Association Between Relative Grip Strength, Insulin Resistance, and Nonalcoholic Fatty Liver Disease Among Middle-Aged and Older Adults: A Prospective Cohort Study.

Introduction: This study aims to investigate the combined association between insulin resistance (IR) levels, relative grip strength (RGS), and the incidence of nonalcoholic fatty liver disease (NAFLD), stratified by sex, using longitudinal data. Methods: The study included 1702 adult participants aged 51-88 years who completed surveys in both 2013-2014 and during a subsequent follow-up in 2019-2020. NAFLD was assessed using the hepatic steatosis index, and RGS was measured using the JAMA-5030J1 equipment (SAEHAN, Korea). To assess the interaction between RGS and IR levels and their impact on NAFLD risk, we employed a proportional hazards Cox regression model. Hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated for NAFLD incidence. Results: After adjusting for various confounding variables, we observed a significant decrease in NAFLD risk in the middle RGS group (HR = 0.70, 95% CI = 0.53-0.93) and high RGS group (HR = 0.31, 95% CI = 0.22-0.44) compared to the low RGS group. In addition, significant sex differences were noted in the relationship between IR, RGS levels, and NAFLD incidence across different groups. Conclusions: This study highlights that higher RGS levels are independently associated with a reduced risk of developing NAFLD. Notably, RGS emerges as a predictive indicator for assessing NAFLD risk.

Hand functioning in progressive multiple sclerosis improves with tDCS added to daily exercises: A home-based randomized, double-blinded, sham-controlled clinical trial.

BACKGROUND: Many individuals with progressive multiple sclerosis (PMS) are challenged by reduced manual dexterity and limited rehabilitation options. Transcranial direct current stimulation (tDCS) during motor training can improve rehabilitation outcomes. We developed a protocol for remotely supervising tDCS to deliver sessions of stimulation paired with training at home. OBJECTIVE: This study evaluated the effectiveness of at-home tDCS paired with manual dexterity training for individuals with PMS. METHODS: Sixty-five right-hand dominant participants with PMS and hand impairment were randomized to receive either active or sham M1-SO tDCS paired with manual dexterity training over 4 weeks. Clinical outcomes were measured by the changes in Nine-Hole Peg Test (9-HPT) and Dellon-Modified-Moberg-Pick-Up Test (DMMPUT). RESULTS: The intervention had high rates of adherence and completion (98% of participants completed at least 18 of 20 sessions). The active tDCS group demonstrated significant improvement for the left hand compared with baseline in 9-HPT (-5.85 ± 6.19 vs -4.23 ± 4.34, p = 0.049) and DMMPUT (-10.62 ± 8.46 vs -8.97 ± 6.18, p = 0.049). The active tDCS group reported improvements in multiple sclerosis (MS)-related quality of life (mean increase: 5.93 ± 13.04 vs -0.05 ± -8.27; p = 0.04). CONCLUSION: At-home tDCS paired with manual dexterity training is effective for individuals with PMS, with M1-SO tDCS enhancing training outcomes and offering a promising intervention for improving and preserving hand dexterity.

Force control of pinch grip: Normative data of a holistic evaluation.

BACKGROUND: Pulp pinch (PP) is a vital hand movement involving muscle strength and sensory integration. Previous research has primarily focused on Maximal Voluntary Contraction, but PP encompasses broader parameters. PURPOSE: This study aims to establish normative data for a comprehensive evaluation of thumb and index force control during PP, including endurance, precision, accuracy in unilateral PP, and force coordination in bilateral PP. STUDY DESIGN: A cross-sectional study. METHODS: Three hundred and twenty eight healthy Italian cis-gender participants (169 females, 159 males) were enrolled in a multiparametric force control evaluation of pinch grip, consisting in: sustained contraction (SC: ability to maintain a stable contraction at 40% MVC, measured as the time until exhaustion), dynamic contraction (DC: the ability to modulate precisely and accurately force output to follow a dynamic force trace), bimanual strength coordination (BSC: the ability to coordinate in-phase bimanual forces at different combined magnitudes) tasks. The sample was divided per sex and stratified in five age groups taking into account hand dominance. Differences in tasks' results between age, sex and hand-dominance were analysed. RESULTS: Endurance (SC) was similar between younger and older adults (η2 =0.047 (Females) and η2 < 0.007 (Males)). Older adults exhibited lower precision (DC) and coordination (BSC) compared to young adults in both sexes (η2 >0.16). Females demonstrated greater endurance (SC) but lower precision and coordination (BSC) compared to males (0.01 <η2 <0.1). No hand dominance effect emerged in SC and DC. CONCLUSIONS: Force accuracy and precision to modulate pinch force to perform a visual feedback force-matching task (DC) and force coordination between hands (BSC) worsen at increasing age. Hand dominance did not influence either endurance or precision of pinch grip in visual-feedback guided task.

