Respiratory mechanics in supine subjects during progressive partial curarization

1982 ◽  
Vol 52 (1) ◽  
pp. 57-63 ◽  
Author(s):  
T. J. Gal ◽  
N. S. Arora
Keyword(s):  
Muscle Strength ◽  
Muscle Weakness ◽  
Respiratory Mechanics ◽  
Handgrip Strength ◽  
Elastic Recoil ◽  
Lung Inflation ◽  
Progressive Muscle Weakness ◽  
Inspiratory Resistance ◽  
Residual Capacity ◽  
Partial Curarization

Respiratory mechanics were studied in six supine conscious volunteers during progressive muscle weakness produced by infusion of d-tubocurarine. Partial curarization was carried out to the point of abolishing head lift ability and handgrip strength. At all levels of partial paralysis, expiratory muscle strength was significantly more impaired than inspiratory strength. Despite this, subjects maintained relatively normal maximal expiratory flow rates, whereas inspiratory flows decreased significantly. The diminished inspiratory flows are not fully explained by decreased driving pressures during force inspiration, since inspiratory resistance increased significantly with the decreased flow. Inspiratory flow patterns suggest a variable extrathoracic obstruction most likely due to the absence of normal airway abductor activity during inspiration. Maximal respiratory muscle weakness decreased forced vital capacity by 29% and total lung capacity by 15%. The decreased level of lung inflation did not alter lung elastic recoil. Functional residual capacity was unchanged, but inspiratory capacity decreased by 25% and residual volume increased by 38%. These changes are in accord with predictions based on the decreased muscle strength and normal respiratory system recoil.

Influence of sex gap on muscle strength and functional mobility in patients with cystic fibrosis

2020 ◽  
Vol 45 (4) ◽  
pp. 387-392 ◽  
Author(s):  
María del M. Martínez-García ◽  
Juan J. Rodríguez-Juan ◽  
Juan D. Ruiz-Cárdenas
Keyword(s):  
Cystic Fibrosis ◽  
Muscle Strength ◽  
Lung Function ◽  
Muscle Weakness ◽  
Walking Speed ◽  
Handgrip Strength ◽  
Pancreatic Insufficiency ◽  
Functional Mobility ◽  
Healthy Controls ◽  
Sit To Stand

The objectives of this study were to determine whether there were differences in handgrip strength and functional mobility between patients with cystic fibrosis (CF) and healthy controls with regard to sex and to ascertain whether these differences were related to lung function. Thirty-eight patients with CF (21 women) and 38 healthy controls aged 18–65 years were included. Muscle weakness and functional mobility were assessed through handgrip strength; walking speed; and time, velocity, and power derived from a single sit-to-stand (STS) test. Patients with CF showed differences for STS variables and walking speed but not for handgrip strength, compared with healthy controls. Considering sex differences, female patients showed differences for all variables analyzed while males with CF only exhibited differences for STS variables, compared with healthy controls. Females with CF showed moderate relationship between muscle weakness, functional mobility, and lung function (|r| = 0.45–0.49; p ≤ 0.05) whereas no relationships were observed for males with CF. The influence of chronic infection with Pseudomonas aeruginosa and pancreatic insufficiency on muscle weakness and functional mobility was similar in both sexes. Differences in muscle strength and functional mobility were predominantly observed in females with CF. These results suggest an important effect of sex gap on muscle weakness and functional mobility in patients with CF. Novelty The influence of sex gap on muscle weakness in CF has been shown. Muscle weakness was predominantly observed in females with CF.

scholarly journals Ventilation heterogeneity in obesity

2014 ◽  
Vol 116 (9) ◽  
pp. 1175-1181 ◽  
Author(s):  
Riccardo Pellegrino ◽  
Alessandro Gobbi ◽  
Andrea Antonelli ◽  
Roberto Torchio ◽  
Carlo Gulotta ◽  
...  
Keyword(s):  
Temporal Variability ◽  
Correlation Coefficients ◽  
Maximum Flow ◽  
Forced Oscillation Technique ◽  
Elastic Recoil ◽  
Lung Volumes ◽  
Ventilation Heterogeneity ◽  
Inspiratory Resistance ◽  
Residual Capacity ◽  
The Difference

