Delayed Impairment of Postural, Physical, and Muscular Functions Following Downhill Compared to Level Walking in Older People

Risk factors for the long-term persistent genitourinary toxicity after stereotactic body radiation therapy for localized prostate cancer: A single-center, retrospective study of 306 patients

OBJECTIVES

To identify risk factors for the long-term persistent genitourinary toxicity (GUT) after stereotactic body radiation therapy (SBRT) for localized prostate cancer (PCa).

METHODS

A total of 306 patients who underwent SBRT at our institution between March 2017 and April 2022 were retrospectively evaluated. SBRT was performed at 35 Gy in five fractions over 5 or 10 days. Factors related to the long-term persistence of acute GUT after SBRT were analyzed.

RESULTS

During the median follow-up period of 39.1 months, 203 (66%) patients experienced any grade of acute GUT, which remained in 78 (26%) patients 6 months after SBRT. Multivariate analysis revealed that age ≥75 years was consistently a significant independent risk factor for any grade of acute GUT 6, 12, and 24 months after SBRT (hazard ratio [HR] 2.31, p = 0.010; HR 2.84, p = 0001; and HR 3.05, p = 0.009, respectively). Older age was not a significant risk factor for the development of grade ≥2 acute GUT. The duration of acute GUT was significantly longer in the older group than in the nonolder group (median duration = 234 vs. 61 days, p < 0.001), and the incidence of persistent GUT was significantly more frequent in the older group beyond 6 months after SBRT.

CONCLUSIONS

Older age is a significant independent risk factor for the long-term persistent GUT after SBRT for localized PCa.

The acute and repeated bout effects of multi-joint eccentric exercise on physical function and balance in older adults

PURPOSE

Eccentric muscle actions generate high levels of force at a low metabolic cost, making them a suitable training modality to combat age-related neuromuscular decline. The temporary muscle soreness associated with high intensity eccentric contractions may explain their limited use in clinical exercise prescription, however any discomfort is often alleviated after the initial bout (repeated bout effect). Therefore, the aims of the present study were to examine the acute and repeated bout effects of eccentric contractions on neuromuscular factors associated with the risk of falling in older adults.

METHODS

Balance, functional ability [timed up-and-go and sit-to-stand], and lower-limb maximal and explosive strength were measured in 13 participants (67.6 ± 4.9 year) pre- and post-eccentric exercise (0, 24, 48, and 72 hr) in Bout 1 and 14 days later in Bout 2. The eccentric exercise intervention was performed on an isokinetic unilateral stepper ergometer at 50% of maximal eccentric strength at 18 step‧min-1 per limb for 7 min (126 steps per limb). Two-way repeated measures ANOVAs were conducted to identify any significant effects (P ≤ 0.05).

RESULTS

Eccentric strength significantly decreased (- 13%) in Bout 1 at 24 hr post-exercise; no significant reduction was observed at any other time-point after Bout 1. No significant reductions occurred in static balance or functional ability at any time-point in either bout.

CONCLUSION

Submaximal multi-joint eccentric exercise results in minimal disruption to neuromuscular function associated with falls in older adults after the initial bout.

Recovery from Resistance Exercise in Older Adults: A Systematic Scoping Review

BACKGROUND

Resistance exercise is recommended for maintaining muscle mass and strength in older adults. However, little is known about exercise-induced muscle damage and recovery from resistance exercise in older adults. This may have implications for exercise prescription. This scoping review aimed to identify and provide a broad overview of the available literature, examine how this research has been conducted, and identify current knowledge gaps relating to exercise-induced muscle damage and recovery from resistance exercise in older adults.

METHODS

Studies were included if they included older adults aged 65 years and over, and reported any markers of exercise-induced muscle damage after performing a bout of resistance exercise. The following electronic databases were searched using a combination of MeSH terms and free text: MEDLINE, Scopus, Embase, SPORTDiscus and Web of Science. Additionally, reference lists of identified articles were screened for eligible studies. Data were extracted from eligible studies using a standardised form. Studies were collated and are reported by emergent theme or outcomes.

RESULTS

A total of 10,976 possible articles were identified and 27 original research articles were included. Findings are reported by theme; sex differences in recovery from resistance exercise, symptoms of exercise-induced muscle damage, and biological markers of muscle damage.

CONCLUSIONS

Despite the volume of available data, there is considerable variability in study protocols and inconsistency in findings reported. Across all measures of exercise-induced muscle damage, data in women are lacking when compared to males, and rectifying this discrepancy should be a focus of future studies. Current available data make it challenging to provide clear recommendations to those prescribing resistance exercise for older people.

