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Objectives To determine the test-retest reliability and minimum detectable change scores for seven common clinical measurements of muscle strength and physical function in a multiethnic sample of sarcopenic, malnourished men and women. Design Each participant visited the laboratory seven times over 25 to 26 weeks. Reliability was assessed for each measurement from Familiarization 1 to Familiarization 2 (R1), Familiarization 2 to baseline testing (R2), Familiarization 3 to 12-week testing (R3), and Familiarization 4 to 24-week testing (R4). Setting Data were collected during a clinical trial at 23 sites in the United States, Belgium, Italy, Mexico, Poland, Spain, Switzerland, and the United Kingdom. Participants Sarcopenic, malnourished, older adults (N = 257; n = 98 men aged 76.8 ± 6.3, n = 159 women aged 75.9 ± 6.6). Measurements During each visit, participants completed the Short Physical Performance Battery ( SPBB) and isometric handgrip and isokinetic leg extensor and flexor strength testing at a slow (1.05 rad/s) and fast (3.15 rad/s) velocity. Results Handgrip strength, gait speed, SPPB score, and isokinetic leg extension and flexion peak torque ( PT) had intraclass correlation coefficients ( ICCs) that were significantly greater than 0 (all ≥0.59) at R1, R2, R3, and R4, although most of these variables demonstrated systematic increases at R1, and several exhibited systematic variability beyond the baseline testing session. Conclusion The ICCs and standard errors of the measurement ( SEMs) generally improved with familiarization, which emphasizes the need for at least one familiarization trial for these measurements in sarcopenic, malnourished older adults. A three tier-approach to interpreting the clinical importance of statistically significant results that includes null hypothesis testing, examination and interpretation of the effect magnitude, and comparison of individual changes with the SEM and minimum detectable change of the measurements used is recommended. [ABSTRACT FROM AUTHOR]

Background Recent evidence suggests that nutritional interventions may improve muscle outcomes in malnutrition and sarcopenia. Objectives We evaluated the effects of 2 high-quality oral nutritional supplements (ONS) differing in amount and type of key nutrients in older adult men and women. Design A multicenter, randomized, double-blinded, controlled clinical trial. Participants Malnourished and sarcopenic men and women, 65 years and older (n = 330). Intervention A 24-week intervention period with 2 energy-rich (330 kcal) ONS treatment groups: Control ONS (C ONS , 14 g protein; 147 IU vitamin D 3 ) versus Experimental ONS (E ONS , 20 g protein; 499 IU vitamin D 3 ; 1.5 g CaHMB) taken twice daily. Both ONS also contained other vitamins, minerals, and nutrients in varying amounts. Measurements Isokinetic peak torque (PT, Nm) leg strength, grip strength (kg), and gait speed (m·s −1 ) were assessed at baseline and 12 and 24 weeks. Left and right leg muscle mass (LMM, kg) were assessed by dual-energy x-ray absorptiometry (DXA). Muscle quality (MQ) was leg strength expressed relative to the tested LMM (Nm·kg −1 ). Subgroup analyses were performed: severe sarcopenia (low skeletal mass index, low grip strength [<30 kg men; <20 kg women], low gait speed [<0.8 m·s −1 ]) and mild-moderate sarcopenia (low skeletal mass index, normal gait speed, or normal grip strength). Results Both ONS groups (E ONS and C ONS ) improved PT, MQ, grip strength, and gait speed from baseline with no treatment differences. Those with severe sarcopenia (44%) exhibited lower baseline PT and MQ, with no differences in strength improvements between treatments. However, participants with mild-moderate sarcopenia exhibited higher baseline PT and MQ, with differences in strength improvements at 12 weeks (E ONS > C ONS , P = .032) in those with normal grip strength. There were no treatment differences based on sarcopenic severity for either grip strength or gait speed. Conclusion ONS improved strength outcomes in malnourished older adults with sarcopenia. In those with mild-moderate sarcopenia, but not severe sarcopenia, consumption of the E ONS improved leg muscle strength and quality compared with the standard C ONS . [ABSTRACT FROM AUTHOR]