Tkk 5401

Handgrip strength was examined three times in each hand using a digital grip strength dynamometer (TKK 5401; Takei Scientific Instruments Co., Ltd., Tokyo, Japan). All subjects were instructed to hold the dynamometer with an upright standing position to keep their arms at their sides. The subjects squeezed the dynamometer with maximum effort, which was maintained for about 3 seconds. The mean of three trials of grip strength in each hand was used[18 ]. Weight and height while wearing light-clothing without shoes, were measured and their body mass index (BMI) was calculated by dividing weight (kg) by squared height (m). Relative handgrip strength, defined as the summation of both hands’ grip strengths divided by BMI, was used to reflect muscle strength. Relative handgrip strength was a recommended tool to measure weakness and low lean mass[15 (link)] and improved the accuracy of the cardiovascular risk estimation model in predicting cardiovascular and all-cause mortality[19 (link)].

Grip strength was measured twice in both hands at 3-minute intervals using a digital grip dynamometer (Takei TKK 5401, Takei Scientific Instruments, Tokyo, Japan). The highest value was defined as the grip strength. The timed up and go test (TUG) was measured as the time taken in seconds for the woman to stand up from a chair without an armrest, walk 3 m, turn, walk back to the chair, and sit down. The short physical performance battery (SPPB) comprises 3 subtests: balance tests (side-by-side stand, semi-tandem stand, and tandem stand), gait speed test, and 5-times chair stand tests (single chair stand and repeated chair stand). Each category was scored from 0 to 4, with the total score ranging from 0 to 12 points. Each SPPB item was tested following established guidelines. Walking speed was defined as the time taken for a participant to walk the middle 4 m of a total distance of 7 m with acceleration and deceleration phases of 1.5 m each in their usual speed.^{[16 (link)]} The 5-times chair stand test measures the time taken to stand 5 times from a sitting position from a straight-backed armchair without using the arms. The physical activity level of the participants was measured using the Korean version of the International Physical Activity Questionnaire short form and classified into 3 groups: high, moderate, and minimal physical activity level.^{[17 (link)]}