Applications of physical performance measures to routine diabetes care for frailty prevention concept: fundamental data with grip strength, gait speed, timed chair stand speed, standing balance, and knee extension strength

IntroductionProgression of muscle strength weakening will lead to a poor physical performance and disability. While this is particularly important in patients with diabetes, the associations of reduced muscle strength measured by grip strength with clinical features and physical performance remain unclear. We investigated clinical features and physical performance measures in association with grip strength in elderly people with diabetes in a primary care setting.Research design and methodsA cross-sectional study was conducted enrolling 634 male and 323 female Japanese patients with type 2 diabetes aged 60 years or older. First, grip strength was measured and the associations of gender-specific grip strength with clinical features were evaluated. Second, in patients with a grip strength below the gender-specific median, physical performance measures, including gait speed, timed chair stand speed, knee extension strength, standing balance, and short physical performance battery scores, were investigated. Patients with and without a low performance defined by Asian Working Group for Sarcopenia were compared in terms of clinical features and physical performance measures.ResultsGrip strength decreased according to aging and longer duration of diabetes and was independently related to body mass index, glycated hemoglobin A1c (HbA1c), serum albumin, albuminuria, neuropathy, and stroke in male patients, and to body mass index and albuminuria in female patients. The physical performance measures became worse proportionally to a decrease in the grip strength. Patients with a low performance exhibited a significantly older age, lower grip strength and serum albumin, higher albuminuria, and poorer physical performance measures than those without.ConclusionsReduced grip strength was associated with glycemic exposure indicators of age-related duration, HbA1c, and vascular complications. The physical performance measures became worse with decreasing grip strength. Measurements of grip strength and physical performance in patients with diabetes may help promote intervention to prevent frailty in future studies.

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Relationship Between Perceived Physical and Mental Fatigability and Physical Performance in Very Old Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.576 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 178-178

Author(s):

Yixin Hu ◽

Zhuangzhuang Zhang ◽

Woei-Nan Bair ◽

Anying Bai ◽

Li Fan

Keyword(s):

Grip Strength ◽

Physical Performance ◽

Performance Measures ◽

Gait Speed ◽

Clinical Importance ◽

Community Dwelling ◽

Very Old ◽

Chair Stand ◽

Old Adults ◽

Usual Gait Speed

Abstract To investigate the relationship between perceived physical and mental fatigability and physical performance in community-dwelling very old adults (≥80 years). We examined the association in one retired community in Beijing including 404 very old adults. Pittsburgh Fatigability Scale (PFS), Chinese version, was used to assess perceived fatigability in physical domain (PFS-P) and mental domain (PFS-M). High fatigability is defined as PFS-P ≥ 15, and PFS-M ≥ 13. Physical performance measures include grip strength, usual gait speed, chair stand and Short Physical Performance Battery (SPPB) test. Women have higher PFS scores (both PFS-P & PFS-M) and higher prevalence of high fatigability than men. After adjusting for sex, usual gait speed and SPPB scores were significantly associated with PFS-P & PFS-M, while grip strength and chair stand performance were significantly associated with PFS-P only. After multivariable adjustment, usual gait speed (B=-3.745, P=0.021) and chair stand performance (B=0.335, P=0.005) were significantly associated with PFS-P, while usual gait speed (B=-2.656, P=0.006) and SPPB scores (B=-0.214, P=0.029) were significantly associated with PFS-M. Perceived physical and mental fatigability is highly prevalent in very older adults and they differ by sex. The significant associations between PFS scores and performance measures suggest that PFS is of potential clinical importance, especially when testing performance measures are not feasible. Utilization of PFS score can assist in identifying target populations who are at risk of reduced physical functions, such as older with depression, older women. Interventions to improve usual gait speed are likely to reduce both perceived physical and mental fatigability.

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ASSOCIATION OF GRIP AND KNEE EXTENSION STRENGTH WITH WALKING SPEED OF OLDER WOMEN RECEIVING HOME-CARE PHYSICAL THERAPY

Journal of Frailty & Aging ◽

10.14283/jfa.2015.74 ◽

2015 ◽

pp. 1-3

Author(s):

R.W. BOHANNON

Keyword(s):

Home Care ◽

Grip Strength ◽

Physical Performance ◽

Gait Speed ◽

Care Setting ◽

Knee Extension ◽

Women Patients ◽

Knee Extension Strength ◽

Relative Value ◽

Walking Performance

Background: Decreased muscle strength and limited physical performance are key elements of frailty and sarcopenia. The relative value of grip and knee extension strength for explaining walking performance has not been clearly established. Objectives: Compare the ability of grip and knee extension strength to explain gait speed. Design: Retrospective use of cross-sectionally obtained data. Setting: Patients’ homes. Participants:Forty-four ambulatory women patients at least 65 years of age. Measurements: Grip and knee extension forces obtained bilaterally with dynamometers and comfortable gait speed. Results: Knee extension forces were, but grip strength forces were not, correlated significantly with gait speed. Knee extension forces were able, but grip strength forces were not able, to satisfactorily identify patients with gait speeds < .40 m/sec. Conclusions:For women receiving therapy in a home-care setting, physical performance as reflected by gait speed is better explained by knee extension strength than by grip strength.

