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Pereira HM, Keenan KG, Hunter SK. Influence of visual feedback and cognitive challenge on the age-related changes in force steadiness. Exp Brain Res 2024; 242:1411-1419. [PMID: 38613669 DOI: 10.1007/s00221-024-06831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/05/2024] [Indexed: 04/15/2024]
Abstract
Force steadiness can be influenced by visual feedback as well as presence of a cognitive tasks and potentially differs with age and sex. This study determined the impact of altered visual feedback on force steadiness in the presence of a difficult cognitive challenge in young and older men and women. Forty-nine young (19-30 yr; 25 women, 24 men) and 25 older (60-85 yr; 15 women; 10 men) performed low force (5% of maximum) static contractions with the elbow flexor muscles in the presence and absence of a cognitive challenge (counting backwards by 13) either with low or high visual feedback gain. The cognitive challenge reduced force steadiness (increased force fluctuation amplitude) particularly in women (cognitive challenge × sex: P < 0.05) and older individuals (cognitive challenge × age: P < 0.05). Force steadiness improved with high-gain visual feedback compared with low-gain visual feedback (P < 0.01) for all groups (all interactions: P > 0.05). Manipulation of visual feedback had no influence on the reduced force steadiness in presence of the cognitive challenge for all groups (all P > 0.05). These findings indicate that older individuals and women have greater risk of impaired motor performance of the upper extremity if steadiness is required during a low-force static contraction. Manipulation of visual feedback had minimal effects on the reduced force steadiness in presence of a difficult cognitive challenge.
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Affiliation(s)
- Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA.
| | - Kevin G Keenan
- Joseph J. Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, USA
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, USA
- Athletic and Human Performance Research Center, Marquette University, Milwaukee, USA
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Scully KJ, Marchetti P, Sawicki GS, Uluer A, Cernadas M, Cagnina RE, Kennedy JC, Putman MS. The effect of elexacaftor/tezacaftor/ivacaftor (ETI) on glycemia in adults with cystic fibrosis. J Cyst Fibros 2022; 21:258-263. [PMID: 34531155 PMCID: PMC8918034 DOI: 10.1016/j.jcf.2021.09.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/06/2021] [Accepted: 09/01/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cystic fibrosis related diabetes (CFRD) is associated with pulmonary decline and compromised nutritional status. Emerging data suggest that CFTR dysfunction may play a direct role in the pathogenesis of CFRD; however, studies investigating the effect of CFTR modulators on glycemic outcomes in patients with cystic fibrosis (CF) have shown mixed results. The impact of elexacaftor-tezacaftor-ivacaftor (ETI) on glycemic control is currently unknown. Our objective was to investigate the effect of ETI initiation on glycemia in adults with CF using continuous glucose monitoring (CGM). METHODS In this prospective observational study, 34 adults with CF and at least one F508del CFTR mutation wore CGM sensors for 14 days prior to starting ETI and again 3-12 months after ETI initiation. Hypoglycemia symptoms were queried at each visit, and most recent anthropometric measures and spirometry data were obtained by chart review. RESULTS Twenty-three participants completed the study. Compared to baseline, average glucose (AG), standard deviation (SD), % time >200 mg/dL, and peak sensor glucose decreased with ETI treatment, and % time in target range 70-180 mg/dL increased. Improvements in glycemic parameters were most notable in individuals with CFRD. There was no significant change in CGM-measured or self-reported hypoglycemia before and after ETI initiation. CONCLUSION Initiation of ETI in adults with CF was associated with improvement CGM-derived measures of hyperglycemia and glycemic variability with no effect on hypoglycemia. Further studies are needed to investigate underlying etiology of these changes and the long-term impact of ETI on glycemic control in patients with CF.
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Affiliation(s)
- Kevin J Scully
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, Harvard Medical School, Boston MA
| | - Peter Marchetti
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA
| | - Gregory S. Sawicki
- Harvard Medical School, Boston MA, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA
| | - Ahmet Uluer
- Harvard Medical School, Boston MA, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston MA
| | - Manuela Cernadas
- Harvard Medical School, Boston MA, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston MA
| | - Rebecca E. Cagnina
- Harvard Medical School, Boston MA, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston MA
| | - John C. Kennedy
- Harvard Medical School, Boston MA, Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston MA
| | - Melissa S. Putman
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, Harvard Medical School, Boston MA, Diabetes Research Center, Massachusetts General Hospital, Boston, MA
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Scully KJ, Jay LT, Freedman S, Sawicki GS, Uluer A, Finkelstein JS, Putman MS. The Relationship between Body Composition, Dietary Intake, Physical Activity, and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis. Nutrients 2022; 14:nu14020310. [PMID: 35057491 PMCID: PMC8777582 DOI: 10.3390/nu14020310] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 02/01/2023] Open
Abstract
Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.
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Affiliation(s)
- Kevin J. Scully
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA 02115, USA;
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
| | - Laura T. Jay
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA 02115, USA;
| | - Steven Freedman
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
- Division of Gastroenterology, Beth Israel Deaconess Hospital, Boston, MA 02115, USA
| | - Gregory S. Sawicki
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Ahmet Uluer
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Joel S. Finkelstein
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
- Division of Endocrinology, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Melissa S. Putman
- Harvard Medical School, Boston, MA 02115, USA; (S.F.); (G.S.S.); (A.U.); (J.S.F.)
- Division of Endocrinology, Massachusetts General Hospital, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-857-218-5017; Fax: +1-617-730-0194
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Choline-Based Multi-Ingredient Supplementation Can Improve Explosive Strength during a Fatiguing Task. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111400. [PMID: 34769925 PMCID: PMC8583572 DOI: 10.3390/ijerph182111400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Various choline-based multi-ingredient supplementations (CMS) have been suggested in the current market, but the research is limited. The purpose of this study was to investigate the acute effect of a CMS on physical performance. Fourteen male college football players (20.4 ± 1.0 years) participated in a randomized double-blind crossover experiment separated by 7 days. Subjects were given a CMS or a placebo 60 min before physical performance testing measures, including maximum vertical jumps, maximum voluntary isometric contractions (MVIC), maximal voluntary concentric contractions (MVCC), and fatiguing contractions. Four MVICs and seven sets of two MVCCs at various loads (1 N·m to 60% MVIC torque) were performed with the knee extensor muscles while seated on a dynamometer before and after the fatiguing tasks. During the fatiguing tasks, 120 MVCCs (4 sets × 30 reps) were performed with a load equivalent to 20% MVIC. Twitch interpolation technique was used to assess muscle contractile properties and voluntary activation. No significant differences were seen at baseline between sessions for all testing measures including vertical jump height, strength, power, muscle contractile properties and voluntary activation. Rate of torque development and impulse was higher in supplemental session compared to control session throughout the fatiguing contractions (p = 0.018, p < 0.001, respectively). Acute CMS can improve explosive strength by delaying the onset of fatigue.
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Putman MS, Greenblatt LB, Bruce M, Joseph T, Lee H, Sawicki G, Uluer A, Sicilian L, Neuringer I, Gordon CM, Bouxsein ML, Finkelstein JS. The Effects of Ivacaftor on Bone Density and Microarchitecture in Children and Adults with Cystic Fibrosis. J Clin Endocrinol Metab 2021; 106:e1248-e1261. [PMID: 33258950 PMCID: PMC7947772 DOI: 10.1210/clinem/dgaa890] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Cystic fibrosis (CF) transmembrane conductance (CFTR) dysfunction may play a role in CF-related bone disease (CFBD). Ivacaftor is a CFTR potentiator effective in improving pulmonary and nutritional outcomes in patients with the G551D-CFTR mutation. The effects of ivacaftor on bone health are unknown. OBJECTIVE To determine the impact of ivacaftor on bone density and microarchitecture in children and adults with CF. DESIGN Prospective observational multiple cohort study. SETTING Outpatient clinical research center within a tertiary academic medical center. PATIENTS OR OTHER PARTICIPANTS Three cohorts of age-, race-, and gender-matched subjects were enrolled: 26 subjects (15 adults and 11 children) with CF and the G551D-CFTR mutation who were planning to start or had started treatment with ivacaftor within 3 months (Ivacaftor cohort), 26 subjects with CF were not treated with ivacaftor (CF Control cohort), and 26 healthy volunteers. INTERVENTIONS All treatments, including Ivacaftor, were managed by the subjects' pulmonologists. MAIN OUTCOME MEASURES Bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT), areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) and bone turnover markers at baseline, 1, and 2 years. RESULTS Cortical volume, area, and porosity at the radius and tibia increased significantly in adults in the Ivacaftor cohort. No significant differences were observed in changes in aBMD, trabecular microarchitecture, or estimated bone strength in adults or in any outcome measures in children. CONCLUSIONS Treatment with ivacaftor was associated with increases in cortical microarchitecture in adults with CF. Further studies are needed to understand the implications of these findings.
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Affiliation(s)
- Melissa S Putman
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA
- Correspondence and Reprint Requests: Melissa S. Putman, Endocrine Unit, Massachusetts General Hospital, 50 Blossom Street, THR-1051, Boston, MA 02114. E-mail:
| | - Logan B Greenblatt
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Michael Bruce
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Taisha Joseph
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hang Lee
- Massachusetts General Hospital Biostatistics Center, Boston, MA, USA
| | - Gregory Sawicki
- Division of Pulmonology, Boston Children’s Hospital, Boston, MA, USA
| | - Ahmet Uluer
- Division of Pulmonology, Boston Children’s Hospital, Boston, MA, USA
- Division of Pulmonology and Critical Care, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Leonard Sicilian
- Division of Pulmonology and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Isabel Neuringer
- Division of Pulmonology and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Catherine M Gordon
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Mary L Bouxsein
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Joel S Finkelstein
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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Pothirat C, Chaiwong W, Liwsrisakun C, Phetsuk N, Theerakittikul T, Choomuang W, Chanayart P. Reliability of the Thai version of the International Physical Activity Questionnaire Short Form in chronic obstructive pulmonary disease. J Bodyw Mov Ther 2021; 27:55-59. [PMID: 34391285 DOI: 10.1016/j.jbmt.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/07/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the reliability of the Thai version of International Physical Activity Questionnaire Short Form (IPAQ-SF) in Chronic Obstructive Pulmonary Disease (COPD) patients. METHODS A cross sectional study was carried out in COPD subjects at Chiang Dao hospital, Chiang Mai, Thailand in June and July 2019. COPD subjects were asked to complete the Thai version of the IPAQ-SF. Calculations for each level of activity were carried out separately (vigorous activity, moderate activity, walking, and sitting). This was carried out twice with an interval of four weeks between visits. The test-retest reliability of the IPAQ was assessed using the intraclass correlation (ICC) with a 95% confidence interval (CI). Cohen's kappa coefficient and percentage agreement were used to test the repeatability of the physical activity classification between the two visits. RESULTS Sixty COPD subjects (50% male), with a mean age of 71.2 ± 7.7 years were included. The least reliability was established for sitting time (ICC = 0.439; 95%CI; 0.212, 0.621, p-value < 0.001) and the greatest for the total physical activity (ICC = 0.837; 95%CI; 0.741, 0.899, p-value < 0.001). The Kappa statistic was 0.433 with a 95%CI; 0.237, 0.639, p-value < 0.001 and the percentage agreement of the physical activity classification between the two visits was 66.7%. CONCLUSION The test-retest reliability was adequate for vigorous activity and total physical activity. Although there are concerns about the agreement for classification of physical activity, the IPAQ-SF may be a useful if not definitive tool for assessing physical activity in COPD.
