Skeletal muscle contractile and noncontractile components in young and older women and men

Age- and sex-dependence of muscle quality: Influence of intramuscular non-contractile tissues

PURPOSE

Muscle quality is explained by the ratio between muscle size and strength. Conventionally, muscle size is evaluated without considering the composition of contractile and non-contractile tissues in muscle, hence the influence of non-contractile tissues on muscle quality is not fully understood, especially within aging muscle. This study investigated the differences in intramuscular non-contractile tissues between different age and sex groups, and investigated their influence on muscle quality.

METHODS

Eighty-two older and 64 young females and males participated. Muscle cross-sectional area (quadriceps and hamstrings), separating contractile and non-contractile areas, was calculated from the magnetic resonance image of the right mid-thigh. Maximal voluntary isometric knee extension and flexion torque was measured. Torque/muscle area and torque/contractile area were calculated for each age and sex group.

RESULTS

Non-contractile/muscle area was higher in older than in young individuals in both muscle groups (p < 0.05), and it was greater in the hamstrings than in the quadriceps. For the hamstrings, torque/muscle area was lower in older than in young individuals in both sexes (p < 0.05). However, torque/contractile area did not show the differences between age groups, only between sexes (males>females) (p < 0.05).

CONCLUSIONS

The results indicate that 1) the presence of non-contractile tissues varies by age and muscle groups, 2) the extensive presence of non-contractile tissues can contribute to the underestimation of its muscle quality, and 3) the sex differences in muscle quality are influenced by factors other than muscle composition.

Neural and muscular contributions to the age-related differences in peak power of the knee extensors in men and women

The mechanisms for the loss in limb muscle power output in old (60-79 yr) and very old (≥80 yr) adults and whether the mechanisms differ between men and women are not well understood. We compared maximal peak power of the knee extensor muscles between young, old, and very old men and women and identified the neural and muscular factors contributing to the age-related differences in power. Thirty-one young (22.9 ± 3.0 yr, 15 women), 82 old (70.3 ± 4.9 yr, 38 women), and 16 very old adults (85.8 ± 4.2 yr, 9 women) performed maximal isokinetic contractions at 14 different velocities (30-450°/s) to identify peak power. Voluntary activation (VA) and contractile properties were assessed with transcranial magnetic stimulation to the motor cortex and electrical stimulation of the femoral nerve. The age-related loss in peak power was ∼6.5 W·yr-1 for men (R2 = 0.62, P < 0.001), which was a greater rate of decline (P = 0.002) than the ∼4.2 W·yr-1 for women (R2 = 0.77, P < 0.001). Contractile properties were the most closely associated variables with peak power for both sexes, such as the rate of torque development of the potentiated twitch (men: R2 = 0.69, P < 0.001; women: R2 = 0.57, P < 0.001). VA was weakly associated with power in women (R2 = 0.13, P = 0.012) but not in men (P = 0.191). Similarly, neuromuscular activation [rates of electromyography (EMG) rise] during the maximal power contraction was associated with power in women (R2 = 0.07, P = 0.042) but not in men (P = 0.456). These data suggest that the age-related differences in maximal peak power of the knee extensor muscles are due primarily to factors within the muscle for both sexes, although neural factors may play a minor role in older women.NEW & NOTEWORTHY The greater age-related loss in power relative to the loss in muscle mass of the knee extensors was primarily due to factors altering the contractile properties of the muscle for both old and very old (≥80 yr) adults. The mechanisms for the decrements in power with aging appear largely similar for men and women, although neural factors may play more of a role in older women.

Chronic Adaptions in Quadriceps Fascicle Mechanics Are Related to Altered Knee Biomechanics After Anterior Cruciate Ligament Reconstruction

Following anterior cruciate ligament reconstruction (ACLR), patients exhibit abnormal walking mechanics and quadriceps dysfunction. Quadriceps dysfunction has been largely attributed to muscle atrophy and weakness. While important, these factors do not capture intrinsic properties of muscle that govern its ability to generate force and withstand load. While fascicle abnormalities after ACLR have been documented in early stages of recovery (<12 mo), long-term effects of ACLR on fascicle mechanics remain unexplored. We evaluated quadriceps fascicle mechanics during walking 3 years post-ACLR and examined the relationship with knee mechanics. Participants included 24 individuals with ACLR and 24 Controls. Linear mixed models compared the ACLR, Contralateral, and Controls limbs for (1) quadriceps strength, (2) fascicle architecture and mechanics, and (3) knee mechanics. No difference in strength or overall fascicle length excursions was found between limbs. The ACLR limb exhibited longer fascicles at heel strike and peak knee extension moment (P < .001-.004), and smaller fascicle angles at heel strike, peak knee extension moment, and overall suppressed fascicle angle excursions (P < .001-.049) relative to the Contralateral and/or Control limb. This indicates an abnormality in fascicle architecture and mechanics following ACLR and suggests abnormalities in contractile function that cannot be explained by muscle weakness and may contribute to long-term gait irregularities.

Association of skeletal muscle oxidative capacity with muscle function, sarcopenia-related exercise performance, and intramuscular adipose tissue in older adults

Muscle function and exercise performance measures, such as muscle endurance capacity, maximal strength, chair stand score, gait speed, and Timed Up and Go score, are evaluated to diagnose sarcopenia and frailty in older individuals. Furthermore, intramuscular adipose tissue (IntraMAT) content increases with age. Skeletal muscle oxidative capacity determines muscle metabolism and maintains muscle performance. This study aimed to investigate the association of skeletal muscle oxidative capacity with muscle function, exercise performance, and IntraMAT content in older individuals. Thirteen older men and women participated in this study. Skeletal muscle oxidative capacity was assessed by the recovery speed of muscle oxygen saturation after exercise using near-infrared spectroscopy from the medial gastrocnemius. We assessed two muscle functions, peak torque and time to task failure, and four sarcopenia-related exercise performances: handgrip strength, gait speed, 30-s chair stand, and Timed Up and Go. The IntraMAT content was measured using axial magnetic resonance imaging. The results showed a relationship between skeletal muscle oxidative capacity and gait speed but not with muscle functions and other exercise performance measures. Skeletal muscle oxidative capacity was not related to IntraMAT content. Skeletal muscle oxidative capacity, which may be indicative of the capacity of muscle energy production in the mitochondria, is related to locomotive functions but not to other functional parameters or skeletal fat infiltration.

Age-related changes in muscle thickness, echo intensity and shear modulus of the iliocapsularis

PURPOSE

This study aimed to clarify age-related changes in the iliocapsularis (IC) using indicators of quantity, quality, and mechanical properties. We also compared the age-related changes in the IC and other hip muscles.

METHODS

Eighty-seven healthy women (ages: 21-82 years, mean age: 45.9 ± 15.7 years) participated in the experiment. We measured thickness, echo intensity, and shear modulus of the IC, iliacus muscle, rectus femoris, and the thickness and shear modulus of the hip joint capsule. Spearman's rank correlation coefficient was used to measure the association of age with variables measured in the muscles and joint capsule.

RESULTS

Thickness of the iliacus muscle and rectus femoris decreased significantly with age, but the thickness of the IC and hip joint capsule showed no significant correlation. The echo intensities of the IC, iliacus muscle, and rectus femoris were positively correlated, which increased with age. Furthermore, the shear modulus of the iliacus, rectus femoris, and hip joint capsule showed an increase with age, whereas the shear modulus of the IC exhibited no correlation with age.

CONCLUSION

The muscle quality of the IC changed significantly, unlike that of the iliacus or rectus femoris. Additionally, the correlation with echo intensity was relatively weaker in the IC compared with the iliacus or rectus femoris.

Replacing sedentary time for physical activity: Does intensity matter for body composition in oldest-old adults?

