Introduction: Investigations of muscle dysfunction in patients with idiopathic pulmonary fibrosis (IPF) are limited to peripheral muscles. However, decreased thoracic muscle mass is known and deterioration of chest wall muscle strength is not clear. Objective: The aims of the present study were to evaluate pectoralis muscle strength located on the chest wall and to investigate the relationship of spirometric measurements and respiratory muscle strength with pectoralis muscle strength. Methods: Elderly patient with IPF (mean disease duration 7.47 +/- 7.04 years) and the age-and sex-matched healthy volunteers were recruited in this cross-sectional study. The pulmonary function test was performed by a portable spirometer for spirometric variables and a gas analyzer for diffusing capacity for carbon monoxide (DLCO). Maximal inspiratory (MIP) and expiratory pressure (MEP) were measured with mouth pressure device. Modified Medical Research Council Dyspnea Scale (MMRC) was used to determined dyspnea severity. The pectoralis muscle strength was assessed isometrically during shoulder joint horizontal adduction movement with a hand-held dynamometer. Results: A total of 17 patients with IPF (9 males, mean age 69.06 +/- 3.94 years) and 19 healthy controls (10 males, mean age 70.95 +/- 4.99 years) were included. Patients with IPF had lower pectoralis muscle strength than healthy controls (p<0.001). Significant relationships were found between pectoralis muscle strength and MIP (r=0.79, p<0.001), MEP (r=0.81, p<0.001), FEV1% (r=0.54, p=0.02), FVC% (r=0.68, p<0.003) and DLCO (r=0.61, p=0.009). With multiple linear regression analysis, pectoralis muscle strength was the only independent predictor of FVC% (adjusted R-2=0.37, p<0.05). Conclusion: In patients with IPF, pectoralis muscle strength decreases and is associated with pulmonary function. In particular pectoralis muscle strength is likely to have an important impact on FVC%. Therefore, we consider that this test should be included routinely in chest diseases and rehabilitation clinics.

Purpose: To investigate the relationship of upper extremity exercise capacity (UEEC) with activities of daily living (ADL), handgrip strength, handgrip endurance, and anthropometric and clinical characteristics in patients with heart failure (HF). Methods: In 48 patients with HF and 50 age- and sex-matched healthy controls, we evaluated UEEC, handgrip strength and endurance, and AD using the 6-minute pegboard ring test (6PBRT), a hydraulic hand dynamometer, and the London Chest Activity of Daily Living (LCADL) scale, respectively. Results: Clinical characteristics were similar between patients with HF (mean age 63.21 ± 8.55 years, 42% female) and healthy controls (mean age 60.16 ± 8.64 years, 54 % female, P > .05). Patients with HF had significantly reduced 6PBRT scores (Cohen’s d = − 1.906), handgrip strength (Cohen’s d = − 0.595), and handgrip endurance (Cohen’s d = − 1.791), as well as higher LCADL scores (Cohen’s d = 1.628) compared to healthy controls ( P < .05). The 6PBRT score showed strong positive correlation with handgrip endurance (r = 0.595, P < .001) and moderate positive correlation with total work capacity (r = 0.497, P < .001). The LCADL _%total revealed a moderate negative correlation with handgrip strength (r = − 0.495, P < .001) and total work capacity (r = − 0.493, P < .001) and a moderate positive correlation with body mass index (r = 0.477, P = .001) in patients with HF. Performance of ADL was not correlated to 6PBRT score in patients with HF. Also, the diagnosis of HF and handgrip endurance were the strongest predictors for 6PBRT score ( P < .05). Conclusions: Patients with HF exhibited a clinically significant decrease in their UEEC. Based on our findings, this decline is likely associated with handgrip endurance.

Rationale: Exercise capacity declines with age. However, the effect of common geriatric symptoms, that are related to physical performance, on exercise capacity is unclear.Aims: The study aimed to determine the impacts of sarcopenia, frailty, balance, and depression on both overall and abnormal exercise capacity.Methods: One hundred and nineteen community‐dwelling older adults over 65 years of age were included in the cross‐sectional study. Sarcopenia and frailty status were determined according to the “European Working Group on Sarcopenia in Older People2” and “Fried frailty criteria”, respectively. Exercise capacity, balance and depression were assessed with the 6‐min walk test (6MWT), the Timed Up and Go Test (TUG) and the Geriatric Depression Scale (GDS), respectively.Results: Of the participants, 5% were sarcopenic, 32.8% were frail, and 29.4% had abnormal exercise capacity (6MWT < 82% pred). According to multivariate linear regression analysis, the model consisting of sarcopenia, frailty, TUG and GDS was explained 53% of the variation in 6MWT (R = 0.73, R² = 0.53, p < 0.001), and all variables except GDS were independent predictors of exercise capacity (p < 0.05). Sarcopenia was the strongest predictor of 6MWT (β =−79.76, p = 0.011). The model including sarcopenia, TUG, frailty, and GDS provided 29% prediction of abnormal exercise capacity (Nagelkerke R² = 29.7, p < 0.001), while TUG was the sole significant predictor in the model (Odd Ratio:1.32, p < 0.002), according to logistic regression analysis.Conclusions: This study indicates that changes in exercise capacity are more influenced by the presence of sarcopenia, and that poor TUG performance is the greatest risk factor for the impaired exercise capacity.