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Toro-Román V, Ferrer-Ramos P, Illera-Domínguez V, Pérez-Chirinos C, Fernández-Valdés B. Functionality, muscular strength and cardiorespiratory capacity in the elderly: relationships between functional and physical tests according to sex and age. Front Physiol 2024; 15:1347093. [PMID: 38516209 PMCID: PMC10956101 DOI: 10.3389/fphys.2024.1347093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction: There are several tests that provide information about physical fitness and functionality in older adults. The aims of this study were: (i) to analyze the differences between sex and age in functional, strength and cardiorespiratory tests; and (ii) to study the correlations between functional, strength and cardiorespiratory tests according to sex and age. Methods: A total of 171 older adults (72.09 ± 13.27 kg; 1.59 ± 0.09 m; 72.72 ± 6.05 years) were divided according to sex (men: n = 63; women: n = 108) and age (≥60 <70: n = 65; ≥70 <80: n = 89; ≥80: n = 18). Anthropometry, body composition, upper limb strength (hand grip; HG), lower limb strength (countermovement jump; CMJ), cardiorespiratory capacity (6 min walking test; 6MWT), timed up and go test (TUG) and Short Physical Performance Battery (SPPB) were assessed. Results: Men showed higher values in CMJ height, HG and expired volume (VE) (p < 0.05). There were no significant differences between sexes in TUG and SPPB. Regarding age, there were significant differences in CMJ, VE and peak oxygen uptake (VO2peak), TUG, gait speed, chair and stand test and SPPB total (p < 0.05). The test times were higher in older people. Regarding correlations, the TUG showed significant correlations in all strength and cardiorespiratory tests, regardless of sex and age. The CMJ correlated more significantly with functional tests compared to HG. Discussion: There were sex and age differences in functional, strength, and cardiorespiratory tests. The execution of quick and low-cost tests such as the CMJ and TUG could provide information on overall physical fitness in older adults.
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Affiliation(s)
| | - Pau Ferrer-Ramos
- Department of Health Sciences, TecnoCampus, Research Group in Technology Applied to High Performance and Health, Universitat Pompeu Fabra, Mataró, Barcelona, Spain
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Abreu F, Zymbal V, Baptista F. Musculoskeletal Fitness for Identifying Low Physical Function in Older Women. Int J Environ Res Public Health 2023; 20:ijerph20085485. [PMID: 37107766 PMCID: PMC10138668 DOI: 10.3390/ijerph20085485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
AIMS This cross-sectional study aimed to analyze the relevance of musculoskeletal fitness for identifying low physical functioning in community-dwelling older women. METHODS Sixty-six older women (73.62 ± 8.23 yrs old) performed a musculoskeletal fitness assessment of the upper and lower limbs. A handheld dynamometer was used to evaluate upper-limb muscle strength through a handgrip (HG) test. Lower-limb power and force were assessed from a two-leg countermovement vertical jump (VJ) on a ground reaction force platform. Physical functioning was assessed subjectively using the Composite Physical Function (CPF) questionnaire and objectively by daily step count measured by accelerometry and gait speed/agility assessed by the 8-Foot Up-and-Go (TUG) test. Logistic regressions and ROC curves were carried out to define odds ratios and ideal cutoff values for discriminatory variables. RESULTS VJ power showed the ability to identify low physical functioning when evaluated through the CPF (14 W/kg, 1011 W), gait speed/agility (15 W/kg, 800 W), or daily accumulated steps (17 W/kg). Considering that VJ power was normalized for body mass, the increase of 1 W/kg corresponds to a decrease of 21%, 19%, or 16% in the chance of low physical functioning when expressed by these variables, respectively. HG strength and VJ force did not show a capacity to identify low physical functioning. CONCLUSIONS The results suggest that VJ power is the only marker of low physical functioning when considering the three benchmarks: perception of physical ability, capacity for mobility, and daily mobility.
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Affiliation(s)
- Frederico Abreu
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Lisbon, Portugal
- Correspondence:
| | - Vera Zymbal
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Lisbon, Portugal
- ESS, Instituto Politécnico de Setúbal, 2910-761 Setúbal, Portugal
| | - Fátima Baptista
- Department of Sports and Health, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1495-751 Lisbon, Portugal
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Gruet M, Behrens M, Peyré-Tartaruga LA. Editorial: Improving exercise testing methods and interpretation in human health and diseases. Front Physiol 2023; 14:1188429. [PMID: 37082247 PMCID: PMC10111030 DOI: 10.3389/fphys.2023.1188429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/07/2023] Open
Affiliation(s)
- Mathieu Gruet
- IAPS Laboratory, University of Toulon, Toulon, France
- *Correspondence: Mathieu Gruet,
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Leonardo A Peyré-Tartaruga
- Programa de Pós-Graduação Em Ciências Pneumológicas, Hospital de Clínicas de Porto, Alegre/Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- LaBiodin Biodynamics Laboratory, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
- Programa de Pós-Graduação em Ciências do Movimento Humano, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
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Zengin A, Ó Breasail M, Parsons CM, Jarjou LM, Janha RE, Jobe M, Prentice A, Cooper C, Ebeling PR, Ward KA. Sex-specific associations between cardiovascular risk factors and physical function: the Gambian Bone and Muscle Ageing Study. J Cachexia Sarcopenia Muscle 2023; 14:84-92. [PMID: 36346161 PMCID: PMC9891990 DOI: 10.1002/jcsm.13069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/30/2022] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Sub-Saharan Africa, the prevalence of obesity, cardiovascular disease (CVD) and impaired physical function are increasing due to rapid urbanization. We investigated sex differences in associations between cardiac workload, arterial stiffness, peripheral vascular calcification (PVC) and physical function in Gambian adults. METHODS A total of 488 Gambians aged 40-75+ years were recruited (men: 239; and women: 249). Supine blood pressure and heart rate were measured to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia peripheral quantitative computed tomography scans. Physical function was assessed by chair rise test (CRT), single two-legged jump (s2LJ) and hand grip strength (HGS). Body composition was measured by dual-energy x-ray absorptiometry; body size corrections were used to calculate fat mass index (FMI) and appendicular lean mass index (ALMI). Estimated glomerular filtration rate (eGFR) was measured from fasting blood samples. The relationship between rate pressure product, pulse pressure or presence of PVC (independent variable) with physical function parameters (dependent variable) was tested using linear regression. Sex-interactions were tested (p-int) adjusting for age, eGFR and ALMI/FMI. Results were expressed as mean differences between men and women with 95% confidence intervals. Mediation analyses used ALMI/FMI as mediator. RESULTS Women weighed less (54.7 kg ± 10.3 vs. 59.9 kg ± 10.3) and were shorter (157.8 cm ± 6.0 vs. 169.2 cm ± 7.0) compared with men (both P < 0.0001). Women had higher FMI (6.8 kg/m2 ± 2.9 vs. 2.9 kg/m2 ± 2.0, P < 0.0001) and eGFR (263.7 mL/min/1.73 m2 ± 133.1 vs. 237.6 mL/min/1.73 m2 ± 134.6), but lower ALMI (6.2 kg/m2 ± 0.7 vs. 8.02 kg/m2 ± 1.0, P < 0.0001) compared with men. There were significant mean differences between men and women in rate pressure product and s2LJ power (-1.08 [-1.21, -0.95]) and force (-0.57 [-0.63, -0.51]), only after adjusting for age, eGFR and FMI. There were significant mean differences in the associations between pulse pressure and CRT power (-0.28 [-0.31, -0.25]), s2LJ power (-1.07 [-1.20, -0.93]) and HGS (-11.94 [-13.35, -10.54]); these differences were greater after adjusting for age, eGFR and FMI, than ALMI. There were similar differences in the associations between PVC and physical function parameters. In men, FMI mediated the association between rate pressuree product and CRT power (P = 0.002), s2LJ force (P < 0.001) and s2LJ power (P = 0.001). ALMI did not mediate associations for either men or women. CONCLUSIONS Multiple risk factors for CVD were associated with poorer physical function in men and were mediated by FMI. There is a need to identify strategies to slow/prevent the rising CVD burden and poor physical function in Sub-Saharan Africa.
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Affiliation(s)
- Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
- MRC Nutrition and Bone Health GroupCambridgeUK
| | - Mícheál Ó Breasail
- MRC Nutrition and Bone Health GroupCambridgeUK
- Ageing and Movement Research Group, Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Camille M. Parsons
- MRC Lifecourse Epidemiology Centre, Human Development and HealthUniversity of SouthamptonSouthamptonUK
| | - Landing M. Jarjou
- MRC Unit The GambiaLondon School of Hygiene and Tropical MedicineThe Gambia
| | | | - Modou Jobe
- MRC Unit The GambiaLondon School of Hygiene and Tropical MedicineThe Gambia
| | - Ann Prentice
- MRC Nutrition and Bone Health GroupCambridgeUK
- MRC Unit The GambiaLondon School of Hygiene and Tropical MedicineThe Gambia
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
| | - Peter R. Ebeling
- Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonVictoriaAustralia
| | - Kate A. Ward
- MRC Nutrition and Bone Health GroupCambridgeUK
- MRC Lifecourse Epidemiology Centre, Human Development and HealthUniversity of SouthamptonSouthamptonUK
- MRC Unit The GambiaLondon School of Hygiene and Tropical MedicineThe Gambia
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Mesinovic J, Rodriguez AJ, Cervo MM, Gandham A, Xu CL, Glavas C, de Courten B, Zengin A, Ebeling PR, Scott D. Vitamin D supplementation and exercise for improving physical function, body composition and metabolic health in overweight or obese older adults with vitamin D deficiency: a pilot randomized, double-blind, placebo-controlled trial. Eur J Nutr 2023; 62:951-964. [PMID: 36333495 PMCID: PMC9638202 DOI: 10.1007/s00394-022-03038-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Vitamin D supplementation may have non-skeletal health benefits and enhance exercise responsiveness, particularly in those with low vitamin D levels. We determined whether, compared with placebo, vitamin D supplementation taken prior to and during a 12-week exercise program improves physical function, body composition or metabolic health, in overweight and obese older adults with vitamin D deficiency. METHODS Fifty overweight or obese older adults (mean ± SD age: 60 ± 6 years; BMI 30.6 ± 5.7 kg/m2) with vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] < 50 nmol/L) were recruited. Participants were randomly allocated to receive either vitamin D3 (4000 IU/day) or matching placebo for 24 weeks. Between weeks 12 and 24, all participants completed multi-modal exercise three days per week while continuing with vitamin D/placebo. Mean changes in physical function (primary outcome: gait speed), body composition and biochemical parameters at weeks 12 and 24 were compared between groups. RESULTS Vitamin D supplementation, with or without exercise, had no effect on gait speed. From baseline to week 12, vitamin D supplementation increased serum 25(OH)D levels (placebo: 2.5 ± 14.7 nmol/L; treatment: 43.4 ± 18.4 nmol/L; P < 0.001) and reduced stair climb times (placebo: 0.3 ± 1.0 s; treatment: - 0.2 ± 1.0 s; P = 0.046). From 12 to 24 weeks, vitamin D supplementation combined with exercise decreased waist circumference (placebo: 1.3 ± 7.3 cm; treatment: - 3.0 ± 6.1 cm; P = 0.02) and waist-to-hip ratio (placebo: 0.01 ± 0.05; treatment: - 0.03 ± 0.05; P = 0.01) relative to placebo. Vitamin D supplementation, with or without exercise, had no effect on other physical function, body composition or metabolic health outcomes. CONCLUSION Vitamin D supplementation had no effect on most physical function, body composition or metabolic health parameters when taken alone, or during exercise, in overweight or obese older adults with vitamin D deficiency. Vitamin D-related improvements in stair climb times and waist circumference suggest that future trials should explore the effects of vitamin D on muscle power, and its effects on body composition when combined with exercise, in populations with moderate or severe vitamin D deficiency.
