Biomedical subjects

Todd M Manini

Publications and source records attributed to Todd M Manini.

13 recordsLinked to original sources

PubMed2006

Midlife physical activity and mobility in older age: The InCHIANTI study.

BACKGROUND: Among older adults, loss of mobility represents a critical stage in the disablement process, whereby the risk for disability is significantly increased. Physical activity is a modifiable risk factor that is associated with reduced risk of losing mobility in older adulthood; however, few studies have examined physical activity performed earlier in life in relation to mobility later in life. METHODS: Data from a population-based study of 1155 adults aged 65 years and older living in the Chianti region of Italy in 1998-2000 were analyzed in 2005 and 2006. Participants retrospectively recalled their physical activity levels in midlife and underwent mobility testing and medical examination. Two objective mobility outcomes were examined as a function of past physical activity: the Short Physical Performance Battery (SPPB) and the ability to walk 400 meters. RESULTS: Older Italian adults (mean age 74.8, standard deviation 7.3) who engaged in higher levels of physical activity in midlife were significantly more likely to perform better on the SPPB than individuals who were less physically active in midlife. In addition, failure to complete the 400-meter walk test was significantly less likely among physically active men (Level II) (odds ratio [OR] = 0.37, 95% confidence interval [CI] = 0.15-0.93) and very active men (Level III) (OR = 0.23, 95% CI = 0.09-0.63) when compared to men who were less active (Level I) in the past (p for trend, 0.008). These associations remained after adjustment for demographic factors, medical conditions, and physiologic impairments. CONCLUSIONS: Older adults who reported higher levels of physical activity in midlife had better mobility in old age than less physically active ones.

Aged↗

PubMed2006

Daily activity energy expenditure and mortality among older adults.

CONTEXT: Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival advantages. OBJECTIVE: To determine whether free-living activity energy expenditure is associated with all-cause mortality among older adults. DESIGN, SETTING, AND PARTICIPANTS: Free-living activity energy expenditure was assessed in 302 high-functioning, community-dwelling older adults (aged 70-82 years). Total energy expenditure was assessed over 2 weeks using doubly labeled water. Resting metabolic rate was measured using indirect calorimetry and the thermic effect of meals was estimated at 10% of total energy expenditure. Free-living activity energy expenditure was calculated as: (total energy expenditure x 0.90) - resting metabolic rate. Participants were followed up over a mean of 6.15 years (1998-2006). MAIN OUTCOME MEASURES: Free-living activity energy expenditure (3 tertiles: low, <521 kcal/d; middle, 521-770 kcal/d; high, >770 kcal/d) and all-cause mortality. RESULTS: Fifty-five participants (18.2%) died during follow-up. As a continuous risk factor, an SD increase in free-living activity energy expenditure (287 kcal/d) was associated with a 32% lower risk of mortality after adjusting for age, sex, race, study site, weight, height, percentage of body fat, and sleep duration (hazard ratio, 0.68; 95% confidence interval, 0.48-0.96). Using the same adjustments, individuals in the highest tertile of free-living activity energy expenditure were at a significantly lower mortality risk compared with the lowest tertile (hazard ratio, 0.31; 95% confidence interval, 0.14-0.69). Absolute risk of death was 12.1% in the highest tertile of activity energy expenditure vs 24.7% in the lowest tertile; absolute risks were similar to these for tertiles of physical activity level. The effect of free-living activity energy expenditure changed little after further adjustment for self-rated health, education, prevalent health conditions, and smoking behavior. According to self-reports, individuals expending higher levels of free-living activity energy were more likely to work for pay (P = .004) and climb stairs (P = .01) but self-reported high-intensity exercise, walking for exercise, walking other than for exercise, volunteering, and caregiving did not differ significantly across the activity energy expenditure tertiles. CONCLUSIONS: Objectively measured free-living activity energy expenditure was strongly associated with lower risk of mortality in healthy older adults. Simply expending energy through any activity may influence survival in older adults.

Activities of Daily Living↗

PubMed2006

Adaptations in human neuromuscular function following prolonged unweighting: II. Neurological properties and motor imagery efficacy.

