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Effect of acute infectious disease on isometric muscle strength.

Isometric strength of different muscle groups was recorded in thiryty-nine patients suffering various acute infectious diseases, predominantly of viral or mycoplasma aetiology. Recordings were performed after subsidence of fever, and 1, and 4 months thereafter. A control group of twenty-two healthy men, confined to bed for the same period of time as the patients, were investigated at the same time intervals. In addition, control measurements were performed after 1 year in the patients, prior to bed rest in the control subjects. As a result of illness muscle strength was decreased significantly to 85.4-95.3% of that recorded at 4 months. In the control subjects strength did not change significantly, the corresponding percentages being 96.3-102.5. Thus, the present data indicate that these illnesses in themselves may bring about isometric muscle strength reduction.

Adult↗

Acute muscle stretching inhibits muscle strength endurance performance.

Since strength and muscular strength endurance are linked, it is possible that the inhibitory influence that prior stretching has on strength can also extend to the reduction of muscle strength endurance. To date, however, studies measuring muscle strength endurance poststretching have been criticized because of problems with their reliability. The purpose of this study was twofold: both the muscle strength endurance performance after acute static stretching exercises and the repeatability of those differences were measured. Two separate experiments were conducted. In experiment 1, the knee-flexion muscle strength endurance exercise was measured by exercise performed at 60 and 40% of body weight following either a no-stretching or stretching regimen. In experiment 2, using a test-retest protocol, a knee-flexion muscle strength endurance exercise was performed at 50% body weight on 4 different days, with 2 tests following a no-stretching regimen (RNS) and 2 tests following a stretching regimen (RST). For experiment 1, when exercise was performed at 60% of body weight, stretching significantly (p < 0.05) reduced muscle strength endurance by 24%, and at 40% of body weight, it was reduced by 9%. For experiment 2, reliability was high (RNS, intraclass correlation = 0.94; RST, intraclass correlation = 0.97). Stretching also significantly (p < 0.05) reduced muscle strength endurance by 28%. Therefore, it is recommended that heavy static stretching exercises of a muscle group be avoided prior to any performances requiring maximal muscle strength endurance.

Adult↗

Heritability of maximal isometric muscle strength in older female twins.

The purpose of the present study was to examine genetic and environmental effects on maximal isometric handgrip, knee extension, and ankle plantar flexion strength. In addition, we wanted to investigate whether the strength of these three muscle groups shares a genetic component or whether the genetic effect is specific for each muscle group. Muscle strength was measured as part of the Finnish Twin Study on Aging in 97 monozygotic (MZ) and 102 dizygotic (DZ) female twin pairs, aged 63-76 yr. The MZ and DZ individuals did not differ from each other in age, body height, weight, or self-related health. The age-adjusted pairwise (intraclass) correlations of the MZ and DZ twins were, respectively, 0.462 and 0.242 in knee extension, 0.435 and 0.345 in handgrip, and 0.512 and 0.435 in ankle plantar flexion strength. The multivariate genetic analysis showed that handgrip and knee extension strength shared a genetic component, which accounted for 14% (95% confidence interval: 4-28%) of the variance in handgrip strength and 31% (95% confidence interval: 18-45%) in knee extension strength. The influence of genetic effects on ankle plantar flexion strength was minor and not significant. Furthermore, these three muscle groups had a nongenetic familial effect in common and nonshared environmental effects in common. The results suggested that muscle strength is under a genetic regulation, but also environmental effects have a significant role in explaining the variability in the muscle strength.

Aged↗

Muscle morphology, enzymatic activity, and muscle strength in elderly men: a follow-up study.

