Eforto® for Healthcare Professionals

Addressing Age-Related Frailty and Decline

The challenge of managing frailty and sarcopenia is central to geriatric medicine. Early identification and intervention are key to preserving independence and improving quality of life for older adults (Epidemiology—Frailty Science).

Relevance: Grip strength is a core component of the frailty phenotype, and declining muscle function is a hallmark of sarcopenia.²⁰ Early detection is critical, as older adults with the lowest grip strength have a 41% higher risk of all-cause mortality and a 63% higher risk of cardiovascular death compared to those with the highest strength.²¹

Strength decay during sustained maximal handgrip varies by age and clinical condition, with older adults showing particularly rapid decline early in the effort.²² Fatigability on the other hand serves as a sensitive prognostic marker of phenotypic aging, offering insight into how fatigue contributes to functional decline and the disablement pathway.²³

Application: Eforto® offers a 5-minute standardized test that can be easily integrated into annual wellness visits or geriatric assessments. It quantifies maximal grip strength and, uniquely, muscle fatigability, providing a more sensitive indicator of declining physical reserves than strength alone.

Clinical Impact: By identifying patients with low or declining muscle function, Eforto® enables timely interventions such as physical therapy, nutritional counseling, and falls prevention programs. Its remote monitoring capabilities also allow tracking of post-hospitalization recovery, helping to mitigate functional decline.²⁴

Strength and Fatigue Management in Cancer Care

Cancer and its treatments frequently lead to debilitating side effects, including cancer cachexia (muscle wasting) and severe cancer-related fatigue (CRF). Managing these conditions is critical for maintaining treatment tolerance and patient quality of life.

Relevance: Involuntary muscle loss affects 50–80% of patients with advanced cancer and is a direct contributor to mortality.²⁵ Cancer-related fatigue is one of the most common and distressing symptoms, impacting 70–90% of patients undergoing treatment. ²⁶

In cancer survivors, fatigability serves as a sensitive, “hidden” biomarker—often outperforming muscle strength in predicting endurance loss and functional vulnerability.²⁷

Application: Eforto® provides an objective tool to monitor muscle function throughout the cancer journey. Regular assessments can detect the early onset of cachexia by tracking declines in strength and endurance, prompting earlier nutritional or rehabilitative support. For CRF, Eforto® distinguishes physical fatigability from subjective tiredness, helping to tailor interventions and validate the patient's experience.

Clinical Impact: Proactive monitoring with Eforto® helps maintain a patient's strength, which can improve their ability to complete planned chemotherapy cycles and tolerate treatment. In survivorship, it serves as a motivational tool to track functional recovery and guide rehabilitation for the millions of cancer survivors worldwide.²⁸

Integrating Muscle Health into Routine Care

Enhancing Surgical Outcomes and Recovery

A patient's physical reserve is a critical determinant of their ability to withstand the stress of major surgery or critical illness. Assessing frailty preoperatively and tracking recovery postoperatively are key to improving outcomes.

Relevance: Frailty significantly increases the risk of postoperative complications, longer hospital stays, and mortality.

Patients with high frailty scores are 2.8 times more likely to experience complications and 32 times more likely to die compared to non-frail patients.³² ICU-acquired weakness affects 25–31% of critically ill patients, rising to 25–50% in those with prolonged ICU stays and up to 70% among elderly ICU patients, representing a major contributor to long-term disability.³³

Preoperative low handgrip strength is linked to approximately 2.2 times higher odds of postoperative complications.³⁴ In one surgical cohort, major complications occurred in 40.3% of patients with low handgrip strength versus 24.6% of those with high strength.³⁵ Surgery-induced inflammation further reduces muscle endurance and increases fatigue, with elderly patients being particularly affected.⁹

Beyond surgery, handgrip strength in community-dwelling older adults predicts subsequent declines in cognition, mobility, functional ability, and overall risk of mortality.³⁶

Application: Eforto® can be used in pre-surgical clinics as a rapid screening tool for frailty, identifying high-risk patients who would benefit from prehabilitation. Post-operatively or after an ICU stay, it enables remote monitoring of a patient's strength and endurance recovery thanks to its ergonomic design, providing a quantitative trajectory that can alert clinicians to setbacks or suboptimal progress.

Clinical Impact: Integrating Eforto® into the perioperative pathway facilitates data-driven decisions. It helps optimize patients for surgery through targeted prehab, supports safer discharge planning, and allows for timely intervention if post-discharge recovery falters, ultimately reducing complications and readmissions.

