Growing evidence supports the important role of nutrition in health and performance. Nutritional interventions, alone or in combination with physical exercise, have proven effective for reducing the ...incidence of different chronic diseases and their associated risk factors (e.g., obesity, diabetes, hypertension, hypercholesterolemia). A healthy diet also seems to prevent many of the detrimental consequences of aging, notably sarcopenia and frailty. On the other hand, diet has been reported to influence physical performance, with nutrition, including nutritional supplements, being a cornerstone in the armamentarium of athletes. The role of nutrition seems, therefore, wide; however, although research is rapidly growing, controversy and debate still exists as to the optimal nutritional strategies for disease prevention and sports performance enhancement. The present Special Issue aimed to report recent findings on the role of nutrition in disease prevention and sports performance enhancement, as well as to summarize current evidence on these topics.
We investigated the effects of acute-phase intensive electrical muscle stimulation (EMS) on physical function in COVID-19 patients with respiratory failure requiring invasive mechanical ventilation ...(IMV) in the intensive care unit (ICU). Consecutive COVID-19 patients requiring IMV admitted to a university hospital ICU between January and April 2022 (EMS therapy group) or between March and September 2021 (age-matched historical control group) were included in this retrospective observational case-control study. EMS was applied to both upper and lower limb muscles for up to 2 weeks in the EMS therapy group. The study population consisted of 16 patients undergoing EMS therapy and 16 age-matched historical controls (median age, 71 years; 81.2% male). The mean period until initiation of EMS therapy after ICU admission was 3.2 ± 1.4 days. The EMS therapy group completed a mean of 6.2 ± 3.7 EMS sessions, and no adverse events occurred. There were no significant differences between the two groups in Medical Research Council sum score (51 vs. 53 points, respectively; P = 0.439) or ICU mobility scale at ICU discharge. Addition of upper and lower limb muscle EMS therapy to an early rehabilitation program did not result in improved physical function at ICU discharge in severe COVID-19 patients.
Muscle weakness, assessed by grip strength, has been shown to predict postoperative mortality in older patients with cancer. Because lower extremity muscle strength well reflects physical ...performance, we examined whether lower knee extension muscle strength predicts postoperative mortality better than grip strength in older patients with gastrointestinal cancer.
Prospective, observational study in a single institution.
A total of 813 patients (79.0 ± 4.2 years, 66.5% male) aged 65 years or older with gastrointestinal cancer who underwent preoperative evaluation of grip strength and isometric knee extension muscle strength between April 2012 and April 2019 were included.
The study participants were prospectively followed up for postoperative mortality. Muscle weakness was defined as the lowest quartile of grip strength or knee extension strength (GS-muscle weakness and KS-muscle weakness, respectively).
Among the study participants, 176 patients died during a median follow-up of 716 days. In the Kaplan-Meier analysis, we found that patients with both GS-muscle weakness and KS-muscle weakness had a lower survival rate than those without muscle weakness. As expected, higher clinical stages and abdominal and thoracic surgeries compared with endoscopic surgery were associated with increased all-cause mortality. In addition, we found that KS-muscle weakness, but not GS-muscle weakness, was an independent prognostic factor after adjusting for sex, body mass index, cancer stage, surgical technique, and surgical site in the Cox proportional hazard model.
In older patients with gastrointestinal cancer, muscle weakness based on knee extension muscle strength can be a better predictor of postoperative prognosis than muscle weakness based on grip strength.
Weakness contributes to the decline of physical function that occurs with aging. Contradictory findings have been reported as to whether neuromuscular activation is impaired with aging, and the ...extent to which it contributes to weakness. The present study uses a longitudinal design to assess how potential age-related change of neuromuscular activation affects strength, power, and mobility function.
Participants included 16 healthy older adults who were healthy and high functioning at baseline. Strength was measured by leg press one repetition maximum. Power production was measured during a maximal effort rapid leg press movement with resistance set to 70% of the one repetition maximum. During the same movement, neuromuscular activation was quantified as the rate of rise of the quadriceps surface electromyogram (rate of electromyogram rise). Thigh muscle cross-sectional area was measured by computed tomography. Mobility function was assessed by the Short Physical Performance Battery.
