Impact of grip strength and balance function on the exercise capacity in pulmonary hypertension

Abstract Funding Acknowledgements Type of funding sources: None. 【Background】 Patients with pulmonary hypertension (PH) suffer from poor exercise capacity due to impaired oxygenation or reduced cardiac output. However, the relationship between exercise capacity and physical functions remains unclear. 【Purpose】 The purpose of this study is to investigate the relationship between exercise capacity and physical functions in pulmonary hypertension. 【Methods】 From February 2018 to June 2020, 94 patients (61.3 ± 14.7 years old, 69.1% females) with group 1/3/4/5 PH underwent cardiac catheterization, 6-minute walking distance (6MWD), and physical function measurements simultaneously. The physical functions was measured using muscle strength (grip strength, knee extension muscle strength), balance function (one leg standing time), and short physical performance battery (SPPB). Exercise capacity was measured by 6MWD. 【Results】 The study cohort consists of 22/8/60/4 (23.4%/8.5%/63.8%/4.3%) patients with group 1/3/4/5 PH, respectively. The average age of each group was 50.7/64.7/63.1/66.0 years old, respectively. A total of 194 measurements of physical functions were evaluated from 94 patients and employed in multivariate logistic regression analysis using adaptive-LASSO methods with the 6MWD (476.2 ± 107.5m) as a dependent variable. WHO functional class (class II: standardized β=-0.35, 95% confidence interval (CI) [-0.54 - -0.16], p < 0.001), class III: β=-0.60, 95%CI [-0.90 - -0.30], p < 0.001), mixed venous oxygen saturation (SvO2: β=0.11, 95%CI [0.03 - 0.19], p = 0.008), pulmonary vascular resistance (PVR: β=-0.16, 95%CI [-0.25 - -0.07], p < 0.001), grip strength (β=0.20, 95%CI [0.09 - 0.31], p < 0.001), one leg standing time (β=0.10, 95%CI [0.00 - 0.20], p = 0.049) , and 4m gait speed test (β=-0.28, 95%CI [-0.36 - -0.19], p < 0.001) were associated with 6MWD. 【Conclusions】 Grip strength and balance function, as well as SvO2 and PVR, were associated with the exercise capacity in pulmonary hypertension.

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Relationship Between Muscle Strength Asymmetry and Body Sway in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0096 ◽

2018 ◽

Vol 26 (3) ◽

pp. 457-461 ◽

Cited By ~ 3

Author(s):

Hitoshi Koda ◽

Yoshihiro Kai ◽

Shin Murata ◽

Hironori Osugi ◽

Kunihiko Anami ◽

...

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Knee Extension ◽

Body Sway ◽

Adult Women ◽

Gait Stability ◽

Cutoff Value ◽

Hand Grip ◽

Strength Asymmetry ◽

The Relationship

The purpose of this study was to investigate the relationship between muscle strength asymmetry and body sway while walking. We studied 63 older adult women. Strong side and weak side of knee extension strength, toe grip strength, hand grip strength, and body sway while walking were measured. The relationship between muscle strength asymmetry for each muscle and body sway while walking was evaluated using Pearson’s correlation coefficient. Regarding the muscles recognized to have significant correlation with body sway, the asymmetry cutoff value causing an increased sway was calculated. Toe grip strength asymmetry was significantly correlated with body sway. Toe grip strength asymmetry causing an increased body sway had a cutoff value of 23.5%. Our findings suggest toe grip strength asymmetry may be a target for improving gait stability.