Obesity is associated with important decrements in lung volumes. Despite this, ventilation remains normally or near normally distributed at least for moderate decrements in functional residual capacity (FRC). We tested the hypothesis that this is because maximum flow increases presumably as a result of an increased lung elastic recoil. Forced expiratory flows corrected for thoracic gas compression volume, lung volumes, and forced oscillation technique at 5–11–19 Hz were measured in 133 healthy subjects with a body mass index (BMI) ranging from 18 to 50 kg/m2. Short-term temporal variability of ventilation heterogeneity was estimated from the interquartile range of the frequency distribution of the difference in inspiratory resistance between 5 and 19 Hz (R5–19_IQR). FRC % predicted negatively correlated with BMI ( r = −0.72, P < 0.001) and with an increase in slope of either maximal ( r = −0.34, P < 0.01) or partial flow-volume curves ( r = −0.30, P < 0.01). Together with a slight decrease in residual volume, this suggests an increased lung elastic recoil. Regression analysis of R5–19_IQR against FRC % predicted and expiratory reserve volume (ERV) yielded significantly higher correlation coefficients by nonlinear than linear fitting models ( r2 = 0.40 vs. 0.30 for FRC % predicted and r2 = 0.28 vs. 0.19 for ERV). In conclusion, temporal variability of ventilation heterogeneities increases in obesity only when FRC falls approximately below 65% of predicted or ERV below 0.6 liters. Above these thresholds distribution is quite well preserved presumably as a result of an increase in lung recoil.

scholarly journals Muscle weakness assessment in older intensive care unit patients

2020 ◽  
Vol 14 (3) ◽  
pp. 166-172
Author(s):  
Amanda Colombo Peteck Lopes ◽  
Paulo Henrique Coltro ◽  
Vagner José Lopes ◽  
Sandra Mari Pistore Fiori ◽  
Jaqueline Santana Knapik ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Muscle Strength ◽  
Length Of Stay ◽  
Muscle Weakness ◽  
Handgrip Strength ◽  
Functional Independence ◽  
Female Patients ◽  
Icu Length Of Stay ◽  
Spearman's Rho ◽  
Spearman’S Rho

INTRODUCTION: After long periods of hospitalization, older adults may develop muscle weakness that can affect their functional independence after discharge. OBJECTIVE: To assess muscle weakness in older patients admitted to an ICU. METHOD: This cross-sectional, descriptive study with a quantitative approach assessed functional independence with the Katz Index and post-ICU muscle strength with a handgrip strength (HS) test and the Medical Research Council (MRC) sum-score. The sample consisted of 60 patients with an average age of 76 (60–99) years, 36 (60%) of whom were female. RESULTS: Post-ICU, 86.7% of the patients were functionally dependent. Female patients had significantly lower HS than males: 7 (0–24) vs. 17 (1–37) (p < 0.001). Female patients who received mechanical ventilation (MV) or sedation had significantly lower HS and MRC scores than those who did not (p < 0.001): HS MV 1 (0–13) vs. 11 (0–24) p < 0.001; MRC MV 35 (14–48) vs. 43 (27–57) p < 0.001; HS sedation 0 (0–12) vs. 9 (0–24) p < 0.001; MRC sedation 34 (14–36) vs. 42 (22–57) p < 0.001, respectively. Finally, there was an inversely proportional correlation between HS, MRC scores, and ICU length of stay, Spearman’s rho = -0.267 (p = 0.0039) and Spearman’s rho = -0.347 (p = 0.007), respectively. CONCLUSION: Older women who received mechanical ventilation and sedation have lower muscle strength than those who did not. As the ICU length of stay increases, muscle strength decreases.

