scholarly journals P72 Muscle weakness affects function differently in males and females in inclusion body myositis: providing results for focused clinical care and clinical trial design

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Jacob Williams ◽  
Alexander Oldroyd ◽  
James Lilleker ◽  
Hector Chinoy ◽  
James Miller
Keyword(s):  
Inclusion Body Myositis ◽  
Disease Duration ◽  
Functional Decline ◽  
Knee Extension ◽  
Clinic Visit ◽  
Ankle Dorsiflexion ◽  
Men And Women ◽  
Male Cohort ◽  
Muscle Groups ◽  
Female Cohort

Abstract Background Sporadic inclusion body myositis (IBM) is a muscle wasting disorder usually affecting those aged over 50 years, characterised by slowly progressive weakness of the distal upper limbs and proximal lower limbs. Particular weakness of pinch, knee extension and ankle dorsiflexion result in functional decline and disability. Weakness-associated functional decline differences between genders has not previously been investigated. This study aimed to investigate for differences of functional decline in men and women with IBM. Methods A cohort of verified adult IBM patients were followed at a single specialist neuromuscular clinic (Royal Victoria Infirmary, Newcastle-upon-Tyne, UK) between 2004-15, with data collected at each clinic visit. Strength of 11 movements was measured via dynamometry at each clinic visit. Patient-reported function was measured via the Neuromuscular Symptom Score (NSS). Generalised linear modelling, adjusted for disease duration, was carried out to identify associations between strength and function (NSS). Pinch, knee extension and ankle dorsiflexion strength measurements were analysed. Modelling was carried out separately for male and female cohorts. Results Data of 75 participants (47% female) was analysed. A total of 591 measurements were taken. Median age at time of IBM diagnosis was 68.8 years. Median baseline NSS score was 45 (IQR 37, 54) for the male cohort and 40 (IQR 29, 45) for the female cohort. The median disease duration of the study cohort was 2.6 years. Reduced function (NSS) was significantly associated with reduced pinch, knee extension and ankle dorsiflexion strength in the male cohort only (Table 1). No significant associations were observed in the female cohort. Conclusion This is the first study to demonstrate that the progression of weakness, in the characteristic muscle groups affected in IBM, impacts on function differently in men and women. These results illustrate the importance of functional assessment in patients with IBM and the importance of focused physiotherapy upon function-dependent muscle groups. Further, potential gender-based differences of weakness-related function in IBM should be considered when designing clinical trials. Disclosures J. Williams None. A. Oldroyd None. J. Lilleker None. H. Chinoy None. J. Miller None.

Inter- and Intra-Rater Reliability of Handheld Dynamometry for Lower Extremity Strength Testing in Pre-Professional Dancers

2021 ◽  
Author(s):  
Marissa Schaeffer ◽  
Laurel Daniels Abbruzzese ◽  
Zoe Tawa ◽  
Kynaston Schultz ◽  
Joanna Binney ◽  
...  
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Physical Therapist ◽  
Force Production ◽  
Knee Extension ◽  
Ankle Dorsiflexion ◽  
Rater Reliability ◽  
Ankle Eversion ◽  
Lower Extremity Strength ◽  
Muscle Groups

Handheld dynamometry (HHD) using external fixation has demonstrated high inter- and intra-rater reliability. Handheld dynamometry offers an objective way to quantify strength; however, setting up external stabilization devices for HHD can be time consuming. This study examined the reliability of HHD for lower extremity strength in dancers using body weight stabilization. Twenty-six pre-professional dancers (age: 20.64 ± 2.21 years) were recruited and assessed by three testers: an experienced physical therapist (ePT), a novice physical therapist (nPT), and a student physical therapist (SPT). To avoid testing fatigue, dancers were divided into two testing groups and were evaluated on separate weekends. Testers used HHD to test isometric force production of six muscle groups in the first cohort and seven different muscle groups in the second cohort. Testing positions were standardized and utilized a “make” test protocol. Intra-class correlation coefficients (ICC), 95% confidence interval, and standard error of measurement were calculated for each position. Inter-rater reliability was > 0.75 for all ICC measures except knee extension and ankle eversion. Intra-rater reliability was > 0.75 for all ICC measures except the ePT (tester A) day 2 for hip extension, internal rotation seated, knee extension, and ankle dorsiflexion; nPT (tester B) day 1 knee flexion; and SPT (tester C) for day 1 knee extension and ankle eversion and days 1 and 2 for ankle dorsiflexion and inversion. It is concluded that HHD can reliably measure force production of hip, knee, and ankle muscle groups without use of external fixation devices.

