Muscle strength and non-alcoholic fatty liver disease/metabolicassociated fatty liver disease

This editorial comments on an article published in a recent issue of World Journal of Gastroenterology,entitled“Association of low muscle strength with metabolic dysfunction-associated fatty liver disease:A nationwide study”.We focused on the association between muscle strength and the incidence of non-alcoholic fatty liver disease(NAFLD)and metabolic-associated fatty liver disease(MAFLD),as well as the mechanisms underlying the correlation and related clinical applications.NAFLD,which is now redefined as MAFLD,is one of the most common chronic liver diseases globally with an increasing prevalence and is characterized by malnutrition,which may contribute to decreased muscle strength.Reduction of muscle strength reportedly has a pathogenesis similar to that of NAFLD/MAFLD,including insulin resistance,inflammation,sedentary behavior,as well as insufficient vitamin D.Multiple studies have focused on the relationship between sarcopenia or muscle strength and NAFLD.However,studies investigating the relationship between muscle strength and MAFLD are limited.Owing to the shortage of specific medications for NAFLD/MAFLD treatment,early detection is essential.Furthermore,the relationship between muscle strength and NAFLD/MAFLD suggests that improvements in muscle strength may have an impact on disease prevention and may provide novel insights into treatments including dietary therapy,as well as tailored physical activity.

Metabolic dysfunction-associated fatty liver disease and low muscle strength: A comment

The diagnosis of non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease only on the basis of laboratory parameter score such as Hepatic Steatosis Index which includes liver enzymes,gender,basal metabolic index,and presence of diabetic mellitus is not sufficient to exclude other causes of deranged liver enzymes especially medications and autoimmune related liver diseases.As the guideline suggests ultrasound is the preferred first-line diagnostic procedure for imaging of NAFLD,as it provides additional diagnostic information and the combination of biomarkers/scores and transient elastography might confer additional diagnostic accuracy and evident from previous similar studies too.

Effect of three-week exercise program on muscle strength and joint mobility in patients with diabetic polyneuropathy:Randomized controlled trial

BACKGROUND Limited joint mobility is the proven risk factor for diabetic foot ulceration when present in the subtalar and first metatarsophalangeal joints.Evidence shows that a foot-related exercise program,combined with a health-promoting program,can improve the signs and symptoms of diabetic polyneuropathy,enhance gait,res-tore mobility in the foot and ankle joints,redistribute pressure while walking,and increase foot strength and function.As a result,these exercise programs can help mitigate the risk factors for diabetic foot ulceration.AIM To determine the effect of supervised stretching,strengthening,functional and walking exercises on joint mobility and muscle strength in patients with diabetic polyneuropathy.METHODS This was a randomized controlled trial conducted in a tertiary hospital.The study included 82 participants allocated into the intervention group(alpha-lipoic acid and exercise on 15 consecutive therapeutic days,n=42)and control group(alpha lipoic acid only,n=40).Muscle strength included dorsal and plantar flexors dynamometry and strength score,while range of motion included ankle,subtalar and first metatarsophalangeal joint goniometry.RESULTS Change of motion range was significantly higher in the intervention group compared to the control group regarding ankle joint on day 15(9.9±7.2 vs 0.1±3.3;P=0.006)and month 6(2.8±7.3 vs-0.9±4.1;P<0.001),subtalar joint on day 15(7.5±5.1 vs-0.25±2.25;P<0.001)and month 6(3.9±6.4 vs-0.13±3.49;P<0.001).Change in dorsal flexors was significantly higher in the intervention group compared to the control group on day 15(2.62±1.69 vs 0.10±1.35;P<0.001)and month 6(0.66±2.38 vs-0.75±1.94;P=0.004)as well as plantar flexors on day 15(3.3±1.6 vs 0.3±1.5;P<0.001)and month 6(1.8±2.2 vs-0.9±2.1;P<0.001).Muscle strength score change was significantly lower in the intervention group compared to the control group on day 15(-1.45±1.42 vs-0.03±0.16;P<0.001)and month 6(-1.17±1.53 vs 0.20±0.56;P<0.001).CONCLUSION Exercise in combination with alpha-lipoic acid can improve joint mobility,as well as strength of the foot and lower leg muscles in patients with diabetic polyneuropathy.

