Effect of Decreased Skeletal Muscle Index and Hand Grip Strength on Functional Recovery in Subacute Ambulatory Stroke Patients

Objectives: Either motor training or repetitive transcranial magnetic stimulation (rTMS) could modulate the neural plasticity after stroke. Therefore, synchronizing the two interventions may optimize the efficiency of recovery. In the present study, we aim to investigate the effect of rTMS along with hand grip training on the neurobehavioral and hand functional recovery in one cohort of subacute stroke patients.Methods: Thirty-nine stroke patients were enrolled in a single-center, single-blinded, randomized clinical trial. We tested different intervention effects of rTMS and hand grip training (group A), rTMS alone (group B), and hand grip training alone (group C). For the rTMS-treated groups, patients received 10 consecutive sessions of 5-Hz stimulation over the affected hemisphere with 750 pulses. Jebsen–Taylor Hand Function Test (JTHFT), Fugl-Meyer assessment of upper extremity (FMA-UE), grip strength, modified Barthel index (mBI), and ipsilesional motor evoked potential (iMEP) latency were assessed and compared across the groups.Results: We found that only rTMS along with hand grip training group all improved in JTHFT, FMA-UE, grip strength, and mBI (p ≤ 0.01) compared with the baseline among the three groups. Furthermore, this study demonstrated that rTMS plus hand grip training had much better results in improvement of neurobehavioral outcomes compared to the rTMS alone- and hand grip training alone-treated patients (p < 0.05). However, no significant differences were detected in neurophysiologic outcome between intra-groups and inter-groups (p > 0.05).Conclusion: These proof-of-concept results suggested that rTMS alone with hand grip training was a unique approach to promote hand functional recovery in stroke patients. It provided important information to design a large-scale multi-center clinical trial to further demonstrate the efficiency of the combination of central and peripheral stimulation.Clinical Trial Registration:http://www.chictr.org.cn (#ChiCTR1900023443).

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IGF-I/IGFBP3/ALS deficiency in sarcopenia: low GHBP suggests GH resistance in a subgroup of geriatric patients

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa972 ◽

2020 ◽

Author(s):

Uta Ferrari ◽

Ralf Schmidmaier ◽

Theresa Jung ◽

Martin Reincke ◽

Sebastian Martini ◽

...

Keyword(s):

Grip Strength ◽

Geriatric Patients ◽

Binding Protein ◽

Hand Grip Strength ◽

Statistical Regression ◽

Cross Sectional ◽

Skeletal Muscle Index ◽

Hand Grip ◽

Igf I ◽

Gh Resistance

Abstract Context Definition of etiological subgroups of sarcopenia may help to develop targeted treatments. Insulin like growth factor (IGF-I), IGF-binding protein 3 (IGFBP3) and acid labile subunit (ALS) build a ternary complex that mediates growth hormone (GH) effects on peripheral organs, such as muscle. Low GH binding protein (GHBP) as a marker of GH receptor number would hint towards GH resistance. Objective Analysis of the association of IGF-I, IGFBP3, and ALS with sarcopenia Study Participants and setting 131 consecutively recruited patients of a geriatric ward for a mono-center cross-sectional analysis, non-sarcopenic patients served as controls. Methods Sarcopenia status by hand grip strength measurement and Skeletal Muscle Index (SMI); IGF-I, IGFBP3, ALS, GH, GH binding protein (GHBP); body mass index (BMI), Activity of Daily Living (ADL), mini mental state test (MMST), routine laboratory parameters, statistical regression modelling. Results Compared to controls, sarcopenic patients did not differ regarding age, sex, ADL, MMST, C reactive protein, glomerular filtration rate and albumin serum concentrations. However, sarcopenic patients had significantly lower IGF-I, IGFBP3 and ALS. IGF I and ALS associated significantly with sarcopenia and low hand grip strength, even after adjustment for age, sex, BMI and albumin, but not with low SMI. GHBP serum was low in sarcopenic patients, but normal in geriatric patients without sarcopenia. Over 60% of patients with IGF-I/ALS deficiency patients showed GH resistance. Conclusions Our data suggest that in geriatric patients low IGF-I/IGFBP3/ALS could be evaluated for causative connection of the sarcopenia spectrum. Low GHBP points towards potential GH resistance as one possible explanation of this deficiency.

