Grip strength predicts physical function in nursing home residents

Raso, Vagner; Tolea, Magdalena loana; Mancini, Rafael Benito; Matsudo, Sandra Marcela Mahecha

doi:10.5935/MedicalExpress.2017.01.04

Brasil

Español English

ORIGINAL RESEARCH • MedicalExpress (São Paulo, online) 4 (1) • Jan-Feb 2017 • https://doi.org/10.5935/MedicalExpress.2017.01.04 copy

Grip strength predicts physical function in nursing home residents

A FORÇA DE PREENSÃO MANUAL PREDIZ A FUNÇÃO FÍSICA DE RESIDENTES DE INSTITUIÇÕES DE LONGA PERMANÊNCIA PARA IDOSOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

PURPOSE:

To analyze the relationship of grip strength and physical function in institutionalized older people.

METHODS:

One hundred and fifty-seven nursing home residents of seven different long-stay institutions underwent evaluation of body composition, cognitive function, grip strength, mobility, balance (balance scale test BERG and single-leg stance test) and gait speed.

RESULTS:

Volunteers had no impairment of cognitive function, functional mobility, balance or gait speed. Men had higher grip strength and achieved higher scores in BERG. Fittest volunteers (i.e., P₇₅ to P₁₀₀) had better functional mobility, BERG and gait speed; less fit volunteers (i.e., P₀ to P₂₅) were taller and had better gait speed. The grip strength was independently associated with functional mobility and balance in the single-leg stance test only in females. The cognitive function (female, P₂₅ to P₇₅, male, total sample) and age (male, total sample) showed a tendency to be mediators of functional mobility. Age and body weight seem to confound the gait speed, especially for females (P₂₅ to P₇₅), while cognitive function confound it in males (P₇₅ to P₁₀₀). However, age and body weight are significantly associated with gait speed (female, total sample).

CONCLUSION:

We can conclude that grip strength was independently associated with functional mobility and balance of institutionalized older women.

KEYWORDS:
Balance; elderly; institutionalization; muscle strength; physical function

	Male (n: 59)	Female (n: 98)	Total (n: 157)
Age (years)	71.5 ± 1.3	76.1 ± 1.5^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	74.3 ± 1.0
Body mass (kg)	66.8 ± 1.9	58.9 ± 1.8^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	62.0 ± 1.4
Body height (m)	1.63 ± 0.1	1.48 ± 0.1^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	1.54 ± 0.1
BMI (kg•m²)	24.9 ± 0.6	26.5 ± 0.7	25.9 ± 0.5
Cognitive function	16.1 ± 1.0	14.6 ± 0.8	15.3 ± 0.6
Grip strength (N)	498.7 ± 22.0	299.5 ± 11.6^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	377.0 ± 13.7
TUGT (s)	18.4 ± 1.4	20.8 ± 1.2	19.9 ± 0.9
BERG	44.3 ± 1.6	36.7 ± 2.9^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	40.5 ± 1.7
Single leg stance (sec)	9.1 ± 1.6	7.1 ± 1.6	7.9 ± 1.2
Gait	-	-	-
ABSspeed (s)	6.9 ± 0.5	9.0 ± 0.8	8.2 ± 0.6
RELspeed (m•s^-1)	2.1 ± 0.1	2.7 ± 0.2	2.5 ± 0.2

	Grip strength
	P₀ to P₂₅		P₂₅ to P₇₅		P₇₅ to P₁₀₀
	Male (n: 10)	Female (n: 18)	Male (n: 40)	Female (n: 65)	Male (n: 9)	Female (n: 15)
Age (years)	74.8 ± 4.3	74.6 ± 2.5	74.2 ± 2.0	80.1 ± 1.6^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	69.7 ± 1.7	52.0 ± 9.7
Body mass (kg)	60.2 ± 7.7	50.5 ± 3.2	63.5 ± 3.6	61.2 ± 2.0	69.9 ± 2.2	76.2 ± 9.0
Body height (m)	1.60 ± 0.2	1.45 ± 0.2^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	1.59 ± 0.1	1.49 ± 0.7^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	1.66 ± 0.1	1.57 ± 0.4
BMI (kg•m²)	23.3 ± 2.8	24.0 ± 1.5	24.4 ± 1.6	27.6 ± 0.9^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	25.5 ± 0.7	31.2 ± 4.3
Cognitive function	7.8 ± 2.4	13.3 ± 1.4	13.5 ± 1.8	15.0 ± 1.1	18.9 ± 1.1	21. 7 ± 1.7
Grip strength (N)	219.9 ± 17.8	186.2 ± 9.4^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	386.2 ± 11.7	346.5 ± 8.2^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	614.2 ± 19.3	559.2 ± 42.6
TUGT (s)	19.6 ± 2.3	25.4 ± 2.0	20.8 ± 2.1	19.5 ± 1.5	16.9 ± 2.2	10.4 ± 1.7^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.
BERG	43.5 ± 1.5	27.6 ± 7.6	40.8 ± 2.0	36.6 ± 3.4	46.5 ± 2.3	53.0 ± 1.0^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.
Balance (s)	4.4 ± 1.2	2.6 ± 0.8	4.6 ± 1.9	7.7 ± 2.3	13.0 ± 2.5	22.8 ± 6.3
Gait	-		-		-
ABSspeed (s)	7.1 ± 0.9	10.3 ± 1.1^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	8.2 ± 0.6	9.1 ± 1.2	6.1 ± 0.8	3.9 ± 0.3^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.
RELspeed (m•s^-1)	2.1 ± 0.3	3.1 ± 0.3^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.	2.5 ± 0.2	2.8 ± 0.4	1.8 ± 0.2	1.2 ± 0.1^* * P < 0.05 (shaded areas indicate significant differences); BMI: body mass index; BERG: Berg balance scale; TUGT: timed up and go test; ABSspeed: absolute speed; RELspeed: relative speed.

