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Postural relief of dyspnoea in severe chronic airflow limitation: relationship to respiratory muscle strength.

Maximal static inspiratory and expiratory pressures (Pimax and Pemax) were measured in six different positions in 40 patients with advanced chronic airflow limitation and in 140 normal subjects to determine whether posture influences respiratory muscle strength. Patients with chronic airflow limitation were studied on days 1 and 5 of an acute exacerbation. There was no postural effect on maximal static pressures in the normal subjects. We divided our patients with chronic airflow limitation into "moderate" and "severe" groups on the basis of a Pimax in the standing position greater or less than 35 cm H2O. The seated leaning-forward position was the preferred posture in 22 of the 23 "severe" patients and 13 of the 17 "moderate" patients. Pimax was greater in the seated leaning-forward position than in the other positions studied (p less than 0.001) on days 1 and 5 in the "severe" patients and (p less than 0.05) on day 5 in the "moderate" patients. Posture had no influence on Pemax in patients with chronic airflow limitation. There was a significant improvement in both Pimax (p less than 0.01 for the "severe" group and p less than 0.05 for the "moderate" group) and Pemax (p less than 0.01 for both groups) between days 1 and 5. The seated leaning-forward position was the optimum posture for the patients to generate maximum inspiratory pressures and to obtain greatest subjective relief of dyspnoea.

Adult↗

Effect of inspiratory resistance and theophylline on respiratory muscle strength in patients with amyotrophic lateral sclerosis.

The effect of breathing through inspiratory flow resistive loads ranging between 4.5 and 27.0 cm H2O/L/s was assessed in eight patients with amyotrophic lateral sclerosis (ALS) and in eight control subjects. ALS patients developed respiratory muscle fatigue manifested by significant declines in negative inspiratory pressure (18.3%), vital capacity (7.2%), and peak inspiratory flow rate (5.5%). Control subjects did not fatigue with these resistances. In ALS patients, theophylline increased respiratory muscle strength after resistive breathing as manifested by an increase in negative inspiratory pressure (28.2%), vital capacity (10%), and peak inspiratory flow rate (11.8%). It is concluded that in patients with ALS, the already weakened respiratory muscles are easily fatigued. Furthermore, theophylline can strengthen loaded respiratory muscles in patients with ALS.

Airway Resistance↗

Balance, reaction time, and muscle strength in exercising and nonexercising older women: a pilot study.

Twenty-one women, aged 57 to 75 years, who had been taking part in exercise programs for periods of 12 months or more underwent tests of muscle strength, reaction time, proprioception, and body sway. The performance of these women in the tests was compared with 21 women of the same age who were not taking part in any organized physical activity and were not exercising more than 30 minutes a day. The women who had been taking part in the exercise program performed significantly better in the tests of quadriceps strength, reaction time, and sway on a compliant surface than the nonexercising women. The exercisers also had lower body mass index scores. These pilot results suggest that exercise may play a role in improving a number of sensori-motor systems that contribute to stability, and that exercise of this nature may help prevent falls in older women.

Accidental Falls↗

Use of isokinetic muscle strength as a measure of severity of rheumatoid arthritis: a comparison of this assessment method for RA with other assessment methods for the disease.

The aim of this study was to study the association between isokinetic muscle strength (IMS) and other clinical indicators of disability and disease activity in patients with rheumatoid arthritis (RA). A cohort of 36 RA patients was followed over a 1-year period with five measurements of disease activity at regular intervals during this time. IMS was measured at seven angular velocities in both knees, on five separate occasions. The measurement was expressed by the level of the fitted line of the seven peak torque values--IMS30. The association between IMS30 and clinical indicators was stated. As an indicator of disability the score from the Stanford Health Assessment Questionnaire (HAQ) was used. As indicators of disease activity morning stiffness, an index of swelling and pain in the joint, erythrocyte sedimentation rate (ESR) and haemoglobin (Hb) were chosen. Larsen's X-ray score was used as an indicator of bone destruction due to longer-lasting disease activity. IMS was significantly associated with the HAQ score, but not with indicators of disease activity or radiological findings. IMS was significantly associated with changes in indicators of disease activity, but not with the changes in the HAQ score, or in the X-ray-score. IMS showed the strongest association with changes in the degree of arthritis of the knee. In conclusion, IMS was associated with the HAQ score and can therefore be used when measuring outcome in a specific group of RA patients. Changes in IMS were associated with indicators of changes in disease activity, and are therefore usable as a measure of patient outcome. Of particular importance is that IMS decreased if a patient developed active arthritis in the knee, and normalised again when the inflammation decreased.