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Affiliation(s)
- Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3068, Australia. .,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia.
| | - Alexander J. Rodriguez
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Mavil May Cervo
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Anoohya Gandham
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Cecilia L.H. Xu
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Costas Glavas
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - Peter R. Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, 246 Clayton Road, Clayton, VIC 3068 Australia ,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
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Gruber M, Peltonen J, Bartsch J, Barzyk P. The validity and reliability of counter movement jump height measured with the Polar Vantage V2 sports watch. Front Sports Act Living 2022; 4:1013360. [PMID: 36385786 PMCID: PMC9650676 DOI: 10.3389/fspor.2022.1013360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/12/2022] [Indexed: 01/20/2023] Open
Abstract
The purpose of the present study was to assess the validity and reliability of the jump height measured by the Polar Vantage V2 sports watch in comparison to a gold-standard force plate measurement. Fifteen healthy adults, seven female, age 20-42 years participated in the study and performed six sets of three CMJs, on two consecutive days. The participants wore the Polar Vantage V2 sports watch (Polar Electro Oy, Kempele, Finland) whilst performing the jumps on two force plates (AMTI, Watertown, Massachusetts, United States). Jump height was on the one hand extracted directly from the watch ("leg recovery test") and on the other hand calculated by the flight time method with the force plate data. To assess validity, we calculated the mean absolute error, constructed Bland-Altman plots and applied an ordinary least squares regression analysis. To test for left-to-right and day-to-day reliability, we calculated Pearson and intraclass correlations. We found a mean error of ≈5% and a high correlation (r = 0.96; p < 0.001) for the jump height measured by the Polar Vantage V2 sports watch compared to the force plate measurement. The Bland-Altmann plot together with the ordinary least squares regression analysis showed no systematic bias between the methods with a minimal difference at a jump height of 30 cm. For reliability of left-to-right and day-to-day measurements, we found high Pearson and ICC correlations and no indications for systematic bias by Bland-Altmann analysis. The present study has demonstrated that the "leg recovery test" of the Polar Vantage V2 sports watch provide a valid and reliable measurement of the mean vertical jump height of three consecutive CMJs. For the first time the jump height of a CMJ can be measured solely by a sports watch without the need to attach additional sensors or measurement devices. Thus, the "leg recovery test" is an easy to administer, valid and reliable test, that can be used in future studies to measure CMJ-height in the field when lab-based assessments are unavailable or inconvenient. This opens new avenues for cross-sectional and longitudinal assessments of neuromuscular power of the lower extremities in a large number of participants.
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Affiliation(s)
- Markus Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany,*Correspondence: Markus Gruber
| | | | - Julia Bartsch
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Philipp Barzyk
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
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Kim SW, Park HY, Jung H, Lim K. Development of Functional Fitness Prediction Equation in Korean Older Adults: The National Fitness Award 2015–2019. Front Physiol 2022; 13:896093. [PMID: 35620610 PMCID: PMC9127254 DOI: 10.3389/fphys.2022.896093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/19/2022] [Indexed: 11/30/2022] Open
Abstract
The main advantage of measuring functional fitness (FF) in older adults is that individual tests can estimate and track the rate of decline with age. This study aimed to develop a multiple linear regression model for predicting FF variables using easy-to-measure independent variables (e.g., sex, age, body mass index, and percent body fat) in Korean older adults. National Fitness Award datasets from the Republic of Korea were used in this analysis. The participants were aged ≥65 years and included 61,465 older men and 117,395 older women. The FF variables included the hand grip strength, lower body strength (30-s chair stand), lower body flexibility (chair sit-and-reach), coordination (figure of 8 walk), agility/dynamic balance (timed up-and-go), and aerobic endurance (2-min step test). An estimation multiple linear regression model was developed using a stepwise technique. In the regression model, the coefficient of determination in the hand grip strength test (adjusted R2 = 0.773, p < 0.001) was significantly high. However, the coefficient of determination in the 30-s chair stand (adjusted R2 = 0.296, p < 0.001), chair sit-and-reach (adjusted R2 = 0.435, p < 0.001), figure of 8 walk (adjusted R2 = 0.390, p < 0.001), timed up-and-go (adjusted R2 = 0.384, p < 0.001), and 2-min step tests (adjusted R2 = 0.196, p < 0.001) was significantly low to moderate. Our findings suggest that easy-to-measure independent variables can predict the hand grip strength in older adults. In future studies, explanatory power will be further improved if multiple linear regression analysis, including the physical activity level and nutritional status of older adults, is performed to predict the FF variables.
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Affiliation(s)
- Sung-Woo Kim
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
| | - Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
| | - Hoeryong Jung
- Department of Mechanical Engineering, Konkuk University, Seoul, South Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute, Konkuk University, Seoul, South Korea
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Department of Physical Education, Konkuk University, Seoul, South Korea
- *Correspondence: Kiwon Lim,
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Zengin A, Shore-Lorenti C, Sim M, Maple-Brown L, Brennan-Olsen SL, Lewis JR, Ockwell J, Walker T, Scott D, Ebeling P. Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol. BMJ Open 2022; 12:e056589. [PMID: 35379631 PMCID: PMC8981296 DOI: 10.1136/bmjopen-2021-056589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Aboriginal and Torres Strait Islander Australians have a substantially greater fracture risk, where men are 50% and women are 26% more likely to experience a hip fracture compared with non-Indigenous Australians. Fall-related injuries in this population have also increased by 10%/year compared with 4.3%/year in non-Indigenous Australians. This study aims to determine why falls and fracture risk are higher in Aboriginal and Torres Strait Islander Australians. SETTING All clinical assessments will be performed at one centre in Melbourne, Australia. At baseline, participants will have clinical assessments, including questionnaires, anthropometry, bone structure, body composition and physical performance tests. These assessments will be repeated at follow-up 1 and follow-up 2, with an interval of 12 months between each clinical visit. PARTICIPANTS This codesigned prospective observational study aims to recruit a total of 298 adults who identify as Aboriginal and Torres Strait Islander and reside within Victoria, Australia. Stratified sampling by age and sex will be used to ensure equitable distribution of men and women across four age-bands (35-44, 45-54, 55-64 and 65+ years). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is within-individual yearly change in areal bone mineral density at the total hip, femoral neck and lumbar spine assessed by dual energy X-ray absorptiometry. Within-individual change in cortical and trabecular volumetric bone mineral density at the radius and tibia using high-resolution peripheral quantitative computed tomography will be determined. Secondary outcomes include yearly differences in physical performance and body composition. ETHICAL APPROVAL Ethics approval for this study has been granted by the Monash Health Human Research Ethics Committee (project number: RES-19-0000374A). TRIAL REGISTRATION NUMBER ACTRN12620000161921.
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Affiliation(s)
- Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Cat Shore-Lorenti
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Marc Sim
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
| | - Louise Maple-Brown
- Charles Darwin University, Menzies School of Health Research, Darwin, Northern Territory, Australia
- Endocrinology Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Sharon Lee Brennan-Olsen
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, Victoria, Australia
- Department of Medicine-Western Health, University of Melbourne, St Albans, Victoria, Australia
| | - Joshua R Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer Ockwell
- Bunurong Health Service, Dandenong & District Aborigines Co-operative Ltd (DDACL), Dandenong, Victoria, Australia
| | - Troy Walker
- Health & Wellbeing, A2B Personnel, Echuca, Victoria, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Peter Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Santos CAF, Amirato GR, Jacinto AF, Pedrosa AV, Caldo-Silva A, Sampaio AR, Pimenta N, Santos JMB, Pochini A, Bachi ALL. Vertical Jump Tests: A Safe Instrument to Improve the Accuracy of the Functional Capacity Assessment in Robust Older Women. Healthcare (Basel) 2022; 10:healthcare10020323. [PMID: 35206937 PMCID: PMC8872295 DOI: 10.3390/healthcare10020323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 01/27/2023] Open
Abstract
Age-related decreases in muscle function lead to disabilities and are associated with negative health outcomes in older people. Although several physical tests can be used to assess physical performance, muscle strength, and power, their interpretation can be hampered by the ceiling effect of some of them. The aim of this study was to assess whether vertical jump tests are safe in terms of physical integrity and whether they are useful in assessing physical performance in forty-one robust older women. The investigation entailed an assessment of anthropometric characteristics, physical functioning tests (Short Physical Performance Battery (SPPB), sit-to-up 5 times and sit-to-up 30 s, gait speed, time-up-to-go test (TUGT)), and tests evaluating muscle strength and power (handgrip, lower limb isokinetic tests, and vertical jumping tests). Significant negative correlations were found between vertical jumping tests and BMI, body fat percentage, sit-to-up 5 times and TUGT. In addition, significant positive correlations were observed between vertical jumping tests and SPPB, gait speed, handgrip, and concentric isokinetic tests of knee muscles. No adverse events in volunteers’ physical integrity were reported during and after the performance of all physical tests. Thus, the study results showed that vertical jumping tests are safe and accurate for assessing physical performance and are useful for monitoring age-related loss of muscle performance in robust older women.
