scholarly journals Associations Between Obesity With Low Muscle Mass and Physical Function in Patients With End-Stage Knee Osteoarthritis

2021 ◽  
Vol 12 ◽  
pp. 215145932110207
Author(s):  
Beom Su Kim ◽  
So Young Lee ◽  
Bo Ryun Kim ◽  
Jun Hwan Choi ◽  
Sang Rim Kim ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Muscle Mass ◽  
Gait Speed ◽  
Linear Regression Analysis ◽  
Stair Climbing ◽  
Normal Muscle ◽  
Timed Up And Go ◽  
Males And Females ◽  
End Stage

Objective: To investigate the prevalence of obesity with low muscle mass and its impact on physical function, quality of life (QOL) and pain in patients with end-stage knee osteoarthritis over 65 years old. Methods: In this cross-sectional study, we assessed a total of 562 patients. After separating the group into males and females, we divided patients into 4 further groups: normal BMI with normal muscle mass, obesity with normal muscle mass, normal BMI with low muscle mass and obesity with low muscle mass. All patients completed stair climbing test (SCT), 6-minute walk test, timed up and go test (TUG), instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, VAS, and EuroQOL 5 dimensions questionnaire. Results: Obesity with low muscle mass was diagnosed in 6 males subjects (7.8%) and 9 female subjects (1.9%). Patients with obesity and low muscle mass performed the SCT-ascent and descent significantly slower than other body composition groups in both males and females. TUG in males and gait speed in females were also significantly slower in the obesity with low muscle mass group. Stepwise multiple linear regression analysis revealed that in males, obesity with low muscle mass was significantly predictive of SCT ascent (β = 0.409, p < 0.001), SCT-descent (β = 0.405, p < 0.001), and TUG (β = 0.283, p = 0.009), and in females, obesity with low muscle mass was significantly predictive of SCT-ascent (β = 0.231, p < 0.001), SCT-descent (β = 0.183, p < 0.001), and gait speed (β=-0.129, p = 0.004). Conclusions: This study confirms that the combination of obesity and low muscle mass is associated with impaired physical function in patients with end-stage knee osteoarthritis.

scholarly journals Knee Extensor Muscle Strength Is More Important Than Postural Balance for Stair-Climbing Ability in Elderly Patients with Severe Knee Osteoarthritis

2021 ◽  
Vol 18 (7) ◽  
pp. 3637
Author(s):  
José Casaña ◽  
Joaquín Calatayud ◽  
Antonio Silvestre ◽  
José Sánchez-Frutos ◽  
Lars L. Andersen ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Postural Balance ◽  
Linear Regression Analysis ◽  
Knee Extensor ◽  
Knee Extension ◽  
Stair Climbing ◽  
Joint Disease ◽  
Timed Up And Go ◽  
Climbing Ability

Knee osteoarthritis is a chronic joint disease which damages articular cartilage. In its severe stages, it results in impairments in balance and muscle strength loss, which affect daily life activities such as walking or climbing stairs. This study sought to investigate associated factors with stair-climbing ability in this population, with special interest in measuring the relevance of postural balance for this task. Forty-four patients scheduled to undergo unilateral total knee arthroplasty were assessed. Timed up and go test, stair ascent–descent test, three different isometric strength tests (knee flexion, knee extension and hip abduction), active knee extension and flexion range of movement and static postural balance assessment were evaluated. Spearman’s correlation coefficients and multiple linear regression analysis determined the strength of association between the different variables and stair-climbing time. No significant association between the stair-climbing time and static balance was found. Significant associations were found between stair-climbing time and timed up and go (r = 0.71; p < 0.0001) and maximal knee extensor strength (r = –0.52; p = 0.0003). One-year increase in age was associated with 0.15 s (95% CI 0.00 to 0.30) slower stair-climbing time. In conclusion, muscle strength is more important than postural balance for stair-climbing ability in this population.

scholarly journals Prognostic value of cardio-hepatic-skeletal muscle syndrome in patients with heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takumi Noda ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
Takafumi Ichikawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Physical Function ◽  
Grip Strength ◽  
Liver Dysfunction ◽  
Gait Speed ◽  
International Normalized Ratio ◽  
Walking Distance ◽  
Leg Strength ◽  
Function Test ◽  
End Stage

