Potential for gross muscle hypertrophy in older men

One-week quercetin intervention modifies motor unit recruitment patterns before and during resistance exercise in older adults: A randomized controlled trial

We investigated the effects of one-week quercetin ingestion on motor unit (MU) behavior and muscle contractile properties before, during, and after a single session of resistance exercise in older adults. Twenty-four older adults were divided into two groups: those receiving quercetin glycosides (QUE) or placebo (PLA), and they performed a single session of resistance exercise. MU behavior before and during resistance exercise and electrically elicited contraction before and after resistance exercise were measured (Day 1), and the same measurements were conducted again after 7 days of placebo or quercetin glycoside ingestion (Day 8). The MU recruitment threshold (RT) was decreased (p < 0.001, 25.6 ± 10.1 to 23.6 ± 9.5 %MVC) and the exerted force normalized by the MU firing rate (FR) was increased (p = 0.003, 1.13 ± 0.24 to 1.18 ± 0.22 %MVC/pps) from Days 1 to 8, respectively, in QUE but not PLA (p = 0.263, 22.6 ± 11.9 to 21.9 ± 11.6 %MVC; p = 0.713, 1.09 ± 0.20 to 1.10 ± 0.19 %MVC/pps, respectively). On Day 1, a significant correlation between MURT and%change in MUFR from the first to last contractions during the resistance exercise was observed in both groups (QUE: p = 0.009, rs = 0.308; PLA: p < 0.001, rs = 0.403). On Day 8 %change in MUFR was negatively correlated with MURT in QUE (p = 0.044, rs = -0.251), but there was no significant correlation in PLA (p = 0.844). There was no difference in electrically elicited contraction before and after the resistance exercise between QUE and PLA (p < 0.05). These results suggest that one-week quercetin ingestion in older adults lowered MURT and led to greater fatigue in MU with higher RT than with lower RT during resistance training.

Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial

BACKGROUND

Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs.

OBJECTIVE

We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users.

METHODS

This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes.

RESULTS

We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001).

CONCLUSIONS

The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.3389/fmed.2022.1071409.

Prediction of 1-year change in knee extension strength by neuromuscular properties in older adults

Improving muscle strength and preventing muscle weakness are important for older adults. The change in strength can be effectively explained by skeletal muscle mass and neural factors. Neural factors are important for older adults because the variation of neural components is greater in older than in young adults, and any decline in strength cannot solely be explained by a decrease in skeletal muscle mass. The purpose of the present study was to investigate whether skeletal muscle mass or motor unit firing properties could explain the change in muscle strength after 1 year. Thirty-eight older adults (75.0 ± 4.7 years, 156.6 ± 7.7 cm, 55.5 ± 9.4 kg, 26 women) performed maximum voluntary knee extension and their skeletal muscle mass was measured using a bioimpedance device. During a submaximal contraction task, high-density surface electromyography was recorded and the signals were decomposed into individual motor unit firing. As an index of motor unit firing properties, the slope and y-intercept (MU intercept) were calculated from the regression line between recruitment thresholds and firing rates in each participant. After 1 year, their maximum knee extension torque was evaluated again. A stepwise multiple regression linear model with sex and age as covariates indicated that MU intercept was a significant explanation with a negative association for the 1-year change in muscle strength (β =  - 0.493, p = 0.004), but not skeletal muscle mass (p = 0.364). The results suggest that neural components might be predictors of increasing and decreasing muscle strength rather than skeletal muscle mass.

Using force or EMG envelope as feedback signal for motor control system

PURPOSE

This work studied muscle neuro-mechanics during symmetrical up-going ramp (UGR) and down-going ramp (DGR).

AIM

to evaluate during the modulation of muscular action the outcome of force feedback (FF) or neural feedback (NF) on the behavior of the trailing signals - i.e. the EMG envelope (eEMG) for FF or force signal for NF.

METHOD

Subjects: 20. Investigated muscles: dorsal interosseous (FDI) and tibialis anterior (TA). Detected signals: force and EMG. Visual feedback: force (FF), eEMG (NF). Effort triangles: ramps duration 7.5 s, vertex at 50 and 100 % of the maximal voluntary action. Eventually, each subject performed FF50%, FF100%, NF50% and NF100% per each muscle. In each condition the areas beneath the force and eEMG signals were computed to calculate the ratios between the DGR and UGR values during the different tasks (force area DGR / force area UGR; eEMG area DGR / eEMG area UGR). Electro-mechanical coupling efficiency (EMCE) was estimated through the eEMG area / force area ratio for both UGR and DGR in each condition.

RESULTS

a) FF. FDI: eEMG area ratio was 0.84 ± 0.15 and 0.73 ± 0.17 for FF50% and FF100%, respectively. TA: eEMG area ratio was 0.88 ± 0.11 and 0.91 ± 0.17 for FF50% and FF100%, respectively. b) NF: FDI: force area ratio was 1.18 ± 0.13 and 1.17 ± 0.13 for NF50% and NF100%, respectively. TA: force area ratio was 1.17 ± 0.21 and 1.07 ± 0.19 for NF50% and NF100%, respectively. c) DGR EMCE was greater than UGR EMCE in all four tasks.

CONCLUSION

The influence of UGR on deployed EMCE in the following force decrement phase underpins the changes of trailing signals area during DGR. This underlines the necessity of a careful evaluation of the features of FF or NF for experimental studies or rehabilitation purposes involving the motor control system.

Effects of home-based bodyweight squat training on neuromuscular properties in community-dwelling older adults

BACKGROUND

It is important to investigate neural as well as muscle morphological adaptations to evaluate the effects of exercise training on older adults.

AIMS

This study was aimed to investigate the effects of home-based bodyweight squat training on neuromuscular adaptation in older adults.

METHODS

Twenty-five community-dwelling older adults (77.7 ± 5.0 years) were assigned to squat (SQU) or control (CON) groups. Those in the SQU group performed 100 bodyweight squats every day and the others in the CON group only performed daily activities for 4 months. Maximum knee extension torque and high-density surface electromyography during submaximal contraction were assessed. Individual motor units (MUs) were identified and divided into relatively low or high-recruitment threshold MU groups. Firing rates of each MU group were calculated. The muscle thickness and echo intensity of the lateral thigh were assessed using ultrasound. As physical tests, usual gait speed, timed up and go test, grip strength, and five-time chair stand test were performed.

RESULTS

While no improvements in muscle strength, muscle thickness, echo intensity, or physical tests were noted in either group, the firing rate of relatively low recruitment threshold MUs significantly decreased in the SQU group after intervention.

CONCLUSIONS

These results suggest that low-intensity home-based squat training could not improve markedly muscle strength or physical functions even if high-repetition and high frequency exercise, but could modulate slightly neural activation in community-dwelling older adults.

Effect of exercise devised to reduce arm tremor in the sighting phase of archery

BACKGROUND

In archery training, side bridges are performed in a posture similar to archery shooting for training the muscles around the shoulder joint and the shoulder girdle of the pusher.

