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Effects of age and regular exercise on muscle strength and endurance.

Twenty male and 20 female non-professional tennis players were classified into two different age groups (n = 10 per group): young active men (30.4 +/- 3.3 years), young active women (27.5 +/- 4.3 years), elderly active men (64.4 +/- 3.7 years), and elderly active women (65.3 +/- 4.5 years). These individuals were matched (n = 10 per group) according to sex, age, height and mass to sedentary individuals of the same socio-economical background: young sedentary men (29.2 +/- 3.4 years), young sedentary women (25.6 +/- 4.4 years), elderly sedentary men (65.2 +/- 3.2 years) and elderly sedentary women (65.6 +/- 4.4 years). An isokinetic dynamometer was used to measure the strength of the knee extensors and flexors (two separate occasions) and the endurance of the extensors. Vastus lateralis electromyogram (EMG) was measured concomitantly. Significant sex, age and exercise effects (P less than 0.001) were observed for peak torque of both muscle groups. The effect of age on extensor strength was more pronounced at high speeds where men were also able to generate larger relative torques than women. No age or sex effects were noted for muscle endurance. However, muscles of active individuals demonstrated a greater resistance to fatigue than those of sedentary individuals. In conclusion, men were found to be stronger than women, age was associated with a decrease in muscle strength, but not of muscle endurance, and tennis players were stronger and had muscles that were more resistant to fatigue than their sedentary pairs in both age groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation.

We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV1 = 41 +/- 3% predicted; mean +/- SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (V(LIM)), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 +/- 8%, 43 +/- 10%, 12 +/- 5%, and 34 +/- 9%, respectively (p < 0.05); quadriceps strength increased 21 +/- 5% (p < 0.01); MIP and MEP increased 29 +/- 11% and 27 +/- 11%, respectively (p < 0.05); V(LIM) increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production (VCO2), oxygen consumption (VO2), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): deltaB correlated with deltaF (r = 0.58, p < 0.01). Increased MIP and V(LIM) did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance.

Aged↗

Short vs. long rest period between the sets in hypertrophic resistance training: influence on muscle strength, size, and hormonal adaptations in trained men.

Acute and long-term hormonal and neuromuscular adaptations to hypertrophic strength training were studied in 13 recreationally strength-trained men. The experimental design comprised a 6-month hypertrophic strength-training period including 2 separate 3-month training periods with the crossover design, a training protocol of short rest (SR, 2 minutes) as compared with long rest (LR, 5 minutes) between the sets. Basal hormonal concentrations of serum total testosterone (T), free testosterone (FT), and cortisol (C), maximal isometric strength of the leg extensors, right leg 1 repetition maximum (1RM), dietary analysis, and muscle cross-sectional area (CSA) of the quadriceps femoris by magnetic resonance imaging (MRI) were measured at months 0, 3, and 6. The 2 hypertrophic training protocols used in training for the leg extensors (leg presses and squats with 10RM sets) were also examined in the laboratory conditions at months 0, 3, and 6. The exercise protocols were similar with regard to the total volume of work (loads x sets x reps), but differed with regard to the intensity and the length of rest between the sets (higher intensity and longer rest of 5 minutes vs. somewhat lower intensity but shorter rest of 2 minutes). Before and immediately after the protocols, maximal isometric force and electromyographic (EMG) activity of the leg extensors were measured and blood samples were drawn for determination of serum T, FT, C, and growth hormone (GH) concentrations and blood lactate. Both protocols before the experimental training period (month 0) led to large acute increases (p < 0.05-0.001) in serum T, FT, C , and GH concentrations, as well as to large acute decreases (p < 0.05-0.001) in maximal isometric force and EMG activity. However, no significant differences were observed between the protocols. Significant increases of 7% in maximal isometric force, 16% in the right leg 1RM, and 4% in the muscle CSA of the quadriceps femoris were observed during the 6-month strength-training period. However, both 3-month training periods performed with either the longer or the shorter rest periods between the sets resulted in similar gains in muscle mass and strength. No statistically significant changes were observed in basal hormone concentrations or in the profiles of acute hormonal responses during the entire 6-month experimental training period. The present study indicated that, within typical hypertrophic strength-training protocols used in the present study, the length of the recovery times between the sets (2 vs. 5 minutes) did not have an influence on the magnitude of acute hormonal and neuromuscular responses or long-term training adaptations in muscle strength and mass in previously strength-trained men.

