Measurement of muscle health in aging

Systematic Evaluation of Isometric Maximal Muscle Strength in an Orthopaedic Cohort

BACKGROUND

Although the lower extremities are essential for movement function and human gait, no normalized isometric maximum strength values, which include the factors gender, age, weight, height, and body mass index (BMI), have been defined to date for orthopaedic patients.

OBJECTIVE

To systematically analyze the isometric maximal muscle strength of a cohort in an orthopaedic outpatient clinic and to evaluate its relation to gender, age, weight, height, BMI, and the differences between diseases.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 4.

METHODS

Isometric maximal muscle strength of knee extension, knee flexion, hip abduction, and hip adduction was measured in orthopaedic patients of an outpatient clinic using a specific muscle strength measurement device. Correlation analysis was performed for age, gender, height, weight, and BMI. Patients were grouped by disease characteristics.

RESULTS

The cohort consisted of 311 subjects (sex: 164 male, 147 female; age: 48.63 years, SD = 16.595; BMI: 26.56 kg/m², SD = 4.9). Age correlated significantly with maximal isometric muscle strength. At the age of 54 years onward, based on 133 patients, a decline in maximum isometric muscle strength was detected. Gender showed a strong influence on maximal isometric muscle strength, with significantly higher values for male patients. Furthermore, weight and height, but not BMI, correlated significantly with muscle strength.

CONCLUSION

For clinical studies comparing different evidence-based training interventions for rehabilitation, it is important to consider determinants such as gender, age, weight, and height for isometric maximum strength measurement. For further validation, follow-up examinations taking into account the performance level, other target groups, and other muscle groups are required to avoid the wide dispersion of isometric maximum strength values. These results and associated determinants are highly clinically relevant and can be used as a reference for further studies in the field of musculoskeletal regeneration.

Lower extremity muscle hypertrophy in response to resistance training in older adults: Systematic review, meta-analysis, and meta-regression of randomized controlled trials

OBJECTIVES

This study aimed to investigate the effects of resistance training (RT) on knee extensor muscle hypertrophy in adults 65 years and older.

METHODS

A systematic search was carried out in PubMed, Embase, and Scopus to review randomized controlled trials that assessed the effects of supervised RT on 1) muscle size, 2) fiber area, and 3) leg lean mass (LLM). Random-effects meta-analyses of standardized mean difference (SMD) and raw mean difference (RMD) for LLM were calculated. We performed a meta-regression to examine the interference of age, training volume, and duration on the results related to hypertrophy at muscle and fiber levels.

RESULTS

Thirty-two studies were included in the review, and 28 were meta-analyzed. The meta-analysis found a significant effect of RT on muscle size (SMD = 0.34; 95 % CI: 0.16-0.52; p < 0.001) and fiber area (SMD = 0.54; 95 % CI: 0.24-0.84; p < 0.001), but not on LLM (RMD = 0.22; 95 % CI: -0.22-0.66 p = 0.321). A subanalysis of studies that assessed quadriceps femoris size (excluding isolated quadriceps femoris muscles from the analysis) also revealed a significant effect of RT (95 % CI: 0.20-0.69; p < 0.001). Regression analysis indicated a significant influence of intervention duration on type II fiber area (p = 0.034), while no significant influence was detected for weekly sets or age for any outcome measure.

CONCLUSIONS

RT promotes muscle hypertrophy in older adults at both whole-muscle and fiber levels, with training duration potentially influencing the response. Measures of leg lean mass may not capture RT-induced adaptation.

Sex-specific poor physical performance in Korean community-dwelling older adults

BACKGROUND

Poor physical performance appears to be different across age and sex. The aim of this study was to examine changes in physical performance across age groups by sex.

METHODS

A cross-sectional study was conducted with 292 community-dwelling older adults (144 males, 148 females; age: 74.7 ± 5.2 years, body mass index: 23.8 ± 2.7 kg/m2). Physical performance tests included (i) strength (handgrip, knee extension, ankle dorsiflexion, ankle plantarflexion, and toe grip), (ii) functional mobility (5 sit-to-stand, 4-m gait speed, and 4-m fast gait speed), and (iii) postural control (timed single-leg stance). Physical performance was compared across four different age groups by sex using ANOVA tests, T-score, and linear regression analysis. All statistical analysis was set at 0.05.

RESULTS

ANOVA showed a significant age effect (p < 0.05) on physical performance measures with only exception for ankle muscle strength. T-score and linear regression analyses revealed sex-specific trends. In males, postural control showed the most significant poor performance, followed by strength. In females, the most notable poor performance was also observed in postural control, followed by functional mobility.

CONCLUSIONS

Most main outcome measures in physical performance worsened over time across age groups while poor performance pattern was different between older males (strength) and females (functional mobility). We highlighted the importance of assessing strength, functional mobility, and postural control in older adults. Based on observed poor performance patterns across age groups by sex, sex-specific interventions should be implemented.

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.

Circulating Amino Acid Concentration after the Consumption of Pea or Whey Proteins in Young and Older Adults Affects Protein Synthesis in C2C12 Myotubes

As older adults tend to reduce their intake of animal-source proteins, plant-source proteins may offer valuable resources for better protein intake. The aim of this study was to assess whether the pea proteins can be used to achieve blood amino acid levels that stimulate muscle protein synthesis. We measured variations in plasma amino acid concentrations in young and older adults given pea (NUTRALYS® S85 Plus) or whey proteins either alone or in a standardized meal. The effect of amino acid concentrations on protein synthesis in C2C12 myotubes was determined. In terms of results, plasma amino acid concentrations reflected the difference between the amino acid contents of whey and pea proteins. Blood leucine showed a greater increase of 91 to 130% with whey protein compared to pea protein, while the opposite was observed for arginine (A greater increase of 147 to 210% with pea compared to whey). Culture media prepared with plasmas from the human study induced age-dependent but not protein-type-dependent changes in myotube protein synthesis. In conclusion, pea and whey proteins have the same qualities in terms of their properties to maintain muscle protein synthesis. Pea proteins can be recommended for older people who do not consume enough animal-source proteins.

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.

Effects of intermittent hypoxia and whole-body vibration training on health-related outcomes in older adults

BACKGROUND

Aging is associated with a health impairment and an increase of the vulnerability of the older people. Strength training under intermittent hypoxic conditions has been shown to have therapeutic effects on individual's health.

AIMS

The aim of this study was to investigate the effects of a combined intermittent hypoxia (IH) and whole-body vibration (WBV) training program on health-related outcomes in older people.