AIM

The purpose of this study was to determine whether a low-tremor side-bridge exercise for 4 weeks improves bow tremor during archery movements.

METHODS

Participants were 20 male college students. First, we measured the tremor during side bridges performed with trunk inclinations of 25°, 40°, 55°, and 70° using an accelerometer attached to the elbow joint and identified low-tremor side bridges. The participants were then randomly divided into intervention and non-intervention groups, and the low-tremor side bridges were performed for 4 weeks.

RESULTS

The effect of the intervention was determined by measuring the total tremor value using an accelerometer attached to the bow and changes in the median power frequency (MdPF) of the middle deltoid, upper trapezius, and lower trapezius. This intervention reduced the bow tremor and the median power frequency of the middle deltoid (p < 0.05).

CONCLUSIONS

The findings suggested that the tremor during the archery sighting phase could be reduced by performing side bridges with a specific trunk angle for a certain period of time. This intervention was also shown to reduce the intermediate frequency of the middle deltoid. The reduced tremor can shorten the sighting phase, which can facilitate injury prevention.

The Efficacy of Short-Term Toe Resistance Training in Chronic Hemodialysis Patients with Type 2 Diabetes

Resistance training is effective in chronic hemodialysis patients with type 2 diabetes mellitus, but its effect on toe pinch force (TPF) is unknown. This study was a randomized controlled trial conducted at three hospitals to investigate the effect of short-term toe resistance training on TPF in chronic hemodialysis patients with type 2 diabetes. The patients were randomly allocated to intervention (performed aerobic exercise and four toe resistance training exercises) and control (performed aerobic exercise only) groups. After 2 weeks of exercise intervention program, evaluations of TPF and clinical parameters were performed. In addition, the rate of retention of exercise therapy was assessed 6 months after the exercise intervention program was completed. After the exercise intervention program, TPF was significantly higher in the intervention group than in the control group. The intervention group had a significantly higher rate of continuation of exercise therapy. Two weeks of toe resistance training significantly increased the TPF in chronic hemodialysis patients with type 2 diabetes. Toe resistance training was shown to be an effective training method for continuing exercise therapy. Toe resistance training is recommended in clinical practice for chronic hemodialysis patients with type 2 diabetes.

Relative contribution of neuromuscular activation, muscle size, and muscle quality to maximum strength output of the thigh muscles in young individuals

This study aimed to investigate the relationship between maximal muscle strength and neuromuscular activation, muscle size, and quality of quadriceps (QF) and hamstring muscles (HM). The study included 24 young men and women. The neuromuscular activation parameter was recorded using a single-channel surface electromyography (EMG) with the root mean square (RMS) during maximal isometric knee extension and flexion from four muscles: rectus femoris and vastus lateralis for QF; biceps femoris and semitendinosus for HM. In addition, the peak torque was measured during the same session. B-mode ultrasonographic transverse images were obtained from the anterior, lateral, and posterior thighs. Furthermore, we calculated the muscle thickness (MT) and echo intensity (EI) of the four muscles as indicators of muscle size and quality. The averaged MT, EI, and absolute RMS of QF were calculated by averaging the values of the rectus femoris and vastus lateralis, and that of HM was calculated by averaging the values of the biceps femoris and semitendinosus. The knee extension peak torque was correlated with EI (r = -0.61, P < 0.01) and RMS (r = 0.53, P < 0.01) in the QF. In contrast, the knee flexion peak torque was correlated with RMS (r = 0.53, P < 0.05) but not with MT and EI in HM. In addition, EI and RMS in QF, and RMS in HM were selected as the major determinants of muscle strength in the stepwise regression analysis. These results suggest that muscle strength is moderately associated with different factors related to the thigh muscles in young individuals.

Using exergame-based exercise to prevent and postpone the loss of muscle mass, muscle strength, cognition, and functional performance among elders in rural long-term care facilities: A protocol for a randomized controlled trial

Objective

Elderly individuals in long-term care facilities (LTCFs) have a higher prevalence of sarcopenia than those in the community. Exercise is the gold standard for preventing and treating sarcopenia. Regarding exercise, multicomponent exercises, including progressive resistance training (PRT), are beneficial. However, developing routine, structured exercise programs for the elderly in LTCFs is difficult because of a shortage of healthcare providers, particularly in rural regions. Exergame-based exercises can increase a player's motivation and reduce staff time for an intervention. Nintendo Switch RingFit Adventure (RFA) is a novel exergame that combines resistance, aerobic, and balance exercises. In this study, we aim to investigate the clinical effectiveness of RFA on muscle and functional performance parameters among the elderly in LTCFs.

Methods

The EXPPLORE (using EXergame to Prevent and Postpone the LOss of muscle mass, muscle strength, and functional performance in Rural Elders) trial is a single-center randomized controlled trial involving elderly individuals (≥60 years) living in LTCFs in rural southern Taiwan. The participants will be equally randomized to the intervention group (exergame-based exercise plus standard care) or the control group (standard care alone). Both groups will receive standard care except that the intervention group will receive exergame-based exercises at the time previously scheduled for sedentary activities in the LTCFs. The exergame-based exercise will be performed using RFA in the sitting position with a specialized design, including arm fit skills and knee assist mode. Each session of the exercise lasts 30 mins and will be performed two times per week for 12 weeks. The primary outcomes will be the osteoporotic fracture index, appendicular skeletal muscle mass index, dominant handgrip strength, and gait speed. Meanwhile, the secondary outcomes will be the dexterity and agility, muscle strength and thickness, range of motion of the joints of the dominant upper extremity, Kihon checklist, Medical Outcomes Study 36-Item Short-Form Health Survey, and Brain Health Test.

Discussion

This trial will provide valuable knowledge on whether exergames using RFA can counteract physical decline and improve quality of life and cognition among the elderly in LTCFs.

Clinical trial registration

[www.ClinicalTrials.gov], identifier [NCT05360667].

Determining the cortical, spinal and muscular adaptations to strength-training in older adults: A systematic review and meta-analysis

There are observable decreases in muscle strength as a result of ageing that occur from the age of 40, which are thought to occur as a result of changes within the neuromuscular system. Strength-training in older adults is a suitable intervention that may counteract the age-related loss in force production. The neuromuscular adaptations (i.e., cortical, spinal and muscular) to strength-training in older adults are largely equivocal and a systematic review with meta-analysis will serve to clarify the present circumstances regarding the benefits of strength-training in older adults. 20 studies entered the meta-analysis and were analysed using a random-effects model. A best evidence synthesis that included 36 studies was performed for variables that had insufficient data for meta-analysis. One study entered both. There was strong evidence that strength-training increases maximal force production, rate of force development and muscle activation in older adults. There was limited evidence for strength-training to improve voluntary-activation, the volitional-wave and spinal excitability, but strong evidence for increased muscle mass. The findings suggest that strength-training performed between 2 and 12 weeks increases strength, rate of force development and muscle activation, which likely improves motoneurone excitability by increased motor unit recruitment and improved discharge rates.