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Affiliation(s)
- Chaicharn Pothirat
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nittaya Phetsuk
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Woranoot Choomuang
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Panida Chanayart
- Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Pereira HM, de Lima FF, Silva BM, Kohn AF. Sex differences in fatigability after ischemic preconditioning of non-exercising limbs. Biol Sex Differ 2020; 11:59. [PMID: 33109241 PMCID: PMC7590792 DOI: 10.1186/s13293-020-00338-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Ischemic preconditioning (IPC) is suggested to decrease fatigability in some individuals but not others. Sex differences in response to IPC may account for this variability and few studies systematically investigated the effects of IPC in men and women. The goal of this study was to determine if time to task failure, perception of pain, and neuromuscular mechanisms of fatigability were altered by IPC in men and women. Methods Ten women (29 ± 5 years old) and 10 men (28 ± 6 years old) performed isometric contractions with the plantar flexor muscles of the dominant leg at 20% of maximal voluntary contraction until task failure. We used a repeated measures design where each individual performed 3 randomized and counterbalanced test sessions: (A) IPC session, cuff inflation and deflation (5 min each repeated 3 times) performed before the exercise by inflating cuffs to the non-dominant leg and arm; (B) sham session, cuffs were inflated for a short period (1 min); and (C) control session, no cuffs were involved. Results Compared with control, IPC increased time to task failure in men (mean difference, 5 min; confidence interval (CI) of mean difference, 2.2; 7.8 min; P = 0.01) but not women (mean difference, − 0.6 min; CI of mean difference, − 3.5; 2.4 min; P = 0.51). In men, but not women, the IPC-induced increase in time to task failure was associated with lower response to pressure pain (r = − 0.79). IPC further exposed sex differences in arterial pressure during fatiguing contractions (session × sex: P < 0.05). Voluntary activation, estimated with the twitch interpolation technique, and presynaptic inhibition of leg Ia afferents were not altered after IPC for men and women. The tested variables were not altered with sham. Conclusions The ergogenic effect of IPC on time to task failure was observed only in men and it was associated with reductions in the perception of pain. This pilot data suggest the previously reported inter-individual variability in exercise-induced fatigability after IPC could be a consequence of the sex and individual response to pain.
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Affiliation(s)
- Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA.
| | - Felipe F de Lima
- Biomedical Engineering Laboratory/EPUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Bruno M Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - André F Kohn
- Biomedical Engineering Laboratory/EPUSP, University of São Paulo, São Paulo, SP, Brazil
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Balducci S. Prevention of type 2 diabetes by physical activity: What has history taught us? Diabetes Metab Res Rev 2020; 36:e3308. [PMID: 32167671 DOI: 10.1002/dmrr.3308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/30/2020] [Accepted: 03/07/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Stefano Balducci
- Department of Clinical and Molecular Medicine, "La Sapienza" University, and Diabetes Unit, Sant'Andrea Hospital, Rome, Italy
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Mostafavi F, Moradi G, Azadi N, Esmaeilnasab N, Roshani D. Using Oaxaca Decomposition to Study Socioeconomic Inequity of Physical Activity among Children Aged 10-12 Years: A Study in West of Iran. Int J Prev Med 2019; 10:83. [PMID: 31198518 PMCID: PMC6547781 DOI: 10.4103/ijpvm.ijpvm_222_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/27/2018] [Indexed: 11/04/2022] Open
Abstract
Background Low physical activity (PA) is increasing public health problem. The present study aimed to determine socioeconomic inequality in PA among children aged 10-12 years old in Kurdistan, west of Iran in 2015. Methods The present cross-sectional study was conducted on 2506 children aged 10-12 in Sanandaj, Iran, in 2015. Data on the children's level of PA were collected using the Modifiable Activity Questionnaire. The concentration index was used to measure inequality and the Oaxaca decomposition to examine the different determinants of the inequality. The data were analyzed in Stata 13 and SPSS 20. Results Of the 2506 participants, 40.90% (38.97-42.82) had insufficient PA. Girls had a lower level of PA than boys (odds ratio [OR] = 0.34; 95% confidence intervals [CI]: 0.28-0.41) and it is directly related to maternal education (OR = 1.71; 95% CI: 1.18-2.47), the family's Socioeconomic status (SES) (OR = 2.18; 95% CI: 1.56-3.05), and the place of residence (OR = 1.68; 95% CI: 1.16-2.44). The concentration index for insufficient PA was -0.25 (95 CI: -0.30 to -0.21), revealing an insufficient PA in the group with a low SES. The prevalence of insufficient PA is 51.38% (95% CI: 48.45-54.31) in poor group and 28.40% (95% CI: 22.80-33.99) in the wealthier group. The Oaxaca decomposition showed maternal education and the place of residence was the most important determinants of inequality. Conclusions According to the findings, most of the children especially in the poor groups didn't have sufficient PA and socioeconomic factors could have the important role.
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Affiliation(s)
- Farideh Mostafavi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Namamali Azadi
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | - Nader Esmaeilnasab
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Daem Roshani
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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10
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Senefeld J, Pereira HM, Elliott N, Yoon T, Hunter SK. Sex Differences in Mechanisms of Recovery after Isometric and Dynamic Fatiguing Tasks. Med Sci Sports Exerc 2019; 50:1070-1083. [PMID: 29298217 DOI: 10.1249/mss.0000000000001537] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to determine whether supraspinal mechanisms contribute to the sex difference in fatigability during and recovery from a dynamic and isometric fatiguing task with the knee extensors. METHODS Transcranial magnetic stimulation and electrical stimulation were used to determine voluntary activation and contractile properties of the knee extensors in 14 men and 17 women (20.8 ± 1.9 yr) after a 1) 60-s sustained, maximal voluntary isometric contraction (MVIC), and 2) dynamic fatiguing task involving 120 maximal voluntary concentric contractions with a 20% MVIC load. RESULTS There were no differences between men and women in the reduction of maximal torque during the sustained MVIC (54.4% ± 18.9% vs 55.9% ± 11.2%, P = 0.49) or in the decrease in power during the dynamic fatiguing task (14.7% ± 20.1% vs 14.2% ± 18.5%, P = 0.92). However, MVIC torque recovered more quickly for women than men after the sustained MVIC and the dynamic task (P < 0.05). The transcranial magnetic stimulation-elicited superimposed twitch was larger for men than for women during the sustained MVIC and in recovery (immediately post, R0.1: 4.7% ± 3.3% vs 2.4% ± 1.9% MVIC; P = 0.02), with no sex difference after the dynamic task (P = 0.35). The reduction in resting twitch amplitude was larger for men than for women immediately after the dynamic task (37% ± 22% vs 23% ± 18%; P = 0.016) with no sex difference after the sustained MVIC (64% ± 16% vs 67% ± 11%; P = 0.46). CONCLUSIONS Supraspinal fatigue contributed to fatigability of the knee extensors more for men than for women after a maximal isometric task, whereas contractile mechanisms explained the sex difference in torque recovery after the fast-velocity dynamic task. The mechanisms for the sex difference in fatigability are task dependent.
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Affiliation(s)
- Jonathon Senefeld
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hugo M Pereira
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Nicholas Elliott
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
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11
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Pereira HM, Schlinder-DeLap B, Keenan KG, Negro F, Farina D, Hyngstrom AS, Nielson KA, Hunter SK. Oscillations in neural drive and age-related reductions in force steadiness with a cognitive challenge. J Appl Physiol (1985) 2019; 126:1056-1065. [PMID: 30817244 DOI: 10.1152/japplphysiol.00821.2018] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
A cognitive challenge when imposed during a low-force isometric contraction will exacerbate sex- and age-related decreases in force steadiness, but the mechanism is not known. We determined the role of oscillations in the common synaptic input to motor units on force steadiness during a muscle contraction with a concurrent cognitive challenge. Forty-nine young adults (19-30 yr; 25 women, 24 men) and 36 old adults (60-85 yr; 19 women, 17 men) performed a cognitive challenge (counting backward by 13) during an isometric elbow flexion task at 5% of maximal voluntary contraction. Single-motor units were decomposed from high-density surface EMG recordings. For a subgroup of participants, motor units were matched during control and cognitive challenge trials, so the same motor unit was analyzed across conditions. Reduced force steadiness was associated with greater oscillations in the synaptic input to motor units during both control and cognitive challenge trials ( r = 0.45-0.47, P < 0.01). Old adults and young women showed greater oscillations in the common synaptic input to motor units and decreased force steadiness when the cognitive challenge was imposed, but young men showed no change across conditions (session × age × sex, P < 0.05). Oscillations in the common synaptic input to motor units is a potential mechanism for altered force steadiness when a cognitive challenge is imposed during low-force contractions in young women and old adults. NEW & NOTEWORTHY We found that oscillations in the common synaptic input to motor units were associated with a reduction in force steadiness when a cognitive challenge was imposed during low-force contractions of the elbow flexor muscles in young women and old men and women but not young men. Age- and sex-related muscle weakness was associated with these changes.
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Affiliation(s)
- Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma , Norman, Oklahoma
| | | | - Kevin G Keenan
- Department of Kinesiology, University of Wisconsin-Milwaukee , Milwaukee, Wisconsin
| | - Francesco Negro
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia , Brescia , Italy
| | - Dario Farina
- Department of Bioengineering, Imperial College London, Royal School of Mines , London , United Kingdom
| | | | - Kristy A Nielson
- Department of Psychology, Marquette University , Milwaukee, Wisconsin
| | - Sandra K Hunter
- Department of Physical Therapy, Marquette University , Milwaukee, Wisconsin
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Pereira HM, Schlinder-Delap B, Nielson KA, Hunter SK. Force Steadiness During a Cognitively Challenging Motor Task Is Predicted by Executive Function in Older Adults. Front Physiol 2018; 9:1316. [PMID: 30333758 PMCID: PMC6176355 DOI: 10.3389/fphys.2018.01316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 08/30/2018] [Indexed: 12/12/2022] Open
Abstract
Motor performance and cognitive function both decline with aging. Older adults for example are usually less steady for a constant-force task than young adults when performing low-intensity contractions with limb muscles. Healthy older adults can also show varying degrees of cognitive decline, particularly in executive function skills. It is not known, however, whether age-related changes in steadiness of low-force tasks and cognitive function are independent of one another. In this study, we determined if executive function skills in aging are associated with the steadiness during a low-force muscle contraction performed with and without the imposition of a cognitive challenge. We recruited 60 older adults (60–85 years old, 34 women, 26 men) and 48 young adults (19–30 years old, 24 women, 24 men) to perform elbow flexor muscle contractions at 5% of maximal voluntary contraction (MVC) force in the presence and absence of a difficult mental-math task (counting backward by 13 from a four-digit number). Force steadiness was quantified as the coefficient of variation (CV) of force and executive function was estimated with the Trail-making Test part A and B. The cognitive challenge increased the CV of force (i.e., decreased force steadiness) with greater changes in older adults than young adults (5.2 vs. 1.3%, respectively, cognitive challenge × age: P < 0.001). Older adults were 35% slower in both parts A and B of the Trail-making Test (P < 0.001), and to eliminate the effects of age and education on this variable, all further analyses were performed with the age-corrected z-scores for each individual using established normative values. Hierarchical regression models indicated that decreased force steadiness during a cognitive challenge trial was in part, explained by the performance in the Trail-making Test part A and B in older (r = 0.53 and 0.50, respectively, P < 0.05), but not in young adults (P > 0.05). Thus, healthy community-dwelling older adults, who have poorer executive function skills, exhibit reduced force steadiness during tasks when also required to perform a high cognitive demand task, and are likely at risk of reduced capacity to perform daily activities that involve cognitively challenging motor tasks.