METHODS

A total of 60 adults (over the age of 65) voluntarily participated in an intervention that lasted 20 weeks (three 30-min sessions per week). The participants were divided into four experimental groups subjected to different environmental conditions (IH vs normoxia) and exercise (non-exercise vs WBV). Functional fitness, body composition, metabolic parameters, inflammatory biomarkers, and bone turnover were evaluated before and after the intervention. A multifactorial ANOVA with repeated measures was performed to explore differences within and between groups.

RESULTS

The results showed that IH and WBV had a positive synergistic effect on inflammatory parameters (CRP and IL-10), bone formation biomarker (PINP), and body composition (muscle and bone mass).

CONCLUSION

In conclusion, a combined IH and WVB training could be a useful tool to prevent the deterioration of health-related outcomes associated with aging. Clinical trial registration NCT04281264. https://clinicaltrials.gov/ .

Prevalence and Trends of Weakness Among Middle-Aged and Older Adults in the United States

ABSTRACT

McGrath, R, FitzSimmons, S, Andrew, S, Black, K, Bradley, A, Christensen, BK, Collins, K, Klawitter, L, Kieser, J, Langford, M, Orr, M, and Hackney, KJ. Prevalence and trends of weakness among middle-aged and older adults in the United States. J Strength Cond Res 37(12): 2484-2490, 2023-Muscle weakness, which is often determined with low handgrip strength (HGS), is associated with several adverse health conditions; however, the prevalence and trends of weakness in the United States is not well-understood. We sought to estimate the prevalence and trends of weakness in Americans aged at least 50 years. The total unweighted analytic sample included 22,895 Americans from the 2006-2016 waves of the Health and Retirement Study. Handgrip strength was measured with a handgrip dynamometer. Men with weakness were below at least one of the absolute or normalized (body mass, body mass index) cut points: <35.5 kg, <0.45 kg/kg, <1.05 kg/kg/m 2 . The presence of any weakness in women was also identified as being below one of the absolute or normalized HGS cut points: <20.0 kg, <0.34 kg/kg, or <0.79 kg/kg/m 2 . There was an increasing trend in the prevalence of any weakness over time ( p < 0.001). The prevalence of weakness was 45.1% (95% confidence interval [CI]: 44.0-46.0) in the 2006-2008 waves and 52.6% (CI: 51.5-53.7) in the 2014-2016 waves. Weakness prevalence was higher for older (≥65 years) Americans (64.2%; CI: 62.8-65.5) compared with middle-aged (50-64 years) Americans (42.2%; CI: 40.6-43.8) in the 2014-2016 waves. Moreover, the prevalence of weakness in the 2014-2016 waves was generally higher in women (54.5%; CI: 53.1-55.9) than in men (50.4%; CI: 48.7-52.0). Differences existed in weakness prevalence across races and ethnicities. The findings from our investigation suggest that the prevalence of weakness is overall pronounced and increasing in Americans. Efforts for mitigating and better operationalizing weakness will elevate in importance as our older American population grows.

Age-related change in muscle strength, muscle mass, and fat mass between the dominant and non-dominant upper limbs

Background

Any form of physical activity is recommended for the older adults to maintain their physical function; however, the effect of daily activities on muscle function still needs to be investigated. Humans always use one dominant hand to perform tasks, providing a natural situation for research on the effect of daily activities on muscle function.

Methods

Five hundred and twenty-six healthy adults were recruited from the community in Beijing. Muscle strength was assessed using a handgrip dynamometer, lean mass, fat mass, bone area and bone mineral content of upper limbs were assessed using dual-energy X ray-absorptiometry. The results were compared between the dominant and non-dominant upper limbs.

Results

The dominant upper limb had better muscle strength, lean mass, bone area and bone mineral content than the non-dominant side. The difference in muscle strength and lean mass between the two upper limbs decreased with the advanced age. In older age, fat mass of upper limbs increased in men, but not in women.

Conclusion

Daily activities can maintain better muscle function in the dominant upper limb than in the non-dominant side; however, the delaying effect on age-related decline in muscle function was limited.

A machine learning approach to identify important variables for distinguishing between fallers and non-fallers in older women

Falls are a significant ongoing public health concern for older adults. At present, few studies have concurrently explored the influence of multiple measures when seeking to determine which variables are most predictive of fall risks. As such, this cross-sectional study aimed to identify those functional variables (i.e. balance, gait and clinical measures) and physical characteristics (i.e. strength and body composition) that could best distinguish between older female fallers and non-fallers, using a machine learning approach. Overall, 60 community-dwelling older women (≥65 years), retrospectively classified as fallers (n = 21) or non-fallers (n = 39), attended three data collection sessions. Data (281 variables) collected from tests in five separate domains (balance, gait, clinical measures, strength and body composition) were analysed using random forest (RF) and leave-one-variable-out partial least squares correlation analysis (LOVO PLSCA) to assess variable importance. The strongest discriminators from each domain were then aggregated into a multi-domain dataset, and RF, LOVO PLSCA, and logistic regression models were constructed to identify the important variables in distinguishing between fallers and non-fallers. These models were used to classify participants as either fallers or non-fallers, with their performance evaluated using receiver operating characteristic (ROC) analysis. The study found that it is possible to classify fallers and non-fallers with a high degree of accuracy (e.g. logistic regression: sensitivity = 90%; specificity = 87%; AUC = 0.92; leave-one-out cross-validation accuracy = 63%) using a combination of 18 variables from four domains, with the gait and strength domains being particularly informative for screening programmes aimed at assessing falls risk.

Effect of resistance training and high-intensity interval training on metabolic parameters and serum level of Sirtuin1 in postmenopausal women with metabolic syndrome: a randomized controlled trial

BACKGROUND

The present study analyzes the influence of resistance training (RT) and high-intensity interval training (HIIT) on metabolic indices and serum levels of Sirtuin1 (SIRT1) in postmenopausal women who suffer from the metabolic syndrome (MetS).

METHODS

45 postmenopausal women aged 45-65 years with MetS were divided into two intervention groups (RT and HIIT) and one control group, each consisting of 15 people. The RT group performed resistance training for both the upper and lower body, while the HIIT group completed 3 min(min) of high-intensity training at 80-90% of their maximum heart rate (HRmax), followed by moderate walking for 3 min at 55-65% of HRmax. These sessions were conducted for a duration of eight weeks and three times a week, with the samples being collected at the baseline and at the end of the treatment, i.e., week 8.

RESULTS

The results showed that weight, waist circumference, body mass index, fat mass, low-density lipoprotein, triglyceride, cholesterol, fasting blood sugar (FBS), hemoglobin A1c (HbA1C), systolic and diastolic blood pressure decreased, and SIRT1 increased significantly in both training groups. Systolic blood pressure, cholesterol, HbA1C, and FBS decreased more in the HIIT group. Skeletal muscle mass and 1-repetition maximum (1-RM) increased more in the RT group.