Adult↗

Isokinetic muscle strength and hiking performance in elite sailors.

The aim of the present study was to describe the isokinetic strength profile and its relation to hiking performance in male (SM, n = 15) and female (SF, n = 6) elite sailors compared to a group of male control subjects (CM, n = 8) similar in age, anthropometry and level of fitness. Eccentric knee extension strength was higher in SM compared to CM (P < 0.01). Furthermore, SM were stronger during trunk extension (P < 0.05), but not during trunk flexion compared to CM. Overall muscle strength was lower in SF compared to SM (P < 0.01) and CM (P < 0.05), except for eccentric knee extension strength, where SF and CM did not differ (P > 0.05). Hiking performance correlated to maximal eccentric and isometric knee extensor strength in SF (rs = 0.83-0.88, P < 0.05) and in CM (rs = 0.73-0.77, P < 0.05) and to maximal eccentric knee extensor strength at high velocity in SM (rs = 0.46-0.54, P < 0.05). For a subgroup of hikers in SM (n = 8), hiking performance correlated to maximal isometric-eccentric knee extensor strength (rs = 0.67-0.74, P < 0.05), whereas no correlations emerged for the non-hikers (n = 7). Few correlations were observed between hiking performance and maximal concentric trunk flexor strength (rs = 0.69-0.92, P < 0.05). Unexpectedly, in SM correlations also were observed between hiking performance and maximal strength of the trunk extensors (rs = 0.46-0.53, hiker subgroup: rs = 0.64-0.67, P < 0.05). In conclusion, notably high levels of maximal eccentric knee extensor strength were observed for the male and female elite sailors examined in the present study. Furthermore, the present results suggest that hiking performance depends in part on maximal isometric-eccentric knee extensor strength. The maximal strength of the trunk extensors, which potentially stabilizes the lower back and spine, also seems to have some importance for the hiking performance of top-level sailors.

Adult↗

Adenovirus-mediated dystrophin minigene transfer improves muscle strength in adult dystrophic (MDX) mice.

Duchenne muscular dystrophy (DMD) and murine X-linked muscular dystrophy (mdx) are both due to absence of the subsarcolemmal protein dystrophin. Recombinant adenovirus vectors (AdV) are considered a promising means for delivering a functional dystrophin gene to muscle. However, the usefulness of AdV for this purpose is limited by vector toxicity as well as immune-mediated elimination of infected fibers. In addition, studies to date of AdV-mediated dystrophin gene transfer have either failed to examine effects on muscle strength or been performed in immunologically immature neonatal animals with little baseline abnormality of force-generating capacity. In the present study, AdV-mediated dystrophin gene transfer was performed in adult mdx mice with pre-existent dystrophic pathology and muscle weakness. The main findings are as follows: (1) acute myofiber toxicity and gene transfer efficiency are both AdV dose-dependent, such that the therapeutic margin of safety is fairly narrow; (2) immunosuppressive therapy (FK506) prevents immune-mediated elimination of dystrophin-positive fibers but not the dose-dependent toxic effects; (3) at the optimal vector dosage and with effective immunosuppression, AdV-mediated dystrophin minigene transfer is capable of alleviating the loss of force-generating capacity as well as histopathological evidence of disease progression normally seen in adult mdx muscles over a 2-month period. These findings have important implications for the eventual application of AdV-mediated dystrophin gene transfer in DMD patients.

Adenoviridae↗

Muscle strength differences in urban and rural populations in Sweden.

The isometric extension and flexion strength of the right knee was investigated in 396 men and 537 women. The probands were randomly selected from the National Population Records, either from the city of Malmö, Sweden, or from a typical agricultural region 60km outside the city. Both the extension and the flexion strength decreased with age in both groups. Between 50 years and 80 years of age the decrease was almost 40%. The urban probands had significantly lower muscle strength in both sexes. The difference was most pronounced for the knee extension strength. Also, the flexion strength was less in the urban population, the difference significant only in octogenarians.

Adult↗

Anaerobic power and muscle strength characteristics of 11 years old elite and non-elite boys and girls from gymnastics, team handball, tennis and swimming.

The aim of the present investigation was to study the possible effects of specificity of training on muscle strength and anaerobic power in children from different sports and at different performance levels in relation to growth and maturation status. Hundred and eighty-four children of both gender participating either in swimming, tennis, team handball or gymnastics were recruited from the best clubs in Denmark. Within each sport, the coach had divided the children into an elite (E) and non-elite (NE) group according to performance level and talent. Tanner stage assessment and body weight and height measurements were performed by a physician. The anaerobic performances were assessed by Wingate tests and jumping performance in squat jump (SJ), countermovement jump (CMJ) and drop jump (DJ) from two heights. Most of the differences between groups in Wingate performance disappeared when the data were normalised to body mass. The gymnasts were the best jumpers and their superiority were increased in the more complex motor coordination tasks like DJ. The results may indicate some influence of training specificity, especially on the more complex motor tasks as DJ and there may be an effect of training before puberty. The performance in the less complex motor tasks like cycling and SJ and CMJ may also be influenced by specific training, but not to the same extent, and heritance may be an important factor for performance in these anaerobic tasks.

