Inflammation appeared to be associated with greater loss of muscle strength .
There was inconclusive evidence that the level of physical activity affects change in skeletal muscle .
In regard to the effect of interventions , only exercise interventions were consistently associated with improved skeletal muscle outcomes .
CONCLUSIONS Adult patients who undergo an unplanned hospital admission may experience a small reduction in knee extension strength and mid-arm muscle mass .
OBJECTIVES The primary objective of the review was to describe change that occurs in skeletal muscle during periods of unplanned hospitalisation in adult patients .
The secondary objective was to examine the relationship between both physical activity and inflammation with the change in skeletal muscle .
A further objective was to investigate the effect of interventions on change in skeletal muscle during periods of unplanned hospitalisation .
Effects on muscle performance of NSAID treatment with Piroxicam versus placebo in geriatric patients with acute infection-induced inflammation. a double blind randomized controlled trial
Background Inflammation is the main cause of disease-associated muscle wasting . In a previous single blind study we have demonstrated improved recovery of muscle endurance following celecoxib treatment in hospitalized geriatric patients with acute infection . Here we further evaluate NSAID treatment with piroxicam in a double blind RCT and investigate the role of cytokines and heat shock proteins ( Hsp ) with respect to muscle performance . We hypothesized that NSAID treatment would preserve muscle performance better than antibiotic treatment alone , by reducing infection-associated inflammation and by increasing expression of cytoprotective Hsp . Methods Consecutive admissions to the geriatric ward were screened . 30 Caucasian patients , median age 84.5 years , with acute infection-induced inflammation and serum levels of CRP > 10 mg/L were included and r and omized to active treatment with 10 mg piroxicam daily or placebo . Assessment comprised general clinical and biochemical parameters , 25 cytokines in serum , intra- and extracellular Hsp27 and Hsp70 , Elderly Mobility Scale ( EMS ) scores , grip strength ( GS ) , fatigue resistance ( FR ) and lean body mass ( LBM ) . Patients were evaluated until discharge with a maximum of 3 weeks after treatment allocation . Results EMS scores , FR and grip work ( GW ) , a measure taking into account GS and FR , significantly improved with piroxicam , but not with placebo . Early decreases in IL-6 serum levels with piroxicam correlated with better muscle performance at week 2 . Basal expression of Hsp27 in monocytes without heat challenge ( WHC ) was positively correlated with FR at baseline and significantly increased by treatment with piroxicam compared to placebo . Profound modifications in the relationships between cytokines or Hsp and changes in muscle parameters were observed in the piroxicam group . Conclusions Piroxicam improves clinical ly relevant measures of muscle performance and mobility in geriatric patients hospitalized with acute infection-induced inflammation . Underlying mechanisms may include modifications in the cytokine network and increases in monocytic expression of cytoprotective Hsp27.Trial registration numberIS RCT N : IS RCT
Inflammation appeared to be associated with greater loss of muscle strength .
There was inconclusive evidence that the level of physical activity affects change in skeletal muscle .
In regard to the effect of interventions , only exercise interventions were consistently associated with improved skeletal muscle outcomes .
CONCLUSIONS Adult patients who undergo an unplanned hospital admission may experience a small reduction in knee extension strength and mid-arm muscle mass .
OBJECTIVES The primary objective of the review was to describe change that occurs in skeletal muscle during periods of unplanned hospitalisation in adult patients .
The secondary objective was to examine the relationship between both physical activity and inflammation with the change in skeletal muscle .
A further objective was to investigate the effect of interventions on change in skeletal muscle during periods of unplanned hospitalisation .