Relationship between muscle strength and rehospitalization in ventricular assist device patients

We examined the relationship between leg extensor muscle strength (LEMS) at discharge and rehospitalization within 1 year in patients with a newly implanted ventricular assist device (VAD). This study included 28 patients who had received a VAD at our institution between October 2013 and February 2019, all of whom had been discharged for 1 year. The patients were divided into two groups according to their LEMS at discharge (higher strength [group H] and lower strength [group L]), based on the median value of the 55.2 kg-force (kgf)/body weight (BW) equation. Exercise performance parameters (e.g., grip strength, 6-min walk distance, and peak VO2) and laboratory data concerning nutritional status were also collected. Nine patients (64.3%) in group L were rehospitalized within 1 year after discharge. The rehospitalization rate was significantly higher in group L than group H (p = 0.020). Compared with discharge, patients exhibited higher grip strength (56.3 vs. 48.6 kg/BW, respectively; p = 0.011), 6-min walk distances (588 vs. 470 m, respectively; p = 0.002), and peak VO2 (15.4 vs. 11.9 mL/min/kg, respectively; p < 0.001) at 1 year after discharge. However, the LEMS (57.4 vs. 58.0 kgf/BW, respectively; p = 0.798) did not increase after discharge in VAD patients who avoided rehospitalization. LEMS at discharge was associated with rehospitalization after VAD surgery; a high LEMS improves the likelihood of avoiding rehospitalization.

Preliminary evidence of differential expression of myogenic and stress factors in skeletal muscle of older adults with low muscle strength

The age-related loss of muscle strength and mass, or sarcopenia, is a growing concern in the ageing population. Yet, it is not fully understood which molecular mechanisms underlie sarcopenia. Therefore, the present study compared the protein expression profile, such as catabolic, oxidative, stress-related and myogenic pathways, between older adults with preserved (8 ♀ and 5 ♂; 71.5 ±2.6 years) and low muscle strength (6 ♀ and 5 ♂; 78.0±5.0 years). Low muscle strength was defined as chair stand test time &gt;15 seconds and/or handgrip strength &lt;16kg (women) or &lt;27kg (men) according the EWGSOP2 criteria. Catabolic signaling (i.e. FOXO1/3a, MuRF1, MAFbx, LC3b, Atg5, p62) was not differentially expressed between both groups, whereas the mitochondrial marker COX-IV, but not PGC1α and citrate synthase, was lower in the low muscle strength group. Stress factors CHOP and p-ERK1/2 were higher (~1.5-fold) in older adults with low muscle strength. Surprisingly, the inflammatory marker p-p65NF-κB was ~7-fold higher in older adults with preserved muscle strength. Finally, expression of myogenic factors (i.e. Pax7, MyoD, desmin; ~2-fold) was higher in adults with low muscle strength. To conclude, whereas the increased stress factors might reflect the age-related deterioration of tissue homeostasis, e.g. due to misfolded proteins (CHOP), upregulation of myogenic markers in the low strength group might be an attempt to compensate for the gradual loss in muscle quantity and quality. These data might provide valuable insights in the processes that underlie sarcopenia.

Nutritional Factors Related to Muscle Weakness 1 Year after Total Hip Arthroplasty: A Case-Control Study

<b><i>Objectives:</i></b> Prolonged muscle weakness after total hip arthroplasty (THA) remains a problem. Despite increasing physical activity up to 3 years after surgery, muscle strength was decreased to 80–90% of the healthy side 2 years after THA. The objective of the present study was to identify the nutritional factors related to muscle weakness 1 year after THA. <b><i>Methods:</i></b> Persons who underwent THA were divided into 2 groups according to the cutoff point of knee extensor strength that represents functional limitation: a normal-strength group of 71 persons and a muscle weakness group of 91 persons. The investigators assessed lower limb isometric strength, the 10-m timed gait test, and daily intakes of energy and nutrients from preoperative to 1 year after THA. The differences in nutrient intakes between the 2 groups (normal-strength group and muscle weakness group) were examined by multiple logistic regression analysis. <b><i>Results:</i></b> There was a significant difference between the groups in energy intake. Daily protein intake was related to knee extension strength gain above the cutoff point 1 year after THA. <b><i>Conclusions and Implications:</i></b> The present study suggested that to prevent prolonged muscle weakness after THA, a sufficient protein intake as well as an exercise intervention may be needed even half a year or after.