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Affiliation(s)
- Hugo M Pereira
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Bonnie Schlinder-Delap
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States
| | - Kristy A Nielson
- Department of Psychology, Marquette University, Milwaukee, WI, United States
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States
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Lee A, Baxter J, Eischer C, Gage M, Hunter S, Yoon T. Sex differences in neuromuscular function after repeated eccentric contractions of the knee extensor muscles. Eur J Appl Physiol 2017; 117:1119-1130. [DOI: 10.1007/s00421-017-3599-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/27/2017] [Indexed: 12/28/2022]
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Lemley KJ, Senefeld J, Hunter SK, Hoeger Bement M. Only women report increase in pain threshold following fatiguing contractions of the upper extremity. Eur J Appl Physiol 2016; 116:1379-85. [DOI: 10.1007/s00421-016-3389-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/08/2016] [Indexed: 02/02/2023]
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May LE, Knowlton J, Hanson J, Suminski R, Paynter C, Fang X, Gustafson KM. Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability. PM R 2015; 8:611-7. [PMID: 26603201 DOI: 10.1016/j.pmrj.2015.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pregnancy is associated with an increased sympathetic state, which can be exacerbated by gestational conditions. Research has shown that exercise during pregnancy lowers heart rate (HR) and can attenuate the symptoms of gestational conditions associated with increased sympathetic control. However, changes in maternal heart autonomic function in response to exercise have not been reported across multiple time points during pregnancy. This analysis is designed to address this gap. OBJECTIVE To determine if exercise throughout gestation improves maternal cardiac autonomic nervous system functioning, as evidenced by decreased HR and increased heart rate variability (HRV) indices. DESIGN Case control study. SETTING Academic medical institution. PARTICIPANTS A total of 56 women with healthy, singleton, low-risk pregnancies. METHODS Participants were asked to complete 3 resting 18-minute HRV recordings at 28, 32, and 36 weeks' gestation, along with a physical activity questionnaire. MAIN OUTCOME MEASURES HRV indices were calculated for time (R peak to R peak interval standard deviation and root mean squared of successive differences) and frequency (very low, low, and high frequency) domain measures. The differences between groups were compared for HRV indices at 28, 32, and 36 weeks. RESULTS Resting HR was significantly lower in the exercise group at 28 weeks (P < .01) compared with the control group. The exercise group had significantly (P < .05) increased measures of resting HRV time domain measures at 28, 32, and 36 weeks' gestation compared with the control group. Resting HRV power was significantly increased (P < .05) in all frequency domain measures at 32 weeks in the exercise group relative to the control group. No differences occurred in sympathovagal balance (low frequency/high frequency ratio) between groups. CONCLUSION Exercise throughout pregnancy can significantly improve cardiac autonomic control. More research is needed to determine if this adaptation to exercise may reduce the risk of adverse outcomes associated with gestational conditions with poor autonomic control, such as diabetes, hypertension, pre-eclampsia, and excessive weight gain.
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Affiliation(s)
- Linda E May
- Foundational Sciences and Research, East Carolina University, 1851 MacGregor Downs Rd, MS 701, #3144, Greenville, NC 27834(∗).
| | - Jennifer Knowlton
- Department of Physical Medicine and Rehabilitation, East Carolina University, Greenville, NC(†)
| | - Jessica Hanson
- Department of Physical Medicine and Rehabilitation, East Carolina University, Greenville, NC(‡)
| | - Richard Suminski
- Department of Physiology, Kansas City University of Medicine and Biosciences, Kansas City, MO(¶)
| | - Christopher Paynter
- Department of Physiology, Kansas City University of Medicine and Biosciences, Kansas City, MO(§)
| | - Xiangming Fang
- Department of Biostatistics, East Carolina University, Greenville, NC(∗∗)
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Pereira HM, Spears VC, Schlinder-Delap B, Yoon T, Harkins A, Nielson KA, Hoeger Bement M, Hunter SK. Sex Differences in Arm Muscle Fatigability With Cognitive Demand in Older Adults. Clin Orthop Relat Res 2015; 473:2568-77. [PMID: 25712862 PMCID: PMC4488210 DOI: 10.1007/s11999-015-4205-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Muscle fatigability can increase when a stressful, cognitively demanding task is imposed during a low-force fatiguing contraction with the arm muscles, especially in women. Whether this occurs among older adults (>60 years) is currently unknown. QUESTIONS/PURPOSES We aimed to determine if higher cognitive demands, stratified by sex, increased fatigability in older adults (>60 years). Secondarily, we assessed if varying cognitive demand resulted in decreased steadiness and was explained by anxiety or cortisol levels. METHODS Seventeen older women (70±6 years) and 13 older men (71±5 years) performed a sustained, isometric, fatiguing contraction at 20% of maximal voluntary contraction until task failure during three sessions: high cognitive demand (high CD=mental subtraction by 13); low cognitive demand (low CD=mental subtraction by 1); and control (no subtraction). RESULTS Fatigability was greater when high and low CD were performed during the fatiguing contraction for the women but not for the men. In women, time to failure with high CD was 16±8 minutes and with low CD was 17±4 minutes, both of which were shorter than time to failure in control contractions (21±7 minutes; high CD mean difference: 5 minutes [95% confidence interval {CI}, 0.78-9.89], p=0.02; low CD mean difference: 4 minutes [95% CI, 0.57-7.31], p=0.03). However, in men, no differences were detected in time to failure with cognitive demand (control: 13±5 minutes; high CD mean difference: -0.09 minutes [95% CI, -2.8 to 2.7], p=1.00; low CD mean difference: 0.75 minutes [95% CI, -1.1 to 2.6], p=0.85). Steadiness decreased (force fluctuations increased) more during high CD than control. Elevated anxiety, mean arterial pressure, and salivary cortisol levels in both men and women did not explain the greater fatigability during high CD. CONCLUSIONS Older women but not men showed marked increases in fatigability when low or high CD was imposed during sustained static contractions with the elbow flexor muscles and contrasts with previous findings for the lower limb. Steadiness decreased in both sexes when high CD was imposed. CLINICAL RELEVANCE Older women are susceptible to greater fatigability of the upper limb with heightened mental activity during sustained postural contractions, which are the foundation of many work-related tasks.
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Affiliation(s)
- Hugo M. Pereira
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201 USA
| | - Vincent C. Spears
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201 USA
| | - Bonnie Schlinder-Delap
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201 USA
| | - Tejin Yoon
- Michigan Technological University, Houghton, MI USA
| | - April Harkins
- Department of Clinical Laboratory Sciences, Marquette University, Milwaukee, WI USA
| | | | - Marie Hoeger Bement
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201 USA
| | - Sandra K. Hunter
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201 USA
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Yoon T, Doyel R, Widule C, Hunter SK. Sex differences with aging in the fatigability of dynamic contractions. Exp Gerontol 2015; 70:1-10. [PMID: 26159162 DOI: 10.1016/j.exger.2015.07.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/01/2015] [Accepted: 07/02/2015] [Indexed: 01/18/2023]
Abstract
This study determined the sex difference with aging in fatigability of the elbow flexor muscles during a dynamic fatiguing task, and explored the associated mechanisms. We compared fatigability of the elbow flexor muscles in 18 young (20.2 ± 1 years: 9 men) and 36 old adults (73.5 ± 1 years: 16 men) during and in recovery from repeated dynamic contractions (~60°/s) with a load equivalent to 20% of maximal voluntary isometric contraction (MVIC) torque until failure. Transcranial magnetic stimulation (TMS) was used to assess supraspinal fatigue (an increase in the superimposed twitch, SIT) and the peak rate of muscle relaxation. Time to failure was briefer for the men than the women (6.1 ± 2.1 vs. 9.7 ± 5.5 min, respectively; P=0.02) with no difference between young and old adults (7.2 ± 2.9 vs. 8.4 ± 5.2 min, respectively, P=0.45) and no interaction (P>0.05). The relative decline in peak relaxation rate with fatigability was similar for young and old adults (P=0.11), but greater for men than women (P=0.046). Supraspinal fatigue increased for all groups and was associated with the time to failure (P<0.05). Regression analysis however, indicated that the time to failure was best predicted by the peak relaxation rate (baseline values and slowing with fatigability) (r(2)=0.55). Rate-limiting contractile mechanisms (e.g. excitation-contraction coupling) were responsible for the increased fatigability of the elbow flexors of men compared with women for a dynamic fatiguing task of slow angular velocity, and this sex difference was maintained with aging. The age difference in fatigability for the dynamic task was diminished for both sexes relative to what is typically observed with isometric fatiguing contractions.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States; Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Ryan Doyel
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States; Creighton University School of Medicine, Omaha, NE, United States
| | - Claire Widule
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States; Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, MD, United States
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI, United States.
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Pereira HM, Spears VC, Schlinder-Delap B, Yoon T, Nielson KA, Hunter SK. Age and sex differences in steadiness of elbow flexor muscles with imposed cognitive demand. Eur J Appl Physiol 2015; 115:1367-79. [PMID: 25633070 DOI: 10.1007/s00421-015-3113-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/14/2015] [Indexed: 01/25/2023]
Abstract
PURPOSE These studies determined (1) age- and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and; (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2). METHODS 36 young adults (18-25 years; 18 women) and 30 older adults (60-82 years; 17 women) performed isometric contractions at 5, 30 and 40 % of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session (no mental math). Study 2 (older adults only) involved a low-cognitive demand session (subtracting by 1s). RESULTS Older individuals exhibited greater increases in force fluctuations (coefficient of variation of force, CV) with high cognitive demand than young adults, with the largest age difference at 5 % MVC (P = 0.01). Older adults had greater agonist EMG activity with high-cognitive demand and women had greater coactivation than men (P < 0.05). In study 2, CV of force increased with low cognitive demand for the older women but not for the older men (P = 0.03). CONCLUSION Older adults had reduced steadiness and increased muscle activation when high cognitive demand was imposed while low cognitive demand induced increased force fluctuations in older women but not older men. These findings have implications for daily and work-related tasks that involve cognitive demand performed simultaneously during submaximal isometric contractions in an aging workforce.
