[Postpoliomyelitis syndrome--additional functional disturbances in persons suffering of poliomyelitis].
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Adult↗
Biomedical subjects
G Grimby
Publications and source records attributed to G Grimby.
Compensatory muscle fiber hypertrophy in elderly men.
Muscle strength and muscle morphology have been studied three times during a period of 11 yr in nine elderly men. On the last occasion the average age was 80.4 (range 79-82) yr. Body cell mass decreased by 6% and muscle strength for knee extension, measured by means of isometric and concentric isokinetic (30-60 degrees/s) recordings, declined by 25-35% over the 11-yr period. Between 76 and 80 yr of age only the isokinetic strength for 30 degrees/s decreased significantly. Muscle fiber composition in the vastus lateralis did not change between 69 and 76 yr of age, but there was a significant reduction in the proportion of type IIb fibers from 76 to 80 yr. The decrease in type II fiber areas was not significant between 69 and 76 yr of age (as in a larger sample from the same population), but a significant increase in both type I and type II fiber areas was recorded from 76 to 80 yr of age and biceps brachii showed similar tendencies. In the same period, the enzymatic activities of myokinase and lactate dehydrogenase subsided in the vastus lateralis, but there was no change for triose phosphate dehydrogenase, 3-hydroxy-CoA-dehydrogenase, and citrate synthase. The muscle fiber hypertrophy in this group of elderly men with maintained physical activity between 76 and 80 yr of age is interpreted as a compensatory adaptation for the loss of motor units. In addition, the adaptation with respect to oxidative capacities seems to be maintained at this age.
Adaptation, Physiological↗
Training can improve muscle strength and endurance in 78- to 84-yr-old men.
Nine men, 78-84 yr of age, participated in a dynamometer training program 2-3 times/wk, totaling 25 sessions, using voluntary maximal isometric, concentric, and eccentric right knee-extension actions (30 and 180 degrees/s). Measurements of muscle strength with a Kin-Com dynamometer and simultaneous electromyograms (EMG) were performed of both sides before and after the training period. Muscle biopsies were taken from the right vastus lateralis muscle. The total quadriceps cross-sectional area was measured with computerized tomography. Training led to an increase in maximal torque for concentric (10% at 30 degrees/s) and eccentric (13-19%) actions in the trained leg. The EMG activity increased at maximal eccentric activities. The total cross-sectional quadriceps area of the trained leg increased by 3%, but no changes were recorded in muscle fiber areas in these subjects, who already had large mean fiber areas (5.15 microns 2 x 10(3)). The fatigue index measured from 50 consecutive concentric contractions at 180 degrees/s decreased and the citrate synthase activity increased in all but one subject. The results demonstrate that increased neural activation accompanies an increase in muscle strength at least during eccentric action in already rather active elderly men and that muscle endurance may also be improved with training.
Aged↗
Use of a Kin-Com dynamometer to study the stretch-shortening cycle during plantar flexion.
The aim of this study was to evaluate the Kin-Com II dynamometer in the study of the stretch-shortening cycle (a concentric muscle action preceded by an eccentric muscle action). Measurements were made of plantar flexion at different angular velocities (120 degrees.s-1 and 240 degrees.s-1) with the knee at two different angles (0 degree and 90 degrees). Ten healthy women ranging in age from 22 to 41 years were studied. Torque values were recorded simultaneously with surface electromyograms (EMG): maximal voluntary concentric torque values were recorded and, after a short rest, the torque values of the concentric action which followed immediately after an eccentric action of the same velocity, both with maximal effort. Mean values were taken at different ankle positions and also averaged over different ranges. A concentric action preceded by an eccentric action generated a torque value on an average about 100% larger than a concentric action alone. The EMG activity was lower or unchanged. It was concluded that the present method could be useful in the study of the stretch-shortening cycle in plantar flexion and in the testing of the behaviour of the elastic components in people with disabilities in the lower limbs.
Adult↗
Effects of a sodium-potassium ion-exchanging seaweed preparation in mild hypertension.
A nonpharmacological approach in the treatment of mild hypertension is often advocated. In an attempt to decrease sodium and increase potassium intake, sixty-two middle-aged patients with mild hypertension were given a potassium loaded ion-exchanging sodium-adsorbing potassium-releasing seaweed preparation (seaweed fiber, SF). The mean blood pressure (MBP), evaluated in a double-blind crossover manner with four weeks familiarization and wash-out periods, showed a significant decrease after four weeks on 12 and 24 g/day SF but not on 6 g/day or placebo treatment. Systolic blood pressure during submaximal exercise decreased on all three SF doses. The decrease in MBP appeared to be significantly higher in sodium-sensitive (11.2 mm Hg, P less than .001) than in sodium-insensitive (5.7 mm Hg, P less than .05) patients and was in salt-sensitive patients significantly correlated to the increase in plasma renin activity (PRA). The urinary sodium excretion decreased, the urinary potassium increased and the sodium/potassium urinary excretion ratio decreased, indicating that the decrease of MBP was dependent on the decreased intestinal absorption of sodium and increased absorption of potassium released from the seaweed preparation. A sodium-potassium ion-exchanging seaweed preparation is an effective means of decreasing sodium and increasing potassium intake, and may be used for antihypertensive treatment in mild hypertension.