Association between Tongue Pressure and Jaw-Opening Force in Older Adults

Tongue pressure (TP) is used to assess tongue muscle strength and is related to function and frailty. While performing TP, it is necessary to elevate the tongue and oral floor by contracting the suprahyoid muscles. However, the association between TP and suprahyoid muscle strength remains unclear. Accordingly, this study investigated the relationship between TP and jaw-opening force (JOF), an indicator of suprahyoid muscle strength. This cross-sectional study included 88 independent community-dwelling participants aged ≥65 years. Age, sex, and the number of remaining teeth were recorded. Ultrasonography was used to evaluate the cross-sectional area of the tongue and geniohyoid muscle, as representatives of the suprahyoid muscles. Sarcopenia was diagnosed based on appendicular skeletal muscle mass index, handgrip strength, and gait speed. Multiple regression analysis was performed with TP as the dependent variable. TP was significantly associated with JOF (β = 0.371, p = 0.003). This study revealed that decreased TP was associated with a decline in JOF and suprahyoid muscle mass in older adults. Thus, low TP may be associated with decreased JOF. Prevention of the weakness of the suprahyoid muscles and maintaining TP may also contribute to the prevention of frailty associated with TP.

Neuromuscular characteristics of front and back legs in junior fencers

In elite fencers, muscle strength and muscle mass of the front leg (FL) are greater than those of the back leg (BL) due to characteristic physiological and biomechanical demands placed on each leg during fencing. However, the development of laterality in their neural and muscular components is not well-understood. The present study investigated neuromuscular characteristics of FL and BL in junior fencers. Nineteen junior fencers performed neuromuscular performance tests for FL and BL, separately. There were no significant differences in the isometric knee extension strength (MVC), unilateral vertical jump (UVJ), vastus lateralis muscle thickness (MT), or motor unit firing rate of the vastus lateralis muscle (MUFR) between FL and BL (p > 0.05). In subgroup analyses, a significantly greater MUFR in FL than BL was noted only in fencers with > 3 years of fencing experience, and significantly greater UVJ in FL than BL was observed solely in fencers with < 3 years of fencing experience (p < 0.05). Strong positive correlations between FL and BL were identified in MVC, MT, and MUFR in fencers with > 3 years of fencing experience, but not in those with < 3 years of experience. These findings suggest that in junior fencers, laterality in neuromuscular performance has not manifested, whereas longer fencing experience induces fencing-dependent laterality in neural components, and laterality in dynamic muscle strength is decreased with fencing experience.

Assessment of changes in muscle mass, strength, and quality and activities of daily living in elderly stroke patients

Whether poststroke rehabilitation improves muscle mass and quality along with the recovery of muscle strength is not clear. In this study, we examined the changes in muscle strength, muscle mass, and muscle quality in patients undergoing poststroke rehabilitation and assessed the relationship of these variables with improvement in activities of daily living (ADL). This prospective study was conducted at stroke rehabilitation unit in Japan. Muscle mass and quality were assessed using bioelectrical impedance analysis (BIA). ADLs were assessed using the functional independence measure (FIM). Grip strength of the nonaffected and affected sides was measured using hand dynamometer. All measurements were performed at admission to the stroke rehabilitation unit and at 4 weeks thereafter. We assessed changes in motor FIM items and examined the relationships among the measured variables. This study included 179 patients. Patients received stroke rehabilitation 7 days a week individually. Muscle strength and quality significantly increased after 4 weeks on both the sides. Muscle mass decreased after 4 weeks; however, there was no significant difference between the two time points. Changes in muscle strength and quality showed a significant correlation with improvement in ADLs [r = 0.66 (male), 0.45 (female) and 0.55 (male), 0.31 (female), respectively]; however, muscle mass showed no correlation with improvement in ADLs. Poststroke rehabilitation improves muscle strength and quality, as well as ADLs. Muscle mass is not an appropriate measure to assess the effects of stroke rehabilitation; it is desirable to instead use muscle strength and quality to assess stroke rehabilitation.

Relationship between Nutritional Status, Body Composition, Muscle Strength, and Functional Recovery in Patients with Proximal Femur Fracture

Sarcopenia is a major issue among the elderly. However, the effects of nutritional status and body composition on functional recovery in patients with proximal femur fractures (PFF) remain unclear. Hence, this study aimed to investigate the effects of nutritional status, body composition (skeletal muscle mass and muscle quality measured by phase angle [PhA] values), and muscle strength on the improvement in activities of daily living (ADL) in patients with PFF. We enrolled patients with PFF admitted to a rehabilitation unit. Nutritional status, body composition, grip strength, and motor Functional Independence Measure (FIM) score were assessed on admission day and at 4 weeks thereafter. Of 148 patients, 84 had femoral neck fractures, and 64 had trochanteric fractures. The mean motor FIM score was 49.2 points at admission and 64.9 points after 4 weeks. In multivariate analysis, higher geriatric nutritional risk index and PhA measured by anthropometry were associated with a significantly higher FIM score after 4 weeks. Muscle strength and quality changes significantly correlated with ADL improvement. Poor nutritional status and decreased muscle strength and quality interfered with ADL recovery. Nutritional management before injury and from the acute phase, and rehabilitation to maintain skeletal muscle status, are important for ADL recovery.

Resistance training improves cognitive function in older adults with different cognitive status: a systematic review and Meta-analysis

The present study investigated the impact of resistance training (RT) on cognitive function in older adults with different cognitive status by conducting a systematic review and meta-analysis of intervention studies. We performed a literature search with no restriction on publication year in MEDLINE, Embase, CINAHL, SPORTDiscus, and AgeLine from inception up to August 2020. Experimental studies investigating the impact of RT on the cognitive function of cognitively healthy (CH) and cognitively impaired (CI) older adults (≥60 years) were included for analysis. Eighteen studies were included in the final analysis, of which ten studies investigated CH community-dwelling older adult, seven studies investigated CI older adults, and one study investigated both. RT significantly improved overall cognitive function in both CH (SMD = 0.54; 95% CI = 0.00 to 1.08, P = 0.047) and CI (SMD = 0.60; 95% CI = 0.21 to 1.16, P = 0.005) older adults. However, short-term memory was only improved in CH older adults (MD = -0.20; 95% CI = -0.25 to -0.15, P < 0.00001). In conclusion, RT improved overall cognitive function in CH and CI older adults, whereas short-term memory, assessed by the digit span of the WAIS III, was only significantly improved in CH older adults.