Adult↗

Respiratory muscle strength in congestive heart failure.

In experimental animals, conditions which drastically decrease cardiac output may reduce the strength and endurance of respiratory muscles leading to hypercapnic respiratory failure. Because patients with chronic CHF have reduced cardiac output and vital capacity (FVC), we measured PImax and PEmax and maximal handgrip force in 16 patients with CHF and 18 AMNs. The patients with CHF had a mean left ventricular ejection fraction of 26 +/- 7 percent. Maximal respiratory pressures were significantly reduced; group mean values (+/- SD) for PImax at FRC were 41.4 +/- 5.6 cm H2O (CHF) and 102.1 +/- 27.4 cm H2O (AMN) (p less than 0.001), with PImax values in five patients with CHF as low as 20 to 30 cm H2O. In most patients, PEmax was comparably reduced. Handgrip force was less dramatically reduced, suggesting selective respiratory muscle weakness. Possible explanations include reduction in respiratory muscle blood flow or generalized muscular atrophy and weakness related to cardiac cachexia.

Forced Expiratory Volume↗

Back extensor and psoas muscle cross-sectional area, prior physical training, and trunk muscle strength--a longitudinal study in adolescent girls.

The association between physical training, low back extensor (erector spinae plus multifidus muscles) and psoas muscle cross-sectional areas (CSA) and strength characteristics of trunk extension and flexion were studied in adolescent girls. A group of athletes (n = 49) (age range 13.7-16.3 years) consisting of gymnasts, figure skaters and ballet dancers was age-matched with non-athletes (n = 17) who acted as a sedentary control group. The CSA of psoas muscles and multifidus plus erector spinae muscles were measured from lumbar axial images by magnetic resonance imaging. Maximal trunk extension and flexion forces were measured in a standing position using a dynamometer and trunk musculature endurance was evaluated using static holding tests. When CSA were adjusted with body mass, the athletes showed significantly greater CSA in both muscles studied (psoas P < 0.001; erector spinae plus multifidus P < 0.05) than the non-athletes. The athletes also had a greater absolute psoas muscle CSA (P < 0.01) and trunk flexion force (P < 0.01) compared to the controls. When the forces were expressed relative to body mass, the athletes were superior both in trunk flexion (P < 0.001) and extension (P < 0.001). There was a significant correlation between muscle CSA and strength parameters, but the force per muscle CSA did not differ significantly between the athletes and the non-athletes. In addition, the athletes showed a better body mass adjusted muscle endurance in trunk flexion (P < 0.05) than the non-athletes. Our study indicated that regular physical training enhances trunk musculature hypertrophy, force and endurance in adolescent girls, and that there is an association between muscle CSA and strength parameters.

Adolescent↗

A cross-sectional analysis of sagittal knee laxity and isokinetic muscle strength in soccer players.

In this cross-sectional study, sagittal knee laxity and isokinetic strength of knee extensor and flexor muscle groups were measured and differences related to leg dominance were evaluated. A total of 44 healthy male soccer players (who had trained regularly at least for the last five years) and 44 sedentary people as their control counterparts were involved in this study. All participants were tested using a KT-1000 knee arthrometer for knee laxity. Isokinetic concentric knee peak torque and hamstring/quadriceps (H/Q) ratio were also measured at 60, 180, 300 degrees/s through a Cybex 2 - 340 dynamometer. Posterior laxity in the non-dominant side of soccer players was significantly higher than in the dominant side (p < 0.005) while there were no significant anterior and total anteroposterior (total AP) laxity differences in both groups. Soccer players had significantly lower anterior and total AP laxity values than controls (p < 0.0001) while there was no significant difference between posterior laxity values in both sides. Dominant extremity demonstrated significantly higher knee flexor peak torque and H/Q ratio at 180 degrees /s in soccer players (p < 0.05). Similarly in sedentary controls, H/Q ratio at 60 degrees /s of the dominant side was significantly higher than that in the non-dominant side (p < 0.05). Soccer players had significantly higher extensor and flexor peak torque values and H/Q ratios than sedentary subjects for both extremities. In both groups, there were no significant correlations between knee laxity and isokinetic knee extensor and flexor strength and H/Q ratios except weak negative correlation between posterior knee laxity and isokinetic extensor peak torque at 60, 180 and 300 degrees /s (p < 0.005, r = - 0.43, p < 0.05, r = - 0.39, p < 0.05, r = - 0.32 respectively) in the non-dominant side of soccer players and at 300 degrees /s (p < 0.05, r = - 0.32) in the non-dominant side of controls. Soccer players demonstrated significantly less sagittal knee laxity and higher isokinetic strength of the knee flexors and extensors compared to sedentary controls. Isokinetic strength difference was found to be higher for the flexor muscle group. Further prospective studies are needed to explain whether the increased H/Q ratio decreases the risk of ligamentous injury.

