The Effects of Muscular Strength and Biochemical Parameters on Mallampati Classification in Elite Athletes and Non-athletes

Yıl 2024, Cilt: 6 Sayı: 3, 518 - 527, 24.09.2024

Zeynel Abidin Erbesler , Tufan Ulcay , Ömer Alperen Gürses , Ahmet Uzun

https://doi.org/10.37990/medr.1518418

Öz

Aim: This study aimed to undertake an anthropometric assessment and to compare the muscular strength of elite athletes with that of a control group to predict Mallampati classification.
Material and Method: The study group consisted of elite track athletes, and the control group consisted of volunteers with similar characteristics. Anthropometric measurements of the hand, fingers, and wrist were made; handgrip strength and the pinch strength of the fingers were also measured. A serum biochemical analysis was then performed. Participants were divided into two groups: those with Modified Mallampati Scores (MMS) I and II, and those with III and IV. A partial correlation test was used to examine the correlations of the variables according to the MMS groups.
Results: The study included 32 elite athletes and 42 volunteer participants. Serum Na level, fingertip to root digit 3 (FTR3), and FTR4 were significantly lower in males in MMS groups 3-4. Among all cases, wrist extension angle (WEA) was found to be significantly lower in MMS group 3-4. However, hand breadth at thumb (HBT), hand depth radial (HDR), breadth at the first joint of digit 2 (BFJD2), pinch strength of thumb (PST), and PSLF were significantly higher in MMS groups 3-4. Among these variables, HBT, BFJD2, PST, and PSLF were significantly higher in elite athletes, but HDR was similar between the study groups. MMS groups showed the highest correlation with the pinch strength of the thumb.
Conclusion: The pinch strength of the thumb and little finger was determined as the most important predictors for the MMS group rather than the handgrip strength (HGS).

Anahtar Kelimeler

Modified Mallampati scores , handgrip strength , anthropometric measurements , elite athletes , difficult airway