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Distinct Trajectories of Individual Physical Performance Measures Across 9 Years in 60- to 70-Year-Old Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa045 ◽

2020 ◽

Vol 75 (10) ◽

pp. 1951-1959

Author(s):

Trynke Hoekstra ◽

Anna Galina Maria Rojer ◽

Natasja M van Schoor ◽

Andrea Britta Maier ◽

Mirjam Pijnappels

Keyword(s):

Physical Performance ◽

Performance Measures ◽

Gait Speed ◽

Successful Aging ◽

Latent Class ◽

Handgrip Strength ◽

Optimal Number ◽

Latent Class Models ◽

Chair Stand ◽

Longitudinal Aging Study Amsterdam

Abstract Background Physical performance is an important factor for successful aging. This study aimed to identify distinct trajectories of multiple physical performance measures over 9 years in individuals aged 60–70 years and to evaluate their characteristics and the overlap between measures. Methods Four physical performance measures were assessed in 440 participants of the Longitudinal Aging Study Amsterdam: tandem stand, gait speed, chair stand, and handgrip strength. Gender-specific latent class models were conducted to obtain distinct trajectories and their degree of overlap. Results Mean age at baseline was 67.9 (SD 1.7) years for males and 68.0 (SD 1.7) years for females. The optimal number of trajectories differed across measures. For tandem stand, no distinct trajectories were found (all 179 males, 198 females). For gait speed, three trajectories were identified, dependent on baseline speed: high-stable (47 males, 27 females), intermediate-stable (132 males, 130 females), and low-declining performance (6 males, 48 females). Two trajectories were identified for the chair stand: a stable (168 males, 150 females) and declining trajectory (10 males, 38 females). For handgrip strength, three declining trajectories were identified differing in baseline performance: high (55 males, 75 females), intermediate (111 males, 118 females), and low (17 males, 10 females). Overall, 11.9% of males and 5.7% of females were classified in similar trajectories across measures. Conclusions Trajectories of physical performance were heterogeneous, but showed similar patterns for males and females. Little overlap between measures was shown, suggesting different mechanisms for decline. This study emphasizes the use of multiple domains to assess physical performance.

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SINGLE PHYSICAL PERFORMANCE MEASURES CANNOT IDENTIFY GERIATRIC OUTPATIENTS WITH SARCOPENIA

Journal of Frailty & Aging ◽

10.14283/jfa.2018.19 ◽

2018 ◽

pp. 1-6

Author(s):

S.M.L.M. Looijaard ◽

S.J. Oudbier ◽

E.M. Reijnierse ◽

G.J. Blauw ◽

C.G.M. Meskers ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Muscle Mass ◽

Physical Performance ◽

Performance Measures ◽

Handgrip Strength ◽

Performance Measure ◽

Community Dwelling ◽

Chair Stand ◽

Stand Test ◽

Chair Stand Test

Background: Sarcopenia is highly prevalent in the older population and is associated with several adverse health outcomes. Equipment to measure muscle mass and muscle strength to diagnose sarcopenia is often unavailable in clinical practice due to the related expenses while an easy physical performance measure to identify individuals who could potentially have sarcopenia is lacking. Objectives: This study aimed to assess the association between physical performance measures and definitions of sarcopenia in a clinically relevant population of geriatric outpatients. Design, setting and participants: A cross-sectional study was conducted, consisting of 140 community-dwelling older adults that were referred to a geriatric outpatient clinic. No exclusion criteria were applied. Measurements: Physical performance measures included balance tests (side-by-side, semi-tandem and tandem test with eyes open and -closed), four-meter walk test, timed up and go test, chair stand test, handgrip strength and two subjective questions on mobility. Direct segmental multi-frequency bioelectrical impedance analysis was used to measure muscle mass. Five commonly used definitions of sarcopenia were applied. Diagnostic accuracy was determined by sensitivity, specificity and area under the curve.Results: Physical performance measures, i.e. side-by-side test, tandem test, chair stand test and handgrip strength, were associated with at least one definition of sarcopenia. Diagnostic accuracy of these physical performance measures was poor. Conclusions: Single physical performance measures could not identify older individuals with sarcopenia, according to five different definitions of sarcopenia.

