Ann Rehabil Med.  2015 Dec;39(6):880-887. 10.5535/arm.2015.39.6.880.

Relationship Between Respiratory Muscle Strength and Conventional Sarcopenic Indices in Young Adults: A Preliminary Study

• Ro HJ
• Kim DK
• Lee SY
• Seo KM
• Kang SH
• Suh HC

• KMID: 2165613
• DOI: http://doi.org/10.5535/arm.2015.39.6.880

Abstract

OBJECTIVE
To investigate the relationships between respiratory muscle strength and conventional sarcopenic indices such as skeletal muscle mass and limb muscle strength.
METHODS
Eighty-nine young adult volunteers who had no history of medical or musculoskeletal disease were enrolled. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Upper and lower limb muscle strength were evaluated by hand grip strength (HGS) and isometric knee extensor muscle strength, respectively. Peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were evaluated using a spirometer to demonstrate respiratory muscle strength. The relationships between respiratory muscle strength and sarcopenic indices were investigated using Pearson correlation coefficients and multiple linear regression analysis adjusted by age, height, and body mass index.
RESULTS
MIP showed positive correlations with SMI (r=0.457 in men, r=0.646 in women; both p<0.01). MIP also correlated with knee extensor strength (p<0.01 in both sexes) and HGS (p<0.05 in men, p<0.01 in women). However, PEF and MEP had no significant correlations with these sarcopenic variables. In multivariate regression analysis, MIP was the only independent factor related to SMI (p<0.01).
CONCLUSION
Among the respiratory muscle strength variables, MIP was the only value associated with skeletal muscle mass.

Keyword

Sarcopenia; Respiratory muscles; Muscle strength; Skeletal muscle; Spirometry

MeSH Terms

Body Mass Index
Electric Impedance
Extremities
Female
Hand
Hand Strength
Humans
Knee
Linear Models
Lower Extremity
Male
Muscle Strength
Muscle, Skeletal
Musculoskeletal Diseases
Respiratory Muscles*
Sarcopenia
Spirometry
Volunteers
Young Adult*

Figure

• 

  Fig. 1 Correlation is shown between (A) maximal inspiratory pressure (MIP) and (B) maximal expiratory pressure (MEP) with skeletal muscle mass. The blue diamonds and solid lines show the results for men; the red hollow squares and dotted lines represent the results for women. SMI, skeletal muscle mass index.

Reference

1. Doherty TJ. Invited review: aging and sarcopenia. J Appl Physiol (1985). 2003; 95:1717–1727. PMID: 12970377.

2. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998; 147:755–763. PMID: 9554417.

3. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39:412–423. PMID: 20392703.

4. Clark BC, Manini TM. What is dynapenia? Nutrition. 2012; 28:495–503. PMID: 22469110.

5. Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB, Velasquez-Mieyer P, et al. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr. 2009; 90:1579–1585. PMID: 19864405.

6. Bean JF, Kiely DK, Herman S, Leveille SG, Mizer K, Frontera WR, et al. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002; 50:461–467. PMID: 11943041.

7. Manini TM, Visser M, Won-Park S, Patel KV, Strotmeyer ES, Chen H, et al. Knee extension strength cutpoints for maintaining mobility. J Am Geriatr Soc. 2007; 55:451–457. PMID: 17341251.

8. Drouin JM, Valovich-mcLeod TC, Shultz SJ, Gansneder BM, Perrin DH. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol. 2004; 91:22–29. PMID: 14508689.

9. Surburg PR, Suomi R, Poppy WK. Validity and reliability of a hand-held dynamometer with two populations. J Orthop Sports Phys Ther. 1992; 16:229–234. PMID: 18796754.

10. Kollock RO Jr, Onate JA, Van Lunen B. The reliability of portable fixed dynamometry during hip and knee strength assessments. J Athl Train. 2010; 45:349–356. PMID: 20617909.

11. Keating JL, Matyas TA. The influence of subject and test design on dynamometric measurements of extremity muscles. Phys Ther. 1996; 76:866–889. PMID: 8710966.

12. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15:95–101. PMID: 24461239.

13. Buchman AS, Boyle PA, Wilson RS, Gu L, Bienias JL, Bennett DA. Pulmonary function, muscle strength and mortality in old age. Mech Ageing Dev. 2008; 129:625–631. PMID: 18755207.

14. Buchman AS, Boyle PA, Wilson RS, Leurgans S, Shah RC, Bennett DA. Respiratory muscle strength predicts decline in mobility in older persons. Neuroepidemiology. 2008; 31:174–180. PMID: 18784416.

15. Evans JA, Whitelaw WA. The assessment of maximal respiratory mouth pressures in adults. Respir Care. 2009; 54:1348–1359. PMID: 19796415.