Low Grip Strength and Muscle Mass Increase the Prevalence of Osteopenia and Osteoporosis in Elderly Women

The risk of developing low muscle strength and muscle mass is affected by aging, osteopenia, and osteoporosis and increases with age. The purpose of this study was to investigate the prevalence and cutoff values for osteoporosis and osteopenia according to the level of grip strength and muscle mass associated with sarcopenia. A cross-sectional study was conducted, and data from 734 women aged from 60 to 79 years old who visited the healthcare center from 2016 to 2019 were analyzed. Bone mineral density was measured on the lumbar spine from 1–4 using dual X-ray absorptiometry. Osteopenia and osteoporosis were classified on the basis of a T-score ranging from −1.0 to −2.4 and under −2.5, respectively. The diagnostic criteria for sarcopenia were a grip strength of <18 kg and muscle mass of <5.7 kg/m2 according to the Asian Working Group of Sarcopenia. Logistic regression analysis was used to determine the odds ratio, and the receiver operating characteristic curve was applied for the cutoff values. There were 351 (47.8%) patients with osteopenia and 152 (20.7%) patients with osteoporosis. The prevalence of osteopenia increased 1.593 times in the lowest grip strength group and 1.810 times in the lowest muscle mass group (p < 0.05). For osteoporosis, the lowest grip strength increased 2.512 times and the lowest muscle mass increased 2.875 times, compared to the highest grip strength group. In the sarcopenia group, osteopenia increased 2.451 times and osteoporosis increased 3.137 times, compared to the non-sarcopenia group (p < 0.05). In conclusion, the prevalence of osteoporosis and osteopenia was increased in elderly women with low grip strength and muscle mass.

The Effect of Extensor Muscle Strength on Meniscus Progression in Subjects Without Radiologic Knee Osteoarthritis -- Data From the Osteoarthritis Initiative

BackgroundHigh extensor strength decreased knee osteoarthritis symptomatic progression in female was well demonstrated. However, few studies detected a significant association between extensor strength and structural progression when joint space narrowing or cartilage loss were the indicators. The pathological change in meniscus could come earlier than that in cartilage and JSN, but no studies have specifically investigated the association between extensor strength and meniscus progression. MethodsParticipants in Osteoarthritis Initiative with both muscle strength and meniscus assessment, KL grade ≤ 1, and BMI < 30, were enrolled. In separate-sex analysis, participants were divided into the high strength group and the low strength group referring to the median baseline maximum extensor muscle strength/weight. Overall and classified meniscus progression in MRI Osteoarthritis Knee Score was compared between the two groups, at 12 months (622 knees) and 24 months (548 knees). ResultsIn females, less overall medial meniscus progression (11.1% [17/153] VS 23.2% [32/138], P=0.04), less medial meniscal medially extrusion (5.2 % [8/155] VS 12.5 % [18/144], P =0.04), and less medial meniscal anteriorly extrusion progression (0 % [0/108] VS 5.3% [6/113], P=0.03), was presented in the high strength group over 24 months. No significant difference was detected in other comparisons (in males, or in lateral meniscus, or in 12 months). Conclusion High baseline extensor strength in females was associated with a decreased risk of 24- month medial meniscus progression. High extensor strength does not only correlate with less symptomatic progression of KOA, but also with lower risk of structural progression.

