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.

[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.

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.

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. Fourteen inflammatory biomarkers were measured at baseline. Participants were followed for 2 years. We analyzed associations between baseline biomarkers and 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: 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 IL-6 and CRP 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 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.

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)

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.

Addressing the functional needs of left ventricular assist device candidates: Development and feasibility of an occupational therapy pre-operative evaluation.

BACKGROUND: Everyday living with a left ventricular assist device (LVAD) is complex, particularly for people with physical or cognitive impairments or limited social supports. There is a need for standardized pre-operative functional evaluations. OBJECTIVES: Our objectives were to describe a pre-operative occupational therapy (OT) evaluation for LVAD candidates, assess its feasibility in routine care, and characterize functional needs. METHODS: We retrospectively reviewed electronic medical records of pre-operative OT consultations for LVAD candidates over four years (n = 209). Occupational profile, vision, and sensation were operationalized from documentation narratives. Daily functioning was measured with Activity Measure for Post-Acute Care, grip strength with dynamometer, cognition with Montreal Cognitive Assessment and Allen Cognitive Level Screen-5, and LVAD self-management with a performance-based ordinal scale. RESULTS: 89.5 % of consultations were completed, averaging 61.2 min (n = 187): 79.1 % (148/187) inpatient and 20.9 % (39/187) outpatient. Patients completed 87.7 % (164/187) to 100.0 % (187/187) of evaluation components. 21.9 % (41/187) of candidates lived alone. 6.4 % (12/187) and 7.0 % (13/185) had visual and sensory dysfunction. 57.4 % were independent with daily activities (104/181). 17.7 % (32/181) had impaired grip strength. 69.3 % (124/179) had impaired cognition, 29.7 % (51/172) with impaired functional cognition for everyday activities. 88.4 % (145/164) required physical or cueing assistance while practicing LVAD batteries management. OTs interpreted that 20.9 % (39/187) would likely require 24/7 post-operative support with LVAD self-care. CONCLUSION: Pre-operative OT evaluations were feasible and emphasized complex functional needs. Assessing LVAD self-care abilities may inform candidacy and facilitate early interventions to optimize functioning. OT should be consulted within interprofessional teams for all LVAD candidates.

Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults.

The health benefits of dietary fiber are widely recognized, but its impact on muscle health remains unclear. Therefore, this study aimed to elucidate the relationship between dietary fiber intake and muscle strength through a cross-sectional analysis of data from the Korea National Health and Examination Survey (KNHANES). Data from a single 24-h dietary recall and handgrip strength tests of 10,883 younger adults aged 19 to 64 years and 3,961 older adults aged ≥ 65 years were analyzed. Low muscle strength was defined as handgrip strength < 28 kg for men and < 18 kg for women. Multivariable linear and logistic regression analyses were conducted to determine the association of dietary fiber intake with muscle strength. Approximately 43% of Korean adults met the recommended intake of dietary fiber, and those with higher dietary fiber consumption also had higher total energy and protein intake. After adjusting for confounding variables, dietary fiber intake was found to be positively associated with maximal handgrip strength in younger women aged 19 to 64 years (ß = 0.015; standard error [SE] = 0.006) and older men aged ≥ 65 years (ß = 0.035; SE = 0.014). For older women aged ≥ 65 years, those in the lowest quartile of dietary fiber intake had a higher risk of low muscle strength than those in the highest quartile after adjustment of confounders (odds ratio 1.709; 95% confidence interval 1.130-2.585). These results suggest that adequate dietary fiber intake may reduce the risk of sarcopenia in older Korean women.

Comparison of Absolute and Relative Grip Strength to Predict Incidence of Metabolic Syndrome: Eight-Year Follow-Up Study in Korea.

