Handgrip Strength Does Not Represent an Appropriate Measure to Evaluate Changes in Muscle Strength During an Exercise Intervention Program in Frail Older People

Introduction:Although handgrip strength is considered a strong predictor of negative health outcomes, it is unclear whether handgrip strength represents a useful measure to evaluate changes in muscle strength following resistance-type exercise training in older people. We assessed whether measuring handgrip strength provides proper insight in the efficacy of resistance-type exercise training to increase muscle mass, strength, and physical performance in frail older people.Methods:Prefrail and frail older people (≥ 65 y) were either conducting a 24-week resistance-type exercise training or no exercise training. Before, during, and after the intervention, handgrip strength (JAMAR), lean body mass (DXA), leg strength (1-RM), and physical performance (SPPB) were assessed.Results:Handgrip strength correlated with appendicular lean mass (r = 0.68; p < .001) and leg strength (r = 0.67; p < .001). After 24 weeks of whole body resistance-type exercise training, leg extension strength improved significantly better when compared with the control group (57 ± 2–78 ± 3 kg vs 57 ± 3–65 ± 3 kg: p < .001). Moreover, physical performance improved significantly more in the exercise group (8.0 ± 0.4–9.3 ± 0.4 points) when compared with the control group (8.3 ± 0.4–8.9 ± 0.4 points: p < .05). These positive changes were not accompanied with any significant changes in handgrip strength (26.3 ± 1.2–27.6 ± 1.2 kg in the exercise group vs 26.6 ± 1.2–26.3 ± 1.3 kg in the control group: p = .71).Conclusion:Although handgrip strength strongly correlates with muscle mass and leg strength in frail older people, handgrip strength does not provide a valid means to evaluate the efficacy of exercise intervention programs to increase muscle mass or strength in an older population.

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FRI0631-HPR SUPPLEMENTATION WITH CREATININE, GLUTAMINE AND Β-HYDROXY-Β-METHYLBUTYRATE IMPROVES MUSCLE MASS AND STRENGTH AND QUALITY OF LIFE IN PATIENTS WITH SARCOPENIA AND KNEE OSTEOARTHRITIS: THE DIMMUS RANDOMIZED STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5777 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 920.2-920

Author(s):

H. Riera ◽

G. Colantuoni ◽

M. Quintero ◽

F. Fernández

Keyword(s):

Quality Of Life ◽

Exercise Training ◽

Physical Function ◽

Muscle Mass ◽

Gait Speed ◽

Handgrip Strength ◽

Intervention Group ◽

Control Group ◽

Knee Oa

Background:Sarcopenia is characterized by progressive loss of muscle mass, strength, and physical function, and often accompanies other diseases such as osteoarthritis (OA)1. Both conditions are also significantly associated with poor quality of life (QoL).Objectives:A randomized controlled study was conducted to evaluate the effectiveness of creatinine, glutamine and β-hydroxy-β-methylbutyrate (HMB) supplementation in enhancing muscle mass and strength, physical function and QoL in adults with sarcopenia and knee OA.Methods:Sixty-two patients aged 40 years and above with sarcopenia diagnosed according to the European Working Group on Sarcopenia and with knee OA according to the criteria of American College of Rheumatology were included in the study DIMMUS. The participants were randomly assigned into two groups of intervention (n=31) and control (n=31). The intervention group received oral nutritional supplementation daily plus standardized exercise programme for 12 weeks and the control group received only rescue analgesic medication and exercise training. Muscle mass (appendicular skeletal muscle mass index [ASMMI] estimated by the Baumgartner et al.’s equation), muscle strength (handgrip strength), physical function (4-m gait speed) and QoL (SARQoL) were measured before and after the 12-week intervention. Safety was also recorded by assessments of adverse events.Results:There was no significant difference in baseline characteristics between the two groups (85.5% women, 63.5 ± 9.6 years, body mass index of 26.8 ± 4.5 kg/m2, 83.9% Kellgren-Lawerence grade II OA and 91.9% mild sarcopenia). A statistically significant improvement in the mean change of ASMMI (3.7 ± 1.0 kg/m2to 3.96 ± 1.1 kg/m2;P=0.0074), handgrip strength (18.8 ± 8.7 kg to 20.5 ± 8.5 kg,P=0.0089), and SARQoL score (59.3 ± 8.8 vs 70.7 ± 16.6;P=0,0003) from baseline to 12 weeks was observed for the intervention group but not for the control group. Both groups showed significant improvements on 4-m gait speed (5.0 ± 0.9 s to 4.4 ± 0.9 s in the intervention group; 5.2 ± 2.9 to 5.0 ± 2.3 m in the control group;P<0.001). One patient reported a treatment-related bad taste in the intervention group.Conclusion:The findings of the present study demonstrated that the combined supplementation of creatinine, glutamine and HMB together with exercise training for 12 weeks may have a positive effect on the muscle mass and strength and QoL in adults with mild sarcopenia and OA. The results provide preliminary experiences and guidance for further clinical trials in both OA and sarcopenic patients.References:[1] Kemmler W, Teschler M, Goisser S, Bebenek M, von Stengel S, Bollheimer LC,et al. Prevalence of sarcopenia in Germany and the corresponding effect of osteoarthritis in females 70 years and older living in the community: results of the FORMoSA study.Clin Interv Aging. 2015;10:1565-73.Disclosure of Interests:None declared

