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The effects of a prolonged running exercise on strength characteristics.

The aim of this study was to examine concentric, isometric, and eccentric strength reductions in the quadriceps muscle following a prolonged running exercise. Before and after a 2 h run (28.4+/-1.4 km) peak torque (PT) of the knee extensors at angular velocities of -120, -90, -60, 0, 60, 120, 180, 240 degrees x s(-1) using an isokinetic dynamometer, electromyographic (EMG) activity of the vastus lateralis (VL) and vastus medialis (VM) muscles and height of a counter movement jump were recorded in twelve well-trained triathletes. Counter movement jump performances decreased by 10% and PT values were all significantly lower (p < 0.01) at each angular velocity following the run. The torque loss was significantly (p < 0.01) greater under eccentric contractions (from 18 to 21%) than under concentric ones (from 11 to 14%). EMG activity (RMS) was lower in both VL and VM muscles after the 2 h run but no difference existed in RMS losses between concentric and eccentric contractions. The present results demonstrate that 1) a prolonged running exercise more greatly affects eccentric force production in the quadriceps muscle, and 2) this specificity seems to be due to an impairment of the muscular contractile mechanism rather than a modification to the neural input.

Adult↗

The interrelationship between physical exercise, muscle strength and body adiposity in a healthy elderly population.

OBJECTIVE: To determine the relationship between habitual physical exercise and body adiposity in a healthy elderly population. RESEARCH DESIGN AND METHODS: Physical exercise was measured by a questionnaire previously adapted for use with the healthy elderly. The level of exercise was converted into calories expended over the previous 14 days and was divided into tertiles. Body adiposity was measured at six sites by anthropometry, and overall percent body fat was measured by bioelectric impedence. PARTICIPANTS AND SETTING: Two hundred and thirteen healthy ambulatory subjects over the age of 60 (116 females and 97 males) were recruited from a large retirement community in Southern Arizona. The mean age of the subjects was 70.0 years. RESULTS: Percent body fat was similar in men with different levels of physical activity (27.9% for lowest tertile of activity, 28.1% for middle tertile of activity, and 28.5% for highest tertile of activity). The corresponding values of percent fat in women was 38.0%, 36.0%, and 37%, respectively. There was a statistically significant increase in muscle strength measured in five muscle groups with a hand-held dynamometer with increasing levels of activity. CONCLUSIONS: These data indicate that level of physical exercise, over the range of 0 to 1,528 Kcal/day, does not predict body adiposity in the healthy elderly population. To decrease body fat without a change in dietary habits would require a more intensive exercise regimen than currently being undertaken by most healthy elderly people.

Aged↗

Relationship between isokinetic muscle strength and exercise capacity in chronic heart failure.

The exercise intolerance and excessive ventilatory response to exercise of chronic heart failure is associated with abnormalities of skeletal muscle function, in particular a reduction in muscle strength. Isometric and isokinetic leg muscle strength were measured in 10 patients with chronic heart failure and 10 age-matched controls. Each subject undertook maximal exercise testing to measure peak oxygen consumption (V(O2)) and the ventilatory response to exercise as measured by the slope of the relation between ventilation and carbon dioxide production (V(E)/V(CO2) slope). Quadriceps strength (mean (S.D.)) was reduced in heart failure as measured by isometric (444.9 (129.6) N vs. 556.0 (136.0); P<0.01) and isokinetic (123.6 (30.2) Nm vs. 146.8 (40.0); P=0.04). Hamstring strength was also reduced as measured by isokinetic testing (53.6 (15.6) Nm vs. 71.1 (28.1); P=0.02). Isokinetic and isometric strengths correlated, but not closely (r=0.52, P<0.001). There were negative correlations between the V(E)/V(CO2) slope, and isokinetic measures: with average torque, r=-0.62, P<0.004; with peak torque, r=-0.64, P=0.002. We have found evidence for reduced muscle function affecting both knee flexors and extensors. This reduction in muscle strength correlates with the ventilatory response to exercise. These observations lend support to the muscle hypothesis of the generation of symptoms in chronic heart failure.

Angiotensin-Converting Enzyme Inhibitors↗

Protein requirements of soccer.