Study on Electromyographic Characteristics of Neck Muscles in College Students with Chronic Neck Pain

Objective:To provide new insights for the evaluation and diagnosis of chronic neck pain(CNP).Methods:22 patients with CNP and 22 healthy individuals were recruited from South China Normal University,who were all college students.The subjects'neck extensor muscle strength in the head neutral position,the natural anteversion position,and the maximum forward flexion position were measured by an isometric muscle strength tester respectively.The neck extensor strength of CNP patients and healthy subjects were compared.Results:In the neutral position,the maximum isometric muscle strength of neck extensor muscles was 12.31 kg for CNP patients and 15.16 kg for healthy individuals,resulting in a ratio of 81%strength in patients compared to healthy subjects.This difference was highly significant(P<0.000).In the natural anteversion position,the respective values were 12.6 kg for CNP patients and 15.05 kg for healthy individuals,with a ratio of 83%,and a significant difference between groups(P<0.001).In the maximum forward flexion position of the head,the values were 13.36 kg for CNP patients and 16.15 kg for healthy individuals,with a ratio of 82%,and a highly significant difference(P<0.000).Conclusion:The neck extensor muscle strength levels in college students with CNP were significantly lower compared to healthy college students across all measured positions.

Association of low muscle strength with metabolic dysfunctionassociated fatty liver disease:A nationwide study

BACKGROUND There is limited evidence regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the association between muscle strength and MAFLD in the general population in Korea.METHODS This nationwide representative cross-sectional study included 31649 individuals aged≥19 years who participated in the Korea National Health and Nutrition Examination Survey between 2015 and 2018.Odds ratios(ORs)and 95%confidence intervals(95%CIs)for MAFLD according to sex-specific quartiles of muscle strength,defined by relative handgrip strength,were calculated using multivariable logistic regression analysis.Additionally,multivariable logistic regression analysis was used to assess the association between muscle strength and probable liver fibrosis in patients with MAFLD.RESULTS Of all the participants,29.3%had MAFLD.The prevalence of MAFLD was significantly higher in the lower muscle strength quartile groups for all participants,sexes,and age groups(P<0.001).A 1.92-fold(OR=1.92,95%CI:1.70–2.16)and 3.12-fold(OR=3.12,95%CI:2.64–3.69)higher risk of MAFLD was observed in the lowest quartile(Q1)group than in the other groups(Q2–Q4)and the highest quartile(Q4)group,respectively.The ORs of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-dependent manner(P for trend<0.001).These associations persisted in both sexes.An inverse association between muscle strength and the risk of MAFLD was observed in all subgroups according to age,obesity,and diabetes mellitus.In patients with MAFLD,the odds of severe liver fibrosis were higher in Q1(OR=1.83,95%CI:1.25–2.69)than in other groups(Q2–Q4).CONCLUSION Among Korean adults,low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.

Correlation analysis of national elite Chinese male table tennis players’ shoulder proprioception and muscle strength

BACKGROUND Shoulder is the most injured part in table tennis players,and it takes multiple roles in transmitting power and striking the center of the ball during the stroke.Proprioception is strongly correlated with high level of athletic performance.It is customary to assume that there is a correlation between proprioception and muscle strength and therefore proprioceptive assessment and rehabilitation is often neglected.AIM To investigate the correlation between isokinetic muscle strength and proprioception in the internal and external rotation muscle groups of elite Chinese male table tennis players,to provide reference for physical training and rehabilitation of elite table tennis players.METHODS A total of 19 national elite table tennis players from the Chinese National Table Tennis Team were recruited in this research.All of them had more than 10 years training experience and had participated major competitions such as the National Games and World Youth Championships.IsoMed 2000 was used to test the peak torque of internal and external rotation isokinetic concentric contraction of the athletes'bilateral shoulder joints at low speed(60°/s)and high speed(180°/s)respectively;IsoMed 2000 was used to conduct the Joint Position Reproduction test to evaluate the athletes'proprioceptive ability capacity at low speed(60°/s)and high speed(180°/s)respectively.If the data satisfied the normal distribution,the correlation between the differences in peak torque s and angles in different directions was analyzed using a Pearson simple linear model;otherwise,Spearman correlation analysis was used.The comparison of proprioceptive ability between the table tennis racket-holding hand and non-racket-holding hands was performed using independent samples t-test if the data satisfied a normal distribution;otherwise,the Mann-Whitney U test was used.RESULTS There was no direct linear correlation between the strength and proprioceptive correlation analysis at slow speed(60°/s)and fast speed(180°/s)in the racket-holding hand;At the slow speed(60°/s)and fast speed(180°/s),there was no correlation between muscle strength and proprioception in the non-racket-holding hand except for the internal rotation variable error(VE)and external rotation relative peak torque,which showed a moderate positive correlation(r=0.477,P<0.05),(r=0.554,P<0.05).The internal rotation’s constant error(CE)and VE were 1.06±3.99 and 2.94±2.16,respectively,for the racket-holding hand,and-3.36±2.39 and 1.22±0.93,respectively,for the non-racket-holding hand;the internal rotation’s CE,VE of the racket-holding hand was lower than that of the non-racket-holding hand,and there was a highly significant difference(P<0.01).CONCLUSION There was no correlation between muscle strength and proprioceptive function in the internal and external rotation of the racket-holding hand’s shoulder in elite Chinese male table tennis players.These results may be useful for interventions for shoulder injuries and for the inclusion of proprioceptive training in rehabilitation programs.

Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery:A meta-analysis

BACKGROUND The clinical role of perioperative respiratory muscle training(RMT),including inspiratory muscle training(IMT)and expiratory muscle training(EMT)in patients undergoing pulmonary surgery remains unclear up to now.AIM To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.METHODS The PubMed,EMBASE(via OVID),Web of Science,Cochrane Library and Physiotherapy Evidence Database(PEDro)were systematically searched to obtain eligible randomized controlled trials(RCTs).Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP).Secondary outcomes were physical activity,exercise capacity,including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test,pulmonary function and the quality of life.RESULTS Seven studies involving 240 participants were included in this systematic review and meta-analysis.Among them,four studies focused on IMT and the other three studies focused on RMT,one of which included IMT,EMT and also combined RMT(IMT-EMT-RMT).Three studies applied the intervention postoperative,one study preoperative and the other three studies included both pre-and postoperative training.For primary outcomes,the pooled results indicated that perioperative RMT improved the postoperative MIP(mean=8.13 cmH_(2)O,95%CI:1.31 to 14.95,P=0.02)and tended to increase MEP(mean=13.51 cmH_(2)O,95%CI:-4.47 to 31.48,P=0.14).For secondary outcomes,perioperative RMT enhanced postoperative physical activity significantly(P=0.006)and a trend of improved postoperative pulmonary function was observed.CONCLUSION Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery.However,RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.

Impact of Association between Functional Training and Respiratory Muscle Training in Elderly: A Randomized Controlled Trial

The elderly population in Brazil has been growing exponentially according to data presented by the IBGE. It is estimated that by 2025 the population will have reached 32 million, placing the country sixth in the world in the population of elderly people. To assess the results of respiratory training associated with functional training on respiratory muscle strength, lung function, and functionality of the elderly. The sample was composed of 40 elderlies, divided into four groups, the experimental group with functional training, one experimental group with functional training associated with respiratory training, one experimental group with respiratory training, and the fourth group, the control group. After the initial and final evaluations, the variables measured were: The Breathing Test, Sit to Stand Test, the SF-36 Quality of Life Questionnaire, and Spirometry. Twenty appointments were conducted twice a week. There were significant differences for variables maximum inspiratory and expiratory pressure;more accentuated in the associated group when compared to the respiratory group;forced vital capacity and forced expiratory volume in the first second/forced vital capacity were meaningful in the associated group;peak expiratory flow means values increased after the intervention;in the six-minute walk test, we noticed a trend to increase values after the intervention. Functional training as well as associated respiratory muscle training provide the most beneficial changes compared only to functional and respiratory training. Therefore, this may be an effective clinical training method for patients’ elderly.

Association Between Constipation and a Reduction in Lower Limb Muscle Strength in Preoperative Patients with Thoracic Spinal Tumors

Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs.Methods A single-center,retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021.The study involved a review of electronic medical records and radiographs and the collection of clinical data.The differences in clinical manifestations between patients with constipation and those without constipation were analyzed.Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled,including 131 patients with constipation and 96 without constipation.The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery(83.2%vs.17.7%,χ~2=99.035,P 0.001).Constipation(OR=9.522,95%CI:4.150±21.849,P 0.001)and urinary retention(OR=14.490,95%CI:4.543±46.213,P 0.001)were independent risk factors for muscle strength decline in the lower limbs.Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness.Moreover,the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.