Assessing the Metabolic and Physical Effects of Combined DPP4 and SGLT2 Inhibitor Therapy in Patients with Type-2 Diabetes Mellitus: An Observational Prospective Pilot Study.

Introduction: This study aimed to assess the efficacy of combined administration of dipeptidyl peptide-4 (DPP4) and sodium-glucose cotransporter-2 (SGLT2) inhibitors on metabolic disorders and their preferable and complementary effects. Methods: The effectiveness of a 24-week intervention on metabolic parameters (including glucose profile), physical functions (grip strength and calf circumference), and health-related quality of life (HR-QOL) was analyzed using the International Physical Activity Questionnaire and Geriatric Depression Scale 5. A total of 39 patients with type-2 diabetes mellitus (T2DM) treated with the combination of DPP4 and SGLT2 inhibitors were included in this multicenter pilot study. Results: Combination therapy significantly reduced the HbA1c level (median [interquartile range]) after 24 weeks (pretreatment: 7.7% [7.3-8.2] vs. posttreatment: 7.1% [6.6-7.9], P < 0.001). The grip strength significantly increased after 24 weeks (1.7 ± 2.7 kg, P < 0.001), while the mean calf circumference and body mass index significantly decreased. In particular, administration of the SGLT2 inhibitor significantly increased total physical activity in participants aged ≥65 years (P = 0.003), while psychological QOL did not significantly improve. Conclusions: Combination therapy with DPP4 and SGLT2 inhibitors decreased HbA1c levels and improved physical function in patients with T2DM. This study confirmed the effectiveness of combination therapy for metabolic disorders and suggested its beneficial and complementary effects. Therefore, advances in treatment plans to achieve further improvements in glucose profiles using DPP4 and SGLT2 inhibitors are recommended to enhance the QOL of patients with T2DM. Clinical trial number: University Hospital Medical Information Network Center: UMIN000045375.

Handgrip Strength and Clinical Evolution of People Living with HIV: A Mini Narrative Review.

HIV infection is a worldwide epidemic. Antiretroviral therapy allows people living with HIV (PLHIV) increased longevity and a better quality of life. Among the various ways of monitoring the clinical evolution of PLHIV, handgrip strength (HGS) is a promising strategy, as this test can be used to assess the health condition quickly and at a low cost. In this sense, the present study aims to describe, through a literature review, the relationship between HGS and the clinical evolution of PLHIV, especially with morbimortality. Initially, it is highlighted that aging, HIV infection, and excess body fat are related to the loss of HGS in PLHIV. Furthermore, PLHIV is more likely to present cardiometabolic diseases that can be aggravated by reduced HGS. Thus, in people without positive HIV serology, low HGS indirectly, through the presence of risk factors or cardiometabolic diseases, or directly increases the chance of mortality. In conclusion, the lack of studies on this topic for PLHIV is highlighted, and more longitudinal studies, including control groups, are needed.

Reliability and Validity of the Martin Vigorimeter for Grip Strength Measurement in Korean Adults.