CONCLUSIONS

RT and HIIT serve as one of the most effective strategies for therapeutically treating patients with metabolic syndrome.

TRIAL REGISTRATION

IRCT, IRCT20221120056548N1. Registered 23 November 2022 - Retrospectively registered.

Single slice thigh CT muscle group segmentation with domain adaptation and self-training

Purpose

Thigh muscle group segmentation is important for assessing muscle anatomy, metabolic disease, and aging. Many efforts have been put into quantifying muscle tissues with magnetic resonance (MR) imaging, including manual annotation of individual muscles. However, leveraging publicly available annotations in MR images to achieve muscle group segmentation on single-slice computed tomography (CT) thigh images is challenging.

Approach

We propose an unsupervised domain adaptation pipeline with self-training to transfer labels from three-dimensional MR to single CT slices. First, we transform the image appearance from MR to CT with CycleGAN and feed the synthesized CT images to a segmenter simultaneously. Single CT slices are divided into hard and easy cohorts based on the entropy of pseudo-labels predicted by the segmenter. After refining easy cohort pseudo-labels based on anatomical assumption, self-training with easy and hard splits is applied to fine-tune the segmenter.

Results

On 152 withheld single CT thigh images, the proposed pipeline achieved a mean Dice of 0.888 (0.041) across all muscle groups, including gracilis, hamstrings, quadriceps femoris, and sartorius muscle.

Conclusions

To our best knowledge, this is the first pipeline to achieve domain adaptation from MR to CT for thigh images. The proposed pipeline effectively and robustly extracts muscle groups on two-dimensional single-slice CT thigh images. The container is available for public use in GitHub repository available at: https://github.com/MASILab/DA_CT_muscle_seg.

Determinants of handgrip strength at age 2 years in children born moderate and late preterm and associations with neurodevelopmental outcomes

BACKGROUND

Handgrip strength (HGS) indicates current and future health. Although preterm infants have an increased risk of poor grip strength in later life, its determinants and relationship with neurodevelopment are not well understood.

AIMS

To determine HGS in children born preterm and explore the relationship of HGS with demography, anthropometry, nutritional factors, and neurodevelopmental outcomes.

STUDY DESIGN

A prospective cohort study of moderate-late preterm babies enrolled in a randomised trial of nutritional support strategies, the DIAMOND trial.

SUBJECTS

A total of 116 children born between 32 and 35 weeks' gestation, whose HGS was measured at 2 years' corrected age.

OUTCOME MEASURES

HGS was measured using a dynamometer, and neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Anthropometry and body composition were assessed at birth, discharge, and at 4 months' and 2 years' corrected age. Information on demographics and breastfeeding practices, including type of milk at discharge and duration of exclusive breastfeeding, was collected using questionnaires.

RESULTS

The mean (standard deviation) HGS was 2.26 (1.07) kg. The Bayley scores were < 85 (-1 standard deviation) in 6 %, 20 %, and 1 % for the cognitive, language, and motor scales, respectively. Multiple regression analysis revealed that HGS was positively associated with language and motor scores (p < .05) after adjusting for confounding factors. HGS was not associated with sex, anthropometry, body composition, or breastfeeding practices. Maternal education was independently associated with HGS (p < .01).

CONCLUSIONS

HGS at age 2 years in children born moderate-late preterm is associated with language and motor development and maternal education level.

Multicompartment body composition analysis in older adults: a cross-sectional study

BACKGROUND

During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes.

METHODS

This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable.

RESULTS

An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R²_adj: 0.83 and SEE: 3.16; BMC: R²_adj: 0.61 and SEE: 0.30; ALST: R²_adj: 0.85 and SEE: 1.65).

CONCLUSION

The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use.

Advanced glycation end products in skeletal muscle health and sarcopenia: A systematic review of observational studies

BACKGROUND

Advanced glycation end products (AGEs) and AGEs receptor (RAGE) may play a role in sarcopenia. This systematic review evaluated the associations between AGEs measured in tissues (skin) by autofluorescence (SAF) and/or circulation (blood, urine) and muscle health outcomes (strength, mass, function) and sarcopenia in observational studies.

METHODS

MEDLINE, Embase, Scopus and Web of Science were searched for studies reporting associations between AGEs and muscle-related outcomes in community-dwelling adults aged ≥ 30 years (until March 2022).

RESULTS

Fourteen cross-sectional and one prospective study were included in the narrative summary. SAF was negatively associated with muscle strength, mass, and physical functioning in adults aged ≥ 30 years (four studies), and muscle mass (three studies), strength, and sarcopenia (one study) in adults aged ≥ 65 years. Circulating AGEs were negatively associated with muscle strength and physical functioning (four studies) and predicted the risk of walking disability (one prospective study), and sarcopenia (one study) in older adults. The role of RAGE in muscle health was inconclusive.

CONCLUSIONS

SAF and circulating AGEs were negatively associated with muscle-related outcomes in adults aged ≥ 30 years in cross-sectional studies. This finding should be confirmed in well-designed prospective studies investigating sarcopenia, as AGEs represent a potentially modifiable target for intervention.

Age-related differences of vastus lateralis muscle morphology, contractile properties, upper body grip strength and lower extremity functional capability in healthy adults aged 18 to 70 years

Background

There is a lack of of cross-sectional research that has investigated muscle morphology, function, and functional capability in all age-bands of healthy adults. The primary aim of this study was to evaluate age-related differences in indices of vastus lateralis (VL) muscle morphology, function and functional capability in a sample of healthy males and females aged 18-70yrs. Secondary aims were to evaluate relationships between age and VL muscle morphology and function and functional capability.

Methods

B mode Ultrasonography and Tensiomyography were used to measure VL muscle thickness, pennation angle, fascicle length, and contractile properties in 274 healthy adults aged 18-70yrs. Measurements of grip strength and functional capability (1-min chair rise test) were also taken. Data analysis included descriptive statistics, correlations, one-way ANOVAs, and multiple regressions.

Results

Negative correlations were found between age and muscle thickness (r_s = -.56), pennation angle (r_s = -.50), fascicle length (r_s = -.30), maximal displacement (r_s = -.24), grip strength (r_s = -.27) and the 1-min chair rise test (r_s = -.32). Positive correlations were observed between age and the echo intensity of the muscle (r_s = .40) and total contraction time (r_s = .20). Differences in the indices of muscle health were noticeable between the 18–29 age band and the 50–59 and 60–70 age bands (p < 0.05). The interaction of age and level of physical activity predicted changes in the variables (r² = .04—.32).

Conclusion

Age-related differences in muscle health are noticeable at 50 years of age, and age-related differences are larger in females compared to males. It was suggested that the thickness of the VL changed the most with age across the adult lifespan and that physical activity likely acts to abate detrimental change.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03183-4.