Background: This study aimed to conduct an analysis of longitudinal study to investigate the association of absolute grip strength, and relative grip strength with incidence of metabolic syndrome. Materials and Methods: Participants who participated in the Korean Genome and Epidemiology Study, a chronic screening program conducted in Ahnseong-si, Gyeonggi-do, a primary survey conducted from 2013 to 2014 were selected. The presence of metabolic syndrome was classified using the standards of the International Diabetes Foundation following previous studies. Grip strength was measured using a JAMA 5030J1 (Saehan, Korea) and calculated the absolute grip strength and relative grip strength. To evaluate the relationship between the absolute grip strength, relative grip strength, and incidence of metabolic syndrome, independent hazard ratios (HRs) and 95% confidence intervals (CIs) for metabolic syndrome were calculated according to absolute and relative grip strength levels using a multivariate extended Cox regression model. Results: The incidence of metabolic syndrome was reduced by 38% (HR = 0.62, 95% CI = 0.43-0.88) for the high absolute grip strength group, compared to the low absolute grip strength group. Also, this study confirmed that the incidence of metabolic syndrome for mid relative grip strength and high relative grip strength groups were reduced by 27% (HR = 0.73, 95% CI = 0.55-0.98) and 55% (HR = 0.45, 95% CI = 0.32-0.64) respectively. Moreover, the incidence of metabolic syndrome was reduced by 45% (HR = 0.55, 95% CI = 0.37-0.82) and 57% (HR = 0.43, 95% CI = 0.29-0.65) for the low-level body mass index (BMI) group with high or low absolute grip strength, respectively. Finally, this study confirmed the association of sex, absolute grip strength, and relative grip strength according to age with incidence of metabolic syndrome was different. Conclusion: We observed that relative grip strength has a higher association with incidence of metabolic syndrome than absolute grip strength. Also, BMI has a higher association with metabolic syndrome than the absolute grip strength.

Hand Grip Strength Assessment Based on Sarcopenia Diagnostic Criteria Predicts Swallowing Function.

The purpose of this study is to clarify whether swallowing function can be inferred from grip strength. Based on the diagnostic criteria of sarcopenia, patients were divided into two groups according to grip strength, and it was analyzed whether there was a difference in the evaluation index for swallowing function between the two groups. Among the cases requesting evaluation of swallowing function from June 10, 2020 to October 28, 2020, 83 cases (mean age: 71.7 years, 59 males and 24 females) who received assessment tests and swallowing endoscopy were included. According to the diagnostic criteria for grip strength in the Asian working group in Sarcopenia, less than 28 kgf and 18 kgf were defined as the weak group for men and women, respectively. Hyodo scores, repeated salivary swallowing tests (RSST), maximum vocalization time (MPT), and dysphagia severity classification (DSS) were compared between the two groups. Of the 83 patients, 29 and 54 were in the normal group and weak group, respectively. In all indicators, the normal group showed significantly better results than the weak group: Hyodo score (2.4 vs. 4.0, p < 0.01), RSST (4.1 times vs. 2.4 times, p < 0.01), MPT (12.1 s vs. 5.9 s, p < 0.001), DSS (4.5 vs. 5.9, p < 0.001), respectively. In multiple regression analysis with DSS as the dependent variable, grip strength was a significant independent variable of DSS even after adjusting for age, gender, and body mass index. Grip strength assessment based on sarcopenia criteria can be a useful tool for estimating swallowing function.

Handgrip strength and upper limb functional performance measures in people over 18 years old: Analysis of relationships and influencing factors.

BACKGROUND: Handgrip strength is a common, simple, and inexpensive method to measure muscle strength. On the other hand, the functional performance measurement involves a usual task which implies repeating elements between the individuals' interaction and the environment. This is fundamental for projecting their results to daily life situation. PURPOSE: To explore the relationship between grip strength and measures of functional performance of the upper limbs (ULs) in people over 18 years of age, and to determine the influence of sociodemographic and anthropometric variables on the relationship. STUDY DESIGN: A cross-sectional study was conducted under the analytical empirical approach, using linear associations between handgrip strength and functional performance measurement tests (correspondence analysis). METHODS: Three hundred sixty-two male and female individuals between 18 and 91 years of age from 4 Colombian cities participated. The grip strength of both ULs measured with a digital dynamometry was associated with the Box and Block Test (BBT, manual dexterity), Nine-Hole Peg Test (NHPT, daily living tasks), and Jebsen-Taylor Hand Function Test (JJT, ability to grasp, pick up, and place). Multiple linear regression analyzes were performed to assess possible explanatory factors of a sociodemographic and anthropometric order. RESULTS: A significant association was found between the grip strength of dominant and non-dominant ULs with all functional performance tests (ρ > 0.27 and p < .001), except for the writing and simulated feeding subtests of the JJT (ρ ≤ 0.16). An interactive effect of age was found in the relationship between grip strength and the 3 functional performance tests. CONCLUSIONS: These results support the association between grip strength with the NHPT, JJT, and BBT measures and the interactive effect of age on the performance of all tests.