Background: Grip strength is important for fine motor skills, and one of the measurement tools for grip strength is the Martin Vigorimeter (MV) dynamometer. Studies on establishing the reliability and validity of the MV in Koreans are limited. We aimed to establish the reliability and validity of the MV for grip strength measurement in healthy Korean adults by comparing it with the Jamar dynamometer, the standard tool used by the American Society of Hand Therapists. Methods: In total, 99 healthy participants (50 men and 49 women) were enrolled. Grip strength was measured using the Jamar dynamometer and MV. Reliability and validity were assessed using the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the measurements of the instruments was analyzed using Pearson's correlation. The effect of hand anthropometry was evaluated, and the conversion equation between the instruments was calculated. Results: MV showed excellent reliability (ICC > 0.90, p < 0.001) and validity with a high correlation (0.7 ≤ r < 0.9) with the Jamar dynamometer. The MDC was acceptable for detecting minimal clinically important differences (< 19.5%) in both instruments (Jamar: 3.4%-6.7%, MV: 3.8% to 6.3%). The grip strength measured using the MV was independent of hand anthropometry, unlike that using the Jamar dynamometer. Conclusions: This study provides insights into the relationship between the Jamar and MV instruments for measuring grip strength in Koreans. The MV is a viable alternative to the Jamar dynamometer in Koreans, offering not only reproducible and reliable measurements of grip strength but also the advantage of being unaffected by variations in hand anthropometry.

Impact of manual dexterity on toothbrushing efficacy in typically developing children: A cross-sectional study.

BACKGROUND: Manual dexterity includes gross motor skills (GMS) and fine motor skills (FMS). Literature reports manual dexterity as a contributing factor for improved oral hygiene and that the required dexterity for toothbrushing develops above 8 years of age. Research suggests grip force, movement speed, and motor coordination should be assessed to improve knowledge on kinetics of brushing teeth. AIM: To assess the impact of manual dexterity on toothbrushing efficacy in 7 to 12 year old children. DESIGN: The cross-sectional study included 150 typically developing 7-12 year old children. Oral health status was recorded using the Decayed, Missing, and Filled Teeth index. GMS and FMS were evaluated using the MInnesota Manual Dexterity Test (MMDT) and Archimedes spiral test (AST), respectively. Toothbrushing efficacy was determined by Turesky modification of Quigley-Hein Plaque Index- difference in mean scores from before and after toothbrushing. RESULTS: Assessment of GMS, FMS, and toothbrushing efficacy using ANOVA showed a significant increase with age (p value: 0.000); unpaired t-test showed an association of toothbrushing efficacy with GMS and FMS irrespective of age (p value: 0.000). CONCLUSION: Manual dexterity was significantly associated with toothbrushing efficacy in typically developing children. AST, a simple test to determine FMS, may help paediatric dentists to guide parents on the supervision of toothbrushing for their child.

A cross-sectional study evaluating grip strength and associated factors in Turkish nurses and nursing students.

BACKGROUND: Grip strength is an important indicator of muscle strength. Nursing job demands physical power, which is related to their muscle strength. However, studies on nurses' grip strength remains lacking. OBJECTIVE: This study aims to examine the differences in grip strength between staff nurses and nursing students and to identify factors associated with grip strength in nursing sample. METHOD: This study was designed as descriptive and analytical. Data collected from nursing students and staff nurses in Turkiye, from May 1 to September 30, 2022. A total of 200 staff nurses and 200 nursing students participated. Data tool included a participant information form, the Perceived Stress Scale-4 (PSS-4), and the Nordic Musculoskeletal Questionnaire (NMQ). Moreover, researchers assessed the anthropometric measurements using the same scale and grip strength using a digital hand dynamometer. RESULTS: There was no significant difference in grip strength of staff and student nurses. 48.8% of participants met or exceeded Turkish normative values. 79.5% of staff nurses and 66.0% of nursing students reported musculoskeletal issues in the last 12 months. Height, waist-to-hip ratio, and neck circumference was found to be significant predictors of grip strength, explaining 57% of the variance. CONCLUSION: Grip strength was similar between staff nurses and nursing students, despite differences in age, BMI, and musculoskeletal issues. Height, waist-to-hip ratio, and neck circumference are key predictors of grip strength in this Turkish nursing sample. Understanding the factors influencing grip strength can help in designing targeted interventions to maintain and improve muscle strength in nursing professionals.