Adult↗

A randomized controlled trial of the effect of naproxen on delayed onset muscle soreness and muscle strength.

OBJECTIVE: To determine the effect of naproxen in attenuating the symptoms (muscle soreness level) and signs (plasma creatine kinase [CK] activity and muscular strength decrement) of delayed onset muscle soreness (DOMS) induced by repeated bouts of eccentric exercise. DESIGN: The design was a randomized, double-blind, placebo-controlled, crossover trial with two testing phases of 8 days' duration that were separated by a "washout" period of 7 days. SETTING: University-based sports science center. PARTICIPANTS: Twenty healthy male volunteers who responded to a notice in the university's athletic complex. INTERVENTIONS: Eccentric single-leg exercises were performed on days 1, 3, and 4 to induce DOMS in the quadriceps muscles. Naproxen or placebo tablets (500 mg) were taken orally twice per day beginning on day 2 and continuing until the end of the testing phase. MAIN OUTCOME MEASURES: Perception of muscle soreness and knee extensor torque were evaluated daily throughout each phase. Plasma CK levels were evaluated on days 1, 3, 6, and 8 of each phase. RESULTS: After the eccentric exercise, plasma CK levels were similarly elevated in both naproxen and placebo conditions (F=1.42; p=0.25). After DOMS developed, naproxen reduced the perception of soreness on day 3, when muscle soreness was highest (F=2.20; p=0.04). After treatments with naproxen, peak quadriceps torque during leg extension at 60 degrees/s was higher than that after treatment with the placebo (F=4.77; p=0.04). There were no significant differences between the naproxen and placebo conditions for leg extension at 180 degrees/s (F= 1.66; p=0.21) and 300 degrees/s (F=0.71; p=0.41). CONCLUSION: The data indicate that therapeutic doses of naproxen do not prevent CK release into the plasma but decrease the perception of muscle soreness and positively influence quadriceps peak torque.

Adult↗

The effect of muscle-sparing versus standard posterolateral thoracotomy on pulmonary function, muscle strength, and postoperative pain.

Increased interest in alternative approaches to thoracotomy has developed because of the considerable morbidity associated with the standard posterolateral technique. We conducted a prospective, randomized, blinded study of 50 consecutive patients to compare postoperative pain, pulmonary function, shoulder strength, and range of shoulder motion between the standard posterolateral and the muscle sparing thoracotomy techniques. Pulmonary function (forced expiratory volume in 1 second and forced vital capacity), shoulder strength, and range of motion were measured preoperatively and at 1 week and 1 month postoperatively. Pain was quantitated by postoperative narcotic requirements, the visual analogue scale, and the McGill pain questionnaire. Morbidity, mortality, and hospital stay were compared between the standard posterolateral and muscle-sparing techniques. There were no differences in postoperative pulmonary function, shoulder range of motion, extent of lung resection, surgical approach time, mortality, or hospital stay. There was significantly less postoperative pain in the muscle-sparing group. The narcotic requirement was less in the first 24 hours (p = 0.0169), and visual analogue scale scores were significantly lower (p less than 0.05) throughout the first postoperative week. Shoulder girdle strength was decreased at 1 week in the standard incision group whereas the strength was preserved with the muscle-sparing approach. Muscle strength had returned to preoperative levels by 1 month in both groups. Morbidity was identical in the two groups with the exception of postoperative seromas. The prevalence of seroma was 23% in the muscle-sparing group and 0% in the standard incision group (p = 0.0125). We have demonstrated that the muscle-sparing incision may be a reasonable alternative to the standard posterolateral approach.

Double-Blind Method↗

Targeted ablation of IKK2 improves skeletal muscle strength, maintains mass, and promotes regeneration.

