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  1. Daly RM, Iuliano S, Fyfe JJ, Scott D, Kirk B, Thompson MQ, et al.
    J Nutr Health Aging, 2022;26(6):637-651.
    PMID: 35718874 DOI: 10.1007/s12603-022-1801-0
    Sarcopenia and frailty are highly prevalent conditions in older hospitalized patients, which are associated with a myriad of adverse clinical outcomes. This paper, prepared by a multidisciplinary expert working group from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR), provides an up-to-date overview of current evidence and recommendations based on a narrative review of the literature for the screening, diagnosis, and management of sarcopenia and frailty in older patients within the hospital setting. It also includes suggestions on potential pathways to implement change to encourage widespread adoption of these evidence-informed recommendations within hospital settings. The expert working group concluded there was insufficient evidence to support any specific screening tool for sarcopenia and recommends an assessment of probable sarcopenia/sarcopenia using established criteria for all older (≥65 years) hospitalized patients or in younger patients with conditions (e.g., comorbidities) that may increase their risk of sarcopenia. Diagnosis of probable sarcopenia should be based on an assessment of low muscle strength (grip strength or five times sit-to-stand) with sarcopenia diagnosis including low muscle mass quantified from dual energy X-ray absorptiometry, bioelectrical impedance analysis or in the absence of diagnostic devices, calf circumference as a proxy measure. Severe sarcopenia is represented by the addition of impaired physical performance (slow gait speed). All patients with probable sarcopenia or sarcopenia should be investigated for causes (e.g., chronic/acute disease or malnutrition), and treated accordingly. For frailty, it is recommended that all hospitalized patients aged 70 years and older be screened using a validated tool [Clinical Frailty Scale (CFS), Hospital Frailty Risk Score, the FRAIL scale or the Frailty Index]. Patients screened as positive for frailty should undergo further clinical assessment using the Frailty Phenotype, Frailty Index or information collected from a Comprehensive Geriatric Assessment (CGA). All patients identified as frail should receive follow up by a health practitioner(s) for an individualized care plan. To treat older hospitalized patients with probable sarcopenia, sarcopenia, or frailty, it is recommended that a structured and supervised multi-component exercise program incorporating elements of resistance (muscle strengthening), challenging balance, and functional mobility training be prescribed as early as possible combined with nutritional support to optimize energy and protein intake and correct any deficiencies. There is insufficient evidence to recommend pharmacological agents for the treatment of sarcopenia or frailty. Finally, to facilitate integration of these recommendations into hospital settings organization-wide approaches are needed, with the Spread and Sustain framework recommended to facilitate organizational culture change, with the help of 'champions' to drive these changes. A multidisciplinary team approach incorporating awareness and education initiatives for healthcare professionals is recommended to ensure that screening, diagnosis and management approaches for sarcopenia and frailty are embedded and sustained within hospital settings. Finally, patients and caregivers' education should be integrated into the care pathway to facilitate adherence to prescribed management approaches for sarcopenia and frailty.
    Matched MeSH terms: Hand Strength/physiology
  2. Ali MA, Sundaraj K, Ahmad RB, Ahamed NU, Islam MA, Sundaraj S
    Technol Health Care, 2014;22(4):617-25.
    PMID: 24990168 DOI: 10.3233/THC-140833
    Normally, surface electromyography electrodes are used to evaluate the activity of superficial muscles during various kinds of voluntary contractions of muscle fiber. The objective of the present study was to investigate the effect of repetitive isometric contractions on the three heads of the triceps brachii muscle during handgrip force exercise.
    Matched MeSH terms: Hand Strength/physiology*
  3. Islam MA, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA
    PLoS One, 2014;9(5):e96628.
    PMID: 24802858 DOI: 10.1371/journal.pone.0096628
    This study aimed: i) to examine the relationship between the magnitude of cross-talk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles with the sub-maximal to maximal isometric grip force, and with the anthropometric parameters of the forearm, and ii) to quantify the distribution of the cross-talk in the MMG signal to determine if it appears due to the signal component of intramuscular pressure waves produced by the muscle fibers geometrical changes or due to the limb tremor.
    Matched MeSH terms: Hand Strength/physiology*
  4. Keevil V, Mazzuin Razali R, Chin AV, Jameson K, Aihie Sayer A, Roberts H
    Arch Gerontol Geriatr, 2013 Jan-Feb;56(1):155-9.
    PMID: 23116975 DOI: 10.1016/j.archger.2012.10.005