Chronic effects of different neuromuscular training on hemodynamic responses estimated vo2max and walking performance in the elderly

Resistance training is an excellent intervention for obtaining different physiological improvements in the elderly. The present study aimed to investigate the chronic effects of different neuromuscular training on cardiovascular, cardiorespiratory, and walking performance responses in the elderly. One hundred five people (64 women and 41 men) participated in the study, physically active, all over 60 years old. They were randomized to compose three groups: Strength Group, (n = 35), Resistance Group (n = 35), and Control Group, (n = 35). Both experimental groups (Strength Group and resistance group) performed four weeks of adaptation and 12 weeks of specific training. The Strength Group and the resistance group did four weeks adaptation phase and 12 weeks intervention load with 70-85% and 50-70%, respectively. The same exercise program was used in the experimental groups, using the alternating method by segment with the bench press, squat, one-sided curved stroke, leg extension, biceps curl, knee flexion, Triceps forehead. Both strength and resistance groups carried out two weekly sessions with an interval of at least 48 and a maximum of 72 hours. A pre and post-evaluation of resting heart rate (HR), blood pressure (systolic and diastolic), rate pressure product (RPP) was performed, and oxygen absorption (VO2max) and walking performance were estimated through the 1600 test meters. In systolic pressure, there was an improvement for the Strength Group (p=0.007) but not for the resistance group (p=0.172) and control group (p=0.999). Between groups, differences were observed between the Strength Group with the control group (p <0.0001). For diastolic pressure, there was a difference for the Strength Group (p=0.000) and not for the resistance group (p=0.916) and the control group (p=0.107). in an inter-group comparison, differences were observed for the Strength Group (p<0.0001) and resistance group (p=0.001) when compared with the control group. For heart hate and double product, in the intra-group analysis, no difference was observed (p>0.05), but in the intergroup, for both variables, the difference was observed for the Strength Group and resistance group when compared with the control group (p<0.0001). Concerning VO2max, the resistance group presents better intra and inter-group results (p<0.05). In walking performance, there were improvements for the Strength Group (p=0.027) and resistance group (p<0.0001). among the groups, the resistance group was the best compared to the Strength Group (p=0.000) and the control group (p<0.0001). Conclusion resistance training can be a great strategy for hemodynamic and cardiorespiratory improvement in the elderly.

Accelerated Dose Escalation with 3 Injections of an Aluminum Hydroxide-Adsorbed Allergoid Preparation of 6 Grasses Is Safe for Children and Adolescents with Moderate to Severe Allergic Rhinitis

A high-dose, accelerated escalation schedule during subcutaneous allergen-specific immunotherapy (AIT) is safe and well-tolerated in adults. However, there are no data in children and adolescents. The aim of the present trial was to assess safety and tolerability of an accelerated dose escalation schedule of an AIT with a grass pollen allergoid in children and adolescents with moderate to severe seasonal rhinoconjunctivitis in a multicenter, open-label, randomized phase II trial. The dose escalation scheme for patients in the One Strength Group included 3 injections with 1 strength B (10,000 TU/mL), whereas the dose escalation scheme for the Standard group included 7 injections with 2 strengths A (1,000 TU/mL) and B (10,000 TU/mL) of an allergoid grass pollen preparation. Overall, <i>n</i> = 50 children (<i>n</i> = 25 in each group; mean age 8.9 + 1.54 years) and <i>n</i> = 37 adolescents (<i>n</i> = 20 and <i>n</i> = 17; 14.2 + 1.62 years) were randomized. For all patients, the mean treatment duration was 59.4 days in the One Strength group and 88.6 days in the Standard group. Treatment-emergent adverse events (TEAEs) related to AIT were reported in 52 and 40% in children and 35 and 35.3% in adolescents, respectively. Systemic allergic reactions occurred in about 5% of our patients and were reported in more patients of the One Strength group (6.7 vs. 2.4%). All systemic reactions were classified as WAO Grade 1. Accelerated high-dose escalation with an aluminum hydroxide-adsorbed grass pollen allergoid can be initiated with a safety and tolerability profile comparable to the standard dose escalation schedule in children and adolescents with allergic rhinitis with or without asthma.

