Postural control is associated with muscle power in post-menopausal women with low bone mass

Combined Aerobic and Strength Training Improves Dynamic Stability and can Prevent against Static Stability Decline in Postmenopausal Women: A Randomized Clinical Trial

OBJECTIVE

 To analyze the effect of combined training (CT) in postural control and gait parameters in postmenopausal women.

METHODS

 A parallel-group, randomized, control study was conducted with 16 weeks of combined training (n = 16) versus a non-training control group (n = 12) in postmenopausal women (aged 59.3 ± 8.0). Pre and postintervention assessments included postural control (using an AMTI force platform - Advanced Mechanical Technology, Inc., Watertown, MA, USA) and gait impairments (using baropodometry). In addition, the upper limb strength and abdominal tests, as well as aerobic capacity, assessed functional indicators.

RESULTS

 The CT intervention in postmenopausal women resulted in improved gait (stride length (p = 0.006); speed (p = 0.013); double support time (p = 0.045); and improved postural control (displacement area of postural sway in a normal base of support with eyes open (p = 0.006). Combined training increased functional indicators (abdominal - p = 0.031; aerobic capacity - p = 0.002).

CONCLUSION

 In conclusion, combined aerobic plus strength training effectively improved gait and balance control in older women. The postmenopausal women from the CT group walked faster and with bigger steps after the intervention than the control group. In addition, they presented decreased postural sway in standing and decreased the percentage of double support time while walking, which means improved static and dynamic balance control and functional indicators.

Influence of Long-Lasting Static Stretching on Maximal Strength, Muscle Thickness and Flexibility

Background: In animal studies long-term stretching interventions up to several hours per day have shown large increases in muscle mass as well as maximal strength. The aim of this study was to investigate the effects of a long-term stretching on maximal strength, muscle cross sectional area (MCSA) and range of motion (ROM) in humans.

Methods: 52 subjects were divided into an Intervention group (IG, n = 27) and a control group (CG, n = 25). IG stretched the plantar flexors for one hour per day for six weeks using an orthosis. Stretching was performed on one leg only to investigate the contralateral force transfer. Maximal isometric strength (MIS) and 1RM were both measured in extended knee joint. Furthermore, we investigated the MCSA of IG in the lateral head of the gastrocnemius (LG) using sonography. Additionally, ROM in the upper ankle was investigated via the functional “knee to wall stretch” test (KtW) and a goniometer device on the orthosis. A two-way ANOVA was performed in data analysis, using the Scheffé Test as post-hoc test.

Results: There were high time-effects (p = 0.003, ƞ² = 0.090) and high interaction-effect (p < 0.001, ƞ²=0.387) for MIS and also high time-effects (p < 0.001, ƞ²=0.193) and interaction-effects (p < 0.001, ƞ²=0,362) for 1RM testing. Furthermore, we measured a significant increase of 15.2% in MCSA of LG with high time-effect (p < 0.001, ƞ²=0.545) and high interaction-effect (p=0.015, ƞ²=0.406). In ROM we found in both tests significant increases up to 27.3% with moderate time-effect (p < 0.001, ƞ²=0.129) and high interaction-effect (p < 0.001, ƞ²=0.199). Additionally, we measured significant contralateral force transfers in maximal strength tests of 11.4% (p < 0.001) in 1RM test and 1.4% (p=0.462) in MIS test. Overall, there we no significant effects in control situations for any parameter (CG and non-intervened leg of IG).

Discussion: We hypothesize stretching-induced muscle damage comparable to effects of mechanical load of strength training, that led to hypertrophy and thus to an increase in maximal strength. Increases in ROM could be attributed to longitudinal hypertrophy effects, e.g., increase in serial sarcomeres. Measured cross-education effects could be explained by central neural adaptations due to stimulation of the stretched muscles.

Rehabilitation therapy for patients with osteoporosis

Fractures in patients with osteoporosis are attributable to falls and reduced bone mass. Therefore, balance and muscle strength should be improved and bone mass should be increased to prevent fractures. This study aims to investigate a rehabilitation treatment for osteoporosis. Exercise is a potentially safe and effective way to increase bone density and prevent postmenopausal bone loss. Based on bone densitometry results, rehabilitation exercises can be applied variably. Fractures caused by osteoporotic fragility may be prevented with multidisciplinary intervention programs including education, environmental modifications, aids, and individually tailored exercise programs. In addition, strengthening the paraspinal muscles may not only maintain bone mineral density but also reduce the risk of vertebral fractures. Rehabilitation after vertebral fractures includes proprioceptive dynamic posture training that decreases kyphotic posturing through the recruitment of back extensors. This training reduces pain, improves mobility, and leads to a better quality of life. Hip fractures may be prevented by hip protectors and exercise programs that can improve the strength and mobility of patients with hip fractures. Considering the musculoskeletal condition, the spine should be protected using a spinal orthosis, taping, hip pad, and walking aid, if necessary. Efforts to activate programs such as fracture liaison services should also be considered.