NF-kappaB is a major pleiotropic transcription factor modulating immune, inflammatory, cell survival, and proliferative responses, yet the relevance of NF-kappaB signaling in muscle physiology and disease is less well documented. Here we show that muscle-restricted NF-kappaB inhibition in mice, through targeted deletion of the activating kinase inhibitor of NF-kappaB kinase 2 (IKK2), shifted muscle fiber distribution and improved muscle force. In response to denervation, IKK2 depletion protected against atrophy, maintaining fiber type, size, and strength, increasing protein synthesis, and decreasing protein degradation. IKK2-depleted mice with a muscle-specific transgene expressing a local Igf-1 isoform (mIgf-1) showed enhanced protection against muscle atrophy. In response to muscle damage, IKK2 depletion facilitated skeletal muscle regeneration through enhanced satellite cell activation and reduced fibrosis. Our results establish IKK2/NF-kappaB signaling as an important modulator of muscle homeostasis and suggest a combined role for IKK inhibitors and growth factors in the therapy of muscle diseases.

Animals↗

Reliability of pelvic floor muscle strength measurement in elderly incontinent women.

Pelvic floor muscles (PFM) play an important role in maintaining urinary continence with increasing age. Therefore, their contractile properties need to be evaluated. The aim of the study was to examine the reliability and correlation of simple techniques to measure PFM strength in elderly women with urinary incontinence. An interview was used to evaluate the ability to stop the urinary stream during micturition and to calculate the incontinence index. A pad test was applied to objectively evaluate the severity of the disease. Functional testing included a digital examination to measure the force and duration of one contraction, a perineometer measurement (Peritron) to assess maximal contraction force and contraction force of 5 s, and a cone-retention test (Femcon) while walking for 1 min and during Valsalva's manoeuvre. This procedure was performed on three separate occasions within one week. The 37 participating women with a mean age of 62+/-8 (mean+/-SD) years had a severity index of 4.4+/-2.6 and a urine loss of 9.5+/-13.6 mg during the pad test. Sixteen women were able to completely stop the urinary stream during micturition. The digital examination showed no intratester variability. The perineometer measurement showed that the absolute difference in maximal contraction force and mean contraction force within 5 s was less than 5.3 mm Hg and 4.5 mm Hg, respectively, with a probability of 0.95. While walking and during Valsalva's manoeuvre, 19 and 20 women, respectively, held the same cone in place on all three occasions. The maximal contraction force and mean force during the 5-s contraction correlated well with the ability to stop the urinary stream and the digital examination but only weakly with the cone-retention tests. The reliability of PFM strength measurement is highest in the digital examination, followed by perineometer measurements, and then by vaginal cone tests. As PFM function is easy to assess, it should be routinely done in the assessment of urinary incontinence in elderly women.

Aged↗

A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee.

OBJECTIVE: To determine whether home-based neuromuscular electrical stimulation (NMES) applied to the quadriceps femoris (QF) muscle increases strength, physical activity, and physical performance in older adults with knee osteoarthritis (OA). METHODS: Thirty-four adults (> 60 yrs) with radiographically confirmed symptomatic knee OA were randomized to NMES plus education or education only (EDU). The primary outcome was isometric QF peak torque (PTIso), with secondary outcomes of daily step counts, total activity vector magnitude, 100-foot walk-turn-walk, timed stair climb, chair rise, and pain. The NMES group used a portable electrical muscle stimulator 3 days a week for unilateral QF training with incremental increases in the intensity of isometric contraction to 30-40% of maximum over 12 weeks. Both groups received the 12-week Arthritis Self-Management course and were followed an additional 12 weeks. RESULTS: The stimulated knee-extensor showed a 9.1% increase in 120 degrees PTIso compared to a 7% loss in the EDU group (time x group interaction for 120 degrees PTIso; p = 0.04). The chair rise time decreased by 11% in the NMES group, whereas the EDU group saw a 7% reduction (p = 0.01, time; p = 0.9, group). Similarly, both groups improved their walk time by approximately 7% (p = 0.02, time; p = 0.61 group). Severity of pain reported following intervention did not differ between groups. CONCLUSION: In older adults with knee OA, a home-based NMES protocol appears to be a promising therapy for increasing QF strength in adults with knee OA without exacerbating painful symptoms.

Aged↗

Comparison of isometric exercise and high volt galvanic stimulation on quadriceps femoris muscle strength.