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Can early assessment of hand grip strength in elderly hip fracture patients predict functional outcome?

10.1101/557371 ◽

2019 ◽

Author(s):

Ivan Selakovic ◽

Emilija Dubljanin-Raspopovic ◽

Ljiljana Markovic-Denic ◽

Vuk Marusic ◽

Andja Cirkovic ◽

...

Keyword(s):

Hip Fracture ◽

Functional Outcome ◽

Grip Strength ◽

Functional Recovery ◽

Multivariate Regression ◽

Cognitive Status ◽

Hand Grip Strength ◽

Early Assessment ◽

Hand Grip

AbstractDecreased muscle strength is not only a risk factor for hip fracture in elderly patients, but plays a role in recovery of physical function. Our aim was to assess the role of grip strength measured early after hip fracture, and classified according to the EWGSOP2 criteria in predicting short- and long-term functional recovery. One hundred ninety-one patients with acute hip fracture consecutively admitted to an orthopaedic hospital have been selected. A multidimensional geriatric assessment evaluating sociodemographic variables, cognitive status, functional status and quality of life prior to fracture, as well as perioperative variables were performed. Follow-ups at 3 and 6 months after surgery were carried out to evaluate functional recovery. Multivariate regression models were used to assess the predictive role of handgrip strength. The mean age of the participants was 80.3 ±6.8 years. Thirty-five percent of our patients with clinically relevant hand grip strength weakness were significantly older, more often female, had a lower BMI, and were of worse physical health. They also had a lower cognitive level, lower Barthel index, and lower EQ5D scores before fracture. Multivariate regression analysis adjusted for age and gender revealed that hand grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations. Our study supports the prognostic role of hand grip strength assessed at hospital admission in patients with hip fracture. Thus, clinicians should be encouraged to include hand grip assessment in their evaluation of hip fracture patients in the acute setting in order to optimize treatment of high-risk individuals.

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P4-204: The association of hand grip strength, skeletal muscle mass, 5-meter walking speed and bone mineral densitometry in a small population of Turkish elderly

Alzheimer s & Dementia ◽

10.1016/j.jalz.2013.05.1596 ◽

2013 ◽

Vol 9 ◽

pp. P781-P781

Author(s):

Umut Safer ◽

Huseyin Doruk ◽

Ilker Tasci ◽

Ilkin Naharci ◽

Ergun Bozoglu

Keyword(s):

Skeletal Muscle ◽

Grip Strength ◽

Muscle Mass ◽

Bone Mineral ◽

Skeletal Muscle Mass ◽

Walking Speed ◽

Small Population ◽

Hand Grip Strength ◽

Hand Grip ◽

Bone Mineral Densitometry

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Malondialdehyde as a Useful Biomarker of Low Hand Grip Strength in Community-Dwelling Stroke Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217918 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7918

Author(s):

Onchuma Mueangson ◽

Parinya Vongvaivanichakul ◽

Kornyok Kamdee ◽

Chutima Jansakun ◽

Wanatsanan Chulrik ◽

...

