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PubMedDate not supplied

The effect of low-intensity aerobic exercise on muscle strength, flexibility, and balance among sedentary elderly persons.

An experimental group of 20 elderly subjects participated in 8 weeks of low-intensity aerobic exercise while 27 subjects in a comparison group maintained their usual level of activity. The program consisted of stretching and strengthening chair exercises. A significant difference between the groups was found for flexibility of the ankles and the right knee. No significant difference was found between the groups for muscle strength or balance, although the experimental group improved their balance by 22%.

Accidental Falls↗
PubMed2005

Hormonal responses and adaptations to resistance exercise and training.

Resistance exercise has been shown to elicit a significant acute hormonal response. It appears that this acute response is more critical to tissue growth and remodelling than chronic changes in resting hormonal concentrations, as many studies have not shown a significant change during resistance training despite increases in muscle strength and hypertrophy. Anabolic hormones such as testosterone and the superfamily of growth hormones (GH) have been shown to be elevated during 15-30 minutes of post-resistance exercise providing an adequate stimulus is present. Protocols high in volume, moderate to high in intensity, using short rest intervals and stressing a large muscle mass, tend to produce the greatest acute hormonal elevations (e.g. testosterone, GH and the catabolic hormone cortisol) compared with low-volume, high-intensity protocols using long rest intervals. Other anabolic hormones such as insulin and insulin-like growth factor-1 (IGF-1) are critical to skeletal muscle growth. Insulin is regulated by blood glucose and amino acid levels. However, circulating IGF-1 elevations have been reported following resistance exercise presumably in response to GH-stimulated hepatic secretion. Recent evidence indicates that muscle isoforms of IGF-1 may play a substantial role in tissue remodelling via up-regulation by mechanical signalling (i.e. increased gene expression resulting from stretch and tension to the muscle cytoskeleton leading to greater protein synthesis rates). Acute elevations in catecholamines are critical to optimal force production and energy liberation during resistance exercise. More recent research has shown the importance of acute hormonal elevations and mechanical stimuli for subsequent up- and down-regulation of cytoplasmic steroid receptors needed to mediate the hormonal effects. Other factors such as nutrition, overtraining, detraining and circadian patterns of hormone secretion are critical to examining the hormonal responses and adaptations to resistance training.

Adaptation, Physiological↗
PubMed1984

Effect of repeated eight-minute muscle loading on the angle of straight-leg raising.

The right lower extremities of 10 experimental subjects were passively loaded for 8 minutes on three consecutive days to determine the effects of such loading on the angle of straight-leg raising. The angle was determined cinematographically each day after loading for 15 seconds, every 30 seconds thereafter during 8 minutes of loading, and 10 minutes and 24 hours after loading. Twenty-four hours after three days of loading, the straight-leg-raising angle of the Experimental Group was an average of 4.4 degrees greater than it was initially. This increase was not statistically significant. The comparable angle of 10 control subjects increased an average of 0.6 degrees. The 4.4 degree increase suggests that muscle lengthens slowly in response to 8 minutes of stretching applied on three consecutive days.

Adult↗
PubMed2001

Physical modalities other than stretch in spastic hypertonia.

This article reviews various physical modalities that have been used in spastic hypertonia, particularly superficial heat and cold, diathermies (ultrasound, microwave, and short-wave irradiation), electrical stimulation (transcutaneous electrical nerve stimulation), implanted spinal stimulation (rectal stimulation), and massage (deep friction, superficial contact). The duration of the effects of most physical therapies is relatively short (e.g., cooling, heating, and massage), which often may limit their application to immediate prestretch or pre-exercise periods. The potential capacity of ultrasound therapy to improve the efficacy of chronic stretch in lengthening muscle may be a promising option. The neurodestructive potential of high intensity microwave for the personnel involved and controlled evidence of its value is required before this modality can be recommended in spasticity. Overall, controlled, double-blind studies are mandated to evaluate the long-term impact of repeated use of these short-term modalities on function and recovery in patients with spasticity.

Animals↗
PubMed2001

[How much strength is needed for fitness?].

In order to tolerate the exertion in fitness exercise in the long term a sufficiently strong trunk musculature should be aimed at. In order to stabilize and balance the trunk and the pelvis there should be an optimal interaction of the muscles of the abdomen, the lateral trunk, the back and the flexors and extensors of the hip. If that balance is disrupted, muscular imbalance and a weakening or shortening of the muscles involved can occur. That imbalance leads to inadequate and excessive strain of the functional system of spine and pelvis. The functional anatomy of the trunk is described with clinical references in order to elucidate this context. A program of strength and stretching exercises for the trunk is presented suited to the needs of those practicing fitness exercise.