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Assessment of sarcopenia in patients with fibromyalgia

Rheumatology International ◽

10.1007/s00296-021-04973-6 ◽

2021 ◽

Author(s):

Abeline Kapuczinski ◽

Muhammad S. Soyfoo ◽

Sandra De Breucker ◽

Joëlle Margaux

Keyword(s):

Skeletal Muscle ◽

Muscle Strength ◽

Older People ◽

Muscle Mass ◽

Physical Performance ◽

Muscle Function ◽

Skeletal Muscle Mass ◽

Fibromyalgia Impact Questionnaire ◽

Control Group ◽

European Working

AbstractFibromyalgia is a chronic disorder characterized by persistent widespread musculoskeletal pain. Patients with fibromyalgia have reduced physical activity and increased sedentary rate. The age-associated reduction of skeletal muscle mass and function is called sarcopenia. The European Working Group on Sarcopenia in Older People developed a practical clinical definition and consensus diagnostic criteria for sarcopenia. Loss of muscle function is common in fibromyalgia and in the elderly. The goal of this study is to determine whether the reduction of muscle function in fibromyalgia is related to sarcopenia according to the European Working Group on Sarcopenia in Older People criteria. Forty-five patients with fibromyalgia and thirty-nine healthy control female subjects were included. All the participants were assessed by Fibromyalgia Impact Questionnaire and SARC-F questionnaire. Muscle mass was evaluated by bioimpedance analysis, muscle strength by handgrip strength test and physical performance with the Short Physical Performance Battery. Fibromyalgia Impact Questionnaire and SARC-F scores were statistically significantly higher in the fibromyalgia group than in the control group, showing severe disease and a higher risk of sarcopenia in the fibromyalgia group (p < 0.001). Muscle strength and physical performance were statistically significantly lower in the group with fibromyalgia than in the control group (p < 0.001). There was no statistical difference between fibromyalgia and control groups regarding skeletal muscle mass (p = 0.263). Our study demonstrated a significant reduction in muscle function in fibromyalgia patients without any loss of muscle mass. Loss of muscle function without decrease in muscle mass is called dynapenia.

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Abstract 19037: Exercise Reduces 24-hr Blood Pressure and Albuminuria in Patients with Moderate Diabetic Kidney Disease

Circulation ◽

10.1161/circ.130.suppl_2.19037 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ulf G Bronas ◽

Marc Weber ◽

Paul Drawz ◽

John Bantle ◽

Daniel Duprez ◽

...

Keyword(s):