    Grip strength is a marker of sarcopenia, the age-related decline in muscle mass and function, and has been little researched in Asian populations. We aimed to describe the feasibility and acceptability of measuring grip strength in hospitalized, older people in Malaysia and to explore its range, determinants and association with length of stay. Patients admitted acutely to the geriatrics ward of a teaching hospital were consecutively recruited. Inability to consent or use the dynamometer led to exclusion. Maximum grip strength, anthropometric data, length of hospital stay, discharge destination, 3-point Barthel score, mini-mental state examination, falls history and number of co-morbidities and medications on admission were recorded. 80/153 (52%) eligible patients were recruited (52 women; age range 64-100 years). 9/153 (6%) refused to participate and 64/153 (42%) were excluded (34 too unwell, 24 unable to consent, 4 unable to use the dynamometer, 2 other reasons). 76/80 patients (95%) reported that they would undergo grip strength measurement again. Determinants were similar to those of Caucasian populations but grip strength values were lower. After adjustment for sex, age and height, stronger grip strength was associated with shorter length of stay [hazard ratio 1.05 (95% CI 1.00, 1.09; P=0.03)]. This is the first report of grip strength measurement in hospitalized older people in Malaysia. It was feasible, acceptable to participants and associated with length of stay. Further research is warranted to elucidate the normative range in different ethnic groups and explore its potential use in clinical practice in Malaysia.
    Matched MeSH terms: Hand Strength/physiology*
  5. Kamarul T, Ahmad TS, Loh WY
    Med J Malaysia, 2006 Dec;61 Suppl B:37-44.
    PMID: 17600991
    Hand grip strength measurement is a recognized part of hand function assessment. The standard measurement using the Jamar dynamometer and comparing these results to the recommended normal values suggested by the manufacturers of the Jamar was questioned as these values were based on Western population. A study comparing a novel method of predicting grip strength using our software was conducted on 25 normal subjects using the LIDO kinetic workset (Group A and B ). These results were then compared against our predictive software (Group A) and the expected values supplied together with the Jamar Dynamometer (Group B). In another group, 22 normal subjects were tested using the Jamar (Group C and D) and then matched against the predicted values using their recommended chart (Group C). The last group (Group D) was tested using the Jamar but the values attained were compared to the results from our software. In group A, the predictability of our predictive method was 100% (both R & L) as compared to (R = 64%, L = 68%) in group B, (R = 27.3%, L = 59.1%) in group C and (R = 81.8%, L = 86.4%) in group D. The differences between the predictability of both methods were statistically significant. The data collected using both the Jamar and the LIDO kinetic workset correlated well to the data from our software but not to the values suggested by the manufacturers of Jamar. We conclude that our method of predicting hand grip values are superior to that suggested by the manufacturers of dynamometers. The standard reference for hand grip strength provided by the manufacturers is less accurate in predicting the grip strength of our local population.
    Matched MeSH terms: Hand Strength/physiology*
  6. Ramlee MH, Beng GK, Bajuri N, Abdul Kadir MR
    Med Biol Eng Comput, 2018 Jul;56(7):1161-1171.
    PMID: 29209961 DOI: 10.1007/s11517-017-1762-3
    The provision of the most suitable rehabilitation treatment for stroke patient remains an ongoing challenge for clinicians. Fully understanding the pathomechanics of the upper limb will allow doctors to assist patients with physiotherapy treatment that will aid in full arm recovery. A biomechanical study was therefore conducted using the finite element (FE) method. A three-dimensional (3D) model of the human wrist was reconstructed using computed tomography (CT)-scanned images. A stroke model was constructed based on pathological problems, i.e. bone density reductions, cartilage wane, and spasticity. The cartilages were reconstructed as per the articulation shapes in the joint, while the ligaments were modelled using linear links. The hand grip condition was mimicked, and the resulting biomechanical characteristics of the stroke and healthy models were compared. Due to the lower thickness of the cartilages, the stroke model reported a higher contact pressure (305 MPa), specifically at the MC1-trapezium. Contrarily, a healthy model reported a contact pressure of 228 MPa. In the context of wrist extension and displacement, the stroke model (0.68° and 5.54 mm, respectively) reported a lower magnitude than the healthy model (0.98° and 9.43 mm, respectively), which agrees with previously reported works. It was therefore concluded that clinicians should take extra care in rehabilitation treatment of wrist movement in order to prevent the occurrence of other complications. Graphical abstract ᅟ.
    Matched MeSH terms: Hand Strength/physiology*
  7. Seow SR, Mat S, Teoh JJ, Mohamad Yusup A, Rajab NF, Ismail IS, et al.
    J Rehabil Med, 2024 Sep 03;56:jrm39986.
    PMID: 39225040 DOI: 10.2340/jrm.v56.39986
    OBJECTIVE: This study delves into the intriguing connection between knee osteoarthritis and diabetes in Malaysia. Specifically, the exacerbation of knee osteoarthritis in the presence of diabetes in terms of symptoms, physical performance, physical activity, psychological status, social participation, and quality of life was discussed.