Defining an international cut-off of two-legged countermovement jump power for sarcopenia and dysmobility syndrome

We aimed to establish jump power cut-offs for the composite outcome of either sarcopenia (EWGSOP2) or dysmobility syndrome using Asian and Caucasian cohorts. Estimated cut-offs were sex specific (women: < 19.0 W/kg; men: < 23.8 W/kg) but not ethnicity specific. Jump power has potential to be used in definitions of poor musculoskeletal health.

PURPOSE

Weight-corrected jump power measured during a countermovement jump may be a useful tool to identify individuals with poor musculoskeletal health, but no cut-off values exist. We aimed to establish jump power cut-offs for detecting individuals with either sarcopenia or dysmobility syndrome.

METHODS

Age- and sex-matched community-dwelling older adults from two cohorts (University of Wisconsin-Madison [UW], Korean Urban Rural Elderly cohort [KURE], 1:2) were analyzed. Jump power cut-offs for the composite outcome of either sarcopenia defined by EWGSOP2 or dysmobility syndrome were determined.

RESULTS

The UW (n = 95) and KURE (n = 190) cohorts were similar in age (mean 75 years) and sex distribution (68% women). Jump power was similar between KURE and UW women (19.7 vs. 18.6 W/kg, p = 0.096) and slightly higher in KURE than UW in men (26.9 vs. 24.8 W/kg, p = 0.050). In UW and KURE, the prevalence of sarcopenia (7.4% in both), dysmobility syndrome (31.6% and 27.9%), or composite of either sarcopenia or dysmobility syndrome (32.6% and 28.4%) were comparable. Low jump power cut-offs for the composite outcome differed by sex but not by ethnicity (< 19.0 W/kg in women; < 23.8 W/kg in men). Low jump power was associated with elevated odds of sarcopenia (adjusted odds ratio [aOR] 4.07), dysmobility syndrome (aOR 4.32), or the composite of sarcopenia or dysmobility syndrome (aOR 4.67, p < 0.01 for all) independent of age, sex, height, and ethnicity.

CONCLUSION

Sex-specific jump power cut-offs were found to detect the presence of either sarcopenia or dysmobility syndrome in older adults independent of Asian or Caucasian ethnicity.

The influence of whole-body electromyostimulation training in middle-aged women

BACKGROUND: Whole-body electromyostimulation (WB-EMS) is a new tendency in training used to complement conventional training. OBJECTIVE: The aim was to analyze the effects of training with WB-EMS on body composition, strength and balance in middle-aged women. METHODS: Twenty-eight women were randomly assigned to two groups: the WB-EMS group (age = 48.1 ± 4.3 years) or the control group (CG) (age = 51.1 ± 5.4 years). All participants continued their training of 2 days⋅week-1 and 60 min⋅day-1 of endurance-dynamic strength exercises and additionally did 20 minutes more of dynamic strength exercises one day⋅week-1: the WB-EMS group did the additional training with WB-EMS and the CG did the same training but without WB-EMS. Body composition, muscle isokinetic strength of the knee flexors/extensors and postural stability were measured before and after 8 weeks of training. RESULTS: After the training program, the WB-EMS group showed lower values for the waist circumference (83.00 ± 7.37 vs. 78.50 ± 7.30 cm; p< 0.01), hip circumference (104.80 ± 8.61 vs. 101.00 ± 6.78 cm; p< 0.05) and total fat mass (37.04 ± 6.08 vs. 36.26 ± 5.78%; p< 0.05). In balance stability the WB-EMS group reduced their Fall Risk Index (1.70 ± 0.51 vs. 1.30 ± 0.38 AU; p< 0.01) and deviation (1.50 ± 0.43 vs. 1.03 ± 0.74 AU; p< 0.01) after training and showed lower values in the Fall Risk Index (p= 0.007) and deviation (p= 0.024). CONCLUSIONS: The WB-EMS training program helps reduce the risk of falling and improves body composition variables and balance results in middle-aged physically active women.