Blood Pressure ◽

Kidney Disease ◽

Exercise Training ◽

Exercise Intervention ◽

Intervention Group ◽

Exercise Group ◽

Moderate Intensity ◽

Control Group ◽

Inverse Association ◽

Moderate Intensity Exercise

Introduction: Observational studies have shown an inverse association between physical function and CVD mortality in patients with chronic kidney disease (CKD) through unknown mechanisms. We have previously reported a significant exercise-induced reduction in resting blood pressure (BP) in 85 patients with stage 2-4 type 2 diabetes related CKD (DKD). The efficacy of exercise to reduce 24-hour ambulatory blood pressure (ABP) and albumin-creatinine ratio (ACR) is unclear. The purpose of this study was to test the hypothesis that 12wks of exercise would reduce 24-hr ABP and ACR in patients with stage 3-4 DKD and hypertension, compared to the control group. Methods: We randomly assigned 28 participants (21 male, age 62.9 yrs, BMI 34.8 kg/m2) with stage 3-4 DKD and hypertension (141(17)/75 (10) mmHg) to either 12-wks of moderate-intensity exercise training, 4x/wk for 45 minutes (n=15) or a usual medical care control group (n=13). The primary endpoint was change in 24-hr ABP at 12-wks. Results: There were no significant differences between groups in baseline demographic or medical variables. There were no changes in pharmacological variables at 12-week follow-up; group comparisons were analyzed by ANCOVA using baseline and exercise performed as covariates. Systolic BP levels and ACR were significantly reduced in the exercise-intervention group compared to the control group (Table 1). Reductions in diastolic BP levels were not significant between groups. Heart rate variables did not differ between groups. There was a strong inverse association between change in aerobic capacity and change in systolic and diastolic BP levels in the exercise group only (r=-.56, p=.039, and -.66, p=.011). Conclusion: This study suggests that exercise training imparts a favorable modulation of BP levels and ACR in patients with stage 3-4 DKD, potentially providing insight into the cardioprotective effect of exercise in this population.

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Can Muscle Mass Be Maintained with A Simple Resistance Intervention in the Older People? A Cluster Randomized Controlled Trial in Thailand

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010140 ◽

2021 ◽

Vol 19 (1) ◽

pp. 140

Author(s):

Bumnet Saengrut ◽

Takeshi Yoda ◽

Yumi Kimura ◽

Yasuko Ishimoto ◽

Rujee Rattanasathien ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Older People ◽

Muscle Mass ◽

Exercise Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Randomized Controlled ◽

Physiological Outcomes

The aging population is rapidly increasing worldwide. Sarcopenia is a common and important health problem among older people. The prevalence of sarcopenia among older Thai adults is increasing. Exercise intervention for sarcopenia prevention may significantly improve muscle strength, body balance, and muscle mass. Therefore, this study aimed to investigate the effects of a simple resistance intervention (SRI) program in preventing sarcopenia on physiological outcomes among community-dwelling older Thai adults. This study was a 12-week randomized controlled trial, which included 80 community-dwelling older adults in Chiang Mai, Thailand, who were randomly assigned into control (40 participants who performed usual exercise) and intervention (40 participants who performed the SRI program) groups. The SRI program was a home-based program consisting of 30 min of resistance exercise three times/week for 12 weeks, health education on sarcopenia. After 12 weeks, all physiological outcomes were measured and were significantly improved in the intervention group compared with baseline; hand grip, skeletal muscle mass index, and walking speed were significantly improved in the intervention group compared with the control group. Based on our results, the SRI program may prevent muscle weakness in community-dwelling older people in Thailand.

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The effect of a multicomponent exercise protocol (VIVIFRAIL©) on inflammatory profile and physical performance of older adults with different frailty status: study protocol for a randomized controlled trial

BMC Geriatrics ◽

10.1186/s12877-021-02030-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marina Petrella ◽

Ivan Aprahamian ◽

Ronei Luciano Mamoni ◽

Carla Fernanda de Vasconcellos Romanini ◽

Natália Almeida Lima ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Inflammatory Mediators ◽

Gait Speed ◽

Exercise Intervention ◽

Intervention Group ◽

Control Group ◽

Frailty Status ◽

Anti Inflammatory ◽

Inflammatory Profile

Abstract Background To investigate whether an exercise intervention using the VIVIFRAIL© protocol has benefits for inflammatory and functional parameters in different frailty status. Methods/design This is a randomized clinical trial in an outpatient geriatrics clinic including older adults ≥60 years. For each frailty state (frail, pre-frail and robust), forty-four volunteers will be randomly allocated to the control group (n = 22) and the intervention group (n = 22) for 12 weeks. In the control group, participants will have meetings of health education while those in the intervention group will be part of a multicomponent exercise program (VIVIFRAIL©) performed five times a week (two times supervised and 3 times of home-based exercises). The primary outcome is a change in the inflammatory profile (a reduction in inflammatory interleukins [IL-6, TNF- α, IL1beta, IL-17, IL-22, CXCL-8, and IL-27] or an increase in anti-inflammatory mediators [IL-10, IL1RA, IL-4]). Secondary outcomes are change in physical performance using the Short Physical Performance Battery, handgrip strength, fatigue, gait speed, dual-task gait speed, depressive symptoms, FRAIL-BR and SARC-F scores, and quality of life at the 12-week period of intervention and after 3 months of follow-up. Discussion We expect a reduction in inflammatory interleukins or an increase in anti-inflammatory mediators in those who performed the VIVIFRAIL© protocol. The results of the study will imply in a better knowledge about the effect of a low-cost intervention that could be easily replicated in outpatient care for the prevention and treatment of frailty, especially regarding the inflammatory and anti-inflammatory pathways involved in its pathophysiology. Trial registration Brazilian Registry of Clinical Trials (RBR-9n5jbw; 01/24/2020). Registred January 2020. http://www.ensaiosclinicos.gov.br/rg/RBR-9n5jbw/.