scholarly journals Synergistic associations of visual and self-reported hearing acuity with low handgrip strength in older adults: a population-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seung Hoon Kim ◽  
Kyungduk Hurh ◽  
Yoonsik Park ◽  
Sung-In Jang ◽  
Eun-Cheol Park
Keyword(s):  
Muscle Strength ◽  
Muscle Weakness ◽  
Handgrip Strength ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sensory Function ◽  
Sectional Study ◽  
Additive Interaction ◽  
Cross Sectional ◽  
Hearing Acuity

Abstract Background It is unclear whether visual and hearing acuity are independently or synergistically associated with muscle strength. We aimed to examine the associations of visual and self-reported hearing acuity with low handgrip strength and the additive interaction between visual and hearing acuity on low handgrip strength in people over 60 years. Method Data of 3,075 individuals aged over 60 years from the 2017 and 2018 Korea National Health and Nutrition Examination Survey were used for this cross-sectional study. Low handgrip strength was defined based on the 20th percentile of the study population (< 30.4 kg for male and < 17.7 kg for female). Visual and self-reported hearing acuity were each divided into three categories: good, moderate, and impaired. Multiple logistic regression and relative excess risk due to interaction (RERI) were performed. Results Of the 3,075 participants, 993 (32.3 %) demonstrated low handgrip strength. Low handgrip strength was more prevalent in participants with moderate (adjusted odds ratio [AOR] = 1.54, 95 % confidence interval [CI] = 1.12–2.12) and impaired visual acuity (AOR = 2.00, 95 % CI = 1.34–2.96). Both moderate and impaired self-reported hearing acuity were significantly associated with low handgrip strength (moderate: AOR = 1.25, 95 % CI = 1.01–1.55; impaired: AOR = 1.66, 95 % CI = 1.15–2.38). The more severe the sensory function decline, the higher the association with muscle weakness. Moreover, combined sensory impairments were associated with deteriorating low handgrip strength (AOR = 8.38), with significantly strong additive interactions (RERI = 2.61, 95 % CI = 2.52–2.70). Conclusions Awareness is needed regarding the risk of reduced muscle strength in individuals with moderate and impaired sensory function. Older people with sensory function decline in clinical settings may benefit from programs such as exercise prescription to prevent muscle weakness.

Biological therapy in idiopathic inflammatory myopathies

2014 ◽  
Vol 155 (1) ◽  
pp. 3-10
Author(s):  
Levente Bodoki ◽  
Melinda Nagy-Vincze ◽  
Zoltán Griger ◽  
Andrea Péter ◽  
Csilla András ◽  
...  
Keyword(s):  
T Cells ◽  
Muscle Weakness ◽  
Biological Therapy ◽  
Therapeutic Options ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Progressive Muscle Weakness ◽  
Immune Mediated ◽  
Novel Therapeutic

Idiopathic inflammatory myopathies are systemic, immune-mediated diseases characterized by proximal, symmetrical, progressive muscle weakness. The aim of this work is to give an overview of the biological therapy used in the treatment of idiopathic inflammatory myopathies. The authors also focus on novel results in the therapy directed against the B- and T-cells. They emphasize the importance of new trials in these diseases which may lead to the introduction of novel therapeutic options in these disorders. Orv. Hetil., 2014, 155(1), 3–10.

scholarly journals Relationships between Socioeconomic Status, Handgrip Strength, and Non-Alcoholic Fatty Liver Disease in Middle-Aged Adults

2021 ◽  
Vol 18 (4) ◽  
pp. 1892
Author(s):  
Jinkyung Cho ◽  
Inhwan Lee ◽  
Dong-Ho Park ◽  
Hyo-Bum Kwak ◽  
Kisuk Min
Keyword(s):  
Socioeconomic Status ◽  
Liver Disease ◽  
Muscle Strength ◽  
Fatty Liver Disease ◽  
Handgrip Strength ◽  
Low Ses ◽  
Middle Aged ◽  
Alcoholic Fatty Liver ◽  
Middle Aged Adults ◽  
Alcoholic Fatty Liver Disease