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Affiliation(s)
- Hugo M Pereira
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Milwaukee, WI, 53201, USA
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Delshad M, Ghanbarian A, Ghaleh NR, Amirshekari G, Askari S, Azizi F. Reliability and validity of the modifiable activity questionnaire for an Iranian urban adolescent population. Int J Prev Med 2015; 6:3. [PMID: 25789138 PMCID: PMC4362275 DOI: 10.4103/2008-7802.151433] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 01/01/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the validity and reliability on the Persian translation of the Modifiable Activity Questionnaire (MAQ) in a sample of Tehranian adolescents. METHODS Of a total of 52 subjects, a sub-sample of 40 participations (55.0% boys) was used to assess the reliability and the validity of the physical activity questionnaire. The reliability of the two MAQs was calculated by intraclass correlation coefficients, and validation was evaluated using Pearson correlation coefficients to compare data between mean of the two MAQs and mean of four physical activity records. RESULTS Intraclass correlation coefficient was calculated to assess the reliability between two MAQs and the results of leisure time physical activity over the past year were 0.97. Pearson correlation coefficients between mean of two MAQs and mean of four physical activity records were 0.49 (P < 0.001), for leisure time physical activities. CONCLUSIONS High reliability and relatively moderate validity were found for the Persian translation of the MAQ in a Tehranian adolescent population. Further studies with large sample size are suggested to assess the validity more precisely.
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Affiliation(s)
- Maryam Delshad
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Ghanbarian
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrollah Rezaei Ghaleh
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Max Planck Institute for Biophysical Chemistry, Gottingen, Germany
| | - Golshan Amirshekari
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Askari
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lemley KJ, Hunter SK, Bement MKH. Conditioned Pain Modulation Predicts Exercise-Induced Hypoalgesia in Healthy Adults. Med Sci Sports Exerc 2015; 47:176-84. [DOI: 10.1249/mss.0000000000000381] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Putman MS, Milliren CE, Derrico N, Uluer A, Sicilian L, Lapey A, Sawicki G, Gordon CM, Bouxsein ML, Finkelstein JS. Compromised bone microarchitecture and estimated bone strength in young adults with cystic fibrosis. J Clin Endocrinol Metab 2014; 99:3399-407. [PMID: 24926955 PMCID: PMC4154107 DOI: 10.1210/jc.2014-1982] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Young adults with cystic fibrosis (CF) are at risk for low bone density and fractures, but the underlying alterations in bone microarchitecture that may contribute to their increased fracture risk are currently unknown. OBJECTIVE The main goal of this study was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) to characterize the bone microarchitecture, volumetric bone mineral density (vBMD), and estimated strength of the radius and tibia in young adults with CF compared with healthy volunteers. DESIGN AND SETTING This was a cross-sectional study at an outpatient clinical research center within a tertiary academic medical center. PARTICIPANTS Thirty young adults with CF, 18 to 40 years of age, were evaluated and compared with 60 healthy volunteers matched by age (±2 years), gender, and race. MAIN OUTCOME MEASURES The primary outcomes were HR-pQCT-derived cortical and trabecular vBMD, bone microarchitecture, and estimates of bone strength. RESULTS At the radius and tibia, young adults with CF had smaller bone cross-sectional area and lower vBMD. Cortical and trabecular microarchitecture were compromised at both sites, most notably involving the trabecular bone of the tibia. These differences translated into lower estimated bone strength both at the radius and tibia. After accounting for body mass index differences, young adults with CF had lower bone area and estimated bone strength at the radius and had compromised trabecular microarchitecture and lower total and trabecular vBMD and estimated bone strength at the tibia. Alterations in trabecular bone density and microarchitecture and estimated strength measures of the tibia were also greater than expected based on dual-energy x-ray absorptiometry-derived areal BMD differences. CONCLUSIONS Young adults with CF have compromised bone microarchitecture and lower estimated bone strength at both the radius and tibia, even after accounting for their smaller body size. These skeletal deficits likely explain the higher fracture risk observed in young adults with CF.
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Affiliation(s)
- Melissa S Putman
- Endocrine Unit (M.S.P., N.D., M.L.B., J.S.F.), and Pulmonary Division (L.S.), Department of Medicine, Massachusetts General Hospital; Pulmonary Division (A.L.), Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts 02114; Divisions of Endocrinology (M.S.P., C.M.G.) and Respiratory Diseases (A.U., G.S.) and Clinical Research Center (C.E.M.), Boston Children's Hospital, Boston, Massachusetts 02115; and Divisions of Adolescent Medicine and Endocrinology (C.M.G.), Hasbro Children's Hospital, Providence, Rhode Island 02903
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Hyngstrom AS, Kuhnen HR, Kirking KM, Hunter SK. Functional implications of impaired control of submaximal hip flexion following stroke. Muscle Nerve 2014; 49:225-32. [PMID: 23625534 DOI: 10.1002/mus.23886] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 04/15/2013] [Accepted: 04/17/2013] [Indexed: 11/09/2022]
Abstract
INTRODUCTION We quantified submaximal torque regulation during low to moderate intensity isometric hip flexion contractions in individuals with stroke and the associations with leg function. METHODS Ten participants with chronic stroke and 10 controls performed isometric hip flexion contractions at 5%, 10%, 15%, 20%, and 40% of maximal voluntary contraction (MVC) in paretic, nonparetic, and control legs. RESULTS Participants with stroke had larger torque fluctuations (coefficient of variation, CV), for both the paretic and nonparetic legs, than controls (P < 0.05) with the largest CV at 5% MVC in the paretic leg (P < 0.05). The paretic CV correlated with walking speed (r2 = 0.54) and Berg Balance Score (r2 = 0.40). At 5% MVC, there were larger torque fluctuations in the contralateral leg during paretic contractions compared with the control leg. CONCLUSIONS Impaired low-force regulation of paretic leg hip flexion can be functionally relevant and related to control versus strength deficits poststroke.
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Vanden Noven ML, Pereira HM, Yoon T, Stevens AA, Nielson KA, Hunter SK. Motor Variability during Sustained Contractions Increases with Cognitive Demand in Older Adults. Front Aging Neurosci 2014; 6:97. [PMID: 24904410 PMCID: PMC4033244 DOI: 10.3389/fnagi.2014.00097] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 05/05/2014] [Indexed: 01/26/2023] Open
Abstract
To expose cortical involvement in age-related changes in motor performance, we compared steadiness (force fluctuations) and fatigability of submaximal isometric contractions with the ankle dorsiflexor muscles in older and young adults and with varying levels of cognitive demand imposed. Sixteen young (20.4 ± 2.1 year: 8 men, 9 women) and 17 older adults (68.8 ± 4.4 years: 9 men, 8 women) attended three sessions and performed a 40 s isometric contraction at 5% maximal voluntary contraction (MVC) force followed by an isometric contraction at 30% MVC until task failure. The cognitive demand required during the submaximal contractions in each session differed as follows: (1) high-cognitive demand session where difficult mental math was imposed (counting backward by 13 from a 4-digit number); (2) low-cognitive demand session which involved simple mental math (counting backward by 1); and (3) control session with no mental math. Anxiety was elevated during the high-cognitive demand session compared with other sessions for both age groups but more so for the older adults than young adults (p < 0.05). Older adults had larger force fluctuations than young adults during: (1) the 5% MVC task as cognitive demand increased (p = 0.007), and (2) the fatiguing contraction for all sessions (p = 0.002). Time to task failure did not differ between sessions or age groups (p > 0.05), but the variability between sessions (standard deviation of three sessions) was greater for older adults than young (2.02 ± 1.05 vs. 1.25 ± 0.51 min, p < 0.05). Thus, variability in lower limb motor performance for low- and moderate-force isometric tasks increased with age and was exacerbated when cognitive demand was imposed, and may be related to modulation of synergist and antagonist muscles and an altered neural strategy with age originating from central sources. These data have significant implications for cognitively demanding low-force motor tasks that are relevant to functional and ergonomic in an aging workforce.
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Affiliation(s)
- Marnie L Vanden Noven
- Exercise Science Program, Department of Physical Therapy, Marquette University , Milwaukee, WI , USA
| | - Hugo M Pereira
- Exercise Science Program, Department of Physical Therapy, Marquette University , Milwaukee, WI , USA
| | - Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University , Milwaukee, WI , USA
| | - Alyssa A Stevens
- Exercise Science Program, Department of Physical Therapy, Marquette University , Milwaukee, WI , USA
| | - Kristy A Nielson
- Department of Psychology, Marquette University , Milwaukee, WI , USA
| | - Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University , Milwaukee, WI , USA
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Imayama I, Alfano CM, Neuhouser ML, George SM, Wilder Smith A, Baumgartner RN, Baumgartner KB, Bernstein L, Wang CY, Duggan C, Ballard-Barbash R, McTiernan A. Weight, inflammation, cancer-related symptoms and health related quality of life among breast cancer survivors. Breast Cancer Res Treat 2014; 140:159-76. [PMID: 23797178 DOI: 10.1007/s10549-013-2594-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/30/2013] [Indexed: 11/28/2022]
Abstract
Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.
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Affiliation(s)
- Ikuyo Imayama
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Senefeld J, Yoon T, Bement MH, Hunter SK. Fatigue and recovery from dynamic contractions in men and women differ for arm and leg muscles. Muscle Nerve 2013; 48:436-9. [PMID: 23494882 DOI: 10.1002/mus.23836] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2013] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. METHODS Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). RESULTS Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and MVIC electromyogram activity than women (P < 0.05). The decline in MVIC and power was greater, and force recovery was slower for the elbow flexors compared with knee extensors. CONCLUSIONS The gender difference in muscle fatigue often observed during isometric tasks was diminished during fast dynamic contractions for upper and lower limb muscles.
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Affiliation(s)
- Jonathon Senefeld
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Milwaukee, Wisconsin, 53201, USA
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Forsythe LP, Alfano CM, George SM, McTiernan A, Baumgartner KB, Bernstein L, Ballard-Barbash R. Pain in long-term breast cancer survivors: the role of body mass index, physical activity, and sedentary behavior. Breast Cancer Res Treat 2012; 137:617-30. [PMID: 23242613 DOI: 10.1007/s10549-012-2335-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 11/02/2012] [Indexed: 12/17/2022]
Abstract
Although pain is common among post-treatment breast cancer survivors, studies that are longitudinal, identify a case definition of clinically meaningful pain, or examine factors contributing to pain in survivors are limited. This study describes longitudinal patterns of pain in long-term breast cancer survivors, evaluating associations of body mass index (BMI), physical activity, sedentary behavior with mean pain severity and above-average pain. Women newly diagnosed with stages 0-IIIA breast cancer (N = 1183) were assessed, on average, 6 months (demographic/clinical characteristics), 30 months (demographics), 40 months (demographics, pain), 5 years (BMI, physical activity, and sedentary behavior), and 10 years (demographics, pain, BMI, physical activity, and sedentary behavior) post-diagnosis. This analysis includes survivors who completed pain assessments 40 months post-diagnosis (N = 801), 10 years post-diagnosis (N = 563), or both (N = 522). Above-average pain was defined by SF-36 bodily pain scores ≥1/2 standard deviation worse than age-specific population norms. We used multiple regression models to test unique associations of BMI, physical activity, and sedentary behavior with pain adjusting for demographic and clinical factors. The proportion of survivors reporting above-average pain was higher at 10 years than at 40 months (32.3 vs. 27.8 %, p < 0.05). Approximately one-quarter of survivors reported improved pain, while 9.0 % maintained above-average pain and 33.1 % reported worsened pain. Cross-sectionally at 10 years, overweight and obese survivors reported higher pain than normal-weight survivors and women meeting physical activity guidelines were less likely to report above-average pain than survivors not meeting these guidelines (p < 0.05). Longitudinally, weight gain (>5 %) was positively associated, while meeting physical activity guidelines was inversely associated, with above-average pain (OR, 95 % CI = 1.76, 1.03-3.01 and 0.40, 0.20-0.84, respectively) (p < 0.05). Weight gain and lack of physical activity place breast cancer survivors at risk for pain long after treatment ends. Weight control and exercise interventions should be tested for effects on long-term pain in these women.