AbstractAlthough heart failure (HF) and liver dysfunction often coexist because of complex cardiohepatic interactions, the association between liver dysfunction and physical dysfunction, and between coexistence of both and prognosis in HF patients remains unclear. We reviewed 895 patients with HF (mean age, 69.4 ± 14.2 years) who underwent liver function test using model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and physical function test (grip strength, leg strength, gait speed, and 6-min walking distance [6MWD]). In the multiple regression analysis, MELD-XI score was independently associated with lower grip strength, leg strength, gait speed, and 6MWD (all P < 0.001). One hundred thirty deaths occurred over a median follow-up period of 1.67 years (interquartile range: 0.62–3.04). For all-cause mortality, patients with high MELD-XI scores and reduced physical functions were found to have a significantly higher mortality risk even after adjusting for several covariates (grip strength, hazard ratio [HR]: 3.80, P < 0.001; leg strength, HR: 4.65, P < 0.001; gait speed, HR: 2.49, P = 0.001, and 6MWD, HR: 5.48, P < 0.001). Liver dysfunction was correlated with reduced physical function. Moreover, the coexistence of lower physical function and liver dysfunction considerably affected prognosis in patients with HF.

MO612THE ROLE OF MECHANICAL MUSCLE POWER IN PHYSICAL DYSFUNCTION: A MODEL FOR TAILORING RESISTANCE-BASED REHABILITATION IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Thomas Wilkinson ◽  
Eleanor Gore ◽  
Jared Palmer ◽  
Luke Baker ◽  
Emma Watson ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Strength Training ◽  
Physical Function ◽  
Muscle Mass ◽  
Gait Speed ◽  
Daily Living ◽  
Muscle Power ◽  
Mechanical Power ◽  
Relative Power

Abstract Background and Aims Individuals living with CKD are characterised by adverse changes in physical function. Knowledge of the factors that mediate impairments in physical functioning is crucial for developing effective interventions that preserve mobility and future independence. Mechanical muscle power describes the rate of performing work and is the product of muscular force and velocity of contraction. Muscle power has been shown to have stronger associations with functional limitations and mortality than sarcopenia in older adults. In CKD, the role of mechanical muscle power is poorly understood and is overlooked as a target in many rehabilitation programmes, often at the expense of muscle mass or strength. The aims of this study were to 1) explore the prevalence of low absolute mechanical power, low relative mechanical power, and low specific mechanical power in CKD; and 2) investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method Mechanical muscle power (relative, allometric, specific) was calculated using the sit-to-stand-5 (STS5) test as per previously validated equations. Legs lean mass was derived from regional analyses conducted using bioelectrical impedance analysis (BIA). Physical performance was assessed using two objective tests: usual gait speed and the ‘time-up-and-go’ (TUAG) test. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index (DASI). Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low, medium and high levels of relative STS power and its main components. Results 102 participants with non-dialysis CKD were included (mean age: 62.0 (±14.1) years, n=49 males (48%), mean eGFR: 38.0 (±21.5) ml.min.1.73m2). The mean estimated relative power was 3.1 (±1.5) W.kg in females and 3.3 (±1.3) W.kg in males. Low relative power was found in 35/102 (34%) patients. Relative power was a significant independent predictor of self-reported ADLs (via the DASI) (B=.413, P=.004), and performance on the TUAG (B=-.719, P&lt;.001) and gait speed (B=.404, P=.003) tests. Skeletal muscle mass was not associated with the DASI or any of the objective function tests Conclusion Patients presenting with low muscle power would benefit from participation in appropriate interventions designed to improve the physiological components accounting for low relative muscle power. Assessment of power can be used to tailor renal rehabilitation programmes as shown in Figure 1. Incorporation of power-based training, a novel type of strength training, designed by manipulating traditional strength training variables and primarily movement velocity and training intensity may present the best strategy for improving physical function in CKD.

scholarly journals Sarcopenia in older black South African women and relationships with physical activity and protein intake

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Amy E. Mendham ◽  
Naomi E. Brooks ◽  
Lisa K. Micklesfield ◽  
Mieke Faber ◽  
Dirk L. Christensen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Function ◽  
Grip Strength ◽  
Muscle Mass ◽  
Gait Speed ◽  
Protein Intake ◽  
Whole Body ◽  
Ageing Population ◽  
Hs Crp ◽  
High Cadence