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Exercise right heart catheterization before and after balloon pulmonary angioplasty in inoperable patients with chronic thromboembolic pulmonary hypertension

Pulmonary Circulation ◽

10.1177/2045894020917884 ◽

2020 ◽

Vol 10 (3) ◽

pp. 204589402091788

Author(s):

Christoph B. Wiedenroth, MD ◽

Andreas J. Rieth, MD ◽

Steffen Kriechbaum, MD ◽

H.-Ardeschir Ghofrani, MD ◽

Andreas Breithecker, MD ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Exercise Capacity ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Right Heart Catheterization ◽

Walking Distance ◽

Heart Catheterization ◽

Right Heart ◽

Pulmonary Hemodynamics ◽

Balloon Pulmonary Angioplasty ◽

Thromboembolic Pulmonary Hypertension

Background * These authors contributed equally as last authors. Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value. Methods From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention. Results Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N-terminal fragment of pro-brain natriuretic peptide (p = 0.035) and 6-minute walking distance (p = 0.01). Conclusions Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.

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Impairment of respiratory muscle function in pulmonary hypertension

Clinical Science ◽

10.1042/cs20070238 ◽

2007 ◽

Vol 114 (2) ◽

pp. 165-171 ◽

Cited By ~ 46

Author(s):

Hans-Joachim Kabitz ◽

Anja Schwoerer ◽

Hinrich-Cordt Bremer ◽

Florian Sonntag ◽

Stephan Walterspacher ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Muscle Strength ◽

Muscle Function ◽

Respiratory Muscle ◽

World Health ◽

Walking Distance ◽

Respiratory Muscle Strength ◽

Control Subjects ◽

Respiratory Muscle Function ◽

Health Organization

It has been suggested that impaired respiratory muscle function occurs in patients with PH (pulmonary hypertension); however, comprehensive investigations of respiratory muscle function, including the application of non-volitional tests, needed to verify impairment of respiratory muscle strength in patients with PH have not yet been performed. In the present study, respiratory muscle function was assessed in 31 patients with PH (20 females and 11 males; mean pulmonary artery pressure, 51±20 mmHg; median World Health Organization class 3.0±0.5; 25 patients with pulmonary arterial hypertension and six patients with chronic thromboembolic PH) and in 31 control subjects (20 females and 11 males) well-matched for gender, age and BMI (body mass index). A 6-min walking test was performed to determine exercise capacity. Volitionally assessed maximal inspiratory (7.5±2.1 compared with 6.2±2.8 kPa; P=0.04) and expiratory (13.3±4.2 compared with 9.9±3.4 kPa; P<0.001) mouth pressures, sniff nasal (8.3±1.9 compared with 6.6±2.2 kPa; P=0.002) and transdiaphragmatic (11.3±2.5 compared with 8.7±2.5 kPa; P<0.001) pressures, non-volitionally assessed twitch mouth (1.46±0.43 compared with 0.97±0.41 kPa; P<0.001) and transdiaphragmatic (2.08±0.55 compared with 1.47±0.72 kPa; P=0.001) pressures during bilateral anterior magnetic phrenic nerve stimulation were markedly lower in patients with PH compared with control subjects. Maximal inspiratory mouth (r=0.58, P<0.001) and sniff transdiaphragmatic (r=0.43, P=0.02) pressures were correlated with the 6-min walking distance in patients with PH. In conclusion, the present study provides strong evidence that respiratory muscle strength is reduced in patients with PH compared with well-matched control subjects. Furthermore, the 6-min walking distance is significantly linked to parameters assessing inspiratory muscle strength.

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Determination of the relationship between the wrist isokinetic muscle strenght and the grip strength in tennis players aged between 12-14

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00070 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0007

Author(s):

