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O livro de Catulo Here is to articles begun through Erwachsene or dealing. Presented are the unadjusted group means. First repetition omitted from analysis of fatigue index. However, they indicated that the type of surgery and the length of time elapsed since BC surgery was independently influencing factors for shoulder flexibility.
The performed isokinetic and isometric tests were safe and feasible. No adverse events were observed; only sporadic muscle soreness was reported by a few patients. Overall, we observed that BC patients undergoing acute cancer treatment had remarkably impaired strength capacity in both isokinetic and isometric values as well as in muscular fatigue compared with healthy individuals.
To our knowledge, this is the first study investigating isometric and isokinetic strength performance in different clinically important BC patient groups, which are at the beginning, or after neo-adjuvant or adjuvant chemotherapy, or just after surgery. Therefore, our results provide new insights into muscle strength performance of BC patients from several perspectives.
First of all, our findings are predominantly in line with other studies investigating strength performance in cancer patients showing that the muscle status of cancer patients is impaired after treatment. However, most published studies in the field assessed strength performance via handgrip[ 26 ] or handheld dynamometry,[ 27, 28 ] with functional tests[ 5 ] or by using the one repetition maximum method. Regarding the reported performance differences between cancer patients and matched healthy controls, the studies mentioned earlier reported larger differences in strength performance than we observed in our studies.
Lastly, differences with regard to strength testing procedures might be of importance. Handheld dynamometry is known to be a valid and reliable testing procedure, but relatively large measurement errors can occur based on an insufficient standardization of the testing position. One of the new insights of this study comes along with the isokinetic testing protocol. Because we included two different testing speeds in the protocol, we were able to draw conclusions in relation to muscle fibre activation.
Research has shown that at lower angular velocities, muscle fibres I and II can be maximally activated, whereas with increasing speed, less slow twitch fibre type I will be recruited. New insights could be also reported with regard to the interaction of CT and fatigue resistance of skeletal muscles. We observed that patients having received CT nearly all treated with anthracycline had less strength and greater muscular fatigue compared with BC patients without CT or just at the beginning of CT.
An explanation for these findings could be an inactivity-related shift of muscle fibres with a transition to more glycolytic phenotype and a CT-induced change in mitochondrial capacity of muscle cells. These circumstances potentially lead to a loss of muscle strength, which can be supported by our objective data. In general, individual strength performance in cancer patients may be influenced by various contextual factors. Some of those factors are independent from the cancer setting e. It is supposed that CT causes oxidative stress to normal tissue and directly impacts skeletal muscles and fatigue.
Sarcopenia is an independent predictor of survival, which is closely related to patients' functional status and potentially to CT toxicity. This might have important clinical implications due to the aforementioned associations with prognostic factors. Aside from reduced strength capacity, upper-body mobility restrictions represent a stressful physical limitation in patients undergoing BC surgery. Impaired shoulder function has been reported in many BC survivors even several years after surgery.
This study reported significant differences in comparison to healthy controls. We can support the results of this small study, but caution needs to be utilized because different testing procedures were used. Interestingly, the time difference between surgery and testing, type of surgery and pain are considered to have no impact on shoulder strength; only flexibility, which was dependent on the type and time since surgery, was impaired. Our study has several strengths.
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We performed stationary isokinetic strength testing, which is the gold standard procedure for functional skeletal muscle assessment. Moreover, we were able to assess many relevant cofactors and include them in adjusted regression models on strength performance in clinically relevant subgroups. Lastly, the current study is the first that reports information about muscular fatigue in relation to different treatment settings, and all patient data could be compared with an age-matched healthy control group.
This study did include some limitations.
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Additionally, the cross-sectional design limits causal inferences. Furthermore, the healthy women were a convenience sample, and despite matching by age groups, differences need to be interpreted with caution. Nevertheless, the strength performance of our healthy participants was in line with comparably aged healthy women. The reason for that is uncertain but might represent the tendency of the treating physician to prescribe CT less frequently to elderly patients due to potential side effects and the fact that response rates vary greatly so that CT is not always beneficial.
Lastly, due to organizational reasons it was not possible to perform a separate familiarization session on the stationary dynamometer. This may led to an underestimation of strength performance. However, the testing situation was standardized for all participants and therefore comparable for all groups. Furthermore, all participants had a short familiarization time at each testing position immediately before the assessment starts.
In conclusion, our study showed that isometric and isokinetic strength testing appears to be safe in a large cohort of BC patients. We reported about significantly impaired isometric and isokinetic strength capacity with higher muscular fatigue in low extremities and dysfunctions in shoulder mobility in our patients. Overall, receiving CT treatment seems to have the greatest impact on muscular strength. Based on the findings in different BC subgroups, the prevention of muscle dysfunction should be an important goal during cancer treatment and underlines the importance for the implementation of resistance training regimens during cancer treatment to mitigate or reverse muscle dysfunction.
Furthermore, systematic resistance training after BC therapy should be considered to alter consequences of muscle dysfunction in cancer rehabilitation. To further understand the mechanisms of muscular dysfunction in cancer patients, there is a need for the assessment of cellular muscle structure and biomarkers combined with accurate gold standard strength testing procedures. The authors certify that they comply with the ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle : update The authors thank the study participants who willingly spent their time to complete the study procedures, the BC centres supporting the recruitment, Dr Jan Oelmann and Dr Andrea Koffka for medical advice and examinations, Petra Armbrust and Dr Tilla Ruf for study coordination and assistance, Werner Diehl for data management, and Michael Paskow for linguistic editing.
Yang, M. Email: Ming Yang This email address is being protected from spambots.
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The aim of this study is to assess the prevalence of sarcopenia and investigate the associations between sarcopenia and long-term mortality and readmission in a population of elderly inpatients in acute care wards. We conducted a prospective observational study in the acute care wards of a teaching hospital in western China. The muscle mass was estimated according to a previously validated anthropometric equation. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia.
Two hundred and eighty-eight participants mean age: Forty-nine participants This condition was similar in men and women The mortality of sarcopenic participants was significantly increased compared with non-sarcopenic participants Sarcopenia, which is evaluated by a combination of anthropometric measures, gait speed, and handgrip strength, is valuable to predict hospital readmission and long-term mortality in elderly patients in acute care wards.
Sarcopenia is defined as an age-related loss of muscle mass, strength, and muscle function, and is currently considered a new geriatric syndrome.