Although the physical demands of soccer have been studied frequently over the years, there has been little attention to the dietary protein needs of soccer players. Recent data from both moderate-intensity, prolonged (endurance) and heavy-resistance (strength) exercise studies indicate that the current recommendations (0.8 g per kg body mass per day) for protein intake are probably suboptimal for individuals who are chronically active. Endurance athletes need more dietary protein than sedentary individuals to maintain an auxiliary fuel source which appears to become increasingly important as exercise is prolonged. Strength athletes can also benefit from a greater protein intake than is currently recommended because it appears that, in combination with heavy-resistance training, it can provide an enhanced stimulus for muscle development. Soccer is a high-intensity, intermittent activity which requires aspects of both strength and endurance over a period of 90 min. As a result, soccer players would be likely to benefit from protein intakes above current recommendations not only because of their potential to enhance strength, but also to provide a supply of amino acids for any increased amino acid oxidation that may occur during training and in competition. Based on the related exercise studies completed to date, it appears that a protein intake of 1.4-1.7 g kg-1 day-1 should be adequate for soccer players. Assuming free access to a wide variety of foods, this protein intake can be easily obtained by most soccer participants. Individuals at greatest risk of falling short of this intake include those who are growing (especially children in developing countries where suboptimal protein intake may be common) or those who consume proteins of lower quality. Although diets high in protein are frequently condemned because of possible kidney problems, it appears these concerns have been over-emphasized. There is no evidence that protein intakes in the range recommended will cause healthy individuals any concerns.

Dietary Proteins↗

Effects of exercise on muscle strength and characteristics in rheumatic diseases and sarcopenia: Protocol for the Care for Muscle (C4M) Study.

OBJECTIVE: Muscle weakness is prevalent in rheumatoid arthritis (RA), osteoarthritis (OA) and sarcopenia (SARC). Endurance exercises may improve mitochondrial function and oxidative capacity, while strength exercises are thought to stimulate myofibrillar protein synthesis. This study aims to compare the effects of strength and endurance exercise and explore the association between muscle characteristics and exercise outcomes in patients with RA, OA and SARC. We hypothesize that responses to endurance and strength exercises in patients with muscle weakness are influenced by intramuscular pathology including muscle morphology, mitochondrial function, and systemic inflammation, based on their disease pathology, potentially requiring personalized training schedules. METHODS: This two-arm, parallel-group exploratory trial will enroll 69 patients (23 RA, 23 OA, 23 SARC), randomized to endurance (n&#x2009;=&#x2009;35) or muscle strength exercises (n&#x2009;=&#x2009;34), using minimization to balance disease type and gender. The 8-week intervention includes two supervised sessions per week using a controlled cable pulley device (Reforter&#x2122;) and fitness equipment, plus one weekly home-based session. The primary outcome is isokinetic muscle strength (peak torque), measured with the Biodex system&#xae;. Secondary outcomes include muscle morphology, mitochondrial function, systemic inflammation and muscle endurance (by Biodex and 6 Minute Walk test). Muscle morphology will be assessed via 3D ultrasound imaging of the vastus lateralis. Mitochondrial function will be analyzed using high-resolution respirometry on muscle biopsies. Systemic inflammation will be measured using multiplex assays or ELISA on serum samples. DISCUSSION: This study will explore differential responses to muscle endurance and muscle strength exercises in patients with RA, OA, and SARC, offering novel insights into the molecular mechanisms of muscle weakness. The findings may help identify potential mechanisms underlying variability in exercise response and provide effect size estimates to guide future confirmatory studies and more targeted exercise interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT06480643 (date of registration28-06-24).

Humans↗

Tongue strength and exercise in healthy individuals and in head and neck cancer patients.