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Affiliation(s)
- Carlos A. F. Santos
- Discipline of Geriatrics and Gerontology, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04020-050, Brazil;
- Postgraduate Program in Health Science Applied to Sports and Physical Activity, Paulista School of Medicine (EPM), Sao Paulo 04022-001, Brazil;
- Correspondence:
| | - Gislene R. Amirato
- Mane Garrincha Sports Education Center, Sports Department of the Municipality of Sao Paulo (SEME), Sao Paulo 04039-034, Brazil;
| | - Alessandro F. Jacinto
- Discipline of Geriatrics and Gerontology, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04020-050, Brazil;
- Postgraduate Program in Translational Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo 04039-002, Brazil
| | - Ana V. Pedrosa
- Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Science and Physical Education, (FCDEF-UC), University of Coimbra, 3040-248 Coimbra, Portugal; (A.V.P.); (A.C.-S.)
| | - Adriana Caldo-Silva
- Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Science and Physical Education, (FCDEF-UC), University of Coimbra, 3040-248 Coimbra, Portugal; (A.V.P.); (A.C.-S.)
| | - António R. Sampaio
- N2i, Polytechnic Institute of Maia, 4475-690 Maia, Portugal; (A.R.S.); (N.P.)
| | - Nuno Pimenta
- N2i, Polytechnic Institute of Maia, 4475-690 Maia, Portugal; (A.R.S.); (N.P.)
| | - Juliana M. B. Santos
- Post-Graduation Program in Science of Human Movement and Rehabilitation, Federal University of Sao Paulo (UNIFESP), Santos 11015-020, Brazil;
| | - Alberto Pochini
- Postgraduate Program in Health Science Applied to Sports and Physical Activity, Paulista School of Medicine (EPM), Sao Paulo 04022-001, Brazil;
| | - André L. L. Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), Sao Paulo 04829-300, Brazil;
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Beck B, Rubin C, Harding A, Paul S, Forwood M. The effect of low-intensity whole-body vibration with or without high-intensity resistance and impact training on risk factors for proximal femur fragility fracture in postmenopausal women with low bone mass: study protocol for the VIBMOR randomized controlled trial. Trials 2022; 23:15. [PMID: 34991684 PMCID: PMC8734256 DOI: 10.1186/s13063-021-05911-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevailing medical opinion is that medication is the primary (some might argue, only) effective intervention for osteoporosis. It is nevertheless recognized that osteoporosis medications are not universally effective, tolerated, or acceptable to patients. Mechanical loading, such as vibration and exercise, can also be osteogenic but the degree, relative efficacy, and combined effect is unknown. The purpose of the VIBMOR trial is to determine the efficacy of low-intensity whole-body vibration (LIV), bone-targeted, high-intensity resistance and impact training (HiRIT), or the combination of LIV and HiRIT on risk factors for hip fracture in postmenopausal women with osteopenia and osteoporosis. METHODS Postmenopausal women with low areal bone mineral density (aBMD) at the proximal femur and/or lumbar spine, with or without a history of fragility fracture, and either on or off osteoporosis medications will be recruited. Eligible participants will be randomly allocated to one of four trial arms for 9 months: LIV, HiRIT, LIV + HiRIT, or control (low-intensity, home-based exercise). Allocation will be block-randomized, stratified by use of osteoporosis medications. Testing will be performed at three time points: baseline (T0), post-intervention (T1; 9 months), and 1 year thereafter (T2; 21 months) to examine detraining effects. The primary outcome measure will be total hip aBMD determined by dual-energy X-ray absorptiometry (DXA). Secondary outcomes will include aBMD at other regions, anthropometrics, and other indices of bone strength, body composition, physical function, kyphosis, muscle strength and power, balance, falls, and intervention compliance. Exploratory outcomes include bone turnover markers, pelvic floor health, quality of life, physical activity enjoyment, adverse events, and fracture. An economic evaluation will also be conducted. DISCUSSION No previous studies have compared the effect of LIV alone or in combination with bone-targeted HiRIT (with or without osteoporosis medications) on risk factors for hip fracture in postmenopausal women with low bone mass. Should either, both, or combined mechanical interventions be safe and efficacious, alternative therapeutic avenues will be available to individuals at elevated risk of fragility fracture who are unresponsive to or unwilling or unable to take osteoporosis medications. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (www. anzctr.org.au ) (Trial number ANZCTR12615000848505, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 368962 ); date of registration 14/08/2015 (prospectively registered). Universal Trial Number: U1111-1172-3652.
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Affiliation(s)
- Belinda Beck
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Clinton Rubin
- Department of Biomedical Engineering, State University of New York at Stony Brook, New York, NY USA
| | - Amy Harding
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Sanjoy Paul
- Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, VIC Australia
| | - Mark Forwood
- School of Pharmacy and Medical Sciences, Gold Coast, QLD Australia
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11
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Rush B, Binkley N, Krueger D, Yamada Y, Kuchnia AJ. Combination of DXA and BIS Predicts Jump Power Better Than Traditional Measures of Sarcopenia. JBMR Plus 2021; 5:e10527. [PMID: 34368612 PMCID: PMC8328796 DOI: 10.1002/jbm4.10527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022] Open
Abstract
Traditional diagnostic criteria for sarcopenia use dual-energy X-ray absorptiometry (DXA)-measured appendicular lean mass (ALM), normalized to height (ALM/ht2) or body mass index (ALM/BMI) to define low muscle mass. However, muscle function declines with aging before the loss of muscle mass is detected by ALM. This is likely due, in part, to qualitative muscle changes such as extracellular and intracellular fluid compartment shifts uncaptured by DXA. We propose combining bioimpedance spectroscopy (BIS), which estimates extracellular and intracellular compartment volume, with DXA to more accurately predict muscle function. This combination may help incorporate muscle quality, thereby improving sarcopenia diagnosis. We cross-sectionally analyzed data from 248 Black and White participants aged 25 to 75 years from the Midlife in the United States Refresher Cohort. We proposed two novel muscle measures: ALM corrected by the BIS-derived whole-body extracellular to intracellular fluid ratio (E/I) and leg lean mass (LLM) corrected by leg-specific E/I, creating (ALM/(E/I)W) and (LLM/(E/I)L), respectively. We compared the associations of traditional muscle measures, ALM/(E/I)W, and LLM/(E/I)L, with grip strength and lower limb power using jumping mechanography. LLM/(E/I)L explained jump power best at R 2 = 0.803 compared with ALM/(E/I)W (p < 0.0001) and all other measures. ALM/(E/I)W explained jump power second best (R 2 = 0.759) but not significantly better than traditional muscle measures. No muscle measure performed better than covariates when predicting handgrip strength. LLM/(E/I)L outperformed ALM/ht2 and ALM/BMI when predicting jump power. We propose LLM/(E/I)L is a powerful and clinically relevant method that accounts for muscle quality. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Benjamin Rush
- Department of Nutritional Sciences University of Wisconsin-Madison Madison WI USA
| | - Neil Binkley
- University of Wisconsin Osteoporosis Clinical Research Program Madison WI USA
| | - Diane Krueger
- University of Wisconsin Osteoporosis Clinical Research Program Madison WI USA
| | - Yosuke Yamada
- Department of Physical Activity, National Institute of Health and Nutrition National Institutes of Biomedical Innovation, Health and Nutrition Tokyo Japan
| | - Adam J Kuchnia
- Department of Nutritional Sciences University of Wisconsin-Madison Madison WI USA
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12
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Choi H, Hong N, Park N, Kim CO, Kim HC, Choi JY, Youm Y, Rhee Y. Computed Tomography-Derived Skeletal Muscle Radiodensity Predicts Peak Weight-Corrected Jump Power in Older Adults: The Korean Urban Rural Elderly (KURE) Study. Calcif Tissue Int 2021; 108:764-774. [PMID: 33566115 DOI: 10.1007/s00223-021-00812-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/16/2021] [Indexed: 01/06/2023]
Abstract
Computed tomography (CT)-derived skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) reflect distinctive quantitative and qualitative characteristics of skeletal muscles. However, data on whether CT-based muscle parameters, especially SMD, can predict muscle function is limited. In a prospective cohort, 1523 community-dwelling older adults who underwent abdominal CT scans and the countermovement two-legged jumping test on a ground reaction force platform were analyzed (mean age 74.7 years, 65.1% women). SMA and SMD were measured at third lumbar vertebra level (L3). Individuals with low jump power (peak weight-corrected jump power < 23.8 W/kg in men and < 19.0 W/kg in women using clinically validated threshold) were older; had lower SMA, SMD, and maximal grip strength values; and had lower chair rise test and timed up and go test performance than those without low jump power. SMD was positively associated with peak weight-corrected jump power (adjusted β = 0.33 and 0.23 per 1 HU increase in men and women, respectively, p < 0.001). One HU decrement in SMD was associated with 10% elevated odds of low jump power (adjusted OR [aOR] 1.10, p < 0.001) after adjusting for age, sex, height, inflammation, and insulin resistance markers, whereas the association of SMA with low jump power was attenuated (aOR 1.00, p = 0.721). SMD showed better discrimination for low jump power than SMA (AUC 0.699 vs. 0.617, p < 0.001), with additional improvement when added to SMA and conventional risk factors (AUC 0.745 to 0.773, p < 0.001). Therefore, CT-measured L3 SMD can be a sensitive surrogate marker for muscle function along with SMA in older adults, which merits further investigation.