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Brain Structure, Cardiorespiratory Fitness, and Executive Control Changes after a 9-Week Exercise Intervention in Young Adults: A Randomized Controlled Trial

Life ◽

10.3390/life11040292 ◽

2021 ◽

Vol 11 (4) ◽

pp. 292

Author(s):

Lina Zhu ◽

Qian Yu ◽

Fabian Herold ◽

Boris Cheval ◽

Xiaoxiao Dong ◽

...

Keyword(s):

Young Adults ◽

Aerobic Exercise ◽

Cardiorespiratory Fitness ◽

Executive Control ◽

Brain Structure ◽

Grey Matter ◽

Exercise Intervention ◽

Exercise Group ◽

Control Group ◽

Younger Adults

Cardiorespiratory fitness (CRF) is assumed to exert beneficial effects on brain structure and executive control (EC) performance. However, empirical evidence of exercise-induced cognitive enhancement is not conclusive, and the role of CRF in younger adults is not fully understood. Here, we conducted a study in which healthy young adults took part in a moderate aerobic exercise intervention program for 9 weeks (exercise group; n = 48), or control condition of non-aerobic exercise intervention (waitlist control group; n = 72). Before and after the intervention period maximal oxygen uptake (VO2max) as an indicator of CRF, the Flanker task as a measure of EC performance and grey matter volume (GMV), as well as cortical thickness via structural magnetic resonance imaging (MRI), were assessed. Compared to the control group, the CRF (heart rate, p < 0.001; VO2max, p < 0.001) and EC performance (congruent and incongruent reaction time, p = 0.011, p < 0.001) of the exercise group were significantly improved after the 9-week aerobic exercise intervention. Furthermore, GMV changes in the left medial frontal gyrus increased in the exercise group, whereas they were significantly reduced in the control group. Likewise, analysis of cortical morphology revealed that the left lateral occipital cortex (LOC.L) and the left precuneus (PCUN.L) thickness were considerably increased in the exercise group, which was not observed in the control group. The exploration analysis confirmed that CRF improvements are linked to EC improvement and frontal grey matter changes. In summary, our results support the idea that regular endurance exercises are an important determinant for brain health and cognitive performance even in a cohort of younger adults.

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The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000100005 ◽

2007 ◽

Vol 125 (1) ◽

pp. 22-28 ◽

Cited By ~ 54

Author(s):

Claudio Battaglini ◽

Martim Bottaro ◽

Carolyn Dennehy ◽

Logan Rae ◽

Edgar Shields ◽

...

Keyword(s):

Breast Cancer ◽

Body Composition ◽

Resistance Training ◽

Cancer Treatment ◽

Cancer Patients ◽

Exercise Intervention ◽

Exercise Group ◽

Moderate Intensity ◽

Control Group ◽

Breast Cancer Patients

CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. DESIGN AND SETTING: Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. METHODS: Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). RESULTS: Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. CONCLUSION: The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment.

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Effect of a Musicians’ Exercise Intervention on Performance-Related Musculoskeletal Disorders

Medical Problems of Performing Artists ◽

10.21091/mppa.2014.4038 ◽

2014 ◽

Vol 29 (4) ◽

pp. 181-188 ◽

Cited By ~ 25

Author(s):

Cliffton Chan ◽

Tim Driscoll ◽

Bronwen J Ackermann

Keyword(s):