The tongue plays a critical role in bolus propulsion through the oral cavity and pharynx. This manuscript reviews the types of lingual impairment and overall oropharyngeal swallowing impairment present after treatment for head and neck cancer; specifically, surgery and primary chemoradiotherapy. Oral tongue impairment in surgically treated patients can include reduced range of motion, reduced control, and reduced ability to manipulate, seal, and propel a bolus into the pharynx. Tongue base impairment can result in reduced bolus clearance through the pharynx, resulting in pharyngeal residue and aspiration. The biologic effects of radiotherapy are described, with tissue fibrosis being a primary contributor to development of oropharyngeal swallow disorders. In patients treated with primary chemoradiotherapy, lingual strength has been found to be reduced, as has oral and pharyngeal structural movement during the swallow. The effects of skeletal muscle strengthening programs on muscle physiology are discussed, as are the effects of tongue strengthening exercise programs on tongue strength and swallowing. Future research needs are addressed.

Chemotherapy, Adjuvant↗

Variations in urine excretion of steroid hormones after an acute session and after a 4-week programme of strength training.

Performing strength exercise, whether acutely or in a training programme, leads to alterations at the hypothalamic-pituitary-testicular and hypothalamic-pituitary-adrenal axes. One way to evaluate these changes is by analysis of the excretion of steroid hormones in the urine. The present study determined the variations in the urine profile of glucuroconjugated steroids after a single session of strength exercise and after a 4-week programme of strength training. The subjects were a group (n = 20) of non-sportsman male university students who worked out 3 days a week [Monday (M), Wednesday (W) and Friday (F)], performing the exercises at 70-75% of one repetition maximum strength (1-RM). Four urine samples were collected per subject: (A) before and (B) after a standard session prior to initiating the training programme, and (C) before and (D) after the same standard session at the end of the study, and they were assayed by gas chromatography coupled to mass spectrometry. The concentrations of the different hormones were determined relatively to the urine creatinine level (ng steroid/mg creatinine) to correct for diuresis. After the exercise sessions, both before and after the training programme, there was a fall in the urine excretion of androgens and estrogens, but no statistically significant changes in the excretion of tetrahydrocortisol (THF) and tetrahydrocortisone (THE). The anabolic/catabolic hormones ratio also decreased after the acute session, although only androstenodione + dehydroepiandrosterone (DHEA)/THE + THF ratio had a significant decrease (P < 0.05). After the training programme, there was a significant (P < 0.01) improvement in the strength of the muscle groups studied, and an increased urinary excretion of all the androgens with respect to the initial state of repose, with the difference being significant in the case of epitestosterone (Epit) (P < 0.05). The androsterone (A) + etiocholanolone (E)/THE + THF ratio increased significantly (P < 0.05) concerning the initial state. We therefore conclude that subjects suffer variations of the urine profile with regard to the steroid hormones before and after the acute strength sessions and after the training period. The alteration after the training programme seems to be due to the subjects' hypothalamic-hypophysis-testicular and hypothalamic-pituitary-adrenal axes adaptations, which enable them to increase physical strength.

Adrenal Cortex Hormones↗

Trampoline exercise vs. strength training to reduce neck strain in fighter pilots.

INTRODUCTION: Fighter pilots' muscular strength and endurance are subjected to very high demands. Pilots' fatigued muscles are at higher risk for injuries. The purpose of this study was to compare the effects of two different training methods in reducing muscular loading during in-flight and cervical loading testing (CLT). METHODS: There were 16 volunteer Finnish Air Force cadets who were divided into 2 groups: a strength training group (STG) and a trampoline training group (TTG). During the 6-wk training period, the STG performed dynamic flexion and extension and isometric rotation exercises, and the TTG performed trampoline bouncing exercises. During in-flight and CLT, muscle strain from the sternocleidomastoid, cervical erector spinae, trapezius, and thoracic erector spinae muscles was recorded with EMG. RESULTS: In-flight muscle strain in the STG after the training period decreased in the sternocleidomastoid 50%, cervical erector spinae 3%, trapezius 4%, and thoracic erector spinae 8%. In the TTG, the decrease was 41%, 30%, 20%, and 6%, respectively. In CLT, the results were similar. After a 3-mo follow-up period with intensive high +Gz flying, EMG during CLT was still lower than in baseline measurements. CONCLUSION: Both training methods were found to be effective in reducing muscle strain during in-flight and CLT, especially in the cervical muscles. There was no statistically significant difference between the training groups. Introduced exercises expand muscles' capacities in different ways and the authors recommend both strength and trampoline training programs to be included in fighter pilots' physical education programs.