The time between baseline and follow-up testing was almost 3 years. Between these time points, rate of electromyogram rise decreased 28% (p = .004) and power decreased 16.5% (p = .01). There was a trend for reduced anterior thigh muscle cross-sectional area (3%, p = .05), but no change in posterior thigh muscle cross-sectional area (p = .84), one repetition maximum strength (p = .72), or Short Physical Performance Battery score (p = .17). Loss of power was strongly associated with reduction in the rate of electromyogram rise (R (2) = .61, p < .001), but not with reduction of anterior thigh muscle cross-sectional area (p = .83).
The present findings suggest that voluntary neuromuscular activation declines with advancing age, contributes to a reduction in power production, and precedes the decline of mobility function.
Summary
Pelvic fracture patients were randomized to blinded daily subcutaneous teriparatide (TPTD) or placebo to assess healing and functional outcomes over 3 months. With TPTD, there was no evidence ...of improved healing by CT or pain reduction; however, physical performance improved with TPTD but not placebo (group difference
p
< 0.03).
Introduction
To determine if teriparatide (20 μg/day; TPTD) results in improved radiologic healing, reduced pain, and improved functional outcome vs placebo over 3 months in pelvic fracture patients.
Methods
This randomized, placebo-controlled study enrolled 35 patients (women and men
>
50 years old) within 4 weeks of pelvic fracture and evaluated the effect of blinded TPTD vs placebo over 3 months on fracture healing. Fracture healing from CT images at 0 and 3 months was assessed as cortical bridging using a 5-point scale. The numeric rating scale (NRS) for pain was administered monthly. Physical performance was assessed monthly by Continuous Summary Physical Performance Score (based on 4 m walk speed, timed repeated chair stands, and balance) and the Timed Up and Go (TUG) test.
Results
The mean age was 82, and >80% were female. The intention to treat analysis showed no group difference in cortical bridging score, and 50% of fractures in TPTD-treated and 53% of fractures in placebo-treated patients were healed at 3 months, unchanged after adjustment for age, sacral fracture, and fracture displacement. Median pain score dropped significantly in both groups with no group differences. Both CSPPS and TUG improved in the teriparatide group, whereas there was no improvement in the placebo group (group difference
p
< 0.03 for CSPPS at 2 and 3 months).
Conclusion
In this small randomized, blinded study, there was no improvement in radiographic healing (CT at 3 months) or pain with TPTD vs placebo; however, there was improved physical performance in TPTD-treated subjects that was not evident in the placebo group.
Muscle strength and performance are associated with fractures. However, the contribution of their rate of decline is unclear.
To assess the independent contribution of the rate of decline in muscle ...strength and performance to fracture risk.
Community-dwelling women (n = 811) and men (n = 440) aged 60 years or older from the prospective Dubbo Osteoporosis Epidemiology Study followed from 2000 to 2018 for incident fracture. Clinical data, appendicular lean mass/height2 (ht)2, bone mineral density, quadricep strength/ht (QS), timed get-up-and-go (TGUG), 5 times repeated sit-to-stand (5xSTS), and gait speed (GS) measured biennially. Rates of decline in muscle parameters were calculated using ordinary least squares regression and fracture risk was assessed using Cox's models.
Incident low-trauma fracture ascertained by x-ray report.
Apart from lean mass in women, all muscle parameters declined over time. Greater rates of decline in physical performance were associated with increased fracture risk in women (Hazard ratios HRs ranging from 2.1 (95% CI: 1.5-2.9) for GS to 2.7 (95% CI: 1.9-3.6) for 5xSTS, while in men only the decline in GS was associated with fracture risk (HR: 3.4 95% CI: 1.8-6.3). Baseline performance and strength were also associated with increased fracture risk in men (HRs ranging from 1.8 (95% CI: 1.1-3.0) for QS to 2.5 (95% CI: 1.5-4.1) for TGUG, but not in women.