Exercise Therapy↗
PubMed1981

Establishing a low back school.

We present a plan for establishing a facility for conservative treatment of patients with low back pain. This system is based on a concept of one therapist instructing one patient in certain anatomy and body mechanics appropriate to his needs. Audiovisual programs are used in this part of the program. Exercises are prescribed for specific muscle groups important in achieving proper postures during the activities of daily living and to stretch contractures that contribute to lordotic stresses on the lumbar spine. After the completion of three or four sessions necessary to achieve reeducation, the patient is asked to demonstrate his proficiency on an obstacle course. The various requirements in terms of personnel, space, equipment, and printed material for establishing such a low back school are enumerated.

Activities of Daily Living↗
PubMed2001

Gadolinium attenuates exercise pressor reflex in cats.

The exercise pressor reflex, which arises from the contraction-induced stimulation of group III and IV muscle afferents, is widely believed to be evoked by metabolic stimuli signaling a mismatch between blood/oxygen demand and supply in the working muscles. Nevertheless, mechanical stimuli may also play a role in evoking the exercise pressor reflex. To determine this role, we examined the effect of gadolinium, which blocks mechanosensitive channels, on the exercise pressor reflex in both decerebrate and alpha-chloralose-anesthetized cats. We found that gadolinium (10 mM; 1 ml) injected into the femoral artery significantly attenuated the reflex pressor responses to static contraction of the triceps surae muscles and to stretch of the calcaneal (Achilles) tendon. In contrast, gadolinium had no effect on the reflex pressor response to femoral arterial injection of capsaicin (5 microg). In addition, gadolinium significantly attenuated the responses of group III muscle afferents, many of which are mechanically sensitive, to both static contraction and to tendon stretch. Gadolinium, however, had no effect on the responses of group IV muscle afferents, many of which are metabolically sensitive, to either static contraction or to capsaicin injection. We conclude that mechanical stimuli arising in contracting skeletal muscles contribute to the elicitation of the exercise pressor reflex.

Achilles Tendon↗
PubMed1995

Hemodynamics during a machine-aided flexibility protocol.

Heart rates and systolic and diastolic blood pressures of 15 subjects were measured before, during, and after a series of four proprioceptive neuromuscular facilitation (PNF) flexibility exercises. The protocol for the study involved the use of two new machines, one designed to increase flexibility of the erector spinae, the other the hamstrings. Each machine provided constant feedback of isometric force, angular displacements, time of contraction, repetitions, and other exercise variables. Each bout of exercise involved an isometric contraction of the lengthened agonist muscle group (12 sec) followed by a concentric contraction of its antagonist in order to place the body part in a more stretched position. Hemodynamic measurements were determined at both a perceived maximal voluntary isometric contraction (MVIC) and at 50% MVIC. Significant increases in hemodynamic factors were observed when exercise measures were compared to pre- and postexercise (resting) values. Higher values, though not significantly so, were found at MVIC than at 50% MVIC on both machines. All values were well within the guidelines of the American College of Sports Medicine.

Adolescent↗
PubMed1997

Aetiology of skeletal muscle 'cramps' during exercise: a novel hypothesis.

The aetiology of exercise-associated muscle cramps (EAMC), defined as 'painful, spasmodic, involuntary contractions of skeletal muscle during or immediately after physical exercise', has not been well investigated and is therefore not well understood. This review focuses on the physiological basis for skeletal muscle relaxation, a historical perspective and analysis of the commonly postulated causes of EAMC, and known facts about EAMC from recent clinical studies. Historically, the causes of EAMC have been proposed as (1) inherited abnormalities of substrate metabolism ('metabolic theory') (2) abnormalities of fluid balance ('dehydration theory'), (3) abnormalities of serum electrolyte concentrations ('electrolyte theory') and (4) extreme environmental conditions of heat or cold ('environmental theory'). Detailed analyses of the available scientific literature including data from recent studies do not support these hypothesis for the causes of EAMC. In a recent study, electromyographic (EMG) data obtained from runners during EAMC revealed that baseline activity is increased (between spasms of cramping) and that a reduction in the baseline EMG activity correlates well with clinical recovery. Furthermore, during acute EAMC the EMG activity is high, and passive stretching is effective in reducing EMG activity. This relieves the cramp probably by invoking the inverse stretch reflex. In two animal studies, abnormal reflex activity of the muscle spindle (increased activity) and the Golgi tendon organ (decreased activity) has been observed in fatigued muscle. We hypothesize that EAMC is caused by sustained abnormal spinal reflex activity which appears to be secondary to muscle fatigue. Local muscle fatigue is therefore responsible for increased muscle spindle afferent and decreased Golgi tendon organ afferent activity. Muscles which cross two joints can more easily be placed in shortened positions during exercise and would therefore decrease the Golgi tendon organ afferent activity. In addition, sustained abnormal reflex activity would explain increased baseline EMG activity between acute bouts of cramping. Finally, passive stretching invokes afferent activity from the Golgi tendon organ, thereby relieving the cramp and decreasing EMG activity.