Anaerobic Threshold↗

The effect of two years' training on aerobic power and muscle strength in male and female cadets.

During their first 2 years of training at the U.S. Military Academy, 11 male and 7 female cadets were studied on five occasions. VO2 max (1/min), lean body mass and body weight increased significantly in both groups. Percent body fat was significantly reduced only after the first summer of training and then returned to initial values. VO2 max (ml/kg.min) did not change in males during the study. However, females increased significantly after the initial 6 weeks of training (44.2 to 48.8 ml/kg.min). They remained at this level through the second summer of training. However, by the end of their second academic year, females' values dropped to 45.9 ml/kg.min. Maximal isometric strength measured 30-40% higher in males than in females. During the last year of training, arm and shoulder strength increased 10.2% in males, but was unchanged in females. Our results suggest that even extended military training did not enable females to significantly narrow the difference with male cadets in muscle strength and aerobic power.

Adult↗

Relationship between leg bone mineral values and muscle strength in women with different physical activity.

This study examines whether knee extensor muscle isometric, isokinetic, and isoinertial strength values in women with different physical activity and body composition patterns are related to leg bone mineral density (BMD) and bone mineral content (BMC) values. A total of 129 women aged 17-40 participated in this study. They were divided into four groups: strength-trained (n = 33), endurance-trained (n = 32), normal weight sedentary (n = 41), and overweight sedentary (n = 23) women. In addition, the subjects were grouped as physically active (n = 65) or sedentary (n = 64) women. BMD and BMC for both legs (LBMD and LBMC, respectively) and for the dominant leg alone (DLBMC), body fat percentage and lean body mass (LBM), maximal knee extension isometric (ISOM) and isokinetic (ISOK) strength at the angular velocity of 60 deg.s(-1), and isoinertial leg explosive strengths (countermovement jump CMJ) were measured. In endurance-trained women, LBMD was dependent on body mass index (BMI) (33.7% of the variance, R2 x 100), and in the physically active group and the total group with LBM (14.6% and 15.6%, respectively). In the overweight group, LBMD was dependent on ISOK strength (21.7% of the variance, R2 x 100). In the sedentary and total groups, ISOM strength was more important (10.3% and 5.0%, respectively); in the strength-trained group, body weight influenced LBMC, accounting for 71.6% of the variance (R2 x 100). In the endurance-trained women, height influenced LMBC (37.9%, R2 x 100). In sedentary and overweight women, LBM accounted for 52.1% and 61.4% of the total variance in LBMC. In these groups, ISOM strength accounted for 15.3% and 25.9% of the variance in LBMC. In overweight women, ISOM and ISOK strength together influenced LBMC highly (64.8% of the variance, R2 x 100). In the sedentary group, the influence of LBM on LBMC was higher than in the active group (82.1% and 50.5% of the variance, respectively). In the total group, LBM influenced LBMC, accounting for 54.5% of the variance (R2 x 100). ISOM strength (22.7%) alone or in combination with ISOK strength (35.8%) and CMJ (41.7%) (R2 x 100) in LBMC in the sedentary group explained the variance. In the total group, ISOM strength alone (13.2%) or in combination with CMJ (17.1%) influenced LBMC (R2 x 100). Our results suggest that (1) muscle strength and anthropometrical parameters were associated with LBMD; (2) LBM and ISOM strength had a significant relationship with DLBMC and LBMC only in nonathletic women; and (3) strength measured with different regimens highly influenced LBMC compared with LBMD, especially in the sedentary groups.

Adolescent↗

Protein metabolism in rheumatoid arthritis and aging. Effects of muscle strength training and tumor necrosis factor alpha.