The Impact of Hand Strength on HbA1c, Body Mass Index and Body Composition by Group According to Sedentary Behaviour: Cross-Sectional Study in Japanese Patients with Type 2 Diabetes Mellitus.

Background: The impact of hand strength in consideration of sedentary behaviour on diabetes management in patients with type 2 diabetes mellitus (T2DM) is unclear. The purpose of this study was to examine the impact of hand strength on HbA1c, body mass index (BMI) and body composition by group according to the duration of sedentary behaviour in Japanese patients with T2DM. Methods: In this retrospective, cross-sectional, single-centre study, hand strength standardised by bodyweight (GS) and sedentary time (ST), were obtained and analysed in a total of 270 Japanese T2DM outpatients in 2021. After dividing the patients into four categories of median values (high and low GS, and long and short ST), odds ratios (ORs) for good control of HbA1c, BMI, waist circumference (WC) and intra-abdominal fat (IAF) were investigated using logistic regression models. Results: The high GS/short ST group was found to have a significantly higher (OR = 2.01; 95% CI: 1.00, 4.03; P = 0.049) for controlled HbA1c compared with that of the low GS/long ST group. The high GS/short ST and the high GS/long ST groups had significantly higher ORs for controlled BMI, WC and IAF compared with the OR of the low GS/long ST group. In addition, the ORs were significantly increased with a positive trend in order from low GS/long ST, low GS/short ST, high GS/long ST, to high GS/short ST in all models (P < 0.001 for trend). Conclusion: Hand strength, with modest effects from sedentary behaviour, could be helpful for diabetes management in T2DM patients.

Genetic Variation and Stroke Recovery: The STRONG Study.

BACKGROUND: Genetic association studies can reveal biology and treatment targets but have received limited attention for stroke recovery. STRONG (Stroke, Stress, Rehabilitation, and Genetics) was a prospective, longitudinal (1-year), genetic study in adults with stroke at 28 US stroke centers. The primary aim was to examine the association that candidate genetic variants have with (1) motor/functional outcomes and (2) stress-related outcomes. METHODS: For motor/functional end points, 3 candidate gene variants (ApoE ε4, BDNF [brain-derived neurotrophic factor], and a dopamine polygenic score) were analyzed for associations with change in grip strength (3 months-baseline), function (3-month Stroke Impact Scale-Activities of Daily Living), mood (3-month Patient Health Questionnaire-8), and cognition (12-month telephone-Montreal Cognitive Assessment). For stress-related outcomes, 7 variants (serotonin transporter gene-linked promoter region, ACE [angiotensin-converting enzyme], oxytocin receptor, FKBP5 [FKBP prolyl isomerase 5], FAAH [fatty acid amide hydrolase], BDNF, and COMT [catechol-O-methyltransferase]) were assessed for associations with posttraumatic stress disorder ([PTSD]; PTSD Primary Care Scale) and depression (Patient Health Questionnaire-8) at 6 and 12 months; stress-related genes were examined as a function of poststroke stress level. Statistical models (linear, negative binomial, or Poisson regression) were based on response variable distribution; all included stroke severity, age, sex, and ancestry as covariates. Stroke subtype was explored secondarily. Data were Holm-Bonferroni corrected. A secondary replication analysis tested whether the rs1842681 polymorphism (identified in the GISCOME study [Genetics of Ischaemic Stroke Functional Outcome]) was related to 3-month modified Rankin Scale score in STRONG. RESULTS: The 763 enrollees were 63.1±14.9 (mean±SD) years of age, with a median initial National Institutes of Health Stroke Scale score of 4 (interquartile range, 2-9); outcome data were available in n=515 at 3 months, n=500 at 6 months, and n=489 at 12 months. At 1 year poststroke, the rs6265 (BDNF) variant was associated with poorer cognition (0.9-point lower telephone-Montreal Cognitive Assessment score, P=1×10-5). For stress-related outcomes, rs4291 (ACE) and rs324420 (FAAH) were risk factors linking increased poststroke stress with higher 1-year depression and PTSD symptoms (P<0.05), while rs4680 (COMT) linked poststroke stress with lower 1-year depression and PTSD. Findings were unchanged when considering stroke subtype. STRONG replicated GISCOME: rs1842681 was associated with lower 3-month modified Rankin Scale score (P=3.2×10-5). CONCLUSIONS: This study identified genetic associations with cognitive function, depression, and PTSD 1 year poststroke. Genetic susceptibility to PTSD and depressive symptoms varied according to the amount of poststroke stress, underscoring the critical role of lived experiences in recovery. Together, the results suggest that genetic association studies provide insights into the biology of stroke recovery in humans.