Managing Heart Failure and Cardiac Rehab

Supporting Neurorehabilitation and Neuromuscular Monitoring

Frailty as a Key Biomarker in Chronic Diseases 

Enhancing Workplace Safety and Recovery

In physically demanding industries, managing employee fatigue is crucial for preventing costly injuries and ensuring a safe work environment.

Relevance: Grip strength and muscle endurance are objective indicators of an employee’s physical readiness. A significant decline in performance can signal fatigue risk, which is a major contributor to workplace accidents. Workers with low grip strength have an approximately 20% higher probability of future work limitations.⁵⁰

Fatigue is also strongly associated with both short- and long-term sickness absence, making it a reliable predictor of workplace absenteeism. Screening tools such as the Checklist Individual Strength can help identify employees at risk and inform preventive interventions.⁵¹

Application: Eforto® can be utilized for pre-employment baseline testing to ensure candidates meet the physical demands of a role. It also functions as a tool to monitor fatigue during shifts and to objectively track functional recovery after a workplace injury, supporting evidence-based return-to-work decisions.

Operational Impact: Eforto® provides occupational health managers with a simple, quantitative screening tool to mitigate injury risk, manage employee fatigue proactively, and create safer and more productive work protocols.

Optimizing Performance and Recovery

For athletes and athletic programs, the margin between peak performance and overtraining is narrow. Managing training loads and recovery is essential for preventing injuries and achieving competitive goals.

Relevance: Grip strength and muscle endurance are reliable markers of neuromuscular readiness and CNS fatigue, with declines signaling overtraining risk before performance drops. In some athlete cohorts, lower preseason grip strength correlates with higher odds of decline or injury, with injury incidence around 25% in sport-specific studies.⁵²

Monitoring these measures helps prevent overtraining, illness, and injury while providing actionable feedback to optimize training and communication. Handgrip strength training can enhance performance in hand-intensive sports, though outcomes also depend on technique, physical capacity, body composition, and tactics. Collaboration among sport scientists and coaches is key to maximizing results.^53,54

Application: Eforto® can be used as a daily "readiness-to-perform" check for athletes. The objective data helps coaches and trainers make informed decisions to guide daily training loads, ensuring athletes are pushed optimally without being pushed into a state of overtraining.

Performance Impact: Eforto® equips coaches, trainers, and sports medicine professionals with a simple, quantitative tool to personalize training, mitigate injury risk, and ensure athletes are physiologically ready for peak performance.

Quantifying Physical Resilience for Healthy Aging

Regular assessment of muscle strength and endurance provides clinicians with actionable biomarkers to detect early functional decline. Tracking these metrics allows for timely, personalized interventions that support resilience and maintain independence in older adults.

Relevance: Longevity clinics focus on optimizing biological age and functional capacity across the lifespan. Frailty and sarcopenia are major accelerators of biological aging and can undermine the benefits of precision medicine and anti-aging interventions since Lower handgrip strength predicts longer hospital stays and poorer physical quality of life, making it a valuable tool to identify frailty and guide early interventions during hospitalization.​​⁵⁵

Fatigability also is a powerful prognostic marker of phenotypic aging, offering early insight into how fatigue contributes to the progression of functional decline.⁵⁶

Application: Eforto® enables routine, longitudinal tracking of muscle strength and endurance—two hallmarks of physical vitality. By integrating Eforto® into biological age assessments, clinics can establish a personalized functional baseline and monitor the effects of interventions such as hormone therapy, exercise regimens, or nutraceuticals.

Clinical Impact: Objective muscle performance data adds a new dimension to biological age scoring systems, providing actionable insight into physical reserve. Over time, Eforto® can demonstrate the effectiveness of interventions in reversing or slowing down functional decline, empowering patients with feedback and motivating adherence to healthy aging strategies.

Disentangling Physical from Perceived Fatigue

Objective assessment of muscle fatigability offers clinicians a reliable biomarker to detect early functional decline that may not be apparent through patient reports alone. Monitoring these metrics over time enables personalized intervention planning and more effective management of chronic fatigue conditions.

Relevance: Chronic fatigue conditions, including Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS), long COVID, and fibromyalgia, are marked by debilitating fatigue that may not be detectable with conventional tests. Differentiating between physical fatigability and subjective tiredness is a critical challenge, with fatigability often revealing functional decline earlier than maximal strength.⁵⁷

Functional Assessment: In patients with chronic fatigue, handgrip strength correlates with and predicts maximal exercise capacity, making it a simple, objective, and practical measure of functional performance.⁵⁸

Application: Eforto® provides a unique capability to measure muscle fatigability objectively, distinguishing it from self-reported symptoms. Clinicians can track changes over time and assess treatment responses—whether through graded activity, pacing, pharmacologic interventions, or lifestyle modifications—using standardized, reproducible metrics.