To assess the independent and combined relationships among objectively measured sedentary time (ST), light intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA) with muscle mass and fat mass (FM) and how theoretical displacement of these inter-dependent behaviours relates to body composition in oldest-old men. A total of 1046 men participating in the year 14 visit of the prospective Osteoporotic Fractures in Men (MrOS) cohort study with complete data for accelerometry, dual x-ray absorptiometry, and deuterated creatine dilution (D3Cr) muscle mass were included in the analysis (84.0 ± 3.8 yrs.). Single, partition, and isotemporal substitution models were used to assess the interrelationships between PA intensities and ST with body composition measures, while controlling for relevant confounders. Replacing 30-min of ST with 30-min of MVPA was associated with lower FM (β =-0.17, p < 0.001) and higher D3Cr muscle mass, although this was of borderline significance (β = 0.07, p = 0.05). Replacing 30-min of ST for LPA was associated with lower FM (β =-0.15, p < 0.001), but there was no effect on D3Cr muscle mass (p > 0.05). Exchanging ST with any intensity of PA is associated with benefits for FM in oldest-old adult men, although substitution with MVPA may be more beneficial than LPA for maintaining/improving skeletal muscle mass.

The combined deleterious effects of multiple sclerosis and ageing on neuromuscular function

BACKGROUND

The prevalence of older (>60 years) people with multiple sclerosis (pwMS) is increasing. This introduces numerous challenges, as both MS and ageing independently contribute to the deterioration of neuromuscular function.

AIM

The aim was to compare the neuromuscular function in pwMS and healthy controls (HC) across three age groups: young, middle-aged, and old.

METHODS

Using a cross-sectional study design, the maximal muscle strength (Fmax) and rate of force development (RFD) of the knee extensors (KE) and plantar flexors (PF) were assessed using an isokinetic dynamometer. In addition, voluntary activation (VA) and resting twitch (RT) were measured using the interpolated twitch technique.

RESULTS

The Fmax, RFD, and VA of the KE were reduced in pwMS compared to HC across age groups. In pwMS, reductions were observed in PF Fmax, RFD, and RT, predominantly in the middle-aged and old age groups. Reductions increased with age in KE for both groups (except for VA) but in PF only for pwMS. The "trajectory" differed between pwMS and HC, as pwMS showed reductions from young to middle age, while HC showed reductions from middle to old age in KE.

CONCLUSION

The combined negative effects of MS and ageing on neuromuscular function were especially present in the PF but also substantial in the KE. RFD showed large deficits for pwMS compared to HC across age groups. The findings can partly be explained by a reduction in VA and RT, but further investigations of neural regulation are needed to explain large RFD deficits.

The effects of creatine supplementation on cognitive performance-a randomised controlled study

BACKGROUND

Creatine is an organic compound that facilitates the recycling of energy-providing adenosine triphosphate (ATP) in muscle and brain tissue. It is a safe, well-studied supplement for strength training. Previous studies have shown that supplementation increases brain creatine levels, which might increase cognitive performance. The results of studies that have tested cognitive performance differ greatly, possibly due to different populations, supplementation regimens, and cognitive tasks. This is the largest study on the effect of creatine supplementation on cognitive performance to date.

METHODS

Our trial was preregistered, cross-over, double-blind, placebo-controlled, and randomised, with daily supplementation of 5 g for 6 weeks each. We tested participants on Raven's Advanced Progressive Matrices (RAPM) and on the Backward Digit Span (BDS). In addition, we included eight exploratory cognitive tests. About half of our 123 participants were vegetarians and half were omnivores.

RESULTS

Bayesian evidence supported a small beneficial effect of creatine. The creatine effect bordered significance for BDS (p = 0.064, η2P = 0.029) but not RAPM (p = 0.327, η2P = 0.008). There was no indication that creatine improved the performance of our exploratory cognitive tasks. Side effects were reported significantly more often for creatine than for placebo supplementation (p = 0.002, RR = 4.25). Vegetarians did not benefit more from creatine than omnivores.

CONCLUSIONS

Our study, in combination with the literature, implies that creatine might have a small beneficial effect. Larger studies are needed to confirm or rule out this effect. Given the safety and broad availability of creatine, this is well worth investigating; a small effect could have large benefits when scaled over time and over many people.

TRIAL REGISTRATION

The trial was prospectively registered (drks.de identifier: DRKS00017250, https://osf.io/xpwkc/ ).

Neural and muscular contributions to the age-related loss in power of the knee extensors in men and women

The mechanisms for the loss in limb muscle power in old (60-79 years) and very old (≥80 years) adults and whether the mechanisms differ between men and women are not well-understood. We compared maximal power of the knee extensor muscles between young, old, and very old men and women and identified the neural and muscular factors contributing to the age-related loss of power. 31 young (22.9±3.0 years, 15 women), 83 old (70.4±4.9 years, 39 women), and 16 very old adults (85.8±4.2 years, 9 women) performed maximal isokinetic contractions at 14 different velocities (30-450°/s) to identify peak power. Voluntary activation (VA) and contractile properties were assessed with transcranial magnetic stimulation to the motor cortex and electrical stimulation of the femoral nerve. The age-related loss in power was ~6.5 W·year-1 for men (R2=0.62, p<0.001), which was a greater rate of decline (p=0.002) than the ~4.2 W·year-1 for women (R2=0.77, p<0.001). Contractile properties were the most closely associated variables with power output for both sexes, such as the rate of torque development of the potentiated twitch (men: R2=0.69, p<0.001; women: R2=0.57, p<0.001). VA was weakly associated with power in women (R2=0.13, p=0.012) but not men (p=0.191), whereas neuromuscular activation (EMG amplitude) during the maximal power contraction was not associated with power in men (p=0.347) or women (p=0.106). These data suggest that the age-related loss in power of the knee extensor muscles is due primarily to factors within the muscle for both sexes, although neural factors may play a minor role in older women.

Quantification of Extramyocellular Lipids and Intramuscular Fat from Muscle Echo Intensity in Lower Limb Muscles: A Comparison of Four Ultrasound Devices against Magnetic Resonance Spectroscopy

This study aimed to compare different ultrasound devices with magnetic resonance spectroscopy (MRS) to quantify muscle lipid content from echo intensity (EI). Four different ultrasound devices were used to measure muscle EI and subcutaneous fat thickness in four lower-limb muscles. Intramuscular fat (IMF), intramyocellular (IMCL) and extramyocellular lipids (EMCL) were measured using MRS. Linear regression was used to compare raw and subcutaneous fat thickness-corrected EI values to IMCL, EMCL and IMF. IMCL had a poor correlation with muscle EI (r = 0.17-0.32, NS), while EMCL (r = 0.41-0.84, p < 0.05-p < 0.001) and IMF (r = 0.49-0.84, p < 0.01-p < 0.001) had moderate to strong correlation with raw EI. All relationships were improved when considering the effect of subcutaneous fat thickness on muscle EI measurements. The slopes of the relationships were similar across devices, but there were some differences in the y-intercepts when raw EI values were used. These differences disappeared when subcutaneous fat thickness-corrected EI values were considered, allowing for the creation of generic prediction equations (r = 0.41-0.68, p < 0.001). These equations can be used to quantify IMF and EMCL within lower limb muscles from corrected-EI values in non-obese subjects, regardless of the ultrasound device used.

Association of appendicular extracellular-to-intracellular water ratio with age, muscle strength, and physical activity in 8,018 community-dwelling middle-aged and older adults

BACKGROUND

The appendicular extracellular-to-intracellular water ratio (Ap ECW/ICW) has recently gained attention as a non-invasive measurable marker of muscle quality. However, there is a lack of basic evidence regarding age-related changes, sex differences, contribution to muscle strength independent of skeletal muscle mass (SMM), and potential improvement through physical activity (PA) in Ap ECW/ICW.

METHODS

This cross-sectional study enrolled 8,018 middle-aged and older Japanese individuals (aged 45-75 years). The Ap ECW/ICW and SMM were measured using segmental bioelectrical impedance spectroscopy. Muscle strength was evaluated by measuring the handgrip strength (HGS) with a dynamometer, and the PA level (PAL) was measured with an accelerometer. We performed a linear regression analysis of the associations of the Ap ECW/ICW with age, HGS, and PAL.

RESULTS

The Ap ECW/ICW increased by 0.019 for men and 0.014 for women per 5-year increase in age (p < 0.001), and the age-related increase was greater in men than in women (p for interaction <0.001). The Ap ECW/ICW was more strongly associated with the HGS than with the SMM in both men and women (p < 0.001). PAL showed a significant inverse association with the Ap ECW/ICW in both men and women (p < 0.001).

