One-repetition submaximal protocol to measure knee extensor muscle strength among older adults with and without sarcopenia: a validation study

Active vitamin D (calcitriol, or 1.25 (OH) 2 D) is associated with muscle weakness, falls, and fracture in community-dwelling older people. This study aimed to investigate the relationship between a serum active vitamin D level and lower extremity muscle strength in elderly patients with pre-dialysis chronic kidney disease (CKD). This cross-sectional study included 231 patients with CKD treated conservatively as outpatients. We analyzed patient background factors, including age, sex, body mass index (BMI), intact parathyroid hormone (PTH), phosphorus, calcium, albumin, serum calcitriol level as an indicator of active vitamin D, and estimated glomerular filtration rate (eGFR) collected from medical records. As an index of lower extremity muscle strength, the isometric knee extension muscle strength-to-weight ratio (kgf/kg) was calculated. The mean patient age was 75.9 ± 6.1 years (68.8% male), and the BMI was 24.1 ± 3.8 kg/m2. A significant correlation was observed between knee extensor muscle strength and serum calcitriol level (r = 0.32, p < 0.01), age (r = –0.30, p < 0.01), BMI (r = −0.31, p < 0.01), intact PTH (r = −0.22, p < 0.01), phosphorus (r = −0.29, p < 0.01), albumin (r = −0.28, p < 0.01), and eGFR (r = 0.25, p < 0.01). Multiple regression analysis showed calcitriol to be significantly associated with knee extensor muscle strength (β: 0.14, 95% confidence interval: 0–0.002, p = 0.04) after adjustment for covariates. These results suggest that the serum active vitamin D level is associated with lower extremity muscle strength in older adults with pre-dialysis CKD. It is necessary to verify whether vitamin D supplementation increases lower extremity muscle strength in pre-dialysis CKD patients.

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Knee extensor muscle strength as a predictor of peak oxygen uptake in patients with heart disease

Journal of Physical Therapy Science ◽

10.1589/jpts.32.265 ◽

2020 ◽

Vol 32 (4) ◽

pp. 265-268

Author(s):

Tsubasa Yokote ◽

Hidenobu Koga ◽

Kyohei Eriguchi ◽

Yoshihiro Imamura

Keyword(s):

Heart Disease ◽

Muscle Strength ◽

Oxygen Uptake ◽

Knee Extensor ◽

Peak Oxygen Uptake ◽

Extensor Muscle ◽

Knee Extensor Muscle Strength

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Abstract 18801: Light-intensity Physical Activity After Discharge Predicts 6-month Postdischarge Adverse Events in Older Japanese Patients With Heart Failure

Circulation ◽

10.1161/circ.132.suppl_3.18801 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Naoki Fujimoto ◽

Kaoru Dohi ◽

So Miyahara ◽

Keishi Moriwaki ◽

Taku Omori ◽

...

Keyword(s):

Physical Activity ◽

Muscle Strength ◽

Light Intensity ◽

Knee Extensor ◽

Extensor Muscle ◽

Moderate Intensity ◽

Sf 36 ◽

Patients With Heart Failure ◽

Steps Per Day ◽

Knee Extensor Muscle Strength

Introduction: Moderate physical activity (PA) is recommended in patients with heart failure (HF). However, patient’ characteristics in those with low PA and the impact of light-intensity PA on postdischarge major adverse cardiovascular events (MACE) remain unclear in older Japanese HF patients. Methods: Thirty seven patients (Stage C/D: 76±5 yrs, 21m) who had been admitted due to HF and 23 Stage A/B patients (73±5 yrs) with risk factors were enrolled. PA was measured using the Omuron HJ350IT accelerometer from the day of discharge for 7 days. Light-intensity PA at an intensity of 1.5-3.0 metabolic equivalents (METs), moderate-intensity PA (≥3METs), and total PA were determined. At discharge, knee-extensor muscle strength, 6-min walking distance (6MWD),SF-36 score, and left ventricular (LV) structure by echocardiography were evaluated. Stage C/D patients were stratified into High-PA and Low-PA according to the median total PA value of 8.4 METs·hour/day. Stage A/B patients underwent these measurements, and values were compared. Factors related to the 6-month postdischarge MACE were assessed. Results: Stage C/D patients were anemic, took fewer steps per day, and had higher brain natriuretic peptide (BNP) than Stage A/B patients. Patients in Low-PA were less likely to engage in household work, and had shorter active time, fewer steps per day, and lower light- and moderate-intensity PA than those in High-PA. No differences were observed in 6MWD (263±110 vs. 303±77 m), knee-extensor muscle strength, BNP (405±346 vs. 267±179 pg/ml), SF-36 physical composite score, or LV ejection fraction between Low-PA and High-PA. Light-intensity and total PA, but not moderate-intensity PA, were associated with the 6-month postdischarge MACE through univariate analyses. Multivariate regression analysis showed that total PA was the independent predictor of the 6-month postdischarge MACE (odds ratio: 0.66) among functional capacity variables including 6MWD and knee-extensor muscle strength. Conclusions: Physical activity, especially at light-intensity, is inversely associated with the 6-month postdischarge MACE in older HF patients. Our results may indicate that postdischarge PA assessed by accelerometer is useful to distinguish those at high risks for MACE.

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