Strength loss following disuse may result from alterations in muscle and/or neurological properties. In this paper, we report our findings on human plantar flexor neurological properties following 4 wk of limb suspension [unilateral lower limb suspension (ULLS)], along with the effect of motor imagery (MI) training on these properties. In the companion paper (Part I), we report our findings on the changes in skeletal muscle properties. Additionally, in the present paper, we analyze our findings to determine the relative contribution of neural and muscular factors in strength loss. Measurements of central activation, the H-reflex, and nerve conduction were made before and after 4 wk of ULLS (n = 18; 19-28 yr). A subset of the subjects (n = 6) performed PF MI training 4 days/wk. Following ULLS, we observed a significant increase in the soleus H-reflex (45.4 +/- 4.0 to 51.9 +/- 3.7% expressed relative to the maximal muscle action potential). Additionally, there were longer intervals between the delivery of an electrical stimulus to the tibial nerve and the corresponding muscle action potential (M-wave latency; mean prolongation 0.49 ms) and H-reflex wave (H-wave latency; mean prolongation 0.46 ms). The efficacy of MI on strength was ambiguous, with no significant effect detected (although a modest effect size was observed; eta2 = 0.18). These findings suggest that unweighting induces plastic changes in neural function that appear to be spatially distributed throughout the nervous system. In terms of the relative contribution of neural and muscular factors regulating strength loss, we observed that neural factors (primarily deficits in central activation) explained 48% of the variability in strength loss, whereas muscular factors (primarily sarcolemma function) explained 39% of the variability.

Action Potentials↗

PubMed2006

Evaluating task modification as an objective measure of functional limitation: repeatability and comparability.

BACKGROUND: Modification of everyday tasks in older adults is associated with risk of deleterious health outcomes. The purpose of this study was to develop a task modification scale to examine its reliability and comparability to timed performance and common measures of physical function and impairment. METHODS: Eighty-two (21 men, 61 women) older adults (74.4 +/- 8.2 years) were observed performing a chair rise (sitting heights: 43 cm, 38 cm, and 30 cm), stair ascent/descent, and kneel and supine rise tasks. Six hierarchically ranked categories (0-5) of modification were created for each task and then summed across tasks (summary modification [MOD] score: range 0-35). Comparisons were made with timed performance, knee extension strength, single-leg balance, self-reported function, five chair stands, and gait speed. RESULTS: Inter-rater reliability (intra-class correlation = 0.98) and participant repeatability (intra-class correlation = 0.92) of the MOD score were excellent. Ninety-six percent of participants modified at least one task (MOD score: 10.5 +/- 7.51, range 0-27). After adjusting for task modification, timed performance showed a lower association with gait speed (time vs MOD score, semipartial r2 = 0.31 vs 0.68), strength (semipartial r2 = 0.14 vs 0.65), and single-leg balance (semipartial r2 = 0.10 vs 0.40) than did the MOD score. The MOD score showed higher correlations with muscle strength and balance impairment than did other measures of functional limitation such as gait speed, time to complete five chair stands, and self-reported physical function. CONCLUSION: Documentation of task modification is reliable across raters and repeatable within participants; in addition, it compares well with other measures of physical function and impairment. Task modification reveals important and intuitive information regarding physical limitation, and deserves greater attention.

Activities of Daily Living↗

PubMed2005

Resistance and functional training reduces knee extensor position fluctuations in functionally limited older adults.

The purpose of this study was to determine the effect of task-specificity on knee extensor steadiness adaptations in functionally limited older adults. Twenty-four functionally limited older adults (74.6+/-7.6 years: 22 women, 2 men) completed a 10-week control period followed by 10 weeks (2 days/week) of resistance (RT), functional (FT) (practicing everyday tasks, i.e., chair rises) or functional + resistance (FRT) training, which featured both shortening and lengthening movements. During testing, subjects performed a steady isometric [10, 25, 50% of maximal voluntary contraction (MVC)] and shortening/lengthening (5, 30, 65% of MVC) knee extensor contractions. There were no steadiness (isometric, shortening or lengthening contractions) changes in the control period and no adaptations in isometric steadiness due to training. RT induced a 37% reduction in shortening fluctuations at 5% of MVC and 35% reduction in lengthening fluctuations at both 30% and 65% of MVC. FRT induced a 60% reduction in shortening fluctuations at 30% of MVC. No adaptations in dynamic steadiness were observed in the FT group. Further analysis indicated that those who were the least steady at baseline showed the greatest training effects during isometric (RT: R (2)=0.25, FRT: R (2)=0.49, FT: R (2)=0.38), shortening (RT: R (2)=0.36, FRT: R (2)=0.36, FT: R (2)=0.35) and lengthening (RT: r (2)=0.29, FRT: r (2)=0.44) contractions. In conclusion, steadiness improvements in groups performing resistance exercise, without a concomitant improvement in the FT group, supports a role for task-specificity in explaining steadiness adaptations, particularly for unsteady older adults.

Activities of Daily Living↗

PubMed2005

Sex differences in muscle fatigability and activation patterns of the human quadriceps femoris.