Adult↗

[Comprehensive geriatric assessment and treatment of elderly diabetic patients].

Because of diversities of physical, mental, and psychological functions as well as clinical and social backgrounds, comprehensive geriatric assessment (CGA) is of great importance in treating elderly diabetic patients. We addressed three issues as to functions important for the CGA. First, we assessed several domains of cognitive function in 213 elderly diabetic patients. Attention and visual memory in diabetic patients without vascular disease were impaired compared with non-diabetic controls after adjusting for age and sex using analysis of covariance. Multivariate analysis revealed that age, hyperglycemia, and the presence of cerebral infarction were independent determinants for the impairment of attention in the diabetic patients. The results suggest that glucose control is important for the maintenance of cognitive function in elderly diabetic patients. Secondly, we assessed positive well-being as a measure of psychological function using a PGC morale scale in 197 elderly diabetic patients without cerebrovascular disease at baseline and examined whether the low well-being affect the development of cerebrovascular disease in a 3-year longitudinal study. The results indicate that low well-being was an independent risk factor for cerebrovascular disease after adjusting conventional risk factors in elderly diabetic patients. Thirdly, as a physical function, we assessed 5-m walking speed for both usual and maximum walking in 64 diabetic patients. The walking speed decreased with age and correlated significantly with the knee extension power and functional reach. The result suggests that muscle-strength exercise and balance training as well as endurance exercises are necessary to improve age-related decreases in walking speed and for effective exercise in elderly patients. From a gerontological point of view, new strategies of elderly diabetes treatment including muscle strength exercise and psychological approaches should be established to improve physical, mental, psychological, and social functions as assessed by the CGA.

Aged↗

Muscle strength and exercise kinetics in COPD patients with a normal fat-free mass index are comparable to control subjects.

STUDY OBJECTIVE: This study was designed to investigate the extent of clinical muscle dysfunction in stable patients with COPD who were attending an out-patient pulmonary clinic compared with that of age-matched control subjects without COPD. DESIGN AND SUBJECTS: Respiratory muscle and hand grip strength, steady-state O(2) kinetics, and body composition were measured in 32 patients with COPD (19 women) [mean (+/- SD) FEV(1), 38 +/- 11% predicted] and 36 age-matched control subjects (13 women). RESULTS: Measurements of handgrip force (mean, 97 +/- 32% vs 106 +/- 26% predicted, respectively), maximal expiratory pressure (mean, 57 +/- 33% vs 61 +/- 22% predicted, respectively), steady-state O(2) kinetics (mean tau, 72 +/- 34 s vs 78 +/- 37 s, respectively) and steady-state CO(2) kinetics (mean tau, 77 +/- 38 s vs 65 +/- 32 s, respectively) at submaximal exercise were similar in patients and control subjects. All the subjects, except for one female COPD patient, had a normal fat-free mass index (FFMI), although on average the FFMI was lower in male patients (19.8 +/- 2.8) than in male control subjects (23.0 +/- 2.8; p < 0.01). CONCLUSIONS: In patients with COPD who were attending a regular outpatient pulmonary clinic, there was no evidence of reduced upper extremity and expiratory muscle strength or prolonged O(2) and CO(2) kinetics during isowork submaximal cardiopulmonary exercise compared to healthy, age-matched control subjects. Also, a normal body composition was found in nearly all COPD patients. This argues against the existence of a clinically significant systemic myopathy in most stable patients with severe COPD and normal FFMI.

Aged↗

Effects of athletic strength and endurance exercise training in young humans on plasma endothelin-1 concentration and arterial distensibility.

