Re: Couple of interesting studies

[Guest guest]

Both studies are very interesting. However strengthening their quadriceps will

probably not improve their outcome, rather the weak quads are a symptom of and

not the cause of overall poor health.

Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Flory <daflory@...>

Supertraining

Sent: Tue, March 15, 2011 10:24:06 AM

Subject: Couple of interesting studies

1 Swallow, beth B., et al, " Quadriceps strength predicts mortality in

patients with moderate to severe chronic obstructive pulmonary disease, "

Thorax2007;62:115-120

2 Kamiya, Kentaro, et al, " Decreased Strength of Quadriceps Increases the Risk

of Mortality... " Circulation 2010;122:A12709

Couple of studies some might find interesting, particularly pertinent, I think,

to the recent discussion of elder training.

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!

[Guest guest]

> On Mar 15, 2011, at 1:19 PM, Ralph Giarnella wrote:

>

> Both studies are very interesting. However strengthening their quadriceps

will

> probably not improve their outcome, rather the weak quads are a symptom of and

> not the cause of overall poor health.

>

> Ralph Giarnella MD

> Southington Ct. USA

>

That's what I was thinking. The exercise to strengthen the quads would probably

have a beneficial effect on Heart Health, and stronger quads would perhaps

reduce the falling down injuries that often lead in to fractures and

complications which result in death (pneumonia) in the elderly. Correlation does

not necessarily equal cause. :-)

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!

[Guest guest]

I hope these studies considered causality properly. 

For example, does decreased quad strength lead to earlier death, or does poor

health and aging lead to decreased quad strength and also mean you are closer to

the end?

This also begs the question " can increasing quad strength lengthen lifespan " ?

Ed White

Sandwich MA USA

From: Flory <daflory@...>

Subject: Couple of interesting studies

Supertraining

Date: Tuesday, March 15, 2011, 10:24 AM

 

1 Swallow, beth B., et al, " Quadriceps strength predicts mortality in

patients with moderate to severe chronic obstructive pulmonary disease, "

Thorax2007;62:115-120

2 Kamiya, Kentaro, et al, " Decreased Strength of Quadriceps Increases the Risk

of Mortality... " Circulation 2010;122:A12709

Couple of studies some might find interesting, particularly pertinent, I think,

to the recent discussion of elder training.

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!

[Guest guest]

Quadriceps strength predicts mortality in patients with moderate to severe

chronic obstructive pulmonary disease

+ Author Affiliations

1. 1Respiratory Muscle Laboratory, Royal Brompton Hospital, London, UK

2. 2Respiratory Muscle Laboratory, King’s College London School of Medicine,

Strand, London, UK

3. 3Department of Biostatistics and Medical Informatics, Hôspital Saint-Louis,

Paris, France

1. Correspondence to:

Dr E B Swallow

Respiratory Muscle Laboratory, Royal Brompton Hospital, Fulham Road, London SW3

6NP, UK; e.swallow@...

* Received 8 March 2006

* Accepted 9 September 2006

* Published Online First 7 November 2006

Abstract

Background: Prognosis in chronic obstructive pulmonary disease (COPD) is poorly

predicted by indices of air flow obstruction, because

other factors that reflect the systemic nature of the disease also influence

prognosis.

Objective: To test the hypothesis that a reduction in quadriceps maximal

voluntary contraction force (QMVC) is a useful predictor of

mortality in patients with COPD.

Methods: A mortality questionnaire was sent to the primary care physician of

184 patients with COPD who had undergone quadriceps strength measurement over

the past 5 years. QMVC was expressed as a percentage of the patient’s body

mass

index. The end point measured was death or lung transplantation, and median

(range) follow-up was 38 (1–54) months.

Results: Data were obtained for 162 patients (108 men and 54 women) with a mean

(SD) percentage of forced expiratory volume in 1 s

(FEV1) predicted of 35.6 (16.2), giving a response rate of 88%. Transplant-free

survival of the cohort was 93.5% at 1 year and 87.1% at 2 years. regression

models showed that the mortality risk increased with increasing age and with

reducing QMVC. Only age (HR 1.72 (95% CI 1.14 to 2.6); p = 0.01) and QMVC

(HR

0.91 (95% CI 0.83 to 0.99); p = 0.036) continued to be significant

predictors

of mortality when controlled for other variables in the multivariate analysis.