The purposes of this study were to determine if the fatigability of the quadriceps femoris varies by biological sex under conditions of normal muscle blood flow and ischemia, and if differences in neuromuscular activation patterns exist. Young men and women (n = 11/group; age 20-39 years) performed a sustained knee extension contraction at 25% of maximal force under conditions of occluded (OCC) and normal muscle blood flow (NON-OCC). Electromyographic (EMG) activity was recorded from the vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and biceps femoris (BF) muscles, and analyzed for fatigue-induced changes in the amplitude and burst rate and duration (transient changes in motor unit recruitment) of the signal. Additionally, force fluctuations during the sustained contraction were quantified. Women had a longer time to task failure during the NON-OCC task [214.9 +/- 20.5 vs. 169.1 +/- 20.5 (SE) s] (P = 0.02), but not during the OCC task (179.6 + 19.6 vs. 165.2 +/- 19.6 s). EMG data demonstrated sex differences in the neuromuscular activation pattern of the RF muscle and the collectively averaged QF muscles. During the NON-OCC and OCC tasks women achieved a higher relative activation of the RF at task failure than men (NON-OCC: 40.68 +/- 4.57 vs. 24.49 +/- 4.19%; OCC: 36.80 +/- 5.45 vs. 24.41 +/- 2.12%) (P = 0.02 and 0.05, respectively). Also, during both tasks, they demonstrated a greater relative activation at task failure than men when an average of the VL, VM and RF was considered. Additionally, women exhibited a greater coefficient of variation in force fluctuations during the last-third of the fatiguing NON-OCC task (6.21 +/- 0.567 vs. 4.56 +/- 0.56%) (P = 0.001). No sex differences in EMG burst rate or duration were observed, although there was a trend towards greater EMG burst rate of the RF in association with muscle fatigue in the women (P = 0.09). Interestingly, the only neuromuscular activation variable that displayed a significant relationship with the time to task failure was the average relative EMG of the QF at task failure, and this relationship was observed under both experimental blood flow conditions (NON-OCC: r = 0.47, P = 0.03; OCC: r = 0.44, P = 0.04). These results indicate that sex differences in muscle blood flow and/or muscle metabolism are in part responsible for the female advantage in fatigue-resistance. Additionally, these findings suggest that men synergistically recruit the RF compartment to a lesser extent than women in association with muscle fatigue, and that women achieve an overall greater relative activation of the QF at task failure than men. However, the implications of these sex differences in neuromuscular activation patterns during fatiguing muscular contractions on the ability to withstand muscle fatigue (prolonged time to task failure) does not appear to be causally related.

Action Potentials↗

PubMed2005

Knee extensor isometric unsteadiness does not predict functional limitation in older adults.

OBJECTIVE: To determine how knee extensor steadiness is related to age and difficulty performing everyday tasks. DESIGN: In this cross-sectional study performed at a research laboratory, 50 older adults (age range, (56-95 yrs) performed steadiness testing at 50% of maximum strength and were timed and rated on four tasks of daily living: chair rise, stair ascent and descent, and walk. The independent variables of age, steadiness, and strength-to-weight ratio were entered into regression models with the ratings and time to complete the four everyday tasks as dependent variables. RESULTS: The strength-to-weight ratio was the only significant predictor in the multiple regression models, explaining 29%, 33%, 14%, and 14% of the variance in gait speed and time to complete a chair rise, stair ascent, and stair descent, respectively. Similar results were seen with task ratings. Age was not correlated with steadiness (r = 0.25, P = 0.07). CONCLUSION: This study suggests that knee extensor isometric steadiness performance does not carry over to tasks of everyday living, and older subjects, regardless of age, have similar steadiness values. Because the strength-to-weight ratio predicted the most variance in functional performance, it is recommended that muscle strength be improved to increase function in older adults.

Activities of Daily Living↗

PubMed2005

Misconceptions about strength exercise among older adults.

The purposes of this study were to determine current opinions of strength exercise among older adults and whether knowledge of recommended protocols differs between strength-exercise participants and nonparticipants. One hundred twenty-nine older adults (77.5 +/- 8.6 years) responded to questions about their opinions, experiences, and knowledge of strength-exercise recommendations. Some misconceptions were identified in the sample, with 48.4% of participants responding "no" to "strength training increases muscle mass," 45% responding "no" to "increasing weight is more important than number of repetitions for building strength," and 37% responding that walking is more effective than lifting weights at building muscle strength. The number of correct responses was related to the number of years in school (semipartial r(2)= .046). More education is needed about the benefits and recommendations to ensure proper use of current strength-exercise protocols among older adults.