Musculoskeletal Disorders ◽

Private Practice ◽

Perceived Exertion ◽

Exercise Intervention ◽

Exercise Program ◽

Exercise Group ◽

Control Group ◽

Full Time ◽

Related Factors ◽

And Performance

PURPOSE: To evaluate the effect of a purpose-designed exercise program on performance-related musculoskeletal disorders (PRMDs) and associated risk factors in a sample of professional orchestral musicians. METHODS: A 10-week exercise program was made available to full-time musicians employed by the eight premier symphony orchestras of Australia. Questionnaires were administered before, immediately after (T1), and 6 months after interventions (T2) containing questions relating to change in frequency and severity of PRMDs, ratings of perceived exertion (RPE) during rehearsal, private practice, and performance, as well as nine performance-related factors. Participants were also asked to rate whether these performance-related factors affected their overall playing capacity during different playing situations. A comparative control group of musicians had no intervention and completed a modified questionnaire at the same time points. RESULTS: Exercise participants (n=30) reported a reduction in frequency (p<0.05) and severity (p<0.05) of PRMDs at T1 but not at T2 compared to controls (n=23). The exercise group reported a significant improvement in RPE during private practice at T1 (p<0.01) and T2 (p<0.01), but not during rehearsal and performance. At T1, the intervention was rated to be moderately to highly effective for three performance-related factors: strengthening muscles that support playing, learning techniques that support playing, and posture. Further, participants reported an intervention effect on overall playing capacity during rehearsal at T1 and T2. CONCLUSIONS: A tailored exercise program for musicians was effective at managing PRMDs, especially in reducing the frequency and severity of PRMDs. Physical therapy exercises should be considered in modifying performance-related factors that have been reported to be predictors of PRMDs.

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Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation

Blood ◽

10.1182/blood-2010-09-306308 ◽

2011 ◽

Vol 117 (9) ◽

pp. 2604-2613 ◽

Cited By ~ 135

Author(s):

Joachim Wiskemann ◽

Peter Dreger ◽

Rainer Schwerdtfeger ◽

Andrea Bondong ◽

Gerhard Huber ◽

...

Keyword(s):

Quality Of Life ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Physical Fitness ◽

Cell Transplantation ◽

Physical Performance ◽

Exercise Intervention ◽

Exercise Group ◽

Psychologic Distress

Abstract Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a home-based setting before hospital admission, during inpatient treatment and a 6- to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P < .01-.03), physical fitness/functioning (P = .02-.03) and global distress (P = .03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care.

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PO-103 The mechanism of long-term regular exercise intervention on liver injury in patients with NAFLD based on miR-146a regulation of TLR4/NF-KB signaling pathway

Exercise Biochemistry Review ◽

10.14428/ebr.v1i4.8823 ◽

2018 ◽

Vol 1 (4) ◽

Author(s):

Qi Peng ◽

Jiaqin Chen ◽

Wei Chen ◽

Chang Feng Shao ◽

Afang Yuan

Keyword(s):

Liver Fibrosis ◽

Liver Injury ◽

Fatty Liver ◽

Signaling Pathway ◽

Exercise Intervention ◽

Exercise Group ◽

Control Group ◽

Regular Exercise ◽

Alcoholic Fatty Liver

Objective To investigate the effects of long-term regular exercise on hepatic function in patients with non-alcoholic fatty liver (NAFLD) using blood biochemistry and liver fibrosis markers, and to compare the differential expression of cytokines related to TLR4/NF-KB signaling pathway. A preliminary discussion was made on its regulation mechanism. Methods Forty patients with NAFLD diagnosed in the Hunan Normal University School of Medicine, according to the degree of steatosis and exercise intervention, the patients were divided into control group (NAFLD group) 20 cases and long-term regular exercise group 20 cases, and the same time in our hospital Twenty patients with physical examination were normal controls; general data of all subjects, ALT, AST, GGT, serum type III procollagen (PCIII), hyaluronan (HA), and type IV collagen (CIV) were examined; Fluorescent quantitative PCR was used to detect the differential expression of TLR4/NF-KB signaling pathway-related cytokines and miR-146a in the blood of each group of subjects, revealing the effects and possible mechanisms of long-term regular exercise on liver fibrosis. Results Compared with the normal group, the levels of serum ALT, AST, GGT, PCIII, HA, and CIV in the non-alcoholic fatty liver patients were significantly lower in the long-term regular exercise group than in the control group; blood TLR4, NF-KB, MY-D88 Compared with the control group, the gene expression level was significantly downregulated in the long-term regular exercise group. Conclusions Long-term regular exercise can effectively reduce nonalcoholic inflammatory liver injury and has a clear anti-fibrotic effect. Its mechanism may be related to long-term regular exercise through regulating the TLR4/NF-KB signaling pathway related factors and the regulation of molecular miR-146a, reducing inflammation and preventing the formation of fibrosis.

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