Association of Muscle Strength With Muscle Thickness and Motor Unit Firing Pattern of Vastus Lateralis Muscle in Youth Athletes

Purpose: Contributions of neural and muscular factors to muscle strength change with growth, but such changes remain unclear in young populations. This study aimed to clarify the association between muscle strength and neural and muscular factors in youth athletes. Methods: Maximal voluntary contraction (MVC) during isometric knee extension, the motor unit firing rate (MUFR), and muscle thickness (MT) of the vastus lateralis were measured in 70 youth male soccer players (mean [SD]; chronological age = 16.3 [0.6] y, peak height velocity age = 13.1 [1.0] y). MUFR and MT were measured with high-density surface electromyography and ultrasonography, respectively. Results: For MUFR and MT, correlations with MVC were calculated and the values of different MVC groups were compared. A significant correlation between MVC and MT (r = .49, P < .01) was noted, but not MUFR (r = .03, P > .05). There was also no significant correlation between MT and MUFR (r = −.33, P > .05). In addition, comparison among groups (higher-/middle-/lower-strength groups) revealed that MT in the lower-strength group was significantly lower than in middle-and higher-strength groups (P < .01). Conclusion: In youth athletes, muscle strength is associated with muscular factors, rather than neural factors, and muscular and neural factors may independently contribute to muscle strength.

Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults

Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people.

Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity.

Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate.

Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT.

Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.

Evidence of resistance training-induced neural adaptation in older adults

The deleterious effects of aging on force production are observable from the age of 40 upwards, depending on the measure. Neural mechanisms contributing to maximum force production and rate of force development have been suggested as descending drive from supraspinal centers, spinal motoneuron excitability, and corticospinal inhibition of descending drive; all of which influence motor unit recruitment and/or firing rate. Resistance-trained Master athletes offer a good source of information regarding the inevitable effects of aging despite the countermeasure of systematic resistance-training. However, most evidence of neural adaptation is derived from longitudinal intervention studies in previously untrained (i.e. resistance-training naïve) older adults. There is good evidence for the effect of resistance-training on the end-point of neural activation, i.e. motor unit behavior, but little to no data on the generation of descending drive from e.g. transcranial magnetic stimulation or cortical imaging studies in older adults. This, along with tracking master athletes over several years, would provide valuable information and could be the focus of future research.

Impact of home-based squat training with two-depths on lower limb muscle parameters and physical functional tests in older adults

This study investigated the effect of home-based shallow and deep squat trainings on knee extension peak torque, muscle thickness, one-repetition maximum (1RM) leg press, and physical function in older individuals. Sixteen participants were randomly assigned to the shallow squat group (SS group; age, 71.0  ±  4.0 years) or deep squat group (DS group, age; 68.6  ± 3.6 years). Chairs of 40-cm height and chairs with a cushion of 20-cm height (60-cm in total) were used as the depth targets for squats, with participants instructed to sink until their hip touched the chair and cushion. Participants performed four sets of squats per day (35 repetitions per set), three days per week, for 12 weeks at their home. Knee extension peak torque, muscle thickness of quadriceps femoris (e.g., vastus lateralis, rectus femoris, and vastus intermedius), and physical function were measured at weeks 0 (baseline), 4, 8, and 12. Maximal isometric knee extension peak torque, muscle thickness, and walking speed did not change significantly over the 12-week training period in either group (P > 0.05). However, compared with the baseline, there was significant improvement in the results of 30-s sit-to-stand repetition tests after weeks 8 and 12 in both groups (P < 0.05). Additionally, 1RM leg press results were significantly improved after weeks 4 and 12 in the DS group, and weeks 4, 8, and 12 in the SS group (P < 0.05). Results indicate that home-based weight-bearing squat training improves lower limb function in older adults, as well as performance in physical functional tests related to activities of daily living. Moreover, such training benefits older adults regardless of whether squats are shallow or deep.

Fish Protein Ingestion Induces Neural, but Not Muscular Adaptations, Following Resistance Training in Young Adults

Purpose: Nutritional supplementation in conjunction with exercise is of interest for the prevention or improvement of declines in motor performances in older adults. An understanding of the effects on both young and older adults contributes to its effective application. We investigated the effect of fish protein ingestion with resistance training on neural and muscular adaptations in young adults using interventions and assessments that have already been tested in older adults.

Methods: Eighteen young adults underwent 8 weeks of isometric knee extension training. During the intervention, nine participants ingested 5 g of fish protein (n = 9, Alaska pollack protein, APP), and the other nine participants ingested casein as a control (n = 9, CAS) in addition to daily meals. Before, during, and after the intervention, the isometric knee extension force, lower extremity muscle mass, and motor unit firing pattern of knee extensor muscles were measured.

Results: Maximum voluntary contraction (MVC) was significantly increased in both APP and CAS groups from 0 weeks to 4, 6, and 8 weeks of intervention (p < 0.001), but there were no significant differences between the groups (p = 0.546–0.931). Muscle mass was not significantly changed during the intervention in either group (p = 0.250–0.698). Significant changes in motor unit firing rates (p = 0.02 and 0.029 for motor units recruited at 20–40% of MVC and at 40–60%) were observed following the intervention in the APP but not CAS (p = 0.120–0.751) group.

Conclusions: These results suggest that dietary fish protein ingestion changes motor unit adaptations following resistance training in young adults.

Using Virtual Reality-Based Rehabilitation in Sarcopenic Older Adults in Rural Health Care Facilities-A Quasi-Experimental Study

Because of a shortage of health care providers, providing rehabilitation in health care facilities is difficult. Virtual reality-based rehabilitation is effective in older populations. There are only a few studies among patients with sarcopenia. This is a quasi-experimental, single-group, pretest-posttest design evaluating the clinical effectiveness of virtual reality-based progressive resistance training among residents aged over 60 years with sarcopenia in rural care facilities. The authors used Oculus Rift with headsets to provide the virtual reality-based progressive resistance training. The authors administered the program twice per week, 30 min per session, for 12 weeks. The primary outcomes were dominant handgrip strength, walking speed, and appendicular skeletal muscle mass index. Data from 30 participants were analyzed. Significant improvements in handgrip strength and walking speed were observed. Although an increasing trend in appendicular skeletal muscle mass index was observed, it did not reach statistical significance. The authors concluded that the virtual reality-based progressive resistance training is partially effective in older sarcopenic adults in health care facilities.

Modulation of Neural and Muscular Adaptation Processes During Resistance Training by Fish Protein Ingestions in Older Adults

Assessments of both neural and muscular adaptations during interventions would provide valuable information for developing countermeasures to age-related muscle dysfunctions. We investigated the effect of fish protein ingestion on training-induced neural and muscular adaptations in older adults. Twenty older adults participated 8 weeks of isometric knee extension training intervention. The participants were divided into two groups who took fish protein (n = 10, Alaska pollack protein, APP) or casein (n = 10, CAS). Maximal muscle strength during knee extension, lower extremity muscle mass (body impedance method), and motor unit firing pattern of knee extensor muscle (high-density surface electromyography) were measured before, during, and after the intervention. Muscle strength were significantly increased in both CAS (124.7 ± 5.8%) and APP (117.1 ± 4.4%) after intervention (p < .05), but no significant differences between the groups were observed (p > .05). Significant increases in lower extremity muscle mass from 0 to 8 weeks were demonstrated only for APP (102.0 ± 3.2, p < .05). Greater changes in motor unit firing pattern following intervention were represented in CAS more than in APP. These results suggest that nutritional supplementations could modulate neural and muscular adaptations following resistance training and fish protein ingestion preferentially induces muscular adaptation without the detectable neural adaptation in older adults.

