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Biomedical subjects

Harri Suominen

Publications and source records attributed to Harri Suominen.

17 recordsLinked to original sources

Aging, muscle fiber type, and contractile function in sprint-trained athletes.

Biopsy samples were taken from the vastus lateralis of 18- to 84-yr-old male sprinters (n = 91). Fiber-type distribution, cross-sectional area, and myosin heavy chain (MHC) isoform content were identified using ATPase histochemistry and SDS-PAGE. Specific tension and maximum shortening velocity (V(o)) were determined in 144 single skinned fibers from younger (18-33 yr, n = 8) and older (53-77 yr, n = 9) runners. Force-time characteristics of the knee extensors were determined by using isometric contraction. The cross-sectional area of type I fibers was unchanged with age, whereas that of type II fibers was reduced (P < 0.001). With age there was an increased MHC I (P < 0.01) and reduced MHC IIx isoform content (P < 0.05) but no differences in MHC IIa. Specific tension of type I and IIa MHC fibers did not differ between younger and older subjects. V(o) of fibers expressing type I MHC was lower (P < 0.05) in older than in younger subjects, but there was no difference in V(o) of type IIa MHC fibers. An aging-related decline of maximal isometric force (P < 0.001) and normalized rate of force development (P < 0.05) of knee extensors was observed. Normalized rate of force development was positively associated with MHC II (P < 0.05). The sprint-trained athletes experienced the typical aging-related reduction in the size of fast fibers, a shift toward a slower MHC isoform profile, and a lower V(o) of type I MHC fibers, which played a role in the decline in explosive force production. However, the muscle characteristics were preserved at a high level in the oldest runners, underlining the favorable impact of sprint exercise on aging muscle.

Adaptation, Physiological↗

Muscle training for bone strength.

The main function of bone is to provide the mechanical integrity for locomotion and protection; accordingly, bone mass and architecture are adjusted to control the strains produced by mechanical load and muscular activity. Age-related patterns involve peak bone mass during growth, a plateau in adulthood, and bone loss during aging. The decline in bone mass and structural integrity results in increased risk of fractures, particularly in post-menopausal women. Athletes competing in strength and power events, such as weight-lifting and jumping, have superior bone mass and structure compared with their untrained counterparts in all age groups. Exercise seems to be most effective during rapid growth, the average gain in bone mineral content (BMC) and density (BMD) in controlled trials being of the order of 2-5% per year. The net gain of BMD after exercise interventions among older people is modest, at a level of 1-3% per year, but it is not clear whether positive effects can be maintained over a longer time. Although aerobic exercise is important in maintaining overall health, the resistance type of muscle training may be more applicable to the basic rules of bone adaptation and site-specific effects of exercise, have more favorable effects in maintaining or improving bone mass and architecture, and be safe and feasible for older people. It has been suggested that there is an opportunity for resistance training, for improved effects on BMD in postmenopausal women in bones which have less daily loading. In addition to BMC and BMD, bone geometry and mass distribution may also change as a result of training and other treatment, such as hormonal replacement therapy, thereby further improving bone strength and reducing fracture risk. Appropriate training regimens may reduce the risk of falls and the severity of fall-related injuries, and also constitute potential therapy to improve functional ability and the quality of life in osteoporotic patients. However, further research is needed on dose-response relationships between exercise and bone strength, the feasibility of high-load, high-speed and impact-type of physical training, and the risks and benefits of intensive exercisein elderly individuals.

Aging↗

Endogenous hormones, muscle strength, and risk of fall-related fractures in older women.

