OBJECTIVE: Muscle strength training is one of the most common therapy methods in physical therapy programs, and the usual goal of this treatment is to improve muscle strength. Little attention has been paid, however, to the effects of strength training on the other components of motor performance. This study examined the effects of a 10-week strength training program on the motor performance of the hand, including reaction time, speed of movement, tapping speed, and coordination in normal healthy volunteers. DESIGN: Before-after trial. SUBJECTS AND SETTING: Sixteen healthy women volunteers aged 25 to 45 years participated. INTERVENTION: Subjects accomplished a 10-week muscle strength training program of the upper extremities. MAIN OUTCOME MEASURES: Reaction time, speed of movement, tapping speed, and coordination were measured three times on consecutive days, and muscle strength and electromyographic values of the right upper extremity were recorded once before the training period. After the training period, the same measurements were made as before the training. RESULTS: The 10-week strength training decreased choice reaction time by 6% (p
The primary purpose of this investigation was to examine the physiological profile of a National Hockey League (NHL) team over a period of 26 years. All measurements were made at a similar time of year (pre-season) in 703 male (mean age +/- SD = 24 +/- 4 y) hockey players. The data were analyzed across years, between positions (defensemen, forwards, and goaltenders), and between what were deemed successful and non-successful years using a combination of points acquired during the season and play-off success. Most anthropometric (height, mass, and BMI) and physiological parameters (absolute and relative VO2 peak, relative peak 5 s power output, abdominal endurance, and combined grip strength) showed a gradual increase over the 26 year period. Defensemen were taller and heavier, had higher absolute VO2 peak, and had greater combined grip strength than forwards and goaltenders. Forwards were younger and had higher values for relative VO2 peak. Goaltenders were shorter, had less body mass, a higher sum of skinfolds, lower VO2 peak, and better flexibility. The overall pre-season fitness profile was not related to team success. In conclusion, this study revealed that the fitness profile for a professional NHL ice-hockey team exhibited increases in player size and anaerobic and aerobic fitness parameters over a 26 year period that differed by position. However, this evolution of physiological profile did not necessarily translate into team success in this particular NHL franchise.
OBJECTIVE: To evaluate activity limitations 3 years after diagnosis of early rheumatoid arthritis (RA) in relation to grip force and sex. METHODS: A total of 217 patients, 153 women and 64 men, with recent-onset RA were included. Activity limitations were reported using the Health Assessment Questionnaire (HAQ) and the Evaluation of Daily Activities Questionnaire (EDAQ). The relationships between activity limitations versus grip force (measured by the Grippit), walking speed, functional impairment, grip ability, pain, plasma C-reactive protein, the 28-joint disease activity score and its components, the physician's global assessment of disease activity, and sex were analyzed by partial least squares (PLS). RESULTS: Women had significantly lower grip force and more activity limitations (HAQ and EDAQ) than men. The PLS analyses demonstrated that grip force was the strongest regressor of activity limitation, closely followed by walking speed. However, within subgroups based on grip force (group 1 = grip force 328 N) and including sexes, women and men had corresponding degrees of activity limitation as reported by the HAQ and EDAQ. CONCLUSION: Our results indicate that the more pronounced activity limitations seen in women with RA, as compared with men, may be explained by lower grip force rather than sex.
This paper sought to provide normative values for grip strength among older adults across different age groups in northwest Russia and to investigate their predictive value for adverse events.
A population-based prospective cohort study of 611 community-dwelling individuals 65+. Grip strength was measured using the standard protocol applied in the Groningen Elderly Tests. The cut-off thresholds for grip strength were defined separately for men and women of different ages using a weighted polynomial regression. A Cox regression analysis, the c-statistic, a risk reclassification analysis, and bootstrapping techniques were used to analyze the data. The outcomes were the 5-year mortality rate, the loss of autonomy and mental decline.
We determined the age-related reference intervals of grip strength for older adults. The 5(th) and 10(th) percentiles of grip strength were associated with a higher risk for malnutrition, low autonomy, physical and mental functioning and 5-year mortality. The 5(th) percentile of grip strength was associated with a decline in autonomy.