Differentiation Between Amyotrophic Lateral Sclerosis and Mimics Using Quantitative Analysis of Fasciculation with Muscle Ultrasound

Objective To determine the diagnostic accuracy of the intensity of fasciculation evaluated by muscle ultrasound in the differential diagnosis of amyotrophic lateral sclerosis(ALS).Methods We prospectively recruited patients who had ALS and neuropathy-radiculopathy attending Peking Union Medical College Hospital from 2017 to 2020.Healthy adults from a community were recruited as healthy controls.Muscle strength was assessed using the Medical Research Council(MRC)scale.At the first visit to the hospital,patients were assessed for maximal grade of fasciculations,total fasciculation score,and fasciculation grade in 16 muscle groups of bilateral upper and lower limbs using ultrasonography.The sensitivity and specificity of maximal grade of fasciculations,total fasciculation score,and fasciculation grade for the diagnosis of ALS were assessed by receiver operating characteristic analyses.Results The percentage of limb muscles with a maximal fasciculation grade higher than grade 2 in ALS patients and neuropathy-radiculopathy patients was 84.9%and 9.8%,respectively(χ^(2)=172.436,P<0.01).Of the 16 limb muscles detected,the total fasciculation score[median(interquartile range)]was 29(15,41)in ALS patients and 3(0,8)in neuropathy-radiculopathy patients(Z=9.642,P<0.001).Remarkable fasciculations were seen in ALS patients whose muscles with a MRC score ranging from 2 to 4,followed by patients with MRC score 5,and then in those with MRC score 0 and 1.The sensitivity and specificity of total fasciculation score for diagnosis of ALS were 80.6%and 93.4%,respectively(cut-off value 14).In patients with ALS,for muscles with MRC score 4 and 5,the percentage of muscles with fasciculation grades≥3 was 42.3%and 24.1%respectively,while in neuropathy-radiculopathy patients,the percentage for muscles with MRC score 4 and 5 was only 1.7%and 0,respectively.Conclusion A combined analysis of fasciculation intensity and MRC score of the limb muscles may be helpful for differential diagnosis of ALS.

Metabolic-associated fatty liver disease is associated with low muscle mass and strength in patients with chronic hepatitis B

BACKGROUND Although the prognostic relevance of sarcopenia has been increasingly recognised in the context of liver disease,there is a paucity of data evaluating body composition in patients with chronic hepatitis B(CHB).Beyond virus-related factors,nutritional and metabolic aspects can be associated with skeletal muscle abnormalities in these patients and should not be disregarded.AIM To evaluate the association between components of sarcopenia and demographic,clinical,lifestyle,nutritional,and biochemical variables in CHB patients.METHODS Dual-energy X-ray absorptiometry(DXA)was used to assess muscle mass by quantifying appendicular lean mass(ALM)adjusted for body mass index(ALMBMI).Muscle function was evaluated by hand grip strength(HGS)and the timed up and go test.Metabolic-associated fatty liver disease(MAFLD)was defined according to the criteria proposed by an international expert panel.A body shape index and the International Physical Activity Questionnaire were used to assess central obesity and physical activity level,respectively.RESULTS This cross-sectional study included 105 CHB outpatients followed at the tertiary care ambulatory centre(mean age,48.5±12.0 years;58.1%males;76.2%without cirrhosis;23.8%with compensated cirrhosis).The DXA-derived fat mass percentage was inversely correlated with the ALMBMI(r=-0.87)and HGS(r=-0.63).In the multivariable analysis,MAFLD,sedentarism and central obesity were positively and independently associated with low ALMBMI.MAFLD and central obesity were independently associated with low HGS.CONCLUSION MAFLD and central obesity were associated with low muscle mass and strength in patients with chronic hepatitis B,independent of the liver disease stage.