[Association of Cigarette Smoking with Muscle Mass Reduction and Low Muscle Strength in Community-Dwelling Elderly Men]

OBJECTIVES

Recently, attention has been paid to the impact of cigarette smoking on skeletal muscles, as its underlying pathophysiological mechanism has been gradually elucidated. In this study, we aimed to examine whether cigarette smoking is associated with muscle mass reduction and low muscle strength in elderly men.

METHODS

The study participants comprised 417 community-dwelling elderly men (aged 73±6 years) without severe glucose intolerance, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM), which was normalized for height (ASM index, kg/m²). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Cumulative smoking exposure level during a lifetime was expressed in pack-years, which is a product of the average number of packs of cigarettes smoked per day and smoking duration in years.

RESULTS

When the participants were stratified on the basis of cumulative smoking exposure (<10 pack-years, 10-39 pack-years, ≥40 pack-years), the ASM index and HGS progressively decreased with increasing exposure level (P for trend <0.01). In multiple regression analysis, heavy smoking (defined as ≥40 pack-years) was found to be a significant determinant of the ASM index and HGS, independent of potential confounding factors. Among former smokers, the subgroup that quit smoking for ≥20 years had a significantly higher ASM index and HGS than the subgroup that quit smoking for <10 years. The duration of smoking cessation was significantly associated with the ASM index and HGS, even after adjusting for cumulative smoking exposure.

CONCLUSIONS

These findings suggest that cigarette smoking contributes to the loss of muscle mass and function in elderly men and that smoking cessation could reverse the impact of cigarette smoking on skeletal muscles.

Effect of milk fat globule membrane supplementation on motor unit adaptation following resistance training in older adults

This study aimed to investigate the effect of milk fat globule membrane (MFGM) supplementation on motor unit adaptation following resistance training in older adults. Twenty-five older males and females took MFGM (n = 12) or a placebo (PLA; n = 12) while performing 8 weeks of isometric knee extension training. During the training, the motor unit firing pattern during submaximal contractions, muscle thickness, and maximal muscle strength of knee extensor muscles were measured every 2 weeks. None of the measurements showed significant differences in muscle thickness or maximal muscle strength (MVC) between the two groups (p > .05). Significant decreases in motor unit firing rate following the intervention were observed in PLA, that is, 14.1 ± 2.7 pps at 0 weeks to 13.0 ± 2.4 pps at 4 weeks (p = .003), but not in MFGM (14.4 ± 2.5 pps to 13.8 ± 1.9 pps). Motor unit firing rates in MFGM were significantly higher than those in PLA at 2, 4, 6, and 8 weeks of the intervention, that is, 15.1 ± 2.3 pps in MFGM and 14.5 ± 3.3 pps in PLA at 70% of MVC for motor units recruited at 40% of MVC at 6 weeks (p = .034). Significant differences in firing rates among motor units with different recruitment thresholds were newly observed following the resistance training intervention in MFGM, indicating that motor unit firing pattern is changed in this group. These results suggest that motor unit adaptation following resistance training is modulated by MFGM supplementation in older adults.

Effect of inspiratory resistive training on diaphragm shear modulus and accessory inspiratory muscle activation

This study aimed to elucidate changes in diaphragm and accessory inspiratory muscle (sternocleidomastoid (SCM) muscle and intercostal muscle (IC)) function after a 6-week training program. Nineteen male elite collegiate swimmers were assigned to either a control group (n = 9) or training group (n = 10). The subjects in the training group performed 30 maximum inspirations at a load resistance of 50% of maximum inspiratory mouth pressure (PImax) using an inspiratory muscle training device. These were conducted twice per day and 6 days per week. At baseline and after 6 weeks, PImax, shear modulus of the diaphragm, and electromyograms (EMG) of the SCM and IC during a maximal inspiratory maneuver were evaluated. Relative change in PImax was greater in the training group than in controls. The shear modulus during a PImax maneuver had increased significantly in both groups after 6 weeks. EMG amplitudes of the SCM increased in the training group after 6 weeks, but not in the control group. EMG amplitudes of the IC did not change after 6 weeks in either group. These results suggest that 6-week inspiratory resistive training significantly improves the activation of the SCM, which could be one of the major mechanisms behind increases in inspiratory muscle strength after resistive training. Novelty Six-week inspiratory resistive training increased diaphragm stiffness during maximal inspiration maneuver. Six-week inspiratory resistive training increased electromyogram amplitudes of the sternocleidomastoid during maximal inspiration maneuver.

Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association

Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.

Effect of Resistance Training and Fish Protein Intake on Motor Unit Firing Pattern and Motor Function of Elderly

We investigated the effect of resistance training and fish protein intake on the motor unit firing pattern and motor function in elderly. Fifty healthy elderly males and females (69.2 ± 4.7 years) underwent 6 weeks of intervention. We applied the leg-press exercise as resistance training and fish protein including Alaska pollack protein (APP) as nutritional supplementation. Subjects were divided into four groups: fish protein intake without resistance training (APP-CN, n = 13), placebo intake without resistance training (PLA-CN, n = 12), fish protein intake with resistance training (APP-RT, n = 12), and placebo intake with resistance training (PLA-RT, n = 13). Motor unit firing rates were calculated from multi-channel surface electromyography by the Convolution Kernel. For the chair-stand test, while significant increases were observed at 6 weeks compared with 0 week in all groups (p < 0.05), significant increases from 0 to 3 weeks and 6 weeks were observed in APP-RT (18.2 ± 1.9 at 0 week to 19.8 ± 2.2 at 3 weeks and 21.2 ± 1.9 at 6 weeks) (p < 0.05). Increase and/or decrease in the motor unit firing rate were mainly noted within motor units with a low-recruitment threshold in APP-RT and PLA-RT at 3 and 6 weeks (12.3 pps at 0 week to 13.6 pps at 3 weeks and 12.1 pps at 6 weeks for APP-RT and 12.9 pps at 0 week to 13.9 pps at 3 weeks and 14.1 pps at 6 weeks for PLA-RT at 50% of MVC) (p < 0.05), but not in APP-CN or PLA-CN (p > 0.05). Time courses of changes in the results of the chair-stand test and motor unit firing rate were different between APP-RT and PLA-RT. These findings suggest that, in the elderly, the effect of resistance training on the motor unit firing rate is observed in motor units with a low-recruitment threshold, and additional fish protein intake modifies these adaptations in motor unit firing patterns and the motor function following resistance training.

