Comparison of Handgrip and Leg Extension Strength in Predicting Slow Gait Speed in Older Adults.
Comparison of Handgrip and Leg Extension Strength in Predicting Slow Gait Speed in Older Adults.
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DOI：
10.1111/jgs.13871
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发表时间：
2016-01
影响因子：
6.3
通讯作者：
Kenny AM
中科院分区：
文献类型：
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作者：
Fragala MS;Alley DE;Shardell MD;Harris TB;McLean RR;Kiel DP;Cawthon PM;Dam TT;Ferrucci L;Guralnik JM;Kritchevsky SB;Vassileva MT;Gudnason V;Eiriksdottir G;Koster A;Newman A;Siggeirsdottir K;Satterfield S;Studenski SA;Kenny AM
FNIH肌肉减少症项目根据握力（HG）制定了临床相关虚弱的循证标准。身体活动性主要依赖于下肢肌肉组织的动作，有必要将HG与腿部力量进行比较，以证明旨在为活动性残疾的鉴别诊断提供信息的力量评估模式的可接受性。比较HG和下肢伸展强度对慢走的相对预测能力。在FNIH肌肉减少症项目的数据中，测量了6766名老年男性和女性（年龄67-93岁）的腿部力量、HG和步态速度。使用分类回归树（CART）分析开发了与缓慢步态速度相关的强度临界点，并使用普通最小二乘回归模型进行了比较。与缓慢步态速度相关的下肢力量的截点，男性和女性分别为154.6和89.9 N-m的等长和94.5和62.28 N-m的等速腿伸展力量。由HG（OR = 1.99至4.33; c-统计量= 0.53至0.67）或腿部力量（OR = 2.52至5.77; c-统计量= 0.61至0.66）定义的虚弱与步态速度缓慢的几率密切相关。下肢力量和HG在预测步态速度时的贡献率分别为1 - 16%和3 - 17%，这取决于性别和力量评估模式。腿部伸肌和前臂屈肌的肌肉无力与缓慢的步态速度有关。腿部伸展力量只是一个稍微好一点的预测缓慢的步态速度。因此，握力和腿部伸展力量似乎都适合于筛选老年人人群中的肌肉无力。
The FNIH Sarcopenia Project developed evidence-based criteria for clinically relevant weakness based on handgrip strength (HG). Physical mobility relies primarily on actions of the lower extremity musculature, an comparison of HG to leg strength is necessary to justify the acceptability of strength assessment modality intended to inform a differential diagnosis of mobility disability. To compare the relative predictive power of HG and leg extension strength for predicting slow walking. Leg strength, HG, and gait speed were measured in 6766 older men and women (aged 67–93 y) in data from the FNIH Sarcopenia Project. Strength cut-points associated with slow gait speed were developed using Classification and Regression Tree (CART) analyses and compared using ordinary least squares regression models. The cut-points of lower extremity strength associated with slow gait speed were 154.6 and 89.9 N-m for isometric and 94.5 and 62.28 N-m for isokinetic leg extension strength in men and women, respectively. Weakness defined by HG (OR = 1.99 to 4.33; c-statistic = 0.53 to 0.67) or leg strength (OR = 2.52 to 5.77; c-statistic = 0.61 to 0.66) strongly relate to the odds of having slow gait speed. Lower extremity strength and HG contributed 1 to 16 % and 3 to 17%, respectively, in the prediction of gait speed depending on sex and mode of strength assessment. Muscle weakness of both the leg extensors and forearm flexors are related to slow gait speed. Leg extension strength is only a slightly better predictor of slow gait speed. Thus, both grip and leg extension strength appear to be suitable for screening for muscle weakness in a population of older adults.