BACKGROUND: Among older people, fracture-causing fall often leads to health deterioration. The role of endogenous hormone status and muscle strength on fall-related fracture risk is unclear. This study investigates if, after adjustment for bone density, endogenous hormones and muscle strength would predict fall-related limb fracture incidence in older community-dwelling women followed-up over 10 years. METHODS: As a part of a prospective population-based study, 187 75-year-old women were investigated. Serum estradiol, testosterone, sex hormone binding globulin, and dehydroepiandrosterone sulfate concentrations were analyzed, and isometric muscle strength and bone mineral density were assessed. Fall-related limb fractures were gathered from patient records. RESULTS: Serum estradiol concentration was a significant predictor of fall-related limb fractures. Women with serum estradiol concentrations less than 0.022 nmol/L had a 3-fold risk (relative risk 3.05; 95% confidence interval, 1.26-7.36), and women with estradiol concentrations between 0.022 and 0.066 nmol/L doubled the risk (relative risk 2.24; 95% confidence interval, 0.97-5.19) of fall-related limb fracture compared to the women with estradiol concentrations ()above 0.066 nmol/L. Adjustment for muscle strength and bone mineral density did not materially change the risk estimates. High muscle strength was associated with a low incidence of fall-related limb fractures. CONCLUSIONS: This study showed that in 75-year-old women higher serum estradiol concentration and greater muscle strength were independently associated with a low incidence of fall-related limb fractures even after adjustment for bone density. Our results suggest that hormonal status and muscle strength have their own separate mechanisms protecting from fall-related fractures. This finding is of importance in developing preventive strategies, but calls for further study.

Accidental Falls↗

Differential effects of sex hormones on peri- and endocortical bone surfaces in pubertal girls.

CONTEXT: The role of sex steroids in bone growth in pubertal girls is not yet clear. Bone biomarkers are indicators of bone metabolic activity, but their value in predicting bone quality has not been studied in growing girls. OBJECTIVE: This study examines the association of sex hormones and bone markers with bone geometry and density in pubertal girls. DESIGN: The study was designed as a 2-yr longitudinal study in pubertal girls. Measurements were performed at baseline and at 1- and 2-yr follow-ups. SETTING: The study was conducted in a university laboratory. PARTICIPANTS: A total of 258 10- to 13-yr-old healthy girls at the baseline participated. METHODS: Peripheral quantitative computed tomography was used to scan the left tibial shaft. Serum 17beta-estradiol (E2), testosterone (T), SHBG, osteocalcin (OC), bone-specific alkaline phosphatase, and tartrate-resistant acid phosphatase isoform 5b were assessed. Data were analyzed using hierarchical linear models with random effect. RESULTS: E2 was a positive predictor for total bone mineral density (BMD), cortical thickness, and a negative predictor for endocortical circumference but had no predictive value for total bone cross-sectional area or periosteal circumference. T was a positive predictor for total cross-sectional area and periosteal circumference as well as endocortical circumference, and a negative predictor for total BMD. OC was negatively correlated with cortical BMD (R2 = 0.325; P < 0.001). CONCLUSIONS: In pubertal girls, E2 and T have different influences on bone properties at the long bone shaft. The results suggest that, at the endocortical surface, E2 inhibits bone resorption during rapid growth, and later, after menarche, acts at higher concentrations to promote bone formation. At the periosteal surface, T promotes bone formation, whereas E2 does not affect it. In addition, OC might be used as a predictor of cortical BMD.

Acid Phosphatase↗

Growth patterns at distal radius and tibial shaft in pubertal girls: a 2-year longitudinal study.