Association between the fMRI manifestations of activated brain areas and muscle strength in patients with space-occupying lesions in motor cortex

BACKGROUND ： Functional magnetic resonance imaging （fMRI） studies have disclosed the changes of the motor function in the motor cortex of ipsilateral and contralateral hemispheres of tumor, which have special significance for making the surgical planning and most greatly minimizing the postoperative functional damages. OBJECTIVE： To analyze the association between the manifestation characteristics of hand functional area and motor dysfunction using fMRI in patients with space-occupying lesions of tumor in motor cortex. DESIGN ： A case-controlled observation SETTING： Department of Radiology, Second Affiliated Hospital, Shantou University Medical College .PARTICIPANTS： Twenty-three patients （13 males and 10 females） with space-occupying lesions of central sulcus area, aged 21-53 years with a mean age of （47±1） years were selected from the Second Affiliated Hospital of Shantou University Medical College. All the patients were diagnosed by MR scanning as space-occupying lesions of motor area, and pathologically confirmed that the lesions involved central sulcus and central Iobule; Lesions occurred in left and right hemispheres in 13 and 10 cases respectively. The tumor types were astrocytoma （n =8）, metastatic tumours （n =7）, meningiomas （n =5） and oligodendroglioma （n =3）. The muscle strength was normal in 11 cases （grade 5） and obviously decreased in 12 cases （grade 2-3 in 3 cases and grade 4 in 9 cases）; muscle strengths of both upper and lower limbs were decreased in 7 cases, and only that of upper limbs was decreased in 5 cases. Informed consents were obtained from all the subjects. Meanwhile, 9 healthy physical examinees （5 males and 4 females） of 20-56 years old with an average of （34±1） years were taken as controls. All the patients and healthy subjects were right-handed. METHODS： All the enrolled subjects were examined with MR scanning and functional imaging. Twenty cases whose clinical symptoms were mild in the patient group and 9 healthy volunteers adopted simple active finger-tapping movements, and for the 3 cases whose clinical symptoms were severe in the patient group, the simple passive finger-tapping movements were used. The manifestations in the activated brain areas were analyzed in the patients with brain tumor of different muscle strength and the controls. The motor deficit and activation of contralateral primary motor cortex （M1） in simple finger-tapping movements were observed in the patient group. MAIN OUTCOME MEASURES： （1） Brain areas activated by finger-tapping movements in each group： （2） Activated volumes in hemisphere by finger-tapping movements between groups. RESULTS： The contralateral M1 area could not be activated in 1 case in the patient group,, all the other 22 patients and 9 healthy subjects were involved in the analysis of results. （1） In the control group, unilateral finger tapping movement activated the contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC. The activation volume was the largest in contralateral primary motor cortex （M1）, smaller in the SMA, and the smallest in PMC. The finger tapping movement in healthy subjects could activate contralateral primary motor cortex （M1）, bilateral SMA and bilateral PMC, which had no obvious differences from the manifestations of brain functional area activated by active finger tapping. There was no significant difference in the volume of activated functional areas between right and left hands. In the patient group, the central sulcos around the tumor in the activated M1 area displaced towards dorsal or ventral side, also extended. The distance of displacement in the functional area was determined as compared with the contralateral central sulcus, and the results suggested the M1 displacement, including that there were 10 cases with the M1 displacement larger than 10 mm in the patients with motor deficit, which were obviously more than in those without motor deficit （n =1, P 〈 0.01）, and the activated volume in contralateral M1 area was obvious smaller in the patients with motor deficit than in those without motor deficit （P 〈 0.01）. （2） The M1 activation and changes were observed in contralateral hemisphere in the patient group, and the activated volume was obviously larger than that in the control group （P 〈 0.01）. The activated volumes of M1 and PMC in ipsilateral hemisphere were obviously larger than those in the control group （P 〈 0.05）, but that of SMA had no obvious difference between the two groups （P 〉 0.05）. CONCLUSION： fMRI can be used to observe the activation of the brain motor functional areas of patient with space-occupying lesions in motor area, and evaluate the state of their motor function. The larger the distance of displacement of M1 compressed by tumor, the more obviously the muscle strength decreases in the patients.