AbstractIntroductionSouth Africa (SA) is a developing country with an ageing population. Adequate nutrition and physical activity (PA) protect against the loss of muscle mass and physical function, both of which are important components of sarcopenia. This study aimed to measure the prevalence of sarcopenia in older black SA women and investigate its associations with PA and protein intake.Materials and MethodsOlder black SA women (age, 68 (range; 60–85 years) n = 122) completed sociodemographic questionnaires, 24 h urine collection (estimate protein intake), venous blood (hs-C-reactive protein (hs-CRP) and ferritin), functional tests (grip strength, 3 m timed-up-and-go (TUG), 10 m walk test) and PA monitoring (activPAL). Dual-energy x-ray absorptiometry whole-body scans assessed fat and fat-free soft tissue mass (FFSTM).ResultsAccording to the European Working group on Sarcopenia in Older People (EWGSOP)2, 2.5% (n = 3) had confirmed sarcopenia of a low severity based on normal physical function. Of the total cohort, 9% (n = 11) had low grip strength, 22.1% (n = 27) had a low appendicular skeletal muscle index (ASMI), and no women had low TUG (s) or gait speed (m/s). Higher ASMI was associated with lower hs-CRP (p = 0.05; Rho = -0.209) and higher ferritin (Rho = 0.252; p = 0.019), grip strength (kg, Rho = 0.223; p = 0.015), and gait speed (m/s, Rho = 0.180; p = 0.050). Protein intake suggested intake of 41.8g/day/ or 0.51 g/kg of body mass/day. Higher total protein intake (g/24h), was associated with higher FFSTM (kg) and ASMI (p < 0.001). PA outcomes were not correlated with FFSTM or ASMI (p > 0.05), however, there was a strong positive correlation of TUG (s) and gait speed (m/s) with time spent: 1) stepping per day (min) and; 2) at a high cadence (> 100 steps/min) (all p < 0.01). Daily step count was 7137 ± 3233 (mean ± Standard deviation), with 97.9 ± 38.7 min of total time spent stepping and 12.6 ± 16.8 min spent stepping at a high cadence (> 100 steps/min). Of note, 13.9% (n = 17) of women were completing > 10,000 steps/day.DiscussionBased on the EWGSOP2 criteria, there is a low prevalence of sarcopenia in older black SA women, explained by the maintenance of strength and physical function that directly related to PA, especially that performed at higher intensities. In contrast, low muscle mass was relatively prevalent (22.1%) and was associated with low dietary protein and not PA. Notably, it may be important to review the cut-points of EWGSOP2 criteria to be specific to the older SA women from disadvantaged communities.

scholarly journals Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population

2020 ◽  
Vol 9 (5) ◽  
pp. 1580
Author(s):  
Mateu Serra-Prat ◽  
Isabel Lorenzo ◽  
Mònica Papiol ◽  
Elisabet Palomera ◽  
Maria Bartolomé ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Water Content ◽  
Muscle Mass ◽  
Lean Mass ◽  
Gait Speed ◽  
Bioelectrical Impedance ◽  
Intracellular Water ◽  
Muscle Quality ◽  
Timed Up And Go ◽  
Cross Sectional

Background: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people. Objectives: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality. Methodology: Design: cross-sectional study. Population: persons aged 65–75 years with a body mass index of 30–39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria. Results: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty. Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM). With this last definition, sarcopenia was related to frailty, gait speed and the TUG test. Conclusions: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

scholarly journals The negative impact of the COVID-19 lockdown on pain and physical function in patients with end-stage hip or knee osteoarthritis

2020 ◽  
Vol 28 (8) ◽  
pp. 2435-2443 ◽  
Author(s):  
Franz Endstrasser ◽  
Matthias Braito ◽  
Markus Linser ◽  
Anna Spicher ◽  
Moritz Wagner ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Negative Impact ◽  
End Stage

Effects of Tai Chi on Gait Kinematics, Physical Function, and Pain in Elderly with Knee Osteoarthritis — A Pilot Study

2008 ◽  
Vol 36 (02) ◽  
pp. 219-232 ◽  
Author(s):  
Chwan-Li Shen ◽  
C. Roger James ◽  
Ming-C. Chyu ◽  
Walter R. Bixby ◽  
Jean-Michel Brismée ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Knee Pain ◽  
Self Efficacy ◽  
Gait Speed ◽  
Stride Length ◽  
Tai Chi ◽  
Stride Frequency ◽  
Gait Kinematics ◽  
Tai Chi Exercise

Our previous study has demonstrated that 6 weeks of Tai Chi exercise significantly improves knee pain and stiffness in elderly with knee osteoarthritis. This study also examine the effects of Tai Chi exercise on gait kinematics, physical function, pain, and pain self-efficacy in elderly with knee osteoarthritis. In this prospective, pretest-posttest clinical trial, 40 men and women (64.4 ± 8.3 years) diagnosed with knee osteoarthritis participated in 6 weeks of instructed Tai Chi training, 1 hour/session, 2 sessions/week. The following measures were taken at baseline and the conclusion of the intervention: (a) gait kinematics including stride length, stride frequency, and gait speed quantified using video analysis, (b) physical function, (c) knee pain, and (d) pain self-efficacy. Data were analyzed using repeated MANCOVA, MANOVA, ANOVA and Wilcoxon tests. After 6 weeks of Tai Chi exercise, stride length ( p = 0.023; 1.17 ± 0.17 vs. 1.20 ± 0.14 m ), stride frequency ( p = 0.014; 0.91 ± 0.08 vs. 0.93 ± 0.08 strides/s), and consequently gait speed (p < 0.025; 1.06 ± 0.19 vs. 1.12 ± 0.15 m/s ) increased in the participants. Physical function was significantly improved ( p < 0.001) and knee pain was significantly decreased ( p = 0.002), while no change was observed in pain self-efficacy. In conclusion, these findings support that Tai Chi is beneficial for gait kinematics in elderly with knee osteoarthritis, and a longer term application is needed to substantiate the effect of Tai Chi as an alternative exercise in management of knee osteoarthritis.