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Affiliation(s)
- Heewon Choi
- Yonsei University College of Medicine, Seoul, South Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Narae Park
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Choi
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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13
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Hong N, Siglinsky E, Krueger D, White R, Kim CO, Kim HC, Yeom Y, Binkley N, Rhee Y, Buehring B. Defining an international cut-off of two-legged countermovement jump power for sarcopenia and dysmobility syndrome. Osteoporos Int 2021; 32:483-493. [PMID: 32894301 PMCID: PMC7929946 DOI: 10.1007/s00198-020-05591-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/10/2020] [Indexed: 12/22/2022]
Abstract
UNLABELLED We aimed to establish jump power cut-offs for the composite outcome of either sarcopenia (EWGSOP2) or dysmobility syndrome using Asian and Caucasian cohorts. Estimated cut-offs were sex specific (women: < 19.0 W/kg; men: < 23.8 W/kg) but not ethnicity specific. Jump power has potential to be used in definitions of poor musculoskeletal health. PURPOSE Weight-corrected jump power measured during a countermovement jump may be a useful tool to identify individuals with poor musculoskeletal health, but no cut-off values exist. We aimed to establish jump power cut-offs for detecting individuals with either sarcopenia or dysmobility syndrome. METHODS Age- and sex-matched community-dwelling older adults from two cohorts (University of Wisconsin-Madison [UW], Korean Urban Rural Elderly cohort [KURE], 1:2) were analyzed. Jump power cut-offs for the composite outcome of either sarcopenia defined by EWGSOP2 or dysmobility syndrome were determined. RESULTS The UW (n = 95) and KURE (n = 190) cohorts were similar in age (mean 75 years) and sex distribution (68% women). Jump power was similar between KURE and UW women (19.7 vs. 18.6 W/kg, p = 0.096) and slightly higher in KURE than UW in men (26.9 vs. 24.8 W/kg, p = 0.050). In UW and KURE, the prevalence of sarcopenia (7.4% in both), dysmobility syndrome (31.6% and 27.9%), or composite of either sarcopenia or dysmobility syndrome (32.6% and 28.4%) were comparable. Low jump power cut-offs for the composite outcome differed by sex but not by ethnicity (< 19.0 W/kg in women; < 23.8 W/kg in men). Low jump power was associated with elevated odds of sarcopenia (adjusted odds ratio [aOR] 4.07), dysmobility syndrome (aOR 4.32), or the composite of sarcopenia or dysmobility syndrome (aOR 4.67, p < 0.01 for all) independent of age, sex, height, and ethnicity. CONCLUSION Sex-specific jump power cut-offs were found to detect the presence of either sarcopenia or dysmobility syndrome in older adults independent of Asian or Caucasian ethnicity.
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Affiliation(s)
- N Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - E Siglinsky
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
- UT Southwestern Medical Center, University of Texas Southwestern, Dallas, TX, USA
| | - D Krueger
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - R White
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - C O Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y Yeom
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea
| | - N Binkley
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - Y Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - B Buehring
- Osteoporosis Clinical Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA.
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Germany.
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Katsoulis K, Mathur S, Amara CE. Reliability of Lower Extremity Muscle Power and Functional Performance in Healthy, Older Women. J Aging Res 2021; 2021:8817231. [PMID: 33680513 DOI: 10.1155/2021/8817231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 01/14/2021] [Accepted: 02/04/2021] [Indexed: 11/18/2022] Open
Abstract
Evaluation of the long-term reliability of muscle power and functional performance tests in older, healthy adults is warranted since determining whether performance is consistent over longer durations is more relevant for intervention studies. Objective. To assess the long-term test-retest reliability of measures of muscle power and lower body functional performance in healthy, nonexercising, older women. Methods. Data were derived from a nonexercising control group (n = 18; age = 73.3 (3.4) years; height = 159.6 (7.7) cm; body mass = 69.5 (12.7) kg; BMI = 27.3 (4.8)) of a randomized controlled trial of muscle power training in older women. Participants underwent lower extremity muscle power (Biodex) and functional testing (Short Physical Performance Battery, gait speed, 30-second chair stands, stair climbing, and 400-meter walk) at week 0 (baseline), 9, and 15. Results. For the upper leg, intraclass correlation coefficients (ICCs) were very high for knee extension power (0.90-0.97) and high to very high for knee flexion power (0.83-0.96). For lower-leg power, ICCs were high to very high for plantar flexion and dorsiflexion (0.83-0.96). ICCs for functional performance were moderate to very high (0.64-0.93). Coefficient of variation of the typical error (CVTE) was <10.5% for knee extension/flexion power, 9.9-20.0% for plantar flexion/dorsiflexion power, and 1.9-14.9% for functional performance. Knee extension power and stair climb power demonstrated the highest reliability for muscle power and function, respectively. Mean values did not change over time, with the exception of the chair stands (p < 0.05); however, these changes were not considered clinically meaningful. Conclusions. The current study provides evidence supporting the long-term reliability of performance assessments of muscle power and lower body functional capacity over a period of up to 15 weeks in healthy, older women.
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15
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Balachandran AT, Vigotsky AD, Quiles N, Mokkink LB, Belio MA, Glenn JM. Validity, reliability, and measurement error of a sit-to-stand power test in older adults: A pre-registered study. Exp Gerontol 2020; 145:111202. [PMID: 33347922 DOI: 10.1016/j.exger.2020.111202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lower body power declines with age and is associated with decreased physical function in older adults. However, the majority of the tools available to measure power are expensive and require considerable space and expertise to operate. The purpose of this study was to assess the validity, reliability, and measurement error of a sit-to-stand power test (STSp) to assess lower body power. METHODS 51 community-dwelling adults, 65 years or older, completed a power test using a pneumatic leg press (LP), the Short Physical Performance Battery (SPPB) that includes a test of balance, usual walking speed, and chair stand tests; Timed Up and Go (TUG) test at both usual and fast paces, and Patient-Reported Outcome Measures (PROMs). A two-week test-retest assessed the reliability in 36 participants. The study hypotheses and analysis were pre-registered prior to data collection and statistical analyses were blinded. RESULTS The mean age was 71.3 years, with 63% females, and an average SPPB score of 10.6 (median = 12). STSp peak power was strongly correlated with LP (r = 0.90, 95% CI (0.82, 0.94). As hypothesized, the STSp peak power showed similar or higher correlations with physical function tests relative to LP peak power: SPPB (0.41 vs. 0.29), chair stand test (-0.44 vs. -0.35), TUG test at usual pace (-0.37 vs. -0.29) and fast pace (-0.41 vs. -0.34) and balance (0.33 vs. 0.22), but not for mobility (0.34 vs. 0.38) and function (0.41 vs. 0.48) questionnaire. For discriminant validity, as hypothesized, males showed higher STSp peak power compared to females (Δ = 492 W, p < .001, Cohen's d = 2.0). Test-retest assessment yielded an intraclass correlation coefficient of 0.96 and a standard error of measurement of 70.4 W. No adverse events were reported or observed for both tests. CONCLUSION The STSp showed adequate validity and reliability in measuring lower body power in community-dwelling older adults. The test is quick, relatively inexpensive, safe, and portable and thus should be considered for use in aging research.
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Affiliation(s)
- Anoop T Balachandran
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America.
| | - Andrew D Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, IL, United States of America
| | - Norberto Quiles
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America
| | - Lidwine B Mokkink
- Amsterdam University Medical Centers, location VUmc, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Mark A Belio
- Department of Family, Nutrition, and Exercise Sciences, Queens College, The City University of New York, Flushing, NY, United States of America
| | - Jordan McKenzie Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, United States of America; Neurotrack Technologies, 399 Bradford St., Redwood City, CA, United States of America
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16
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Konrad KL, Baeyens JP, Birkenmaier C, Ranker AH, Widmann J, Leukert J, Wenisch L, Kraft E, Jansson V, Wegener B. The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain-A prospective clinical intervention study. PLoS One 2020; 15:e0236780. [PMID: 32822361 PMCID: PMC7446884 DOI: 10.1371/journal.pone.0236780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/12/2020] [Indexed: 11/26/2022] Open
Abstract
Background According to present guidelines, active exercise is one key component in the comprehensive treatment of nonspecific chronic back pain (NSCBP). Whole body electromyostimulation (WB-EMS) is a safe, and time-effective training method, that may be effective in NSCBP-patients. Methods In this prospective and controlled nonrandomized clinical study, two therapeutic approaches were compared. One group received 20 minutes WB-EMS per week. An active control group (ACG) received a multimodal therapy program. A third group included subjects without back pain. To all groups, the following measurement instruments were applied: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), North American Spine Society Instrument (NASS); SF 36 survey and measurements for muscular function and postural stability. In the EMS-group: T0: baseline; T1: at 6 weeks; T2: at 12 weeks and T3: at 24 weeks. In the ACG: T0 baseline and T1 after 4 weeks. Results In the intervention group, 128 patients with low back pain were enrolled, 85 in the WB-EMS group and 43 in the ACG. 34 subjects were allocated to the passive control group. The average age was 58.6 years (18–86 years). In the EMS group, the NRS (1–10) improved statistically and clinically significantly by 2 points. The ODI was reduced by 19.7 points. The NASS and most of the SF 36 items improved significantly. In the multimodal treatment group, only the muscular function improved slightly. Conclusion Our data support the hypothesis that WB-EMS is at least as effective as a multimodal treatment, which is often referred to as being the golden standard. Therefore WB-EMS may be an effective and, with 20 min./week training time, very time-efficient alternative to established multimodal treatment models.