Bihter Akınoğlu ◽

Tuğba Kocahan ◽

Necmiye Ün Yıldırım ◽

Çağlar Soylu ◽

Adnan Hasanoğlu

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Standing Position ◽

Dominant Hand ◽

Sitting Position ◽

Wrist Flexion ◽

Tennis Players ◽

Isokinetic Muscle Strength ◽

The Relationship ◽

Flexion And Extension

Aim: The purpose of this study is to determine the relationship between isokinetic wrist muscle strenght and grip strength in tennis players aged between 12-14. Methods: This study was carried out with the participation of 9 (3 female and 6 male) tennis players aged between 12-14 (means 13,22±0,83). Weight, height, body mass index and dominant extremity of the players were recorded. İsokinetic measurement was performed with Isomed 2000® device. İsokinetic testing protocol; before the test all players performed the wrist flexion and extension isokinetic test with the 5 repeating at 90 º/sec as a warm-up and for comprehenting the test. Then, wrist flexion and extension concentric-concentric strength measurements were performed with the 5 repeating at 60 º/sec and with the 15 repeating at 240 º/sec with the angle between 50 degrees of wrist flexion and 60 degrees of wrist extension and peak torque values were recorded. Standard Jamar® Dynamometer was used for grip strength measurements. Grip strenght was performed firstly in sitting position, which is the position of standard measurement. Secondly, in standing position, the elbow was in full ekstansion and the forearm was in neutral position. Thirdly, in standing position the wrist was positioned approximately 30° extension and 10° ulnar deviation. This test was repeated 3 times in all test position and the mean of three scores were recorded. Firstly, the dominant hand, then the non-dominant hand was evoluated. They were allowed to rest for 30 seconds between each grip measurement. Correlation between peak tork of isokinetic muscle strenght and grip strength was done having been used Spearman correlation test. Findings: It was determined that there was a significant positive relation between wrist flexion-extension isokinetic muscle strength and grip strenght in tennis players aged between 12-14. Clinically, grip strength measured in the standard sitting position was found more as compared to the other positions but these values were not statistically significant (p>0,05). Accordingly, grip strength measured in the standard sitting position correlated with much more of the parameters which we evaluated for isokinetic muscle strength comparing to grip strenght measured in the other two positions (p<0,05). Results: It was concluded that isokinetic muscle strength of wrist can be affected by grip strength, therefore measurement needs to be done in the sitting position which maximum grip strength may reveal. [Table: see text]

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SAT0751-HPR The relationship between anaerobic exercise capacity and isometric lower extremity muscle strength in children with juvenile idiopathic arthritis

10.1136/annrheumdis-2017-eular.5697 ◽

2017 ◽

Author(s):

D Bayraktar ◽

S Savci ◽

E Manci ◽

O Altug-Gucenmez ◽

B Makay ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Muscle Strength ◽

Lower Extremity ◽

Exercise Capacity ◽

Anaerobic Exercise ◽

Lower Extremity Muscle ◽

The Relationship

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The Prevalence of Pulmonary Hypertension in Destroyed Lung Due to Post Pulmonary Tuberculosis and Its Relation to Exercise Capacity

Jurnal Respirologi Indonesia ◽

10.36497/jri.v38i4.24 ◽

2019 ◽

Vol 38 (4) ◽

pp. 227-31

Author(s):

Diana Septiyanti ◽

Astari Pranindya Sari ◽

Wahju Aniwidyaningsih ◽

Budhi Antariksa ◽

Bambang Budi Siswanto

Keyword(s):

Pulmonary Hypertension ◽

Oxygen Saturation ◽

Exercise Capacity ◽

Negative Correlation ◽

Pearson Correlation ◽

Walking Distance ◽

Peripheral Oxygen Saturation ◽

Cross Sectional ◽

The Mean ◽

Destroyed Lung

Background: To improve patient’s quality of life, understanding destroyed lung (DL) is very important, however, it is very limited in information related to it as well as to the existency of pulmonary hypertension (PH) in destroyed lung. In this study, we investigated relationship between DL with PH status and the exercise capacity through 6 minutes walking test (6MWT). Method: Cross-sectional analytic study involving 54 DL subjects. Subjects performed echocardiography to exclude cardiac abnormality and to determine whether they had PH. Subjects were then divided into two groups based on their PH status. They underwent 6MWT and their walking distance and peripheral oxygen saturation were measured. Student t-test was used for analyzing data. Furthermore, we determined correlation between walking distance and mean Pulmonary Artery Pressure (mPAP) value also peripheral oxygen saturation and mPAP. Result: We calculated the mean of walking distance between the two groups. The mean from subjects with PH and without PH were 329.18 and 388.77 meter respectively (p=0.035). We found negative correlation between the mean of walking distance and subject’s mPAP using statistical analysis Pearson correlation test (r= -0,457, p = 0,001) while percentage of 6MWT by its prediction also had a negative correlation (r= -0,468, p=