CONCLUSIONS

Ap ECW/ICW is higher with age, and it varies by sex. The Ap ECW/ICW may reflect muscle strength more than the SMM, suggesting that the Ap ECW/ICW may be improved by PA. The findings from this study may provide a framework for further Ap ECW/ICW research.

Human skeletal muscle-specific atrophy with aging: a comprehensive review

Age-related skeletal muscle atrophy appears to be a muscle group-specific process, yet only a few specific muscles have been investigated and our understanding in this area is limited. This review provides a comprehensive summary of the available information on age-related skeletal muscle atrophy in a muscle-specific manner, nearly half of which comes from the quadriceps. Decline in muscle-specific size over ∼50 yr of aging was determined from 47 cross-sectional studies of 982 young (∼25 yr) and 1,003 old (∼75 yr) individuals and nine muscle groups: elbow extensors (-20%, -0.39%/yr), elbow flexors (-19%, -0.38%/yr), paraspinals (-24%, -0.47%/yr), psoas (-29%, -0.58%/yr), hip adductors (-13%, -0.27%/yr), hamstrings (-19%, -0.39%/yr), quadriceps (-27%, -0.53%/yr), dorsiflexors (-9%, -0.19%/yr), and triceps surae (-14%, -0.28%/yr). Muscle-specific atrophy rate was also determined for each of the subcomponent muscles in the hamstrings, quadriceps, and triceps surae. Of all the muscles included in this review, there was more than a fivefold difference between the least (-6%, -0.13%/yr, soleus) to the most (-33%, -0.66%/yr, rectus femoris) atrophying muscles. Muscle activity level, muscle fiber type, sex, and timeline of the aging process all appeared to have some influence on muscle-specific atrophy. Given the large range of muscle-specific atrophy and the large number of muscles that have not been investigated, more muscle-specific information could expand our understanding of functional deficits that develop with aging and help guide muscle-specific interventions to improve the quality of life of aging women and men.

Serum Adiponectin and Leptin Is Not Related to Skeletal Muscle Morphology and Function in Young Women

Adipokines secreted from adipose tissue, such as adiponectin and leptin, enhance skeletal muscle metabolism. Animal studies have shown that adipokine knockout leads to a reduction in muscle function. Muscle function is determined by muscle size and quality; therefore, it is speculated that lower adipokine levels affect skeletal muscle size and quality, eventually leading to lower muscle function. This study aimed to investigate the relationship between adipokines and skeletal muscle morphology and function in young individuals. A total of 21 young women participated in this study. Adiponectin and leptin levels were analyzed using fasting blood samples from all participants. B-mode ultrasound images of the thigh and calf were obtained, and the muscle thickness and echo intensity were measured in the vastus lateralis (VL) and medial gastrocnemius (MG). The shear modulus was measured from the VL and MG using shear wave elastography. Knee extension and plantar flexion peak torques were measured as muscle functions. Adiponectin and leptin were not related to echo intensity, shear modulus, and muscle thickness in the VL and MG (r_s = -0.26-0.37, P > .05). Furthermore, no relationship was observed between adiponectin, leptin, knee extension, and dorsiflexion peak torque (r_s = -0.28-0.41, P > .05). These negative results suggest that adiponectin and leptin levels in young women are not associated with muscle size and quality, nor are they related to muscle function.

Passive muscle stiffness is correlated with the intramuscular adipose tissue in young individuals

PURPOSE

We investigated the relationship between intramuscular adipose tissue (IntraMAT) and muscle stiffness (passive and mechanical) and lengthening in young individuals, hypothesizing that (1) passive muscle stiffness is negatively correlated with the IntraMAT content, and (2) the IntraMAT content is negatively correlated with mechanical changes in muscle stiffness and fascicle length during passive dorsiflexion.

METHODS

Twenty men and women (20.3 ± 1.3 years) participated in this study. Axial T1-weighted magnetic resonance imaging was performed at the thickest point of the medial gastrocnemius (MG) to measure the IntraMAT cross-sectional area (CSA) and muscle tissue CSA (units; cm²). The shear wave velocity (SWV) and fascicle length at the three ankle joint angles, namely 15° with plantarflexion (PF15), 0° with neutral position (NP), and 15° with dorsiflexion (DF15), were measured as parameters of muscle stiffness (unit; m/s) and lengthening (unit; cm) using ultrasound shear wave elastography and B-mode imaging. We further calculated the changes in SWV and fascicle length from PF15 to NP and from NP to DF15 as mechanical muscle stiffness and lengthening, respectively.

RESULTS

There was a relationship between IntraMAT CSA and absolute SWV at DF15 (r = - 0.47, P < 0.05). Further, a relationship was observed between IntraMAT CSA and change in SWV and fascicle length from NP to DF15 (r = - 0.47 and r = 0.59, P < 0.05); whereas no relationship was observed between changes in fascicle length and muscle SWV (r = - 0.23, P = 0.33).

CONCLUSION

These results may indicate biomechanical and/or physiological associations between IntraMAT CSA and passive muscle stiffness.

Single muscle fibre contractile function with ageing

Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas for future research. Surprisingly, most studies observe that the size and contractile function of fibres expressing slow myosin heavy chain (MHC) I are well-preserved with ageing. In contrast, there are profound age-related decrements in the size and contractile function of the fibres expressing the MHC II isoforms. Notably, lifelong aerobic exercise training is unable to prevent most of the decrements in fast fibre contractile function, which have been implicated as a primary mechanism for the age-related loss in whole-muscle power output. These findings reveal a critical need to investigate the effectiveness of other nutritional, pharmaceutical or exercise strategies, such as lifelong resistance training, to preserve fast fibre size and function with ageing. Moreover, integrating single fibre contractile mechanics with the molecular profile and other parameters important to contractile function (e.g. phosphorylation of regulatory proteins, innervation status, mitochondrial function, fibre economy) is necessary to comprehensively understand the ageing skeletal muscle phenotype.

Organotypic cultures as aging associated disease models

Aging remains a primary risk factor for a host of diseases, including leading causes of death. Aging and associated diseases are inherently multifactorial, with numerous contributing factors and phenotypes at the molecular, cellular, tissue, and organismal scales. Despite the complexity of aging phenomena, models currently used in aging research possess limitations. Frequently used in vivo models often have important physiological differences, age at different rates, or are genetically engineered to match late disease phenotypes rather than early causes. Conversely, routinely used in vitro models lack the complex tissue-scale and systemic cues that are disrupted in aging. To fill in gaps between in vivo and traditional in vitro models, researchers have increasingly been turning to organotypic models, which provide increased physiological relevance with the accessibility and control of in vitro context. While powerful tools, the development of these models is a field of its own, and many aging researchers may be unaware of recent progress in organotypic models, or hesitant to include these models in their own work. In this review, we describe recent progress in tissue engineering applied to organotypic models, highlighting examples explicitly linked to aging and associated disease, as well as examples of models that are relevant to aging. We specifically highlight progress made in skin, gut, and skeletal muscle, and describe how recently demonstrated models have been used for aging studies or similar phenotypes. Throughout, this review emphasizes the accessibility of these models and aims to provide a resource for researchers seeking to leverage these powerful tools.

Combined fibre atrophy and decreased muscle regeneration capacity driven by mitochondrial DNA alterations underlie the development of sarcopenia

BACKGROUND

Mitochondrial dysfunction caused by mitochondrial (mtDNA) deletions have been associated with skeletal muscle atrophy and myofibre loss. However, whether such defects occurring in myofibres cause sarcopenia is unclear. Also, the contribution of mtDNA alterations in muscle stem cells (MuSCs) to sarcopenia remains to be investigated.

METHODS

We expressed a dominant-negative variant of the mitochondrial helicase, which induces mtDNA alterations, specifically in differentiated myofibres (K320E^skm mice) and MuSCs (K320E^msc mice), respectively, and investigated their impact on muscle structure and function by immunohistochemistry, analysis of mtDNA and respiratory chain content, muscle transcriptome and functional tests.