Effects of virtual reality balance games combined with muscle strength training on balance function and motor ability of Parkinson's patients

Objective To investigate the effects of virtual reality balance games combined with strengthening muscle training on balance function and exercise capacity in patients with Parkinson's disease.Methods Sixty patients with Parkinson's disease were selected from January 2018 to October 2019.The random number table method was divided into the control group(n=30)and the observation group(n=30).Both groups were given conventional drugs and For rehabilitation training,the observation group was given a virtual reality balance game combined with strengthening muscle training.The upper limbs,lower limbs,balance function,comprehensive rehabilitation effect and daily living ability were compared before and after training.Results After training,the Brunnstrom score,FMA-UE,FMA-LE score,and cadence score of the two groups of patients increased.The common contraction rate(CR)of the biceps brachii in elbow flexion and the three heads of the brachii in elbow extension Muscle CR,standing walking test,10m walking test,reduced left and right step difference,and the observation group was better than the control group,which was significant(P<0.05).Conclusion Patients with Parkinson's disease have improved their upper and lower extremity motor capacity and balance function through virtual reality balance games combined with strengthening muscle training,which can improve the overall rehabilitation effect and ability of daily living.

Relationship between Muscle Strength, Muscle Mass and BMD in Postmenopausal Female of Zhuang in Guangxi Province of China

Objective: To explore the correlation between muscle strength, muscle mass and bone mineral density (BMD) in Zhuang female population, body composition analysis and grip strength, and to analyze the possible influencing factors of BMD. Methods: 182 postmenopausal women were selected from Guangxi Province of China. Broadband ultrasound attenuation (BUA) was used to evaluate BMD. Grip dynamometer to assess muscle strength. Height, weight and muscle mass of each part were measured by body composition measuring instrument. Body mass index (BMI), skeletal muscle mass index (SMI) and limb skeletal muscle mass (SM) were calculated according to the measurement results. Results: BUA, grip strength and SMI in postmenopausal women of Zhuang nationality showed a decreasing trend with age (p p p r = 0.305, p Conclusion: With the increase of age, the decline rate of muscle strength of postmenopausal Zhuang women in Guangxi is slower than that of BMD and muscle mass. SM can better reflect the BMD level of the body than SMI, and the LSM is the main influencing factor of BMD.

Characteristics of Body Composition and Relationship between Muscle Mass and Muscle Strength among Elderly Women in Different Age Groups

Age-related changes in the body composition of older adults differ among age groups. The purpose of the present study was to clarify the characteristics of body compositions in young (age, 65 - 74 years;yE group) and old (age, ≥75 years;oE group) elderly women, and compare the relationship between muscle mass and strength in elderly women with that in young women for preventing motor function loss in older adults. A total of 30 elderly and 45 young women aged ≥ 65 and 19 - 22 years, respectively, participated in this study. The participants underwent body composition measurement via bioelectrical impedance analysis and examinations of handgrip and leg muscle strength. The age-related body composition changes varied among age groups. Compared with young women, fat-free mass (FFM) in the yE group did not decrease significantly;however, fat mass (FM) and waist-hip ratio (WHR) were significantly greater. Compared with the yE group, decreases in FFM, FM, and WHR in the oE group were significant;furthermore, the decrease in FM measurements was attributed to the loss of FM in the trunk and limbs (upper and lower). The measurement results suggested that the greater FM decrease in the oE group was characterized by decreases in both visceral and subcutaneous fat. In the yE group, the muscle mass was comparable to that in young women;however, there was a remarkable reduction in the lower-limb muscle mass (9% - 10%). In the oE group, muscle mass was reduced in all body parts, including upper and lower limbs and trunk. In young women, significant positive correlations between muscle mass and muscle strength in the upper and lower limbs were observed. No such correlations in the lower limbs were found in elderly women, indicating that muscle mass is not proportionally reflected in muscle strength. In conclusion, for improving and maintaining the health of elderly women, especially those above the age of 75 years, it is important to maintain muscle mass, including muscle strength, and prevent the loss of muscle quality.