Lower extremity muscle strength reference values for young Saudi male adults aged 21 to 23 years and their correlation with anthropometric parameters and balance

Normative reference values for muscle strength are needed for muscle strength assessment and estimation of prognosis in lower extremity related neuromuscular disorders, as muscle strength influenced by anthropometric parameters and muscle strength itself affects balance. Normative reference values for muscle strength in the Saudi Arabian population is lacking in the literature. Hence, the current study aimed to establish normative reference values for lower extremity muscle strength and to correlate these values with anthropometric parameters and balance. Lower extremity muscle strength and balance were assessed by baseline hand-held dynamometer and by forward, lateral, and oblique direction reach tests in 421 young male adults between 21 and 23 years of age. The mean and standard deviation of lower extremity strength ranged from 43.83 ± 16.92 lb to 62.07 ± 10.74 lb. Body weight, body mass index, and oblique and lateral reach distances were correlated with some knee and ankle muscle strength values. Body weight, body mass index, and balance showed significant effect on lower extremity muscle strength. Furthermore, decreased muscle strength may impair balance; the current clinical practice should evaluate body weight, body mass index, and muscle strength during the assessment process.

EFFECT OF FATIGUE ON EXPLOSIVE STRENGTH AND MUSCLE ARCHITECTURE OF THE VASTUS LATERALIS

ABSTRACT Introduction: There has been little research on changes in rate of torque development (RTD) and muscle architecture. This study evaluated the effect of fatigue on RTD and muscle architecture of the vastus lateralis (VL). Methods: Seventeen volunteers (25.5 ± 6.2 years; 177.2 ± 12.9 cm; 76.4 ± 13.1 kg) underwent isokinetic knee extension assessment at 30°/s to obtain the peak torque (PT-ISK), before and after a set of intermittent maximal voluntary isometric contractions (MVIC) (15 reps – 3 s contraction, 3 s rest) used to promote muscle fatigue, monitored by the median frequency (MDF) of the electromyography from the VL, rectus femoris and vastus medialis muscles. Before and after the fatigue protocol, ultrasound images of the VL were obtained to measure muscle thickness (MT), fascicle length (FL), and fascicle angle (FA). The peak isometric torque (PT-ISM) and the RTDs in 50 ms windows were calculated for each MVIC. The RTDs were reported as absolute values and normalized by the PT-ISM. Results: Fatigue was confirmed due to significant reductions in MDF in all three muscles. After the fatigue protocol, the PT-ISK was reduced from 239.0±47.91 to 177.3±34.96 Nm, and the PT-MVIC was reduced from 269.5±45.63 to 220.49±46.94 Nm. All the RTD absolute values presented significant change after the fatigue protocol. However, the normalized RTD did not demonstrate any significant differences. No significant differences were found in the muscle architecture of the VL. Conclusions: The reduction in explosive strength occurred concomitantly with the reduction in maximum strength, as evidenced by the lack of changes in normalized TDT. Level of Evidence III.

Effect of hypoxic conditioning on functional fitness, balance and fear of falling in healthy older adults: a randomized controlled trial

Background

Hypoxic conditioning has been proposed as a new tool to mitigate the sarcopenia and enhance health-related function, but decrements in standing balance have been observed during hypoxia exposure. The aim of the study was to evaluate the effect of a hypoxic conditioning training on functional fitness, balance and fear of falling in healthy older adults.

Methods

A total of 54 healthy older adults (aged 65–75 years), who voluntarily participated in the study, were randomly divided into three groups: the control group (CON), the normoxia training group (NT) that performed strength training in normoxia, and the hypoxia training group (HT) that trained under moderate hypoxic conditions at a simulated altitude of 2500 m asl. The training programme that was performed during 24 weeks was similar in both experimental groups and consisted of a full-body workout with elastic bands and kettlebells (three sets × 12–15 reps). The Senior Fitness Test (SFT), the Single Leg Stance test (SLS) and the Short Falls Efficacy Scale-International (FES-I) were assessed before and after the intervention.

Results

Results showed that after training, either in normoxia or in hypoxia, the participants increased upper and lower body strength, and the aerobic endurance, and decreased the fear of falling.

Conclusions

The moderate hypoxic conditioning seems to be a useful tool to increase the functional capacity in healthy older adults without observing a decline in balance.

Trial registration

ClinicalTrials.gov NCT04281264. Registered February 9, 2019-Retrospectively registered.

[Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging]

OBJECTIVE

To investigate the correlation between the quadriceps cross-sectional area (CSA) and quadriceps muscle volume (QMV) at different horizontal levels from the upper edge of the patella, and to determine the best observation position.

METHODS

Thigh magnetic resonance imaging (MRI) images of 22 Chinese young men [age: (29±6) years] with anterior cruciate ligament (ACL) rupture were examined. The CSA was measured at 18, 15, and 12 cm above the upper edge of the pate-lla (denoted by CSA-18, CSA-15 and CSA-12 respectively), and the QMV and CSA were determined by semiautomatic segmentation. A curve model was established to estimate QMV. Bland-Altman analysis was performed to determine the confidence limits of the volumes.

RESULTS

On the unaffected side, the mean QMV was (1 944.45±323.77) cm³. The quadriceps CSA at the upper edge of the patella at 18, 15, and 12 cm was (80.80±12.16) cm², (77.53±12.03) cm², and (72.68±10.51) cm², respectively. The coefficients of determination (R²), ascertained using curve estimation models, for the 3 positions were 0.819, 0.755, and 0.684 (P < 0.001), and the standard deviations of the volume estimated value (SEE) were 7.4%, 8.7%, and 9.8%. The fitting equations of the three horizontal positions were all good, but the fitting degree of CSA-18 was the highest. The Bland-Altman scatter plot showed that the arithmetic means of the QMV at 18, 15 and 12 cm from the upper edge of the patella 0.8 cm³, -1.1 cm³, and 0.9 cm³ and 95% limits of agreement (LoA) were (-268.8, 270.5), (-315.2, 313.1), and (-355.7, 357.5), respectively. The estimated QMV was in good agreement with the measured value. The difference between the estimated CSA-18 and measured values was the smallest. The results on the affected side were consistent.

CONCLUSION

The correlation between QMV and CSA in the young men with the upper edge of patella as baseline was reliable and consistent. Among them, CSA-18 had the highest correlation with the QMV. However, different observation sites could be selected for different injuries of the quadriceps.

