Assessment of Muscle Function and Physical Performance in Daily Clinical Practice

Abstract

It is well recognized that poor muscle function and poor physical performance are strong predictors of clinically relevant adverse events in older people. Given the large number of approaches to measure muscle function and physical performance, clinicians often struggle to choose a tool that is appropriate and validated for the population of older people they deal with. In this paper, an overview of different methods available and applicable in clinical settings is proposed. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were organized afterwards where the whole group could amend and discuss the recommendations further. Several characteristics should be considered when choosing a tool: (1) purpose of the assessment (intervention, screening, diagnosis); (2) patient characteristics (population, settings, functional ability, etc.); (3) psychometric properties of the tool (test-retest reliability, inter-rater reliability, responsiveness, floor and ceiling effects, etc.); (4) applicability of the tool in clinical settings (overall cost, time required for the examination, level of training, equipment, patient acceptance, etc.); (5) prognostic reliability for relevant clinical outcomes. Based on these criteria and the available evidence, the expert group advises the use of grip strength to measure muscle strength and the use of 4-m gait speed or the Short Physical Performance Battery test to measure physical performance in daily practice. The tools proposed are relevant for the assessment of muscle weakness and physical performance. Subjects with low values should receive additional diagnostic workups to achieve a full diagnosis of the underlying condition responsible (sarcopenia, frailty or other).

Red Ginseng Improves Exercise Endurance by Promoting Mitochondrial Biogenesis and Myoblast Differentiation

“…Additionally, an increase in myogenesis can lead to improved exercise performance [36]. RG treatment was shown to promote myogenic differentiation in our study.…”

“…Increases in muscle cell growth and differentiation is known as key contributing factors that can improve physical performance [35,36], and we next examined whether RG treatment had any effect on myogenesis. RG treatment promoted myogenic differentiation and increased the fusion index (the number of nuclei inside MHC-positive myotubes divided by total number of nuclei; Figure 6A, B).…”

The Effects of a 6-Month High Dose Omega-3 and Omega-6 Polyunsaturated Fatty Acids and Antioxidant Vitamins Supplementation on Cognitive Function and Functional Capacity in Older Adults with Mild Cognitive Impairment

“…The consumption of the specific formula significantly increased the completed sit-to-stand cycles in the STS-30 and STS-60 tests as well, and the improvement was observed from the first three months of supplementation. These tests measuring lower body power, balance and endurance are the most important physical performance clinical tests, because they relate to the most demanding daily life activities [23]. In contrast, the study of Logan and Spriet did not find any improvement in STS-30 following 3 g/d of EPA and DHA intake for 12 wk in older females [30].…”

“…Functional capacity was evaluated using three sit-to-stand (STS) tests (STS-5, STS-30 and STS-60), the timed-up-and-go (TUG) test, the 6-min walk test (6MWT), and the handgrip strength (HGS) test. The sit-to-stand tests measure lower body power, balance and endurance and require participants to rise from a chair with their arms across their chest and sit down again [23,43]. The STS-5 record the amount of time (in seconds) to complete five sit-to-stand cycles, while the STS-30 and STS-60 score is the total cycles (repetitions) achieved in 30 and 60 s, respectively.…”

“…In 2015, the World Health Organization (WHO) in its world report on ageing and health, defines healthy ageing as "the process of developing and maintaining the functional ability that enables well-being in older age" [2]. Moreover, it is well recognized that muscle weakness and poor functional ability are strong predictors of clinically relevant adverse outcomes in older adults including falls, dementia, nursing home admission and mortality [21][22][23][24]. In the last decade, there have been numerous studies demonstrating a positive impact of EPA and DHA supplementation on skeletal muscle strength and mass, even though this was not confirmed in other studies [25][26][27][28][29].…”