UNLABELLED: Bone changes, in terms of both size and BMD, were assessed longitudinally in pubertal girls. Before puberty, BMD at the distal radius declined, whereas bone size increased, suggesting that normal growing girls experience a transient period of increased bone fragility. This could explain the elevated low-trauma forearm fracture rates reported in earlier studies. INTRODUCTION: Longitudinal data on bone growth during puberty are sparse. Such information is needed to understand the sequence of biological changes, the physical and mechanical consequences for the growing skeleton, and the implications for later life. MATERIALS AND METHODS: The geometric properties and volumetric BMD (vBMD) of the distal radius and tibial shaft were measured using pQCT in 258 pubertal girls followed over 2 years. A new hierarchical linear statistical modeling approach was used to determine true longitudinal trends. RESULTS: The growth rates of cross-sectional area (CSA) and BMC of the distal radius peaked at 16 and 9 months before menarche, respectively. This growth asynchrony between bone size and mass meant that total vBMD of the distal radius declined until 1 year before menarche. At the tibial shaft, total vBMD and cortical vBMD increased monotonically without any such transient reduction. Cortical thickness increased linearly, which was accounted for mainly by bone formation at the periosteal surface before menarche, but by both periosteal and endocortical apposition after menarche. During puberty, the ratio of cortical-to-total CSA of the tibial shaft increased and that of marrow-to-total CSA decreased. CONCLUSIONS: The temporal pattern of bone growth during puberty differs at the distal radius and tibial shaft. A transient decrease in vBMD, arising from asynchronous bone size and mass growth, occurs only at the radius. In the tibia, the mechanism of cortical thickening changes from periosteal apposition premenarche to both periosteal and endocortical apposition postmenarche.

Adolescent↗

Risk factors for clinical stress fractures in male military recruits: a prospective cohort study.

This prospective study was aimed at evaluating risk factors for symptomatic stress fractures among 179 Finnish male military recruits, aged 18 to 20 years. The subjects were studied in the very beginning of the military service of 6 to 12 months in summer. Bone mineral content (BMC) and density (BMD) were measured by dual energy X-ray absorptiometry (DXA) at the lumbar spine and at the hip and heel ultrasound investigation was performed. Blood was sampled for determination of serum total and free testosterone, total and free estradiol, sex hormone-binding globulin (SHBG), procollagen type I N propeptide, total and carboxylated osteocalcin, tartrate-resistant acid phosphatase 5b, 25-hydroxyvitamin D (25-OHD), and intact parathyroid hormone (iPTH), as well as for studying the XbaI and PvuII polymorphisms of the estrogen receptor gene and the CAG repeat polymorphism of the androgen receptor gene. Urine was collected for the determination of N-terminal cross-linking telopeptide of type I collagen. Muscle strength was measured and Cooper's test was performed. Current exercise, smoking, calcium intake, and alcohol consumption were recorded using a questionnaire. During military service, 15 men experienced a stress fracture, diagnosed with X-ray in 14 and with nuclear magnetic resonance in one man. Those who experienced a fracture were taller than those who did not (P = 0.047). The result of Cooper's test was worse in the fracture group than in the non-fracture group (P = 0.026). Femoral neck and total hip BMC and BMD, adjusted for age, weight, height, exercise, smoking, and alcohol and calcium intake were lower (P = 0.021-0.041) for the fracture group. Stress fractures associated with higher iPTH levels (P = 0.022) but not with lower 25-OHD levels. Bone turnover markers as well as sex hormone and SHBG levels were similar for men with and without stress fracture. There was no difference in the genetic analyses between the groups. In conclusion, tall height, poor physical conditioning, low hip BMC and BMD, as well as high serum PTH level are risk factors for stress fractures in male Finnish military recruits. Given the poor vitamin D status of young Finnish men, intervention studies of vitamin D supplementation to lower serum PTH levels and to possibly reduce the incidence of stress fractures are warranted.

Acid Phosphatase↗

Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial.

BACKGROUND: Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period. OBJECTIVE: The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition in girls aged 10-12 y. DESIGN: This placebo-controlled intervention trial randomly assigned 195 healthy girls at Tanner stage I-II, aged 10-12 y, with dietary calcium intakes <900 mg/d to 1 of 4 groups: calcium (1000 mg) + vitamin D3 (200 IU), calcium (1000 mg), cheese (1000 mg calcium), and placebo. Primary outcomes were bone indexes of the hip, spine, and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography. RESULTS: With the use of intention-to-treat or efficacy analysis, calcium supplementation with cheese resulted in a higher percentage change in cortical thickness of the tibia than did placebo, calcium, or calcium + vitamin D treatment (P = 0.01, 0.038, and 0.004, respectively) and in higher whole-body bone mineral density than did placebo treatment (P = 0.044) when compliance was >50%. With the use of a hierarchical linear model with random effects to control for growth velocity, these differences disappeared. CONCLUSIONS: Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium. Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty.