Newly compiled Tai Chi (Bafa Wubu) promotes lower extremity exercise: a preliminary cross sectional study

Background

Tai Chi (Bafa Wubu) is a new type of simplified Tai Chi widely practiced by Tai Chi enthusiasts that has developed and perfected simplified Tai Chi movement and enriched Tai Chi practice methods. When practicing, Tai Chi athletes and enthusiasts can choose the Bafa Wubu movements to practice according to their physical conditions. The purpose of this article is to discuss the mechanism by which Bafa Wubu promotes lower extremity exercise from the perspective of exercise biomechanics.

Objectives

This article aims to explore the scientific training methods and technical characteristics of Bafa Wubu, and its contribution to comprehensive exercise of the lower extremities, by analyzing the biomechanical characteristics of the lower extremities of participants who practice Bafa Wubu at different levels and by comparing their ground reaction force, lower limb joints, and muscles during Bafa Wubu.

Methods

A total of 16 male participants were recruited and divided into an amateur group (N = 8) and a professional group (N = 8). The data were collected by a BTS 3D infrared-based motion capture system, and Kistler 3D force plate. The lower extremity joint forces and muscle strength were calculated by anybody simulation software with inverse dynamics.

Results

During elbowing and leaning sideways with steps sideways (ELS), the ground reaction force of the professional group was significantly higher than that of the amateur group in the sagittal, vertical, and frontal axes (P < 0.01). While stepping forward, backward, and sideways, the professional group's joints loading at the hip, knee, and ankle was always higher in the vertical direction (P < 0.01). Furthermore, during warding off with steps forward (WOF), laying with steps forward (LF), and rolling back with steps backward (RBB), hip joint loading increased in the med-lat direction. During actions with steps backward and sideways, the professional group's ankle flexion/extension torque and hip abduction/rotation torque were significantly larger than those of the amateur group (P < 0.01). Different actions in Bafa Wubu activate muscles to different degrees, whereas the iliacus is mainly responsible for stabilizing postures when practitioners perform standing knee lifting motions.

Conclusions

Professional groups who have been practicing Tai Chi (Bafa Wubu) for a long time have higher ground reaction force, and the force on the three joints of the lower extremities is different for various movements, which has positive significance for exercising the joints of the lower extremities. In addition, various motions activate muscles of different types at different levels. For amateurs to practice different movements to stimulate the muscles, targeted areas of practice promote the lower extremity muscles' synergistic force. In summary, the muscles and joints of the lower extremity can obtain comprehensive and balanced exercise through Bafa Wubu.

Effectiveness of eccentric-biased exercise interventions in reducing the incidence of falls and improving functional performance in older adults: a systematic review

Aim

To systematically review the literature on the effectiveness of eccentric exercise interventions in reducing falls and improving the functional performance in older adults.

Findings

The existing literature was of mixed quality and suggested that eccentric exercises can be as effective as conventional exercises in improving functional performance in healthy older adults. There was limited evidence focussing on the aspect of incidence of falls.

Message

Eccentric exercises may be as effective as conventional exercises in improving geriatric function, although evidence remains limited. More research is needed to explore any adverse effects of such exercises in older adults.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00571-8.

Background

Exercise has been known to preserve and enhance functional performance in older adults. Eccentric exercise involves muscle contractions characterised by unique features such as lengthening of the muscle–tendon complex by a greater opposing force.

Aims

To systematically review randomised-controlled trials (RCTs) investigating the effectiveness of eccentric exercises in reducing the incidence of falls and improving the functional performance in older adults.

Key methods

We conducted a systematic review of RCTs following the PRISMA-P guidelines. Searches were completed in the Cochrane Central Register of Controlled Trials, Embase, CINAHL, Medline, and Global Health CABI. We included RCTs reporting at least one of the following outcomes—falls, Berg balance scale, timed-up and go test, chair stand test, stair climb test, maximal walking speed, and minute walking distance. Two reviewers screened papers for eligibility and assessed the quality of included papers using the Cochrane Collaborative risk-of-bias tool for randomised trials. Data were extracted by a single reviewer and cross-checked by the second reviewer. A narrative synthesis was undertaken, given the high level of heterogeneity across studies.

Results

Ten studies were assessed as eligible for inclusion in the review. Overall, eccentric exercises were as effective as conventional resistance exercises in improving the selected outcomes by most studies. Additionally, when pre-exercise and post-eccentric exercise functional performance measures were compared, there was a statistically significant improvement in nearly all measures. The quality of trials was mixed (one high, four moderate, two low–moderate, and three low risk of bias).

Conclusions

Our systematic review suggests that eccentric exercises can be as effective as conventional exercises in older adults. Evidence suggests that such exercise interventions can lead to an improvement in geriatric function.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41999-021-00571-8.