Keyword(s):

Muscle Strength ◽

Grip Strength ◽

Muscle Weakness ◽

Serum Levels ◽

Hand Grip Strength ◽

Community Dwelling ◽

Stroke Patients ◽

Post Stroke ◽

Hand Grip ◽

Stress Oxidative

The assessment of muscle strength by hand grip strength (HGS) is used to evaluate muscle weakness and wasting among stroke patients. This study aimed to investigate the association of oxidative stress/oxidative damage and inflammatory biomarkers with muscle strength and wasting, as evaluated by HGS, among community-dwelling post-stroke patients. The HGS of both paretic and non-paretic limbs was negatively associated with modified Rankin scale (mRS) values. The serum levels of catalase activity and malondialdehyde (MDA), and plasma tumor necrosis factor (TNF)-α levels were significantly increased in post-stroke patients compared with non-stroke controls. Further analysis highlighted that hydrogen peroxide was positively correlated with HGS in the paretic limbs. Interestingly, an elevated MDA level, excluding advanced age and high mRS, increased the risk of low HGS in the non-paretic limbs of stroke patients. This study suggests that there is a detrimental association between MDA and muscle strength and early muscle wasting among post-stroke patients. Hence, MDA is a potentially useful biomarker of muscle weakness and wasting in post-stroke patients living in the community.

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Hand Grip Measure Tool Post-Stroke Patients

Indonesian Journal of electronics, electromedical engineering, and medical informatics ◽

10.35882/ijeeemi.v1i2.3 ◽

2020 ◽

Vol 1 (2) ◽

pp. 60-63

Author(s):

Ria Ramadhani ◽

Endang Dian Setioningsih ◽

Torib Hamzah

Keyword(s):

Grip Strength ◽

Hand Grip Strength ◽

Load Cell ◽

Stroke Patients ◽

Strength Criteria ◽

Hand Muscles ◽

Post Stroke ◽

Weight Measurement ◽

Hand Grip ◽

Measurement Results

Handgrip Dynamometer is a tool used to view the strength of the hand muscles post-stroke patients. In this study Handgrip Dynamometer created to look at the hand grip strength in real time and find out the hand grip strength criteria, there are three indicators: the criteria of mild, moderate or strong. Handgrip dynamometer using the Arduino Uno control over the entire system and Load Cell as a sensor. Load Cell Output will be boosted by Analog Signal conditioner HX711 and then processed in the microcontroller, then will be displayed on the LCD. Berdasarlan weight measurement results obtained by the result of error by 0% By comparison to using weights, sehingga can be concluded that the tool can be used according to its function.

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Telerehabilitation is Effective to Recover Functionality and Increase Skeletal Muscle Mass Index in COVID-19 Survivors

International Journal of Telerehabilitation ◽

10.5195/ijt.2021.6415 ◽

2021 ◽

Vol 13 (2) ◽

Author(s):

Jorge Cancino-López ◽

Patricio Zarricueta Vergara ◽

Bárbara Leyton Dinamarca ◽

Pedro Figueroa Contreras ◽

Luis Miño Cárcamo, ◽

...

Keyword(s):

Skeletal Muscle ◽

Grip Strength ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Elbow Flexion ◽

Hand Grip Strength ◽

Step Test ◽

Chair Stand ◽

Hand Grip ◽

Skeletal Muscle Mass Index

Objective: The purpose of this study was to evaluate the effects of a telerehabilitation program for COVID-19 survivors on their functionality, aerobic capacity, upper-lower body strength and skeletal muscle mass index. Methods: Fifty patients (22 M); age 54.1±15.4 who became ill with COVID-19 during 2020 completed a 24-session telerehabilitation program. The following measures were taken: Barthel’s index, two minutes step test (2MST), elbow flexion one-repetition maximal (1RM), short physical performance battery (SPPB), hand grip strength, 30-second chair stand, skeletal muscle index (SMI), body fat percentage, resting pulse, arterial blood pressure, and pulse oximetry. Results: There was a significant increase in the Barthel index (p?0.0001), 2MST (p?0.0001), 1RM elbow flexion (p?0.0001), SPPB (p?0.0001), hand grip strength (p?0.0001), 30-second chair stand (p?0.0001), and SMI (p?0.0001). Conclusion: A 24 session in-home telerehabilitation program promoted the recovery of physical independence and increases in skeletal muscle mass index and physical fitness.

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