Biomarkers of Inflammation and Longitudinal Evaluation of Lung Function, Physical Activity, and Grip Strength: A Secondary Analysis in the CASCADE Study.

Rationale: Physical activity, lung function, and grip strength are associated with exacerbations, hospitalizations, and mortality in people with chronic obstructive pulmonary disease (COPD). We tested whether baseline inflammatory biomarkers were associated with longitudinal outcomes of these physiologic measurements. Methods: The COPD Activity: Serotonin Transporter, Cytokines, and Depression (CASCADE) study was a prospective observational study of individuals with COPD. A total of 14 inflammatory biomarkers were measured at baseline. Participants were followed for 2 years. We analyzed associations between baseline biomarkers and forced expiratory volume in 1 second (FEV1), physical activity, and grip strength. We used a hierarchical hypothesis testing procedure to reduce type I error. We used Pearson correlations to test associations between baseline biomarkers and longitudinal changes in the outcomes of interest. We used Fisher's linear discriminant analysis to test if linear combinations of baseline biomarkers predict rapid FEV1 decline. Finally, we used linear mixed modeling to test associations between baseline biomarkers and outcomes of interest at baseline, year 1, and year 2; models were adjusted for age, smoking status, baseline biomarkers, and FEV1. Results: A total of 302 participants (age 67.5 ± 8.5 years, 19.5% female, 28.5% currently smoking) were included. Baseline biomarkers were not associated with longitudinal changes in grip strength, physical activity, or rapid FEV1 decline. Higher interleukin-6 and C-reactive protein were associated with lower physical activity at baseline and these relationships persisted at year 1 and year 2. Conclusion: Baseline inflammatory biomarkers did not predict changes in lung function or physical activity, but higher inflammatory biomarkers were associated with persistently low levels of physical activity.

Comparison of the Effects of Volar-Assisted and Elastic Wrist Splints on Edema, Pain, Grip Strength, and Functionality in Pregnant Women With Carpal Tunnel Syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is a common musculoskeletal problem in pregnancy. The aim of this study is to compare the effects of rigid and elastic wrist splints on edema, pain levels, grip strength, and upper-extremity functionality in pregnant women with CTS. METHODS: Forty-one pregnant women in the last trimester of pregnancy who were diagnosed with CTS were included in the study. The grip strength was evaluated with the Jamar hand dynamometer, functionality with the Quick Disabilities of the Arm, Shoulder, and Hand and Boston Carpal Tunnel Syndrome Questionnaire, pain with the Visual Analog Scale (VAS), and edema with the water overflow method. RESULTS: The mean age of the participants was 31.71 ± 5.78 years, body mass index was 28.85 ± 3.63 kg/m2, duration of pain was 2.24 ± 0.79 months, and their pain intensity was 6.63 ± 1.69 according to the VAS. As a result of the study, reductions in pain (P = .001), increases in functionality values (P = .001), increases in grip strength (P = .001), and decreases in edema (P = .001) were observed in both groups after the treatment. However, there was no significant difference in pain, functionality, or grip strength values between the groups after the treatment (P > .05). CONCLUSION: In this study comparing the effects of a wrist splint to those of an elastic splint, both treatment methods for pregnant women with CTS decreased pain and edema, increased grip strength, and improved upper-extremity functionality. Considering individual needs, characteristics, and living conditions, both splints can be recommended for pregnant women with CTS.