This study presents age- and sex-specific reference values for grip strength in the 65+ Russian population derived from a prospective cohort study. The norms can be used in clinical practice to identify patients at increased risk for adverse outcomes.
Cites: J Hand Surg Eur Vol. 2009 Feb;34(1):76-8419129352
PURPOSE: The purpose is to study the age trajectory of hand-grip strength after the age of 45 years. METHODS: In this study, we use data from three large nationwide population-based surveys of Danes aged 45 to 102 years with a total of 8342 participants with grip-strength measurements and up to 4 years of follow-up. Grip strength was measured by using a portable hand dynamometer. RESULTS: Grip strength declines throughout life for both males and females, but among the oldest women, the longitudinal curve reaches a horizontal plateau. The course of the decline is estimated by using full information in the longitudinal data and is found to be almost linear in the age span of 50 to 85 years. In this age span, mean annual grip-strength loss is estimated to be 0.59 (0.02) (SE) kg for men and 0.31 (0.01) kg for women. CONCLUSION: This study confirms the previously reported grip-strength decline with increasing age. Estimates were obtained by using full-information methods from large population-representative studies. Equations of expected grip strength, as well as tables with sex-, age-, and height-stratified reference data, provide an opportunity to include grip-strength measurement in clinical care in similar populations.
Several consensus groups have previously published operational criteria for sarcopenia, incorporating lean mass with strength and/or physical performance. The purpose of this manuscript is to describe the prevalence, agreement, and discrepancies between the Foundation for the National Institutes of Health (FNIH) criteria with other operational definitions for sarcopenia.
The FNIH Sarcopenia Project used data from nine studies including: Age, Gene and Environment Susceptibility-Reykjavik Study; Boston Puerto Rican Health Study; a series of six clinical trials from the University of Connecticut; Framingham Heart Study; Health, Aging, and Body Composition Study; Invecchiare in Chianti; Osteoporotic Fractures in Men Study; Rancho Bernardo Study; and Study of Osteoporotic Fractures. Participants included in these analyses were aged 65 and older and had measures of body mass index, appendicular lean mass, grip strength, and gait speed.
The prevalence of sarcopenia and agreement proportions was higher in women than men. The lowest prevalence was observed with the FNIH criteria (1.3% men and 2.3% women) compared with the International Working Group and the European Working Group for Sarcopenia in Older Persons (5.1% and 5.3% in men and 11.8% and 13.3% in women, respectively). The positive percent agreements between the FNIH criteria and other criteria were low, ranging from 7% to 32% in men and 5% to 19% in women. However, the negative percent agreement were high (all >95%).
The FNIH criteria result in a more conservative operational definition of sarcopenia, and the prevalence was lower compared with other proposed criteria. Agreement for diagnosing sarcopenia was low, but agreement for ruling out sarcopenia was very high. Consensus on the operational criteria for the diagnosis of sarcopenia is much needed to characterize populations for study and to identify adults for treatment.
Cites: J Nutr Health Aging. 2013 Jan;17(1):76-8023299384
The long-term effect of distal radial fracture malunion on activity limitations is unknown. Between 2001 and 2002, we conducted a prospective cohort study of all patients with distal radial fracture treated with casting or percutaneous fixation in northeast Scania in Sweden. In that original study, the patients completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline and at 2 years. We performed a long-term follow-up study of patients who were 18 to 65 years of age at the time of the fracture to investigate the association between fracture malunion and activity limitations.
In this long-term follow-up, patients who had participated in the original study completed the DASH questionnaire and a visual analog scale (VAS) for pain and for satisfaction (scored, 0 [best] to 100) and underwent radiographic and physical examinations at 12 to 14 years after the fracture. We defined malunion as dorsal angulation of =10°, ulnar variance of =3 mm, and/or radial inclination of =15°. We also assessed the presence of radiocarpal osteoarthritis and ulnar styloid nonunion. The primary outcome was the change in DASH score from baseline. Secondary outcomes were DASH, pain, and satisfaction scores, wrist range of motion, and grip strength at the time of the follow-up.
