<p> Recent evidence has demonstrated that isometric handgrip training may improve resting arterial blood pressure. The current study evaluated the ability of simple, spring handgrips to reduce resting arterial blood pressure in normotensive participants using an 8-week randomized controlled design.</p> <p> Forty-nine (age: 66 ± 1) participants, 28 female and 21 males were recruited. All participants completed 5 pre-training sessions, used to familiarize and assess baseline blood pressure, heart rate and maximal hand strength. Maximal hand strength was assessed by three bilateral, maximal contractions with a hand dynamometer. Blood pressure and heart rate were assessed with an automated acquisition system. Participants were stratified to control and intervention groups based on baseline age and blood pressure by matched-pair randomization.</p> <p> Participants in the training condition (n = 25) completed 8 weeks of thrice weekly handgrip training at approximately 30% of their baseline maximal hand strength using a spring handgrip. Seated blood pressure and heart rate were assessed prior to each training session following 10 minutes of isolated rest. Training included 4, 2-minute contractions separated by 2 minutes of rest and completed bilaterally. Control participants (n = 24) completed weekly-seated measurements of blood pressure and heart rate following 10 minutes of isolated rest. Following 8 weeks of intervention all participants completed 3 sessions of post-training measurements.</p> <p> In trained participants, resting systolic and diastolic pressure decreased significantly from pre- to post- (SBP: 122 ± 3 mmHg to 112 ± 3 mmHg, DBP: 70 ± 1 mmHg to 67 ± 1 mmHg) while heart rate remained unaltered. Pulse pressure was significantly reduced with handgrip training, from 52 ± 3 mmHg to 45 ± 3 mmHg. Control participants demonstrated no changes in blood pressure, heart rate and pulse pressure, over the course of the study.</p> <p> In conclusion, spring handgrip training results in significant decreases in systolic, diastolic and pulse pressure. The mechanisms behind these improvements remain unknown and require further investigation.</p> / Thesis / Master of Science (MSc)

<p> This study examined the effects of isometric handgrip training (IHG) on resting blood pressure and resting arterial compliance in the carotid and brachial arteries of medicated hypertensive individuals. Previous studies found that isometric training reduced resting arterial blood pressure (RBP) in high-normal and medicated hypertensive individuals. Investigators have also found an improvement in central arterial compliance with aerobic training and a reduction in central arterial compliance with age, cardiovascular disease and resistance training. The effects of isometric training on arterial compliance have not been examined previously.</p> <p> Ten participants participated in a one-hand IHG intervention, nine participants in a two-hand IHG intervention and 5 participants served as the non-exercising controls. Each experimental group performed four, 30% maximal voluntary IHG contractions for 2 minutes, 3 days a week, for 8 weeks. The one-hand group trained only their non-dominant hand, while the two-hand group trained both hands. Measurements of resting arterial blood pressure, and cross sectional compliance of the brachial and carotid arteries were made pre-training, after four weeks of training and after the completion of the eight-week training protocol.</p> <p> There were no changes in resting arterial blood pressure after training. Mean carotid and brachial artery diameters did not change with resistance training. There were no significant changes in brachial or carotid cross sectional compliance with isometric training. In conclusion, moderated level isometric training did not elicit changes in resting arterial blood pressure and resting muscular and elastic arterial compliance in medicated hypertensive individuals compared to a non-exercising control group.</p> / Thesis / Master of Science (MSc)