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Affiliation(s)
- Karl Lorenz Konrad
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Jean-Pierre Baeyens
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Christof Birkenmaier
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Anna Helena Ranker
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Jonas Widmann
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Johannes Leukert
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Lisa Wenisch
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Eduard Kraft
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Volkmar Jansson
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
| | - Bernd Wegener
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, Ludwig-Maximilians- University Munich (LMU), Munich, Germany
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
- * E-mail:
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Shere C, Fuggle NR, Edward MH, Parsons CM, Jameson KA, Cooper C, Dennison EM, Ward KA. Jumping Joints: The Complex Relationship Between Osteoarthritis and Jumping Mechanography. Calcif Tissue Int 2020; 106:115-123. [PMID: 31655874 PMCID: PMC6994439 DOI: 10.1007/s00223-019-00622-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/09/2019] [Indexed: 12/31/2022]
Abstract
We investigated the relationship between lower limb osteoarthritis (OA) and muscle strength and power (assessed by jumping mechanography) in UK community-dwelling older adults. We recruited 249 older adults (144 males, 105 females). OA was assessed clinically at the knee according to ACR criteria and radiographically, at the knee and hip, using Kellgren and Lawrence grading. Two-footed jumping tests were performed using a Leonardo Mechanography Ground Reaction Force Platform to assess maximum muscle force, power and Esslinger Fitness Index. Linear regression was used to assess the relationship between OA and jumping outcomes. Results are presented as β (95% confidence interval). The mean age of participants was 75.2 years (SD 2.6). Males had a significantly higher maximum relative power during lift off (mean 25.7 W/kg vs. 19.9 W/kg) and maximum total force during lift off (mean 21.0 N/kg vs. 19.1 N/kg) than females. In adjusted models, we found significant associations in males between clinical knee OA and maximum relative power [- 6.00 (CI - 9.10, - 2.94)] and Esslinger Fitness Index [- 19.3 (- 29.0, - 9.7)]. In females, radiographic knee OA was associated with total maximum power [- 2.0 (- 3.9, - 0.1)] and Esslinger Fitness Index [- 8.2 (- 15.9, - 0.4)]. No significant associations were observed for maximum total force. We observed significant negative associations between maximum relative power and Esslinger Fitness Index and clinical knee OA in males and radiographic knee OA in females. We have used novel methodology to demonstrate relationships between muscle function and OA in older adults.
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Affiliation(s)
- C Shere
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - N R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - M H Edward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - K A Jameson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
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Abstract
Sedentary aging is often characterized by physical dysfunction and chronic degenerative diseases. In contrast, masters athletes demonstrate markedly greater physiological function and more favorable levels of risk factors for cardiovascular disease, osteoporosis, frailty, and cognitive dysfunction than their sedentary counterparts. In many cases, age-related deteriorations of physiological functions as well as elevations in risk factors that are typically observed in sedentary adults are substantially attenuated or even absent in masters athletes. Older masters athletes possess greater functional capacity at any given age than their sedentary peers. Impressive profiles of older athletes provide insight into what is possible in human aging and place aging back into the domain of "physiology" rather than under the jurisdiction of "clinical medicine." In addition, these exceptional aging athletes can serve as a role model for the promotion of physical activity at all ages. The study of masters athletes has provided useful insight into the positive example of successful aging. To further establish and propagate masters athletics as a role model for our aging society, future research and action are needed. © 2020 American Physiological Society. Compr Physiol 10:261-296, 2020.
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Affiliation(s)
- Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Takashi Tarumi
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Jörn Rittweger
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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Dionyssiotis Y, Skarantavos G, Kantaidou I, Papadatou MC, Papagelopoulos P, Angoules A, Papathanasiou J, Lyritis GP. Evaluation of physical performance in musculoskeletal and rheumatic diseases with jumping mechanography. J Frailty Sarcopenia Falls 2019; 4:116-121. [PMID: 32300726 PMCID: PMC7155307 DOI: 10.22540/jfsf-04-116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Low muscle function is a component of sarcopenia. Rheumatic and musculoskeletal diseases are related to increased muscle loss and decreased muscle performance. Our purpose was to study muscle function among pre and postmenopausal women and women with rheumatic diseases. METHODS Two hundred fifty seven women were included in the study: Group POST OST included 61 osteoporotic postmenopausal women under treatment with osteoporotic drugs and calcium/vitamin D supplements (mean age 65±9.6 years), group POST HEALTH consisted of 117 healthy postmenopausal women (mean age 62.9±9.8 yrs), Group RHEUM included 20 women with rheumatic diseases (mean age 58.85±13yrs), and group PRE included 59 healthy premenopausal women (mean age 35±7.6 yrs). For the measurement of objective parameters of movement (Force, velocity, Power), we used the mechanography system in Leonardo platform (Novotec, Germany). Personal Power (Power/Weight) was also calculated. RESULTS Height was decreased with age, while body mass index (BMI) and weight were significantly increased. In groups POST OST, POST HEALTH, RHEUM, all measured parameters were statistically decreased in comparison with group PRE. No statistical significance was found among POST HEALTH and POST OST women. CONCLUSIONS Jumping mechanography can be proposed as a novel tool to assess physical performance in musculoskeletal and rheumatic diseases. It offers to the clinician additional information, while quantitatively assesses muscle function, for assessing sarcopenia.
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Affiliation(s)
- Yannis Dionyssiotis
- 1 Physical Medicine & Rehabilitation Department, National Rehabilitation Center EKA, Ilion, Athens, Greece
| | - Grigorios Skarantavos
- Rheumatology and Bone Unit, 1 Department of Orthopedics, General University Hospital ATTIKON, Chaidari, Greece
| | - Inga Kantaidou
- Physiotherapy Department, Municipality of Neapoli – Sykies, Thessaloniki, Greece
| | - Maria-Christina Papadatou
- 1 Physical Medicine & Rehabilitation Department, National Rehabilitation Center EKA, Ilion, Athens, Greece
| | - Panayiotis Papagelopoulos
- 1 Department of Orthopedics, Athens University School of Medicine, General University Hospital ATTIKON, Chaidari, Greece
| | - Antonios Angoules
- Department of Medical Laboratories, Technological Educational Institute of Athens, Egaleo, Athens, Greece
| | - Jannis Papathanasiou
- Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, Bulgaria
| | - George P. Lyritis
- Hellenic Osteoporosis Foundation, Kifissia, Greece
- Corresponding author: Yannis Dionyssiotis, MD, MSc., PhD, 1st Physical Medicine and Rehabilitation Department, National Rehabilitation Center EKA, 13122 Ilion, Athens, Greece E-mail:
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Mehmet H, Yang AWH, Robinson SR. Measurement of hand grip strength in the elderly: A scoping review with recommendations. J Bodyw Mov Ther 2019; 24:235-243. [PMID: 31987550 DOI: 10.1016/j.jbmt.2019.05.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Hand grip strength has been widely used as a lead measure in geriatric conditions such as frailty. However, diversity in assessment protocols and methodologies creates uncertainty in the comparison of outcome measurements. The aim of this study was to review the literature relating to the measurement of hand grip strength in older adults, in order to develop further consensus in relation to the use of existing protocols in clinical and community settings, with an emphasis on practicality and suitability for frail persons. METHODS Five electronic English databases were searched using keywords such as 'hand grip strength', 'clinimetric assessment', and their synonyms. Age-related trends in adults aged ≥65 years were assessed, and comparisons were made of the following variables: dynamometer model and handle setting, hand positioning, warm-up trials, grip duration, number of repeated tests, rest periods, laterality of tested hand, and whether encouragement was given to the subjects. RESULTS Thirty-four research papers met the inclusion criteria and were included. A Jamar hand dynamometer was most frequently used. Variations were found in the positioning of the subject and in the duration of the rest period, which ranged from 10 to 20 s to 1 min. Grip strength was typically measured three times in the dominant hand, with the strongest grip being recorded and no encouragement being provided during assessment. CONCLUSIONS Based on the scoping review, we propose a detailed and standardised protocol that is suitable for the assessment of hand grip strength in frail older adults.
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Affiliation(s)
- Hanife Mehmet
- School of Health and Biomedical Sciences, RMIT University, Australia
| | - Angela W H Yang
- School of Health and Biomedical Sciences, RMIT University, Australia
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Zengin A, Jarjou LM, Prentice A, Cooper C, Ebeling PR, Ward KA. The prevalence of sarcopenia and relationships between muscle and bone in ageing West-African Gambian men and women. J Cachexia Sarcopenia Muscle 2018; 9:920-928. [PMID: 30221478 PMCID: PMC6204597 DOI: 10.1002/jcsm.12341] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/08/2018] [Accepted: 07/02/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The rapidly rising ageing population in low and middle-income countries (LMIC) will lead to a concurrent increase in musculoskeletal diseases. Sarcopenia is a disease caused by progressive loss of skeletal muscle mass and strength, leading to adverse outcomes including frailty, falls, fractures, and premature mortality. We investigated the prevalence of sarcopenia, assessed the suitability of current diagnostic guidelines and explored muscle-bone relationships in ageing men and women from rural Gambia. METHODS A total of 249 women and 239 men aged 40-75+ years were recruited. Body composition was measured using dual energy X-ray absorptiometry. Comparisons of the Foundations for the National Institutes of Health (FNIH) and European Working Group On Sarcopenia (EWGSOP) definitions of sarcopenia to define prevalence and to identify poor physical capability were determined. Functional ability was assessed by jumping mechanography to calculate lower limb muscle force and power; grip strength was assessed by a hand dynamometer. Peripheral quantitative computed tomography was used to assess muscle-bone relationships. RESULTS The prevalence of sarcopenia in Gambian men and women significantly varied depending on the definition used; in men 20% and 19% and in women 45% and 10% for FNIH and EWGSOP, respectively. The FNIH appendicular lean mass cut-off had greatest sensitivity and specificity in identifying low functional ability in Gambian adults. Muscle force was positively associated with measures of tibial bone size, strength, and mineral content. CONCLUSIONS The variation in the prevalence of sarcopenia depends on the definition used and highlights the importance of measuring functional capability across ethnic populations.