Concentric and Eccentric Knee Extension Strength in Older and Younger Men and Women

1995 ◽  
Vol 20 (4) ◽  
pp. 429-439 ◽  
Author(s):  
Michelle M. Porter ◽  
Aung Myint ◽  
John F. Kramer ◽  
Anthony A. Vandervoort
Keyword(s):  
Age Differences ◽  
Knee Extension ◽  
Key Words Aging ◽  
Men And Women ◽  
Younger Men ◽  
Muscle Groups ◽  
Aging Muscle ◽  
Effects Of Aging ◽  
Muscle Actions ◽  
Older Men And Women

Decrements in isometric and concentric (Conc) muscular strength with increased age are well documented. However, little information is available on the effects of aging on eccentric (Ecc) strength, even though Ecc or lengthening muscle actions are used in most physical activities. This study examined Conc and Ecc peak torques (PT) during knee extension at 90°/sec in healthy older (62 to 89 yrs) and younger (20 to 29 yrs) men and women. Conc PT decreased more with age than did Ecc (p < 0.01), for both men and women. PT values for the older men and women as a percentage of those of the younger ones were 58.3 and 46.6% for Conc, and 75.1 and 61.7% for Ecc, respectively. These age differences need to be considered during isokinetic evaluations of Conc versus Ecc strength. Other muscle groups should be investigated, and mechanisms remain to be determined. Key words: aging, muscle, isokinetics

scholarly journals Early-onset vs. Late-onset Parkinson’s disease: A Clinical-pathological Study

2015 ◽  
Vol 43 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Leslie Wayne Ferguson ◽  
Ali H. Rajput ◽  
Alexander Rajput
Keyword(s):  
Parkinson Disease ◽  
Early Onset ◽  
Disease Duration ◽  
Late Onset ◽  
Disease Onset ◽  
Clinic Visit ◽  
Pathological Study ◽  
Younger Age ◽  
Wearing Off ◽  
Selection For

AbstractBackground:Several studies have compared early-onset Parkinson disease (EOPD) and late-onset Parkinson disease (LOPD) but most are not based on autopsy confirmed cases.Methods:We compared clinical and pharmacological profiles, time to reach irreversible Hoehn and Yahr (H&Y) Stage 3 and levodopa motor complications in autopsy confirmed EOPD and LOPD cases.Results:At first clinic visit EOPD cases were younger but had longer disease duration and they died at a younger age (all p<0.0001). Anti-Parkinsonian drug use, including levodopa, was significantly delayed in EOPD. Lifetime use of amantadine (p<0.05) and dopamine agonists (p<0.01) were higher in EOPD. While lifetime use of levodopa was similar in the two groups, levodopa was used for a significantly longer period by EOPD (p< 0.0001). EOPD had a higher cumulative incidence of dyskinesias (p<0.01), wearing-off (p<0.01), and on-off (p<0.01). However, the time to dyskinesia onset was similar in the two groups. The threshold to wearing-off was much longer in EOPD (p<0.01). H&Y stage profile at first visit was similar in the two groups. The duration from disease onset to reach irreversible H&Y stage 3 was significantly longer in EOPD.Conclusions:Our observations indicate that progression of PD is slower in EOPD and suggest that the pre-clinical interval in this group is longer. These findings can be used for case selection for drug trials and studies of the pathogenesis of PD.

scholarly journals Association of plasma sex hormone levels with functional decline in elderly men and women

2009 ◽  
Vol 9 (3) ◽  
pp. 282-289 ◽  
Author(s):  
Shiho Fukai ◽  
Masahiro Akishita ◽  
Shizuru Yamada ◽  
Tatsuya Hama ◽  
Sumito Ogawa ◽  
...  
Keyword(s):  
Functional Decline ◽  
Sex Hormone ◽  
Elderly Men ◽  
Men And Women ◽  
Hormone Levels

Relationship Between Weightbearing Ankle Dorsiflexion Passive Range of Motion and Ankle Kinematics During Gait

2017 ◽  
Vol 107 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Min-Hyeok Kang ◽  
Jae-Seop Oh
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
Knee Extension ◽  
Ankle Dorsiflexion ◽  
Physically Active ◽  
Ankle Kinematics ◽  
The Difference ◽  
Analysis System ◽  
The Relationship ◽  
Paired T Test