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Affiliation(s)
- Laura P Forsythe
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
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Yoon T, Schlinder-Delap B, Hunter SK. Fatigability and recovery of arm muscles with advanced age for dynamic and isometric contractions. Exp Gerontol 2012; 48:259-68. [PMID: 23103238 DOI: 10.1016/j.exger.2012.10.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 09/21/2012] [Accepted: 10/19/2012] [Indexed: 01/22/2023]
Abstract
This study determined whether age-related mechanisms can increase fatigue of arm muscles during maximal velocity dynamic contractions, as it occurs in the lower limb. We compared elbow flexor fatigue of young (n=10, 20.8±2.7 years) and old men (n=16, 73.8±6.1 years) during and in recovery from a dynamic and an isometric postural fatiguing task. Each task was maintained until failure while supporting a load equivalent to 20% of maximal voluntary isometric contraction (MVIC) torque. Transcranial magnetic stimulation (TMS) was used to assess supraspinal fatigue (superimposed twitch, SIT) and muscle relaxation. Time to failure was longer for the old men than for the young men for the isometric task (9.5±3.1 vs. 17.2±7.0 min, P=0.01) but similar for the dynamic task (6.3±2.4 min vs. 6.0±2.0 min, P=0.73). Initial peak rate of relaxation was slower for the old men than for the young men, and was associated with a longer time to failure for both tasks (P<0.05). Low initial power during elbow flexion was associated with the greatest difference (reduction) in time to failure between the isometric task and the dynamic task (r=-0.54, P=0.015). SIT declined after both fatigue tasks similarly with age, although the recovery of SIT was associated with MVIC recovery for the old (both sessions) but not for the young men. Biceps brachii and brachioradialis EMG activity (% MVIC) of the old men were greater than that of the young men during the dynamic fatiguing task (P<0.05), but were similar during the isometric task. Muscular mechanisms and greater relative muscle activity (EMG activity) explain the greater fatigue during the dynamic task for the old men compared with the young men in the elbow flexor muscles. Recovery of MVC torque however relies more on the recovery of supraspinal fatigue among the old men than among the young men.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI 53201, United States
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MAY LINDAE, SUMINSKI RICHARDR, LANGAKER MICHELLED, YEH HUNGWEN, GUSTAFSON KATHLEENM. Regular Maternal Exercise Dose and Fetal Heart Outcome. Med Sci Sports Exerc 2012; 44:1252-8. [DOI: 10.1249/mss.0b013e318247b324] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gasevic D, Frohlich J, Mancini GBJ, Lear SA. The association between triglyceride to high-density-lipoprotein cholesterol ratio and insulin resistance in a multiethnic primary prevention cohort. Metabolism 2012; 61:583-9. [PMID: 22075272 DOI: 10.1016/j.metabol.2011.09.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/23/2011] [Accepted: 09/20/2011] [Indexed: 11/30/2022]
Abstract
The objective was to explore the clinical utility of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio in predicting insulin resistance (IR) in 4 ethnic groups and the relationship between IR and TG/HDL-C in comparison to that with other lipid measures. Apparently healthy Aboriginals, Chinese, Europeans, and South Asians (N = 784) were assessed for sociodemographics, lifestyle, anthropometry, lipids, glucose, and insulin. The homeostasis model assessment of IR was used as a measure of IR. Compared with other lipid parameters, TG/HDL-C was the highest correlate of the homeostasis model assessment of IR (age and sex adjusted) in Aboriginals (r = 0.499, P < .001), Chinese (r = 0.432, P < .001), Europeans (r = 0.597, P < .001), and South Asians (0.372, P < .001). For a 1-unit increase in TG/HDL-C, the odds of being insulin resistant increased about 4 times (odds ratio [OR], 3.95; 95% confidence interval [CI], 1.86-8.42; P < .001) in Aboriginals, 3.4 times in Chinese (OR, 3.44; 95% CI, 1.79-6.62; P < .001), 1.9 times in Europeans (OR, 1.94; 95% CI, 1.00-3.75; P = .049), and 1.8 times in South Asians (OR, 1.77; 95% CI, 0.91-3.45; P = .094) (age, sex, smoking, physical activity, body mass index, and waist circumference adjusted). Receiver operating characteristic curve analyses revealed areas under the curve (95% CI) of 0.777 (0.707-0.847) in Aboriginals, 0.723 (0.647-0.798) in Chinese, 0.752 (0.675-0.828) in Europeans, and 0.676 (0.590-0.762) in South Asians. Optimal cutoffs (sensitivity, specificity) of TG/HDL-C for identifying individuals with IR were 0.9 (93.0%, 51.9%), 1.1 (71.7%, 61.5%), 1.1 (73.5%, 70.9%), and 1.8 (52.0%, 77.9%) in Aboriginal, Chinese, European, and South Asian individuals, respectively. The TG/HDL-C ratio may be a good marker to identify insulin-resistant individuals of Aboriginal, Chinese, and European, but not South Asian, origin.
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Affiliation(s)
- Danijela Gasevic
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC, V6B 5K3 Canada.
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Alfano CM, Imayama I, Neuhouser ML, Kiecolt-Glaser JK, Smith AW, Meeske K, McTiernan A, Bernstein L, Baumgartner KB, Ulrich CM, Ballard-Barbash R. Fatigue, inflammation, and ω-3 and ω-6 fatty acid intake among breast cancer survivors. J Clin Oncol 2012; 30:1280-7. [PMID: 22412148 DOI: 10.1200/jco.2011.36.4109] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Evidence suggests that inflammation may drive fatigue in cancer survivors. Research in healthy populations has shown reduced inflammation with higher dietary intake of ω-3 polyunsaturated fatty acids (PUFAs), which could potentially reduce fatigue. This study investigated fatigue, inflammation, and intake of ω-3 and ω-6 PUFAs among breast cancer survivors. METHODS Six hundred thirty-three survivors (mean age, 56 years; stage I to IIIA) participating in the Health, Eating, Activity, and Lifestyle Study completed a food frequency/dietary supplement questionnaire and provided a blood sample assayed for C-reactive protein (CRP) and serum amyloid A (30 months after diagnosis) and completed the Piper Fatigue Scale and Short Form-36 (SF-36) vitality scale (39 months after diagnosis). Analysis of covariance and logistic regression models tested relationships between inflammation and fatigue, inflammation and ω-3 and ω-6 PUFA intake, and PUFA intake and fatigue, controlling for three incremental levels of confounders. Fatigue was analyzed continuously (Piper scales) and dichotomously (SF-36 vitality ≤ 50). RESULTS Behavioral (P = .003) and sensory (P = .001) fatigue scale scores were higher by increasing CRP tertile; relationships were attenuated after adjustment for medication use and comorbidity. Survivors with high CRP had 1.8 times greater odds of fatigue after full adjustment (P < .05). Higher intake of ω-6 relative to ω-3 PUFAs was associated with greater CRP (P = .01 after full adjustment) and greater odds of fatigue (odds ratio, 2.6 for the highest v lowest intake; P < .05). CONCLUSION Results link higher intake of ω-3 PUFAs, decreased inflammation, and decreased physical aspects of fatigue. Future studies should test whether ω-3 supplementation may reduce fatigue among significantly fatigued breast cancer survivors.
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Affiliation(s)
- Catherine M Alfano
- Office of Cancer Survivorship, National Cancer Institute, 6116 Executive Blvd, Ste 404, Bethesda, MD 20892-8336, USA.
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Keller ML, Pruse J, Yoon T, Schlinder-Delap B, Harkins A, Hunter SK. Supraspinal fatigue is similar in men and women for a low-force fatiguing contraction. Med Sci Sports Exerc 2012; 43:1873-83. [PMID: 21364478 DOI: 10.1249/mss.0b013e318216ebd4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE This study determined the contribution of supraspinal fatigue to the sex difference in neuromuscular fatigue for a low-intensity fatiguing contraction. Because women have greater motor responses to arousal than men, we also examined whether cortical and motor nerve stimulation, techniques used to quantify central fatigue, would alter the sex difference in muscle fatigue. METHODS In study 1, cortical stimulation was elicited during maximal voluntary contractions (MVC) before and after a submaximal isometric contraction at 20% MVC with the elbow flexor muscles in 29 young adults (20 ± 2.6 yr, 14 men). In study 2, 10 men and 10 women (19.1 ± 2.9 yr) performed a fatiguing contraction in the presence and absence of cortical and motor nerve stimulation. RESULTS Study 1: Men had a briefer time to task failure than women (P = 0.009). Voluntary activation was reduced after the fatiguing contraction (P < 0.001) similarly for men and women. Motor-evoked potential area and the EMG silent period increased similarly with fatigue for both sexes. Peak relaxation rates, however, were greater for men than women and were associated with time to task failure (P < 0.05). Force fluctuations, RPE, HR, and mean arterial pressure increased at a greater rate for men than for women during the fatiguing contraction (P < 0.05). Study 2: Time to task failure, force fluctuations, and all other physiological variables assessed were similar for the control session and stimulation session (P > 0.05) for both men and women. CONCLUSIONS Supraspinal fatigue was similar for men and women after the low-force fatiguing contraction, and the sex difference in muscle fatigue was associated with peripheral mechanisms. Furthermore, supraspinal fatigue can be quantified in both men and women without influencing motor performance.