OBJECTIVE: To determine the effects of rheumatoid arthritis (RA) on whole-body protein metabolism. METHODS: We examined protein metabolism and its hormonal and cytokine mediators before and 12 weeks after progressive resistance muscle strength training in 8 healthy young (mean +/- SD age 25 +/- 2 years) and 8 healthy elderly (70 +/- 5 years) men and women, and in 8 adults with RA (42 +/- 13 years). An additional 6 healthy elderly subjects (69 +/- 3 years) served as a swimming-only control group. RESULTS: Subjects with RA had higher rates of protein breakdown than did young or elderly healthy subjects (79.9 +/- 17.2 versus 60.3 +/- 5.8 and 63.7 +/- 12.4 mumoles/gm total body potassium/hour, respectively, P < 0.05), while there was no effect of age per se. Patients treated with methotrexate had normal rates of protein breakdown (P < 0.01 versus RA without methotrexate; P not significant versus healthy young subjects). Increased protein catabolism in RA was no longer evident after strength training. In multiple regression analysis, levels of tumor necrosis factor alpha (TNF alpha) (r = 0.47, P = 0.01) and growth hormone (r = -0.51, P = 0.006) were associated with protein breakdown, and plasma glucagon levels were inversely correlated with protein synthesis (r = -0.45, P = 0.02). Growth hormone (r = -0.56, P = 0.002) and glucagon (r = 0.45, P = 0.04, levels were associated with protein oxidation. CONCLUSION: Adults with RA have increased whole-body protein breakdown, which correlates with growth hormone, glucagon, and TNF alpha production.

Adult↗

Muscle strength and fiber composition in athletes and sedentary men.

Members of Swedish national teams in track and field events (sprinting and jumping), downhill skiing, race walking, orienteering, and a group of sedentary men were studied to examine the relationship between muslce fiber characteristics in needle biopsy samples form m. vastus lateralis and muscle strength measured as peak torque during isokinectic knee extensions. In comparison with the sedentary group the following differences were found: a) percentage fast twitch fibers was lower in the endurance athetes, b) fast to slow twitch muscle fiber area ratio was higher in the track athletes, c)track athletes and downhill skier attained higher peak torque values at all angular velocities examined. The track athletes had, however, higher torque values at the fastest angular velocity as compared to the downhill skiers, whereas there was no differnce under isometric conditions. The proportion of fast twitch fibers was related to torque produced, especially at high motion velocity. The training also appeared to affect the force-velocity relationship.

Adult↗

Effect of salbutamol on muscle strength and endurance performance in nonasthmatic men.

PURPOSE: The ergogenic effect of acute beta2-adrenergic agonist administration in nonasthmatic individuals has not been clearly demonstrated. Therefore, the acute effects of oral administration of the beta2-adrenergic agonist salbutamol (4 mg) on muscle strength and endurance performance were studied in 16 nonasthmatic men in a double-blind randomized cross-over study. METHODS: Peak expiratory flow (Mini Wright Peakflowmeter), isokinetic strength of the knee extensors and knee flexors at four angular velocities (Cybex II dynamometer), and endurance performance in a cycle ergometer test until exhaustion at 70% of maximal workload were measured. RESULTS: Peak expiratory flow increased from 601 +/- 67 L x min(-1) to 629 +/- 64 L x min(-1) after salbutamol (P < 0.05). Peak torque was higher after salbutamol than after placebo (4.4% for the knee extensors, 4.9% for the knee flexors) (P < 0.05). Mean endurance time increased from 3,039 +/- 1,031 s after placebo to 3,439 +/- 1,287 s after salbutamol (P = 0.19). When four subjects complaining about adverse side effects were excluded from the analysis, the increase in endurance time (729 +/- 1,007 s or 29%) was statistically significant (P <-0.05). Salbutamol did not affect VO2, respiratory exchange ratio, heart rate, and plasma free fatty acid and glycerol concentration during exercise; plasma lactate and potassium concentrations were increased (P < 0.05). CONCLUSIONS: Under the conditions of this study, oral salbutamol appears to be an effective ergogenic aid in nonasthmatic individuals not experiencing adverse side effects.

Administration, Oral↗

A new concept for isokinetic hamstring: quadriceps muscle strength ratio.

Conventionally, the hamstring:quadriceps strength ratio is calculated by dividing the maximal knee flexor (hamstring) moment by the maximal knee extensor (quadriceps) moment measured at identical angular velocity and contraction mode. The agonist-antagonist strength relationship for knee extension and flexion may, however, be better described by the more functional ratios of eccentric hamstring to concentric quadriceps moments (extension), and concentric hamstring to eccentric quadriceps moments (flexion). We compared functional and conventional isokinetic hamstring: quadriceps strength ratios and examined their relation to knee joint angle and joint angular velocity. Peak and angle-specific (50 degrees, 40 degrees, and 30 degrees of knee flexion) moments were determined during maximal concentric and eccentric muscle contractions (10 degrees to 90 degrees of motion; 30 and 240 deg/sec). Across movement speeds and contraction modes the functional ratios for different moments varied between 0.3 and 1.0 (peak and 50 degrees), 0.4 and 1.1 (40 degrees), and 0.4 and 1.4 (30 degrees). In contrast, conventional hamstring:quadriceps ratios were 0.5 to 0.6 based on peak and 50 degrees moments, 0.6 to 0.7 based on 40 degrees moment, and 0.6 to 0.8 based on 30 degrees moment. The functional hamstring:quadriceps ratio for fast knee extension yielded a 1:1 relationship, which increased with extended knee joint position, indicating a significant capacity of the hamstring muscles to provide dynamic knee joint stability in these conditions. The evaluation of knee joint function by use of isokinetic dynamometry should comprise data on functional and conventional hamstring:quadriceps ratios as well as data on absolute muscle strength.