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Affiliation(s)
- Ayse Zengin
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health SciencesMonash University, Monash Medical CentreClaytonVICAustralia
- MRC Elsie Widdowson LaboratoryCambridgeUK
| | | | - Ann Prentice
- MRC Elsie Widdowson LaboratoryCambridgeUK
- MRC Unit The GambiaKenebaThe Gambia
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research UnitUniversity of OxfordOxfordUK
| | - Peter R. Ebeling
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health SciencesMonash University, Monash Medical CentreClaytonVICAustralia
| | - Kate A. Ward
- MRC Elsie Widdowson LaboratoryCambridgeUK
- MRC Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
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Kuchnia AJ, Yamada Y, Teigen L, Krueger D, Binkley N, Schoeller D. Combination of DXA and BIS body composition measurements is highly correlated with physical function-an approach to improve muscle mass assessment. Arch Osteoporos 2018; 13:97. [PMID: 30218261 DOI: 10.1007/s11657-018-0508-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023]
Abstract
RATIONALE Fluid volume estimates may help predict functional status and thereby improve sarcopenia diagnosis. MAIN RESULT Bioimpedance-derived fluid volume, combined with DXA, improves identification of jump power over traditional measures. SIGNIFICANCE DXA-measured lean mass should be corrected for fluid distribution in older populations; this may be a surrogate of muscle quality. PURPOSE Sarcopenia, the age-related loss of muscle mass and function, negatively impacts functional status, quality of life, and mortality. We aimed to determine if bioimpedance spectroscopy (BIS)-derived estimates of body water compartments can be used in conjunction with dual-energy X-ray absorptiometry (DXA) measures to aid in the prediction of functional status and thereby, ultimately, improve the diagnosis of sarcopenia. METHODS Participants (≥ 70 years) had physical and muscle function tests, DXA, and BIS performed. Using a BMI correction method, intracellular water (ICWc), extracellular water (ECWc), and ECWc to ICWc (E/Ic) ratio was estimated from standard BIS measures. Jump power was assessed using jump mechanography. RESULTS The traditional measure used to diagnose sarcopenia, DXA-derived appendicular lean mass (ALM) corrected for height (ALM/ht2), was the least predictive measure explaining jump power variability (r2 = 0.31, p < 0.0001). The best measure for explaining jump power was a novel variable combining DXA ALM and BIS-derived E/Ic ratio (ALM/(E/Ic); r2 = 0.70, p < 0.0001). ALM/(E/Ic) and ICWc had the highest correlation with jump power and grip strength, specifically jump power (r = 0.84 and r = 0.80, respectively; p < 0.0001). CONCLUSIONS The creation of a novel variable (ALM/(E/Ic)) improved the ability of DXA to predict jump power in an older population. ALM/(E/Ic) substantially outperformed traditional lean mass measures of sarcopenia and could well be an improved diagnostic approach to predict functional status. DXA-measured ALM should be corrected for fluid distribution, i.e., ALM/(E/Ic); this correction may be considered a surrogate of muscle quality.
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Taani MH, Siglinsky E, Kovach CR, Buehring B. Psychosocial Factors Associated With Reduced Muscle Mass, Strength, and Function in Residential Care Apartment Complex Residents. Res Gerontol Nurs 2018; 11:238-248. [DOI: 10.3928/19404921-20180810-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 06/20/2018] [Indexed: 12/14/2022]
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Rupp T, Butscheidt S, Jähn K, Simon MJ, Mussawy H, Oheim R, Barvencik F, Amling M, Rolvien T. Low physical performance determined by chair rising test muscle mechanography is associated with prevalent fragility fractures. Arch Osteoporos 2018; 13:71. [PMID: 29968169 DOI: 10.1007/s11657-018-0490-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/18/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study examined associations between physical performance assessed by chair rising test muscle mechanography and DXA T-score as well as body composition in a large patient cohort. Next to various significant interrelationships between these muscle and bone parameters, lower physical performance was associated with prevalent fragility fractures. PURPOSE Although the interaction between muscle and bone has been demonstrated in various aspects, the clinical focus in the diagnosis of musculoskeletal disorders mainly lies on the skeletal assessments. Accordingly, the association between muscle function, bone mineral density (BMD), and fragility fractures remains to be further elucidated with a feasible muscle assessment in a clinical setting. METHODS Patient data (2076 patients, 1538 women, 538 men) were evaluated retrospectively from a large dual energy X-ray absorptiometry (DXA) database as well as from chair rising test (CRT) that was performed on a muscle mechanograph. To determine potential predictors of the CRT time and maximum force, a multivariate regression analysis was performed including age, DXA T-score, and body composition indices. Furthermore, CRT results were compared between non-fracture and fracture cases. RESULTS We determined independent predictors for CRT time such as age, femoral DXA T-score, and total fat mass, whereas CRT force was only influenced by total lean mass. Both women and men with previous fragility fractures displayed a longer CRT time (women p = 0.009, men p = 0.001) and lower CRT force (women p < 0.001, men p < 0.001) than those with no fractures, while no clear differences in CRT results could be detected between normal BMD, osteopenia, and osteoporosis based on DXA T-scores. CONCLUSIONS Our study demonstrates that in addition to the associations between chair rising time and femoral T-score assessed by DXA, low muscle strength is associated with previous fragility fractures.
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Siglinsky E, Buehring B, Krueger D, Binkley N, Yamada Y. Could bioelectric impedance spectroscopy (BIS) measured appendicular intracellular water serve as a lean mass measurement in sarcopenia definitions? A pilot study. Osteoporos Int 2018; 29:1653-1657. [PMID: 29574521 DOI: 10.1007/s00198-018-4475-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/06/2018] [Indexed: 01/25/2023]
Abstract
UNLABELLED DXA lean mass measurement for sarcopenia diagnosis is not always possible. Bioelectric impedance spectroscopy (BIS), a portable technology, is a potential alternative to DXA-measured lean mass. This pilot study explores the possibility and proposes an arbitrarily chosen potential cut-point for appendicular intracellular water corrected by height (aICW/ht2). INTRODUCTION Sarcopenia definitions often include DXA lean mass measurement. However, DXA is not always available. We explored the potential of a less-expensive mobile method, bioelectric impedance spectroscopy (BIS), to assess lean mass for sarcopenia determination. We hypothesized that BIS-measured appendicular intracellular water (aICW/ht2) would correlate with DXA-measured appendicular lean mass (ALM)/ht2 and with functional parameters. If so, establishing an aICW/ht2 cut-point in sarcopenia definitions may be feasible. METHODS Sixty-one community-dwelling women, mean age 79.9, had BIS and DXA lean mass, grip strength, gait speed, and jumping mechanography assessments. BIS aICW was calculated using limb length and intracellular water resistance. aICW/ht2 was compared to DXA-measured ALM/ht2 by linear regression. The European Working Group ALM/ht2 and an exploratory aICW/ht2 cut-point were utilized. RESULTS In this cohort, ALM/ht2 and aICW/ht2 were moderately correlated, R2 = 0.55, p < 0.0001. Lean mass was low in 7 and normal in 44 by BIS and DXA. Those with low aICW/ht2 had lower grip strength (p = 0.04) and jump power (p = 0.0002) than those with normal aICW/ht2 and ALM/ht2. Subjects with low ALM/ht2 had lower jump power (p = 0.0006) but were not different in gait speed or grip strength. CONCLUSIONS BIS aICW is correlated with DXA-measured ALM directly, and when height adjusted. An aICW/ht2 cut-point of 6.5 L/m2 identified 70% of women with low ALM/ht2. Women with low lean mass by DXA and BIS had poorer function measured by jump power. These pilot data support further evaluation of BIS measurement inclusion into sarcopenia definitions.
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Affiliation(s)
- E Siglinsky
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - B Buehring
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - D Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - N Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA.
| | - Y Yamada
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
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Hong N, Kim CO, Youm Y, Kim HC, Rhee Y. Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study. Osteoporos Int 2018. [PMID: 29520606 DOI: 10.1007/s00198-018-4466-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
UNLABELLED In a community-dwelling elderly cohort (Korean Urban Rural Elderly), low peak jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities. Jump power measurement improved discrimination of individuals with dysmobility syndrome when added to conventional risk factors. INTRODUCTION Dysmobility syndrome was proposed to encompass the risks affecting musculoskeletal outcomes. Jump power measurement is a safe, reproducible high-intensity test for physical function in elderly. However, the relationship between jump power and dysmobility syndrome remains unknown. METHODS A total of 1369 subjects (mean 71.6 years; women, 66%) were analyzed from a community-based cohort. Dysmobility syndrome was defined as the presence of ≥ 3 factors among falls in the preceding year, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go (TUG) performance. Subjects were grouped into tertiles of jump power relative to weight based on sex-stratified cutoffs (32.4 and 27.6 W/kg in men; 23.9 and 19.9 W/kg in women) or into the failed-to-jump group. RESULTS The prevalence of dysmobility syndrome was 20% overall, increasing from the highest (T1) to lowest (T3) jump power tertile (1, 11, 15% in men; 11, 16, 39% in women) and the failed-to-jump group (39% in men; 48% in women). Low jump power or failed-to-jump was associated with elevated odds of dysmobility syndrome (T3 vs. T1, adjusted odds ratio [aOR] 4.35, p < 0.001; failed-to-jump vs. T1, aOR 7.60, p < 0.001) and its components including falls, low lean mass, high fat mass, and poor TUG performance but not osteoporosis after adjustment for covariates. Jump power modestly discriminated dysmobility syndrome (area under the curve [AUC], 0.71, p < 0.001), which improved discriminatory performance when added to conventional risk factors (AUC, from 0.75 to 0.79, p < 0.001). CONCLUSIONS Low peak jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities.
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Affiliation(s)
- Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 120-752, Korea
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, 120-752, Korea.