Muscle Performance Changes with Age in Active Women

The purpose of this study was to examine age-related differences in muscle performance in women divided into young (YW, 20–39 years, n = 29) middle-aged (MAW, 40–59 years, n = 33), and older (OW, ≥60 years, n = 40) age groups. Methods: Hand grip strength, vertical jump performance, and knee extensor (KE) strength (0 deg/s, 60 deg/s, and 240 deg/s), speed of movement (SoM; at 1 Nm, 20%, 40%, and 60% isometric strength), and endurance (30-repetition test at 60 degs/s and 240 deg/s) were assessed. Computed tomography-acquired muscle cross-sectional area (mCSA) was measured and included to determine specific strength (KE strength/mCSA). Results: Hand grip strength was similar across groups, while jump performance declined with age (YW and MAW > OW, p < 0.001). KE strength declined significantly with age (all conditions p < 0.01), while specific strength was similar across groups. SoM was significantly higher for YW and MAW compared to OW (both p < 0.01). An age × velocity interaction revealed YW KE endurance was similar between conditions, whereas MAW and OW displayed significantly better endurance during the 60 deg/s condition. OW displayed impaired KE endurance at 240 deg/s (vs. YW and MAW, p < 0.01) but improved at 60 deg/s (vs. YW, p < 0.01). Dynamic torque decline increased with age (YW < OW, p = 0.03) and was associated with intramuscular adipose tissue (r = 0.21, p = 0.04). Conclusions: Performance declines were most evident among OW, but few performance deficits had emerged in MAW. Interestingly, strength declines disappeared after normalizing to mCSA and endurance appears to be velocity-dependent.

Computed tomography-based skeletal muscle and adipose tissue attenuation: Variations by age, sex, and muscle

OBJECTIVE

This study aimed to investigate how skeletal muscle attenuation and adipose tissue (AT) attenuation of the quadriceps, hamstrings, paraspinal muscle groups and the psoas muscle vary according to the targeted muscles, sex, and age.

DESIGN

Population-based cross-sectional study.

SETTING

Community-dwelling old population in Reykjavik, Iceland.

SUBJECTS

A total of 5331 older adults (42.8% women), aged 66-96 years from the Age, Gene/Environment Susceptibility (AGES)- Reykjavik Study, who participated in the baseline visit (between 2002 and 2006) and had valid thigh and abdominal computed tomography (CT) scans were studied.

METHODS

Muscle attenuation and AT attenuation of the quadriceps, hamstrings, paraspinal muscle groups and the psoas muscle were determined using CT. Linear mixed model analysis of variance was performed for each sex, with skeletal muscle or AT attenuation as the dependent variable.

RESULTS

Muscle attenuation decreased, and AT attenuation increased with age in both sexes, and these differences were specific for each muscle, although not in all age groups. Age-related differences in muscle and AT attenuation varied with specific muscle. In general, for both sexes, skeletal muscle attenuation of the hamstrings declined more than average with age. Men and women displayed a different pattern in the age differences in AT attenuation for each muscle.

CONCLUSIONS

Our data support the hypotheses that skeletal muscle attenuation decreases, and AT attenuation increases with aging. In addition, our data add new evidence, supporting that age-related differences in skeletal muscle and AT attenuation vary between muscles.

The Importance of Complementary Collaboration of Researchers, Veterinarians, and Husbandry Staff in the Successful Training of Marmoset Behavioral Assays

Interest in marmosets as research models has seen exponential growth over the last decade, especially given that the research community is eager to improve on gaps with historical animal models for behavioral and cognitive disorders. The spectrum of human disease traits that present naturally in marmosets, as well as the range of analogous human behaviors that can be assessed in marmosets, makes them ideally suited as translational models for behavioral and cognitive disorders. Regardless of the specific research aims of any project, without close collaboration between researchers, veterinarians, and animal care staff, it would be impossible to meet these goals. Behavior is inherently variable, as are marmosets that are genetically and phenotypically diverse. Thus, to ensure rigor, reliability, and reproducibility in results, it is important that in the research environment, the animal's daily husbandry and veterinary needs are being met and align with the research goals while keeping the welfare of the animal the most critical and highest priority. Much of the information described herein provides details on key components for successful behavioral testing, based on a compendium of methods from peer-reviewed publications and our own experiences. Specific areas highlighted include habituation procedures, selection of appropriate rewards, optimization of testing environments, and ways to integrate regular veterinary and husbandry procedures into the research program with minimal disruptions to the behavioral testing plan. This article aims to provide a broad foundation for researchers new to establishing behavioral and cognitive testing paradigms in marmosets and especially for the veterinary and husbandry colleagues who are indispensable collaborators of these research projects.

Exploring the Preventive Effect and Mechanism of Senile Sarcopenia Based on "Gut-Muscle Axis"

Age-related sarcopenia probably leads to chronic systemic inflammation and plays a vital role in the development of the complications of the disease. Gut microbiota, an environmental factor, is the medium of nutritional support to muscle cells, having significant impact on sarcopenia. Consequently, a significant amount of studies explored and showed the presence of gut microbiome–muscle axis (gut–muscle axis for short), which was possibly considered as the disease interventional target of age-related sarcopenia. However, a variety of nutrients probably affect the changes of the gut–muscle axis so as to affect the healthy balance of skeletal muscle. Therefore, it is necessary to study the mechanism of intestinal–muscle axis, and nutrients play a role in the treatment of senile sarcopenia through this mechanism. This review summarizes the available literature on mechanisms and specific pathways of gut–muscle axis and discusses the potential role and therapeutic feasibility of gut microbiota in age-related sarcopenia to understand the development of age-related sarcopenia and figure out the novel perspective of the potential therapeutic interventional targets.

Age and sex-related decline of muscle strength across the adult lifespan: a scoping review of aggregated data

Muscle strength is sex-related and declines with advancing age; yet, a comprehensive comparative evaluation of age-related strength loss in human females and males has not been undertaken. To do so, segmented piecewise regression analysis was performed on aggregated data from studies published from 1990 to 2018 and are available in CINAHL, EMBASE, MEDLINE, and PsycINFO databases. The search identified 5613 articles that were reviewed for physical assessment results stratified by sex and age. Maximal isometric and isokinetic 60°·s-1 knee extension (KE) and knee flexion (KF) contractions from 57 studies and 15 283 subjects (N = 7918 females) had sufficient data reported on females and males for meaningful statistical evaluation to be undertaken. The analysis revealed that isometric KE and KF strength undergo similar rapid declines in both sexes late in the sixth decade of life. Yet, there is an abrupt age-related decline in KE 60°·s-1 peak torque earlier in females (aged 41.8 years) than males (aged 66.7 years). In the assessment of KF peak torque, an age-related acceleration in strength loss was only identified in males (aged 49.3 years). The results suggest that age-related isometric strength loss is similar between sexes while the characteristics of KE and KF peak torque decline are sex-related, which likely explains the differential rate of age-related functional decline. Novelty Inclusion of muscle strength and torque of KE and KF data from >15 000 subjects. Isometric KE and KF strength loss are similar between sexes. Isokinetic 60°·s-1 KE torque decline accelerates 25 years earlier in females and female age-related KF peak torque decline does not accelerate with age.