[Relationship between serum 25-hydroxyvitamin D and handgrip strength in middle-aged and elderly people in five cities of Western China].

OBJECTIVE: To explore the association between serum 25-hydroxyvitamin D [25(OH)D] and handgrip strength in middle-aged and elderly people in 5 cities of Western China. METHODS: Based on the data of a cross-sectional survey conducted in the 5 cities of Western China from February to July 2023, the relevant demographic characteristics of people were collected by questionnaire, handgrip strength was collected by physical examination, and serum 25(OH)D was detected by HPLC-MS/MS. The association between the serum 25(OH)D and handgrip strength was analyzed using Logistic regression and Chi-square test for between-group comparisons models. RESULTS: The prevalence of 25(OH)D deficiency and insufficiency among the middle-aged and elderly people in the 5 cities of Western China was 52.9% and 34.5%, respectively. The people who were older, female, and sampled in winter had lower serum 25(OH)D levels (P < 0.05). The prevalence of loss of handgrip strength among the middle-aged and elderly people was 25.3%. The prevalence of handgrip strength loss was higher in the aged 65-80 participants with 25(OH)D deficiency (45. 0%) than in those with 25(OH)D insufficiency (32.6%) and 25(OH)D sufficiency (20.6%). The highest prevalence of loss of handgrip strength was found in the aged 75-80 participants with 25(OH)D deficiency (62. 1%), followed by the 25(OH)D insufficient group (11.1%, P < 0.05). The study found that middle-aged and elderly people with 25(OH)D deficiency had a 1.4-fold increased risk of handgrip strength loss compared with those with 25(OH)D sufficiency (OR=2.403, 95%CI: 1.202-4.804, P=0.013). No significant association was found between 25(OH)D insufficiency and handgrip strength status in the middle-aged and elderly people. For every 5 µg/L increase in total serum 25(OH)D, the risk of handgrip strength loss reduced by 13.1% (OR=0.869, 95%CI: 0.768-0.982, P=0.025). For every 5 µg/L increase in serum 25(OH)D2, the risk of handgrip strength loss reduced by 24.1% (OR=0.759, 95%CI: 0.582-0.990, P=0.042). No significant association was found between serum 25(OH)D3 levels and the risk of handgrip strength loss. The risk of handgrip strength loss in middle-aged and elderly people was reduced by 25.2% for each incremental increase in the total serum 25(OH)D levels (deficient, insufficient and sufficient) (OR=0.748, 95%CI: 0.598-0.936, P=0.011). The risk of handgrip loss was reduced by 40.0% for each incremental increase in serum 25(OH)D levels in the aged 65-80 and aged 65-69 participants, and by 80.0% for each incremental increase in 25(OH)D levels in the aged 75-80 parti-cipants. CONCLUSION: Serum total 25(OH)D and 25(OH)D2 levels are associated with handgrip strength status in middle-aged and elderly people in the 5 cities of Western China.

Effects of Nordic Walking on Functional Capacity of Women Cohort with Breast Cancer.

Background: Breast cancer is one of the most common tumours and one of the leading causes of death among women in all parts of the world. The aim of this study is to investigate the influence of Nordic walking on the functional capacity of women who have undergone surgery for breast cancer. Methods: The study involved a cohort of women who exercised through Nordic walking for 10 weeks (from March to May 2022). The subjects trained with a licenced instructor (INWA method), with two training sessions per week of 70-80 min each. We collected information on pain, arm mobility, hand grip strength, shoulder joint range of motion bilaterally, circumference of both arms, body mass index, physical activity, aerobic capacity, and endurance. Results: There were 14 women, median age 63. BMI was significantly lower (28.9/28.1; p = 0.013) after training and a difference in shoulder range of motion was better (anteflexion right (142.5/170, p = 0.002), retroflexion right (40/60, p = 0.005), abduction right (135/180, p = 0.005), abduction left (135/180, p = 0.005)). There was no difference in right hand strength, while there was a significant difference in left hand strength (19/20, p = 0.007). A correlation was found between BMI and the six-minute walk test (r = -0.70; p = 0.005). Conclusions: Considering the multidimensionality of the disease itself and the results of this study, we believe that Nordic walking is a favourable and good choice of physical activity for breast cancer patients.