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Buehring B, Siglinsky E, Krueger D, Evans W, Hellerstein M, Yamada Y, Binkley N. Comparison of muscle/lean mass measurement methods: correlation with functional and biochemical testing. Osteoporos Int 2018; 29:675-683. [PMID: 29198074 DOI: 10.1007/s00198-017-4315-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/13/2017] [Indexed: 12/25/2022]
Abstract
UNLABELLED DXA-measured lean mass is often used to assess muscle mass but has limitations. Thus, we compared DXA lean mass with two novel methods-bioelectric impedance spectroscopy and creatine (methyl-d3) dilution. The examined methodologies did not measure lean mass similarly and the correlation with muscle biomarkers/function varied. INTRODUCTION Muscle function tests predict adverse health outcomes better than lean mass measurement. This may reflect limitations of current mass measurement methods. Newer approaches, e.g., bioelectric impedance spectroscopy (BIS) and creatine (methyl-d3) dilution (D3-C), may more accurately assess muscle mass. We hypothesized that BIS and D3-C measured muscle mass would better correlate with function and bone/muscle biomarkers than DXA measured lean mass. METHODS Evaluations of muscle/lean mass, function, and serum biomarkers were obtained in older community-dwelling adults. Mass was assessed by DXA, BIS, and orally administered D3-C. Grip strength, timed up and go, and jump power were examined. Potential muscle/bone serum biomarkers were measured. Mass measurements were compared with functional and serum data using regression analyses; differences between techniques were determined by paired t tests. RESULTS Mean (SD) age of the 112 (89F/23M) participants was 80.6 (6.0) years. The lean/muscle mass assessments were correlated (.57-.88) but differed (p < 0.0001) from one another with DXA total body less head being highest at 37.8 (7.3) kg, D3-C muscle mass at 21.1 (4.6) kg, and BIS total body intracellular water at 17.4 (3.5) kg. All mass assessment methods correlated with grip strength and jump power (R = 0.35-0.63, p < 0.0002), but not with gait speed or repeat chair rise. Lean mass measures were unrelated to the serum biomarkers measured. CONCLUSIONS These three methodologies do not similarly measure muscle/lean mass and should not be viewed as being equivalent. Functional tests assessing maximal muscle strength/power (grip strength and jump power) correlated with all mass measures whereas gait speed was not. None of the selected serum measures correlated with mass. Efforts to optimize muscle mass assessment and identify their relationships with health outcomes are needed.
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Affiliation(s)
- B Buehring
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - E Siglinsky
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - D Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA
| | - W Evans
- University of California, Berkeley, CA, USA
| | | | - Y Yamada
- National Institute of Health & Nutrition, Tokyo, Japan
| | - N Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA.
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Strotmeyer ES, Winger ME, Cauley JA, Boudreau RM, Cusick D, Collins RF, Chalhoub D, Buehring B, Orwoll E, Harris TB, Caserotti P. Normative Values of Muscle Power using Force Plate Jump Tests in Men Aged 77-101 Years: The Osteoporotic Fractures in Men (MrOS) Study. J Nutr Health Aging 2018; 22:1167-1175. [PMID: 30498822 PMCID: PMC8963464 DOI: 10.1007/s12603-018-1081-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine normative values for weight-bearing, countermovement leg extension ("jump") tests in the oldest men and characteristics of those not completing vs. completing tests. DESIGN 2014-16 cross-sectional exam. SETTING Six U.S. sites from the Osteoporotic Fractures in Men (MrOS) Study. PARTICIPANTS Community-dwelling men (N=1,841) aged 84.5±4.2 (range: 77-101) years. INTERVENTIONS N/A. MEASUREMENTS Jump tests on a force plate measured lower-extremity muscle peak power/kg, velocity and force/kg at peak power, with normative values for 5-year age groups and by limitations in moderate-intensity activities of daily living (ADLs) and climbing several flights of stairs. RESULTS Jump completion was 68.9% (N=1,268/1,841) and 98% (1,242/1,268) had ≥1 analyzable trial/participant. Exclusions primarily were due to poor mobility and/or balance: 24.8% (456/1,841) prior to and 6.4% (N=117/1,841) after attempting testing. Peak power was 20.8±5.3 W/kg, with 1.2±0.3 m/s for velocity, and 16.7±1.9 N/kg for force at peak power. Each 5-year age group >80 years had subsequently 10% lower power/kg, with 30% lower power/kg at >90 vs. ≤80 years (all p<0.05). Velocity and force/kg at peak power were 24% and 9% lower respectively, at >90 vs. ≤80 years (all p<0.05). Limitations in both moderate ADLs and climbing several flights of stairs were associated with 16% lower age-adjusted power/kg, equivalent to 5-10 years of aging, with 11% and 6% lower age-adjusted velocity and force/kg respectively, vs. those without limitation (all p<0.05). Men not completing vs. completing jumps had older age, higher BMI, lower physical activity, more comorbidities, worse cognition, more IADLs/ADLs and more falls in the past year (all p<0.05). Post-jump pain occurred in 4.6% (58/1,268), with 2 participants stopping testing due to pain. Only 24/1,242 (2%) had all trials/participant without flight (i.e., inability to lift feet), with 323/1,242 having ≥1 trial/participant without flight (total of 28%). No serious adverse safety events (e.g., injury) occurred. CONCLUSIONS A multicenter cohort of oldest men with a range of function had higher declines in jump power/kg and velocity vs. force/kg across each 5-year age group >80 years. Future research should examine age- and functional-related declines in jump measures related to physical performance decline, falls, fractures, and disability.
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Affiliation(s)
- E S Strotmeyer
- Elsa S. Strotmeyer, PhD, MPH, 130 N. Bellefield Ave., Room 515, Pittsburgh, PA 15213, Office phone: 412-383-1293,
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Maratova K, Soucek O, Matyskova J, Hlavka Z, Petruzelkova L, Obermannova B, Pruhova S, Kolouskova S, Sumnik Z. Muscle functions and bone strength are impaired in adolescents with type 1 diabetes. Bone 2018; 106:22-27. [PMID: 29017892 DOI: 10.1016/j.bone.2017.10.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 09/05/2017] [Accepted: 10/06/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Sarcopenia and osteoporosis are among the late complications of type 1 diabetes (T1D) in adults. Whether and to what extent musculoskeletal impairment is present in childhood and adolescence has yet to be determined. The aim of this study was to assess volumetric bone mineral density (BMD) and dynamic muscle function in adolescents with T1D and to assess the clinical and biochemical predictors of their musculoskeletal system. METHODS Ninety-five children and adolescents (59 boys and 36 girls, mean age 16.2±1.2years) with T1D were included in this cross-sectional study. Study participants were divided into two groups according to the duration of the disease (<6years and >9years, respectively). Volumetric BMD of the non-dominant tibia was assessed using peripheral quantitative computed tomography (pQCT). Dynamic muscle function was evaluated using jumping mechanography. Gender- and height-specific Z-scores were calculated using published reference data. HbA1c was evaluated retrospectively as an average over the past 5years. RESULTS Relative muscle power (Pmax/mass) and force (Fmax/body weight) were significantly decreased in T1D subjects (mean Z-scores -0.4±1.0; p<0.001, and -0.3±1.1; p<0.01, respectively). The duration of T1D negatively affected Pmax/mass (p<0.01) but not Fmax/body weight (p=0.54). Patients with T1D had also decreased trabecular BMD, the Strength-Strain Index and cortical thickness (mean Z-scores -0.8±1.3; -0.5±0.8 and -1.1±0.8, respectively, p<0.001 for all) whereas cortical BMD was increased when compared to controls (Z-score 1.2±0.90, p<0.001). No association was observed between the HbA1c and 25-hydroxyvitamin D levels and bone or muscle parameters. CONCLUSION T1D influences the musculoskeletal system in adolescence. Decreased muscle function could contribute to the osteoporosis reported in adult diabetic patients.
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Affiliation(s)
- Klara Maratova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Ondrej Soucek
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Jana Matyskova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Zdenek Hlavka
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University in Prague, Sokolovska 49/83, 186 75 Prague 8, Czech Republic.
| | - Lenka Petruzelkova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Barbora Obermannova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Stepanka Pruhova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Stanislava Kolouskova
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
| | - Zdenek Sumnik
- Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic.
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Yamada Y, Buehring B, Krueger D, Anderson RM, Schoeller DA, Binkley N. Electrical Properties Assessed by Bioelectrical Impedance Spectroscopy as Biomarkers of Age-related Loss of Skeletal Muscle Quantity and Quality. J Gerontol A Biol Sci Med Sci 2017; 72:1180-1186. [PMID: 28814064 PMCID: PMC5861891 DOI: 10.1093/gerona/glw225] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/19/2016] [Indexed: 12/25/2022] Open
Abstract
Skeletal muscle, in addition to being comprised of a heterogeneous muscle fiber population, also includes extracellular components that do not contribute to positive tensional force production. Here we test segmental bioelectrical impedance spectroscopy (S-BIS) to assess muscle intracellular mass and composition. S-BIS can evaluate electrical properties that may be related to muscle force production. Muscle fiber membranes separate the intracellular components from the extracellular environment and consist of lipid bilayers which act as an electrical capacitor. We found that S-BIS measures accounted for ~85% of the age-related decrease in appendicular muscle power compared with only ~49% for dual-energy x-ray absorptiometry (DXA) measures. Indices of extracellular (noncontractile) and cellular (contractile) compartments in skeletal muscle tissues were determined using the Cole-Cole plot from S-BIS measures. Characteristic frequency, membrane capacitance, and phase angle determined by Cole-Cole analysis together presented a S-BIS complex model that explained ~79% of interindividual variance of leg muscle power. This finding underscores the value of S-BIS to measure muscle composition rather than lean mass as measured by DXA and suggests that S-BIS should be highly informative in skeletal muscle physiology.
