Rate of Force Development Is Related to Maximal Force and Sit-to-Stand Performance in Men With Stages 3b and 4 Chronic Kidney Disease

Jared M Gollie, Michael O Harris-Love, Samir S Patel, Nawar M Shara, Marc R Blackman, Jared M Gollie, Michael O Harris-Love, Samir S Patel, Nawar M Shara, Marc R Blackman

Abstract

Introduction: The primary aims of the present study were to assess the relationships of early (0-50 ms) and late (100-200 ms) knee extensor rate of force development (RFD) with maximal voluntary force (MVF) and sit-to-stand (STS) performance in participants with chronic kidney disease (CKD) not requiring dialysis.

Methods: Thirteen men with CKD (eGFR = 35.17 ±.5 ml/min per 1.73 m2, age = 70.56 ±.4 years) and 12 non-CKD men (REF) (eGFR = 80.31 ± 4.8 ml/min per 1.73 m2, age = 70.22 ±.9 years) performed maximal voluntary isometric contractions to determine MVF and RFD of the knee extensors. RFD was measured at time intervals 0-50 ms (RFD0-50) and 100-200 ms (RFD100-200). STS was measured as the time to complete five repetitions. Measures of rectus femoris grayscale (RF GSL) and muscle thickness (RF MT) were obtained via ultrasonography in the CKD group only. Standardized mean differences (SMD) were used to examine differences between groups. Bivariate relationships were assessed by Pearson's product moment correlation.

Results: Knee extensor MVF adjusted for body weight (CKD=17.14 ±.1 N·kg0.67, REF=21.55 ±.3 N·kg0.67, SMD = 0.79) and STS time (CKD = 15.93 ±.4 s, REF = 12.23 ±.7 s, SMD = 1.03) were lower in the CKD group than the REF group. Absolute RFD100-200 was significantly directly related to adjusted MVF in CKD (r = 0.56, p = 0.049) and REF (r = 0.70, p = 0.012), respectively. STS time was significantly inversely related to absolute (r = -0.75, p = 0.008) and relative RFD0-50 (r = -0.65, p = 0.030) in CKD but not REF (r = 0.08, p = 0.797; r = 0.004, p = 0.991). Significant inverse relationships between RF GSL adjusted for adipose tissue thickness and absolute RFD100-200 (r =-0.59, p = 0.042) in CKD were observed.

Conclusion: The results of the current study highlight the declines in strength and physical function that occur in older men with CKD stages 3b and 4 not requiring dialysis. Moreover, early RFD was associated with STS time in CKD while late RFD was associated MVF in both CKD and REF.

Clinical trial registration: ClinicalTrials.gov, identifier: NCT03160326 and NCT02277236.

Keywords: chronic kidney disease; maximal voluntary force; muscle quality; physical function; strength.

Conflict of interest statement

Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Relationships between absolute rate of force development (RFD) and maximal voluntary force (MVF) at time intervals (A) 0–50 ms and (B) 100–200 ms, and absolute RFD and adjusted MVF at time intervals (C) 0–50 ms and (D) 100–200 ms. Gray circles and dashed lines represent patients with chronic kidney disease stages (CKD) 3b and 4 not on dialysis (CKD) while solid circles and lines represent reference participants (REF). N, newtons; N·s−1, newtons per second. Significance level set at p ≤ 0.05. N·kg0.67, newtons per kilogram to the two-thirds power.
Figure 2
Figure 2
Relationships between absolute rate of force development (RFD) and sit-to-stand (STS) at time intervals (A) 0–50 ms and (B) 100–200 ms, and relative RFD and STS at time intervals, (C) 0–50 ms and (D) 100–200 ms. Gray circles and dashed lines represent patients with chronic kidney disease stages (CKD) 3b and 4 not on dialysis (CKD) while solid circles and lines represent reference participants (REF). N·s−1, Newtons per second; %MVF·s−1, percent maximal voluntary force per second; s, seconds. Significance level set at p ≤ 0.05.
Figure 3
Figure 3
Relationships between (A) knee extensor absolute rate of force development (RFD) at time interval 100–200 ms (RFD100−200) and adjusted rectus femoris grayscale (RF GSL), (B) relative RFD100−200 and adjusted RF GSL, (C) absolute RFD100−200 and adjusted RF muscle thickness (MT), and (D) relative RFD100−200 and adjusted RF MT in patients with chronic kidney disease (CKD) stages 3b and 4 not on dialysis. Significance level set at p ≤ 0.05.

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