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Effects of Resistance Exercise on Muscle Mass, Strength, and Physical Performances in Elderly with Diagnosed Sarcopenia: A Systematic Review and Meta-Analysis

Exercise Science ◽

10.15857/es.2020.29.2.109 ◽

2020 ◽

Vol 29 (2) ◽

pp. 109-120

Author(s):

Kyung Min Kim ◽

Hyun Joo Kang

Keyword(s):

Resistance Exercise ◽

Grip Strength ◽

Muscle Mass ◽

Physical Performance ◽

Meta Analysis ◽

Knee Extension ◽

Timed Up And Go ◽

Knee Extension Strength ◽

Hand Grip ◽

Appendicular Muscle Mass

PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, p=.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, p=.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, p=.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, p=.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, p=.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, p=.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.

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Abstract P298: Associations Between Time-varying Physical Activity and Physical Performance Measures in Postmenopausal Women: the Women’s Health Initiative

Circulation ◽

10.1161/circ.135.suppl_1.p298 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Deepika Laddu ◽

Betsy C Wertheim ◽

David O Garcia ◽

Robert Brunner ◽

Aladdin H Shadyab ◽

...

Keyword(s):

Physical Activity ◽

Functional Status ◽

Women's Health ◽

Grip Strength ◽

Older Women ◽

Physical Performance ◽

Performance Measures ◽

Time Varying ◽

Health Initiative ◽

The Women’S Health Initiative

Introduction: Maintaining regular physical activity (PA) may delay the onset of functional disability and preserve mobility later in life. Whereas many population-based studies have reported the prospective relationship of initial PA levels to later-life functional status, few studies have examined the longitudinal relationships between changes in PA to changes in physical functioning. This study examined associations between changes in PA and changes in standard physical performance measures (PPM) over 6-years in older women. Methods: Recreational PA was reported using the WHI questionnaire; gait speed, timed chair stand, and grip strength were assessed in clinic using standardized protocols. Exposures were assessed at baseline, years 1, 3 and 6 of the Women’s Health Initiative Clinical Trials (n=5092 women; mean age = 69.8 y). Mixed effects linear regression models were used to evaluate the association between time-varying PA and change in each PPM. Potential interactions between time-varying PA and race and age (<70 y; ≥70 y) were also tested. Results: At baseline, 23.0% women were categorized as sedentary (SED; <100 MET-min/wk), 30.4% as light PA level (100- <500 MET-min/wk), 27.5% as moderate (500- <1200 MET-min/wk); and 19.1% as high PA (≥ 1200 MET-min/wk). Significant, dose-response associations between PA and improvements in all PPMs were observed over the 6 y follow-up after adjusting for demographic, lifestyle, and clinical factors. Compared to SED, women in the high PA groups showed better grip strength (0.48 kg higher; P <0.01), more chair stands (0.35 more; P <0.001), and faster gait speeds (0.06 m/s faster ; P <0.001). Older women (≥70 y) benefited more from higher levels of PA than the younger women (P interaction for age =0.014), as reflected by their greater increase in chair stands ( P <0.001); however, interactions between PA and race were not significant. Conclusions: These findings provide evidence that, in post-menopausal women, maintaining higher PA levels over time is associated with benefits in lower extremity function, as compared to being sedentary. These data are consistent with the view that regular PA plays an important role in maintaining functional status during aging, particularly in older women.

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Vitamin D Concentrations and Physical Performance in Competitive Adolescent Swimmers

Pediatric Exercise Science ◽

10.1123/pes.2013-0034 ◽

2014 ◽

Vol 26 (1) ◽

pp. 64-70 ◽

Cited By ~ 9

Author(s):

Gal Dubnov-Raz ◽

Netachen Livne ◽

Raanan Raz ◽

Daniel Rogel ◽

Avner H. Cohen ◽

...