A follow-up study of muscle strength, muscle morphology, and enzymatic activity in 23 men, 73-83 years of age, was performed 7 years after the first investigation. With the exception of two men treated for congestive heart failure and four treated for hypertension, all were apparently clinically healthy and none had functional locomotor disturbances. Body weight was reduced by 2% and body cell mass by 6%, whereas the quadriceps muscle strength decreased 10%-22% over the 7-year period. Fiber composition in the vastus lateralis did not change significantly, and there was no significant difference between the biopsies from the biceps brachii and vastus lateralis. In the vastus lateralis, there was a reduction in fast-twitch fiber areas, which were smaller than in the biceps brachii (not studied at the previous investigation). There were also more histopathologic changes in the vastus lateralis than in the biceps brachii. The enzymatic activities of lactate dehydrogenase and myokinase, which were studied on both occasions in the vastus lateralis, did not change, and the activities of the other measured enzymes indicated a maintained metabolic capacity at high age. Oxidative enzymatic activities were higher in the vastus lateralis, and glycolytic enzymatic activities were higher in the biceps brachii, which could partly be explained by differences in relative fiber areas.

Aged↗

Sustained maintenance of exercise induced muscle strength gains and normal bone mineral density in patients with early rheumatoid arthritis: a 5 year follow up.

OBJECTIVE: To investigate at 5 years whether an initial 2 year home based strength training period imposes sustained effects on muscle strength, bone mineral density (BMD), structural joint damage, and on disease activity in patients with early rheumatoid arthritis (RA). METHODS: Seventy patients were randomised either to perform home based strength training with loads of 50-70% of repetition maximum (EG) or range of motion exercises (CG). Both groups were encouraged to take part in aerobic activities 2-3 times a week. Maximal muscle strength of different muscle groups was measured by dynamometers, and BMD at the femoral neck and lumbar spine by dual x ray densitometry. Disease activity was assessed by the 28 joint disease activity score, and joint damage by x ray findings. RESULTS: 62 patients completed 2 years' training and 59 patients attended check up at 5 years. Mean (SD) maximum muscle strength indices increased from baseline to 2 years-in EG from 212 (78) kg by a mean (95% CI) of 68 (55 to 80) and in CG from 195 (72) kg by 35 (13 to 60) kg-and remained at that level for the next 3 years. Development of BMD in EG tended to be more favourable than that in CG. Muscle strength training was not detrimental to joint structures or disease activity. CONCLUSION: The patients' exercise induced muscle strength gains during a 2 year training period were maintained throughout a subsequent self monitored training period of 3 years. Despite substantial training effects in muscle strength, BMD values remained relatively constant. Radiographic damage remained low even at 5 years.

Adult↗

Respiratory muscle strength in hypothyroidism.

To investigate respiratory muscle strength in patients with hypothyroidism, global respiratory muscle strength was assessed by measuring mouth pressure during PImax and PEmax efforts. Maximum pressures, VC, FEV1, FVC, T3, T4, and TSH were measured in 43 hypothyroid patients. Measurements were made before and three months after replacement therapy with thyroxine. The results showed that the mean value of PImax and PEmax increased after treatment. Significant change was found in the mean value of VC, FEV1, and FVC after treatment but not in the FEV1/FVC ratio. A highly statistically significant linear relationship was found between PImax and TSH and between PEmax and TSH as well as between PImax and T3 and PEmax and T3. We conclude that hypothyroidism affects respiratory muscle strength and that this weakness is linearly related to thyroid hormone levels. Respiratory muscle weakness is present in both inspiratory and expiratory muscles and is reversible with treatment.

Adult↗

Influence of muscle strength, physical activity and weight on bone mass in a population-based sample of 1004 elderly women.