Acoustic Myography in Assessment of Isokinetic and Isometric Muscle Strength in a Healthy Danish Population

Isokinetic and isometric force measurements involving a dynamometer setup are widely used in training and in muscle assessment. For further understanding of the method, we investigated the activation of key functional muscles during isokinetic and isometric movements. During force measurements in an isokinetic Biodex System 3 ProTM, acoustic myography (AMG) was applied. Ten healthy subjects (5 men/5 women) in each decade from 20 to 69 years of age participated in the study. Measurements were carried out during extension and flexion of the ankle, knee and elbow joints. Muscle fibre use was measured by efficiency (E-score) and fibre recruitment (temporal (T-score) and spatial (S-score) summation). AMG measurements showed good reproducibility, and the recruitment pattern of muscle fibres did not change with gender or age. Overall, a significantly higher E-score (P < 0.05) was found at the lower angular velocities than at the higher ones, indicating a lower level of muscle efficiency at higher velocities. Muscles used for knee movement exhibited higher scores than muscles associated with the ankle and elbow joints, most likely related to the greater degree of force production at this joint compared to the ankle and elbow. The ability to activate and inactivate muscle fibres during periods of isokinetic activity becomes increasingly more difficult as the velocity increases. When assessing training effects in sports or rehabilitation, AMG in parallel with isokinetic measurements adds important additional information by giving a measure of possible improvements in efficiency and fibre use.

The Progress of the Study on the Effect of Vibration Training on Muscle Strength Exercise

Vibration training is more and more extensively applied to the field of strength training. It, as a beneficial supplement to the traditional strength, is able to improve specific strength or the strength of weak positions, for the purpose of achieving the muscle strength development in an all-round way. In this paper, the anatomy, physiology, and biomechanics foundations for vibration training to increase muscle strength are mainly analyzed, and then the principle of vibration training to increase muscle strength is further expounded, and also the increase of muscle strength is discussed from the aspects such as vibration frequency, vibration amplitude, vibration posture, vibration intermittent time, and vibration mode, so as to clarify the domestic and foreign progress of the study on vibration training.

Relationship between Respiratory Muscle Strength and Static Balance in Older People Requiring Support and Care

Purpose: This study aimed to clarify the relationship between respiratory muscle strength and balance in older people requiring support or nursing care. Methods: Thirty-seven older subjects aged 65 years or older who were certified as requiring nursing care or support were included in the study. Maximal inspiratory pressure (PIMAX), maximal expiratory pressure (PEMAX), and one-leg standing time were measured. Additionally, the Functional Reach Test (FRT) was performed. Pearson correlation coefficient and multiple regression analyses were performed. Results: One-leg standing time was positively correlated with PEMAX, and was particularly correlated with PIMAX, while FRT score was not correlated with respiratory muscle strength. Multiple regression analysis with one-leg standing time as the dependent variable and PIMAX and PEMAX as independent variables showed that only PIMAX was significantly correlated with one-leg standing time. Conclusion: Focusing on expiratory and inspiratory muscle strength is important for improving one-leg standing ability and thus preventing falls in older people.

Assessment of the Plantar Pressure, Muscle Strength and Balance in Patients with Type 2 Diabetes Mellitus in Cyprus

Aims: Diabetes Mellitus (DM) is a metabolic disorder which affects whole systems of human body. This study aimed to compare the strength of foot muscles, dynamic balance, and peak plantar pressure between diabetic patients before developing polyneuropathy and healthy peers. Methods: 21 people, 11 diabetic patients and 10 age-matched healthy peers, were included in the study. A manual muscle tester (model 01163 Lafayette) was used to assess muscle strength. Pedobarography was the device to determine the distribution of plantar pressure into nine regions of foot. Dynamic balance was also measured by using a mobile platform (Techno-body, PK 200 WL, Italy). Results: Diabetic and control groups had similar muscle strength and dynamic balance (p > 0.05). Most of the plantar pressure findings were also similar (p > 0.05). There were significant differences in only two regions of foot between two groups (p < 0.05). Conclusion: Diabetes Mellitus is not a factor influencing balance and muscle strength before polyneuropathy. However, it is possible to state that it may negatively affect the distribution of plantar pressure so clinians should assess and treat this distribution in the patients with DM.

Effects of Water Immersion in Different Water Depths on Respiratory Function and Respiratory Muscle Strength among Elderly People: An Observational Study

The aim was to investigate the effect of three water levels (umbilical, 4th rib, and clavicular) on the respiratory function and respiratory muscle strength among elderly. Spirometry and respiratory strength were measured on land as baseline data. Next, water depth conditions were determined randomly, and spirometry and respiratory muscle strength were measured at each water level. The Vital Capacity and Expiratory reserve volume in the clavicular level were significantly lower than those in the land and umbilical trials. No significant difference was observed in other respiratory functions. Chest circumference and respiratory muscle strength were not significantly different among all conditions.