title: Upper and lower extremity muscle strength levels associated with an exercise capacity of 5 metabolic equivalents in male patients with heart failure.
abstract: OBJECTIVE
  Exercise capacity of fewer than 5 metabolic equivalents (METs) has been associated with high risk of death and poor physical functioning in male patients with heart failure (HF). Therefore, we aimed to determine upper and lower extremity muscle strength levels required to attain an exercise capacity of 5 or more METs in male outpatients with HF.
  
  
  METHODS
  We enrolled 148 male HF patients (age 60.1 ± 1.0 years). Peak oxygen uptake (peak (Equation is included in full-text article.)o2) was assessed by cardiopulmonary exercise testing (CPX). After CPX, we further divided the patients into groups according to exercise capacity: 5 or more METs (group A, n = 85) and fewer than 5 METs (group B, n = 63). Handgrip strength and knee extensor and flexor muscle strengths were assessed as indices of upper and lower extremity muscle strength, respectively. Receiver operating characteristic curves were used to select cutoff values for upper and lower extremity muscle strength resulting in an exercise capacity of 5 or more METs in these patients.
  
  
  RESULTS
  Exercise capacity of 5 or more METs in male HF patients was equivalent to approximately 35.2 kgf of handgrip strength and 1.70 Nm/kg of knee extensor and 0.90 Nm/kg of knee flexor muscle strengths.
  
  
  CONCLUSIONS
  These upper and lower extremity muscle strength values may be useful target goals for improvement of exercise capacity, risk management, and activities of daily living in male HF patients.
authors.affiliation: Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kanagawa, Japan. izawapk@ga2.so-net.ne.jp
authors.forename: Kazuhiro P
authors.initials: KP
authors.lastname: Izawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Oka
authors.forename: Koji
authors.initials: K
authors.lastname: Hiraki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morio
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hironobu
authors.initials: H
authors.lastname: Katata
authors.forename: Naohiko
authors.initials: N
authors.lastname: Osada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Omiya
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D010101:Oxygen Consumption; D012372:ROC Curve; D034941:Upper Extremity / Q000502:physiology*