Analysis of Variance↗

Human muscle strength training: the effects of three different regimens and the nature of the resultant changes.

1. Increases in strength and size of the quadriceps muscle have been compared during 12 weeks of either isometric or dynamic strength training. 2. Isometric training of one leg resulted in a significant increase in force (35 +/- 19%, mean +/- S.D., n = 6) with no change in the contralateral untrained control leg. 3. Quadriceps cross-sectional area was measured from mid-thigh X-ray computerized tomography (c.t.) scans before and after training. The increase in area (5 +/- 4.6%, mean +/- S.D., n = 6) was smaller than, and not correlated with, the increase in strength. 4. The possibility that the stimulus for gain in strength is the high force developed in the muscle was examined by comparing two training regimes, one where the muscle shortened (concentric) and the other where the muscle was stretched (eccentric) during the training exercise. Forces generated during eccentric training were 45% higher than during concentric training. 5. Similar changes in strength and muscle cross-sectional area were found after the two forms of exercise. Eccentric exercise increased isometric force by 11 +/- 3.6% (mean +/- S.D., n = 6), and concentric training by 15 +/- 8.0% (mean +/- S.D., n = 6). In both cases there was an approximate 5% increase in cross-sectional area. 6. It is concluded that as a result of strength training the main change in the first 12 weeks is an increase in the force generated per unit cross-sectional area of muscle. The stimulus for this is unknown but comparison of the effects of eccentric and concentric training suggest it is unlikely to be solely mechanical stress or metabolic fluxes in the muscle.

Action Potentials↗

Effects of physical activity on bone mineral content and muscle strength in women: a cross-sectional study.

Physical exercise is known to increase bone mass in men, whereas the effect is less predictable in women. In this cross-sectional report, effects of physical activity on women aged 38-64 years are studied. Bone mass and muscle strength were compared between 30 regularly exercising women jogging only once a week for at least three years and an equal number of controls matched for age. BMC of the distal third of the radius was significantly higher in the active women. The active women over age 50 also had higher trabecular bone mass in the distal end of the radius. Quadriceps strength and balance were also found to be better in the activity group. Active women had a different lifestyle than the non-active women, with less consumption of alcohol, oestrogens, and tobacco. This report supports the hypothesis that regular moderate physical activity might reduce bone loss in women.

Adult↗

Muscle morphology and enzymes in proximal and distal muscle groups of lower limb from patients with corticosteroid treated rheumatoid arthritis: the relationship to maximal isokinetic muscle strength.

Abnormal morphological and enzymatic patterns in the lateral vastus muscle have been found in women with corticosteroid treated rheumatoid arthritis. By means of biopsies from the lateral heads of right gastrocnemius muscles, the histology and enzyme activities were compared with those found in right vastus lateralis biopsies. The findings were correlated with isometric and isokinetic strength of the plantar flexors. The relative occurrence of type I fibres in the gastrocnemius muscle was 46.4 +/- 18.7 (SD) %, which is significantly higher than found in the vastus lateralis [35.7 +/- 13.3 (SD) %] (P less than 0.03). The relatively lower percentage of type II fibres in the gastrocnemius muscle was due to a relatively low percentage of type II A fibres [mean 27.9 +/- 16.4 (SD) %] (P less than 0.05). The area of type I fibres in the gastrocnemius muscle was 26.1 X 10(2) +/- 10.0 (SD) micron 2, which is 74% of the mean area for type I fibres found in the vastus lateralis (P less than 0.01). The area of type II fibres in the gastrocnemius was 14.9 X 10(2) +/- 7.1 (SD) micron 2, which is 77% of the mean area for type II fibres found in the vastus lateralis. The isokinetic muscle strength of the plantar flexors in corticosteroid treated patients with rheumatoid arthritis was reduced to less than 50% at all angular velocities when compared with healthy women. The same difference was found in the knee extensors.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxyacyl CoA Dehydrogenases↗