RESULTS

K320E^skm mice at 24 months of age had higher levels of mtDNA deletions compared with controls in soleus (SOL, 0.07673% vs. 0.00015%, P = 0.0167), extensor digitorum longus (EDL, 0.0649 vs. 0.000925, P = 0.0015) and gastrocnemius (GAS, 0.09353 vs. 0.000425, P = 0.0004). K320E^skm mice revealed a progressive increase in the proportion of cytochrome c oxidase deficient (COX^- ) fibres in skeletal muscle cross sections, reaching a maximum of 3.03%, 4.36%, 13.58%, and 17.08% in EDL, SOL, tibialis anterior (TA) and GAS, respectively. However, mice did not show accelerated loss of muscle mass, muscle strength or physical performance. Histological analyses revealed ragged red fibres but also stimulated regeneration, indicating activation of MuSCs. RNAseq demonstrated enhanced expression of genes associated with protein synthesis, but also degradation, as well as muscle fibre differentiation and cell proliferation. In contrast, 7 days after destruction by cardiotoxin, regenerating TA of K320E^msc mice showed 30% of COX^- fibres. Notably, regenerated muscle showed dystrophic changes, increased fibrosis (2.5% vs. 1.6%, P = 0.0003), increased abundance of fat cells (2.76% vs. 0.23%, P = 0.0144) and reduced muscle mass (regenerated TA: 40.0 mg vs. 60.2 mg, P = 0.0171). In contrast to muscles from K320E^skm mice, freshly isolated MuSCs from aged K320E^msc mice were completely devoid of mtDNA alterations. However, after passaging, mtDNA copy number as well as respiratory chain subunits and p62 levels gradually decreased.

CONCLUSIONS

Taken together, accumulation of large-scale mtDNA alterations in myofibres alone is not sufficient to cause sarcopenia. Expression of K320E-Twinkle is tolerated in quiescent MuSCs, but progressively leads to mtDNA and respiratory chain depletion upon activation, in vivo and in vitro, possibly caused by an increased mitochondrial removal. Altogether, our results suggest that the accumulation of mtDNA alterations in myofibres activates regeneration during aging, which leads to sarcopenia if such alterations have expanded in MuSCs as well.

Muscle quality indices separately associate with joint-level power-related measures of the knee extensors in older males

PURPOSE

The purpose of this study was to investigate associations of muscle quality indices with joint-level power-related measures in the knee extensors of thirty-two older males (65-88 years).

METHODS

Muscle quality indices included: echo intensity, ratio of intracellular- to total water content (ICW/TW), and specific muscle strength. Echo intensity was acquired from the rectus femoris (EI_RF) and vastus lateralis (EI_VL) by ultrasonography. ICW/TW was computed from electrical resistance of the right thigh obtained by bioelectrical impedance spectroscopy. Specific muscle strength was determined as the normalized maximal voluntary isometric knee extension (MVIC) torque to estimated knee extensor volume. Isotonic maximal effort knee extensions with a load set to 20% MVIC torque were performed to obtain the knee extension power-related measures (peak power, rate of power development [RPD], and rate of velocity development [RVD]). Power and RPD were normalized to MVIC.

RESULTS

There were no significant correlations between muscle quality indices except between EI_RF and EI_VL (|r|≤ 0.253, P ≥ 0.162). EI_RF was negatively correlated with normalized RPD and RVD (r ≤  - 0.361, P ≤ 0.050). ICW/TW was positively correlated with normalized peak power (r = 0.421, P = 0.020). Specific muscle strength was positively correlated with absolute peak power and RPD (r ≥ 0.452, P ≤ 0.012).

CONCLUSION

Knee extension power-related measures were lower in participants with higher EI, lower ICW/TW, and lower specific muscle strength, but the muscle quality indices may be determined by independent physiological characteristics.

Association of muscle mass and quality with hand grip strength in elderly patients with heart failure

In patients with heart failure, it is unknown whether the extracellular water (ECW)/intracellular water (ICW) ratio is associated with muscle strength, and thus, it is not well understood whether poor muscle quality contributes to muscular weakness. This study examined the relationship among hand grip strength, skeletal muscle mass index (SMI), and upper limb ECW/ICW ratio in patients with heart failure. This study followed a cross-sectional design. Demographic data, medical information, and hand grip strength were collected. The SMI and ECW/ICW ratio were measured using bio-impedance analysis (BIA). Hierarchical multiple regression analysis was conducted to identify factors associated with hand grip strength. 51 patients with heart failure were analyzed for this study (mean age 84.58 ± 7.18). Hierarchical multiple regression analysis identified SMI as well as upper limb ECW/ICW ratio as factors associated with hand grip strength, independent of age, sex, body mass index, and Life Space Assessment scores. Standardized partial regression coefficients representing the magnitude of involvement of each independent variable were 0.33 and - 0.16. The coefficient of determination adjusted for degrees of freedom (R²), representing the contribution rate of the regression equation, was 0.830. We revealed that loss of hand grip strength in patients with heart failure is associated with not only with a decrease in skeletal muscle mass, but also with a decline in muscle quality, characterized by an increased upper limb ECW/ICW ratio. BIA is a simple and useful method to measure the ECW/ICW ratio, and in turn, the muscle quality, in patients with heart failure.

Muscle weakness is associated with non-contractile muscle tissue of the vastus medialis muscle in knee osteoarthritis

BACKGROUND

Quadriceps weakness is assumed to be associated with compositional properties of the vastus medialis muscle in patients with knee osteoarthritis (OA).

METHODS

The aim was to determine the association of non-contractile muscle tissue in the vastus medialis muscle, measured with routine MRI, with muscle extensor strength in patients with knee OA. Sagittal T1-weighted 3T MRI of 94 patients with knee OA, routinely acquired in clinical practice were used for analysis. Using the MRI's, the amount of non-contractile muscle tissue in the vastus medialis muscle was measured, expressed as a percentage of (non)-contractile tissue, dichotomized into a low and a high non-contractile percentage group. Muscle strength was assessed by isokinetic measurement of knee extensors and by conduction of the Get-Up and Go (GUG) test. In regression analyses, associations of percentage of non-contractile muscle tissue with muscle strength and GUG time were determined and controlled for sex, age, BMI and radiographic severity.

RESULTS

A high percentage of non-contractile muscle tissue (> 11.2%) was associated with lower muscle strength (B = -0.25, P = 0.006) and with longer GUG time (B = 1.09, P = 0.021). These associations were specifically confounded by sex and BMI, because these two variables decreased the regression coefficient (B) with > 10%.

CONCLUSIONS

A high percentage of non-contractile muscle tissue in the vastus medialis muscle measured by clinical T1-weighted 3T MRI is associated with muscle weakness. The association is confounded by sex and BMI. Non-contractile muscle tissue seems to be an important compositional property of the vastus medialis muscle underlying quadriceps weakness.

Metabolomics as an Important Tool for Determining the Mechanisms of Human Skeletal Muscle Deconditioning

Muscle deconditioning impairs both locomotor function and metabolic health, and is associated with reduced quality life and increased mortality rates. Despite an appreciation of the existence of phenomena such as muscle anabolic resistance, mitophagy, and insulin resistance with age and disease in humans, little is known about the mechanisms responsible for these negative traits. With the complexities surrounding these unknowns and the lack of progress to date in development of effective interventions, there is a need for alternative approaches. Metabolomics is the study of the full array of metabolites within cells or tissues, which collectively constitute the metabolome. As metabolomics allows for the assessment of the cellular metabolic state in response to physiological stimuli, any chronic change in the metabolome is likely to reflect adaptation in the physiological phenotype of an organism. This, therefore, provides a holistic and unbiased approach that could be applied to potentially uncover important novel facets in the pathophysiology of muscle decline in ageing and disease, as well as identifying prognostic markers of those at risk of decline. This review will aim to highlight the current knowledge and potential impact of metabolomics in the study of muscle mass loss and deconditioning in humans and will highlight key areas for future research.

Intramuscular fat in gluteus maximus for different levels of physical activity

We aimed to determine if gluteus maximus (GMAX) fat infiltration is associated with different levels of physical activity. Identifying and quantifying differences in the intramuscular fat content of GMAX in subjects with different levels of physical activity can provide a new tool to evaluate hip muscles health. This was a cross-sectional study involving seventy subjects that underwent Dixon MRI of the pelvis. The individuals were divided into four groups by levels of physical activity, from low to high: inactive patients due to hip pain; and low, medium and high physical activity groups of healthy subjects (HS) based on hours of exercise per week. We estimated the GMAX intramuscular fat content for each subject using automated measurements of fat fraction (FF) from Dixon images. The GMAX volume and lean volume were also measured and normalized by lean body mass. The effects of body mass index (BMI) and age were included in the statistical analysis. The patient group had a significantly higher FF than the three groups of HS (median values of 26.2%, 17.8%, 16.7% and 13.7% respectively, p < 0.001). The normalized lean volume was significantly larger in the high activity group compared to all the other groups (p < 0.001, p = 0.002 and p = 0.02). Employing a hierarchical linear regression analysis, we found that hip pain, low physical activity, female gender and high BMI were statistically significant predictors of increased GMAX fat infiltration.