Notre comportement au quotidien nécessite la prise en compte d'informations et l'élaboration d'actions qui peuvent nous paraître banales. Il est cependant le fruit d'un traitement élaboré et complexe de la part de notre cerveau. Ce traitement cérébral est à la base des fonctions cognitives et motrices chez l'homme. Si nous voulions enregistrer in situ l'évolution temporelle des signaux cérébraux traduisant notre comportement lors de tâches cognitives et/ou sensori-motrices, nos choix se porteraient sur l'utilisation de méthodes non-invasives utilisées en neuroergonomie. Parmi les méthodes actuellement disponibles en neuroimagerie fonctionnelle, la spectroscopie proche infrarouge (NIRS) quantifiant indirectement l'activité corticale (i.e., modification de la réponse hémodynamique) apparaît la plus pertinente quant à l'appréciation de l'activité corticale en continu. Dans cette thèse, nous nous sommes intéressés, en exploitant la NIRS, à mettre en évidence les corrélats entre l'activité corticale (lobe frontal) et le niveau de sollicitation engendré par des charges de travail dans des tâches cognitives et/ou motrices à des intensités sous-maximales et de difficultés variables. Trois études ont été menées, dont les résultats montrent que l'activité hémodynamique mesurée par NIRS varie en fonction de la charge de travail. L'activité corticale est estimable à une intensité d'effort sous-maximale pour des tâches cognitives et/ou motrices, à condition que l'analyse des signaux soit suffisamment discriminante pour des sollicitations faibles à modérées. Ce travail a révélé la sensibilité et l'utilité de la NIRS dans l'exploration de la charge de travail. / Daily behavior requires taking into account some information and actions planning which may seem trivial for us. However, it is the fruit of a complex and sophisticated processing from the brain. The cerebral processes underlie cognitive and motor functions in humans. In order to record in situ the temporal evolution of cerebral signals reflecting our behavior during cognitive and/or sensorimotor tasks, different non-invasive methods from Neuroergonomics could be used. Among the available functional neuroimaging methods, the near infrared spectroscopy (NIRS) allowing indirectly to measure cortical activity (ie, changes in hemodynamic response) appears relevant to appreciate continuously cortical activity.In this thesis, using NIRS, we were interested in highlighting the correlates between cortical activity (frontal lobe) and the level of stimulation induced by workload during cognitive and/or motor tasks at sub-maximal efforts and variable difficulties. Three studies were conducted. The results indicate that the hemodynamic activity changes by NIRS depend on the workload. The cortical activity is measurable at a sub-maximal intensity for cognitive and/or motor tasks, as long as the signal analysis can discriminate low to moderate loads. This work has revealed the sensitivity and usefulness of NIRS in workload application.

Les travaux de cette thèse s’inscrivent à la frontière des neurosciences et de la physiologie musculaire. Trois études se sont articulées de la préparation et l’exécution motrice. La première étude (A) a relié l'activité cérébrale à l'activité musculaire lors de la préparation motrice. Les résultats ont montré que des régions, telles que le cortex moteur primaire et l’aire motrice supplémentaire sont impliquées dans l'activité du muscle fléchisseur (FDS) alors que d’autres régions, telles que les ganglions de la base, les aires fronto-pariétales et le cervelet, sont impliquées dans l'activité du muscle extenseur (EDC). L’étude (B) a exploré le rôle du réseau cérébro-cérébelleux et du réseau striatal lors de l’exécution d’une tâche cognitive et motivationnelle. Les données ont révélé que la partie antérieure du lobule VI droit était activée par l'exécution motrice tandis que sa partie postérieure était spécifiquement activée par les encouragements verbaux. Les mesures de l’interaction psychophysiologique ont permis de faire immerger une boucle de connectivité fermée et formée par le cortex cérébral, le cervelet et les noyaux rouges. La troisième étude (C) concerne l’effet de la consigne réalisée lors de l’exécution motrice sur les paramètres neuromusculaires de FDS et EDC. Les résultats ont montré que la Force Maximale Volontaire, la Pente Maximale de Montée de Force et l’éléctromyographie associée étaient plus élevées (p < 0.05) avec la consigne accompagnée d’encouragement verbal. / The present work fits on the border of neurosciences and muscular physiology. Three studies explored the brain and muscle activities following motor preparation and execution. The first study (A) linked brain and muscle activity during motor preparation. The results revealed that regions (e.g primary motor cortex and supplementary motor area) are involved in the activity of the flexor muscle (FDS) while other regions (e.g basal ganglia, fronto-parietal areas and cerebellum) are involved in the activity of the extensor muscle (EDC). The study (B) explored the role of cerebro-cerebellar and striatal networks during the execution period of cognitive and motivational task. The data showed that the anterior part of the right lobule VI was activated by the motor task, while its posterior part was specifically activated by verbal encouragement. Measurements of psychophysiological interaction revealed a closed connectivity loop formed by the cerebral cortex, the cerebellum and the red nuclei. The third study (C) concerned the effect of instruction on neuromuscular parameters of FDS and EDC muscles during motor execution. The results showed that the Maximum Voluntary Force, the Maximum Rate of Force Development and the associated electromyographic signal are the highest (p < 0.05) with cognitive, motivational and verbal encouragement condition.