Conclusion: QMVC is simple and provides more powerful prognostic information on

COPD than that provided by age, body mass index and forced

expiratory volume in 1 s.

Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Ed White <kitesurfer257@...>

Supertraining

Sent: Wed, March 16, 2011 9:09:11 AM

Subject: Re: Couple of interesting studies

I hope these studies considered causality properly.

For example, does decreased quad strength lead to earlier death, or does poor

health and aging lead to decreased quad strength and also mean you are closer to

the end?

This also begs the question " can increasing quad strength lengthen lifespan " ?

Ed White

Sandwich MA USA

From: Flory <daflory@...>

Subject: Couple of interesting studies

Supertraining

Date: Tuesday, March 15, 2011, 10:24 AM

1 Swallow, beth B., et al, " Quadriceps strength predicts mortality in

patients with moderate to severe chronic obstructive pulmonary disease, "

Thorax2007;62:115-120

2 Kamiya, Kentaro, et al, " Decreased Strength of Quadriceps Increases the Risk

of Mortality... " Circulation 2010;122:A12709

Couple of studies some might find interesting, particularly pertinent, I think,

to the recent discussion of elder training.

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!

[Guest guest]

Core 2. Epidemiology and Prevention of CV Disease: Physiology, Pharmacology and

Lifestyle

Session Title: Exercise and Cardiac Rehabilitation in Heart Failure

Abstract 12709: Decreased Strength of Quadriceps Increases the Risk of Mortality

in Patients with Chronic Heart Failure.

Kentaro Kamiya; Takashi Masuda; Atsuhiko Matsunaga; Kazumasa Miida; Misao N

Ogura; Masahiko Kimura; Chiharu Noda; Minako Ymaoka-Tojo; Takayuki Inomata;

Tohru Izumi

Kitasato Univ Hosp, Sagamihara, Japan; Kitasato Univ, Sagamihara, Japan;

Kitasato Univ Hosp, Sagamihara, Japan; Kitasato Univ, Sagamihara, Japan;

Kitasato Univ Sch of medicine, Sagamihara, Japan

Background: Although cardiac cachexia is characterized by anexaggerated loss of

skeletal muscle mass and muscle weakness,the diagnostic value of its muscle

weakness was still undetermined.The purpose of this study was to investigate the

relationshipbetween quadriceps strength and cardiovascular mortality inpatients

with chronic heart failure (CHF) and to clarify thelevel of quadriceps strength

that indicates a poor prognosis.

Methods: The isometric muscle strength of quadriceps was prospectivelymeasured

at the hospital discharge in 90 consecutive CHF patients,63 males and 27 females

aged 67.9 ± 12.6 yrs, which wasexpressed as % body weight (%BW). Cardiovascular

mortality wasanalyzed with a proportional-hazards models based on

cardiovascularrisk factors including age, medications, brain natriuretic

peptide,estimated glomerular filtration rate and left ventricular

ejectionfraction.

Results: During the follow-up period of 340±240 days,9 patients died of

cardiovascular events. The relation betweenquadriceps strength and event free

survival rate is shown inFigure. Patients who had lower quadriceps strength had

significantlylower survival, and their mortality risk was increased by

2.67-foldper 10 %BW decrease (95% confidence interval: 1.06 to 6.67,P<0.05).

Patients with <30%BW of quadriceps strength hada 12.85-fold higher mortality

risk as compared with those with40%BW. The two-year mortality rate indicated by

quadriceps strengthof <30%BW was 51%.

Conclusion: A Quadriceps strength of <30%BW indicated a poorprognosis in

patients with CHF.

Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Ed White <kitesurfer257@...>

Supertraining

Sent: Wed, March 16, 2011 9:09:11 AM

Subject: Re: Couple of interesting studies

I hope these studies considered causality properly.

For example, does decreased quad strength lead to earlier death, or does poor

health and aging lead to decreased quad strength and also mean you are closer to

the end?

This also begs the question " can increasing quad strength lengthen lifespan " ?