Age-related fatty infiltration of lumbar paraspinal muscles: a normative reference database study in 516 Chinese females

Background

Fatty infiltration, as a result of aging, is an essential biomarker of muscle degeneration. This research aimed to investigate the age-dependent change of fatty degeneration in the paraspinal muscles of healthy Chinese women. This study also explores the effect of body size on fatty infiltration of paraspinal muscles.

Methods

Cross-sectional area of paraspinal muscles (CSA_muscle) and intermuscular adipose tissue (CSA_IMAT) were measured at the L3 mid-vertebral level of 516 healthy females, who underwent abdomen quantitative computed tomography (QCT) scans. Subsequently, IMAT% [CSA_IMAT / (CSA_IMAT + CSA_muscle)] were calculated. The relationship between basic information and measurements was evaluated using Spearman correlations. Comparisons of QCT results among different BMI subgroups in different age groups were analyzed with the Kruskal-Wallis H test and LSD, post-hoc correction. Age-related changes were calculated after the adjustment of height and weight.

Results

The mean CSA_IMAT of 20-29 years group (n=69) and 70-79 years group (n=25) were 3.00 cm² and 11.06 cm², respectively. While the mean CSA_muscle of 20-29 years group was 38.46 cm² and 70-79 years group was 30.86 cm². The mean IMAT% difference between 20-29 years group and 70-79 years group was -18.55%. Strong, positive non-linear associations were observed between ageing and CSA_IMAT, along with IMAT% (r=0.656, P<0.01; r=0.714, P<0.01). However, CSA_muscle was shown to decrease with age in a weak, negative linear fashion (r=-0.265, P<0.01). Positive relationships between BMI and CSA_IMAT, CSA_muscle, along with IMAT%, were found. Significant differences were observed between obesity and normal BMI subgroup for all variables in three age groups. CSA_IMAT showed a larger age-related difference compared to CSA_muscle.

Conclusions

Fatty infiltration in paraspinal muscles increased with age and BMI, while muscle loss may be associated with aging. The present study provided standardized reference data for the fatty degeneration of paraspinal muscles across the adult lifespan of Chinese females, which will play a critical role in future studies.

Relationship between smoking status and muscle strength in the United States older adults

OBJECTIVES

Muscle strength in older adults is associated with greater physical ability. Identifying interventions to maintain muscle strength can therefore improve quality of life. The purpose of this study was to evaluate whether current or former smoking status is associated with a decrease in muscle strength in older adults.

METHODS

Data from the Health and Retirement Study from 2012-2014 were analyzed with regard to maximum dominant hand grip strength, maximum overall hand grip strength, and smoking status (current, former, or never). Unadjusted linear regression was conducted. Other factors known to be related to strength were included in the adjusted linear regression analyses.

RESULTS

For maximum grip strength, the regression coefficient was 4.91 for current smoking (standard error [SE], 0.58; p<0.001), 3.58 for former smoking (SE, 0.43; p<0.001), and 28.12 for never smoking (SE, 0.34). Fully adjusted linear regression on the relationship between dominant hand grip strength and smoking did not yield a significant result. The factors significantly associated with dominant hand grip strength were male sex, younger age, a race/ethnicity of non-Hispanic White or non-Hispanic Black, higher income, morbidity of ≤1 condition, no pain, and moderate or vigorous exercise more than once a week.

CONCLUSIONS

Muscle strength in older adults was not associated with smoking status in the adjusted analysis.

MicroRNA-141-3p Negatively Modulates SDF-1 Expression in Age-Dependent Pathophysiology of Human and Murine Bone Marrow Stromal Cells

Stromal cell-derived factor-1 (SDF-1 or CXCL12) is a cytokine secreted by cells including bone marrow stromal cells (BMSCs). SDF-1 plays a vital role in BMSC migration, survival, and differentiation. Our group previously reported the role of SDF-1 in osteogenic differentiation in vitro and bone formation in vivo; however, our understanding of the post-transcriptional regulatory mechanism of SDF-1 remains poor. MicroRNAs are small noncoding RNAs that post-transcriptionally regulate the messenger RNAs (mRNAs) of protein-coding genes. In this study, we aimed to investigate the impact of miR-141-3p on SDF-1 expression in BMSCs and its importance in the aging bone marrow (BM) microenvironment. Our data demonstrated that murine and human BMSCs expressed miR-141-3p that repressed SDF-1 gene expression at the functional level (luciferase reporter assay) by targeting the 3'-untranslated region of mRNA. We also found that transfection of miR-141-3p decreased osteogenic markers in human BMSCs. Our results demonstrate that miR-141-3p expression increases with age, while SDF-1 decreases in both the human and mouse BM niche. Taken together, these results support that miR-141-3p is a novel regulator of SDF-1 in bone cells and plays an important role in the age-dependent pathophysiology of murine and human BM niche.

Physiological changes during prolonged standing and walking considering age, gender and standing work experience

Occupational standing is associated with musculoskeletal and venous disorders. The aim was to investigate whether lower leg oedema and muscle fatigue development differ between standing and walking and whether age, gender and standing work habituation are factors to consider. Sixty participants (15 young females, 15 young males, 15 older males, and 15 young males habituated to standing work) were included and required to stand/walk for 4.5 hours in three periods with two seated breaks. Waterplethysmography/bioelectrical impedance, muscle twitch force and surface electromyography were used to assess lower leg swelling (LLS) and muscle fatigue as well as gastrocnemius muscle activity, respectively. While standing led to LLS and muscle fatigue, walking did not. Low-level medial gastrocnemius activity was not continuous during standing. No significant influence of age, gender and standing habituation was observed. Walking can be an effective prevention measure to counteract the detrimental effects of quasi-static standing.Practitioner summary: Prolonged standing leads to lower leg oedema and muscle fatigue while walking does not. The primary cause of fatigue may be in other muscles than the medial gastrocnemius. Walking may be an effective prevention measure for health risks of occupational standing when included intermittently.Abbreviation: BI: bioelectrical impedance; LLS: lower leg swelling; SEMG: surface electromyography; MTF: muscle twitch force; WP: waterplethysmography; Bsl: Baseline; L: Lunch; E: Evening; MTM: method times measurement; EA: electrical activity; IQR: interquartile range; p: percentile; M: mean; SE: standard error; Adj: adjusted.