Absorptiometry, Photon↗

The effect of hormone replacement therapy and/or exercise on skeletal muscle attenuation in postmenopausal women: a yearlong intervention.

Hormone replacement therapy (HRT) has been reported to exert a positive effect on preserving muscle strength following the menopause, however, the mechanism of action remains unclear. We examined whether the mechanism involved preservation of muscle composition as determined by skeletal muscle attenuation. Eighty women aged 50-57 years were randomly assigned to either: HRT, exercise (Ex), HRT+exercise (ExHRT), and control (Co) for 1 year. The study was double-blinded with subjects receiving oestradiol and norethisterone acetate (Kliogest) or placebo. Exercise included progressive high-impact training for the lower limbs. Skeletal muscle attenuation in Hounsfield units (HU) was determined by computed tomography of the mid-thigh. Areas examined were the quadriceps compartment (includes intermuscular adipose tissue), quadriceps muscles, the posterior compartment and posterior muscles. Muscle performance was determined by knee extensor strength, vertical jump height, and running speed over 20 m. Fifty-one women completed the intervention. Vertical jump height and running speed improved in the HRT and ExHRT groups compared with Co (interaction, P<0.01). For both the quadriceps compartment and quadriceps muscles, HU significantly increased (interaction, P<or=0.005) for HRT, Ex, and ExHRT compared with Co. For the posterior compartment, HU for the HRT and ExHRT were significantly increased compared with Co, while for posterior muscles, ExHRT was significantly greater than Co. Although the effects were modest, the results indicate that HRT, either alone or combined with exercise, may play a role in preserving/improving skeletal muscle attenuation in early postmenopausal women and thereby exert a positive effect on muscle performance.

Adipose Tissue↗

Age and sex differences in blood lactate response to sprint running in elite master athletes.

The effect of age and sex on anaerobic glycolytic capacity in master athletes is currently unclear. To study this issue, we determined blood lactate concentrations after competitive sprint running in male and female master athletes of different age. Eighty-one men (40-88 yrs) and 75 women (35-87 yrs) participating in the sprint events (100-m, 200-m, 400-m) in the European Veterans Athletics Championships were studied. Blood samples were taken from the fingertip and analysed for peak lactate concentration ([La]bpeak). The [La]bpeak following 100-m to 400-m races showed a curvilinear decline (p < 0.001-0.05) with age in both men and women. However, the age related differences in the [La]b peak were not significant before 70 years of age. No significant sex related differences were found in [La]b peak for any sprint event. The [La]b peak correlated significantly (p < 0.001-0.05) with running times in all sprint distances except for the age-controlled correlation in men for the 100-m and 200-m. In conclusion, the present study showed age but not sex differences in blood lactate response to competitive sprint running in master athletes. Although the [La]b peak level of the athletes was considerably higher than that reported for untrained men and women, these cross-sectional findings suggest that anaerobic energy production from glycolysis declines in later years and may be a factor in the deterioration in sprint performance.

Adult↗

Determinants of lower-body muscle power in early postmenopausal women.

OBJECTIVES: To investigate the association between muscle size, density, and fiber composition; body composition; maximal isometric knee extension strength (KES); and lower-body muscle power in healthy postmenopausal women. DESIGN: Cross-sectional analysis of baseline data from a 1-year randomized controlled experiment. SETTING: University-based research laboratory. PARTICIPANTS: Seventy-eight healthy postmenopausal women aged 50 to 57. MEASUREMENTS: Maximal lower-body muscle power was assessed using vertical jump height (VJH). Maximal isometric KES was measured on a dynamometer chair. Computed tomography scans were used to determine lean-tissue cross-sectional area and density of the thigh and lower leg muscles. Relative area occupied by type I, IIa, IIax, and IIx muscle fibers was assessed from the vastus lateralis muscle. lean body mass and total body fat mass were assessed using bioelectrical impedance. RESULTS: High VJH was associated with low body fat mass, high KES, and high density of thigh and lower leg muscles. Multivariate linear regression modeling revealed that high thigh muscle density (beta=0.242; P=.019), relative area occupied by the fastest muscle fiber types (IIax+IIx; beta=0.246; P=.007), KES (beta=0.247; P=.007), and low body fat mass (beta=-0.455; P<.001) were independently associated with high VJH, accounting for 45% of the variability in VJH. CONCLUSION: This study showed that thigh muscle composition, muscle strength, and body fat mass are important determinants of lower-body muscle power production during weight-bearing activity in healthy postmenopausal women.