Strength exercise training induces a decrease in arterial distensibility, whereas endurance exercise training causes an increase in arterial distensibility. Endothelin-1 (ET-1), which is produced by vascular endothelial cells, has potent vasoconstrictor and proliferative activity on vascular smooth muscle cells. We hypothesized that endogenous ET-1 participates in alteration of arterial distensibility by different exercise training types (i.e., strength and endurance exercise training). The purpose of the present study was to investigate plasma ET-1 concentration and arterial distensibility in strength- and endurance-trained athletes. Subjects were male strength-trained athletes (discus, hammer, or javelin throwers; 22.2 years; SA), male endurance-trained athletes (long- or middle-distance runners; 20.7 years; EA), and sedentary healthy men (20.6 years; sedentary control, SC). Maximum hand-grip strength was markedly greater in SA compared with EA and SC (55.3 vs. 41.1 vs. 40.5 kg, P < 0.05). Maximum oxygen uptake was markedly greater in EA than in SA and SC (60.9 vs. 43.1 vs. 43.6 ml/kg/min, P < 0.05). Arterial pulse wave velocity (PWV), which is an index of arterial distensibility, was significantly higher in SA than in EA and SC (688 vs. 529 vs. 601 cm/sec, P < 0.05). In EA, PWV was significantly lower in comparison to that in SC (P < 0.05). Thus arterial distensibility was lower in SA than in EA and SC and higher in EA than in SC. Plasma ET-1 concentration was significantly higher in SA compared with EA and SC (1.64 vs. 1.12 vs. 1.24 pg/ml, P < 0.05). Plasma ET-1 concentration tended to be lower in EA than in SC. These results suggest that the difference in plasma ET-1 level may participate in the mechanism underlying different adaptation of arterial distensibility between strength- and endurance-trained athletes.

Adult↗

Protein nutrition for the athlete.

Endurance exercise results in a protein catabolic state characterized by decreased protein synthesis, increased amino acid oxidation, and increased conversion of amino acids to glucose. The adaptive response to performance of strength exercise, on the other hand, results in an anabolic state in hypertrophying muscles, and the accretion of protein is the result of increased protein synthesis. Because of changes in protein metabolism there is an increased dietary requirement for protein in both endurance and strength exercise. However, the normal dietary intake of protein is adequate for athletes as long as the energy intake is sufficient to maintain body weight. There is little scientific evidence that consumption of large protein supplements will have any beneficial effect on muscle hypertrophy, muscular strength, or physical performance.

Dietary Proteins↗

Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults.

This investigation evaluated training responses to prolonged electrical muscle stimulation (EMS) in sedentary adults. Fifteen healthy subjects (10 men, 5 women) with a sedentary lifestyle completed a 6-wk training program during which they completed an average of 29 1-h EMS sessions. The form of EMS used by the subjects was capable of eliciting a cardiovascular exercise response without loading the limbs or joints. It achieved this by means of inducing rapid, rhythmical contractions in the large leg muscles. A crossover study design was employed with subjects undergoing their habitual activity levels during the nontraining phase of the study. The training effect was evaluated by means of a treadmill test to determine peak aerobic capacity [peak oxygen consumption (Vo(2))], a 6-min walking distance test, and measurement of body mass index (BMI) and quadriceps muscle strength. At baseline, the mean values for peak Vo(2), 6-min walking distance, quadriceps strength, and BMI were 2.46 +/- 0.57 l/min, 493.3 +/- 36.8 m, 360.8 +/- 108.7 N, and 26.9 +/- 3.4 kg/m(2), respectively. After training, subjects demonstrated statistically significant improvements in all variables except BMI. Peak Vo(2) increased by an average of 0.24 +/- 0.16 l/min (P < 0.05), walking distance increased by 36.6 +/- 19.7 m (P < 0.005), and quadriceps strength increased by 87.5 +/- 55.9 N (P < 0.005); we did not observe a significant effect due to training on BMI (P > 0.05). These results suggest that EMS can be used in sedentary adults to improve physical fitness. It may provide a viable alternative to more conventional forms of exercise in this population.

Adaptation, Physiological↗

Serum amino acid responses to three different exercise sessions in male power athletes.