Background: Measurement of weightbearing ankle dorsiflexion (DF) passive range of motion (PROM) has been suggested as a way to estimate ankle kinematics during gait; however, no previous study has demonstrated the relationship between ankle DF during gait and ankle DF PROM with knee extension. We examine the relationship between maximum ankle DF during gait and nonweightbearing and weightbearing ankle DF PROM with knee extension. Methods: Forty physically active individuals (mean ± SD age, 21.63 ± 1.73 years) participated in this study. Ankle DF PROM with knee extension was measured in the nonweightbearing and weightbearing conditions; maximum ankle DF during gait was assessed using a three-dimensional motion analysis system. The relationship between each variable was calculated using the Pearson product moment correlation coefficient, and the difference in ankle DF PROM between the nonweightbearing and weightbearing conditions was analyzed using a paired t test. Results: The weightbearing measurement (r = 0.521; P &lt; .001) for ankle DF PROM showed a greater correlation with maximum ankle DF during gait than did the nonweightbearing measurement (r = 0.245; P = .029). Ankle DF PROM was significantly greater in the weightbearing than in the nonweightbearing condition (P &lt; .001) despite a significant correlation between the two measurements (r = 0.402; P &lt; .001). Conclusions: These findings indicate that nonweightbearing and weightbearing measurements of ankle DF PROM with knee extension should not be used interchangeably and that weightbearing ankle DF PROM with the knee extended is more appropriate for estimating ankle DF during gait.

scholarly journals Optimism and Mortality in Older Men and Women: The Rancho Bernardo Study

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Ericha G. Anthony ◽  
Donna Kritz-Silverstein ◽  
Elizabeth Barrett-Connor
Keyword(s):  
Cancer Mortality ◽  
Older Men ◽  
Population Based ◽  
Clinic Visit ◽  
Men And Women ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Positive Attitudes ◽  
Cox Proportional Hazard Models ◽  
Older Men And Women

Purpose.To examine the associations of optimism and pessimism with all-cause, cardiovascular disease (CVD), coronary heart disease (CHD), and cancer mortality in a population-based sample of older men and women followed ≤12 years.Methods.367 men and 509 women aged ≥50 from the Rancho Bernardo Study attended a 1999–2002 research clinic visit when demographic, behavioral, and medical history were obtained and completed a 1999 mailed survey including the Life Orientation Test-Revised (LOT-R). Mortality outcomes were followed through 2012.Results.Average age at baseline was 74.1 years; during follow-up (mean = 8.1 years), 198 participants died, 62 from CVD, 22 from CHD, and 49 from cancer. Total LOT-R, optimism and pessimism scores were calculated. Participants with the highest optimism were younger and reported less alcohol use and smoking and more exercise. Cox proportional hazard models showed that higher total LOT-R and optimism, but not pessimism scores, were associated with reduced odds of CHD mortality after adjusting for age, sex, alcohol, smoking, obesity, physical exercise, and medication (HR = 0.86, 95% CI = 0.75, 0.99; HR = 0.77, 95% CI = 0.61, 0.99, resp.). No associations were found for all-cause, CVD, or cancer mortality.Conclusions.Optimism was associated with reduced CHD mortality in older men and women. The association of positive attitudes with mortality merits further study.

A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women

1991 ◽  
Vol 71 (2) ◽  
pp. 644-650 ◽  
Author(s):  
W. R. Frontera ◽  
V. A. Hughes ◽  
K. J. Lutz ◽  
W. J. Evans
Keyword(s):  
Muscle Strength ◽  
Peak Torque ◽  
Cross Sectional Study ◽  
Fat Free Mass ◽  
Knee Extensors ◽  
Cross Sectional ◽  
Men And Women ◽  
Age Related ◽  
Muscle Groups ◽  
Old Men

The isokinetic strength of the elbow and knee extensors and flexors was measured in 200 healthy 45- to 78-yr-old men and women to examine the relationship between muscle strength, age, and body composition. Peak torque was measured at 60 and 240 degrees/s in the knee and at 60 and 180 degrees/s in the elbow by use of a Cybex II isokinetic dynamometer. Fat-free mass (FFM) was estimated by hydrostatic weighing in all subjects, and muscle mass (MM) was determined in 141 subjects from urinary creatinine excretion. FFM and MM were significantly lower (P less than 0.001) in the oldest group. Strength of all muscle groups at both testing speeds was significantly (P less than 0.006) lower (range 15.5–26.7%) in the 65- to 78- than in the 45- to 54-yr-old men and women. When strength was adjusted for FFM or MM, the age-related differences were not significant in all muscle groups except the knee extensors tested at 240 degrees/s. Absolute strength of the women ranged from 42.2 to 62.8% that of men. When strength was expressed per kilogram of MM, these gender differences were smaller and/or not present. These data suggest that MM is a major determinant of the age- and gender-related differences in skeletal muscle strength. Furthermore, this finding is, to a large extent, independent of muscle location (upper vs. lower extremities) and function (extension vs. flexion).

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