Clinical Impact: By quantifying the physiological component of fatigue, Eforto® supports more precise diagnosis and targeted interventions. It also provides validation to patients whose symptoms are often misunderstood or minimized, enhancing therapeutic alliance and enabling personalized rehabilitation strategies.

Early Detection of (Sub)Clinical Frailty

Early identification of declining muscle strength and fatigability allows pharmacists to act as frontline detectors of (sub)clinical frailty. These assessments provide actionable insights that can guide referrals, lifestyle recommendations, or adjustments in medication management.

Relevance: Pharmacies are increasingly becoming community health hubs, well-positioned to detect early signs of health deterioration. Frailty often develops silently and is only recognized after adverse events like falls, hospitalizations, or rapid functional decline. Fraility is associated with increased adverse outcomes and may predict higher risk of drug toxicity or complications, e.g., in chemo or polypharmacy contexts. ⁵⁹

Application: With its 5-minute protocol and portable device, Eforto® is ideal for pharmacy-based screening programs. Pharmacists can integrate muscle function assessments into medication reviews or wellness campaigns, identifying individuals with low strength or high fatigability who may benefit from early intervention or referral.

Public Health Impact: By making frailty screening more accessible, Eforto® empowers pharmacies to play a key role in preventative care. Early detection of declining muscle health enables timely lifestyle or medical interventions, helping to reduce the burden of avoidable hospitalizations and preserve independence among aging adults.

Strengthening Capacity for Better Quality of Life 

Maintaining adequate nutrition is a cornerstone of muscle health, functional performance, and overall well-being. Early detection of nutritional deficits allows for timely interventions that preserve strength, prevent frailty, and improve clinical outcomes.

Relevence: Malnutrition, sarcopenia, and frailty are common but often overlooked conditions that can lead to serious health problems. Grip strength is a key indicator of nutritional status and physical capacity in older adults, with declines signaling frailty, increased malnutrition risk, cachexia, and reduced function. In malnourished surgical or oncology patients, low handgrip strength is associated with roughly twice the risk of complications or mortality and longer hospital stays.⁶⁰

Handgrip strength also reflects early changes in muscle function due to nutritional deprivation and is widely used to assess nutritional status and evaluate outcomes in intervention studies.⁶¹ Additionally, poor diet quality is linked to higher perceived physical fatigability, which explains about 65% of the association with reduced physical function.⁶²

Application: Eforto® empowers dietitians with objective, real-time data on muscle function, enabling tailored nutrition plans based on each patient’s physical reserves. Its mobile platform supports continuous monitoring of nutritional outcomes, ensuring early intervention, treatment tracking and personalized care in both remote and in-person settings.

Public Health Impact: Eforto® enables widespread screening for malnutrition and muscle loss, allowing early dietary interventions. This helps reduce hospital stays, supports recovery, and promotes healthier aging across populations.

Broadening Reach and Continuity of Care

The future of healthcare is proactive and decentralized. Eforto® supports scalable preventive care and telehealth by enabling patients to track muscle function and fatigability at home. This empowers self-management, while early detection of declining reserves allows timely interventions, improving outcomes and reducing costs.

Relevance: Effective telemedicine and remote patient monitoring (RPM) require objective, reliable data that can be collected by patients at home. Eforto® enables clinicians to capture precise measures of muscle strength and fatigability remotely, which are critical indicators of functional capacity and overall health status. These metrics help identify early signs of decline, track chronic disease progression, and support proactive interventions, ensuring care is data-driven even outside clinical settings.^13-15

Application: Eforto®’s self-guided mobile app combined with the validated vigorimeter is ideal for telehealth and RPM programs targeting healthy aging, chronic disease management, or post-discharge rehabilitation. The system supports remote rehabilitation by allowing therapists and health coaches to objectively monitor patients’ functional recovery between visits, overcoming access barriers and maintaining continuity of care. Muscle fatigability, measured through Eforto®, also serves as a sensitive marker for evaluating patient responses to interventions such as physical therapy, anti-inflammatory treatments, or tailored exercise programs.

Clinical Impact: By extending the reach of clinicians beyond the hospital walls, Eforto® enables scalable and cost-effective monitoring of at-risk populations. Real-time data on strength and endurance empowers health coaches and care managers to detect negative trends early, initiate timely interventions, and adjust care plans based on objective feedback. This approach facilitates preventive care, enhances patient independence, reduces readmissions, and ultimately supports healthier outcomes for individuals managing chronic conditions or recovering from acute health events.