Is knee extension strength a better predictor of functional performance than handgrip strength among older adults in three different settings?

Abstract Background We assessed the quantitative changes in muscle mass and strength during 2 weeks of hospitalization in immobile and mobile acutely ill hospitalized older adults. Methods Forty-one patients (82.4 ± 6.6 years, 73.0% females) participated in this prospective longitudinal observational study. Mobility status was defined according to walking ability as described in the Barthel-Index. Functional status, including handgrip strength and isometric knee-extension strength, and mid-thigh magnetic resonance imaging (MRI) measurements of cross-sectional area (CSA) were conducted on admission and at discharge. Results Twenty-two participants (54%) were immobile and 19 (46%) mobile. In all, 54.0 and 12.0% were at risk of malnutrition and malnourished, respectively. The median time between baseline and follow-up for MRI scans were 13 days in mobile and immobile participants (P = 0.072). Mid-thigh muscle and subcutaneous fat CSA significantly decreased by 3.9cm2 (5.0%, P = 0.002) and 5.3cm2 (5.7%, P = 0.036) during hospitalization whereas intermuscular fat remained unchanged in immobile subjects. No significant changes were observed in mobile patients. In a regression analysis, mobility was the major independent risk factor for changes in mid-thigh muscle CSA as a percentage of initial muscle area (P = 0.022) whereas other variables such as age (P = 0.584), BMI (P = 0.879), nutritional status (P = 0.835) and inflammation (P = 0.291) were not associated with muscle mass changes. There was a significant decrease in isometric knee extension strength (P = 0.002) and no change in handgrip strength (P = 0.167) in immobile patients whereas both parameters increased significantly over time in mobile patients (P = 0.048 and P = 0.012, respectively). Conclusions Two weeks of disease-related immobilization result in a significant loss of thigh muscle mass and muscle strength in older patients with impaired mobility. Concomitantly, there was a significant reduction of subcutaneous adipose tissue in immobile older hospitalized patients whereas no changes were observed in intermuscular fat among these patients. These data highlight the importance of mobility support in maintaining muscle mass and function in older hospitalized patients.

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A single-arm feasibility study of community-delivered Baduanjin (Qigong practice of the eight Brocades) training for frail older adults

10.21203/rs.3.rs-26070/v2 ◽

2020 ◽

Author(s):

Xiao Liu ◽

Jean Wei Ting Seah ◽

Benedict Wei Jun Pang ◽

Mary Ann Tsao ◽

Falong Gu ◽

...

Keyword(s):

Older Adults ◽

Adverse Events ◽

Training Program ◽

Grip Strength ◽

Fall Risk ◽

Knee Extension ◽

Hand Grip Strength ◽

Frail Older Adults ◽

Knee Extension Strength ◽

Hand Grip

Abstract Background: Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. We studied the feasibility of a community-delivered Baduanjin (BDJ) training program among pre-frail/frail community-dwelling older people. We examined 1) safety (adverse events), physical and psychological effects; and 2) feasibility of recruitment, retention, adherence; recruitment efforts and any program challenges, so as to inform future studies.Methods: Our study was a single arm pre-post study in a community setting. Sixteen week group BDJ training (2x/week in the first 4 weeks, and 3x/week thereafter) co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results: Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation, resulting in 12 older adults (9 women) enrolled into the program. During the program, one participant was hospitalized (unrelated to BDJ training) and the other 11 (aged 77±6 years; 2 frail, 9 prefrail at baseline) completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance >80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n=2) or maintained (n=9) their frailty statuses. There post-training outcomes in hand grip strength, knee extension strength, TUG , MQ , FES , MoCA , GDS and EQ-5D-5L index score appeared to be better. The reduction of frailty and PPA fall risk scores were of moderate-to-large effect size. Conclusions: Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.

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Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2020.0182.r1.30102020 ◽

2021 ◽

Vol 139 (1) ◽

pp. 77-80

Author(s):

Diogo Carvalho Felício ◽

José Elias Filho ◽

Bárbara Zille de Queiroz ◽

Juliano Bergamaschine Mata Diz ◽

Daniele Sirineu Pereira ◽

...