Multicomponent Exercise Improves Hemodynamic Parameters and Mobility, but Not Maximal Walking Speed, Transfer Capacity, and Executive Function of Older Type II Diabetic Patients

The present study aimed to investigate the effects of a 6-month multicomponent exercise program (MCEP) on functional, cognitive, and hemodynamic parameters of older Type 2 diabetes mellitus (T2DM) patients. Moreover, additional analyses were performed to evaluate if T2DM patients present impaired adaptability in response to physical exercise when compared to nondiabetic volunteers. A total of 72 T2DM patients and 72 age-matched healthy volunteers (CG) were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. Results indicate T2DM and nondiabetic patients present an increase in mobility (i.e., usual walking speed) after the MCEP. However, improvements in maximal walking speed, transfer capacity, and executive function were only observed in the CG. On the other hand, only T2DM group reveals a marked decline in blood pressure. In conclusion, data of the current study indicate that a 6-month MCEP improves mobility and reduce blood pressure in T2DM patients. However, maximal walking speed, transfer capacity, and executive function were only improved in CG, indicating that T2DM may present impaired adaptability in response to physical stimulus.

Relationships between muscle strength and multi-channel surface EMG parameters in eighty-eight elderly

Background

Since age-related muscle strength loss cannot be explained solely by muscle atrophy, other determinants would also contribute to muscle strength in elderly. The present study aimed to clarify contribution of neuromuscular activation pattern to muscle strength in elderly group. From 88 elderlies (age: 61~ 83 years), multi-channel surface electromyography (EMG) of the vastus lateralis muscle was recorded with two-dimensional 64 electrodes during isometric submaximal ramp-up knee extension to assess neuromuscular activation pattern. Correlation analysis and stepwise regression analysis were performed between muscle strength and the parameters for signal amplitude and spatial distribution pattern, i.e., root mean square (RMS), correlation coefficient, and modified entropy of multi-channel surface EMG.

Results

There was a significant correlation between muscle strength and RMS (r = 0.361, p = 0.001) in the elderly. Muscle thickness (r = 0.519, p < 0.001), RMS (r = 0.288, p = 0.001), and normalized RMS (r = 0.177, p = 0.047) were selected as major determinants of muscle strength in stepwise regression analysis (r = 0.664 in the selected model).

Conclusion

These results suggest that inter-individual difference in muscle strength in elderly can be partly explained by surface EMG amplitude. We concluded that neuromuscular activation pattern is also major determinants of muscle strength on elderly in addition to indicator of muscle volume.

Muscle Mass, Quality, and Composition Changes During Atrophy and Sarcopenia

Skeletal muscle mass (SMM) and muscle strengh reach their peak in 20s to 40s of age in human life and then decrease with advancing age. The decrease rate of muscle strength or power was twice to four times as large as that of the SMM. Thus, the normalized muscle force (muscle strength divided by SMM) also decreases in aging. It depends on the number of factors in skeletal muscle tissues and neuromuscular system. In human study, SMM cannot be measured directly without dissection so that all of the methodologies are indirect methods to assess SMM, even computing tomography or magnetic resonance imaging. Dual-energy X-ray absorptiometry, ultrasonography, anthropometry, and bioelectrical impedance analysis (BIA) are used as secondary indirect methods to estimate SMM. Recent researches show muscle composition changes in aging, and in particular, the ratio of muscle cell mass (MCM) against SMM decrease and relative expansion of extracellular water (ECW) and extracellular space is observed with advancing age and/or decrease of physical function. The intracellular water (ICW) and ECW estimated by segmental bioelectrical impedance spectroscopy or multifrequency BIA are good biomarkers of the ratio of MCM against SMM in limbs. The BIS and other state-of-the-art technology for assessment of muscle mass, quality, and composition are useful to fully understand the muscle atrophy in a living organism.

Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer

We established a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Twenty-two gastric cancer patients aged 65 years or older with a diagnosis of sarcopenia according to the algorithm proposed by the European Working Group on Sarcopenia in Older People received our preoperative program. The median duration of the program participation was 16 days. Total calorie and protein intakes were significantly higher after the program than before [29.4 ± 6.9 kcal/kg ideal body weight (IBW) vs 27.3 ± 5.6 kcal/kg IBW, p = 0.049, and 1.3 ± 0.4 g/kg IBW vs 1.1 ± 0.3 g/kg IBW, p = 0.0019, respectively]. Handgrip strength significantly increased after the program (21.2 ± 5.2 kg vs 20.0 ± 5.3 kg, p = 0.022). Likewise, gait speed and skeletal muscle mass index increased, although the differences did not reach statistical significance. Four patients became nonsarcopenic after the program. Postoperative complications were observed in three patients (13.6%); however, none of these complications were severe (Clavien-Dindo grade III or lower). A preoperative exercise and nutritional support program has the potential to reduce sarcopenia and improve postoperative outcome in elderly sarcopenic patients with gastric cancer.

The Extracellular to Intracellular Water Ratio in Upper Legs is Negatively Associated With Skeletal Muscle Strength and Gait Speed in Older People

Skeletal muscles contain a large volume of water that is classified into intracellular (ICW) and extracellular (ECW) water fractions. Nuclear magnetic resonance-based biomarkers suggest that increased water T2 heterogeneities, as well as elevated water T2 relaxation in the quadriceps occurs in the elderly when compared with young adults. However, nuclear magnetic resonance is difficult to apply to a large-scale study or a clinical setting for sarcopenia and frailty screening. Segmental bioelectrical impedance spectroscopy is a unique tool used to assess the segmental ratio of ECW/ICW in the limbs. We evaluated 405 community-living people aged between 65 and 90 years. ECW and ICW in the upper legs were assessed by segmental bioelectrical impedance spectroscopy. Isometric knee extension strength, gait speed, and skeletal muscle mass were measured. Thigh ECW/ICW was negatively correlated with knee extension strength and gait speed (r = -.617 and -.431, respectively, p < .001) and increased with age (p < .001). Thigh ECW/ICW was a significant predictor of knee extension strength and gait speed independent of age, sex, body mass index, and skeletal muscle mass. Relative expansion of ECW against ICW in the thigh muscles is a factor in decreased muscle quality and a biomarker of muscle aging.

A pilot study of short-term toe resistance training in patients with type 2 diabetes mellitus

Objective

The purpose of this pilot study was to investigate the effect of short-term toe resistance training on toe pinch force and toe muscle quality in patients with type 2 diabetes mellitus.

Methods

A total of 12 patients with type 2 diabetes mellitus who were hospitalized to improve glycemic control (8 men and 4 women, duration of diabetes 12.2 ± 9.5 years) were enrolled in this pilot study. Exercise therapy was performed with conventional aerobic exercise and four newly developed toe resistance training exercises for 2 weeks. Changes in anthropometric parameters, blood pressure (BP), heart rate, and muscle parameters, i.e. muscle mass, toe pinch force and toe muscle quality were evaluated after the exercise program.