High physical activity level has been associated with high bone mass and low fracture risk and is therefore recommended to reduce fractures in old age. The aim of this study was to estimate the effect of potentially modifiable variables, such as physical activity, muscle strength, muscle mass and weight, on bone mass in elderly women. The influence of isometric thigh muscle strength, self-estimated activity level, body composition and weight on bone mineral density (dual energy X-ray absorptiometry; DXA) in total body, hip and spine was investigated. Subjects were 1004 women, all 75 years old, taking part in the Malmö Osteoporosis Prospective Risk Assessment (OPRA) study. Physical activity and muscle strength accounted for 1-6% of the variability in bone mass, whereas weight, and its closely associated variables lean mass and fat mass, to a much greater extent explained the bone mass variability. We found current body weight to be the variable with the most substantial influence on the total variability in bone mass (15-32% depending on skeletal site) in a forward stepwise regression model. Our findings suggest that in elderly women, the major fracture-preventive effect of physical activity is unlikely to be mediated through increased bone mass. Retaining or even increasing body weight is likely to be beneficial to the skeleton, but an excess body weight increase may have negative effects on health. Nevertheless, training in elderly women may have advantages by improving balance, co-ordination and mobility and therefore decreasing the risk of fractures.

Aged↗

Dynamic strength training in patients with early rheumatoid arthritis increases muscle strength but not bone mineral density.

OBJECTIVE: To assess the effects of 12 months' dynamic strength training on muscle strength and bone mineral density (BMD) at the lumbar spine and femoral neck in patients with early rheumatoid arthritis (RA). METHODS: Thirty-two subjects in the training group (EG) and 33 in the control group (CG) completed the study. EG carried out strength training 2 times a week with moderate loads of 50-70% of repetition maximum. They were also encouraged to do recreational physical activities. CG performed recreational physical activities and range of motion exercises. Maximal strength of the knee extensors, trunk extensors and flexors, and grip strength were recorded with dynamometers. BMD was measured using dual x-ray absorptiometry. Modified Disease Activity Score, erythrocyte sedimentation rate, and pain were used for the estimation of disease activity, and Stanford Health Assessment Questionnaire to measure functional disability. RESULTS: The 12 month resistance training in EG led to statistically significant mean increases of 22-35% in all muscle groups examined. CG patients were also able to increase their strength to some degree (3-24%), but at the end of the study strengths in CG were significantly lower than in EG. By the end of the study lumbar spine BMD had changed by +0.19% (4.24) in EG and by -1.14% (4.36) in CG. The corresponding changes of femoral BMD were +1.10% (3.71) and -0.03% (3.58). The changes in BMD were minor and statistically not significant in both groups. However, femoral BMD was found to be decreased among those patients treated periodically with oral glucocorticoids (n = 15, 3 subjects from EG and 12 from CG) compared with changes in BMD among those not treated with systemic glucocorticoids (n = 50). CONCLUSION: Minimally supervised strength training resulted in significant improvements in muscle strength without detrimental effects on disease activity. The detected annual changes in central BMD were minor and statistically insignificant in both groups. Special attention should be focused on those patients with RA with high disease activity and concomitant glucocorticoid treatment.

Arthritis, Rheumatoid↗

Longitudinal changes in selected physical capabilities: muscle strength, flexibility and body size.

OBJECTIVES: first, to record, in a representative sample of older men and women, longitudinal changes in (i) maximal voluntary strength of the handgrip muscles, (ii) maximal range of movement in the shoulder joint and (iii) body weight and skeletal size; second, to explore associations between the changes in muscle strength and both customary physical activity and health outcomes. DESIGN: longitudinal analyses of survivors measured at baseline, and 4-year and 8-year follow-ups. PARTICIPANTS: 350 survivors of a random sample originally aged 65 and over. RESULTS: over 8 years average loss of body weight was slight but significant at about 2 kg (less than 5%). Loss of shoulder range was negligible, while loss of muscle strength was significant at about 40 N (less than 2% per year). Demispan remained stable across all three points of measurement. These mean values concealed substantial variation in the rate of loss of strength, which was twice as fast in the older groups, especially in the women. These losses could not be attributed to worsening health, although this was observed. All the respondents had at least two chronic health problems at the 8-year stage. For the changes in handgrip strength, reduced reported habitual use of the handgrip muscles and increased symptoms of anxiety and depression were significant independent covariates in addition to age and time (all P < 0.0001). CONCLUSION: there are significant independent associations between the loss of muscle strength in old age and both decline in physical activity and increase in depression scores. This is strongly suggestive of causal links and confirms the need to encourage physical activity and control depression in order to maintain strength and function in old age.