Aged↗

Oral health and reduction in respiratory capacity in a cohort of community-dwelling elderly people: a population-based 5-year follow-up study.

OBJECTIVES: Several anaerobic bacteria originating in periodontal pockets have been isolated from infected lungs and pharyngeal microflora. Increased bacterial load in lungs is known to be a risk factor for decline in forced expiratory volume during the first second. The aim was to evaluate both cross-sectionally and longitudinally the association between oral health status and forced expiratory volume during the first second (FEV1) in older residents of the city of Jyväskylä, Finland. DESIGN: Cross-sectional and prospective cohort study over a 5-year follow-up. SETTING: Research laboratory of the University of Jyväskylä. PARTICIPANTS: In 1990 dental status and FEV1 were examined in 203 80-year-old people, of whom 88 survivors were retested 5 years later. MAIN OUTCOME MEASURES: Primary: dental status and FEV1. Secondary: existence of pulmonary diseases, height, handgrip strength, smoking, and length of education. RESULTS: Participants were regrouped into three categories according to their baseline oral health status. At baseline, men with complete prostheses had the lowest FEV1. Five years later the greatest reduction in FEV1 was seen in subjects with poor periodontal status or complete prostheses (-9.4%) while those with healthy periodontal status showed no reduction in FEV1 values (+1.0%, p = 0.006). CONCLUSIONS: Periodontal infections and complete prostheses may be reservoirs for pathogens which may be harmful and partly explain the observed reduction in FEV1 during ageing.

Aged↗

Vitamin D status as a determinant of peak bone mass in young Finnish men.

Severe vitamin D deficiency causes rickets, but scarce data are available about the extent to which vitamin D status determines the development of the peak bone mass in young adults. Our aim was to evaluate the prevalence of vitamin D deficiency [serum 25-hydroxyvitamin D (25-OHD) less than the lower limit of the reference range of 20-105 nmol/liter] and the relationship between vitamin D status and peak bone mass among young Finnish men. A cross-sectional study of determinants of peak bone mass with data on lifestyle factors collected retrospectively was performed in 220 young men, aged 18.3-20.6 yr. One hundred and seventy men were recruits of the Finnish Army, and 50 were men of similar age who had postponed their military service for reasons not related to health. Bone mineral content, bone mineral density, and scan area were measured in lumbar spine and upper femur by dual energy x-ray absorptiometry. Serum 25-OHD concentrations were followed prospectively for 1 yr. In July 2000, only 0.9% of the men had vitamin D deficiency, but 6 months later, in the winter, the respective percentage was 38.9%. After adjusting for age, height, weight, exercise, smoking, calcium, and alcohol intake, there existed a positive correlation between serum 25-OHD and bone mineral content at lumbar spine (P = 0.057), femoral neck (P = 0.041), trochanter (P = 0.010), and total hip (P = 0.025). The correlation coefficients for the bone mineral densities at the four measurement sites were 0.035, 0.061, 0.056, and 0.068, respectively. No correlation was found to scan area. We conclude that vitamin D deficiency is very common in Finnish young men in the winter, and it may have detrimental effects on the acquisition of maximal peak bone mass. As in Finland vitamin D supplementation to infants is now stopped at the age of 3 yr, it can be asked whether at our latitude it should be continued from that age onward, not for the prevention of rickets, but as prophylaxis for osteoporosis.