16. Syabbalo N. Assessment of respiratory muscle function and strength. Postgrad Med J. 1998; 74:208–215. PMID: 9683973.

17. Buckinx F, Reginster JY, Dardenne N, Croisiser JL, Kaux JF, Beaudart C, et al. Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry: a cross-sectional study. BMC Musculoskelet Disord. 2015; 16:60. PMID: 25887598.

18. Janssen I, Heymsfield SB, Baumgartner RN, Ross R. Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol (1985). 2000; 89:465–471. PMID: 10926627.

19. Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gomez J, et al. Bioelectrical impedance analysis. Part II: utilization in clinical practice. Clin Nutr. 2004; 23:1430–1453. PMID: 15556267.

20. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002; 50:889–896. PMID: 12028177.

21. Pedrero-Chamizo R, Albers U, Tobaruela JL, Melendez A, Castillo MJ, Gonzalez-Gross M. Physical strength is associated with Mini-Mental State Examination scores in Spanish institutionalized elderly. Geriatr Gerontol Int. 2013; 13:1026–1034. PMID: 23506641.

22. Arai H, Akishita M, Chen LK. Growing research on sarcopenia in Asia. Geriatr Gerontol Int. 2014; 14(Suppl 1):1–7. PMID: 24450555.

23. Innes EV. Handgrip strength testing: a review of the literature. Aust Occup Ther J. 1999; 46:120–140.

24. Kim WK, Kim DK, Seo KM, Kang SH. Reliability and validity of isometric knee extensor strength test with hand-held dynamometer depending on its fixation: a pilot study. Ann Rehabil Med. 2014; 38:84–93. PMID: 24639931.

25. Katoh M, Yamasaki H. Comparison of reliability of isometric leg muscle strength measurements made using a hand-held dynamometer with and without a restraining belt. J Phys Ther Sci. 2009; 21:37–42.

26. Servio TC, Pereira RS, Cataneo DC. Study on functional cardiorespiratory changes after laparoscopic Nissen fundoplication. Acta Cir Bras. 2012; 27:499–504. PMID: 22760837.

27. Pessoa IM, Coelho CM, Mendes LP, Montemezzo D, Pereira DA, Parreira VF. Comparison of three protocols for measuring the maximal respiratory pressures. Fisioterapia em Movimento. 2015; 28:31–39.

28. American Thoracic Society. European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002; 166:518–624. PMID: 12186831.

29. Rantanen T, Guralnik JM, Foley D, Masaki K, Leveille S, Curb JD, et al. Midlife hand grip strength as a predictor of old age disability. JAMA. 1999; 281:558–560. PMID: 10022113.

30. Ploutz-Snyder LL, Manini T, Ploutz-Snyder RJ, Wolf DA. Functionally relevant thresholds of quadriceps femoris strength. J Gerontol A Biol Sci Med Sci. 2002; 57:B144–B152. PMID: 11909879.

31. Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006; 61:72–77. PMID: 16456196.

32. Cesari M, Pedone C, Chiurco D, Cortese L, Conte ME, Scarlata S, et al. Physical performance, sarcopenia and respiratory function in older patients with chronic obstructive pulmonary disease. Age Ageing. 2012; 41:237–241. PMID: 22156558.

33. Greising SM, Mantilla CB, Gorman BA, Ermilov LG, Sieck GC. Diaphragm muscle sarcopenia in aging mice. Exp Gerontol. 2013; 48:881–887. PMID: 23792145.

34. van der Palen J, Rea TD, Manolio TA, Lumley T, Newman AB, Tracy RP, et al. Respiratory muscle strength and the risk of incident cardiovascular events. Thorax. 2004; 59:1063–1067. PMID: 15563706.

35. Huang CH, Yang GG, Wu YT, Lee CW. Comparison of inspiratory muscle strength training effects between older subjects with and without chronic obstructive pulmonary disease. J Formos Med Assoc. 2011; 110:518–526. PMID: 21783021.

36. Jain P, Kavuru MS, Emerman CL, Ahmad M. Utility of peak expiratory flow monitoring. Chest. 1998; 114:861–876. PMID: 9743179.

37. Kim J, Davenport P, Sapienza C. Effect of expiratory muscle strength training on elderly cough function. Arch Gerontol Geriatr. 2009; 48:361–366. PMID: 18457885.

38. Tamplin J, Berlowitz DJ. A systematic review and meta-analysis of the effects of respiratory muscle training on pulmonary function in tetraplegia. Spinal Cord. 2014; 52:175–180. PMID: 24418958.

39. Simoes LA, Dias JM, Marinho KC, Pinto CL, Britto RR. Relationship between functional capacity assessed by walking test and respiratory and lower limb muscle function in community-dwelling elders. Rev Bras Fisioter. 2010; 14:24–30. PMID: 20414558.

40. Kim J, Sapienza CM. Implications of expiratory muscle strength training for rehabilitation of the elderly: Tutorial. J Rehabil Res Dev. 2005; 42:211–224. PMID: 15944886.