Effects of Kin Ball Initiation: Pre- and Post-Pandemic Impact on Palmar Muscle Strength, Endurance, and Coordination in Non-Athlete Participants.

The aim of our research is to introduce Kin Ball for the first time in Romania and assess its impact on the motor capacities of practitioners, particularly focusing on its potential contribution to developing motor skills in young students within the academic sphere, despite the challenges posed by the COVID-19 pandemic. DESIGN: A retrospective, case-control study with a focus on four distinct research groups. SETTING: The research was conducted in a camp setting, situated in the mountainous region of Bughea de Sus, Romania. PARTICIPANTS: The study included 94 students, comprising 54 boys and 40 girls, with an overall average age of 20.85 ± 2 years. All participants were classified as non-athletes based on their level of sports practice. INTERVENTIONS: The Kin Ball initiation program, a key component of the study, comprised 20 training sessions conducted in 10-day stages, systematically evaluating participants' motor skills. MAIN OUTCOME MEASURES: The study assessed palmar muscle strength, endurance, and co-ordination function. RESULTS: Statistical analyses, including the Kolmogorov-Smirnov test, revealed notable differences in the initiation process and significant variations (p < 0.05) in all measurements performed in 2022. In 2019, the tests recorded both significant and statistically insignificant differences, as indicated by the calculation of Cohen's d indicator. CONCLUSIONS: The study underscored the influence of reduced movement during the pandemic on motor skills and highlighted Kin Ball's potential as an alternative sport within physical education curricula. Despite lower baseline motor capacities observed in 2022, participants exhibited significant progress, emphasizing Kin Ball's capacity to improve physical skills. These findings underscore the importance of alternative sports such as Kin Ball in fostering holistic personal development and mitigating the impact of pandemic-induced disruptions on motor skills.

Asociación de fuerza prensil y extensores de rodilla con estado nutricional de adultos mayores pertenecientes a la comunidad / Association of grip strength and knee extensors with nutritional status of community-dwelling older adults

Antecedentes y objetivo: Determinar la asociación de fuerza prensil de mano y extensores de rodilla con el estado nutricional de adultos mayores de la comunidad. Material y métodos: Estudio observacional transversal. Se analizó peso y talla de 847 adultos mayores según índice de masa corporal y se clasificaron en cuatro categorías nutricionales según el Ministerio de Salud de Chile. Se evaluó la fuerza prensil de mano y extensores de rodilla para ambas extremidades. La fuerza fue normalizada por masa corporal y se utilizó la correlación de Spearman entre índice de masa corporal y fuerza muscular. Resultados: La muestra fue de 582 mujeres y 265 hombres con edad promedio de 71,72±7,09. Las mujeres presentaron un índice de masa corporal de 30,03±5,48 y los hombres 27,64±4,05, la categoría más numerosa fue normopeso (n = 288) y la menor bajo peso (n = 74). La fuerza prensil de mano presentó mayor correlación que extensores de rodilla, específicamente, fuerza prensil de mano derecha (r: -0,40). La mayor correlación y significancia la presentó la categoría obesa para todas las mediciones de fuerza, resultando la fuerza prensil de mano derecha como la más alta (r: -0,29). Conclusiones: El aumento del estado nutricional de los adultos mayores influye negativamente sobre la fuerza muscular. La mejor asociación entre índice de masa corporal y fuerza muscular fue la prensión de mano derecha. Resalta el hallazgo del aumento de la esperanza de vida a medida que disminuye el IMC de la muestra. Futuros estudios deberían generar percentiles y valores normalizados en población chilena.(AU)