Absorptiometry, Photon↗

Relationship of sex hormones to bone geometric properties and mineral density in early pubertal girls.

This study aimed to evaluate the associations among serum 17beta-estradiol (E2), testosterone (T), sex hormone-binding globulin (SHBG), bone geometric properties, and mineral density in 248 healthy girls between the ages of 10 and 13 yr old. The left tibial shaft was measured by peripheral quantitative computed tomography (Stratec XCT-2000; Stratec Medizintechnik, GmbH, Pforzheim, Germany). The cortical bone and marrow cavity areas were expressed as proportions of the total tibial cross-sectional area (CSA). Cortical thickness and total volumetric bone mineral density (vBMD) were also determined. These tibial geometric and densitometric measures were correlated against the serum sex hormone concentrations after controlling for age and body size. The results showed that E2 was negatively associated with marrow cavity proportion (r = -0.19, P = 0.003) and positively associated with cortical proportion and thickness and with total vBMD (r = 0.26, P < 0.001; r = 0.25, P < 0.001; and r = 0.23, P < 0.001, respectively). However, T was not associated with these bone variables. On the other hand, SHBG was positively associated with marrow cavity proportion (r = 0.17, P = 0.007) and negatively associated with cortical proportion and thickness and with total vBMD (r = -0.14, P = 0.029; r = -0.16, P = 0.010; and r = -0.18, P = 0.005, respectively). Total bone CSA did not correlate with E2, T, or SHBG. These results suggest that E2 has a positive effect on bone geometric and densitometric development by suppressing bone turnover at the endocortical surface during the early pubertal period, that SHBG plays an opposite role to E2, and that T has no detectable effect.

Absorptiometry, Photon↗

Age-related differences in 100-m sprint performance in male and female master runners.

PURPOSE: This study was undertaken to investigate age-related differences in the velocity and selected stride parameters in male and female master sprinters and to determine which stride characteristics were related to the overall decline in the performance of the 100 m with age. METHODS: The performances of 70 finalists (males 40-88 yr, females 35-87 yr) at the European Veterans Athletics Championships were recorded using two high-speed cameras (200 Hz) with a panning video technique and distance markers at 10-m intervals. Velocity, stride length (SL), stride rate (SR), ground contact time (CT), and flight time (FT) during the acceleration, peak velocity, and deceleration phases of the 100-m race were determined from the video records with the aid of the Peak Performance analysis system. RESULTS: There was a general decline in sprint performances with age, the decrease becoming more evident around 65-70 yr of age. The velocity during the different phases of the run declined on average from 5 to 6% per decade in males and from 5 to 7% per decade in females. Similarly, SL showed clear reductions with increasing age, whereas SR remained unchanged until the oldest age groups in both genders. Furthermore, the CT, which correlated with velocity, was significantly longer, and FT, which correlated with both velocity and SL, was shorter in older age groups. CONCLUSION: Our findings indicated that age-associated differences in velocity in elite master sprinters were similar in each phase of the 100-m run. The deterioration of the overall performance with age was primarily related to reduction in SL and increase in CT.

Acceleration↗

Serum osteocalcin in relation to calcaneal bone mineral density in elderly men and women: a 5-year follow-up.