    DESIGN: This cross-sectional study recruited adults aged 50 and above by convenient sampling and grouped them into: knee osteoarthritis-diabetes-, knee osteoarthritis+diabetes-, knee osteoarthritis-diabetes+, and knee osteoarthritis+diabetes+.

    SUBJECTS/PATIENTS: Of 436 recruited participants, 261 (59.8%) participants reported knee osteoarthritis.

    METHODS: Handgrip strength, Timed Up and Go test, 6 Meter Walk Test, and 5 Times Sit to Stand Test were measured using standardized procedures. Six questionnaires were administered for the remaining parameters.

    RESULTS: Across groups, there were significant differences: 6 Meter Walk Test (p = 0.024), Timed Up and Go test (p = 0.020), and 5 Times Sit to Stand Test (p strength, 5 Times Sit to Stand Test, quality of life, and physical inactivity after adjustment. Knee osteoarthritis+diabetes- was independently associated with reduced Timed Up and Go test and social isolation.

    CONCLUSION: The findings revealed the diabetic knee osteoarthritis subgroup's unique physical and psychosocial features of reduced muscle strength and physical inactivity. Future studies should investigate whether managing metabolic factors, and enhancing physical activity and strength exercises, can reduce knee osteoarthritis symptoms and disease severity.

    Matched MeSH terms: Hand Strength/physiology
  8. Saedon NI, Frith J, Goh CH, Ahmad WAW, Khor HM, Tan KM, et al.
    Clin Auton Res, 2020 04;30(2):129-137.
    PMID: 31696333 DOI: 10.1007/s10286-019-00647-3
    PURPOSE: Consensus definitions currently define initial orthostatic hypotension (IOH) as ≥ 40 mmHg systolic (SBP) or ≥ 20 mmHg in diastolic blood pressure (DBP) reductions within 15 s of standing, while classical orthostatic hypotension (COH) is defined as a sustained reduction ≥ 20 mmHg SBP or ≥ 10 mmHg SBP within 3 min of standing. The clinical relevance of the aforementioned criteria remains unclear. The present study aimed to determine factors influencing postural blood pressure changes and their relationship with physical, functional and cognitive performance in older adults.

    METHODS: Individuals aged ≥ 55 years were recruited through the Malaysian Elders Longitudinal Research (MELoR) study and continuous non-invasive BP was monitored over 5 min of supine rest and 3 min of standing. Physical performance was measured using the timed-up-and-go test, functional reach, handgrip and Lawton's functional ability scale. Cognition was measured with the Montreal Cognitive Assessment. Participants were categorized according to BP responses into four categories according to changes in SBP/DBP reductions from supine to standing:

    Matched MeSH terms: Hand Strength/physiology*
  9. Damayanthi HDWT, Moy FM, Abdullah KL, Dharmaratne SD
    Asian Nurs Res (Korean Soc Nurs Sci), 2018 Sep;12(3):231-236.
    PMID: 30193884 DOI: 10.1016/j.anr.2018.08.008
    PURPOSE: Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka.

    METHODS: A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors.

    RESULTS: The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94-13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55-18.49 kg) than females (10.59, 95% confidence interval: 10.12-11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only.

    CONCLUSION: Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.