Age Factors↗

PubMed2004

Leg muscle activity during walking with assistive devices at varying levels of weight bearing.

OBJECTIVE: To evaluate the muscle activation patterns at varying levels of weight-bearing forces during assisted walking with an axillary crutch and a recently designed device that allows weight transfer through the pelvic girdle (ED Walker). DESIGN: Descriptive, repeated measures. SETTING: University-based research laboratory. PARTICIPANTS: Twelve healthy volunteers (age, 39.6+/-13.6 y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Electromyographic activity was recorded from the anterior tibialis, soleus, biceps femoris, and vastus lateralis muscles on a test leg during assisted axillary crutch and ED Walker ambulation. Force platform readings measured weight-bearing load (non, light, heavy). These values were normalized to normal walking gait. RESULTS: In the vastus lateralis and soleus muscles, both devices allowed for approximately 50% and 65% reductions in electromyographic activity during the non-weight-bearing condition. During crutch ambulation, electromyographic activity of the soleus was significantly reduced compared with that required for normal walking at all levels of weight-bearing load. In the vastus lateralis for the weight-bearing conditions, the ED Walker required significantly higher electromyographic activity than crutch ambulation (light: 105.0%+/-12.3% vs 72.7%+/-10.1%; heavy: 144.8%+/-23.5% vs 100.0%+/-13.5%). Both devices required similar peak vertical ground reaction forces during the heavy weight-bearing conditions (crutch: 75%+/-1.6%; ED Walker: 73%+/-1.8%), whereas axillary crutch gait produced less force than the ED Walker in the light condition (32%+/-2.0% vs 48%+/-1.6%). CONCLUSIONS: During walking with assistive devices, muscle activation patterns varied with weight-bearing load. The leg extensor muscles appeared to incur a greater reduction in muscle activity when compared with their flexor counterparts. Additionally, the ED Walker and axillary crutch differed with respect to their muscle activity levels and weight-bearing characteristics. Clinically, knowledge of these muscle activity and force characteristics may aid in the decision-making process of prescribing a device type and timeline to follow in restoring weight-bearing loads.

Activities of Daily Living↗

PubMed2003

Gender differences in skeletal muscle fatigability are related to contraction type and EMG spectral compression.

The purposes of this study were 1) to evaluate gender differences in back extensor endurance capacity during isometric and isotonic muscular contractions, 2) to determine the relation between absolute load and endurance time, and 3) to compare men [n = 10, age 22.4 +/- 0.69 (SE) yr] and women (n = 10, age 21.7 +/- 1.07 yr) in terms of neuromuscular activation patterns and median frequency (MF) shifts in the electromyogram (EMG) power spectrum of the lumbar and hip extensor muscles during fatiguing submaximal isometric trunk extension exercise. Subjects performed isotonic and isometric trunk extension exercise to muscular failure at 50% of maximum voluntary contraction force. Women exhibited a longer endurance time than men during the isometric task (146.0 +/- 10.9 vs. 105.4 +/- 7.9 s), but there was no difference in endurance performance during the isotonic exercise (24.3 +/- 3.4 vs. 24.0 +/- 2.8 repetitions). Absolute load was significantly related to isometric endurance time in the pooled sample (R(2) = 0.34) but not when men and women were analyzed separately (R(2) = 0.05 and 0.04, respectively). EMG data showed no differences in neuromuscular activation patterns; however, gender differences in MF shifts were observed. Women demonstrated a similar fatigability in the biceps femoris and lumbar extensors, whereas in men, the fatigability was more pronounced in the lumbar musculature than in the biceps femoris. Additionally, the MF of the lumbar extensors demonstrated a greater association with endurance time in men than in women (R(2) = 0.45 vs. 0.19). These findings suggest that gender differences in muscle fatigue are influenced by muscle contraction type and frequency shifts in the EMG signal but not by alterations in the synergistic activation patterns.

Adult↗

PubMed2003

Derecruitment of the lumbar musculature with fatiguing trunk extension exercise.