Ed White

Sandwich MA USA

From: Flory <daflory@...>

Subject: Couple of interesting studies

Supertraining

Date: Tuesday, March 15, 2011, 10:24 AM

1 Swallow, beth B., et al, " Quadriceps strength predicts mortality in

patients with moderate to severe chronic obstructive pulmonary disease, "

Thorax2007;62:115-120

2 Kamiya, Kentaro, et al, " Decreased Strength of Quadriceps Increases the Risk

of Mortality... " Circulation 2010;122:A12709

Couple of studies some might find interesting, particularly pertinent, I think,

to the recent discussion of elder training.

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!

[Guest guest]

Both studies, for which I provided an abstract in the previous postings,

indicate that poor quad strength indicates a poor prognosis. I one study it was

in patients with severe respiratory problems and in the other patiets with

cardiac problems. The poor quad strength was not a contributor to poor outcome

but rather an prognostic indicator of poor outcome.

Having dealt with patients in both conditions their poor health precludes any

significant exercise and as a result they suffer from cachexia.

Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Ralph Giarnella <ragiarn@...>

Supertraining

Sent: Wed, March 16, 2011 3:43:38 PM

Subject: Re: Couple of interesting studies

Quadriceps strength predicts mortality in patients with moderate to severe

chronic obstructive pulmonary disease

+ Author Affiliations

1. 1Respiratory Muscle Laboratory, Royal Brompton Hospital, London, UK

2. 2Respiratory Muscle Laboratory, King’s College London School of Medicine,

Strand, London, UK

3. 3Department of Biostatistics and Medical Informatics, Hôspital Saint-Louis,

Paris, France

1. Correspondence to:

Dr E B Swallow

Respiratory Muscle Laboratory, Royal Brompton Hospital, Fulham Road, London SW3

6NP, UK; e.swallow@...

* Received 8 March 2006

* Accepted 9 September 2006

* Published Online First 7 November 2006

Abstract

Background: Prognosis in chronic obstructive pulmonary disease (COPD) is poorly

predicted by indices of air flow obstruction, because

other factors that reflect the systemic nature of the disease also influence

prognosis.

Objective: To test the hypothesis that a reduction in quadriceps maximal

voluntary contraction force (QMVC) is a useful predictor of

mortality in patients with COPD.

Methods: A mortality questionnaire was sent to the primary care physician of

184 patients with COPD who had undergone quadriceps strength measurement over

the past 5 years. QMVC was expressed as a percentage of the patient’s body

mass

index. The end point measured was death or lung transplantation, and median

(range) follow-up was 38 (1–54) months.

Results: Data were obtained for 162 patients (108 men and 54 women) with a mean

(SD) percentage of forced expiratory volume in 1 s

(FEV1) predicted of 35.6 (16.2), giving a response rate of 88%. Transplant-free

survival of the cohort was 93.5% at 1 year and 87.1% at 2 years. regression

models showed that the mortality risk increased with increasing age and with

reducing QMVC. Only age (HR 1.72 (95% CI 1.14 to 2.6); p = 0.01) and QMVC

(HR

0.91 (95% CI 0.83 to 0.99); p = 0.036) continued to be significant

predictors

of mortality when controlled for other variables in the multivariate analysis.

Conclusion: QMVC is simple and provides more powerful prognostic information on

COPD than that provided by age, body mass index and forced

expiratory volume in 1 s.

Ralph Giarnella MD

Southington Ct. USA

________________________________

From: Ed White <kitesurfer257@...>

Supertraining

Sent: Wed, March 16, 2011 9:09:11 AM

Subject: Re: Couple of interesting studies

I hope these studies considered causality properly.

For example, does decreased quad strength lead to earlier death, or does poor

health and aging lead to decreased quad strength and also mean you are closer to

the end?

This also begs the question " can increasing quad strength lengthen lifespan " ?

Ed White

Sandwich MA USA

From: Flory <daflory@...>

Subject: Couple of interesting studies

Supertraining

Date: Tuesday, March 15, 2011, 10:24 AM

1 Swallow, beth B., et al, " Quadriceps strength predicts mortality in

patients with moderate to severe chronic obstructive pulmonary disease, "

Thorax2007;62:115-120

2 Kamiya, Kentaro, et al, " Decreased Strength of Quadriceps Increases the Risk

of Mortality... " Circulation 2010;122:A12709

Couple of studies some might find interesting, particularly pertinent, I think,

to the recent discussion of elder training.

Fair winds and happy bytes, Dave Flory, Flower Mound, TX, U.S.A.

--

Speak softly, study Aikido, & you won't need to carry a big stick!