Aged↗

Using a stopwatch to assess pelvic muscle strength in the urine stream interruption test.

Pelvic muscle strength is important in maintaining urinary continence. The urine stream interruption test provides a simple measure of pelvic muscle strength. This study evaluated the accuracy of the test as adapted for clinical use. Women (n = 75) were tested according to standardized protocol. The test was simultaneously timed using a uroflowmeter (for research purposes) and a stopwatch (a technique more feasible in the practice setting). The stopwatch-timed urine stream interruption test was consistent with the uroflowmeter score (r = 0.90, p < 0.00) and demonstrated adequate repeatability (r = -0.69, p < 0.00). The stopwatch test was related to a digital measure of pelvic muscle strength (r = -0.49, p = 0.00), i.e., women with greater pelvic muscle strength were able to interrupt the stream of urine more quickly. Significantly less involuntary urine loss was seen in women whose stopwatch test score was two seconds or less as compared with those whose scores were greater than two seconds (t = -4.83, p = < 0.00, df = 73). Clinicians can use the urine stream interruption test as a baseline measure and as a tool to assess changes in pelvic muscle strength.

Adolescent↗

Do knee injuries have long-term consequences for isometric and dynamic muscle strength?

To ascertain whether decrements in knee extensor muscle strength persist years after a traumatic ligamentous or meniscal knee injury, with reference to (1) the type of muscle activity, (2) the dominance of injury, and (3) the time since injury, 36 subjects with previous unilateral knee injuries were assessed. Peak voluntary quadriceps muscle strength was measured using the KinCom 500H dynamometer during isometric, concentric (30 degrees.s-1 and 120 degrees.s-1) and eccentric contractions (30.s-1), and the findings for each type of contraction were compared. Significant differences in quadriceps muscle strength were seen between (1) the injured and uninjured limbs during maximal voluntary isometric (P = 0.0003), concentric (P < 0.0001) and eccentric (P < 0.0001) contractions, and (2) the isometric and concentric decrements (P = 0.004), and the isometric and eccentric decrements (P = 0.012) within the same injured limb. The decrements in eccentric strength were significantly greater if they affected the dominant rather than the non-dominant limb (P = 0.0186). No relationship was seen between the time since injury and the degree of isometric or dynamic decrement. Deficits in quadriceps muscle strength remained for a long time after traumatic knee injury, with exercise levels rarely returning to the previously uninjured state. The degree of decrement in muscle strength was dependent upon the type of muscle activity, with concentric and eccentric activity showing greater decrements than those seen with isometric activity. Deficits in the type of activity varied widely in the same individual, and eccentric decrements were significantly worse following dominant knee injuries. Possible explanations for these findings and the implications for rehabilitation following knee injury are discussed.

Adolescent↗

Effect of recombinant human growth hormone on the muscle strength response to resistance exercise in elderly men.

Normal aging is characterized by detrimental changes in body composition, muscle strength, and somatotropic function. Reduction in muscle strength contributes to frailty and risk for fracture in the elderly. Although older adults increase muscle strength as a result of resistance exercise training, the strength gains quickly level off, with only modest increases thereafter despite continued training. To investigate whether age-related deficits in the somatotropic axis limit the degree to which muscle strength can improve with resistance training in older individuals, we conducted a double blind, placebo-controlled exercise trial. Eighteen healthy elderly men (65-82 yr) initially underwent progressive weight training for 14 weeks to invoke a trained state. Subjects were then randomized to receive either 0.02 mg/kg BW.day recombinant human GH (rhGH) or placebo, given sc, while undertaking a further 10 weeks of strength training. Sequential measurements were made of muscle strength (one repetition maximum), body composition (dual energy x-ray absorptiometry), and circulating levels of insulin-like growth factor-I (IGF-I) and IGF-binding protein-3. For each exercise, strength increased for both groups (P = 0.0001) through 14 weeks of training, with little improvement thereafter. Increases in muscle strength ranged from 24-62% depending on the muscle group. Baseline plasma IGF-I concentrations were similar in both groups (mean +/- SEM, 106 +/- 9 micrograms/L), approximately half that observed in healthy young adults. In the rhGH group, IGF-I levels increased to 255 +/- 32 micrograms/L at week 15 and 218 +/- 21 micrograms/L at week 24 (P < 0.001). In the placebo group, IGF-I increased slightly to 119 +/- 6 micrograms/L at 24 weeks. IGF-binding protein-3 also increased in the rhGH group (P < 0.05). rhGH had no effect on muscle strength at any time, and no systematic difference in muscle strength was observed between groups throughout the study. Body weight did not change in either group, but lean body mass increased, and fat mass decreased (P < 0.05) in the rhGH group. Supplementation with rhGH does not augment the response to strength training in elderly men. These results suggest that deficits in GH secretion do not underlie the time-dependent leveling off of muscle strength seen with training in the elderly and provide no support for the popular view of GH as an ergogenic aid.