Relationship between physical activity time and intramuscular adipose tissue content of the thigh muscle groups of younger and older men

We investigated the effect of physical activity on muscle tissue size and intramuscular adipose tissue (IntraMAT) content in the thigh muscle groups of younger and older men. Twenty younger and 20 older men participated in this study. The muscle tissue cross-sectional area (CSA) and the IntraMAT content in the quadriceps femoris (QF), hamstrings (HM), hip adductors (AD), and mid-thigh total were measured using magnetic resonance imaging. The physical activity time was measured using a triaxial accelerometer, and four levels of physical activity were determined depending on the metabolic equivalent of task (METs), including sedentary (≤ 1.5 METs), light intensity (≤ 2.9 METs), moderate intensity (3.0–5.9 METs), and vigorous intensity (≥ 6.0 METs). No significant correlation was observed between the physical activity parameters and muscle tissue CSA in both groups. The IntraMAT content of the three muscle groups (QF, AD, and HM) and the total thigh was inversely correlated with the time of moderate-intensity physical activity (r_s =  − 0.625 to − 0.489, P < 0.05, for all comparisons) in the young group, but not in the older group. These results indicate that IntraMAT accumulation was associated with the amount of moderate-physical activity in younger men.

The Science of Frailty: Sex Differences

Frailty is an important clinical syndrome of age-related decline in physiologic reserve and increased vulnerability. In older adults, frailty leads to progressive multisystem decline and increased adverse clinical outcomes. The pathophysiology of frailty is hypothesized to be driven by dysregulation of neuroendocrine, inflammatory, and metabolic pathways. Sex-specific differences in the prevalence of frailty have been observed. Treatment interventions of geriatric care can be applied to the care of frail older women with these differences in mind. As additional evidence regarding sex-specific differences in frailty emerges, research efforts should encompass the development of screening tools and therapeutic interventions that optimize outcomes.

Estimating thigh skeletal muscle volume using multi-frequency segmental-bioelectrical impedance analysis

Background

The primary aim of this study was to investigate whether using the extracellular water/intracellular water (ECW/ICW) index and phase angle combined with segmental-bioimpedance analysis (BIA) improved the model fitting of skeletal muscle volume (SMV) estimation. The secondary aim was to compare the accuracy of segmental-BIA with that of ultrasound for estimating the quadriceps SMV measured with MRI.

Methods

Seventeen young men (mean age, 23.8 ± 3.3 years) participated in the study. The T-1 weighted images of thigh muscles were obtained using a 1.5 T magnetic resonance imaging (MRI) scanner. Thigh and quadriceps SMVs were calculated as the sum of the products of anatomical cross-sectional area and slice thickness of 6 mm across all slices. Segmental-BIA was applied to the thigh region, and data on the 50-kHz bioelectrical impedance (BI) index, ICW index, ECW/ICW index, and phase angle were obtained. The muscle thickness index was calculated as the product of the mid-thigh muscle thickness, determined using ultrasound, and thigh length. The standard error of estimate (SEE) of the regression equation was calculated to determine the model fitting of SMV estimation and converted to %SEE by dividing the SEE values by the mean SMV.

Results

Multiple regression analysis indicated that the combination of 50-kHz BI and the ECW/ICW index or phase angle was a significant predictor when estimating thigh SMV (SEE = 7.9 and 8.1%, respectively), but were lower than the simple linear regression (SEE = 9.4%). The ICW index alone improved the model fitting for the estimation equation (SEE = 7.6%). The model fitting of the quadriceps SMV with the 50-kHz BI or ICW index was similar to that with the skeletal muscle thickness index measured using ultrasound (SEE = 10.8, 9.6 and 9.7%, respectively).

Conclusions

Combining the traditionally used 50-kHz BI index with the ECW/ICW index and phase angle can improve the model fitting of estimated SMV measured with MRI. We also showed that the model suitability of SMV estimation using segmental-BIA was equivalent to that on using ultrasound. These data indicate that segmental-BIA may be a useful and cost-effective alternative to the gold standard MRI for estimating SMV.

Brown adipose tissue fat-fraction is associated with skeletal muscle adiposity

PURPOSE

While brown adipose tissue (BAT) activity is known to be associated with both muscle and adipose tissue volumes, the association between BAT and muscle composition remains unclear, especially in adults. Therefore, the present study aimed to examine the association between BAT parameters (glucose uptake and fat-fraction) and muscle volumes and intramuscular adipose tissue contents among healthy young and middle-aged men.

METHODS

BAT glucose uptake was determined using positron emission tomography with [¹⁸F]-2-deoxy-2-fluoro-D-glucose (¹⁸F-FDG) during cold exposure in 19 young and middle-aged men (36.3 ± 10.7 years). The fat-fraction of BAT was determined from volumes of interest set in cervical and supraclavicular adipose tissue depots using signal fat-fraction maps via magnetic resonance imaging (MRI). Muscle volumes and intramuscular adipose tissue contents of m. tibialis anterior and m. multifidus lumborum were measured using MRI.

RESULTS

The fat-fraction of BAT was significantly associated with intramuscular adipose tissue content in m. tibialis anterior (n = 13, r_s = 0.691, P = 0.009). A similar trend was also observed in m. multifidus lumborum (n = 19, r_s = 0.454, P = 0.051). However, BAT glucose uptake was not associated with intramuscular adipose tissue contents in both muscles, nor were muscle volumes associated with the BAT glucose uptake and fat-fraction.

CONCLUSION

The fat-fraction of BAT increases with skeletal muscle adiposity, especially in the lower leg, among healthy young and middle-aged men.

Evaluation of rehabilitation exercise effects by using gradation-based skeletal muscle echo intensity in older individuals: a one-group before-and-after trial study

Background

Higher muscle echo intensity (EI) reflects higher content of fat and/or connective tissue within skeletal muscle, eventually inducing lower muscle strength, physical dysfunction, and metabolic impairment. Continuous exercise decreases muscle EI in older individuals; however, it is not well understood how several months’ rehabilitation exercise affects gradation-based EI. The purpose of this study was to investigate the effects of 6 months of rehabilitation exercise on gradation-based higher and lower EI in older men and women.

Methods

Twenty-seven men and women (7 men, 20 women; age, 75.6 ± 6.4 years; height, 154.3 ± 8.5 cm; weight, 55.8 ± 9.7 kg) participated in this study. This study was a one-group before-and-after trial. They needed long-term care for activities of daily living. They performed rehabilitation exercises consisting of resistance exercises using a hydraulic resistance machine, stretching, and aerobic exercises using a recumbent bicycle once or twice a week for 6 months. B-mode ultrasonographic transverse image was taken from thigh muscles, e.g., rectus femoris, vastus lateralis, and biceps femoris. We calculated gradation-based cross-sectional area (CSA) from thigh muscles by dividing 256 greyscale level to 10 different components levels (e.g., 0–24, 25–49, 50–74, …, 200–224 and 225–249 a.u.).

Results

Lowest EI (e.g., 0–24 a.u.) CSA of thigh muscle was significantly increased after the exercise (0.3 ± 0.3 to 1.0 ± 0.8 cm²; P < 0.05). Middle to higher EI (e.g., 50–74, 75–99, 100–124, 125–149, 150–174, 175–199 and 200–224 a.u.) CSAs were significantly decreased from 23.0 to 68.7% after the exercise (P < 0.05).

Conclusions

Several months’ rehabilitation exercise affected both lower and higher EI in older men and women. This result suggests that rehabilitation exercise changes muscle composition by increasing contractile muscle tissue and decreasing fat and connective tissues.