Biomechanical and aesthetic outcomes following radial forearm free flap transfer: comparison of ipsilateral full-thickness skin graft and traditional split-thickness skin graft.

The radial forearm free flap (RFFF) is associated with donor site morbidity. This study aimed to quantify the functional and aesthetic outcomes after closure of the RFFF donor site using triangular full-thickness skin grafts (FTSGs) harvested adjacent to the flap or traditional split-thickness skin grafts (STSGs). The study included patients who underwent oral cavity reconstruction with an RFFF between March 2017 and August 2021. The patients were divided into two groups based on the donor site closure method: FTSG or STSG. The primary outcomes were biomechanical grip strength, pinch strength, and range of wrist movements. Subjective donor site morbidity, aesthetic and functional results were also analysed. The study included 75 patients (FTSG n = 35; STSG n = 40). Postoperatively, there was a statistically significant difference in grip strength (P = 0.049) and wrist extension (P = 0.047) between the FTSG and STSG groups, in favour of the STSG. Differences between the groups in pinch strength and other wrist motions were not statistically significant. The harvesting time was significantly shorter for the FTSG (P = 0.041) and the appearance of the donor site was better (P = 0.026) when compared to the STSG. Cold intolerance was more frequent in the STSG group (32.5% STSG vs 6.7% FTSG; P = 0.017). Subjective function, numbness, pain, hypertrophic scar, itching, and social stigma did not differ significantly between the groups. Compared with the STSG, the FTSG showed better cosmesis and avoided additional donor sites, with clinically negligible differences in hand biomechanics.

Muscle Strength Indexes and Its Association With Cardiometabolic Risk Factors in Adolescents: An Allometric Approach.

Background and aims: Muscle strength (MS) has been associated with better cardiometabolic health prognosis. However, the result for the beneficial relationship seems to be dependent on the influence of body size in determining MS levels. We investigate the association between allometric MS indexes and its association with cardiometabolic risk factors in adolescents. Methods: It was a cross-sectional study comprising 351 adolescents (male: 44.4%; age range 14-19 years) from Southern Brazil. MS was assessed by handgrip strength and three different allometric approaches were adopted: 1) MS index based on theoretical allometric exponent; 2) MS index including body mass and height; 3) MS index including fat-free mass and height. Obesity, high blood pressure, dyslipidemia, glucose imbalance and high-sensitivity C-reactive protein were investigated as individual factors or as combinations (either as combinations of components - presence of two adverse conditions, or number of components present in an individual - 0, 1, 2, 3+ cardiometabolic risk factors). Logistic and multinomial logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results: MS index based on theoretical allometric exponent was associated with lower likelihood (OR: 0.54; 95% CI: 0.28 - 0.89) for the presence of three or more cardiometabolic risk factors in the same individual. Conclusion: This study suggests that MS index based on the theoretical allometric exponent can be superior to allometric MS indexes that included body mass and height, or fat-free mass and height in representing the presence of high number of cardiometabolic risk factors in adolescents.

Natural History of Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay: a 4-Year Longitudinal Study.

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a neurologic disorder with generally well-known clinical manifestations. However, few studies assessed their progression rate using a longitudinal design. This study aimed to document the natural history of ARSACS over a 4-year period in terms of upper and lower limb functions, balance, walking capacity, performance in daily living activities, and disease severity. Forty participants were assessed on three occasions over 4 years. Participant performance was reported in raw data as well as in percentage from reference values to consider the normal aging process. Severe balance and walking capacity impairments were found, with a significant performance decrease over the 4 years. Balance reached a floor score of around 6 points on the Berg Balance Scale for participants aged >40 years, while other participants lost about 1.5 points per year. The mean loss in walking speed was 0.044 m/s per year and the mean decrease in the distance walked in 6 min was 20.8 m per year for the whole cohort. Pinch strength, balance, walking speed, and walking distance decreased over time even when reported in percentage from reference values. Major impairments and rapid progression rates were documented in the present study for upper limb coordination, pinch strength, balance, and walking capacity in the ARSACS population. A progression rate beyond the normal aging process was observed. These results provide fundamental insights regarding the disease prognosis that will help to better inform patients, develop specific rehabilitation programs, and improve trial readiness.

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

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.