BACKGROUND: The purpose of this study was to investigate serum amino acid responses to 3 different exercise sessions in male power athletes (sprinters and jumpers; n=11). METHODS: All subjects performed 2 running exercise sessions: a short run session (SRS) of 3 x 4 x 60 m with recoveries of 120 and 360 sec, and a long run session (LRS) of 20 sec runs with recoveries of 100 sec until exhaustion. Ten subjects performed a strength exercise session (SES) of 90 min. Serum amino acids (n=21) were assayed 10 min before and 10 min after the sessions. Peak blood lactate was analyzed from fingertip blood samples taken 1 and 5 min after the sessions. RESULTS: The before-after comparisons showed that the essential amino acids (EAAs) decreased by 8.7% (p<0.01) and alanine increased by 26.7% (p<0.001) after SRS. Following LRS the EAAs decreased also by 8.7% (p<0.01) and alanine increased by 25.3% (p<0.001). In the sum of all amino acids there were no changes after SRS and LRS but a significant decrease (14.8%; p<0.01) was observed after SES. Also the EAAs decreased (20.6%; p<0.001) but alanine, taurine and citrulline were the only single amino acids with no changes after SES. The peak blood lactate concentrations after SRS, LRS and SES were 13.8+/-1.9, 16.4+/-1.3 and 2.5+/-0.4 mmol/L, respectively. The lactate value after SES differed (p<0.001) from the values observed after SRS and LRS. The comparison of the changes in the serum amino acid concentrations following the 3 exercise sessions revealed that SRS and LRS were very similar but SES differed from SRS and LRS strongly (p<0.01) in the sum of all amino acids. CONCLUSIONS: The current data indicate that the sum concentrations of all amino acids in serum decrease after the strength exercise session but not after the lactic anaerobic running exercises.

Adult↗

Potential benefits of resistance exercise training on nutritional status in renal failure.

Resistance or strength exercise training may help reverse the malnutrition common among patients in chronic renal failure and delay the progression of renal disease. Resistance training is characterized by resisting, lifting, and lowering weights. It results in muscle mass accretion, improved physical function, and slowed progression of muscle wasting. Resistance exercise training for a period of 8 to 12 weeks results in significant increases in muscle mass, muscle strength, and muscle function in frail "healthy" elderly individuals as well as in specific patient populations. States of malnutrition leading to muscle wasting directly affect lean tissue mass and functional capacity. Even at dietary protein intake below the Recommended Dietary Allowances, resistance training appears to exert an anabolic effect by improving energy intake and protein use allowing nitrogen retention. The potential benefits of resistance exercise extend beyond this direct impact on protein metabolism. They include improvements in functional capacity such as gait, balance, mobility, strength, exercise tolerance, improved glucose uptake, insulin sensitivity, and self-efficacy and self-esteem. Currently, the effects of resistance exercise in renal patients are unknown, although they are well shown in the case of other diseases. The potential benefits that resistance exercise training may have on muscle mass and function, nutritional status, hyperglycemia, disease progression, and the overall mental well-being of renal patients deserve further investigation. As an adjunct to current treatment modalities for chronic renal failure, resistance exercise may serve as a cost-effective, interdisciplinary, noninvasive approach to counteract malnutrition and improve the quality of life.

Exercise↗

Isometric exercise increases strength and does not produce sustained creatinine phosphokinase increases in a patient with polymyositis.

A patient with active stable idiopathic polymyositis received a 4-week supervised right quadriceps and biceps isometric strengthening program. He demonstrated a significant increase in isometric peak torque without a sustained rise in creatinine phosphokinase (CPK). A significant decrease in postexercise CPK occurred at the end of the exercise program. We conclude a randomized clinical trial using a nonexercised patient group vs an exercised patient group may be useful.

Creatine Kinase↗

Effect of exercise and strength training on cardiovascular status in HIV-infected patients receiving highly active antiretroviral therapy.

A routine evaluation of lipid metabolism and body fat distribution along with a careful cardiovascular risk stratification according to international guidelines are required for HIV-infected patients receiving highly active antiretroviral therapy. Intervention includes evaluation of patients for both epidemiological and clinical factors, and for anthropometric and biochemical parameters. Diet counseling, prescription of antihyperlipidemic drugs and exercise training are the cornerstones of programs devoted to protecting patients from side effects of therapies that compromise quality of life and the functions of organs like the pancreas and heart that are involved in lipid disorders.

Antiretroviral Therapy, Highly Active↗