Of 85 eligible patients, 63 (74%) responded to the questionnaires and underwent examinations. Malunion was found in 25 patients, osteoarthritis was found in 38 patients, and styloid nonunion was found in 9 patients. Compared with patients without malunion, those with malunion had significantly worse DASH scores from baseline to 12 to 14 years (p = 0.002); the adjusted mean difference was 11 points (95% confidence interval [CI], 4 to 17 points). Similarly, follow-up scores were significantly worse among patients with malunion; the adjusted mean difference was 14 points (95% CI, 7 to 22 points; p 0.05) with DASH scores, VAS pain or satisfaction scores, or grip strength.
Patients who sustain a distal radial fracture at the age of 18 to 65 years and develop malunion are more likely to have worse long-term outcomes including activity limitations and pain.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
To investigate the predictive value of hand grip/body weight ratio and hand grip strength in early adulthood for obtaining a disability pension (DP) due to musculoskeletal disorders in later life.
A nationwide population-based sample of men born 1951-76 (n=1,387,166) in Sweden and anthropometric and strength indicators from their conscription examination. Register data on the date and diagnoses of granted DP between the years 1971-2006. Cox proportional hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (95% CI).
The lowest quintile of hand grip/body weight ratio predicted a greatly increased risk (HR 2.51, 95% CI 2.40-2.63) for DP due to musculoskeletal disorders compared to the mid-quintile. The highest quintile of hand grip/body weight ratio predicted a decreased risk (HR 0.80, 95% CI 0.75-0.84). Stratification of the hand grip/body weight ratio with body mass index confirmed the results. However, the highest quintiles of hand grip strength adjusted for height and weight predicted a somewhat increased risk for DP due to musculoskeletal disorders (HR 1.25, 95% CI 1.18-1.32).
This study indicates that the hand grip/body weight ratio in young adulthood is strongly and inversely associated with men's risk of obtaining a disability pension due to musculoskeletal disorders in later life. However, the risk seems to be mediated through the body weight. The properties of hand grip/body weight ratio should be further evaluated before it can be recommended for use in clinical and epidemiological studies.
The aim of the present study was to investigate the associations between grip strength change and postmenopausal bone loss. The study population, 622 peri- and postmenopausal women, was a random sample of the OSTPRE-study cohort (n=13,100) in Kuopio, Finland. Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual X-ray absorptiometry and grip strength with a pneumatic squeeze dynamometer at baseline in 1989-1991, at the 5-year follow-up in 1994-1997 and at the 10-year follow-up in 1999-2001. Women were divided into three groups according to the change in age-grouped grip strength quartile they belonged to in each measurement (n in 5-year/10-year follow-up): "decreased" (n=150/n=140), "maintained" (n=314/n=320) and "improved" (n=158/n=162). Women within the improved group had significantly lower bone loss at both FN and LS in comparison to the other two groups after 10 years of follow-up (P
To study the associations of instrumental activities of daily living (IADL) and the handgrip strength with oral self-care among dentate home-dwelling elderly people in Finland.
The study analysed data for 168 dentate participants (mean age 80.6 years) in the population-based Geriatric Multidisciplinary Strategy for Good Care of the Elderly (GeMS) study. Each participant received a clinical oral examination and structured interview in 2004-2005. Functional status was assessed using the IADL scale and handgrip strength was measured using handheld dynamometry.
Study participants with high IADL (scores 7-8) had odds ratios (ORs) for brushing their teeth at least twice a day of 2.7 [95% confidence intervals (CI) 1.1-6.8], for using toothpaste at least twice a day of 2.0 (CI 0.8-5.2) and for having good oral hygiene of 2.8 (CI 1.0-8.3) when compared with participants with low IADL (scores =6). Participants in the upper tertiles of the handgrip strength had ORs for brushing the teeth at least twice a day of 0.9 (CI 0.4-1.9), for using the toothpaste at least twice a day of 0.9 (CI 0.4-1.8) and for good oral hygiene of 1.1 (CI 0.5-2.4) in comparison with the study subjects in the lowest tertile of handgrip strength.
The results of this study suggest that the functional status, measured by means of the IADL scale, but not handgrip strength, is an important determinant of oral self-care among the home-dwelling elderly.