Electromyography↗
PubMed2004

Long-term effectiveness of an inpatient pulmonary rehabilitation program for elderly COPD patients: comparison between young-elderly and old-elderly groups.

OBJECTIVE: To evaluate the long-term effects of pulmonary rehabilitation in elderly COPD patients, we monitored patients for 1 year after they completed a 2-week inpatient pulmonary rehabilitation program. We also compared the effects of pulmonary rehabilitation on young-elderly (age 65-74 years) and old-elderly (age 75 years or over) COPD patients. METHODOLOGY: Fifty-nine elderly COPD patients (mean age 72.8 years) were studied. They underwent a comprehensive 2-week inpatient pulmonary rehabilitation program incorporating 10 exercise sessions, each of which included endurance training of the lower extremities, peripheral muscle conditioning training of the upper and lower extremities, and stretching, along with various education sessions. The effects of pulmonary rehabilitation were evaluated at 3, 6, and 12 months after completion of the program. RESULTS: Overall, patient health-related quality of life (HRQoL) as assessed by a QoL scale, and dyspnoea as assessed by an oxygen cost diagram, improved significantly over the 12-month period. Exercise capacity assessed by a 6-min walking distance test (6MWD) was similarly significantly improved. However, there was some fall-off in terms of the distance walked 12 months after pulmonary rehabilitation. The improvements in exercise capacity, dyspnoea, and HRQoL did not differ between the two groups, with the exception that the 6MWD (P < 0.01) and the QoL scale (P < 0.05) at 3 months post-pulmonary rehabilitation were significantly higher in the old-elderly group. CONCLUSIONS: Pulmonary rehabilitation is an effective treatment in terms of improving dyspnoea, exercise capacity and HRQoL in elderly COPD patients, and the benefits are almost comparable for young-elderly and old-elderly patients.

Age Factors↗
PubMed2005

[The effects of an exercise program for the female elderly in the community].

In Mizumaki-cho, Fukuoka, a "School of muscle-building for the elderly" was held by the self-help group "MIZUMAKI Iki-iki senior club" once a week from Sep. 2002 to Mar. 2004. This school program included stretching, aerobics and resistance exercises. In this study, we clarified the effect of exercise for the 38 elderly females in this school. Their average age was 65.8 years old. Blood pressure, BMI, body %Fat, VO2 max, grasping power, time of standing on one leg with eyes open, anteflexion while sitting, time of walking for 10 m and time of standing up from sitting on a chair were measured before starting school, after 6 months, 12 months and 18 months. Every measured value except BMI and VO2 max was improved, and these improvements continued for 18 months. Especially, it was shown that time of standing on one leg with eyes open, time of standing up from sitting on a chair and time of walking for 10 m improved by 121.6%, 112.7%, 30.4%, respectively, compared with each measured value at the start. These improvements might produce the effect of fall prevention for the elderly. From the results of this study, it was clarified that regular exercise builds up the muscles of the female elderly, and continuation of exercise also extends the effect of exercise for the female elderly.

Accidental Falls↗
PubMed1994

The effect of therapeutic muscle stretch on neural processing.

Therapeutic muscle stretch is a commonly used procedure despite little evidence in support of efficacy or information about the mechanisms underlying the various methods. The purpose of this work was to compare the sequential application of static and ballistic muscle stretch with static muscle stretch alone, using the electrically elicited Hoffmann reflex (H-reflex) as a measure of excitability of homonymous motoneurons. The foot was passively dorsiflexed and either maintained in this position or rapidly and repeatedly dorsiflexed at a velocity of 1.0 radian/sec. Hoffmann reflexes were taken using established criteria under control conditions and during stretch conditions. An analysis of variance indicated a significant difference (p < 0.05) between condition means, with H-reflex amplitude reducing to 60 and 15% of the control value during static and ballistic stretch, respectively. Since reductions in alpha-motoneuron pool excitability correlate with increased flexibility, ballistic stretch applied following static stretch appears more effective than static stretch alone.