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Affiliation(s)
- Manda L Keller
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI 53201, USA
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Yoon T, Schlinder-Delap B, Keller ML, Hunter SK. Supraspinal fatigue impedes recovery from a low-intensity sustained contraction in old adults. J Appl Physiol (1985) 2011; 112:849-58. [PMID: 22174405 DOI: 10.1152/japplphysiol.00799.2011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, respectively, P < 0.001). The time to failure was associated with initial peak rates of relaxation of muscle fibers and pressor response (P < 0.05). Increments in torque (superimposed twitch; SIT) generated by transcranial magnetic stimulation (TMS) during brief MVCs, increased during the fatiguing contraction (P < 0.001) and then decreased during recovery (P = 0.02). The increase in the SIT was greater for the old adults than the young adults during the fatiguing contraction and recovery (P < 0.05). Recovery of MVC torque was less for old than young adults at 10 min post-fatiguing contraction (75.1 ± 8.7 vs. 83.6 ± 7.8% of control MVC, respectively, P = 0.01) and was associated with the recovery of the SIT (r = -0.59, r(2) = 0.35, P < 0.001). Motor evoked potential (MEP) amplitude and the silent period elicited during the fatiguing contraction increased less for old adults than young adults (P < 0.05). The greater fatigue resistance with age during a low-intensity sustained contraction was attributable to mechanisms located within the muscle. Recovery of maximal strength after the low-intensity fatiguing contraction however, was impeded more for old adults than young because of greater supraspinal fatigue. Recovery of strength could be an important variable to consider in exercise prescription of old populations.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin 53201, USA
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Alfano CM, Lichstein KL, Vander Wal GS, Smith AW, Reeve BB, McTiernan A, Bernstein L, Baumgartner KB, Ballard-Barbash R. Sleep duration change across breast cancer survivorship: associations with symptoms and health-related quality of life. Breast Cancer Res Treat 2011; 130:243-54. [PMID: 21567239 PMCID: PMC3929112 DOI: 10.1007/s10549-011-1530-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 04/16/2011] [Indexed: 10/18/2022]
Abstract
Sleep duration among breast cancer survivors correlates with fatigue, depression, and health-related quality of life (HRQOL); however, this has not been studied longitudinally. This study investigated patterns of sleep duration change across the early breast cancer survivorship period, their demographic and clinical predictors, and their relationships with subsequent cancer-related symptoms and HRQOL. Breast cancer survivors (n = 572), were assessed 6 months post-diagnosis (current sleep & retrospective reports of pre-diagnosis sleep), 30 months post-diagnosis (sleep), and 39 months post-diagnosis (symptoms, HRQOL). Sleep duration change was determined by examining sleep at each time point in relation to published norms. Analysis of variance and logistic regression models tested demographic and clinical differences between the sleep change groups; linear regression models tested differences in symptoms and HRQOL. Half of the survivors reported no sleep duration change over time; however, 25% reported sleep changes indicating a temporary (5.6%), late-occurring (14%), or sustained (5.9%) change. Survivors reporting sustained or temporary sleep changes were more likely to have been treated with chemotherapy (OR = 2.62, P < 0.001) or gained weight after diagnosis (OR = 1.82, P = 0.04) than those with no sleep change. Sustained sleep changes were related to greater subsequent severity, affective, and sensory aspects of fatigue (βs = 2.0, 2.3, 1.8; all P < 0.0001) and lower vitality (β = -10.8, P = 0.005). Survivors treated with chemotherapy and those who gain weight after diagnosis may have increased risk for sustained sleep duration changes, which may increase their fatigue. These results point to the need for routine assessment of sleep as part of survivorship care.
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Affiliation(s)
- Catherine M Alfano
- Office of Cancer Survivorship, National Cancer Institute, DCCPS/NCI/NIH/DHHS, Bethesda, MD, 20892-8336, USA.
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Tomioka K, Iwamoto J, Saeki K, Okamoto N. Reliability and validity of the International Physical Activity Questionnaire (IPAQ) in elderly adults: the Fujiwara-kyo Study. J Epidemiol 2011; 21:459-65. [PMID: 21946625 PMCID: PMC3899462 DOI: 10.2188/jea.je20110003] [Citation(s) in RCA: 213] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background The International Physical Activity Questionnaire (IPAQ) is a self-reported questionnaire for assessing physical activity and has been tested in 12 countries among adults aged 18 to 65 years. The present study evaluated the reliability and validity of the IPAQ among adults aged 65 years and older. Methods The study included 164 men and 161 women selected from participants of the Fujiwara-kyo Study, a prospective cohort of elderly Japanese adults. To examine test–retest reliability, the participants were asked to complete the IPAQ twice, 2 weeks apart. The criterion validity of the IPAQ was tested by using an accelerometer. Results Based on intraclass correlation coefficients, the reliability of the total IPAQ was 0.65 and 0.57 for men and women, respectively, aged 65 to 74 years and 0.50 and 0.56 for those aged 75 to 89 years. The Spearman correlation coefficients between total IPAQ score and total physical activity measured by accelerometer (TPA-AC) were 0.42 and 0.49 for men and women, respectively, aged 65 to 74 and 0.53 and 0.49 for those aged 75 to 89. Weighted kappa coefficients between total IPAQ score and TPA-AC were 0.49 and 0.39 for men and women, respectively, aged 65 to 74 and 0.46 and 0.47 for those aged 75 to 89. Conclusions The reliability of the IPAQ was not sufficient, but the validity was adequate. Although there were some limitations with regard to repeatability and agreement in classification, the IPAQ was a useful tool for assessing physical activity among elderly adults.
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Affiliation(s)
- Kimiko Tomioka
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Kashihara, Japan.
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Farr JN, Lee VR, Blew RM, Lohman TG, Going SB. Quantifying bone-relevant activity and its relation to bone strength in girls. Med Sci Sports Exerc 2011; 43:476-83. [PMID: 20631644 DOI: 10.1249/mss.0b013e3181eeb2f2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
UNLABELLED Physical activity (PA) is critical for maximizing bone development during growth. However, there is no consensus on how well existing PA measurement tools predict bone strength. PURPOSE The purposes of this study were to compare four methods of quantifying PA (pedometer, 3-d PA recall (3DPAR), bone-specific PA questionnaire (BPAQ), and past year PA questionnaire (PYPAQ)), in young girls and to evaluate their ability to predict indices of bone strength. METHODS A total of 329 girls aged 8-13 yr completed a pedometer assessment, the 3DPAR, the BPAQ, and a modified PYPAQ. Peripheral quantitative computed tomography was used to assess bone strength index (BSI) at metaphyseal (4% distal femur and tibia) sites and strength-strain index (SSI) at diaphyseal (femur = 20%, tibia = 66%) sites of the nondominant leg. Correlations and hierarchical multiple regression were used to assess relationships among PA measures and indices of bone strength. RESULTS After adjusting for maturity, correlations between PA measures and indices of bone strength were positive, although low (r = 0.01-0.20). Regression models that included covariates (maturity, body mass, leg length, and ethnicity) and PA variables showed that PYPAQ score was significantly (P < 0.05) associated with BSI and SSI at all sites and explained more variance in BSI and SSI than any other PA measure. Pedometer steps were significantly (P < 0.05) associated with metaphyseal femur and tibia BSI, and 3DPAR score was significantly (P < 0.05) associated with metaphyseal femur BSI. BPAQ score was not significantly (P > 0.05) associated with BSI or SSI at any sites. CONCLUSIONS A modified PYPAQ that accounts for the duration, frequency, and load of PA predicted indices of bone strength better than other PA measures.
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Affiliation(s)
- Joshua N Farr
- Department of Physiological Sciences, University of Arizona, Tucson, AZ 85721-0093, USA.
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Weeks BK, Beck BR. The Relationship between Physical Activity and Bone during Adolescence Differs according to Sex and Biological Maturity. J Osteoporos 2010; 2010:546593. [PMID: 20981148 PMCID: PMC2957145 DOI: 10.4061/2010/546593] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 07/14/2010] [Accepted: 08/02/2010] [Indexed: 11/20/2022] Open
Abstract
This study examines the relationships between bone mass, physical activity, and maturational status in healthy adolescent boys and girls. Methods. Ninety-nine early high-school (Year 9) students were recruited. Physical activity and other lifestyle habits were recorded via questionnaire. Anthropometrics, muscle power, calcaneal broadband ultrasound attenuation (BUA), bone mineral content (BMC), and lean tissue mass were measured. Maturity was determined by Tanner stage and estimated age of peak height velocity (APHV). Results. Boys had greater APHV, weight, height, muscle power, and dietary calcium than girls (P < .05). Boys exhibited greater femoral neck BMC and trochanteric BMC while girls had higher BUA and spine BMAD (P < .05). Physical activity and vertical jump predicted BMAD and BUA most strongly for boys whereas years from APHV were the strongest predictor for girls. Conclusion. Sex-specific relationships exist between physical activity, maturity and bone mass during adolescence.
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Affiliation(s)
- Benjamin K. Weeks
- Griffith Health Institute, Griffith University, QLD 4222, Australia,School of Physiotherapy and Exercise Science, Gold Coast Campus, Griffith University, QLD 4222, Australia,*Benjamin K. Weeks:
| | - Belinda R. Beck
- Griffith Health Institute, Griffith University, QLD 4222, Australia,School of Physiotherapy and Exercise Science, Gold Coast Campus, Griffith University, QLD 4222, Australia
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Aerobic exercise during pregnancy influences fetal cardiac autonomic control of heart rate and heart rate variability. Early Hum Dev 2010; 86:213-7. [PMID: 20356690 DOI: 10.1016/j.earlhumdev.2010.03.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 03/05/2010] [Accepted: 03/08/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND Previous studies using ultrasound technology showed that fetal heart rate (HR) may be responsive to maternal aerobic exercise. Although it is recognized that cardiac autonomic control may be influenced by the intrauterine environment, little is known about how maternal exercise affects fetal heart development. AIMS This study tested the hypothesis that regular maternal exercise throughout gestation influences fetal cardiac autonomic control of HR and heart rate variability (HRV) when compared to fetuses of non-exercising women. STUDY DESIGN Magnetocardiograms (MCGs) were recorded using a dedicated fetal biomagnetometer at 28, 32 and 36 weeks gestational age (GA) from 26 regularly exercising (>30 min of aerobic exercise, 3x per week) and 35 healthy, non-exercising pregnant women. Fetal MCG was isolated and normal R-peaks were marked to derive fetal HR and HRV in the time and frequency domains. We applied a mixed-effects model to investigate the effects of exercise, GA and fetal activity state. RESULTS At 36 weeks GA, during the active fetal state, fetal HR was significantly lower in the exercise group (p=<0.0006). Post-hoc comparisons showed significantly increased HRV in the exercise group during the active fetal state at 36 weeks GA for both time and frequency domain measures. CONCLUSION These results indicate that regular maternal exercise throughout gestation results in significantly lower fetal HR and increased HRV.
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Griffith EE, Yoon T, Hunter SK. Age and load compliance alter time to task failure for a submaximal fatiguing contraction with the lower leg. J Appl Physiol (1985) 2010; 108:1510-9. [PMID: 20299610 DOI: 10.1152/japplphysiol.01396.2009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to compare the time to failure and muscle activation of young and old adults for a sustained isometric submaximal contraction with the dorsiflexor muscles when the foot was restrained to a force transducer (force-control task) compared with supporting an equivalent inertial load unrestrained in the sagittal plane (position-control task). Seventeen young (23.6+/-6.5 yr) and 12 old (70.0+/-5.0 yr) adults performed the force-control and position-control tasks at 30% maximal voluntary contraction (MVC) until task failure on separate days. Despite the similar load torque for each task, time to failure was longer for the force-control than position-control task (10.4+/-4.5 vs. 8.6+/-3.4 min, P=0.03) for the young and old adults. The old adults, however, had a longer time to task failure than the young adults for both tasks (11.4+/-4.4 vs. 8.1+/-2.1 min, P=0.01), with no interaction of age and task (P=0.83). The rate of increase in agonist and antagonist root-mean-square EMG, agonist EMG bursting activity, mean arterial pressure, and heart rate during the fatiguing contraction was greater for the position-control than force-control task for the young and old adults. The old adults had a less rapid rate of increase in EMG activity, fluctuations in motor output, and cardiovascular measures than the young adults for both tasks. Development of fatigue can be manipulated in young and old adults by providing greater support to the foot and less ankle compliance during daily and ergonomic tasks that require prolonged activation of the lower leg. Minimizing load compliance to one degree of freedom during a position-control task maintained the greater fatigue resistance with age for an isometric contraction.