Adult↗
Walking habits and health-related factors in a 70-year-old population.
Walking and other physical activities were studied in a representative population sample of 619 70-year-old people in the city of Gothenburg, Sweden. Walking was the most common physical activity declared, and two thirds of those without an obvious disability walked 30 min or more every day. Subjects who took a daily walk of at least 30 min had a significantly better climbing capacity, higher bone mineral content and lower concentration of blood triglycerides than subjects who walked less. Male 'walkers' had a significantly larger lung volume than 'non-walkers'. Walkers had a more positive attitude towards physical activity as well as a higher estimation of their own physical fitness than non-walkers.
Aged↗
Muscle structure and function before and after surgery for primary hyperparathyroidism.
In 23 unselected cases of primary hyperparathyroidism (pHPT), muscle strength, morphology and enzymatic activities were studied and electromyography (EMG) performed before and 6 months after surgical treatment. Hypercalcemia was mostly mild or moderate. Nine women undergoing surgery for benign thyroid conditions served as controls regarding muscle strength, while muscle morphologic and enzymatic data were compared with findings in healthy persons of similar age. Only three pHPT patients reported muscle weakness preoperatively, and two were subjectively improved after surgery. Muscle strength did not differ significantly before or after operation between patients and controls: After surgery both groups showed increased isokinetic muscle strength at higher angular velocities. Nor did muscle morphology differ between pHPT patients and controls. No conclusive EMG changes were found before or after surgery for pHPT but postoperatively the pHPT patients showed significant increase in glycolytic but not oxidative muscle enzymes, possibly reflecting early effect of pHPT on especially type II fibers, which previously were shown to be most extensively involved in pHPT. Otherwise no measurable negative effects of mild or moderate pHPT were found on muscle strength or function.
Adult↗
Electromyographic and morphological functional compensation in late poliomyelitis.
Patients with prior poliomyelitis may experience muscle function deterioration decades after onset of disease. The present study is aimed at describing electromyographic and morphometric evidence of muscular compensation and of on-going muscular instability. Ten subjects 42-62 years of age with onset of polio 25-52 years earlier were studied with macro EMG, single-fiber EMG (SFEMG), muscle strength measurement, and morphometrical analysis of muscle biopsies from the vastus lateralis muscle. SFEMG revealed increased fiber density (FD) and large macro-MUP potentials indicating pronounced reinnervation as compensation to loss of motor neurons. From electrophysiological data of motor unit size, morphometric measures of fiber size, and muscle strength data, the minimal degree of motor neuron loss was estimated to be greater than 70%.
Adult↗
Domestic activities and walking in the elderly: evaluation from a 30-hour heart rate recording.
The physical activity pattern among 43 subjects (25 women, 18 men) from the Intervention Study of Elderly in Gothenburg (IVEG) has been evaluated by means of heart rate monitoring, rating of perceived exertion and recording activities over a 30-hour period. These subjects had previously been interviewed about their activity pattern, including the duration of their daily walks. In 91% of the participants the average heart rate was below 100 beats/min during walking. Considerable individual variations were noted in the duration of domestic activities and of walks. Using heart rate levels equal to or above the average heart rate during walking as a criterion, it was found that 68% of the women, but only 17% of the men, spent more time on domestic activities than on walking. Nonetheless, it is suggested that in addition to walking, domestic activities, owing to their duration, are important in maintaining physical fitness in the elderly, especially among women. This should be taken into account when physical activity is being classified (to avoid bias in favour of men). A modified version of a previously published six-grade scale for the classification of physical activity has been suggested.
Activities of Daily Living↗
Increased muscle dynamic endurance associated with weight reduction on a very-low-calorie diet.
To assess muscle function after a period of negative energy balance, 32 obese women were placed on a 544-kcal/d, high-protein diet for 4 wk. Weight loss was associated with a decrease in the waist-to-hip-circumference ratio (WHR) and significantly higher emptying of abdominal than gluteal fat cells. The low-calorie regimen was associated with a significant increase in isokinetic muscle endurance, a decrease in glycogen concentration, and an increase in glycogen synthase (GS) activity and its fractional velocity (FV). The GS activity and its FV were negatively correlated with the WHR before treatment whereas their subsequent increase was correlated with the decrease in WHR. Dietary treatment produced a decrease in the isokinetic muscle strength, which was correlated with the reduction in lean body mass. The improvement in dynamic endurance observed after energy restriction parallels not only the increase in GS activity in muscle but also the decrease in glycogen stores and glucose oxidation, and most probably depends on the increased utilization of fatty acids.
Adipose Tissue↗
Isokinetic strength training in below-knee amputees.