Rate of decline in physical performance in both genders, and baseline strength and performance in men, contributed independently to fracture risk. Sit-to-stand and GS were the tests most consistently associated with fractures. Further studies are required to determine whether muscle strength and/or performance improve the predictive accuracy of fracture prediction models.
Muscle mass and strength ineluctably decline with advancing age. Yet, the impact of ethnicity on the pattern of changes and their magnitude is unclear. The aims of the present study were to analyze ...age- and gender-specific changes in measures of muscle mass and strength among community-living persons and to identify differences between Caucasian and Asian participants.
The Italian survey (“Longevity Check-up”), conducted during Milan EXPO 2015, consisted of a population assessment aimed at evaluating the prevalence of specific health metrics in persons outside of a conventional research setting (n=1924), with a special focus on muscle mass and strength. The Taiwanese survey used the first-wave sampling from the I-Lan Longitudinal Aging Study (ILAS) collected from August 2011 to August 2013 (n=1839). ILAS was designed to explore the interrelationship between sarcopenia and frailty in community-dwelling older people in Taiwan. In both studies, muscle mass was estimated by measuring the calf circumference (CC), whereas muscle strength was assessed by handgrip strength testing.
The mean age of the 1924 Italian participants was 62.5years (standard deviation 8.3, range from 50 to 98years), of whom 1031 (53.6%) were women. Similarly, the mean age of the Taiwanese sample was 63.9years (standard deviation 9.3, range from 50 to 92years), with 966 (52.5%) women. CC declined with age in both genders and was significantly greater among Italian participants compared with Taiwanese people in all age groups. A similar effect of age was observed for muscle strength. As for CC, muscle strength was significantly greater among Italian persons relative to Taiwanese participants.
Muscle mass and strength declined with age in both ethnic groups. Caucasians showed greater muscle mass and performed better than their Asian counterparts. However, the age at which declines began to appear and the rate of decline during aging were comparable between the two populations.
•Sarcopenia is a major cause of physical function decline, disability, and mortality.•Declines in muscle mass and muscle strength occur during aging.•Calf circumference declines with age in both genders.•Italian participants show greater calf circumference and muscle strength compared to Taiwanese.•Muscle mass and strength curves for Caucasian and Asiatic people may serve as references.
Background
Management strategies that incorporate spirituality and religiosity (S/R) have been associated with better health status in clinical populations. However, few data are available for ...patients with chronic obstructive pulmonary disease (COPD) to improve the traditional disease‐model treatment.
Aims
The objectives of this study were to evaluate the association between S/R and physical and psychological status in patients with stable COPD.
Design
This is a cross‐sectional study.
Methods
Religiosity, spiritual well‐being and S/R Coping were measured. Physical status was evaluated with the activity of daily living, dyspnoea and the impact of the disease. Psychological status was assessed with anxiety and depression symptoms and quality of life. Spearman correlation coefficients were calculated, multivariate linear regression was applied in the analyses. This study is reported following the STROBE recommendations.
Results
Seventy‐two patients with stable COPD (male 58%, aged 68 ± 9 years, forced expiratory volume in 1s (FEV1) of 49.2 ± 19.6% predicted) were included. There was no association between S/R and activity of daily living. However, higher spiritual well‐being and lower Negative S/R Coping was associated with reduced dyspnoea and burden of the disease. Increased S/R and lower Negative S/R Coping was also associated with less anxiety, depression and better quality of life. Multivariate linear regression showed that S/R variables explained the physical and psychological health status in people with stable COPD. Conclusions: Higher spirituality and less negative S/R Coping are associated with reduced dyspnoea, the burden of the disease, anxiety and depression symptoms, and better quality of life in patients with stable COPD.
Relevance to clinical practice
Understanding how religiosity and spirituality are associated with physical and psychological features in patients with COPD may contribute to the long‐term management of this patient population.
PDF