Aged↗

Progressive resistance muscle strength training of hospitalized frail elderly.

OBJECTIVE: To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training. DESIGN: Muscle strength (one repetition maximum), functional abilities (sit-to-stand maneuver and 20-sec maximal safe gait speed), and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training. The nonrandomized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home. Participants included 19 recuperating elderly subjects (14 male, 5 female; 13 ambulatory, 6 nonambulatory) >64 yr (mean age, 82.8+/-7.9 yr). RESULTS: The one repetition maximum increased an average of 74%+/-49% (median, 70%; interquartile range, 38%-95%, and an average of 20+/-13 kg (P = 0.0001). Sit-to-stand maneuver times improved in 15 of 19 cases (79%). Maximum safe gait speeds improved in 10 of 19 cases (53%). Four of the six nonambulatory subjects progressed to ambulatory status. No subject experienced a complication. CONCLUSIONS: A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses. A randomized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages, if any, over routine posthospital care that includes traditional low-intensity physical therapy.

Activities of Daily Living↗

Testosterone administration preserves protein balance but not muscle strength during 28 days of bed rest.

Decrements in muscle strength as a result of prolonged bed rest are well defined, but little is known about potential countermeasures for preventing loss of strength under this condition. The purpose of this study was to determine whether testosterone administration would preserve protein balance and muscle strength during prolonged bed rest. Ten healthy men (age, 36 +/- 2 yr; height, 177.2 +/- 3.4 cm; weight, 80.5 +/- 3.9 kg; mean +/- SE) were admitted to our in-patient metabolic unit. After a 1-week ambulatory run-in period, each subject was confined to bed for 28 days at 6 degree head-down tilt while receiving a daily oral dose of T3 (50 microg/day). During the bed rest/T3 period, six of the men were randomized to receive testosterone enanthate by i.m. injection (T; 200 mg/week) while four received placebo in a double blind fashion. Nitrogen balance was determined throughout, and whole body [13C]leucine kinetics were assessed at baseline and on day 26 of bed rest. Before bed rest and on the third day of reambulation, the muscle strength of the knee extensors and flexors and shoulder extensors and flexors was determined at 60 degrees/s on a Cybex isokinetic dynamometer. Despite improved [13C]leucine kinetics and maintenance of nitrogen balance and lean body mass in T-treated subjects, little preservation of muscle strength, particularly in the knee extensors, was noted. Muscle strength [reported as the best work repetition in foot-pounds (FtLb)] for right knee extensors declined (P = 0.011) similarly in both groups; from 165 +/- 15 to 126 +/- 18 FtLb in T-treated men and from 179 +/- 22 to 149 +/- 13 FtLb in placebo-treated men. Overall, there was less of a decline in extension and flexion strength of the shoulder compared to the knee, with no benefit from T. These results suggest that in the absence of daily ambulatory activity, T administration will not increase or, in the case of this bed rest model, preserve muscle strength.