Results

There were no significant differences of body weight, body mass index, BP, heart rate, and upper/lower muscle mass after exercise performance. However, toe pinch force was significantly increased (pre: 2.92 ± 1.19 kg, post: 3.65 ± 1.58 kg, p = 0.007). Toe muscle quality (toe pinch force/lower leg muscle mass) were also significantly increased (pre: 2.15 ± 0.86 kg/kg, post: 2.72 ± 1.26 kg/kg, p = 0.009).

Conclusions

Two weeks of toe resistance training significantly increased toe pinch force and toe muscle quality in patients with type 2 diabetes mellitus. Toe resistance training is might be essential for treating patients with diabetes mellitus in clinical practice.

Effects of Multicomponent Exercise on Functional and Cognitive Parameters of Hypertensive Patients: A Quasi-Experimental Study

Purpose. The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP) on physical function and cognitive parameters of normotensive (NTS) and hypertensive (HTS) older patients and verify if age can influence the adaptations in response to the exercise. Methods. A total of 218 subjects, 101 NTS and 117 HTS, were recruited and underwent functional and cognitive evaluations before and after six months of a MCEP. The program of exercise was performed twice a week, for 26 weeks. The physical exercises were thought to mimic the activities of daily living and, therefore, aggregated functional and walking exercises. Exercise sessions were performed at moderate intensity. Results. Data indicated that HTS and NST patients showed a similar increase in the performance of walking speed test and one-leg stand test after the MCEP. Regarding age, results did not show differences in the magnitude of adaptations between old and young HTS and NTS patients. Conclusions. Data of the present study indicated that a 6-month MCEP was able to increase equally balance and mobility in NTS and HTS patients. Moreover, data demonstrated that aging did not seem to impair the capacity to adapt in response to exercise in both groups.

Effects of Elastic Band Resistance Training on Glucose Control, Body Composition, and Physical Function in Women With Short- vs. Long-Duration Type-2 Diabetes

This study examined whether the existing duration of type-2 diabetes influenced patient responses to progressive resistance training. Twenty-six women with type-2 diabetes were stratified into short- (3 ± 2 years; n = 12) or long-standing (10 ± 3 years; n = 14) disease groups. Patients participated in a high daily or high weekly frequency elastic band resistance training program that consisted of 2 daily sessions, 5 d·wk for 12 weeks. Glucose control, body composition, and physical function were evaluated pre- and posttraining. No significant diabetes duration × training interactions were detected for blood markers of glucose control (p > 0.05); however, there were significant main effects of training driven by comparable improvements in both cohorts (hemoglobin A1c, -13 to 18%; fasting glucose, -23 to 31%; postprandial glucose, -36 to 40%; insulin, -34 to 40%; C-peptide, -38 to 51%; p ≤ 0.05). Anthropometrics and body composition were also favorably modified in both the groups after training (weight, -5 to 9%; body mass index, -6 to 9%; waist-to-hip ratio, -3 to 5%; percent fat, -14 to 20%; p ≤ 0.05). Likewise, indices of physical function improved in both the groups after training (bicep curl repetitions, +15-33%; sit-and-stand repetitions, +45-47%; p ≤ 0.05). A few exceptions were noted in which patients with long-standing disease demonstrated greater pre-to-post gains (p ≤ 0.05) in grip strength (+11-13%) and peak exercise time (+19%) and load (+21%) during graded exercise, whereas those with shorter disease duration did not. Overall, these data suggest that patients with a long history of diabetes respond positively to resistance training and in a manner comparable to their recently diagnosed counterparts. Therefore, current inactivity in patients with long-standing disease should not deter from beginning an exercise program.

Training at non-damaging intensities facilitates recovery from muscle atrophy

INTRODUCTION

Resistance training promotes recovery from muscle atrophy, but optimum training programs have not been established. We aimed to determine the optimum training intensity for muscle atrophy.

METHODS

Mice recovering from atrophied muscles after 2 weeks of tail suspension underwent repeated isometric training with varying joint torques 50 times per day.

RESULTS

Muscle recovery assessed by maximal isometric contraction and myofiber cross-sectional areas (CSAs) were facilitated at 40% and 60% maximum contraction strength (MC), but at not at 10% and 90% MC. At 60% and 90% MC, damaged and contained smaller diameter fibers were observed. Activation of myogenic satellite cells and a marked increase in myonuclei were observed at 40%, 60%, and 90% MC.

CONCLUSIONS

The increases in myofiber CSAs were likely caused by increased myonuclei formed through fusion of resistance-induced myofibers with myogenic satellite cells. These data indicate that resistance training without muscle damage facilitates efficient recovery from atrophy. Muscle Nerve 55: 243-253, 2017.

Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke

Objective: To examine the effectiveness of task-oriented progressive resistance strength training on lower extremity strength and functional performance in chronic stroke subjects.

Design: Single-blind, randomized controlled trial.

Setting: Medical centre and district hospital.

Subjects: Forty-eight subjects at least one year post stroke.

Interventions: Participants randomly allocated to two groups, control (n-/24) and experimental (n-/24). Subjects in the control group did not receive any rehabilitation training. Subjects in the experimental group were put on a four-week task-oriented progressive resistance strength training.

Main measures: Lower extremity muscle strength, gait velocity, cadence, stride length, six-minute walk test, step test, and timed up and go test.

Results: Muscle strength significantly improved in the experimental group for strong side muscle groups (ranged from 23.9% to 36.5%) and paretic side muscle groups (ranged from 10.1% to 77.9%). In the control group muscle strength changes ranged from 6.7% gain to 11.2% decline. The experimental group showed significant improvement in all selected measures of functional performance except for the step test. In the control group, the number of repetitions of the step test significantly decreased (-20.3%) with no change in other functional tests. There was a significant difference between groups for muscle strength and all functional measures. The strength gain was significantly associated with gain in the functional tests.

Conclusions: The task-oriented progressive resistance strength training programme could improve lower extremity muscle strength in individuals with chronic stroke and could carry over into improvement in functional abilities.

Relationships Between Physical Activity Habits and Functional Neuromuscular Capacities in Healthy Older Adults

There is general agreement that to maintain quality of life for an aging individual, independence and self-direction need to be sustained. Relationships between levels of physical activity and changes in neuromuscular capacities among 30 women and 32 men (average age = 71 years) were examined, and four dimensions of functional neuromuscular capacities were evaluated: body agility, balance, upper-extremity function, and speed of movement planning/execution. Selected anthropometric and phystological characteristics were also measured. Physical activity habits were assessed by questionnaire and interview. Positive and potentially important relationships between physical activity levels and selected neuromuscular abilities were found. Activity habits were significantly related to general anthropometric and physiological characteristics. This study suggests that selected functional neuromuscular capacities are better maintained in healthy, physically active older adults, and the nature of capacities affected may be different for men and women.