Kaynakça

• Endlich Y, Lee J, Culwick MD. Difficult and failed intubation in the first 4000 incidents reported on webAIRS. Anaesth Intensive Care. 2020;48:477-87.
• Roth D, Pace NL, Lee A, et al. Airway physical examination tests for detection of difficult airway management in apparently normal adult patients. Cochrane Database Syst Rev. 2018;5:CD008874.
• Kolhe SA, Daokar SS. Clinical assessment of the correlation between tongue pressure, modified mallampati score, BMI, and obstructive sleep apnea. Journal of Indian Orthodontic Society. 2024;58:150-7.
• Davis DP, Olvera DJ. HEAVEN criteria: derivation of a new difficult airway prediction tool. Air Med J. 2017;36:195-7.
• Saraf A, Yadav A. A study to rank predictors of preoperative airway assessment on the basis of accuracy of prediction while performing laryngoscopy in obese patients. IOSR-JDMS. 2018;17:04-10.
• Schnittker R, Marshall SD, Berecki-Gisolf J. Patient and surgery factors associated with the incidence of failed and difficult intubation. Anaesthesia. 2020;75:756-66.
• Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103:429-37.
• Lee SL, Hosford C, Lee QT, et al. Mallampati class, obesity, and a novel airway trajectory measurement to predict difficult laryngoscopy. Laryngoscope. 2015;125:161-6.
• Tasli H, Karaman NE, Isler D, Subasi B. A predictor of difficult airway: the tasli classification in transnasal flexible laryngoscopy. J Voice. 2023;37:945-50.
• Motamedi M, Soltani M, Amiri M, Memary E. The relationship between orotracheal intubation difficulty scoring systems and anthropometric factors. Adv J Emerg Med. 2018;3:e5.
• Bourgonjon B, Vermeylen K, Tytgat N, Forget P. Anaesthesia for elite athletes. Eur J Anaesthesiol. 2022;39:825-34.
• Peck B, Renzi T, Peach H, et al. Examination of risk for sleep-disordered breathing among college football players. J Sport Rehabil. 2019;28:126-32.
• Jacobson BH. Anthropometric cross-sectional comparisons of college football players and potential health implications. J Strength Cond Res. 2012;26:3358-64.
• George CF, Kab V, Kab P, et al. Sleep and breathing in professional football players. Sleep Med. 2003;4:317-25.
• Han CH, Chung JH. Association between hand grip strength and spirometric parameters: Korean National health and Nutrition Examination Survey (KNHANES). J Thorac Dis. 2018;10:6002-9.
• Ulcay T, Kamaşak B, Kaya K, et al. The effect of hand anthropometric variables on grip strength in grip elite athletes and non-athletes. Turk J Sport Exe. 2021;23:102-10.
• Kim S, Yoon HK, Rhee CK, et al. Hand grip strength and likelihood of moderate-to-severe airflow limitation in the general population. Int J Chron Obstruct Pulmon Dis. 2022;17:1237-45.
• Cakit E, Durgun B, Cetik O, Yoldas O, A survey of hand anthropometry and biomechanical measurements of dentistry students in Turkey. Human Factors and Ergonomics in Manufacturing & Service Industries. 2014;24:739-53.
• Jee SC, Yun MH. An anthropometric survey of Korean hand and hand shape types. International Journal of Industrial Ergonomics. 2016;53:10-8.
• Mirmohammadi SJ, Mehrparvar AH, Mostaghaci M, et al. Anthropometric hand dimensions in a population of Iranian male workers in 2012. Int J Occup Saf Ergon. 2016;22:125-30.
• Mohammad YA. Anthropometric characteristics of the hand based on laterality and sex among Jordanian. International Journal of Industrial Ergonomics. 2005;35:747-54.
• Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985;32:429-34.
• Wang B, Yao W, Xue Q, et al. Nomograms for predicting difficult airway based on ultrasound assessment. BMC Anesthesiol. 2022;22:23.
• Xu J, Wang B, Wang M, et al. The value of multiparameter combinations for predicting difficult airways by ultrasound. BMC Anesthesiol. 2022;22:311.
• Wang W, Di C, Mona S, et al. Tongue function: an underrecognized component in the treatment of obstructive sleep apnea with mandibular repositioning appliance. Can Respir J. 2018;2018:2157974.
• Costantino A, Rinaldi V, Moffa A, et al. Hypoglossal nerve stimulation long-term clinical outcomes: a systematic review and meta-analysis. Sleep Breath. 2020;24:399-411.
• Diaféria G, Santos-Silva R, Truksinas E, et al. Myofunctional therapy improves adherence to continuous positive airway pressure treatment. Sleep Breath. 2017;21:387-95.
• Birman MV, Solomon GS, Vender MI. Functional capacity evaluation in hand surgery. J Hand Surg Am. 2016;41:133-4.
• Herbin ML. Work capacity evaluation for occupational hand injuries. J Hand Surg Am. 1987;12:958-61.
• Rantanen T, Volpato S, Ferrucci L, et al. Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism. J Am Geriatr Soc. 2003;51:636-41.
• Sallinen J, Stenholm S, Rantanen T, et al. Hand-grip strength cut points to screen older persons at risk for mobility limitation. J Am Geriatr Soc. 2010;58:1721-6.
• Boatright JR, Kiebzak GM, O'Neil DM, Peindl RD. Measurement of thumb abduction strength: normative data and a comparison with grip and pinch strength. J Hand Surg Am. 1997;22:843-8.
• Gentilucci M, Caselli L, Secchi C. Finger control in the tripod grasp. Exp Brain Res. 2003;149:351-60.
• Smeets JBJ, van der Kooij K, Brenner E. A review of grasping as the movements of digits in space. J Neurophysiol. 2019;122:1578-97.
• Maleki-Ghahfarokhi A, Dianat I, Feizi H, Asghari-Jafarabadi M. Influences of gender, hand dominance, and anthropometric characteristics on different types of pinch strength: a partial least squares (PLS) approach. Appl Ergon. 2019;79:9-16.
• Lam NW, Goh HT, Kamaruzzaman SB, et al. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population. Singapore Med J. 2016;57:578-84.
• Ziyagil MA, Gürsoy R, Dane Ş, et al. Effects of handedness on the hand grip strength asymmetry in Turkish athletes. Comprehensive Psychology. 2015;4:20.
• Ügurlu U, Özdogan H. Age- and gender-specific normative data of pinch strengths in a healthy Turkish population. J Hand Surg Eur Vol. 2012;37:436-46.
• Lin T, Huang JF, Lin QC, et al. The effect of CPAP treatment on venous lactate and arterial blood gas among obstructive sleep apnea syndrome patients. Sleep Breath. 2017;21:303-9.
• Akbari G. Role of zinc supplementation on ischemia/reperfusion injury in various organs. Biol Trace Elem Res. 2020;196:1-9.