    Matched MeSH terms: Hand Strength/physiology*
  10. Taha Z, Musa RM, P P Abdul Majeed A, Alim MM, Abdullah MR
    Hum Mov Sci, 2018 Feb;57:184-193.
    PMID: 29248809 DOI: 10.1016/j.humov.2017.12.008
    Support Vector Machine (SVM) has been shown to be an effective learning algorithm for classification and prediction. However, the application of SVM for prediction and classification in specific sport has rarely been used to quantify/discriminate low and high-performance athletes. The present study classified and predicted high and low-potential archers from a set of fitness and motor ability variables trained on different SVMs kernel algorithms. 50 youth archers with the mean age and standard deviation of 17.0 ± 0.6 years drawn from various archery programmes completed a six arrows shooting score test. Standard fitness and ability measurements namely hand grip, vertical jump, standing broad jump, static balance, upper muscle strength and the core muscle strength were also recorded. Hierarchical agglomerative cluster analysis (HACA) was used to cluster the archers based on the performance variables tested. SVM models with linear, quadratic, cubic, fine RBF, medium RBF, as well as the coarse RBF kernel functions, were trained based on the measured performance variables. The HACA clustered the archers into high-potential archers (HPA) and low-potential archers (LPA), respectively. The linear, quadratic, cubic, as well as the medium RBF kernel functions models, demonstrated reasonably excellent classification accuracy of 97.5% and 2.5% error rate for the prediction of the HPA and the LPA. The findings of this investigation can be valuable to coaches and sports managers to recognise high potential athletes from a combination of the selected few measured fitness and motor ability performance variables examined which would consequently save cost, time and effort during talent identification programme.
    Matched MeSH terms: Hand Strength/physiology*
  11. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, et al.
    Lancet, 2015 Jul 18;386(9990):266-73.
    PMID: 25982160 DOI: 10.1016/S0140-6736(14)62000-6
    Reduced muscular strength, as measured by grip strength, has been associated with an increased risk of all-cause and cardiovascular mortality. Grip strength is appealing as a simple, quick, and inexpensive means of stratifying an individual's risk of cardiovascular death. However, the prognostic value of grip strength with respect to the number and range of populations and confounders is unknown. The aim of this study was to assess the independent prognostic importance of grip strength measurement in socioculturally and economically diverse countries.
    Matched MeSH terms: Hand Strength/physiology*
  12. Ling LL, Chan YM, Mat Daud Z'
    Asia Pac J Clin Nutr, 2019;28(2):401-410.
    PMID: 31192570 DOI: 10.6133/apjcn.201906_28(2).0023
    BACKGROUND AND OBJECTIVES: Poor sleep quality is prevalent among hemodialysis (HD) patients and leads to adverse health outcomes. This study investigated the association of nutritional parameters with sleep quality among Malaysian HD patients.

    METHODS AND STUDY DESIGN: A cross-sectional study was conducted among 184 Malaysian HD patients. Anthropometric measurements and handgrip strength (HGS) were obtained using standardized protocols. Relevant biochemical indicators were retrieved from patients' medical records. Nutritional status was assessed using the dialysis malnutrition score. The sleep quality of patients was determined using the Pittsburgh Sleep Quality Index questionnaire on both dialysis and non-dialysis days.

    RESULTS: Slightly more than half of the HD patients were poor sleepers, with approximately two-third of them having a sleep duration of <7 hours per day. Sleep latency (1.5±1.2) had the highest sleep component score, whereas sleep medicine use (0.1±0.6) had the lowest score. Significantly longer sleep latency and shorter sleep duration were observed in the poor sleepers, regardless of whether it was a dialysis day or not (p<0.001). Poor sleep quality was associated with male sex, old age, small triceps skinfold, hypoproteinemia, hyperkalemia, hyperphosphatemia, and poorer nutritional status. In a multivariate analysis model, serum potassium (β=1.41, p=0.010), male sex (β=2.15, p=0.003), and HGS (β=-0.088, p=0.021) were found as independent predictors of sleep quality.

    CONCLUSIONS: Poor sleep quality was evident among the HD patients in Malaysia. The sleep quality of the HD patients was associated with nutritional parameters. Routine assessment of sleep quality and nutritional parameters indicated that poor sleepers have a risk of malnutrition and may benefit from appropriate interventions.

    Matched MeSH terms: Hand Strength/physiology*
  13. Fung FY, Koh YLE, Malhotra R, Ostbye T, Lee PY, Shariff Ghazali S, et al.
    BMC Geriatr, 2019 04 29;19(1):122.
    PMID: 31035928 DOI: 10.1186/s12877-019-1137-8
    BACKGROUND: Sarcopenia is the age-related loss of muscle mass and function, which increases fall risks in older persons. Hyperglycemia relating to Type-2 Diabetes Mellitus (T2DM) is postulated to aggravate sarcopenia. This study aimed to determine the prevalence of sarcopenia among ambulatory community-dwelling older patients, aged 60-89 years, with T2DM in a primary care setting and to identify factors which mitigate sarcopenia.

    METHODS: A total of 387 patients were recruited from a public primary care clinic in Singapore. Data on their socio-demography, clinical and functional status, levels of physical activity (International Physical Activity Questionnaire) and frailty status was collected. The Asian Working Group for Sarcopenia (AWGS) criteria were used to define sarcopenia based on muscle mass, grip strength and gait speed.

