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Clinical validation of Eforto® in 61 community-dwellers, 26 geriatric inpatients & 25 hip fracture patients showed moderate to excellent inter-and intra-rater reliability and excellent correlation with an analog grip strength device.

Superiority of the pneumatic bulb-based vigorimeter over clamp-based dynamometer for measuring grip strength

The Eforto Device is based on the pneumatic bulb-based Martin Vigorimeter, recognized for its superior performance in grip strength measurement over traditional clamp-based dynamometers. Research led by De Dobbeleer et al. (Experimental Gerontology, 2018) showed that this Vigorimeter provides a more accurate measure of muscle fatigability in older non- to frail women. In practical terms, the Martin Vigorimeter, a pneumatic device, required less assistance for geriatric patients compared to the Jamar Dynamometer (Sipers et al., Journal of the American Medical Directors Association, 2016). Moreover, research indicates that the pneumatic system offers increased sensitivity in identifying subjects with higher muscle endurance (De Dobbeleer et al., Experimental Gerontology, 2020). Therefore, the pneumatic bulb based Eforto Device, is an effective tool for precise grip strength measurements and assessing muscle fatigability.

Muscle fatigability and self-perceived fatigue is more responsive than maximal strength.

Research indicates that muscle fatigability is more sensitive to inflammation in geriatric patients than maximal strength. Studies show treatments like COX-2 inhibitor celecoxib and NSAID piroxicam can improve fatigue resistance in these patients (Mets, T., et al., 2004; Beyer, I., et al., 2011). A study by Bautmans et al. (2005) also found that inflammation impaired muscle function before measurable muscle atrophy occurred. Thus, assessing muscle fatigability is more effective in understanding the impact of inflammation on muscle performance in older persons.

Muscle fatigability and self-perceived fatigue is strongly correlated to inflammatory status and its recovery.

The intricate link between inflammation and muscle fatigue is becoming increasingly clear, with evidence revealing that our body's inflammatory status directly influences muscle performance and how we perceive fatigue.

In a groundbreaking study by Beyer et al. (2011), treatment with the anti-inflammatory drug piroxicam led to improved muscle function in older patients with inflammation due to infection. The study also discovered that reductions in inflammation were tied to better muscle performance.

This observation echoes findings from Bautmans et al. (2005) who noted worse muscle function in hospitalized geriatric patients with inflammation. Even with appropriate treatment for their primary disease, these patients' muscle function didn't improve, highlighting inflammation's stubborn impact on muscle fatigue.

Zembron-Lacny et al. (2019) further emphasized this relationship, finding higher levels of inflammatory markers and lower growth factors in older men, changes that related to altered body composition, muscle strength, and aging-related muscle changes.

Additionally, studies by Horvath et al. (2007) and Schaap et al. (2006) suggest inflammatory cytokines play a pivotal role in muscle fatigue and could predict future muscle strength decline in older individuals.

Muscle fatigability and self-perceived fatigue captures early signs of frailty and sarcopenia before they can be diagnosed.

Fatigue and how we perceive it are key indicators of early frailty and Sarcopenia, even before clinical diagnosis. A study by Knoop et al. (2021) highlighted the "Capacity to Perceived Vitality" (CPV) ratio, a ratio between muscle grip strength and self-perceived fatigue, as a reliable early frailty marker. Simultaneously, research by Avlund (2010) suggested that fatigue could indicate accelerated aging, while Eldadah (2010) introduced "fatigability" as a measure of fatigue in relation to the causing activity level. Lastly, Simonsick et al. (2014) found assessing fatigability could identify threats to independent functioning earlier. These findings highlight the role of fatigue assessments in capturing early signs of frailty and sarcopenia, helping ensure proactive interventions.

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