Resistance Exercise, Aging, Disuse, and Muscle Protein Metabolism

Skeletal muscle is the organ of locomotion, its optimal function is critical for athletic performance, and is also important for health due to its contribution to resting metabolic rate and as a site for glucose uptake and storage. Numerous endogenous and exogenous factors influence muscle mass. Much of what is currently known regarding muscle protein turnover is owed to the development and use of stable isotope tracers. Skeletal muscle mass is determined by the meal- and contraction-induced alterations of muscle protein synthesis and muscle protein breakdown. Increased loading as resistance training is the most potent nonpharmacological strategy by which skeletal muscle mass can be increased. Conversely, aging (sarcopenia) and muscle disuse lead to the development of anabolic resistance and contribute to the loss of skeletal muscle mass. Nascent omics-based technologies have significantly improved our understanding surrounding the regulation of skeletal muscle mass at the gene, transcript, and protein levels. Despite significant advances surrounding the mechanistic intricacies that underpin changes in skeletal muscle mass, these processes are complex, and more work is certainly needed. In this article, we provide an overview of the importance of skeletal muscle, describe the influence that resistance training, aging, and disuse exert on muscle protein turnover and the molecular regulatory processes that contribute to changes in muscle protein abundance. © 2021 American Physiological Society. Compr Physiol 11:2249-2278, 2021.

MRI and muscle imaging for idiopathic inflammatory myopathies

Although idiopathic inflammatory myopathies (IIM) are a heterogeneous group of diseases nearly all patients display muscle inflammation. Originally, muscle biopsy was considered as the gold standard for IIM diagnosis. The development of muscle imaging led to revisiting not only the IIM diagnosis strategy but also the patients' follow-up. Different techniques have been tested or are in development for IIM including positron emission tomography, ultrasound imaging, ultrasound shear wave elastography, though magnetic resonance imaging (MRI) remains the most widely used technique in routine. Whereas guidelines on muscle imaging in myositis are lacking here we reviewed the relevance of muscle imaging for both diagnosis and myositis patients' follow-up. We propose recommendations about when and how to perform MRI on myositis patients, and we describe new techniques that are under development.

Exercise rescues mitochondrial coupling in aged skeletal muscle: a comparison of different modalities in preventing sarcopenia

Skeletal muscle aging is associated with a decline in motor function and loss of muscle mass- a condition known as sarcopenia. The underlying mechanisms that drive this pathology are associated with a failure in energy generation in skeletal muscle, either from age-related decline in mitochondrial function, or from disuse. To an extent, lifelong exercise is efficacious in preserving the energetic properties of skeletal muscle and thus may delay the onset of sarcopenia. This review discusses the cellular and molecular changes in skeletal muscle mitochondria during the aging process and how different exercise modalities work to reverse these changes. A key factor that will be described is the efficiency of mitochondrial coupling—ATP production relative to O₂ uptake in myocytes and how that efficiency is a main driver for age-associated decline in skeletal muscle function. With that, we postulate the most effective exercise modality and protocol for reversing the molecular hallmarks of skeletal muscle aging and staving off sarcopenia. Two other concepts pertinent to mitochondrial efficiency in exercise-trained skeletal muscle will be integrated in this review, including- mitophagy, the removal of dysfunctional mitochondrial via autophagy, as well as the implications of muscle fiber type changes with sarcopenia on mitochondrial function.

Increased total body extracellular-to-intracellular water ratio in community-dwelling elderly women is associated with decreased handgrip strength and gait speed

OBJECTIVE

As the extracellular-to-intracellular water (ECW/ICW) ratio of the thigh is negatively associated with knee extension strength or gait speed in the elderly, an increase in the total body ECW/ICW ratio in the elderly is considered to be related to a decrease in physical function. However, these relationships have not been properly investigated. The aim of this study was to investigate the relationship of handgrip strength and gait speed with the total body ECW/ICW ratio in community-dwelling elderly women.

METHODS

The present study used a cross-sectional design. We enrolled 71 community-dwelling women, ≥65 y of age, who could independently perform activities of daily living. The total body ECW/ICW ratio was measured using bioelectrical impedance analysis. Relationships between the total body ECW/ICW ratio and grip strength and gait speed were assessed using Pearson's correlation coefficient. Additionally, stepwise multiple regression analysis was used to identify the factors that were independently associated with handgrip strength and gait speed. The independent variables considered were the total body ECW/ICW ratio, age, body mass index, number of medications, presence of pain, and a history of certain conditions.

RESULTS

The results indicated that an increased total body ECW/ICW ratio in community-dwelling elderly women was associated with a decreased handgrip strength and gait speed. Furthermore, the total body ECW/ICW ratio was significantly, independently associated with handgrip strength even after adjusting for confounding factors.

CONCLUSION

These findings suggest that the total body ECW/ICW ratio may indicate health conditions in community-dwelling elderly women.

Age-Related Change in Muscle Characteristics and Resistance Training for Older Adults

In older adults, muscle weakness contributes greatly to functional restrictions on daily living activities, increased risk of falls, and adverse physiological changes. It has been suggested that not only muscle mass but also muscular infiltration of noncontractile elements may influence muscular performance such as strength and rapid force production. It is proved that resistance training may provoke substantial increases in muscle size even if it is performed at low intensities in older individuals. Also, recent studies have demonstrated the effectiveness of resistance training on muscle quality such as muscular infiltration of noncontractile elements for older people. This review shows the age-related changes in muscle mass and muscle quality, which were measured by muscle echo intensity on ultrasound images, and low-intensity resistance training effects on muscle volume and muscle quality.

Obesity Associated with Low Lean Mass and Low Bone Density Has Higher Impact on General Health in Middle-Aged and Older Adults

It is believed that the phenomenon of simultaneous changes in body composition could have a higher negative impact on general health. Thus, we aimed to investigate the prevalence of concomitant body composition disturbances and evaluate the association with dietary intake, sedentary behaviour, muscle strength, and performance. This is a cross-sectional study with 218 community-dwelling adults, aged 63 (59–69) years, both sexes (52% female) recruited from the Health Survey of the City of São Paulo. Assessments include appendicular lean mass (LM), fat mass and bone mineral density (BMD) by DXA, grip strength, time spent sitting, and dietary intake. Subjects were clustered into 8 groups: (1) normal, (2) osteopenia (OP), (3) low LM, (4) obesity, (5) OP + low LM, (6) obesity + OP, (7) obesity + low LM, and (8) obesity + OP + low LM. Statistical analyses include ANCOVA, the chi-square test, and linear regression models. 52 (23%) individuals presented obesity associated with another body composition change, with 14 (6%) having the combination of the 3 conditions (obesity + OP + low LM). All groups with obesity showed lower protein intake ( $p\le 0.001$ ); however, those with obesity or obesity + low LM spent more time in a sitting position ( $p=0.002$ ), and the group with obesity + OP + low LM had the lowest grip strength. The combination of obesity with low LM and OP presented the aggravating factor of being associated with lower grip strength. In a context of demographic and nutrition transition, the findings represent a demand for longitudinal investigations.

Muscle architecture, voluntary activation, and low-frequency fatigue do not explain the greater fatigue of older compared with young women during high-velocity contractions

Although high-velocity contractions elicit greater muscle fatigue in older than young adults, the cause of this difference is unclear. We examined the potential roles of resting muscle architecture and baseline contractile properties, as well as changes in voluntary activation and low-frequency fatigue in response to high-velocity knee extensor work. Vastus lateralis muscle architecture was determined in quiescent muscle by ultrasonography in 8 young (23.4±1.8 yrs) and 8 older women (69.6±1.1). Maximal voluntary dynamic (MVDC) and isometric (MVIC), and stimulated (80Hz and 10Hz, 500ms) isometric contractions were performed before and immediately after 120 MVDCs (240°.s-1, one every 2s). Architecture variables did not differ between groups (p≥0.209), but the half-time of torque relaxation (T1/2) was longer in older than young women at baseline (151.9±6.0 vs. 118.8±4.4 ms, respectively, p = 0.001). Older women fatigued more than young (to 33.6±4.7% vs. 55.2±4.2% initial torque, respectively; p = 0.004), with no evidence of voluntary activation failure (ΔMVIC:80Hz torque) in either group (p≥0.317). Low-frequency fatigue (Δ10:80Hz torque) occurred in both groups (p<0.001), as did slowing of T1/2 (p = 0.001), with no differences between groups. Baseline T1/2 was inversely associated with fatigue in older (r2 = 0.584, p = 0.045), but not young women (r2 = 0.147, p = 0.348). These results indicate that differences in muscle architecture, voluntary activation, and low-frequency fatigue do not explain the greater fatigue of older compared with young women during high-velocity contractions. The inverse association between baseline T1/2 and fatigue in older women suggests that factors related to slower muscle contractile properties may be protective against fatigue during fast, repetitive contractions in aging.

