A Systematic Review of Isokinetic Muscle Strength in a Healthy Population With Special Reference to Age and Gender.

CONTEXT: Despite increasing use of reference values in isokinetic measurements and increasing importance, there is no systematic review of the reference values for lower and upper limb isokinetic muscle strength. OBJECTIVE: A systematic review to analyze studies on the reference values and protocols for the measurement for upper and lower limb isokinetic muscle strength in an untrained and noninjured healthy population. DATA SOURCES: MEDLINE, Scopus, Scielo, and CINAHL (from the earliest date available to June 2020). STUDY SELECTION: Studies that measured a set of reference values for isokinetic muscle strength. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Two reviewers selected studies independently. Data related to participants characteristics, outcomes of interest, isokinetic parameters, reference values for isokinetic muscle strength, and quality of evidence assessment were systematically reviewed independently by 2 authors. RESULTS: A total of 31 studies met the study criteria. The included studies were used to synthesize the isokinetic muscle strength data according to age-group and sex. We extracted 1845 normative data related to isokinetic strength. Of these, 1181 items referred to lower limbs and 664 items to upper limbs. CONCLUSION: In general, agonist muscle groups are stronger than antagonist muscles, and the men tend to obtain higher strength values than women. The angular velocity varied from 10 to 300 deg/s. The reference values identified can be useful for professionals to obtain during the isokinetic evaluation of the diagnostic parameters of muscle deficiency.

Effectiveness of sacubitril-valsartan in patients with cancer therapy-related cardiac dysfunction: a systematic review of clinical and preclinical studies.

INTRODUCTION: Cancer therapy-related cardiac dysfunction (CTRCD) is a critical problem with an impact on both oncological and cardiovascular prognosis, especially when it prevents patients from receiving cancer treatment. However, there are very limited data on the efficacy of sacubitril/valsartan in the prevention and treatment of cardiotoxicity. This systematic review aimed to evaluate the potential benefit of sacubitril/valsartan in patients with CTRCD. EVIDENCE ACQUISITION: The databases included MEDLINE, Embase, LILACS, Scopus and Cochrane Central up to January 20, 2022. All pre-clinical and clinical studies including observational studies (cohorts, case-control, cross-sectional and case reports) that used sacubitril/valsartan for prevention or treatment of CTRCD. The primary effectiveness endpoints was CTRCD, defined as a clinically significant change in left ventricular ejection fraction (LVEF) at the end of the follow-up. EVIDENCE SYNTHESIS: And after applying the eligibility criteria, 12 articles (9 in humans and 3 preclinical studies) were included in this systematic review. The 3 preclinical studies demonstrated beneficial effects in preventing, attenuating and/or delaying the onset of myocardial damage at the cellular level, ventricular dysfunction and remodeling. Regardind human studies, most of them were composed of case reports. The largest study consisted of a retrospective multicentric cohort with 64 patients. CONCLUSIONS: All clinical studies have demonstrated that used Sac/Val in human showed a significant increase in LVEF, and when reported, a reduction in left ventricular volume and NT-proBNP (or BNP). Randomized clinical trials are needed to confirm this hypothesis.

Content comparisons of stroke-specific quality of life based upon the international classification of functioning, disability, and health.

PURPOSE: To link the concepts underlying the Stroke-Specific Quality of Life (SS-QOL) scale with those of the International Classification of Functioning, Disability, and Health (ICF), which are two different perspectives to consider functioning and health. This will facilitate the understanding of the relationships between the SS-QOL and the ICF. One of the purposes of the ICF is to be used as a common terminology and a clinical problem-solving tool in clinical and research settings. The ICF concept of functioning can also serve as the basis for the operationalization of the health-related quality of life. Thus, efforts should be made to allow the concurrent use of the ICF and health measurements in both clinical and research settings. METHODS: Linking of the SS-QOL concepts with the ICF categories was carried out by two independently trained health care professionals who applied the standardized eight linking rules that were specifically developed and updated for this purpose. The degree of agreement between the health care professionals was determined by kappa coefficients. RESULTS: Of the 49 items of the SS-QOL, 54 concepts were identified. The level of agreement between the health care professionals showed that the kappa coefficients ranged from 0.75 to 1.00. Three concepts (5.5%) could not be linked to the ICF and were coded as not covered. Fifty-one were linked to the ICF categories for the following components: 22 (41%)-body functions; 26 (48%)-activities and participation; and three (5.5%)-environmental factors. Eleven ICF chapters were identified. CONCLUSIONS: Several categories of the ICF were linked to the items of the SS-QOL, with acceptable levels of agreement. These categories were specific and meaningful for stroke subjects, since the majority of the identified concepts were included in the comprehensive ICF core set for stroke. The findings indicated that the ICF provided a useful framework for the conceptual understanding of the SS-QOL, which demonstrated multiple representations of the ICF categories and covered a broad range of the ICF components that were meaningful for the stroke subjects.