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Affiliation(s)
- Erin E Griffith
- Department of Physical Therapy, Marquette University, PO Box 1881, Milwaukee, WI 53201, USA
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Abebe W, Mozaffari M. Endothelial dysfunction in diabetes: potential application of circulating markers as advanced diagnostic and prognostic tools. EPMA J 2010. [PMID: 23199039 PMCID: PMC3405304 DOI: 10.1007/s13167-010-0012-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Endothelial dysfunction is a predisposing factor for vascular disease in diabetes, which contributes significantly to the mortality of diabetic patients. The currently utilized assessment methods of endothelial function/dysfunction in humans are associated with various limitations. Circulating endothelial-derived/associated markers have been proposed as potential alternatives for evaluation of the endothelium in condition of vascular disorders. These indicators include von Willebrand factor, soluble thrombomodulin, soluble E-selectin, asymmetric dimethylarginine, tissue plasminogen activator, endothelial microparticles, circulating endothelial cells and circulating endothelial progenitor cells. While tentative evidence is available for most of these biomarkers to serve as reliable sources of information, their usefulness for routine clinical applications has not yet been established. Thus, circulating endothelial markers are currently the subject of intense research interest and it is anticipated that as more information becomes available their improved quantification will provide a suitable diagnostic and prognostic tool for vascular events in diabetes and related diseases.
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Affiliation(s)
- Worku Abebe
- Department of Oral Biology, CL 2140, School of Dentistry, Medical College of Georgia, Augusta, GA 30912-1128 USA
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Hunter SK, Griffith EE, Schlachter KM, Kufahl TD. Sex differences in time to task failure and blood flow for an intermittent isometric fatiguing contraction. Muscle Nerve 2009; 39:42-53. [PMID: 19086076 DOI: 10.1002/mus.21203] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to compare the time to task failure, postcontraction hyperemia, and vascular conductance of young men and women for a submaximal intermittent fatiguing contraction performed with the handgrip muscles. Twenty men and 20 women (mean +/- SD: 22 +/- 4 years) performed an isometric contraction at 50% of maximal voluntary contraction (MVC) (6-s contraction, 4-s rest) until task failure. Forearm venous occlusion plethysmography was used to estimate the peak blood flow (after 10-min occlusion) and blood flow at rest after 6-s submaximal contractions of varying intensities, and during an intermittent fatiguing contraction at 1-min intervals and task failure. The time to task failure was longer for the women compared with the men (408 +/- 205 s vs. 297 +/- 57 s, P < 0.05). Postcontraction hyperemia and vascular conductance were greater for men than for women after nonfatiguing 6-s submaximal contractions performed at 20%, 40%, 50%, 60%, and 80% of MVC force (P < 0.05). In contrast, hyperemia and vascular conductance were similar for both genders when measured at 50 s into the fatiguing contraction, at each minute thereafter, and at task failure. Regression analysis indicated that the rate of electromyographic activity and perceived exertion were the significant predictors of the time to task failure. The longer time to task failure for women compared with men for an intermittent fatiguing contraction with handgrip muscles was not explained by postcontraction hyperemia or vascular conductance with fatigue.
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Affiliation(s)
- Sandra K Hunter
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin 53233, USA.
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41
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Weeks BK, Beck BR. The BPAQ: a bone-specific physical activity assessment instrument. Osteoporos Int 2008; 19:1567-77. [PMID: 18414964 DOI: 10.1007/s00198-008-0606-2] [Citation(s) in RCA: 151] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 02/14/2008] [Indexed: 10/22/2022]
Abstract
UNLABELLED A newly developed bone-specific physical activity questionnaire (BPAQ) was compared with other common measures of physical activity for its ability to predict parameters of bone strength in healthy, young adults. The BPAQ predicted indices of bone strength at clinically relevant sites in both men and women, while other measures did not. INTRODUCTION Only certain types of physical activity (PA) are notably osteogenic. Most methods to quantify levels of PA fail to account for bone relevant loading. Our aim was to examine the ability of several methods of PA assessment and a new bone-specific measure to predict parameters of bone strength in healthy adults. METHODS We recruited 40 men and women (mean age 24.5). Subjects completed the modifiable activity questionnaire, Bouchard 3-day activity record, a recently published bone loading history questionnaire (BLHQ), and wore a pedometer for 14 days. We also administered our bone-specific physical activity questionnaire (BPAQ). Calcaneal broadband ultrasound attenuation (BUA) (QUS-2, Quidel) and densitometric measures (XR-36, Norland) were examined. Multiple regression and correlation analyses were performed on the data. RESULTS The current activity component of BPAQ was a significant predictor of variance in femoral neck bone mineral density (BMD), lumbar spine BMD, and whole body BMD (R(2) = 0.36-0.68, p < 0.01) for men, while the past activity component of BPAQ predicted calcaneal BUA (R(2) = 0.48, p = 0.001) for women. CONCLUSIONS The BPAQ predicted indices of bone strength at skeletal sites at risk of osteoporotic fracture while other PA measurement tools did not.
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Affiliation(s)
- B K Weeks
- School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
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Alfano CM, Smith AW, Irwin ML, Bowen DJ, Sorensen B, Reeve BB, Meeske KA, Bernstein L, Baumgartner KB, Ballard-Barbash R, Malone KE, McTiernan A. Physical activity, long-term symptoms, and physical health-related quality of life among breast cancer survivors: a prospective analysis. J Cancer Surviv 2008; 1:116-28. [PMID: 18648952 DOI: 10.1007/s11764-007-0014-1] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Many breast cancer survivors experience persistent physical symptoms of cancer and treatment that can decrease health-related quality of life (HRQOL). This prospective study investigated physical activity (PA), occurrence of physical symptoms, and HRQOL in a large, ethnically-diverse cohort of breast cancer survivors. MATERIALS AND METHODS Survivors (n = 545), on average 6 months post-diagnosis, were assessed in person or by mail at baseline (retrospective reports of pre-diagnosis PA), at 29 months post-diagnosis (post-diagnosis PA), and at 39 months post-diagnosis (pain, hormone symptoms, sexual interest/dysfunction, fatigue, physical subscales of HRQOL). Linear regression and analysis of covariance assessed the relationships between pre- and post-diagnosis PA and PA change after cancer with symptoms and HRQOL. RESULTS Greater pre-diagnosis PA was associated with better physical functioning at 39 months (betas 1.1-2.3; all p < 0.01) but was generally unrelated to symptoms. Greater post-diagnosis sports/recreational PA was related to less fatigue and better physical functioning (betas -0.146, 2.21; both p < 0.01). Increased PA after cancer was related to less fatigue and pain and better physical functioning (all p < 0.01). Significant positive associations were found for moderate to vigorous and vigorous sports/recreation PA, not household activity. Results were similar for Hispanic and non-Hispanic White women. DISCUSSION/CONCLUSIONS Increased PA, especially after cancer, was consistently related to better physical functioning and to reduced fatigue and bodily pain, underscoring the need for PA promotion among survivors. IMPLICATIONS FOR CANCER SURVIVORS Survivors may be able to decrease fatigue and bodily pain and be better able to pursue daily activities through increasing recreational PA after cancer.
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Affiliation(s)
- Catherine M Alfano
- Comprehensive Cancer Center and School of Public Health, The Ohio State University, Columbus, OH, USA
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Hunter SK, Todd G, Butler JE, Gandevia SC, Taylor JL. Recovery from supraspinal fatigue is slowed in old adults after fatiguing maximal isometric contractions. J Appl Physiol (1985) 2008; 105:1199-209. [PMID: 18687979 DOI: 10.1152/japplphysiol.01246.2007] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study compared the contribution of supraspinal fatigue to muscle fatigue in old and young adults. Transcranial magnetic stimulation (TMS) of motor cortex was used to assess voluntary activation during maximal voluntary contractions (MVCs) of elbow flexor muscles in 17 young adults (25.5 +/- 3.6 yr; mean +/- SD) and 7 old adults (73.0 +/- 3.3 yr). Subjects performed a fatigue task involving six sustained MVCs (22-s duration, separated by 10 s). Young adults exhibited greater reductions in maximal voluntary torque (67 +/- 15% of baseline) than the old (37 +/- 6%; P < 0.001). Increments in torque (superimposed twitch) generated by TMS during sustained MVCs increased for the young and old (P < 0.001) but were larger for the old adults at the start of the sustained contractions and during recovery (P < 0.05). Voluntary activation was less for the old adults at the start of some sustained contractions and during recovery (P = 0.02). Motor-evoked potential area increased similarly with age during the fatiguing task but was greater for the old adults than young during recovery. Silent period duration lengthened less for the old adults during the fatigue task. At the end of the fatiguing task, peak relaxation rate of muscle fibers had declined more in the young than the old adults. The greater endurance with age is largely due to a difference in mechanisms located within the muscle. However, recovery from the fatiguing exercise is impaired for old adults because of greater supraspinal fatigue than in the young.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI.