scholarly journals Características de indivíduos com hemiparesia segundo a percepção sobre a dificuldade na subida de escadas

2015 ◽  
Vol 13 ◽  
pp. 269 ◽  
Author(s):  
Fernando Wendelstein Cano ◽  
Daniela Parizotto ◽  
Stella Maris Michaelsen
Keyword(s):  
Quality Of Life ◽  
Gait Speed ◽  
Motor Impairment ◽  
Stair Climbing ◽  
Self Perception ◽  
Timed Up And Go ◽  
Body Function ◽  
Quality Of Life Scale ◽  
Climbing Stairs

Introduction: climbing up and down stairs is entered directly into the Community ambulation and activities of daily living. In individuals with hemiparesis after stroke, this activity may be compromised due to deficits in components of body function and structures, activity and participation. Objective: To identify the characteristics of individuals with hemiparesis, according to the self-perception of difficulty climbing stairs and relate to components of body function and structures (BFS), activity and participation with the cadence of up / down stairs. Method: Twenty-five subjects (57.8±12.4 years) with chronic hemiparesis (57.8±42.7 months) were divided into two groups as perceived with and without difficulty climbing stairs by this particular question in the Stroke Specific Quality of Life Scale (SSQOL). In the BSF domain was rated lower limb motor impairment (Fugl-Meyer Scale), the activity domain, gait/mobility (gait speed, the Timed Up and Go-TUG) and balance (one-leg support and BERG) and participation domain the quality of life with SSQOL. Results: The group with self-perception without difficulty showed less motor impairment and higher levels of activity and participation. Strong correlations of the stair climbing cadence with the Fugl-Meyer Scale and TUG and between stair descent cadence with gait speed and TUG. Conclusion: Variables of body function andstructures , activity and participation are lower in the group with self-perceived difficulty in stair climbing and are correlated with the cadence of stair ascent and descent. 

scholarly journals The Stair Climb Power Test as an Efficacy Outcome in Randomized Trials of Function Promoting Therapies in Older Men

2019 ◽  
Vol 75 (6) ◽  
pp. 1167-1175 ◽  
Author(s):  
Thiago Gagliano-Jucá ◽  
Zhuoying Li ◽  
Karol M Pencina ◽  
Tinna Traustadóttir ◽  
Thomas G Travison ◽  
...  
Keyword(s):  
Physical Function ◽  
Gait Speed ◽  
Randomized Trials ◽  
Older Men ◽  
Stair Climbing ◽  
Retest Reliability ◽  
Leg Press ◽  
Efficacy Outcome ◽  
Press Performance ◽  
Test Retest Reliability

Abstract Background Standardization of performance-based physical function measures that are reliable and responsive to intervention is necessary for efficacy trials of function promoting anabolic therapies (FPTs). Herein, we describe a standardized method of measuring stair climbing power (SCP) and evaluate its ability to assess improvements in physical function in response to an FPT (testosterone) compared to gait speed. Methods We used a 12-step SCP test with and without carrying a load (loaded, LSCP or unloaded, USCP) in two testosterone trials in older men. SCP was determined from mass, total step-rise, and time of ascent measured with an electronic timing system. Associations between SCP and leg press performance (strength and power), testosterone levels, and gait speed were assessed. Test–retest reliability was evaluated using interclass correlation and Bland–Altman analyses. Results Baseline SCP was negatively associated with age and positively with leg strength and power and gait speed. Both tests of SCP were safe and showed excellent reliability (intra-class correlation 0.91–0.97 in both cohorts). Changes in testosterone concentrations were associated with changes in USCP and LSCP, but not gait speed in mobility-limited men. Changes in leg press performance were associated with SCP in both trials. Conclusions Both USCP and LSCP are safe and have high test–retest reliability. Compared to gait speed, SCP is associated more robustly with leg press performance and is sensitive to testosterone therapy. The LSCP might be a more responsive outcome than gait speed to evaluate the efficacy of FPT in randomized trials.

scholarly journals 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

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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