Forearm Muscle Activity During the Handgrip Test in Breast Cancer Survivors: A Cross-Sectional Study

INTRODUCTION/BACKGROUND

Breast cancer survivors (BCS) frequently show upper limb dysfunctions. The forearm muscle activity measured by surface electromyography (sEMG) in this population has not been studied. This study aimed to describe forearm muscle activity in BCS, as well as to assess its possible relationship with other variables related to upper limb functionality and cancer-related fatigue (CRF).

MATERIALS AND METHODS

A cross-sectional study was carried out including 102 BCS as volunteers at a secondary care in Malaga, Spain. BCS were included if they were aged between 32 and 70 years old, without evidence of cancer recurrence at the time of recruitment. The forearm muscle activity (microvolts, µV) was assessed by sEMG during the handgrip test. The handgrip strength was assessed by dynamometry (kg), the upper limb functionality (%) was measured by the upper limb functional index (ULFI) questionnaire and the CRF was also assessed by revised Piper Fatigue Scale (0-10 points).

RESULTS

BCS reported reduced forearm muscle activity (287.88 µV) and reduced handgrip strength (21.31 Kg), a good upper limb functionality (68.85%), and a moderate cancer-related fatigue (4.74). Forearm muscle activity showed a poor significant correlation (r = -0.223, P = .038) with the CRF. Handgrip strength showed a poor correlation with the upper limb functionality (r = 0.387, P < .001) and age (r=-0.200, P = .047).

CONCLUSION

BCS showed a reduced forearm muscle activity. BCS also presented a poor correlation between forearm muscle activity and handgrip strength. Both outcomes tended to lower values with higher levels of CRF, while preserving a good upper limb functionality.

Hand Grip and Leg Muscle Strength in Hemodialysis Patients and Its Determinants

BACKGROUND

Chronic kidney disease is associated with chronic inflammation and progressive loss of peripheral muscle strength and the ability to exercise, and these changes are highly pronounced in patients receiving hemodialysis (HD). We evaluated hand grip strength (HGS) and leg muscle strength (LMS) in patients receiving HD and attempted to identify factors associated with muscle strength.

METHODS

We screened HGS (opposite the fistula side) and LMS (both sides) in HD patients at a single center (n = 112) by using digital hand and leg dynamometers (T.K.K. 5401 and 5710e/5715, Takei Scientific Instruments Co. Ltd., Niigata, Japan).

RESULTS

The mean age of patients was 62.6 years, and 73.2% of the patients were male. Diabetes was the cause of kidney failure in 50% of the patients, and the median HD vintage was 34 months. A total of 77.7% of patients reported that they participated in regular home-based exercise, and 29.5% of patients regularly participated in hospital-based resistance exercise. HGS and LMS showed good correlation (r = 0.715, P < 0.001). HGS (25.1 vs. 17.0 kg) and LMS (30.1 vs. 20.4 kg) were greater in males (P < 0.001 and P < 0.001, respectively) than in females. Older patients (≥ 60 years) showed less LMS than younger patients in both males and females (P = 0.012 and P = 0.037, respectively), but HGS did not differ according to age. Patients performing regular home- or hospital-based exercise showed higher HGS than those who did not exercise (24.2 vs. 18.6 kg, P = 0.011), but LMS was not significantly different (29.3 vs. 23.6 kg, P = 0.185). Multiple linear regression analysis proved that male sex, younger age, and any type of exercise were factors associated with improved HGS and LMS. Groups of older age (≥ 60 years), male sex, and shorter duration of HD (< median) benefitted more from exercise.

CONCLUSION

Sex, age, and exercise were the most important determinants of muscle strength in HD patients. We need to encourage patients to engage in regular home or group exercise from the beginning of dialysis and introduce new feasible forms of exercise for HD patients.

Association between Hand Grip Strength and Self-Rated Health in Middle- and Old-Aged Korean Citizens

Background

To investigate the relationship between hand grip strength (HGS) and self-rated health in middleand old-aged Korean subjects.