Although low socioeconomic status (SES) and decreased muscle strength have been found to be associated with the risk factors of non-alcoholic fatty liver disease (NAFLD), including insulin resistance, obesity, and metabolic syndrome, the associations among SES, muscle strength, and NAFLD are still unclear. We aimed to investigate the combined effect of SES and relative handgrip strength (HGS) on the risk of NAFLD in middle-aged adults. Data from 5272 middle-aged adults who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014–2018 were analyzed. NAFLD was defined using the hepatic steatosis index (HSI) > 36 and the comprehensive NAFLD score (CNS) ≥ 40 in the absence of other causes of liver disease. SES was based on a self-reported questionnaire. Overall, individuals with low SES (odds ratio (OR) = 1.703, 95% confidence interval (CI): 1.424–2.037, p < 0.001) or low HGS (OR = 12.161, 95% CI: 9.548–15.488, p < 0.001) had a significantly higher risk of NAFLD. The joint association analysis showed that a low SES combined with a low HGS (OR = 2.479, 95% CI: 1.351–4.549, p = 0.003) further significantly increased the risk of NAFLD when adjusted for all the covariates, compared with individuals with a high SES and a high HGS (OR = 1). The current findings suggest that both low SES and low HGS were independently and synergistically associated with an increased risk of NAFLD in middle-aged Korean adults.

scholarly journals Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Tatsuma Okazaki ◽  
Yoshimi Suzukamo ◽  
Midori Miyatake ◽  
Riyo Komatsu ◽  
Masahiro Yaekashiwa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Muscle Strength ◽  
Older People ◽  
Serum Albumin ◽  
Muscle Mass ◽  
Muscle Weakness ◽  
Fat Mass ◽  
Respiratory Muscle ◽  
Respiratory Muscle Strength ◽  
Respiratory Muscle Weakness

Introduction: The respiratory muscle strength regulates the effectiveness of coughing, which clears the airways and protects people from pneumonia. Sarcopenia is an aging-related loss of muscle mass and function, the worsening of which is associated with malnutrition. The loss of respiratory and swallowing muscle strength occurs with aging, but its effect on pneumonia is unclear. This study aimed to determine the risks of respiratory muscle weakness on the onset and relapse of pneumonia in older people in conjunction with other muscle-related factors such as malnutrition. Methods: We conducted a longitudinal study with 47 pneumonia inpatients and 35 non-pneumonia controls aged 70 years and older. We evaluated the strength of respiratory and swallowing muscles, muscle mass, and malnutrition (assessed by serum albumin levels and somatic fat) during admission and confirmed pneumonia relapse within 6 months. The maximal inspiratory and expiratory pressures determined the respiratory muscle strength. Swallowing muscle strength was evaluated by tongue pressure. Bioelectrical impedance analysis was used to evaluate the muscle and fat mass. Results: The respiratory muscle strength, body trunk muscle mass, serum albumin level, somatic fat mass, and tongue pressure were significantly lower in pneumonia patients than in controls. Risk factors for the onset of pneumonia were low inspiratory respiratory muscle strength (odds ratio [OR], 6.85; 95% confidence interval [CI], 1.56–30.11), low body trunk muscle mass divided by height2 (OR, 6.86; 95% CI, 1.49–31.65), and low serum albumin level (OR, 5.46; 95% CI, 1.51–19.79). For the relapse of pneumonia, low somatic fat mass divided by height2 was a risk factor (OR, 20.10; 95% CI, 2.10–192.42). Discussion/Conclusions: Respiratory muscle weakness, lower body trunk muscle mass, and malnutrition were risk factors for the onset of pneumonia in older people. For the relapse of pneumonia, malnutrition was a risk factor.