Eight below-knee amputees performed isokinetic training of knee extensor- and knee-flexor muscles for a period of 8-12 weeks at angular velocities of 60 degrees/s, 180 degrees/s and 240 degrees/s. Before and after training isokinetic and isometric knee extensor/flexor strength was measured. Muscle biopsies were taken from the vastus lateralis and the cross-sectional area of the thigh muscles was measured with computerized tomography. Peak torque of the amputated leg increased significantly in all knee-extension tests and in knee-flexion at 180 degrees/s, and in the non-amputated leg in extension at 180 degrees/s, 240 degrees/s and for isometric strength at 60 degrees knee angle. Knee-flexion strength increased at 240 degrees/s. The cross-sectional area of the muscle fibers increased in the amputated leg in all patients except one. There was no significant increase in the non-amputated leg which also was trained. The quotient between the cross-sectional areas of type II and type I fibers increased from 1.04 to 1.20 in the amputated leg, demonstrating an increase specially in the type II fibers. There was no difference in the non-amputated leg. The cross-sectional area of the thigh muscles did not show any significant change in either leg. The patients estimated their ability to walk after training to more than double the distance compared to before training. They could also manage better without walking aids. The increase in strength and the synchronous increase in the size of type II (fast twitch) fibers indicate that the training model has activated also these motor units which probably have not been given as much training earlier.
Adult↗
Disability and handicap in late poliomyelitis.
The impact of long-standing polio sequelae in terms of disability and handicap was studied in 41 patients (17 men and 24 women, mean age 54 years). Twenty-nine (71%) of these met the criteria for post-polio syndrome. The Katz' ADL index, the Functional Status Questionnaire (FSQ), selected questions concerning social needs and support and the WHO ICIDH-Classification of handicaps were used. A substantial impact on intermediate (secondary or instrumental) ADL was a consistent finding, most severely affecting the quality of mobility. This emphasizes needs for individual rehabilitation services including transportation, walking and domestic aids.
Activities of Daily Living↗
[Rehabilitation needs remain after discharge from somatic emergency departments].
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Aged↗
Use of the WHO classification in assessing the prevalence of diseases, impairments and handicaps in Punjab Province, Pakistan.
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Community Health Services↗
Research in rehabilitation. Sweden.
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Persons with Disabilities↗
Muscle adaptive changes in post-polio subjects.
Nineteen post-polio subjects (9 men and 10 women) aged 41-65 years were studied by means of muscle strength measurements (Cybex) of knee extension and muscle biopsies of the vastus lateralis for morphometric, histopathological and enzymatic analyses. Data from a reference group of 10 male subjects, age 42-51 years, are also given. Fourteen of the post-polio subjects had experienced a post-polio syndrome-like drop in function. All had had polio at least 25 years earlier. In nine of the 19 subjects, type I fibers accounted for more than 70% of the total. There was a significant negative correlation between muscle strength and the percentage of type I fibers in women. Large cross-section areas of muscle fibers were found, with an average mean fiber area of 8 microns 2 X 10(3). It is assumed that the large muscle fiber areas are due to an extreme use of the remaining muscle fibers in post-polio subjects with low muscle strength. There were significant negative correlations between muscle strength values and mean fiber area in men. Most subjects had single atrophic fibers; groups of atrophic fibers were less common. Internal nuclei and splitting were seen in about half of the subjects. The activity of citrate synthase was low, but normal for glycolytic enzymes.
Adult↗
Perception of effort in isometric and dynamic muscular contraction.
The perception of muscular effort was studied using estimation and production methods in the adductor pollicis and quadriceps. A psychometric scale (percentage magnitude) was used. Static contractions were studied in the adductor pollicis, and both dynamic (isokinetic) and static contractions were studied in quadriceps. Linear and logarithmic equations were fitted for the perceived effort as a percentage of the maximum in relation to the produced percentage maximal force or torque. The logarithmic exponent was around or above 1.0. No significant difference was found between mean exponent and intercept values for the adductor pollicis and the quadriceps, or when estimated or produced values for the two muscles were compared. There was no difference in the same subjects between the equations for static and dynamic contractions with low angular velocity of the quadriceps.
Adult↗
The effect of unilateral isokinetic strength training on local adipose and muscle tissue morphology, thickness, and enzymes.
One-leg exercise of 5 weeks duration in 10 healthy middleaged women resulted in a significant increment of muscle force in the exercising leg and in a less, but at some angular velocities also significant, increase in the nonexercising leg. The thickness of subcutaneous tissue measured by ultrasound and skinfold caliper decreased, while muscle thickness increased in the exercising leg only. The increased thickness of muscle tissue was associated with an increase in the relative number and relative fiber area of type II fibers in the exercising leg. The mean fiber area of type IIB fibers increased significantly as well as the activity of lactate dehydrogenase and myokinase. The decrease of thickness of subcutaneous adipose tissue was not associated with a significant decrease in fat cell size and was probably due to geometrical factors secondary to hypertrophy of the underlying muscle. It is concluded that the relationship between lean and fat components of the human thigh is significantly influenced by changes in the activity of the thigh skeletal muscles, but a local dynamic strength training program can hardly be used for local emptying of the fat depot over the exercising muscles.
Adenosine Triphosphatases↗