Sex differences in motor unit discharge rates at maximal and submaximal levels of force output

This study evaluated potential sex differences in motor unit (MU) behaviour at maximal and submaximal force outputs. Forty-eight participants, 24 females and 24 males, performed isometric dorsiflexion contractions at 20%, 40%, 60%, 80%, and 100% of a maximum voluntary contraction (MVC). Tibialis anterior electromyography was recorded both by surface and intramuscular electrodes. Compared with males, females had a greater MU discharge rate (MUDR) averaged across all submaximal intensities (Δ 0.45 pps, 2.56%). Males exhibited greater increases in MUDR above 40% MVC, surpassing females at 100% MVC (p’s < 0.01). Averaged across all force outputs, females had a greater incidence of doublet and rapid discharges and a greater percentage of MU trains with doublet and rapid (5–10 ms) discharges (Δ 75.55% and 61.48%, respectively; p’s < 0.01). A subset of males (n = 8) and females (n = 8), matched for maximum force output, revealed that females had even greater MUDR (Δ 1.38 pps, 7.47%) and percentage of MU trains with doublet and rapid discharges (Δ 51.62%, 56.68%, respectively; p’s < 0.01) compared with males at each force output, including 100% MVC. Analysis of the subset of strength-matched males and females suggest that sex differences in MU behaviour may be a result of females needing to generate greater neural drive to achieve fused tetanus.

Novelty Females had higher MUDRs and greater percentage of MU trains with doublets across submaximal force outputs (20%–80% MVC). Differences were even greater for a strength matched subset. Differences in motor unit behaviour may arise from musculoskeletal differences, requiring greater neural drive in females.

Changes in Strength, Mobility, and Body Composition Following Self-Selected Exercise in Older Adults

The purpose of this trial was to examine the effects of self-selected exercise intensities plus either whey protein or placebo supplementation on vital signs, body composition, bone mineral density, muscle strength, and mobility in older adults. A total of 101 participants aged 55 years and older (males [n = 34] and females [n = 67]) were evaluated before and after 12 weeks of self-selected, free-weight resistance exercise plus 30 min of self-paced walking three times per week. The participants were randomized into two groups: whey protein (n = 46) or placebo (n = 55). Three-way mixed factorial analyses of variance were used to test for mean differences for each variable. The 12 weeks of self-selected, self-paced exercise intensities improved resting heart rate, fat-free mass, percent body fat, handgrip strength, bench press strength, leg press strength, and all mobility measurements (p < .05) in males and females despite supplementation status. This suggests that additional protein in well-fed healthy older adults does not enhance the benefit of exercise.

Five-year longitudinal changes in thigh muscle mass of septuagenarian men and women assessed with DXA and MRI

Magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA) were used to assess changes in thigh lean mass in septuagenarian men and women during a 5-year longitudinal study. Twenty-four older individuals participated in the study (10 men: 71.6 ± 4.1 years; 14 women: 71.3 ± 3.2 years at baseline). Thigh MRI and whole-body DXA scans were used to estimate changes in thigh lean mass. Both MRI and DXA showed that thigh lean mass was reduced by approximately 5% (P = 0.001) over the 5-year period in both men and women. The percentage loss of muscle mass determined with MRI and DXA showed moderate correlation (R² = 0.466; P < 0.001). Bland–Altman analysis showed that the average change over 5 years of follow-up measured by DXA was only 0.18% greater than MRI, where the limits of agreement between DXA and MRI were ± 10.4%. Baseline thigh lean mass did not predict the percentage loss of thigh lean mass over the 5-year period (R² = 0.003; P = 0.397), but a higher baseline body fat percentage was associated with a larger loss of thigh muscle mass in men (R² = 0.677; P < 0.003) but not in women (R² = 0.073; P < 0.176). In conclusion, (1) DXA and MRI showed a similar percentage loss of muscle mass over a 5-year period in septuagenarian men and women that (2) was independent of baseline muscle mass, but (3) increased with higher baseline body fat percentage in men.

Obesity-associated poor muscle quality: prevalence and association with age, sex, and body mass index

BACKGROUND

Muscle quality (i.e., the expression of muscle function per unit of muscle mass) has been proposed as a clinically-relevant measure to detect individuals at risk of functional incapacity. Individuals with obesity might be at an increased risk of having poor muscle quality. Thus, we aimed to analyze the prevalence of poor muscle quality in obese individuals, to determine associated variables, and to provide normative values for this population.

METHODS

203 individuals with obesity (103 women, age: 18-75 years, body mass index (BMI): 35-64 kg·m^- 2) participated in this cross-sectional study. Their muscle strength (handgrip dynamometry), muscle power (sit-to-stand test) and muscle mass (bioelectrical impedance analysis) were measured, and muscle quality (strength/power to muscle mass ratio) was compared with reference values obtained in young healthy individuals. Muscle quality was individually categorized as normal, low or poor based on specific muscle strength and power (i.e., strength and power per unit of muscle mass, respectively). Sex and age-specific normative values of specific muscle strength and power were computed for the whole cohort.

RESULTS

Age and being a woman were inversely associated with specific muscle strength, with age being also inversely associated with specific muscle power. A small proportion of participants (6%) presented with an impaired (i.e., low/poor) specific muscle power while most of them (96%) had impaired specific muscle strength. Eventually, 84% of the participants were deemed to have poor muscle quality. Being a woman (odds ratio [OR]: 18.09, 95% confidence intervals [CI]: 4.07-80.38), age (OR: 1.06, 95%CI: 1.03-1.10) and BMI (OR: 1.22, 95%CI: 1.07-1.38) were independently associated with a higher risk of poor muscle quality in adjusted analyses.

CONCLUSIONS

These findings show a high prevalence of poor muscle quality among individuals with obesity, with age, sex and BMI being independent predictors.

Age- and Sex-Related Differences in the Maximum Muscle Performance and Rate of Force Development Scaling Factor of Precision Grip Muscles

The aim of this study was to explore the effects of age and sex on the rate of force development scaling factor (RFD-SF) and maximum performance (i.e., maximum grip force [GFMax] and maximum rate of grip force development [RGFDMax]) of precision handgrip muscles. Sixty-four subjects, allocated in four groups according to their age and sex, were asked to hold an instrumented handle with the tip of the digits and perform two tests: maximum voluntary contraction and RFD-SF tests. In the maximum voluntary contraction test, GFMax and RGFDMax were assessed. In the RFD-SF test, the subjects generated quick isometric force pulses to target amplitudes varying between 20% and 100% of their GFMax. The RFD-SF and R2 values were obtained from the linear relationship between the peak values of the force pulses and the corresponding peak values of the rate of force development. Younger adults and males produced higher GFMax and RGFDMax and presented higher R2 and RFD-SF than older adults and females, respectively. No correlations between GFMax and RFD-SF and between RGFDMax and RFD-SF were observed.

Relationship of Physical Function to Single Muscle Fiber Contractility in Older Adults: Effects of Resistance Training With and Without Caloric Restriction

BACKGROUND

Previous studies support beneficial effects of both resistance exercise training (RT) and caloric restriction (CR) on skeletal muscle strength and physical performance. The goal of this study was to determine the effects of adding CR to RT on single-muscle fiber contractility responses to RT in older overweight and obese adults.

METHODS

We analyzed contractile properties in 1,253 single myofiber from muscle biopsies of the vastus lateralis, as well as physical performance and thigh muscle volume, in 31 older (65-80 years), overweight or obese (body mass index = 27-35 kg/m2) men (n = 19) and women (n = 12) who were randomly assigned to a standardized, progressive RT intervention with CR (RT+CR; n = 15) or without CR (RT; n = 16) for 5 months.