This master's thesis deal with the ability to maintain trunk stability in paraplegic patients in the relation to the functional skills of upper extremity. Its aim is to determine the extent to which posture influences grip strength in these persons. It consists of two parts. The first part includes introduction of the spinal cord injury and findings of the mechanisms and functional significance of the torso in relation to posture and everyday activities. Further, it presents the possibilities of utilization and different ways of measurement of grip strength in clinical practice. In the second part, the results of the measurement of grip strength in paraplegic persons in three different positions - lying on the back and in two different sitting positions - are analyzed. The measurements were undertaken using a dynamometer. It was measured twice, always after one week period. All patients attend the standard therapy provided by the Spinal Unit in the University Hospital in Motol, where they have been also hospitalized in that time. The results refer to certain dependency of gripstrength of upper extremity to posture in paraplegic persons. This was proved within the comparison of values from sitting position with back support and without back support. In the first named position were reached higher...

Background: In 2014, there were nearly 2 billon overweight people around the world. This causes excessive costs for the society and is also a threat to the human condition. In recent time, there has been an increase of understanding the individual parts of the body composition. One method to measure body composition is using a bioelectrical impedance analyzer. The current recommendation is to measure during fasting conditions. However, there are few studies that have investigated a meal’s effect on body composition measured with bioelectrical impedance analysis, and those studies have presented varying results. If a bioelectrical impedance analyzer could be used without previous fasting, it would increase the use and utility of bioelectrical impedance analyzers. This could in turn, for example, reduce waiting lists in hospitals where bioelectrical impedance analyzers are used. Aim: The main aim of this study was to investigate a meal’s effect on body composition when measured with a bioelectrical impedance analyzer. The secondary aim was to investigate the correlation between skeletal muscle mass and hand grip strength when using a bioelectrical impedance analysis and a hand-held dynamometer respectively, during fasting conditions. Methods: In this present study, 27 subjects in the age of 21-59 years old participated. The subjects arrived at the laboratory in the morning during fasting conditions. Firstly, a bioelectrical impedance analyze and a hand grip strength test were completed. Thereafter, all subjects ate a meal containing at least 500 kcal. The following bioelectrical impedance analysis were completed 60, 90 and 120 minutes’ post meal intake. The data was then analyzed in SPSS version 20 through a paired T-test and a Pearson correlation test respectively. Results: The results showed that all body composition parameters investigated in this present study, except for minerals, not were statistically different 90 minutes after a meal intake containing at least 500 kcal, compared to the fasting condition, when measured with a bioelectrical impedance analyzer. Furthermore, a moderate correlation was found between hand grip strength and skeletal muscle mass for women. The same correlation was found weak for men. Conclusion: The results from this present study indicates that it is possible to measure body composition with a bioelectrical impedance analyzer 90 minutes’ post meal intake, except for minerals. Also, it indicates that a hand grip strength test is not a valid test for measuring skeletal muscle mass.

