Abstract-A group of relatively uncommon but important genetic cardiovascular diseases (GCVDs) are associated with increased risk for sudden cardiac death during exercise, including hypertrophic cardiomyopathy, long-QT syndrome, Marfan syndrome, and arrhythmogenic right ventricular cardiomyopathy. These conditions, characterized by diverse phenotypic expression and genetic substrates, account for a substantial proportion of unexpected and usually arrhythmia-based fatal events during adolescence and young adulthood. Guidelines are in place governing eligibility and disqualification criteria for competitive athletes with these GCVDs (eg, Bethesda Conference No. 26 and its update as Bethesda Conference No. 36 in 2005). However, similar systematic recommendations for the much larger population of patients with GCVD who are not trained athletes, but nevertheless wish to participate in any of a variety of recreational physical activities and sports, have not been available. The practicing clinician is frequently confronted with the dilemma of designing noncompetitive exercise programs for athletes with GCVD after disqualification from competition, as well as for those patients with such conditions who do not aspire to organized sports. Indeed, many asymptomatic (or mildly symptomatic) patients with GCVD desire a physically active lifestyle with participation in recreational and leisure-time activities to take advantage of the many documented benefits of exercise. However, to date, no reference document has been available for ascertaining which types of physical activity could be regarded as either prudent or inadvisable in these subgroups of patients. Therefore, given this clear and present need, this American Heart Association consensus document was constituted, based largely on the experience and insights of the expert panel, to offer recommendations governing recreational exercise for patients with known GCVDs.

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Musculoskeletal fitness, as assessed by SRT, was a significant predictor of mortality in 51-80-year-old subjects. Application of a simple and safe assessment tool such as SRT, which is influenced by muscular strength and flexibility, in general health examinations could add relevant information regarding functional capabilities and outcomes in non-hospitalized adults.

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It is well-established that at old age there is a significant decline in muscle strength. Reference values for muscle strength might be useful for assessment of muscle impairment and of physiological adaptations. However, it is still unclear whether gender affects the rate of decline. Therefore, the aim of this study is to investigate the effect of gender and age on handgrip strength and to establish reference values for this variable. Reviewing medical charts collected from 1994 to 2005, a convenience sample of 2,648 subjects (1,787 men and 861 women), aged between 18 and 90 years, was obtained. Our results show higher handgrip strength for men compared with women (36.8 +/- 0.20 vs. 21.0 +/- 0.18 kg; p < 0.001). The regression analysis with a quadratic model shows that aging accounts for 30% of the variance in handgrip strength (r(2) = 0.30; p < 0.001) in men and 28% (r(2) = 0.28; p < 0.001) in women. In addition, the bent linear regression with multiple regressors show that a faster decline in handgrip strength occurs at the age of 30 years for men and 50 years for women. We conclude that handgrip strength decline with age differs between genders, making useful the existence of distinct male and female normative age group data.

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