RESULTS

Both interventions evoked an increase in force normalized to cross-sectional area (CSA), in type-I and type-II fibers and knee extensor quality. However, these improvements were not different between intervention groups. In the RT group, changes in total thigh fat volume inversely correlated with changes in type-II fiber force (r = -.691; p = .019). Within the RT+CR group, changes in gait speed correlated positively with changes in type-I fiber CSA (r = .561; p = .030). In addition, increases in type-I normalized fiber force were related to decreases in thigh intermuscular fat volume (r = -0.539; p = .038).

CONCLUSION

Single muscle fiber force and knee extensor quality improve with RT and RT+CR; however, CR does not enhance improvements in single muscle fiber contractility or whole muscle in response to RT in older overweight and obese men and women.

CCN1 induces adipogenic differentiation of fibro/adipogenic progenitors in a chronic kidney disease model

Previous studies have shown that sarcopenic obesity is highly prevalent in patients with chronic kidney disease (CKD). Here, the association between CKD and sarcopenic obesity were investigated. The 5/6 nephrectomy was performed to establish CKD in mice. Fluorescence-activated cell sorting (FACS), quantitative real-time PCR, ELISA kits assay, immunohistochemistry, and cell proliferation assay were carried out to investigate the condition of muscle loss and fatty infiltration were in CKD mice and the origin of adipocytes. Muscle atrophy occurred and adipogenic gene expression, Perilipin and FABP4 were markedly increased in the hind limb muscle of CKD mice. Results indicated that fibro/adipogenic progenitors (FAPs) are the precursor of adipocytes in the muscle of CKD mice. Meanwhile, the content of extracellular matrix protein CCN1 was notably increased in serum of CKD patients with sarcopenic obesity which was also found in muscle and serum of CKD mice. CCN1 induced the differentiation of FAPs into adipocytes. These results suggest that CKD mice are susceptible to sarcopenic obesity. CCN1 may be a novel activator of the differentiation of FAPs in CKD muscle.

Physical Exercise in the Oldest Old

Societies are progressively aging, with the oldest old (i.e., those aged >80-85 years) being the most rapidly expanding population segment. However, advanced aging comes at a price, as it is associated with an increased incidence of the so-called age-related conditions, including a greater risk for loss of functional independence. How to combat sarcopenia, frailty, and overall intrinsic capacity decline in the elderly is a major challenge for modern medicine, and exercise appears to be a potential solution. In this article, we first summarize the physiological mechanisms underlying the age-related deterioration in intrinsic capacity, particularly regarding those phenotypes related to functional decline. The main methods available for the physical assessment of the oldest old are then described, and finally the multisystem benefits that exercise (or "exercise mimetics" in those situations in which volitional exercise is not feasible) can provide to this population segment are reviewed. In summary, lifetime physical exercise can help to attenuate the loss of many of the properties affected by aging, especially when the latter is accompanied by an inactive lifestyle and benefits can also be obtained in frail individuals who start exercising at an advanced age. Multicomponent programs combining mainly aerobic and resistance training should be included in the oldest old, particularly during disuse situations such as hospitalization. However, evidence is still needed to support the effectiveness of passive physical strategies including neuromuscular electrical stimulation or vibration for the prevention of disuse-induced negative adaptations in those oldest old people who are unable to do physical exercise. © 2019 American Physiological Society. Compr Physiol 9:1281-1304, 2019.

Higher and Lower Muscle Echo Intensity in Elderly Individuals Is Distinguished by Muscle Size, Physical Performance and Daily Physical Activity

This study was performed to identify factors that discriminate muscle echo intensity (EI) among parameters of body composition, physical function and daily physical activity in elderly individuals. A total of 209 men and women (73.7 ± 2.8 y) were evaluated. EI was measured on ultrasonographic axial thigh muscle images. The participants were categorized into the low, mid and high EI groups. We measured the skeletal muscle mass index (SMI) and physical functions. The high EI group exhibited a significantly lower SMI, slower 5-m walking time and shorter 6-min walking distance than the low EI group and had a shorter moderate-intensity activity time than the mid EI group. As a result of the discriminant analysis, elderly individuals were categorized into EI groups by SMI, daily activity and physical function. The data indicate that morphologic and functional parameters and the daily activity level help to discriminate higher and lower muscle EI.

Advancements in magnetic resonance imaging-based biomarkers for muscular dystrophy

Recent years have seen steady progress in the identification of genetic muscle diseases as well as efforts to develop treatment for these diseases. Consequently, sensitive and objective new methods are required to identify and monitor muscle pathology. Magnetic resonance imaging offers multiple potential biomarkers of disease severity in the muscular dystrophies. This Review uses a pathology-based approach to examine the ways in which MRI and spectroscopy have been used to study muscular dystrophies. Methods that have been used to quantitate intramuscular fat, edema, fiber orientation, metabolism, fibrosis, and vascular perfusion are examined, and this Review describes how MRI can help diagnose these conditions and improve upon existing muscle biomarkers by detecting small increments of disease-related change. Important challenges in the implementation of imaging biomarkers, such as standardization of protocols and validating imaging measurements with respect to clinical outcomes, are also described.

A micromechanical muscle model for determining the impact of motor unit fiber clustering on force transmission in aging skeletal muscle

This study used a micromechanical finite element muscle model to investigate the effects of the redistribution of spatial activation patterns in young and old muscle. The geometry consisted of a bundle of 19 active muscle fibers encased in endomysium sheets, surrounded by passive tissue to model a fascicle. Force was induced by activating combinations of the 19 active muscle fibers. The spacial clustering of muscle fibers modeled in this study showed unbalanced strains suggesting tissue damage at higher strain levels may occur during higher levels of activation and/or during dynamic conditions. These patterns of motor unit remodeling are one of the consequences of motor unit loss and reinnervation associated with aging. The results did not reveal evident quantitative changes in force transmission between old and young adults, but the patterns of stress and strain distribution were affected, suggesting an uneven distribution of the forces may occur within the fascicle that could provide a mechanism for muscle injury in older muscle.

Improved strength prediction combining clinically available measures of skeletal muscle mass and quality

BACKGROUND

Measures of skeletal muscle function decline at a faster rate with ageing than do indices of skeletal muscle mass. These observations have been attributed to age-related changes in muscle quality, another functional determinant separate from skeletal muscle mass. This study tested the hypothesis that improved predictions of skeletal muscle strength can be accomplished by combining clinically available measures of skeletal muscle mass and quality.

METHODS

The participants included 146 healthy adult (age ≥ 18 years, range 18-77 years; X ± SD 47 ± 17 years and body mass index 16.5-51.8 kg/m2 ; 27.7 ± 6.2 kg/m2 ) men (n = 60) and women (n = 86) in whom skeletal muscle mass was estimated as appendicular lean soft tissue (LST) measured by dual-energy X-ray absorptiometry and skeletal muscle quality as bioimpedance analysis-derived phase angle and B-mode-evaluated echogenicity of mid-thigh skeletal muscle. Strength of the right leg and both arms was quantified as knee isokinetic extension and handgrip strength using dynamometers. The statistical significance of adding phase angle or echogenicity to strength prediction multiple regression models that included extremity-specific LST and other covariates (e.g. age and sex) was evaluated to test the study hypothesis.

RESULTS

Right leg LST mass alone was significantly (P < 0.0001) correlated with isokinetic right leg strength (R2  = 0.57). The addition of segmental phase angle measured in the right leg at 50 kHz increased the R2 of this model to 0.66 (P < 0.0001); other phase angle frequencies (5 and 250 kHz) did not contribute significantly to these models. Results were similar for both right and left arm handgrip strength prediction models. Adding age and sex as model covariates increased the R2 values of these models further (e.g. right leg strength model R2 increased to 0.71), but phase angle continued to remain a significant (all P < 0.01) predictor of extremity strength. Similarly, when predicting isokinetic right leg strength, mid-thigh skeletal muscle echogenicity added significantly (P < 0.0001) to right leg LST, increasing R2 from 0.57 to 0.64; age was a significant (P < 0.0001) covariate in this model, increasing R2 further to 0.68.

CONCLUSIONS

The hypothesis of the current study was confirmed, strongly supporting and extending earlier reports by quantifying the combined independent effects of skeletal muscle mass and quality on lower-body and upper-body measures of strength. These observations provide a clinically available method for future research aimed at optimizing sarcopenia and frailty risk prediction models.