A 5-year follow-up study investigated serum concentrations of total (tOC) and intact (iOC) osteocalcin in relation to calcaneal bone mineral density (BMD). The study comprised two cohorts, 75- and 80-year-olds, both resident in the city of Jyväskylä, Finland. Baseline OC and BMD were obtained for 161 men and 233 women, of whom 83 men and 189 women participated in follow-up bone measurements. The mean concentration of tOC increased from 9.6 +/- 4.3 to 13.2 +/- 8.5 microg/l (P = 0.001) in men and from 11.2 +/- 4.9 to 14.0 +/- 6.1 microg/l (P < 0.001) in women, whereas mean iOC decreased from 6.4 +/- 3.0 to 5.9 +/- 3.0 microg/l (P = 0.273) and from 7.7 +/- 3.7 to 6.9 +/- 3.4 microg/l (P = 0.021) in men and women, respectively. TOC and iOC levels correlated inversely with BMD and change in BMD in both sexes (r ranged from -0.223 to -0.422 and P = 0.048 < or = 0.001). When we divided the baseline tOC and iOC values into four quartiles, the decrease in BMD was significantly greater in the third tOC quartiles in women and in the fourth tOC and iOC quartiles in men when compared with the lower quartiles. During the 5-year period, 19 men and 59 women sustained at least one fracture. These individuals with fractures had significantly higher iOC values and tended to have higher tOC values compared with the nonfracture group at baseline (P = 0.038 and 0.087, respectively). Our results indicate that baseline serum tOC and iOC were associated with bone loss and predicted fracture in the two cohorts of independently living elderly men and women.

Aged↗

Improving cardiovascular fitness by strength or endurance training in women aged 76-78 years. A population-based, randomized controlled trial.

BACKGROUND: there have been few population-based, randomized controlled trials on the effects of strength or endurance training on cardiovascular fitness in older women. OBJECTIVE: to study the effects of strength or endurance training on cardiovascular fitness in women aged 76-78 years. DESIGN: a population-based, randomized controlled trial. SETTING: exercise laboratory in a university faculty of sport and health sciences. SUBJECTS: we randomly assigned 42 medically-screened women aged 76-78 years, drawn from the population register to strength (n=16), endurance (n=15) or control (n=11) groups. METHODS: subjects in the two exercise groups performed a supervised, individually tailored 18-week strength or endurance training programme. Controls continued with physical activity at their normal level. RESULTS: the strength training group showed an increase in cycle ergometer peak power from 68.1 to 70.3 W (P=0.035 compared with controls). Their peak power per kg body weight increased from 1.02 to 1.05, while that of the endurance training group increased from 0.91 to 0.93 (P=0.027 and P=0.049 respectively). Peak oxygen uptake increased from 18.1 to 19.7 ml x kg(-1) x min(-1) in the strength and from 17.1 to 18.2 in the endurance group (non-significant). Six subjects (19%) in the exercise groups withdrew from the study because of health problems. CONCLUSIONS: even with its limitations, the study suggests that the effect of 18-week strength or endurance training on cardiovascular fitness among women aged >/=75 is relatively small. Furthermore, health problems can emerge during training programmes in medically-screened elderly women.

Aged↗

Muscle strength as a predictor of onset of ADL dependence in people aged 75 years.

The aim of this prospective study over 5 years was to examine maximal isometric strength of multiple muscle groups as a predictor of losing independence in activities of daily living (ADL). The participants were from the Nordic Research on Aging (NORA75). These analyses are restricted to 567 people who at baseline were independent in ADL and participated in strength tests, and who five years later participated in follow-up ADL assessments. Tests on maximal isometric strength of hand grip, elbow flexion, knee extension and trunk flexion and extension were done using adjustable dynamometers. For each muscle group tested, three equal groups were formed for men and women separately based on distributions of results. Those who reported being unable or needing help for eating, dressing, bathing, toileting, walking indoors or transferring from a bed or a chair were rated as ADL dependent. Of the 227 initially ADL independent men, 21 (9.3%) became dependent in ADL. In women, the figures were 30 (8.8%) of 340. Multiple logistic regression models were used to predict the risk of ADL dependence in groups based on strength tertiles. After confirming that the association of muscle strength and incident ADL-dependence was similar in men and women, both genders were included in the same analyses adjusted for body weight and height, gender and research locality. Gender specific cut-offs were used for strength tertiles. All the strength tests predicted ADL dependence, with those being in the lowest tertile having two to three times greater risks than those in the highest tertile of strength. Further adjustments for chronic diseases did not materially change the results. Strength tests could be used to identify people who are still independent in ADL but who are at increased risk of becoming dependent because of poor muscle strength, and who could reduce their risk by strengthening exercises.

Activities of Daily Living↗