Keyword(s):

Test Performance ◽

Elderly Women ◽

Handgrip Strength ◽

Knee Extension ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Timed Up And Go ◽

Cross Sectional ◽

Knee Extension Strength

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Manual muscle testing overlooks many knee extension strength deficits among older adults

Isokinetics and Exercise Science ◽

10.3233/ies-2010-0382 ◽

2010 ◽

Vol 18 (4) ◽

pp. 185-187 ◽

Cited By ~ 2

Author(s):

Richard W. Bohannon

Keyword(s):

Older Adults ◽

Knee Extension ◽

Manual Muscle Testing ◽

Knee Extension Strength ◽

Muscle Testing

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Association of knee-extension strength with instrumental activities of daily living in community-dwelling older adults

Geriatrics and Gerontology International ◽

10.1111/ggi.12158 ◽

2013 ◽

Vol 14 (3) ◽

pp. 674-680 ◽

Cited By ~ 14

Author(s):

Narumi Kojima ◽

Hunkyung Kim ◽

Kyoko Saito ◽

Hideyo Yoshida ◽

Yuko Yoshida ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Knee Extension ◽

Community Dwelling ◽

Knee Extension Strength ◽

Instrumental Activities ◽

Community Dwelling Older Adults

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Effects of Self-Paced Resistance Training and Detraining on Knee Extension Strength in Community-Dwelling Older Adults: A Pilot Study

Physical & Occupational Therapy In Geriatrics ◽

10.1080/j148v26n01_05 ◽

2007 ◽

Vol 26 (1) ◽

pp. 63-72

Author(s):

Yasuyoshi Asakawa ◽

Ryutaro Takahashi ◽

Haruyasu Yamaguchi ◽

Yumiko Inui ◽

Chiaki Hashizume

Keyword(s):

Older Adults ◽

Pilot Study ◽

Resistance Training ◽

Knee Extension ◽

Community Dwelling ◽

Knee Extension Strength ◽

Community Dwelling Older Adults ◽

Training And Detraining

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Sarcopenic Obesity Indices Are Major Determinants of Bone Strength in Older Adults With Obesity

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.486 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A239-A239

Author(s):

Giulia Gregori ◽

Arjun Paudyal ◽

Yann Barnouin ◽

Alessandra Celli ◽

Reina Condevillamar Villareal ◽

...

Keyword(s):

Older Adults ◽

Physical Function ◽

Grip Strength ◽

Bone Strength ◽

Distal Radius ◽

Bone Quality ◽

Gait Speed ◽

Failure Load ◽

Knee Extension ◽

Knee Extension Strength

Abstract Background: The increasing number of older adults with obesity is a growing public health problem because of increased risk of fractures especially at the ankle and upper leg despite normal or high bone mineral density. Among the contributory factors for fracture risk in this population may be aging- and obesity- associated physical frailty and impaired bone quality. However, how the adverse changes in physical function and body composition in this aging and obese population contribute to bone quality as assessed by finite element analyses (FEA) of bone strength has not been determined. Methods: One-hundred sixty-nine older (age ≥ 65 yrs.) adults with obesity (BMI ≥ 30 kg/m2) were recruited to participate in lifestyle intervention trials at our Medical Center. All underwent baseline measurements of bone strength (failure load [N] and stiffness [N.mm-1]) as estimated using FEA from high-resolution peripheral quantitative tomography (HR-pQCT) of the distal radius and tibia. In addition, body composition (appendicular lean mass/BMI [ALMBMI], fat mass/height2 [FMI]) was assessed by dual-energy x-ray absorptiometry (DXA) and physical function by the modified physical performance test (PPT), knee extension strength (isokinetic dynamometry), hand grip strength, and 4-meter gait speed. Results: Bivariate analyses showed that ALMBMI (r=.57 to .58), FMI (r=-.16 to -.17), gait speed (r=.20 to .21), grip strength (.56 to .57), and knee extension strength (r=.40 to .42) correlated with stiffness and failure load at the distal radius (all P<0.05). In addition, ALMBMI (r=.65 to .67), FMI (r=-.22 to .23), gait speed (r+.18 to .19), grip strength (r=.58 to .59), and knee extension strength (r=.44 to .45) correlated with stiffness and failure load at the distal tibia (all P<0.05). Controlling for age and sex, multiple regression analyses revealed that ALMBMI (β=.34 to .35) and grip strength (β=.28 to .29) were the independent predictors of stiffness and failure load at the distal radius, explaining 45% to 46% of the variance in stiffness and failure load (P<0.001). On the other hand, multiple regression analyses revealed that ALMBMI (β=.45 to .52), grip strength (β=.27 to .28), and FMI (β=.17 to .18) were the independent predictors of stiffness and failure load at the distal tibia, explaining 74% to 75% of the variance in stiffness and failure load (P<0.001). Conclusions: These findings suggest the importance of preserving muscle mass while reducing fat mass and improving physical function to maintain bone quality and decrease the risk of fractures when older adults with obesity undergo lifestyle intervention.