In this study, we analyzed elderly people in Thailand to identify the validity of suggested cutoff points of physical measures, handgrip strength, usual walking speed, and a composite score of both measures to predict functional limitations. Moreover, we examined whether these physical performance measures are accurate indicators of the investigated health outcomes. Methods: Using Receiver Operating Characteristics (ROC) analysis, we investigated a sample of 8272 respondents aged 60 to 79 years. All data were based on the 2009 National Health Examination Survey (NHES IV) of Thailand. Results: For males aged 60 to 69 years, handgrip strength was used as an indicator of functional limitations. The cutoff point for disabilities in the activities of daily living (ADLs) was 29.5 kg, while in other limitations it ranged from 28.7 to 31.3 kg. In contrast, usual walking speed was able to indicate ADL disabilities at 0.7 m per second (m/s). As one might expect, the cutoff points for males aged 70 to 79 years were lower than for males in the 60 to 69 age group. For females, handgrip strength was able to indicate ADL disabilities at 16.5 kg for both the 60 to 69, and 70 to 79 age groups. Likewise, walking speed was indicative of ADL disabilities at 0.6 m/s for both age groups. Interestingly, the composite measure increases the ability to detect ADL disabilities in the younger group but not in the older group. The area under the curve (AUC) of cutoffs measuring the detection power of a diagnostic test was varied, ranging from 0.535 to 0.7386. Conclusions: The cutoff points of three measures varied according to sex and type of functional limitations. Our findings also showed that physical performance measures were useful for identifying people with an increased risk of functional limitations, particularly for ADL disabilities. However, although the AUC of the cutoffs of other functional limitations were relatively low, they should be considered with caution.

Introdução: O ângulo de fase (AF), derivado da análise de bioimpedância elétrica (BIA), tem sido interpretado como indicador de integridade da membrana celular; e a dinamometria manual têm sido usados como indicadores de prognóstico em algumas situações clínicas. Objetivos: avaliar o comportamento do AF e da dinamometria manual em pacientes submetidos à cirurgia cardíaca e associá-los com EuroSCORE e desfechos clínicos. Métodos: Estudo de coorte prospectivo com 50 pacientes submetidos à cirurgia cardíaca, com idade ≥18 anos, entre janeiro de 2015 e outubro de 2015. O AF e a dinamometria manual foram aferidos em três momentos: pré-operatório, pré-alta hospitalar e três meses após à cirurgia. Também foram coletadas as seguintes variáveis: tempo de circulação extracorpórea (CEC), isquemia, ventilação mecânica (VM), tempo de internação na Unidade de Terapia Intensiva (UTI) e tempo de internação hospitalar após à cirurgia e foi calculado o EuroSCORE. Resultados: Os pacientes foram de predominância do sexo masculino 32 (64%) com idade média de 62,8 ± 10,2 anos, tempo de estadia na UTI de 3 dias (2 – 23), tempo de internação pré-operatória de 7 (5 – 61) dias e EuroSCORE 4 (0 – 10) dias. Houve redução do AF, com diferença entre o período pré-operatório e os dois momentos de avaliação no pós-operatório (p<0,001). Quando a dinamometria manual foi avaliada ao longo do tempo foi observada uma redução entre o préoperatório e a pré-alta hospitalar (p<0,001) e recuperação dessa nos três meses após à cirurgia (p<0,001). A VM e o EuroSCORE tiveram correlação inversa com o AF e a dinamometria manual nos três momentos. A correlação do AF no período pré-operatório do EuroScore p=0,007 e o segundo e o terceiro momento p<0,001, e para os três momentos da VM (p<0,001), respectivamente. Já a correlação da dinamometria manual no primeiro e no segundo momento com o EuroSCORE e a VM p <0,001 e no terceiro momento p=0,010 e p=0,018, respectivamente. Conclusões: O AF e a dinamometria manual parecem estar associados ao tempo de VM, tempo de internação na UTI e tempo de internação no pós-operatório em pacientes submetidos à cirurgia cardíaca. / Background and aims: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), have been interpreted as cell membrane integrity indicator; and the handgrip strength (HGS) have been used as prognostic indicators in some clinical situations. This study aims to evaluate the PA and HGS behavior in patients undergoing cardiac surgery and associate these with clinical outcomes and prognostic. Methods: Cohort prospective study of consecutive recruited patients undergoing cardiac surgery aged ≥18 years. The PA and HGS were measured at three set points: preoperatively, hospital predischarge and three months after surgery. Were also collected: time of cardiopulmonary bypass (CPB), ischemia, mechanical ventilation (MV), length of stay (LOS) in Intensive Care Unit (ICU) and LOS after surgery and calculated the EuroSCORE. Results: A decrease in PA was observed between the preoperative and the two postoperative stages (p<0.001). When the HGS was evaluated over time was seen a reduction between preoperative and predischarge (p<0.001) and a recovery in three months after surgery (p<0.001). The MV and EuroSCORE had an inverse association with PA and HGS in three stages. PA correlation in the first stage of the EuroSCORE p=0.007 and the second and third stage p<0.001, and for the three stages of MV (p<0.001), respectively. In HGS correlation in the first and second stage of the EuroSCORE and MV p<0,001 and in the third stage p=0.010 and p=0.018, respectively. Conclusion: PA and HGS appears to be related to MV time, LOS in ICU and LOS after surgery in patients undergoing cardiac surgery.