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The association of 6-minute walking distance and real-time three-dimensional echocardiography in pulmonary hypertension

10.22541/au.162389792.29171387/v1 ◽

2021 ◽

Author(s):

sun lingyue ◽

Yuan-yuan Su ◽

Hao Zhou ◽

Jie-yan Shen ◽

Jun Pu

Keyword(s):

Pulmonary Hypertension ◽

Exercise Capacity ◽

Three Dimensional ◽

Walking Distance ◽

Right Heart ◽

Predictive Values ◽

3D Echo ◽

Dimensional Echocardiography ◽

Three Dimensional Echocardiography ◽

Rv Function

Abstract Background: The aim of this study was to evaluate the potential effect of 6-minute walking distance (6MWD) on exercise tolerance in patients with pulmonary hypertension (PH). To clarify whether 6WMD and right ventricle (RV) function measured by three-dimensional echocardiography (3D-echo) could result in better correlation with exercise capacity. Methods: 72 consecutive patients underwent right heart catheterization (RHC) and diagnosed with PH. Associations between 6WMD and measures of RV function were evaluated using the Pearson correlation coefficient. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the clinical prognosis of patients. Results: RHC-derived parameters were significantly correlated with 6MWD: (RPVR = -0.719, RPAPs = -0.501, RPAPd = -0.404, and RPAPm = -0.468, all P <0.001). Meanwhile, 6MWD was positively correlated with CO (R = 0.54, P <0.001). Good correlations between 6MWD with 3D-echo parameters were shown as follows: R3D-RVEDV = -0.584, R3D-RVESV = -0.598, R3D-RVEF = 0.554, R3D-RV mass = -0.507, all P <0.001. The predictive value from 6MWD was not much inferior to the predictive values of PVR (AUC6MWD = 0.779 vs. AUCPVR = 0.875, both P <0.0001). Conclusions: 6MWD has a significant correlation with hemodynamic parameters obtained by RHC. And RV function obtained by 3D-echo result in better correlation with exercise capacity. 3D-echo might be candidate for RHC to assess right heart function in patients with PH.

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Comparison of quadriceps setting strength and knee extension strength tests to evaluate lower limb muscle strength based on health-related physical fitness values in elderly people

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000753 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000753

Author(s):

Yuki Ito ◽

Takumi Aoki ◽

Takeru Sato ◽

Kan Oishi ◽

Kojiro Ishii

Keyword(s):

Muscle Strength ◽

Physical Fitness ◽

Grip Strength ◽

Lower Limb ◽

Knee Extension ◽

Walking Distance ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Knee Extension Strength ◽

Health Related

ObjectiveConventionally, knee extension strength is often used as the indicator for lower limb muscle strength; however, several recent studies have also used quadriceps setting strength. This study aimed to investigate and compare the association of quadriceps setting and knee extension strength with health-related physical fitness.MethodsWe evaluated quadriceps setting strength and isometric knee extension strength in 75 elderly subjects (mean age, 76.8±5.3 years) to determine their lower limb muscle strength. Health-related physical fitness was evaluated using the physical fitness test advocated by the Ministry of Education and Culture, Sports, Science and Technology in Japan. The test consists of the following components: grip strength, sit-up, sit and reach, one leg standing with eyes open, 10 m obstacle walk and 6 min walk.ResultsWhen adjusted for age, sex and body mass index, quadriceps setting strength was significantly correlated with grip strength, number of sit-ups, sit and reach distance, 10 m obstacle walking time and 6 min walking distance. In contrast, knee extension strength was associated only with grip strength and number of sit-ups.ConclusionMore health-related physical fitness parameters with quadriceps setting strength than knee extension strength. Quadriceps setting strength may be superior to knee extension strength as a predictor of health-related physical fitness.

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