scholarly journals Correlation between age, muscle architecture, and muscle strength in children with Erb’s palsy

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ahmed Saad Awad ◽  
Mostafa Soliman Ali ◽  
Mohamed Ismail Elassal
Keyword(s):  
Muscle Strength ◽  
Muscle Weakness ◽  
Muscle Thickness ◽  
Study Groups ◽  
Pennation Angle ◽  
Muscle Architecture ◽  
Active Movement ◽  
Significant Relation ◽  
Erb’S Palsy ◽  
Significant Difference

Abstract Background Muscle weakness is a widespread problem in children with Erb’s palsy as it can cause changes in muscle architecture parameters, which can be detected by ultrasonography. This study was conducted to determine the relation between age, muscle architecture, and muscle strength in children with Erb’s palsy. A total of 40 children with Erb’s palsy from both sexes aged 1–2.5 years were included in this study. Muscle thickness and pennation angle were measured by ultrasonography, and muscle strength was measured using the active movement scale. Results A significant relation was found between age, muscle thickness, pennation angle, and muscle strength (P < 0.05). Moreover, a significant difference was found in muscle architecture parameters during relaxation and contraction in both study groups and in each study group (P < 0.05). Conclusion Muscle weakness in children with Erb’s palsy has an effect on muscle architecture parameters, and these parameters also increase with age.

Relationship of end-expiratory pressure, lung volume, and 99mTc-DTPA clearance

1987 ◽  
Vol 63 (4) ◽  
pp. 1586-1590 ◽  
Author(s):  
J. A. Cooper ◽  
H. van der Zee ◽  
B. R. Line ◽  
A. B. Malik
Keyword(s):  
Lung Volume ◽  
Clearance Rate ◽  
Base Line ◽  
Lung Inflation ◽  
Alveolar Epithelial ◽  
Pulmonary Clearance ◽  
Residual Capacity ◽  
Dose Response Effect ◽  
Relationship Of ◽  
Line P

We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH2O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH2O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH2O PEEP. At 2.5 cmH2O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH2O (P less than 0.05). Between 15 and 20 cmH2O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized 99mTc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation.

scholarly journals Circulating levels of IGF1 are associated with muscle strength in middle-aged- and oldest-old women

2011 ◽  
Vol 164 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Diana G Taekema ◽  
Carolina H Y Ling ◽  
Gerard Jan Blauw ◽  
Carel G Meskers ◽  
Rudi G J Westendorp ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Oldest Old ◽  
Muscle Growth ◽  
Serum Levels ◽  
Middle Aged ◽  
Cross Sectional ◽  
The Relationship ◽  
Circulating Levels

ObjectiveIn aging populations, poor handgrip strength has been associated with physical disability and mortality. IGF1 is an important mediator of muscle growth and regeneration affecting muscle function. We studied the relationship between circulating levels of IGF1, its binding protein 3 (IGFBP3), and handgrip strength and physical performance in middle-aged- and oldest-old subjects.DesignCross-sectional analysis in two different cohorts composed of middle-aged- (n=672, mean 63.9±6.7 years) and oldest-old subjects (n=272, all 89 years).MethodsHandgrip strength, functional performance and ability, and serum levels of IGF1 and IGFBP3 were measured in all subjects and analyzed by linear regression for men and women separately.ResultsIGF1 and IGFBP3 levels declined with chronological age and were positively associated with handgrip strength in middle-aged- and oldest-old women (both, P<0.05), but not in men of either age group. Furthermore, higher serum levels of IGF1 were associated with slower walking speed in oldest-old men (P=0.012), and serum levels of IGFBP3 were positively associated with activities of daily living in the oldest-old women (P=0.002).ConclusionThe significant relationship between IGF1 levels and muscle strength found in women but not in men suggests a gender-specific influence of IGF1 on muscle strength. Further studies are necessary to test the relationship with physical performance.

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