Effects of Functional Strength Training on Functional Movement and Balance in Middle-Aged Adults

Functional movement deficiencies cause falls and injuries in adults. Functional strength training (FST) is emerging as a new training method for athletes, middle-aged and older adults, to improve functional movement: The present study was conducted in order to investigate the effects of FST on balance and functional movement in healthy and independent middle-aged adults. The sample for this study consisted of 46 physically active individuals (24 female and 22 male). A total of 46 subjects were divided based on randomly into the functional strength training (FST) group (n = 26) aged: 51.55 ± 3.73 years; height: 168.69 ± 8.8 cm; body mass: 75.88 ± 12.18; and traditional strength training (TST) group (n = 20) age: 52.85 ± 4.01; height: 166.9 ± 9.98; body mass: 76.15 ± 10.45. Each group performed 24 sessions of a training protocol three-time a week. The functional movement was assessed using the functional movement screen (FMS) protocol. Balance performance was determined by using the balance error scoring system (BESS). Bodyweight and body fat ratio were measured using bioelectric impedance. There was a significant statistical difference between FMS total scores after an eight-week FST in the FST group. After the intervention, the functional strength group tended to have significantly better balance control than the traditional strength group (p = 0.01). Statistically, significant differences were observed between pre-test and post-test in the intervention group on BMI, body fat, and body mass (p = 0.01). There were not found significant differences in balance control and FMS score in TST group. As a result of this study, FST positively affected the FMS total score and balance performance in middle-aged adults. Early detections of the deficiencies in functional movement and balance in the middle ages may reduce the risk of insufficiency and fall in adults through targeted functional strength training intervention.

Lower Grip Strength and Insufficient Physical Activity Can Increase Depressive Symptoms Among Middle-Aged and Older European Adults

Objectives: The present study aimed to explore the interaction between grip strength and physical activity on depression, and investigate the association of physical activity with the change in depression by different grip strength groups among middle-aged and older European adults.Methods: A total of 13936 participants aged 50 years or older from the Survey of Health, Ageing and Retirement in Europe 2007-2017 were included in this study. Group-based trajectory modeling was used to identify the low, middle and high group of grip strength by gender. Generalized estimated equations were fitted to analyze the interaction effect.Results: Significant interactions between grip strength group and physical inactivity were found (O interaction=16.70, p<0.001). Significant interactions between physical inactivity and time on depression were identified in low (b interaction=22.15, p<0.001) and moderate (j interaction=22.85, p<0.001) grip strength, but a similar result was not found in high grip strength (e interaction=3.20, p=0.526). Participants in the physical inactivity group had higher depression scores in the low and moderate grip strength group.Conclusions: Grip strength and physical inactivity have interaction with depression. Lower grip strength and insufficient physical activity could increase depressive symptoms. People with lower grip strength and physical inactivity should pay special attention to the prevention of depression.

Experimental Study of Features of Thin-Walled Pipes Sizing in the Line of a Pipe Rolling Plant with an Automatic Mill

The aim of the study is to establish the actual level of working loads on the roll drive line of the sizing mill installed as part of the PRP-220 with an automatic mill, when switching to the production of steel pipes from increased strength group. The study is based on a complex experimental and theoretical analysis. After the processing of the results of experimental studies a comparison of the most loaded sizing route for a thin-walled pipe with a diameter of 244.5 mm and a wall thickness of 8.9 mm (D/S = 27.5) made of steel of strength group “D” was made with the route for a pipe with a diameter of 177.8 mm and a wall thickness of 9.2 mm (D/S = 19.3) from steel of strength group “E”. Graphs of the observed processes are presented, as well as calculated predictive values of sizing of thin-walled pipes for steel of strength group “E”, obtained on the basis of an experimental-theoretical analysis of the growth of flow stress. Recommendations have been given for improving the equipment of the PRP-220 sizing mill for the production of pipes with increased diameters from steels of increased strength groups.