Methods

The data used for this study were derived from the Korean Longitudinal Study of Aging. A total of 9,132 participants were enrolled using the year 2006 as the baseline, with additional data collected throughout the followup period until 2016. Chi-square test and generalized estimating equation regression models were used for data analysis. HGS was measured in a sitting position with the elbow fixed at 90° on both sides using a dynamometer, and calculated using the values measured from both sides. Relative HGS was measured by dividing HGS by the subject’s body mass index. Self-rated health was assessed with the question “How would you rate your current health in general?” and answers were categorized as “excellent,” “moderate,” or “poor.”

Results

HGS was shown to be inversely associated with self-rated health (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.93–0.94; P<0.0001). Patients aged 65 years or older with lower scores were more likely to report poor self-rated health. Similar results were obtained with relative HGS (OR, 0.40; 95% CI, 0.36–0.45; P<0.0001), but standard HGS had better model fitting (quasi-likelihood under independence model criteria=33,890).

Conclusion

HGS may be considered an index for the diagnosis of sarcopenia and may also affect self-rated health, which is a multidimensional indicator of an individual’s health status and can identify patients who may require special attention.

Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI

The purpose of this study was to report age- and gender-specific distribution of the hand grip strength (HGS) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-3 (2015) survey and determine cut-off values for low muscle strength of HGS of Koreans. Of a total of 7,380 participants, 4,553 were subjected to measurements of HGS, including 1,997 men and 2,556 women with a mean age of 49.3 years (range, 19-80 years). The mean ages of men and women were 49.0 and 49.5 years, respectively. HGS was measured using a digital hand dynamometer. It was defined as maximal measured grip strength of the dominant hand. The cut-off value for low muscle strength was defined as the lower 20th percentile of HGS of the study population. Maximum grip strength of men was significantly higher than that of women (40.2 kg in men vs. 24.2 kg in women, P < 0.001). The mean HGS was increased from the age of 19 to 39 years. It was peaked in the age of 35 to 39 years range for both men and women. It was then decreased after 39 years. The cut-off values of HGS in male and female elderly healthy populations were 28.6 and 16.4 kg, respectively. These data might be used as reference values when evaluating sarcopenia and assessing hand injuries.

Relationship of BODE Index to functional tests in chronic obstructive pulmonary disease

OBJECTIVE

To determine if there is a correlation between the BODE Index and variables assessed during the Activities of Daily Living assessment, performance on lower limber tests, and peripheral muscle impairment of the upper limb in patients with chronic obstructive pulmonary disease.

MATERIALS AND METHODS

Ten men (aged 58 to 80 years old) with moderate to very severe obstruction were evaluated and classified by the BODE Index. They were evaluated by pulmonary ventilation (VE), oxygen consumption (VO2), and carbonic gas production (VCO2) on the ADL assessment; Distance Walking (DW) in the Six Minute Walking Test (6MWT) and the Six Minute Walking Test on Treadmill (6MWTT); number of repetitions in the Sit-to-Stand Test; and the Hand Grip Strength Test. Correlations were evaluated between the classification and the tests performed (Pearson and Spearman test, p<0.05).

RESULTS

The mean of the total score for the BODE Index was 2.80 (+/-1.03), with three patients scoring in the first quartile (Q1) and seven scoring in the second quartile (Q2). This Index showed a negative correlation with the 6MWTT (r=-0.86), the Sit-to-Stand Test (r=-0.66), and the Hand Grip Strength Test (r=-0.83).

CONCLUSIONS

Our results show that there is no correlation between the BODE Index and the ventilatory and metabolic responses in the Activities of Daily Living assessment. On the other hand, a correlation was observed between the BODE Index and the variables assessed in the 6MWTT, Sit-to-Stand Test, and Hand Grip Strength Test in moderate to very severe Chronic Obstructive Pulmonary Disease patients. This suggests that these tests can be employed as predictors of physical exercise capacity, perhaps as complementary tests to the BODE Index.