	Model summary		Age		Body mass		Cognitive function		Grip strength
	M	F	M	F	M	F	M	F	M	F
TUGT
P₀ to P₂₅	---	.49 (.07)	---	.292 (.367)	---	.064 (.841)	---	-.022 (.942)	---	-.358 (.246)
P₂₅ to P₇₅	.50 (.05)	.52 (.14)	-.059 (.844)	.172 (.347)	.337 (.283)	.220 (.207)	-.274 (.376)	-.341 (.051)	-.252 (.429)	-.257 (.177)
P₇₅ to P₁₀₀	.50 (.16)	---	.111 (.577)	---	-.059 (.787)	---	-.284 (.179)	---	-.283 (.185)	---
Total	.43 (.11)	.53 (.23)	.070 (.636)	.198 (.116)	.036 (.818)	.153 (.254)	-.320 (.062)	-.211 (.100)	-.157 (.376)	-.387 (.006)
BERG
P₀ to P₂₅	---	---	---	---	---	---	---	---	---	---
P₂₅ to P₇₅	.65 (.04)	.48 (.03)	.206 (.597)	-.473 (.129)	.232 (.559)	-.173 (.540)	.144 (.712)	.184 (.507)	.427 (.312)	-.040 (.896)
P₇₅ to P₁₀₀	.54 (.09)	---	-.002 (.994)	---	.307 (.265)	---	.191 (.461)	---	.210 (.425)	---
Total	.53 (.17)	.60 (.23)	.036 (.834)	-.315 (.114)	.304 (.110)	-.109 (.600)	.164 (.410)	.262 (.190)	.223 (.290)	.325 (.130)
Balance
P₀ to P₂₅	---	.21 (.38)	---	-.041 (.914)	---	-.108 (.775)	---	.089 (.802)	---	.156 (.659)
P₂₅ to P₇₅	.29 (.25)	.18 (.10)	-.216 (.500)	.100 (.631)	.011 (.973)	-.043 (.826)	.058 (.855)	-.006 (.976)	-.178 (.592)	.213 (.321)
P₇₅ to P₁₀₀	.47 (.05)	---	-.438 (.059)	---	-.170 (.483)	---	-.116 (.614)	---	.016 (.944)	---
Total	.48 (.15)	.34 (.05)	-.383 (.012)	-.055 (.698)	-.148 (.348)	-.091 (.545)	-.058 (.730)	.021 (.883)	.279 (.120)	.347 (.026)

	Summary model		Age		Body mass		Cognitive function		Grip strength
	M	F	M	F	M	F	M	F	M	F
Absolute speed
P₀ to P₂₅	---	.36 (.14)	---	.207 (.488)	---	.260 (.390)	---	-.283 (.320)	---	.057 (.838)
P₂₅ to P₇₅	.43 (.11)	.51 (.16)	.084 (.779)	.327 (.078)	.170 (.577)	.334 (.058)	.021 (.945)	-.169 (.318)	-.466 (.152)	-.213 (.258)
P₇₅ to P₁₀₀	.52 (.13)	---	-.105 (.599)	---	-.045 (.834)	---	-.371 (.083)	---	-.284 (.185)	---
Total	.43 (.10)	.46 (.16)	.015 (.919)	.317 (.016)	-.119 (.443)	.307 (.028)	-.202 (.228)	-.159 (.224)	-.210 (.235)	-.234 (.094)
Relative speed
P₀ to P₂₅	---	.36 (.14)	---	.207 (.488)	---	.260 (.390)	---	-.283 (.320)	---	.057 (.838)
P₂₅ to P₇₅	.43 (.11)	.51 (.16)	.084 (.779)	.327 (.078)	.170 (.577)	.334 (.058)	.021 (.945)	-.169 (.318)	-.466 (.152)	-.213 (.258)
P₇₅to P₁₀₀	.52 (.13)	---	-.105 (.599)	---	-.045 (.834)	---	-.371 (.083)	---	-.284 (.185)	---
Total	.43 (.10)	.46 (.16)	.015 (.919)	.317 (.016)	-.119 (.443)	.307 (.028)	-.202 (.228)	-.159 (.224)	-.210 (.235)	-.234 (.094)

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