Early changes in isokinetic lower limb muscle strength in recovering geriatric subjects on the basis of nutritional status.
BACKGROUND
In older people, the decrease in muscle mass and strength has a bad effect on functional status. Malnutrition and lack of physical activity exacerbate this phenomenon.


OBJECTIVE
The main purpose of this study was to estimate isokinetic lower limb muscle strength in recovering older subjects on the basis of nutritional status.


METHODS
Twenty-eight elderly subjects hospitalized for an acute event (85.8 +/- 6 years), including 16 malnourished, were enrolled in this study when clinically stable (T0). Re-assessment at one-month was performed in nine after oral supplementation and conventional physiotherapy (T1). The Maximal Peak Torque (MPT) of the ankle plantar flexors was estimated in concentric mode at 30 and 60 degrees /s. The MPT of the knee flexors and extensors was evaluated in the same mode at 30 degrees /s, 60 degrees /s and 120 degrees /s. All patients underwent a nutritional examination with anthropometric measures, dietary intake survey, biochemical indexes and determination of the medial gastrocnemius volume by magnetic resonance imaging.


RESULTS
At T0, whatever the muscle group tested (except at 120 degrees /s for the knee), the MPT appeared significantly lower in the malnourished group. At T1, the increase in MPT (plantar flexors) in malnourished patients was greater at 60 degrees /s (+23.8 %) than at 30 degrees /s (+14.8 %). Correlations between MPT and nutritional parameters were observed in the malnourished group only at T1 and in the normal-nourished group.


CONCLUSIONS
Isokinetic assessment seems to be a pertinent method to estimate lower limb muscle strength in older and frail subjects. Early modifications in strength were observed in malnourished patients who received oral supplementation and physiotherapy.
Dehail
P
P
Departement de Geriatrie, Unite de Soins de Suite et Readaptation - CHU Bordeaux - Hopital Xavier-Arnozan, 33604 Pessac Cedex, France. patrick.dehail@chu-bordeaux.fr
Joseph
P-A
PA
Faux
P
P
Rainfray
M
M
Emeriau
J P
JP
Barat
M
M
Bourdel-Marchasson
I
I
D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D019587:Dietary Supplements; D005260:Female; D006760:Hospitalization; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D009752:Nutritional Status; D026741:Physical Therapy Modalities; D011502:Protein-Energy Malnutrition / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*