    RESULTS: The study population comprised men (53%), Chinese (69%), mean age = 68.3 ± SD5.66 years, lived in public housing (90%), had hypertension (88%) and dyslipidemia (96%). Their mean muscle mass was 6.3 ± SD1.2 kg/m2; mean gait speed was 1.0 ± SD0.2 m/s and mean grip strength was 25.5 ± SD8.1 kg. Overall, 30% had pre-sarcopenia, 24% with sarcopenia and 4% with severe sarcopenia. Age (OR = 1.14; 95%CI = 1.09-1.20;p 

    Matched MeSH terms: Hand Strength/physiology
  14. Jamil NA, Gray SR, Fraser WD, Fielding S, Macdonald HM
    Osteoporos Int, 2017 04;28(4):1433-1443.
    PMID: 28083666 DOI: 10.1007/s00198-016-3901-3
    The current study examined the relationship between vitamin D status and muscle strength in young healthy adults: residents (>6 months) and newcomers (0-3 months), originally from sunny climate countries but currently living in the northeast of Scotland. Our longitudinal data found a positive, albeit small, relationship between vitamin D status and knee extensor isometric strength.

    INTRODUCTION: Vitamin D has been suggested to play a role in muscle health and function, but studies so far have been primarily in older populations for falls prevention and subsequent risk of fractures.

    METHODS: Vitamin D status was assessed in a healthy young adults from sunny climate countries (n = 71, aged 19-42 years) with 56% seen within 3 months of arriving in Aberdeen [newcomers; median (range) time living in the UK = 2 months (9-105 days)] and the remainder resident for >6 months [residents; 23 months (6-121 months)]. Participants attended visits every 3 months for 15 months. At each visit, fasted blood samples were collected for analysis of serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), carboxy-terminal collagen crosslinks (CTX) and N-terminal propeptide of type I collagen (P1NP). Maximal voluntary contractions (MVC) were performed for grip strength (both arms) and for maximal isometric strength of the knee extensors (right knee).

    RESULTS: There were small seasonal variations in 25(OH)D concentrations within the newcomers and residents, but no seasonal variation in bone turnover markers. There was a positive, albeit small, association between 25(OH)D and knee extensor maximal isometric strength. Mixed modelling predicted that for each 1 nmol/L increase in 25(OH)D, peak torque would increase by 1 Nm (p = 0.04).

    CONCLUSIONS: This study suggests that vitamin D may be important for muscle health in young adults migrating from sunnier climates to high latitudes, yet the potential effect is small.

    Matched MeSH terms: Hand Strength/physiology
  15. Bala U, Leong MP, Lim CL, Shahar HK, Othman F, Lai MI, et al.
    PLoS One, 2018;13(5):e0197711.
    PMID: 29795634 DOI: 10.1371/journal.pone.0197711
    BACKGROUND: Down syndrome (DS) is a genetic disorder caused by presence of extra copy of human chromosome 21. It is characterised by several clinical phenotypes. Motor dysfunction due to hypotonia is commonly seen in individuals with DS and its etiology is yet unknown. Ts1Cje, which has a partial trisomy (Mmu16) homologous to Hsa21, is well reported to exhibit various typical neuropathological features seen in individuals with DS. This study investigated the role of skeletal muscles and peripheral nerve defects in contributing to muscle weakness in Ts1Cje mice.

    RESULTS: Assessment of the motor performance showed that, the forelimb grip strength was significantly (P<0.0001) greater in the WT mice compared to Ts1Cje mice regardless of gender. The average survival time of the WT mice during the hanging wire test was significantly (P<0.0001) greater compared to the Ts1Cje mice. Also, the WT mice performed significantly (P<0.05) better than the Ts1Cje mice in the latency to maintain a coordinated motor movement against the rotating rod. Adult Ts1Cje mice exhibited significantly (P<0.001) lower nerve conduction velocity compared with their aged matched WT mice. Further analysis showed a significantly (P<0.001) higher population of type I fibres in WT compared to Ts1Cje mice. Also, there was significantly (P<0.01) higher population of COX deficient fibres in Ts1Cje mice. Expression of Myf5 was significantly (P<0.05) reduced in triceps of Ts1Cje mice while MyoD expression was significantly (P<0.05) increased in quadriceps of Ts1Cje mice.

    CONCLUSION: Ts1Cje mice exhibited weaker muscle strength. The lower population of the type I fibres and higher population of COX deficient fibres in Ts1Cje mice may contribute to the muscle weakness seen in this mouse model for DS.

    Matched MeSH terms: Hand Strength/physiology
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