Abstract
Purpose
To examine the relationship between handgrip strength and leg extension power, walking speed, and intermittent claudication for lumbar spinal stenosis (LSS) using computed tomography.
Methods
We examined patients who underwent laminectomy for LSS from June 2015 through March 2018. Before spine surgery, we evaluated walking distance, handgrip strength, leg extension power (LEP), 10-m walk test (time and steps), psoas muscle index (PMI), and the area of both total and multifidus muscle using plain computed tomography imaging at the third lumbar level. Handgrip strength was compared with comorbidities including anemia, diabetes, hypertension, marital status, etc.
Results
There were 183 patients (55 female, 128 male) with a mean age of 70.5 years. Handgrip strength significantly correlated with LEP (P < 0.001, r = 0.723), walking speed (P < 0.001, r = − 0.269), 10-m walking test (steps) (P < 0.001, r = − 0.352), area of skeletal muscle at L3 level (P < 0.001, r = 0.469), area of psoas muscle (P < 0.001, r = 0.380), PMI (P < 0.001, r = 0.253), and intermittent claudication. Age, height, and weight were correlated with handgrip strength, but BMI was not correlated. Handgrip strength was significantly reduced by anemia, hypertension, and single marital status.
Conclusions
The more handgrip strength patients with LSS have, the more LEP, the faster walking speed, the greater area of psoas and skeletal muscle, the fewer steps for a 10-m walk they have, and the longer walking distance. Age, height, and weight were associated with handgrip strength, but BMI has no association. Low handgrip strength was related to comorbidities including anemia, hypertension, and marital status.
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References
Janssen I, Heymsfield SB, Wang ZM, Ross R (2000) Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr. J Appl Physiol 89:81–88. https://doi.org/10.1152/jappl.2000.89.1.81
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in older people. Age Ageing 39:412–423. https://doi.org/10.1093/ageing/afq034
Rantanen T, Harris T, Leveille SG et al (2000) Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci 55:M168–173. https://doi.org/10.1093/gerona/55.3.m168
Manini TM, Clark BC (2012) Dynapenia and aging: an update. J Gerontol A Biol Sci Med Sci 67:28–40. https://doi.org/10.1093/gerona/glr010
Kilgour RD, Vigano A, Trutschnigg B et al (2010) Cancer-related fatigue: the impact of skeletal muscle mass and strength in patients with advanced cancer. J Cachexia Sarcopenia Muscle 1:177–185. https://doi.org/10.1007/s13539-010-0016-0
Norman K, Stobaus N, Smoliner C et al (2010) Determinants of hand grip strength, knee extension strength and functional status in cancer patients. Clin Nutr 29:586–591. https://doi.org/10.1016/j.clnu.2010.02.007
Chen CH, Ho C, Huang YZ, Hung TT (2011) Hand-grip strength is a simple and effective outcome predictor in esophageal cancer following esophagectomy with reconstruction: a prospective study. J Cardiothorac Surg 6:98. https://doi.org/10.1186/1749-8090-6-98
Shen F, Kim HJ, Lee NK et al (2018) The influence of hand grip strength on surgical outcomes after surgery for degenerative lumbar spinal stenosis: a preliminary result. Spine J 18:2018–2024. https://doi.org/10.1016/j.spinee.2018.04.009
Lee JC, Cha JG, Kim Y, Kim YI, Shin BJ (2008) Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls. Spine (Phila Pa 1976) 33:318–325. https://doi.org/10.1097/BRS.0b013e318162458f
Park S, Kim HJ, Ko BG et al (2016) The prevalence and impact of sarcopenia on degenerative lumbar spinal stenosis. Bone Jt J 98-B:1093–1098. https://doi.org/10.1302/0301-620X.98B8.37623
Eguchi Y, Suzuki M, Yamanaka H et al (2018) Influence of skeletal muscle mass and spinal alignment on surgical outcomes for lumbar spinal stenosis. Asian Spine J 12:556–562. https://doi.org/10.4184/asj.2018.12.3.556
Wannaprom N, Treleaven J, Jull G, Uthaikhup S (2018) Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculoskelet Sci Pract 35:25–29. https://doi.org/10.1016/j.msksp.2018.02.001
Hamaguchi Y, Kaido T, Okumura S et al (2016) Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults. Nutrition 32:1200–1205. https://doi.org/10.1016/j.nut.2016.04.003
Chen LK, Liu LK, Woo J et al (2014) Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 15:95–101. https://doi.org/10.1016/j.jamda.2013.11.025
de Araujo AC, Amaral TLM, Monteiro GTR, de Vasconcellos MTL, Portela MC (2020) Factors associated with low handgrip strength in older people: data of the Study of Chronic Diseases (Edoc-I). BMC Public Health 20:395. https://doi.org/10.1186/s12889-020-08504-z
Fragala MS, Alley DE, Shardell MD et al (2016) Comparison of handgrip and leg extension strength in predicting slow gait speed in older adults. J Am Geriatr Soc 64:144–150. https://doi.org/10.1111/jgs.13871
Pizzigalli L, Micheletti Cremasco M, La Antonio T, Rainoldi A, Roberto B (2017) Hand grip strength and anthropometric characteristics in Italian female national basketball teams. J Sports Med Phys Fitness 57:521–528. https://doi.org/10.23736/S0022-4707.16.06272-1
Wong SL (2016) Grip strength reference values for Canadians aged 6 to 79: Canadian Health Measures Survey, 2007 to 2013. Health Rep 27:3–10
Lauretani F, Russo CR, Bandinelli S et al (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95:1851–1860. https://doi.org/10.1152/japplphysiol.00246.2003
Zuckerman J, Ades M, Mullie L et al (2017) Psoas muscle area and length of stay in older adults undergoing cardiac operations. Ann Thorac Surg 103:1498–1504. https://doi.org/10.1016/j.athoracsur.2016.09.005
Reeve TET, Ur R, Craven TE et al (2018) Grip strength measurement for frailty assessment in patients with vascular disease and associations with comorbidity, cardiac risk, and sarcopenia. J Vasc Surg 67:1512–1520. https://doi.org/10.1016/j.jvs.2017.08.078
Grelat M, Gouteron A, Casillas JM et al (2019) Walking speed as an alternative measure of functional status in patients with lumbar spinal stenosis. World Neurosurg 122:e591–e597. https://doi.org/10.1016/j.wneu.2018.10.109
Toyoda H, Hoshino M, Ohyama S et al (2019) The association of back muscle strength and sarcopenia-related parameters in the patients with spinal disorders. Eur Spine J 28:241–249. https://doi.org/10.1007/s00586-018-5858-8
Morley JE (2008) Sarcopenia: diagnosis and treatment. J Nutr Health Aging 12:452–456
Clark BC (2019) Neuromuscular changes with aging and sarcopenia. J Frailty Aging 8:7–9. https://doi.org/10.14283/jfa.2018.35
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The authors acknowledge Mr. Nishikawa and many physical therapists in Shinkaminokawa hospital for providing support in carrying out this study.
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Inoue, H., Watanabe, H., Okami, H. et al. Handgrip strength correlates with walking in lumbar spinal stenosis. Eur Spine J 29, 2198–2204 (2020). https://doi.org/10.1007/s00586-020-06525-1
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DOI: https://doi.org/10.1007/s00586-020-06525-1