Aim: To determine the association of hand grip strength and knee extensor strength with the nutritional status of community-dwelling older adults. Material and methods: Observational cross-sectional study. Weight and height of 847 older adults were analyzed according to body mass index and classified into four nutritional categories according to the Chilean Ministry of Health. Hand grip and knee extensors strength for both extremities were evaluated. Strength was normalized by body mass. Spearman's correlation between body mass index and muscle strength was used. Results: The sample was 582 women, 265 men and an average age of 71.72±7.09. The women had a BMI of 30.03±5.48 and the men of 27.64 ± 4.05, the most numerous category was normal weight (n = 288) and the lowest low weight (n = 74). Hand grip strength presented a higher correlation than knee extensors, specifically, right hand grip strength (r: −0.40). The highest correlation and significance were presented by the obese category for all strength measurements, with right hand grip strength being the highest (r: −0.29). Conclusions: The increase in the nutritional status of older adults has a negative influence on muscle strength. The best association between body mass index and muscle strength was the right hand grip. The finding of the increase in life expectancy as the nutritional status of the sample decreases stands out. Future studies are needed to generate percentiles and normalized values in the Chilean population.(AU)

Comparison of Absolute and Relative Grip Strength to Predict Incidence of Diabetes Mellitus in Korea: A Prospective Cohort Study.

Background: This study aimed to investigate the association between absolute grip strength (AGS), relative grip strength (RGS) levels, and the risk of developing diabetes in middle-aged adults, utilizing longitudinal data. Methods: A total of 1935 participants, 51-81 years of age, were engaged in surveys both in 2017-2018 and during the subsequent follow-up survey in 2019-2020. Diabetes diagnosis and treatment were the criteria for categorizing individuals as "diabetic." Grip strength was measured using the JAMA-5030J1 equipment (SAEHAN, Korea), and AGS and RGS were also categorized into tertiles by gender. A proportional hazards Cox regression model was used to evaluate the relationship among AGS, RGS, and the risk of developing diabetes. Subsequently, we computed the hazard ratio (HR) and 95% confidence interval (95% CI) for the risk of developing diabetes. Results: After adjusting for various confounding variables, a significant reduction in diabetes risk was observed in the high grip strength group, adjusted for body mass index (RGS1) and body weight (RGS2), compared with the low RGS1 and RGS2 groups (RGS1 HR = 0.54, 95% CI = 0.36-0.80; RGS2 HR = 0.50, 95% CI = 0.34-0.73). However, there were no significant associations between AGS and diabetes risk. Furthermore, significant differences in the relationship among AGS, RGS levels, and the risk of developing diabetes were found across gender and insulin resistance levels. Conclusion: This study underscores the importance of RGS levels in predicting the incidence of diabetes, with AGS, RGS1, and RGS2 emerging as significant predictive indicators for assessing diabetes risk.

Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults.

BACKGROUND: Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. METHODS: We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. RESULTS: From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. CONCLUSION: Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.

Reduced calf muscle pump function is not explained by handgrip strength measurements.

OBJECTIVE: Reduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between handgrip strength (HGS) and CPF. METHODS: Patients referred to the Gonda Vascular Laboratory for noninvasive venous studies were identified and consented. Patients underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cutoff for reduced CPF (rCPF) was defined as an ejection fraction of <45%. Maximum HGS bilaterally was obtained (three trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated. RESULTS: 115 patients (mean age, 59.2 ± 17.4 years; 67 females, mean body mass index, 30.83 ± 6.46) were consented and assessed for HGS and CPF. rCPF was observed in 53 right legs (46%) and 67 left legs (58%). CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) patients. HGS was reduced bilaterally in 74 (64.3%), unilaterally in 23 (20%), and normal in 18 (15.7%) patients. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side. CONCLUSIONS: There is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF, indicating different pathophysiological mechanisms for each process.

Quality of life and strength, but not cytokines, are associated with DAS-28 in active and inactive rheumatoid arthritis / Qualidade de vida e força, porém não as citocinas, estão associadas ao DAS-28 em pacientes com artrite reumatoide na fase ativa e inativa

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.