The purpose of this study was to compare the effectiveness of both high volt galvanic current (HVG) and isometric exercise to strengthen the quadriceps femoris muscles in 17 healthy subjects. The subjects were divided into three groups. The Control Group (n = 6) received no exercise or stimulation. The Isometric Exercise Group (n = 5) performed 15 sessions of maximum isometric contractions, and the Electrical Stimulation Group (n = 6) engaged in 15 sessions of electrically stimulated isometric contractions. The Isometric Exercise Group was found to have an increase in strength significantly greater (p less than .05) than either the Control or Electrical Stimulation Group. No increase in strength was observed in either the Control or Electrical Stimulation Group. This study indicates that HVG stimulation is not as effective as isometric exercise in increasing strength in muscle.

Adult↗

The positive effects of negative work: increased muscle strength and decreased fall risk in a frail elderly population.

BACKGROUND: The objective of this study was to determine if a chronic eccentric training intervention, i.e., negative work, could limit or even reverse sarcopenia and its related impairments and functional limitations. Is high-force eccentric training tolerable by elderly people and will it result in improved muscle size, strength, balance, and fall risk? METHODS: 21 frail elderly subjects (mean age, 80 years) experienced 11 weeks of lower extremity resistance training. The experimental eccentric (ECC) group (n=11) performed negative work while exercising on a high-force eccentric ergometer. The active "controls" performed traditional (TRAD) (n=10) lower extremity resistance exercises (weight training). Muscle fiber cross-sectional area and strength, balance, stair descending abilities, and fall risk were assessed prior to and following this intervention. RESULTS: All ECC subjects who started the negative work intervention completed the study and reported the training to be relatively effortless; they experienced minimal and transient muscle soreness. Both groups experienced a significant increase in muscle fiber cross-sectional area (ECC=60%, TRAD=41%). Only the ECC group experienced significant improvements in strength (60%), balance (7%), and stair descent (21%) abilities. The timed up and go task improved in both groups, but only the ECC group went from a high to a low fall risk. CONCLUSIONS: These data demonstrate that lower extremity resistance exercise can improve muscle structure and function in those with limited exercise tolerance. The greater strength increase following negative work training resulted in improved balance, stair descent, and fall risk only in the ECC group. Because low energy cost is coupled to high force production with eccentric exercise, this intervention may be useful for a number of patients that are otherwise unable to achieve high muscle forces with traditional resistance exercise.

Accidental Falls↗

Quadriceps concentric and eccentric exercise 2: differences in muscle strength, fatigue and EMG activity in eccentrically-exercised sore and non-sore muscles.

The purpose of this study was to determine whether the previously reported muscle weakness and increases in EMG and EMG/force ratio after eccentric exercise were related to ensuing soreness or simply to the exercise mode. Delayed-onset muscle soreness, maximal voluntary force and the surface electromyogram (EMG) of the quadriceps were studied in 10 healthy male subjects following 20 min of bench-stepping with a constant leading leg. Prior to stepping and at 0, 0.25, 0.50, 0.75, 1, 3, 24 and 48 h afterwards the subjects performed a 30 s isometric maximal voluntary contraction (MVC) of the extensors of each leg during which the isometric force and the root mean square voltage of the surface EMG (rms EMG) were recorded. Muscle soreness was recorded prior to and at 0, 0.75, 3, 24 and 48 h after the stepping task by means of a force probe. No soreness was experienced in the concentrically exercised muscles, but in the eccentrically exercised muscles 5 subjects were not sore and 5 experienced soreness after 24 h, increasing to 48 h. There were no significant differences between sore and non-sore muscles in muscle weakness, fatigue during 30 s, the EMG amplitudes or the EMG/force ratios during peak force and the 30 s MVC (p >0.05). Muscle weakness following eccentric exercise was related to the exercise mode and was independent of subsequent soreness. Both weakness and soreness may be related to muscle damage, but involve different mechanisms.

Adult↗

Shoulder muscle strength, endurance and electromyographic fatigue in ankylosing spondylitis.

Shoulder muscle performance was tested in 8 working ankylosing spondylitis (AS) patients and compared with 10 healthy male referents. The AS patients were all in a non-active state and had no shoulder symptoms. Electromyographic fatigue development in the descending part of the trapezius muscle was significantly faster in the AS group during an endurance time test than in the referents. This indicates a change in muscle function consistent with previous reports of myopathy in AS patients. There were no significant differences in shoulder forward flexion strength, endurance time or recovery of endurance time between the AS patients and the referents.

Adult↗