Age-related changes in motor unit firing pattern of vastus lateralis muscle during low-moderate contraction

Age-related changes in motor unit activation properties remain unclear for locomotor muscles such as quadriceps muscles, although these muscles are preferentially atrophied with aging and play important roles in daily living movements. The present study investigated and compared detailed motor unit firing characteristics for the vastus lateralis muscle during isometric contraction at low to moderate force levels in the elderly and young. Fourteen healthy elderly men and 15 healthy young men performed isometric ramp-up contraction to 70 % of the maximal voluntary contractions (MVC) during knee extension. Multichannel surface electromyograms were recorded from the vastus lateralis muscle using a two-dimensional grid of 64 electrodes and decomposed with the convolution kernel compensation technique to extract individual motor units. Motor unit firing rates in the young were significantly higher (~+29.7 %) than in the elderly (p < 0.05). There were significant differences in firing rates among motor units with different recruitment thresholds at each force level in the young (p < 0.05) but not in the elderly (p > 0.05). Firing rates at 60 % of the MVC force level for the motor units recruited at <20 % of MVC were significantly correlated with MVC force in the elderly (r = 0.885, p < 0.0001) but not in the young (r = 0.127, p > 0.05). These results suggest that the motor unit firing rate in the vastus lateralis muscle is affected by aging and muscle strength in the elderly and/or age-related strength loss is related to motor unit firing/recruitment properties.

Examination of a neural cross-over effect using resting mechanomyographic mean frequency from the vastus lateralis muscle in different resting positions following aerobic exercise

PURPOSE

To evaluate the potential neural cross-over effect between the vastus lateralis muscles in different postural resting positions.

METHODS

Subjects exercised on an upright cycle ergometer, using only their dominate leg, for 2 min at 30 % VO2 peak. Following this warm-up, subjects then cycled (still using only their dominant leg) for 30 min at 60 % VO2 peak. After the aerobic phase, subjects cooled down (again, using only their dominant leg) for 2 min at 30 % VO2 peak. Resting mechanomyography mean frequency was measured prior to and following aerobic exercise.

RESULTS

There was an approximate 6.3 ± 6.8 and a 10 ± 5.1 % increase (upright sitting position with the subject's knee joint angle fixed at 180°); an approximate 7 ± 6.6 and a 16.1 ± 6.5 % increase (upright sitting position with the subject's knee joint angle fixed at 90°); an approximate 0.5 ± 6.8 and 3.7 ± 5.6 % increase (lying supine position with the subject's knee joint angle fixed at 180°); and an approximately 2 ± 8.3 and 2.5 ± 8.6 % increase (lying supine position with the subject's knee joint angle fixed at 90°) in normalized mechanomyography mean frequency after aerobic exercise for the dominant and non-dominate vastus lateralis muscles, respectfully.

CONCLUSION

There appears to be a statistically significant neural cross-over effect for the vastus lateralis muscle, during three of the four postural resting positions, with the non-dominant vastus lateralis muscle having a greater increase in mechanomyography mean frequency.

Effects of Short-Term Dynamic Constant External Resistance Training and Subsequent Detraining on Strength of the Trained and Untrained Limbs: A Randomized Trial

Short-term resistance training has been shown to increase isokinetic muscle strength and performance after only two to nine days of training. The purpose of this study was to examine the effects of three days of unilateral dynamic constant external resistance (DCER) training and detraining on the strength of the trained and untrained legs. Nineteen men were randomly assigned to a DCER training group or a non-training control group. Subjects visited the laboratory eight times, the first visit was a familiarization session, the second visit was a pre-training assessment, the subsequent three visits were for training sessions (if assigned to the training group), and the last three visits were post-training assessments 1, 2, and 3 (i.e., 48 h, 1 week, and 2 weeks after the final training session). Strength increased in both trained and untrained limbs from pre- to post-training assessment 1 for the training group and remained elevated at post-training assessments 2 and 3 (p ≤ 0.05). No changes were observed in the control (p > 0.05). Possible strength gains from short-term resistance training have important implications in clinical rehabilitation settings, sports injury prevention, as well as other allied health fields such as physical therapy, occupational therapy, and athletic training.

Skeletal muscle homeostasis and plasticity in youth and ageing: impact of nutrition and exercise

Skeletal muscles comprise a substantial portion of whole body mass and are integral for locomotion and metabolic health. Increasing age is associated with declines in both muscle mass and function (e.g. strength‐related performance, power) with declines in muscle function quantitatively outweighing those in muscle volume. The mechanisms behind these declines are multi‐faceted involving both intrinsic age‐related metabolic dysregulation and environmental influences such as nutritional and physical activity. Ageing is associated with a degree of ‘anabolic resistance’ to these key environmental inputs, which likely accelerates the intrinsic processes driving ageing. On this basis, strategies to sensitize and/or promote anabolic responses to nutrition and physical activity are likely to be imperative in alleviating the progression and trajectory of sarcopenia. Both resistance‐ and aerobic‐type exercises are likely to confer functional and health benefits in older age, and a clutch of research suggests that enhancement of anabolic responsiveness to exercise and/or nutrition may be achieved by optimizing modifications of muscle‐loading paradigms (workload, volume, blood flow restriction) or nutritional support (e.g. essential amino acid/leucine) patterns. Nonetheless, more work is needed in which a more holistic view in ageing studies is taken into account. This should include improved characterization of older study recruits, that is physical activity/nutritional behaviours, to limit confounding variables influencing whether findings are attributable to age, or other environmental influences. Nonetheless, on balance, ageing is associated with declines in muscle mass and function and a partially related decline in aerobic capacity. There is also good evidence that metabolic flexibility is impaired in older age.

Medium-intensity, high-volume "hypertrophic" resistance training did not induce improvements in rapid force production in healthy older men

The aim of the study was to determine whether it is possible to improve both maximum and rapid force production using resistance training that is typically used to induce muscle hypertrophy in previously untrained older men. Subjects (60-72 years) performed 20 weeks of "hypertrophic" resistance training twice weekly (n = 27) or control (n = 11). Maximum dynamic and isometric leg press, as well as isometric force over 0-100 ms, and maximum concentric power tests were performed pre- and post-intervention. Muscle activity was assessed during these tests by surface electromyogram of the vastus lateralis and medialis muscles. Muscle hypertrophy was assessed by panoramic ultrasound of the vastus lateralis. The intervention group increased their maximum isometric (from 2268 ± 544 to 2538 ± 701 N) and dynamic force production (from 137 ± 24 to 165 ± 29 kg), and these changes were significantly different to control (isometric 12 ± 16 vs. 1 ± 9 %; dynamic 21 ± 12 vs. 2 ± 4 %). No within- or between-group differences were observed in rapid isometric force or concentric power. Relative increases in vastus lateralis cross-sectional area trended to be statistically greater in the intervention group (10 ± 8 vs. 3 ± 6 %, P = 0.061). It is recommendable that resistance training programs for older individuals integrate protocols emphasizing maximum force/muscle hypertrophy and rapid force production in order to induce comprehensive health-related and functionally important improvements in this population.