Keyword(s):

Vitamin D ◽

General Population ◽

Grip Strength ◽

Physical Performance ◽

Performance Measures ◽

Swimming Performance ◽

Serum Vitamin ◽

Performance Parameters ◽

Serum Vitamin D ◽

Measures Of Performance

Serum vitamin D concentrations (25[OH]D) are associated with physical performance in the general population, but few studies have been published in athletes. 80 competitive adolescent swimmers from both sexes were tested for serum 25(OH)D concentrations, grip strength, balance and swimming performance at several speeds. Spearman’s correlations were used to examine the associations between 25(OH)D concentrations and age-adjusted measures of performance. Performance parameters were also compared between vitamin D sufficient (n = 27), insufficient (25[OH]D ranging 20−29.9 ng/ml, n = 42), and deficient (25[OH]D < 20 ng/ml, n = 11) participants. No significant associations were found between serum 25(OH)D concentrations and any of the performance measures, with no significant differences found between vitamin D sufficient, insufficient and deficient participants. In competitive adolescent swimmers, serum vitamin D concentrations were not associated with strength, balance or swimming performance. Vitamin D insufficient/deficient swimmers did not have reduced performance.

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SCREENING FOR LOW SHORT PHYSICAL PERFORMANCE BATTERY SCORES: CAN GRIP STRENGTH AND SINGLE CHAIR STAND BE USEFUL?

Innovation in Aging ◽

10.1093/geroni/igz038.2510 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S679-S680

Author(s):

Paulo H Chaves

Keyword(s):

Older Adults ◽

Grip Strength ◽

Physical Performance ◽

Nursing Home Residents ◽

Short Physical Performance Battery ◽

Clinical Settings ◽

Or Efficiency ◽

Chair Stand ◽

Screening Approach ◽

Time Space

Abstract The clinical value of low Short Physical Performance Battery (SPPB) scores for identification of older adults at-disability-risk who may benefit from structured intervention is well-established. Feasibility concerns – e.g., time, space constraints – are factors that often preclude SPPB implementation in clinical settings. We assessed whether grip strength (GS) and/or single chair stand (SCS), simple and highly feasible tests, could be useful for clinical identification of older adults with poor SPPB performance. Cross-sectional study using most recent data (Round 7) from the National Health and Aging Trends Study, which enrolled a large U.S. representative sample of Medicare beneficiaries 65 years and older (baseline round: 2011; yearly follow-ups). Nursing home residents were excluded. Sample size was 4,612. Outcome: poor SPPB performance (score <8). Low GS: <20 Kg (women) or <30 Kg (men), and able to do a SCS without use of arm (yes/no) were predictors. Logistic regression, areas under the curves (AUC), and accuracy statistics were computed. AUC for low GS was 0.66, and SCS inability was 0.68; when both tests were considered together, AUC increased significantly: 0.76. Among those SCS-unable (n=752), 95.6% had SPPB<8. A two-stage screening approach; i.e., detection of SCS inability first, followed by low GS in those SCS-able resulted in a net-sensitivity of 75.3%, and net-specificity of 83.5%. Sequential screening with SCS and GS testing might offer a case finding screening approach appealing to busy clinical settings from feasibility, accuracy, and/or efficiency perspectives for identification of older adults with low SPPB who may benefit from established interventions.

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The effects of the body mass index on the physical function and the quality of life in the elderly

Baltic Journal of Health and Physical Activity ◽

10.29359/bjhpa.2020.suppl.1.06 ◽

2020 ◽

Vol Supplement 1 (1) ◽

pp. 55-62

Author(s):

RAZIYE ŞAVKIN ◽

GÖKHAN BAYRAK ◽

NIHAL BÜKER

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Body Mass Index ◽

Physical Health ◽

Physical Function ◽

Grip Strength ◽

Physical Performance ◽

The Elderly ◽

The Body

Background: As in all age groups, the prevalence of overweight and obesity is gradually increasing in the elderly. The aim of this study is to examine the effect of the body mass index (BMI) on the physical function and the overall quality of life in the elderly. Materials and methods: 265 community-dwelling older adults (131 women and 134 men) were included. BMI, grip strength (hand-held dynamometer), physical performance (Short Physical Performance Battery, SPPB) and overall quality of life (WHOQOL-BREF) were assessed. Results: 265 older adults were divided into three groups: normal (n=66), overweight (n=116), obese (n=83). SPPS and WHOQOL-BREF psychological health scores of the normal group were statistically significantly higher than in the obese group (p≤0.005). The WHOQOL-BREF physical health score of the normal and the overweight groups was significantly higher than in the obese group (p≤0.005). Grip strength, SPPB and WHOQOL-BREF physical health scores of older men in all groups were better than in women (p≤0.005). Conclusions: BMI negatively affects the physical function, physical health and the psychological domain of the quality of life in the elderly. In order to avoid or limit the effects of disability secondary to obesity and promote healthy ageing, the elderly should be encouraged to increase their physical activity and maintain healthy weight.

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