The Motion of Body Center of Mass During Walking: A Review Oriented to Clinical Applications

Human walking is usually conceived as the cyclic rotation of the limbs. The goal of lower-limb movements, however, is the forward translation of the body system, which can be mechanically represented by its center of mass (CoM). Lower limbs act as struts of an inverted pendulum, allowing minimization of muscle work, from infancy to old age. The plantar flexors of the trailing limbs have been identified as the main engines of CoM propulsion. Motion of the CoM can be investigated through refined techniques, but research has been focused on the fields of human and animal physiology rather than clinical medicine. Alterations in CoM motion could reveal motor impairments that are not detectable by clinical observation. The study of the three-dimensional trajectory of the CoM motion represents a clinical frontier. After adjusting for displacement due to the average forward speed, the trajectory assumes a figure-eight shape (dubbed the “bow-tie”) with a perimeter about 18 cm long. Its lateral size decreases with walking velocity, thus ensuring dynamic stability. Lateral redirection appears as a critical phase of the step, requiring precise muscle sequencing. The shape and size of the “bow-tie” as functions of dynamically equivalent velocities do not change from child to adulthood, despite anatomical growth. The trajectory of the CoM thus appears to be a promising summary index of both balance and the neural maturation of walking. In asymmetric gaits, the affected lower limb avoids muscle work by pivoting almost passively, but extra work is required from the unaffected side during the next step, in order to keep the body system in motion. Generally, the average work to transport the CoM across a stride remains normal. In more demanding conditions, such as walking faster or uphill, the affected limb can actually provide more work; however, the unaffected limb also provides more work and asymmetry between the steps persists. This learned or acquired asymmetry is a formerly unsuspected challenge to rehabilitation attempts to restore symmetry. Techniques of selective loading of the affected side, which include constraining the motion of the unaffected limb or forcing the use of the affected limb on split-belt treadmills which impose a different velocity and power to either limb, are now under scrutiny.

A new approach to the classification of muscle health: preliminary investigations

OBJECTIVE

Upper leg skeletal or lean tissue mass (LTM), strength and muscle quality have emerged as time-sensitive indices of muscular health. The aim of this study was to generate a comparative data set based on these indices, in healthy young (n  =  30, 29.0  ±  3.0 y old) and older (n  =  32, 58.7  ±  2.8 years old) adults, in order to evaluate their construct validity in establishing cut-points for muscle health.

APPROACH

Whole body and upper leg LTM was obtained (iDXATM; GE Healthcare, Madison, WI) prior to the assessment of maximal voluntary isometric torque of the knee extensors and flexors (Cybex Isokinetic Dynamometer; Humac Norm, USA).

MAIN RESULTS

Peak isometric upper leg torque showed the greatest age-related difference (-29.0%), followed by muscle quality (-19.1%) and upper leg LTM (-9.8%).

SIGNIFICANCE

Cut-points based on Z and T-scores generated from the young adult mean suggest muscle quality demonstrates the greatest construct validity toward the aim of classifying the muscular health of adults. Data generated from large, representative and sex-specific samples are required to adequately classify the muscular health of adults.

Influence of between-limb asymmetry in muscle mass, strength, and power on functional capacity in healthy older adults

PURPOSE

Numerous daily tasks such as walking and rising from a chair involve bilateral lower limb movements. During such tasks, lower extremity function (LEF) may be compromised among older adults. LEF may be further impaired due to high degrees of between-limb asymmetry. The present study investigated the prevalence of between-limb asymmetry in muscle mass, strength, and power in a cohort of healthy older adults and examined the influence of between-limb asymmetry on LEF.

METHODS

Two hundred and eight healthy older adults (mean age 70.2 ± 3.9 years) were tested for LEF (400 m walking and 30-seconds chair stand). Furthermore, maximal isometric and dynamic knee extensor strength, leg extensor power, and lower limb lean tissue mass (LTM) were obtained unilaterally.

RESULTS

Mean between-limb asymmetry in maximal muscle strength and power ranged between 10% and 13%, whereas LTM asymmetry was 3 ± 2.3%. Asymmetry in dynamic knee extensor strength was larger for women compared with men (15.0 ± 11.8% vs 11.1 ± 9.5%; P = .005) Leg strength and power were positively correlated with LEF (r²  = .43-.46, P < .001). The weakest leg was not a stronger predictor of LEF than the strongest leg. Between-limb asymmetry in LTM and isometric strength was negatively associated with LEF (LTM; r²  = .12, P = .005, isometric peak torque; r²  = 0.40, P = .03.) but dynamic strength and power were not.

CONCLUSION

The present study supports the notion that in order to improve or maintain LEF, healthy older adults should participate in training interventions that increase muscle strength and power, whereas the effects of reducing between-limb asymmetry in these parameters might be of less importance.

Relationship between age, BMI, head posture and superficial neck muscle stiffness and elasticity in adult women

This study determined relationships between age, BMI and cranio-vertebral angle (CVA) (independent variables) and stiffness and elasticity of sternocleidomasteoid [SCM] and upper trapezius [UT] (dependent variables) muscles in sitting posture in 95 women across adult life. Moreover, a stepwise regression was performed to determine to what extent the dependent variables are explained by age, BMI and CVA. Age was moderately correlated with BMI (r = 0.41), and both age and BMI were moderately negatively correlated with CVA (r = −0.54 and −0.55, respectively). High (r = 0.73) and moderate (r = 0.53) linear relationships were present between age and logarithmic decrement (inversely related to elasticity) and stiffness of SCM muscle, respectively. Low (r = 0.36) and moderate (r = 0.47) relationships were present between age and logarithmic decrement and stiffness of UT muscle, respectively. Age accounted for 53% variance in elasticity and 28.5% variance in stiffness of SCM, and for 13% variance in elasticity and 22% variance in stiffness of UT muscle. Introduction of BMI but not CVA to the model explained the variance of these parameters by additional 0–8%. Among the studied factors age is the major correlate of stiffness and elasticity of neck muscles across the adult life.

