliar o estado funcional para recrutamento de pacientes. A força de preensão manual e a destreza dos pacientes foram medidas por meio de um dinamômetro e do teste de nove buracos. Os parâmetros da função respiratória: capacidade vital forçada, volume expiratório forçado no primeiro segundo e pico de fluxo expiratório foram avaliados por meio da espirometria. Resultados A média de idade dos 30 pacientes foi de 11,5 ± 3,79 anos. Relações significativas foram encontradas entre as pontuações do teste de nove buracos e os parâmetros da função respiratória em ambos os lados. Correlações significativas foram encontradas entre a força de preensão manual e os parâmetros da função respiratória (p< 0,05). Na análise de regressão linear, observou-se que o volume expiratório forçado no primeiro segundo e os valores de pico de fluxo expiratório puderam ser explicados em diferentes percentuais (p< 0,05). Conclusões As medidas de força de preensão manual e destreza podem ser utilizadas como indicadores para estimar parâmetros da função respiratória em termos de custo e acessibilidade, embora se saiba que não substituirão os testes de função respiratória.
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Introdução: O processo de envelhecimento ocasiona alterações no sistema cardiovascular e afeta a capacidade funcional. Objetivo: Analisar as associações entre indicadores sociodemográficos, índice de massa corporal (IMC), comorbidades, nível de atividade física (NAF) e força de preensão palmar (FPP) na variabilidade da frequência cardíaca (VFC) em idosos. Métodos: Estudo transversal com idosos participantes de grupos de convivência no município de Tubarão, Santa Catarina. As variáveis sexo, idade, altura, peso, tabagismo e comorbidades foram autorreferidas. O NAF foi calculado pelo Questionário Internacional de Atividade Física (IPAQ) versão curta. Os dados da VFC foram obtidos com um cardiofrequencímetro, sendo extraídos os componentes FC média (frequência cardíaca média), SDNN (desvio-padrão de todos os intervalos RR), RMSSD (raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes), RRTri (índice triangular), LF (componente de baixa frequência), HF (componente de alta frequência) e LF/HF (razão entre os componentes de baixa e alta frequência). A FPP foi mensurada com um dinamômetro. Resultados: Participaram 73 idosos com mediana (p25-p75) de idade de 77,0 (68,5 - 77,0) anos, sendo 65 (89%) mulheres. Verificou-se aumento de HF nos homens e RMSSD superior na faixa etária de 70 a 80 anos. Ocorreu diminuição da FC média e aumento de RRTri e LF quando NAF moderado/alto. Um acréscimo de SDNN, RMSSD e HF foi observado em valores diminuídos de FPP das mulheres. Conclusão: Sexo, faixa etária, NAF e FPP das mulheres estiveram associados na modulação autonômica cardíaca, enquanto que IMC, comorbidades, tabagismo e FPP dos homens não interferiram significativamente.
Introduction: The aging process causes changes in the cardiovascular system and affects functional capacity. Objective: To analyze the associations between sociodemographic indicators, body mass index (BMI), comorbidities, level of physical activity (LPA), and grip strength (GS) in heart rate variability (HRV) in the elderly. Methods: A cross-sectional study was carried out with elderly participants of socialization groups in Tubarão, Santa Catarina. The variables sex, age, height, weight, smoking, and comorbidities were self-reported. The LPA was calculated by the short version of the International Physical Activity Questionnaire (IPAQ). The HRV data were obtained with a cardiofrequency meter, and the following components were extracted: mean HR (mean heart rate), SDNN (standard deviation of all RR intervals), RMSSD (square root of the mean square of the differences between adjacent normal RR intervals), RRTri (triangular index), LF (low frequency component), HF (high frequency component) and LF/HF (ratio between low and high frequency components). The measuring of GS was with a dynamometer. Results: 73 elders participated, with a median (p25p75) age of 77.0 (68.5 77.0) years, 65 (89%) of whom were women. An increased HF in men and higher RMSSD in the 70 to 80 years old age group were verified. A decrease in mean HR and an increase in RRTri and LF occurred when moderate/high LPA. The study showed an increase in SDNN, RMSSD, and HF in decreased GS values of women. Conclusion: Sex, age group, LPA, and GS of women were associated with cardiac autonomic modulation, while BMI, comorbidities, smoking, and GS of men did not interfere significantly.
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EnvelhecimentoRESUMO
Objective: To compare and correlate handgrip strength (HGS) with functional capacity and cognitive status in centenarians. Method: This is a cross-sectional study. The study population consisted of 127 centenarians, of which 78 met the inclusion criteria, with a mean age of 101.7 ± 2.52 years. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and functional capacity using the Katz Scale. To investigate HGS, we used a manual dynamometer. The level of significance was 5%. Results: Centenarian men have higher right (p= 0.005) and left (p<0.001) HGS compared to women. About functional capacity, centenarians more functional present higher right and left HGS (p<0.001) when compared to intermediate and less functional. Furthermore, when analyzing cognition, centenarians with preserved cognitive status have higher right and left HGS (p<0.001) than cognitively impaired elderly. In the relationship analysis, it was possible to verify that the lower the MMSE score, the higher the right (rho= 0.59; p<0.001) and left (rho= 0.57; p<0.001) HGS. Furthermore, the lower the Katz Scale score, the higher the right (rho= -0.53; p<0.001) and left (rho= -0.57; p<0.001) HGS. Conclusion: Our results show that male centenarians, more functional and with preserved cognitive status have higher HGS in both hands. Moreover, we found a moderate negative relationship between HGS and functional capacity and a moderate positive relationship between HGS and cognitive status of centenarians.
Objetivo: Comparar e correlacionar a força de preensão manual (HGS) com a capacidade funcional e o estado cognitivo em centenários. Método: Este é um estudo de corte transversal. A população do estudo consistiu em 127 centenários, dos quais 78 preenchiam os critérios de inclusão, com uma idade média de 101,7 ± 2,52 anos. O estado cognitivo foi avaliado utilizando o Mini-Mental State Examination (MMSE) e a capacidade funcional utilizando a Escala Katz. Para investigar o HGS, utilizamos um dinamômetro manual. O nível de significância foi de 5%. Resultados: Os homens centenários têm o HGS mais alto à direita (p= 0,005) e à esquerda (p<0,001) em comparação com as mulheres. Quanto à capacidade funcional, os centenários mais funcionais apresentam HGS mais altos à direita e à esquerda (p<0,001) quando comparados com os intermediários e menos funcionais. Além disso, ao analisar a cognição, os centenários com estado cognitivo preservado têm HGS direito e esquerdo mais elevados (p<0,001) do que os idosos com deficiência cognitiva. Na análise da relação, foi possível verificar que quanto mais baixa a pontuação MMSE, mais alta a direita (rho= 0,59; p<0,001) e esquerda (rho= 0,57; p<0,001) HGS. Além disso, quanto mais baixa a pontuação da Escala Katz, mais alta a direita (rho= -0,53; p<0,001) e esquerda (rho= -0,57; p<0,001) HGS. Conclusão: Os nossos resultados mostram que os centenários masculinos, mais funcionais e com estatuto cognitivo preservado, têm HGS mais elevado em ambas as mãos. Além disso, encontramos uma relação negativa moderada entre HGS e capacidade funcional e uma relação positiva moderada entre HGS e estado cognitivo dos centenários.