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Yoon T, De-Lap BS, Griffith EE, Hunter SK. Age-related muscle fatigue after a low-force fatiguing contraction is explained by central fatigue. Muscle Nerve 2008; 37:457-66. [PMID: 18236468 DOI: 10.1002/mus.20969] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The contribution of central fatigue during and after low- and high-force isometric contractions sustained until failure with age is not established. We compared the time to failure and changes in voluntary activation measured using motor point stimulation of 15 young and 15 old adults for an isometric contraction sustained with the elbow flexor muscles at 20% and 80% of maximal voluntary contraction (MVC) force. Young adults had a briefer time to task failure than old adults for the 20% MVC fatiguing contraction, but a similar duration for the 80% task. Voluntary activation was reduced at the end of the 20% MVC task, but by greater magnitudes for old than young adults. The reduction in MVC torque after the low-force task was associated with the reduction in voluntary activation. After the 80% task, voluntary activation declined to similar levels for the young and old adults. Electromyographic activity levels (% MVC) of the biceps brachii and brachioradialis muscles during the fatiguing contraction were greater for the old than young for the 20% MVC task, but similar with age for the 80% MVC task. Our findings indicate that intensity and duration of contraction can be manipulated in young and old adults to induce varying magnitudes of fatigue within the central nervous system. Aging increases: (1) fatigue within the central nervous system immediately after a low-force fatiguing contraction, and (2) the potential for large neural adaptations during neuromuscular rehabilitation in old adults.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI 53201, USA
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Abstract
The growing prevalence of Type 2 diabetes with its high morbidity and excess mortality is imposing a heavy burden on healthcare systems. Because of the magnitude of the problem, obviating diabetes has been a long-standing dream. In the last decade, a number of intervention strategies have been shown to be effective for the prevention of diabetes in high-risk populations with prediabetes. Seven studies have now confirmed that lifestyle modifications, including weight-reducing diets and exercise programs, are very effective in precluding or delaying Type 2 diabetes in high-risk populations with impaired glucose tolerance (IGT). Two major trials are the Diabetes Prevention Study (n = 522) from Finland and the Diabetes Prevention Program (n = 3234) from the US. Both studies have shown that intensive lifestyle intervention could reduce the progression of IGT to diabetes by 58%. Furthermore, four currently-available drugs have been established as being effective in preventing diabetes in subjects with prediabetes. The Diabetes Prevention Program revealed that metformin 850 mg b.i.d. reduced the risk of diabetes by 31%. The STOP-NIDDM (Study To Prevent Non-Insulin-Dependent Diabetes Mellitus) trial (n = 1429) showed that acarbose 100 mg t.i.d. with meals decreased the incidence of diabetes by 36% when the diagnosis was based on 2 oral glucose tolerance tests. The XENDOS (Xenical in the Prevention of Diabetes in Obese Subjects) study examined the use of orlistat, an antiobesity drug, as an adjunct to an intensive lifestyle modification program in obese non-diabetic subjects. Orlistat treatment resulted in a 37% decline in the development of diabetes. More recently, the DREAM (Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication) study (n = 5269) demonstrated that rosiglitazone at 8 mg once/day in subjects with prediabetes (IGT and/or impaired fasting glucose) was effective in reducing the risk of diabetes by 60%. It can be concluded that Type 2 diabetes can be prevented or delayed through lifestyle modifications and/or pharmacologic interventions. This is a fact.
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Affiliation(s)
- Jean-Louis Chiasson
- Université de Montréal, Research Group on Diabetes and Metabolic Regulation Research Centre, CHUM - Hôtel-Dieu, Department of Medicine, Montreal, Canada.
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Yoon T, Schlinder Delap B, Griffith EE, Hunter SK. Mechanisms of fatigue differ after low- and high-force fatiguing contractions in men and women. Muscle Nerve 2007; 36:515-24. [PMID: 17626289 DOI: 10.1002/mus.20844] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The magnitude of failure in voluntary drive after fatiguing contractions of different intensities in men and women is not known. The purpose of this study was to compare the time to task failure and voluntary activation of men and women for a sustained isometric contraction performed at a low and high intensity with the elbow flexor muscles. Nine men and nine women sustained an isometric contraction at 20% and 80% of maximal voluntary contraction (MVC) force until task failure during separate sessions. The men had a shorter time to failure than women for the 20% but not the 80% MVC task. Voluntary activation was reduced to similar levels for the men and women at the end of the fatiguing contractions but was reduced less after the 80% MVC task than the 20% MVC contraction. Twitch amplitude was reduced similarly at task failure for both sexes and to similar levels at termination of the 20% and 80% MVC tasks. The rate of change in mean arterial pressure was the main predictor of time to failure for the low-force sustained contraction. These results suggest that women experienced greater muscle perfusion, less peripheral fatigue, and a longer time to task failure than men during the low-force fatiguing contraction. However, the low-force task induced greater central fatigue than the high-force contraction for both men and women. Thus, low-force, long-duration fatiguing contractions can be used in rehabilitation to induce significant fatigue within the central nervous system and potentially greater neural adaptations in men and women.
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Affiliation(s)
- Tejin Yoon
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI 53201, USA
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Hunter SK, Butler JE, Todd G, Gandevia SC, Taylor JL. Supraspinal fatigue does not explain the sex difference in muscle fatigue of maximal contractions. J Appl Physiol (1985) 2006; 101:1036-44. [PMID: 16728525 DOI: 10.1152/japplphysiol.00103.2006] [Citation(s) in RCA: 148] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Young women are less fatigable than young men for maximal and submaximal contractions, but the contribution of supraspinal fatigue to the sex difference is not known. This study used cortical stimulation to compare the magnitude of supraspinal fatigue during sustained isometric maximal voluntary contractions (MVCs) performed with the elbow flexor muscles of young men and women. Eight women (25.6 +/- 3.6 yr, mean +/- SD) and 9 men (25.4 +/- 3.8 yr) performed six sustained MVCs (22-s duration each, separated by 10 s). Before the fatiguing contractions, the men were stronger than the women (75.9 +/- 9.2 vs. 42.7 +/- 8.0 N.m; P < 0.05) in control MVCs. Voluntary activation measured with cortical stimulation before fatigue was similar for the men and women during the final control MVC (95.7 +/- 3.0 vs. 93.3 +/- 3.6%; P > 0.05) and at the start of the fatiguing task (P > 0.05). By the end of the six sustained fatiguing MVCs, the men exhibited greater absolute and relative reductions in torque (65 +/- 3% of initial MVC) than the women (52 +/- 9%; P < 0.05). The increments in torque (superimposed twitch) generated by motor cortex stimulation during each 22-s maximal effort increased with fatigue (P < 0.05). Superimposed twitches were similar for men and women throughout the fatiguing task (5.5 +/- 4.1 vs. 7.3 +/- 4.7%; P > 0.05), as well as in the last sustained contraction (7.8 +/- 5.9 vs. 10.5 +/- 5.5%) and in brief recovery MVCs. Voluntary activation determined using an estimated control twitch was similar for the men and women at the start of the sustained maximal contractions (91.4 +/- 7.4 vs. 90.4 +/- 6.8%, n = 13) and end of the sixth contraction (77.2 +/- 13.3% vs. 73.1 +/- 19.6%, n = 10). The increase in the area of the motor-evoked potential and duration of the silent period did not differ for men and women during the fatiguing task. However, estimated resting twitch amplitude and the peak rates of muscle relaxation showed greater relative reductions at the end of the fatiguing task for the men than the women. These results indicate that the sex difference in fatigue of the elbow flexor muscles is not explained by a difference in supraspinal fatigue in men and women but is largely due to a sex difference of mechanisms located within the elbow flexor muscles.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, PO Box 1881, Marquette University, Milwaukee, WI 53201, USA.
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Schulz LO, Harper IT, Smith CJ, Kriska AM, Ravussin E. Energy intake and physical activity in Pima Indians: comparison with energy expenditure measured by doubly-labeled water. ACTA ACUST UNITED AC 2006; 2:541-8. [PMID: 16355515 DOI: 10.1002/j.1550-8528.1994.tb00103.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To test the validity of survey techniques for measuring diet and activity patterns of Pima Indians, sequential 24-hour recalls, a food frequency questionnaire (FFQ), and an activity questionnaire were compared to free-living energy expenditure. Total energy expenditure (TEE) measured by doubly labeled water was 13.27 +/- 2.95 MJ/d for the 12 males (mean +/- SD: 35 +/- 14 yr; 97 +/- 35 kg; 32 +/- 9% body fat) and 11.67 +/- 1.85 MJ/d for the 9 females (31 +/- 13 yr; 106 +/- 32 kg; 49 +/- 6% body fat). Energy intake assessed by 24-hour recall was 13.59 +/- 7.81 MJ/d for men and 9.29 +/- 2.77 MJ/d for women, compared to 12.84 + 2.85 and 9.40 + 2.61 MJ/d for men and women, respectively, by FFQ. Both dietary methods indicated significant underreporting by women when compared to TEE. Energy intake assessed by FFQ was significantly correlated with TEE (r=0.48, p=0.03). This was true with 24-hour recall energy intake only when data from two extremely large alcohol consumers were eliminated (r=0.64, p=0.03, N=19). Although a low level of activity was apparent, the activity questionnaire produced significant correlations with measurements of energy expenditure and therefore represents an important tool for examining the relationship between physical activity and diseases.
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Affiliation(s)
- L O Schulz
- Department of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
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Hunter SK, Schletty JM, Schlachter KM, Griffith EE, Polichnowski AJ, Ng AV. Active hyperemia and vascular conductance differ between men and women for an isometric fatiguing contraction. J Appl Physiol (1985) 2006; 101:140-50. [PMID: 16601303 DOI: 10.1152/japplphysiol.01567.2005] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
To understand the role of muscle perfusion in the sex differences of muscle fatigue, we compared the time to task failure, postcontraction (active) hyperemia, and vascular conductance for an isometric fatiguing contraction performed by young men and women with the handgrip muscles at 20% of maximal voluntary contraction (MVC) force. In study 1, the men (n = 16) were stronger than the women (n = 18), and study 2, the men (n = 7) and women (n = 7) were matched for strength. Isometric contractions were sustained during two sessions: 1) until the target force could no longer be achieved or 2) for 4 min. For both studies, blood flow and vascular conductance were similar for the men and women at rest and after 10 min of occlusion, and at task failure for the fatiguing contraction estimated using forearm venous occlusion plethysmography. In study 1, the time to task failure was longer for the women (11.4 +/- 2.8 min) than for the men (8.4 +/- 2.4 min; P = 0.003). However, at the end of the 4-min contraction, active hyperemia and vascular conductance were greater for the men than the women (99 vs. 70% peak blood flow; P < 0.001). In study 2, the men and women had similar strength and a similar time to failure (8.4 +/- 1.6 vs. 8.6 +/- 2.3 min). Active hyperemia was greater for the men than the women (86 vs. 64% peak flow; P = 0.038) after the 4-min contraction, as was vascular conductance (80 vs. 57% peak conductance; P = 0.02). Thus the briefer time to failure of men than women for an isometric fatiguing contraction is a function of the greater strength of men but is not dependent on differences in the active hyperemia and vascular conductance.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, PO Box 1881, Marquette University, Milwaukee, Wisconsin 53201, USA.
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Hunter SK, Rochette L, Critchlow A, Enoka RM. Time to task failure differs with load type when old adults perform a submaximal fatiguing contraction. Muscle Nerve 2005; 31:730-40. [PMID: 15810019 DOI: 10.1002/mus.20325] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Young adults exhibit a longer time to task failure when performing a submaximal isometric contraction by pushing against a force transducer (force task) than when supporting an equivalent inertial load (position task). The purpose of this study was to compare the time to failure for old adults when they performed a force task and a position task with the elbow flexor muscles. Eighteen old adults (72 +/- 4 years) performed the force and position tasks at 20% maximal voluntary contraction (MVC) force until task failure. The time to task failure was briefer for the position task (10.6 +/- 6.1 min) than the force task (22.8 +/- 9.1 min, P < 0.05). The rate of increase in electromyographic (EMG) bursting activity, ratings of perceived exertion, mean arterial pressure, heart rate, and fluctuations in motor output during the fatiguing contraction were greater for the position task. However, the increase in averaged EMG for the elbow flexor muscles was greater at termination of the force task. The difference in time to failure for the two tasks was due to a higher level of central neural activity during the position task and was similar to that observed for young adults. These findings indicate that the type of load supported influences the mechanisms and time to task failure for sustained contractions in old adults, and have implications for the design of tasks for rehabilitation and for tasks that minimize fatigue.
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Affiliation(s)
- Sandra K Hunter
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado, USA.
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