Diffusion-weighted MRI with intravoxel incoherent motion modeling for assessment of muscle perfusion in the thigh during post-exercise hyperemia in younger and older adults

Aging is associated with impaired endothelium-dependent vasodilation that leads to muscle perfusion impairment and contributes to organ dysfunction. Impaired muscle perfusion may result in inadequate delivery of oxygen and nutrients during and after muscle contraction, leading to muscle damage. The ability to study the relationship between perfusion and muscle damage has been limited using traditional muscle perfusion measures, which are invasive and risky. To overcome this limitation, we optimized a diffusion-weighted MRI sequence and validated an intravoxel incoherent motion (IVIM) analysis based on Monte Carlo simulation to study muscle perfusion impairment with aging during post-exercise hyperemia. Simulation results demonstrated that the bias of IVIM-derived perfusion fraction (f_p ) and diffusion of water molecules in extra-vascular tissue (D) ranged from -3.3% to 14% and from -16.5% to 0.002%, respectively, in the optimized experimental condition. The dispersion in f_p and D ranged from 3.2% to 9.5% and from 0.9% to 1.1%, respectively. The mid-thigh of the left leg of four younger (21-30 year old) and four older (60-90 year old) healthy females was studied using the optimized protocol at baseline and at seven time increments occurring every 3.25 min following in-magnet dynamic knee extension exercise performed using a MR-compatible ergometer with a workload of 0.4 bar for 2.5 min. After exercise, both f_p and D significantly increased in the rectus femoris (active muscle during exercise) but not in adductor magnus (inactive muscle), reflecting the fact that the local increase in perfusion with both groups showed a maximum value in the second post-exercise time-point. A significantly greater increase in perfusion from the baseline (p < 0.05) was observed in the younger group (37 ± 12.05%) compared with the older group (17.57 ± 15.92%) at the first post-exercise measurement. This work establishes a reliable non-invasive method that can be used to study the effects of aging on dynamic changes in muscle perfusion as they relate to important measures of physical function.

Sarcopenia does not affect clinical outcomes following lumbar fusion

Sarcopenia, defined as decreased skeletal muscle mass or function, has recently been found to have increased perioperative morbidity and mortality. The relationship between sarcopenia and clinical outcomes in patients undergoing lumbar fusion has not been examined. This study investigates whether sarcopenia affects fusion rates and outcomes following single-level lumbar decompression and fusion. A retrospective analysis was undertaken of 97 consecutive patients who underwent a single level lumbar fusion for degenerative spondylolisthesis. Demographics, perioperative data, and patient reported clinical outcomes were collected. Measurements of paraspinal muscle CSA were made using a standardized protocol at the level of the L3-4 disc space on a preoperative lumbar MRI. Univariate analysis was used to compare cohorts with regards to demographics, comorbidities, and clinical outcomes. Of 97 patients, 16 patients (15.8%) were in the sarcopenic cohort utilizing a threshold of 986.1 mm²/m². Reoperation rates were not significantly different between the two groups (0% vs 3.6%, p = .451). The sarcopenia cohort had lower BMI (28.1 vs 31.8, p = .017) and less male patients (6.3% vs 55.6%, p < .001). Mean follow-up was 18.3 months. There was no significant difference in postoperative Oswestry Disability Index (ODI) (24.7 vs 23.2, p = .794) Short Form 12 Physical (38.0 vs. 40.4, p = .445) Mental scores (55.5 vs. 53.6, p = .503), or visual analog scale (VAS) back pain scores (3.4 vs. 3.3, p = .818). No significant difference was found with regards to outcomes when comparing sarcopenic to non-sarcopenic patients undergoing lumbar fusion. Sarcopenia does not impact the clinical success of lumbar fusion for degenerative spondylolisthesis.

Effect of aging on muscle and tendon properties in highly functioning elderly people

This study analyzes long-term changes in muscle strength, muscle architecture, and patellar tendon mechanical properties in a specific sample of physically active elderly people. Twenty-two participants were re-examined from a former 12-week-long skiing intervention study: 11 from the intervention group (IG: 7 ♀, 4 ♂; 67 ± 3 years) and 11 from the control group (CG: 6 ♀, 5 ♂; 66 ± 4 years). Muscle architecture, strength endurance, maximum torque, and tendon properties were analyzed three times within 6 months, and again 6 years later in a follow-up test. No changes in either group could be observed between June 2009 and April 2015 in any parameter. This can be interpreted positively because no age-related decreases were found. Although our participants were physically active from the very beginning (>150 min/wk), it must be noted that the intensity of the physical activity was too low to provoke physiological improvements in leg strength or muscle/tendon morphology.

Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures

BACKGROUND AND AIMS

Body composition assessment is often used in clinical practice for nutritional evaluation and monitoring. The standard method, dual-energy X-ray absorptiometry (DXA), is hardly feasible in routine clinical practice contrary to Bioelectrical Impedance Analysis (BIA) method. We thus aimed to compare body composition assessment by DXA and BIA according to the body mass index (BMI) in a large cohort.

METHODS

Retrospectively, we analysed DXA and BIA measures in patients followed in a Nutrition Unit from 2010 to 2016. Body composition was assessed under standardized conditions in the morning, after a fasting period of 12 h, by DXA (Lunar Prodigy Advance) and BIA (Bodystat QuadScan 4000, Manufacturer's equation). Bland-Altman test was performed for each class of BMI (kg/m2) and fat mass and fat free mass values were compared using Kruskal-Wallis test. Pearson correlations were also performed and the concordance coefficient of Lin was calculated.

RESULTS

Whatever the BMI, BIA and DXA methods reported higher concordance for values of FM than FFM. Body composition values were very closed for patients with BMI between 16 and 18,5 (difference < 1kg). For BMI > 18,5 and BMI < 40, BIA overestimated fat free mass from 3,38 to 8,28 kg, and underestimated fat mass from 2,51 to 5,67 kg compared with DXA method. For BMI ≥ 40, differences vary with BMI. For BMI < 16, BIA underestimated fat free mass by 2,25 kg, and overestimated fat mass by 2,57 kg. However, limits of agreement were very large either for FM and FFM values, irrespective of BMI.

CONCLUSION

The small bias, particularly in patients with BMI between 16 and 18, suggests that BIA and DXA methods are interchangeable at a population level. However, concordance between BIA and DXA methods at the individual level is lacking, irrespective of BMI.

Current body composition measurement techniques

PURPOSE OF REVIEW

The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition.

RECENT FINDINGS

Body composition measurement methods are continuously being perfected. Ongoing efforts involve multisegmental and multifrequency bioelectrical impedance analysis, quantitative magnetic resonance for total body water, fat, and lean tissue measurements, imaging to further define ectopic fat depots. Available techniques allow for the measurement of fat, fat-free mass, bone mineral content, total body water, extracellular water, total adipose tissue and its subdepots (visceral, subcutaneous, and intermuscular), skeletal muscle, select organs, and ectopic fat depots.

SUMMARY

There is an ongoing need for methods that yield information on metabolic and biological functions. Based on the wide range of measurable properties, analytical methods and known body composition models, clinicians, and scientists can quantify a number of body components and with longitudinal assessment, can track changes in health and disease with implications for understanding efficacy of nutritional and clinical interventions, diagnosis, prevention, and treatment in clinical settings. With the greater need to understand precursors of health risk beginning prior to conception, a gap exists in appropriate in-vivo measurement methods with application beginning during gestation, that is, fetal development.