Adult↗

Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women.

The separate effects of 18 weeks of intensive strength and endurance training on isometric knee extension (KE) and flexion (KF) strength and walking speed were studied in 76- to 78- year-old women. Maximal voluntary isometric force for both KE and KF was measured in a sitting position on a custom-made dynamometer chair at a knee angle of 60 degrees from full extension. Maximal walking speed was measured over a distance of 10 m. The endurance-trained women increased KE torque and KE torque/body mass after the first 9 weeks of training when compared with the controls. when comparing the baseline, 9 week and 18 week measurements within the groups separately, both the endurance- and strength-training groups increased KE torque, KE torque/body mass and walking speed. Individual changes in KE torque/body mass before and after 18 weeks of training averaged 19.1% in the strength group, 30.9% in the endurance group and 2.0% in the controls. This study indicates that in elderly women the effects of physical training on muscle strength and walking speed occur after endurance as well as strength training. The considerable interindividual variation in change of muscle performance is also worth noticing.

Aged↗

The influence of prior activity upon inspiratory muscle strength in rowers and non-rowers.

The aim of this study was to investigate whether a 'warm-up' phenomenon in the strength of the inspiratory muscles exists, and, under this assumption, whether whole body warm-up protocols or a specific respiratory warm-up is more effective in this respect. Eleven club level rowers performed a rowing warm-up, and twelve university students performed a general cycling warm-up. Both groups also performed a specific respiratory warm-up. Inspiratory muscle strength (Mueller manoeuvre) and lung function (flow-volume loops) were measured before and after the three conditions. Isokinetic strength during knee extension was measured before and after the rowing warm-up. The two whole body warm-up protocols had no effect on inspiratory muscle strength or any lung function parameter despite the significant (3.8+/-SD 1.4%; p<0.05) increase in peak torque that the rowing warm-up elicited. The respiratory warm-up induced a significant increase in inspiratory mouth pressure (8.5+/-1.8%; p<0.0001) but not in any other lung function parameter. Following the rowing incremental test to exhaustion, maximum inspiratory pressure decreased by 7.0+/-2.0%, which is an indication of respiratory muscle fatigue. These data suggest that the inspiratory muscle strength can be enhanced with preliminary activity, a phenomenon similar to the one known to exist for other skeletal muscles. In addition, a specific respiratory warm-up is more effective in this respect than whole body protocols.

Adult↗

Effect of gender, age, and anthropometry on axial and appendicular muscle strength.

OBJECTIVE: To assess age and gender differences in muscle strength. DESIGN: The strength of back extensors, upper limbs (grip), and lower limbs (knee extensors) was measured. Anthropometric measurements and body mass index also were assessed. RESULTS: Group comparisons were made for each decade. Back extensor strength (BES) in subjects aged 20 to 89 yr ranged from 93 to 832 N in men and from 71 to 440 N in women. BES peaked in the fourth decade for men and in the fifth decade for women. When the two genders were compared, muscle strength in women was less than that in men at all ages. At different decades, women's BES ranged from 54% to 76% compared with that of men's BES. There was a 64% loss of BES in men from the peak in their fourth decade (556 N) to the lowest level in their ninth decade (201 N). Women experienced a 50.4% loss from the peak in their fifth decade (306 N) to the lowest level in their ninth decade (152 N). CONCLUSIONS: Men had a greater loss of BES than women with increasing age. In both genders, there was more loss of BES than appendicular muscle strength. Reduction in BES in women coincided with increased body mass index in older age. In women, there was a negative correlation between body weight and level of physical activity, whereas this finding was not evident in men. Background factors related to a higher incidence of back pain, falls, and fractures, especially in women, may be a reduction in muscle strength, along with increasing age and body mass index. This cross-sectional study showed that physiologic reduction of muscle strength, which began early in life, later stopped and that muscle strength even improved, despite the aging process. Therefore, initiating strengthening exercises at any age is encouraged to prevent the impact of several age-related musculoskeletal challenges.

Adult↗