Adult↗
PubMed2006

Gadolinium does not blunt the cardiovascular responses at the onset of voluntary static exercise in cats: a predominant role of central command.

The cardiovascular adaptation at the onset of voluntary static exercise is controlled by the autonomic nervous system. Two neural mechanisms are responsible for the cardiovascular adaptation: one is central command descending from higher brain centers, and the other is a muscle mechanosensitive reflex from activation of mechanoreceptors in the contracting muscles. To examine which mechanism played a major role in producing the initial cardiovascular adaptation during static exercise, we studied the effect of intravenous administration of gadolinium (55 micromol/kg), a blocker of stretch-activated ion channels, on the increases in heart rate (HR) and mean arterial blood pressure (MAP) at the onset of voluntary static exercise (pressing a bar with a forelimb) in conscious cats. HR increased by 31 +/- 5 beats/min and MAP increased by 15 +/- 1 mmHg at the onset of voluntary static exercise. Gadolinium affected neither the baseline values nor the initial increases of HR and MAP at the onset of exercise, although the peak force applied to the bar tended to decrease to 65% of the control value before gadolinium. Furthermore, we examined the effect of gadolinium on the reflex responses in HR and MAP (18 +/- 7 beats/min and 30 +/- 6 mmHg, respectively) during passive mechanical stretch of a forelimb or hindlimb in anesthetized cats. Gadolinium significantly blunted the passive stretch-induced increases in HR and MAP, suggesting that gadolinium blocks the stretch-activated ion channels and thereby attenuates the reflex cardiovascular responses to passive mechanical stretch of a limb. We conclude that the initial cardiovascular adaptation at the onset of voluntary static exercise is predominantly induced by feedforward control of central command descending from higher brain centers but not by a muscle mechanoreflex.

Animals↗
PubMed2002

Heat stress facilitates stretch-induced hypertrophy of cultured muscle cells.

Increased mechanical stress induced by stretch is an important growth stimulus in skeletal muscle. Heat shock proteins (HSPs) are an important family of endogenous, protective proteins. HSP90 and HSP70 families show elevated levels under beat stress. Mechanical stress, such as physical exercise, is known to induce not only muscular hypertrophy but also the elevation of HSPs expression in skeletal muscle. The purpose of this study was to determine whether heat stress facilitates the stretch-induced hypertrophy of skeletal muscle cells. Cultured rat myotubes (L6) were plated on collagenized Silastic membranes and incubated at 41 degrees C for 60 and 75 minutes (heat shock). Following the incubation, the cells were subjected two-second stretching and four-second releasing for 4 days at 37 degrees C. Protein concentrations in the homogenates and pellets of the cultured skeletal muscle cells increased under heat shock and/or mechanical stretching. The protein concentration of cells following mechanical stretching following heat shock was significantly higher than that following either heat shock or mechanical stretching alone. HSP72 in supernatants and HSP90 in pellets increased under heat shock and/or mechanical stretching. HSP90 in supernatants decreased following heat shock and/or mechanical stretching. Changes in HSPs and cellular protein concentrations in stressed cells suggest that the expression of HSPs may be closely related with muscular hypertrophy.

Journal Article↗
PubMed2005

Exercise prescription for a patient 3 months after hip fracture.

BACKGROUND AND PURPOSE: Most patients with hip fracture do not return to prefracture functional status 1 year after surgery. The literature describing interventions, however, does not use classic overload and specificity principles. The purpose of this case report is to describe the use of resistance training to improve functional outcomes in a patient following hip fracture. CASE DESCRIPTION: The patient was a 68-year-old woman who had a comminuted intertrochanteric fracture of the left hip 3 months previously. She used a cane for ambulation, and her walking was limited. The patient received 16 sessions of lower-extremity strengthening exercises, aerobic training on a stationary bicycle, functional training supervised by a physical therapist, and a home stretching program. OUTCOME: The patient's isometric muscle force for involved hip extension, hip abduction, and knee extension improved by 86%, 138%, and 33%, respectively; walking endurance increased by 22.5%; balance improved by 400%; balance confidence increased by 41%; and self-reported ability to perform lower-extremity functional activities increased by 20%. DISCUSSION: The authors believe that some patients can perform comprehensive exercise programs after hip fracture and that properly designed programs can affect patient outcomes beyond observed impairments.

Aged↗