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Affiliation(s)
- Yosuke Yamada
- Department of Nutritional Science, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Bjoern Buehring
- Osteoporosis Clinical Research Program
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
- GRECC, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | | | - Rozalyn M Anderson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
- GRECC, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | | | - Neil Binkley
- Osteoporosis Clinical Research Program
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
- GRECC, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
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Zengin A, Pye SR, Cook MJ, Adams JE, Rawer R, Wu FC, O'Neill TW, Ward KA. Associations of muscle force, power, cross-sectional muscle area and bone geometry in older UK men. J Cachexia Sarcopenia Muscle 2017; 8:598-606. [PMID: 28474432 PMCID: PMC5566651 DOI: 10.1002/jcsm.12198] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/23/2017] [Accepted: 02/07/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Ageing is associated with sarcopenia, osteoporosis, and increased fall risk, all of which contribute to increased fracture risk. Mechanically, bone strength adapts in response to forces created by muscle contractions. Adaptations can be through changes in bone size, geometry, and bending strength. Muscle mass is often used as a surrogate for muscle force; however, force can be increased without changes in muscle mass. Increased fall risk with ageing has been associated with a decline in muscle power-which is a measure of mobility. The aims of this study were as follows: (i) to investigate the relationship between muscle parameters in the upper and lower limbs with age in UK men and the influence of ethnicity on these relationships; (ii) to examine the relationships between jump force/grip strength/cross-sectional muscle area (CSMA) with bone outcomes at the radius and tibia. METHODS White European, Black Afro-Caribbean, and South Asian men aged 40-79 years were recruited from Manchester, UK. Cortical bone mineral content, cross-sectional area, cortical area, cross-sectional moment of inertia, and CSMA were measured at the diaphysis of the radius and tibia using peripheral quantitative computed tomography. Lower limb jump force and power were measured from a single two-legged jump performed on a ground-reaction force platform. Grip strength was measured using a dynamometer. Associations between muscle and bone outcomes was determined using linear regression with adjustments for age, height, weight, and ethnicity. RESULTS Three hundred and one men were recruited. Jump force was negatively associated with age; for every 10 year increase in age, there was a 4% reduction in jump force (P < 0.0001). There was a significant age-ethnicity interaction for jump power (P = 0.039); after adjustments, this was attenuated (P = 0.088). For every 10 year increase in age, grip strength decreased by 11%. Jump force was positively associated with tibial bone outcomes: a 1 standard deviation greater jump force was associated with significantly higher cortical bone mineral content 3.1%, cross-sectional area 4.2%, cortical area 3.4%, and cross-sectional moment of inertia 6.8% (all P < 0.001). Cross-sectional muscle area of the lower leg was not associated with tibial bone outcomes. Both grip strength and CSMA of the arm were positively associated, to a similar extent, with radius diaphyseal bone outcomes. CONCLUSIONS Jump force and power are negatively associated with age in UK men. In the lower limb, the measurement of jump force is more strongly related to bone outcomes than CSMA. It is important to consider jump force and power when understanding the aetiology of bone loss and mobility in ageing men.
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Affiliation(s)
- Ayse Zengin
- Nutrition & Bone Health, Elsie Widdowson LaboratoryMedical Research Council Human Nutrition ResearchFulbourn Rd CB1 9NLCambridgeUK
| | - Stephen R. Pye
- Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Science CentreThe University of ManchesterOxford RoadManchesterM13 9PTUK
| | - Michael J. Cook
- Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Science CentreThe University of ManchesterOxford RoadManchesterM13 9PTUK
| | - Judith E. Adams
- Radiology and Manchester Academic Health Science Centre (MAHSC)Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust and University of ManchesterOxford RoadManchesterM13 9WLUK
| | - Rainer Rawer
- Novotec Medical GmbHDurlacher Str. 35Pforzheim75172Germany
| | - Frederick C.W. Wu
- Andrology Research Unit, Centre for Endocrinology and Diabetes, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre (MAHSC)The University of Manchester, Central Manchester University Hospitals NHS Foundation TrustOld St Mary's Building, Hathersage RoadManchesterM13 9WLUnited Kingdom
| | - Terence W. O'Neill
- Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Science CentreThe University of ManchesterOxford RoadManchesterM13 9PTUK
- NIHR Manchester Musculoskeletal Biomedical Research UnitCentral Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science CentreGrafton StreetManchesterM13 9WLUK
- Department of RheumatologySalford Royal NHS Foundation TrustStott LaneSalfordM6 8HDUK
| | - Kate A. Ward
- Nutrition & Bone Health, Elsie Widdowson LaboratoryMedical Research Council Human Nutrition ResearchFulbourn Rd CB1 9NLCambridgeUK
- Medical Research Council Lifecourse Epidemiology UnitUniversity of SouthamptonTremona RoadSouthamptonSO16 6YDUK
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Levine DM, Lipsitz SR, Linder JA. Changes in Everyday and Digital Health Technology Use Among Seniors in Declining Health. J Gerontol A Biol Sci Med Sci 2017; 73:552-559. [DOI: 10.1093/gerona/glx116] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/09/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- David M Levine
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Stuart R Lipsitz
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Linder
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Lee EY, Lee SJ, Kim KM, Seo DH, Lee SW, Choi HS, Kim HC, Youm Y, Kim CO, Rhee Y. Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women. Calcif Tissue Int 2017; 100:585-594. [PMID: 28275826 DOI: 10.1007/s00223-017-0239-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 01/12/2017] [Indexed: 01/03/2023]
Abstract
Sarcopenia is considered to be a risk factor for osteoporotic fracture, which is a major health problem in elderly women. In this study, we aimed to investigate the association of sarcopenia, with regard to muscle mass and function, with prevalent vertebral fracture in community-dwelling elderly women. We recruited 1281 women aged 64 to 87 years from the Korean Urban Rural Elderly cohort study. Muscle mass and function were measured using bioimpedance analysis and jumping mechanography. Skeletal muscle index (SMI) and jump power were used as an indicator of muscle mass and function, respectively. Among the participants, we observed 282 (18.9%) vertebral fractures and 564 (44.0%) osteoporosis. Although age, body mass index, and prevalence of osteoporosis increased as both SMI and jump power decreased, prevalence of vertebral fracture increased only when jump power decreased. In univariate analysis, compared with the highest quartile of jump power, the lowest quartile had a significant odds ratio of 2.80 (95% CI 1.79-4.36) for vertebral fracture. This association between jump power and vertebral fracture remained significant, with an odds ratio of 3.04 (95% CI 1.77-5.23), even after adjusting for other risk factors including age, bone mineral density, previous fracture, and cognitive function. In contrast, there was no association between SMI and vertebral fracture. Based on our results, low jump power, but not SMI, is associated with vertebral fracture in community-dwelling elderly Korean women. This finding suggests that jump power may have a more important role than muscle mass itself for osteoporotic fracture.
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Affiliation(s)
- Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su Jin Lee
- Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
| | - Kyoung Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Da Hea Seo
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Seung Won Lee
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Han Sol Choi
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Taani MH, Kovach CR, Buehring B. Muscle Mechanography: A Novel Method to Measure Muscle Function in Older Adults. Res Gerontol Nurs 2017; 10:17-24. [DOI: 10.3928/19404921-20161209-03] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/11/2016] [Indexed: 12/23/2022]
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Verroken C, Zmierczak HG, Goemaere S, Kaufman JM, Lapauw B. Association of Jumping Mechanography-Derived Indices of Muscle Function with Tibial Cortical Bone Geometry. Calcif Tissue Int 2016; 98:446-55. [PMID: 26671019 DOI: 10.1007/s00223-015-0094-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
Jumping mechanography has been developed to estimate maximum voluntary muscle forces. This study assessed associations of jumping mechanography-derived force and power measurements with tibial cortical bone geometry, compared to other estimates of muscle mass, size, and function. Healthy men (n = 181; 25-45 years) were recruited in a cross-sectional, population-based sibling-pair study. Muscle parameters include isokinetic peak torque of the quadriceps, DXA-derived leg lean mass, mechanography-derived peak jump force and power, and pQCT-derived mid-tibial (66 %) muscle cross-sectional area (CSA). Mid-tibial cortical bone parameters were assessed by pQCT. In age, height, and weight-adjusted analyses, jump force and power correlated positively with cortical bone area, cortical thickness, and polar strength-strain index (SSIp) (β = 0.23-0.34, p ≤ 0.001 for force; β = 0.25-0.30, p ≤ 0.007 for power) and inversely with endosteal circumference adjusted for periosteal circumference (ECPC) (β = -0.16, p < 0.001 for force; β = -0.13, p = 0.007 for power). Force but not power correlated with cortical over total bone area ratio (β = 0.25, p = 0.002). Whereas leg lean mass correlated with all cortical parameters except cortical over total bone area ratio (β = 0.25-0.62, p ≤ 0.004), muscle CSA only correlated with cortical bone area, periosteal circumference, and SSIp (β = 0.21-0.26, p ≤ 0.001), and quadriceps torque showed no significant correlations with the bone parameters. Multivariate models indicated that leg lean mass was independently associated with overall bone size and strength reflected by periosteal and endosteal circumference and SSIp (β = 0.32-0.55, p ≤ 0.004), whereas jump force was independently associated with cortical bone size reflected by ECPC, cortical thickness, and cortical over total bone area ratio (β = 0.13-0.28; p ≤ 0.002). These data indicate that jumping mechanography provides relevant information about the relationship of muscle with bone geometry.
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Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium.
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
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Hinton PS, Nigh P, Thyfault J. Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial. Bone 2015; 79:203-12. [PMID: 26092649 PMCID: PMC4503233 DOI: 10.1016/j.bone.2015.06.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/30/2015] [Accepted: 06/12/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the effects of 12 mo of resistance training (RT, 2×/wk, N=19) or jump training (JUMP, 3×/wk, N=19) on bone mineral density (BMD) and bone turnover markers (BTM) in physically active (≥ 4h/wk) men (mean age: 44 ± 2 y; median: 44 y) with osteopenia of the hip or spine. METHODS Participants rated pain and fatigue following each RT or JUMP session. All participants received supplemental calcium (1200 mg/d) and vitamin D (10 μg/d). BMD was measured at 0, 6, and 12 mo using DXA scans of the whole body (WB), total hip (TH) and lumbar spine (LS). BTM and 25 OHD were measured by ELISA. The effects of RT or JUMP on BMD and BTM were evaluated using 3x2 repeated measures ANOVA (time, group). This study was conducted in accordance with the Declaration of Helsinki and was approved by the University of Missouri IRB. RESULTS At baseline, 36 of 38 participants were vitamin D sufficient (25OHD >50 nmol/L); at 12 mo, all participants were 25OHD sufficient. 25OHD did not differ between groups. WB and LS BMD significantly increased after 6 months of RT or JUMP and this increase was maintained at 12 mo; TH BMD increased only in RT. Osteocalcin increased significantly after 12 mo of RT or JUMP; CTx decreased significantly after 6 mo and returned to baseline concentrations at 12 mo in both RT and JUMP. Pain and fatigue ratings after RT or JUMP sessions were very low at 0, 6, and 12 mo. CONCLUSION RT or JUMP, which appeared safe and feasible, increased BMD of the whole body and lumbar spine, while RT also increased hip BMD, in moderately active, osteopenic men.
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Affiliation(s)
- Pamela S Hinton
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia MO 65211, USA.
| | - Peggy Nigh
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia MO 65211, USA
| | - John Thyfault
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia MO 65211, USA; Internal Medicine - Division of GI and Hepatology, University of Missouri, Columbia MO 65211, USA
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