Malnutrition is concerning in children because it effects proper growth and development. Handgrip Strength (HGS) has been identified as a diagnostic indicator for identifying pediatric malnutrition but normal reference ranges have not yet been established; therefore, HGS can be used to identify malnutrition but not quantify the degree of malnutrition: mild, moderate, or severe. The aim of this study was to determine if HGS differed between hospitalized and non-hospitalized children and to describe the association between HGS and several parameters including height, weight, body mass index (BMI), and mid-upper arm circumference (MUAC). One hundred nine hospitalized and 110 non-hospitalized pediatric patients ages 6-14 years participated in this cross sectional, nonequivalent control group design study. Nutrition status was evaluated using BMI z scores and MUAC z scores, and HGS was evaluated within 48 hours of hospital admission or at a well-child appointment. According to BMI z scores, 24.8% of hospitalized and 18.3% of non-hospitalized participants were malnourished. Mean HGS of hospitalized participants was not significantly different from non-hospitalized participants (p=.2053). HGS was found to be associated with age, height, dominant hand, and MUAC z scores in all participants. The difference in HGS measurements was not statistically significant between hospitalized and non-hospitalized children using a one-time HGS measurement. Further research examining HGS measurements over time as well as comparing HGS measurements to the degree of malnutrition deficit in pediatrics is needed.

Functional magnetic resonance imaging (fMRI) can be used to track neural activation in the brain during functional activities. The purpose of this study was to investigate brain neural responses to blood flow restricted (BFR) versus control handgrip exercise. Using a randomized crossover design, 25 subjects (12 males, 13 females) completed handgrip exercises during two conditions: BFR vs. control. To familiarize participants with the exercise conditions, one week prior to MRI scanning participants completed each exercise condition once on separate days, with 72 hours between days. The following week fMRI scans were performed at the same time of day, separated by 72 hours. The exercise protocol consisted of five 30-second sets of squeezing a nonmetallic handgrip exerciser (a reported 13.6 kg resistance), doing as many repetitions as possible, with 20-second rest intervals between sets. We saw a significant main effect of exercise condition (BFR versus control) between premotor dorsal (PMd)(F = 5.71, p = 0.022), premotor ventral (PMv)(F = 8.21, p = 0.007), and right ventral striatum (VS_R)(F = 7.36, p = 0.01). When considering anatomical regions of interest, we did not find significant differences between exercise conditions in bilateral S1 (p > 0.82), primary motor cortex (M1)(p > 0.33), supplementary motor area (SMA)(p > 0.66), cerebellum (CB)(p > 0.70), insular cortex (INS)(p > 0.45), anterior cingulate cortex (ACC)(p > 0.24), or thalamus (TH)(p > 0.66). Bilateral ACC (ACC_B), right middle frontal gyrus (MFG_R), and the right primary sensory cortex (S1_R) showed significant linear trends (p = 0.001) over the five exercise sets. Finally, the S1_R, left primary sensory cortex (S1_L), and the right anterior cingulate cortex (ACC_R) showed a main effect of set (p < 0.02). These data demonstrate that acute training with BFR during handgrip exercise results in different neural activation patterns in select areas of the brain, compared to a control. These results show that while completing less work with BFR exercise, subjects can achieve a similar amount of brain neural activation as with a higher-volume exercise. Brain neural activation is important to overall patient health and these findings may be important for prescribing training with BFR in clinical and applied research settings.