STUDY DESIGN: This was a descriptive study involving 20 healthy individuals. OBJECTIVES: To evaluate the neuromuscular activation patterns of the lumbar paraspinal and hip extensor muscles during isotonic trunk extension exercise. SUMMARY OF BACKGROUND DATA: Few studies have evaluated the effect of muscle fatigue on the lumbar musculature during isotonic exercise. METHODS: Electromyographic activity was recorded continuously from the lumbar paraspinal, gluteus maximus, and biceps femoris muscles during isotonic trunk extension exercise performed to muscular failure. Root mean squared electromyography was determined over the concentric portion of each repetition, and polynomial regression analysis was used to describe the association between fatigue and the recruitment patterns. RESULTS: The lumbar paraspinals demonstrated an increase in the electromyogram signal up to 57.9% of maximal fatigue, at which point decrements in electromyography were observed (lumbar [quadratic curve] R2 = 0.0807, SEE = 0.228; beta2 = -8.245(-5)) (P < 0.000). Associated with fatigue, the gluteus maximus demonstrated an increase in electromyography, with an exponential breakpoint occurring at 35.9% of maximal fatigue (gluteus maximus [quadratic curve]: R2 = 0.5059, SEE = 0.865; beta2 = 0.00017) (P = 0.014). The biceps femoris demonstrated a linear increase in electromyography with fatigue (R2 = 0.4667, SEE = 0.284; beta2 = 0.0091) (P < 0.000). To further investigate the derecruitment of the lumbar extensors associated with fatigue, study participants were analyzed individually with regression analyses. Results revealed that the majority of study participants (68.5%) demonstrated a significant decrease (quadratic bend) in lumbar electromyography, with decrements in muscle activity beginning at 53% of maximum. CONCLUSION: During fatiguing trunk extension exercise, an increase in the lumbar paraspinal electromyogram signal occurs up to approximately 55% of maximum fatigue, at which point a decrease in electromyography is observed. Associated with this derecruitment is a concomitant increase in hip extensor muscle activity, suggesting that as the lumbar musculature becomes fatigued, these muscles allow for continuation of the exercise.

Abdominal Muscles↗

PubMed2002

Electromyographic activity of the lumbar and hip extensors during dynamic trunk extension exercise.

OBJECTIVE: To evaluate the effects of exercise intensity and multiple sets on muscle activation patterns during trunk extension exercise. DESIGN: Descriptive, repeated measures. SETTING: University-based musculoskeletal research laboratory. PARTICIPANTS: Twenty volunteers recruited from a university setting. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Electromyographic activity was recorded from the L3-4 paraspinal region, gluteus maximus, and biceps femoris muscles during multiple sets of trunk extension exercise at intensities representing 40%, 50%, and 70% of peak isometric force. RESULTS: As exercise intensity increased, the electromyographic activity of the gluteus maximus increased to a greater extent than the activity of the paraspinal region. At the 50% intensity level, biceps femoris electromyographic activity was significantly greater than the paraspinal region electromyographic activity, whereas at the 70% intensity no differences were found between muscles. During multiple sets of exercise at the same intensity a muscle by set interaction was observed. This interaction revealed that with respect to other muscle groups, the electromyographic activity of the gluteus maximus increased between sets 1 and 2, whereas electromyographic decrements occurred in the paraspinal region. During exercise at the 40% intensity level, biceps femoris electromyographic activity increased to a greater extent between sets 1 and 2 when compared with the paraspinal region. CONCLUSION: Exercise intensity and multiple sets result in alterations in muscle recruitment patterns of the lumbar and hip extensor muscles. These findings raise questions as to the efficacy of added loading and multiple sets during trunk extension exercise.

Adult↗

PubMed2002

Electromyographic activity of the trunk extensor muscles: effect of varying hip position and lumbar posture during Roman chair exercise.

OBJECTIVE: To evaluate the effect of hip position and lumbar posture on the surface electromyographic activity of the trunk extensors during Roman chair exercise. DESIGN: Descriptive, repeated measures. SETTING: University-based musculoskeletal research laboratory. PARTICIPANTS: Twelve healthy volunteers (7 men, 5 women; age range, 18-35y) without a history of low back pain were recruited from a university setting. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Surface electromyographic activity was recorded from the lumbar extensor, gluteal, and hamstring musculature during dynamic Roman chair exercise. For each muscle group, electromyographic activity (mV/rep) was compared among exercises with internal hip rotation and external hip rotation and among exercises by using a typical lumbar posture (nonbiphasic) and a posture that accentuated lumbar lordosis (biphasic). RESULTS: For the lumbar extensors, electromyographic activity during exercise was 18% greater with internal hip rotation than external hip rotation (P< or =.05) and was 25% greater with a biphasic posture than with a nonbiphasic posture (P< or =.05). For the gluteals and hamstrings, there was no difference in electromyographic activity between internal and external hip rotation or between biphasic and nonbiphasic postures (P >.05). CONCLUSION: The level of recruitment of the lumbar extensors can be modified during Roman chair exercise by altering hip position and lumbar posture. Clinicians can use these data to develop progressive exercise protocols for the lumbar extensors with a variety of resistance levels without the need for complex equipment.

Adolescent↗