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The impact of disease-related immobilization on thigh muscle mass and strength in frail older hospitalized patients

10.21203/rs.3.rs-27443/v1 ◽

2020 ◽

Author(s):

Nikola Rommersbach ◽

Rainer Wirth ◽

Gero Lueg ◽

Christiane Klimek ◽

Mirja Schnatmann ◽

...

Keyword(s):

Muscle Mass ◽

Handgrip Strength ◽

Knee Extension ◽

Hospitalized Patients ◽

Thigh Muscle ◽

Knee Extension Strength ◽

Isometric Knee Extension ◽

Intermuscular Fat ◽

Prospective Longitudinal ◽

The Impact

Abstract Background We assessed the quantitative changes in muscle mass and strength during two weeks of hospitalization in immobile and mobile acutely ill hospitalized older adults. Methods 41 patients (82.4 ± 6.6 years, 73.0% females) participated in this prospective longitudinal observational study. Mobility status was defined according to walking ability as described in the Barthel-Index. Functional status, including handgrip strength and isometric knee-extension strength, and mid-thigh magnetic resonance imaging measurements of cross-sectional area (CSA) were conducted on admission and at discharge. Results Twenty-two participants (54%) were immobile and 19 (46%) mobile. In all, 54.0% and 12.0% were at risk of malnutrition and malnourished, respectively. The median time between baseline and follow-up for MRI scans were 13 days in mobile and immobile participants (P = 0.072). Mid-thigh muscle and subcutaneous fat CSA significantly decreased by 3.9 cm2 (5.0%, P = 0.002) and 5.3 cm2 (5.7%, P = 0.036) during hospitalization whereas intermuscular fat remained unchanged in immobile subjects. No significant changes were observed in mobile patients. In a regression analysis, mobility was the major independent risk factor for changes in mid-thigh muscle CSA as a percentage of initial muscle area (P = 0.022) whereas other variables such as age (P = 0.584), nutritional status (P = 0.835) and inflammation (P = 0.291) were not associated with muscle mass changes. There was a significant decrease in isometric knee extension strength (P = 0.002) and no change in handgrip strength (P = 0.167) in immobile patients whereas both parameters increased significantly over time in mobile patients (P = 0.048 and P = 0.012, respectively). Conclusions Two weeks of disease-related immobilization result in a significant loss of thigh muscle mass and muscle strength. Concomitantly, there was a significant reduction of subcutaneous adipose tissue whereas no changes were observed in intermuscular fat in frail older hospitalized patients.

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Iron deficiency, fatigue and muscle strength and function in older hospitalized patients

European Journal of Clinical Nutrition ◽

10.1038/s41430-020-00742-z ◽

2020 ◽

Cited By ~ 1

Author(s):

Sophia Neidlein ◽

Rainer Wirth ◽

Maryam Pourhassan

Keyword(s):

Risk Factor ◽

Iron Deficiency ◽

Barthel Index ◽

Independent Risk Factor ◽

Iron Supplementation ◽

Handgrip Strength ◽

Knee Extension ◽

Hospitalized Patients ◽

Knee Extension Strength ◽

Prospective Longitudinal

Abstract Background/Objectives Iron deficiency is common in older patients. We investigated whether iron deficiency is an independent risk factor for functional impairment, low muscle function, fatigue, and rehabilitation progress in older hospitalized patients. Subjects/Methods Two hundred twenty-four patients (age range 65–95 years; 67% females) who were consecutively admitted to a geriatric acute care ward participated in this prospective longitudinal observational study. Ferritin, iron, transferrin in serum, and blood hemoglobin were measured and current iron supplementation was recorded. Fatigue and comorbidity were measured using the fatigue severity scale and Charlson Comorbidity Index, respectively. Barthel Index, handgrip strength, and isometric knee extension strength were conducted at the time of hospital admission and before discharge. Results Ninety-one (41%) patients had iron deficiency in which the majority had functional iron deficiency (78/91, 86%). Absolute iron deficiency with and without anemia was diagnosed in 12 (13%) and one patients, respectively. Barthel Index and handgrip and knee extension strength significantly improved during hospitalization in iron deficiency and non-iron deficiency groups. Knee extension strength showed better improvement in iron-deficient patients receiving iron supplementation and iron supplementation during hospital stay was the main predictor for improvement in knee extension strength. Comorbidity, iron deficiency, and changes in handgrip strength were the major independent risk factors for poor improvement in Barthel Index during hospitalization. There were significant associations between patients’ fatigue and iron deficiency, comorbidity, and female gender. Conclusion Iron deficiency is an independent risk factor for fatigue and poor functional recovery among older hospitalized patients. Iron supplementation seems to be capable of improving functional performance.

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