Muscle fibre type composition in infant and adult populations and relationships with obesity

Histological analysis of the medial gastrocnemius muscle in young healthy children

Introduction: Histological data on muscle fiber size and proportion in (very) young typically developing (TD) children is not well documented and data on capillarization and satellite cell content are also lacking. Aims: This study investigated the microscopic properties of the medial gastrocnemius muscle in growing TD children, grouped according to age and gender to provide normal reference values in healthy children. Methods: Microbiopsies of the medial gastrocnemius (MG) muscle were collected in 46 TD boys and girls aged 2-10 years subdivided into 4 age groups (2-4, 4-6, 6-8 and 8-10 years). Sections were immunostained to assess fiber type cross-sectional area (fCSA) and proportion, the number of satellite cells (SC), capillary to fiber ratio (C/F), capillary density for type I and II fiber (CFD), capillary domain, capillary-to-fiber perimeter exchange index (CFPE) and heterogeneity index. fCSA was normalized to fibula length2 and the coefficient of variation (CV) was calculated to reflect fCSA intrasubject variability. Results: Absolute fCSA of all fibers increased with age (r = 0.72, p < 0.001) but more in boys (+112%, p < 0.05) than in girls (+48%, p > 0.05) Normalized fCSA, CV and fiber proportion did not differ between age groups and gender. C/F was strongly correlated with age in boys (r = 0.83, p < 0.001), and to a lesser extent in girls (r = 0.37, p = 0.115), while other capillary parameters as well as the number of SC remained stable with increasing age in boys and girls. Discussion: This study provides reference values of histological measures in MG according to age in normally growing boys and girls. These data may be used as a reference to determine disease impact and efficacy of therapeutic approach on the muscle.

Comprehensive Physical Work Capacity Evaluations for Korean Farmers Assessed in Healthy Volunteers

OBJECTIVE

To establish the lower limits of normative values of the physical work capacity for Korean farmers in healthy working individual.

METHODS

We developed a comprehensive set of physical work capacity evaluation items that encompass common farming tasks. These items include measurements of trunk flexion/extension angles, strength (hand grip, trunk flexion/extension, leg/back lifting, and pushing/pulling), and positional tolerances. We calculated the normative values for the items and defined the normal range in 124 healthy volunteers aged 20-79 years. We calculated the intraclass correlation coefficient (ICC) to validate the test-retest reliability of the measurements protocol.

RESULTS

The normal values for each measurement item were as follows: trunk flexion and extension angle (65.3°±11.6° and 29.6°±6.6°), dominant hand grip strength (32.2±10.5 kgf), trunk flexion and extension strength (288.4±119.0 N and 297.3±129.9 N), leg and back lifting strength (452.9±233.5 N and 349.2±166.7 N), pushing and pulling strength (214.7±75.1 N and 221.7±63.3 N), and positional tolerance time (squat: 76.8±9.0 seconds, front: 73.8±7.7 seconds, twist: 82.2±8.8 seconds, upward: 71.9±11.3 seconds). Regarding test-retest reliability, all strength measurements demonstrated excellent absolute agreement (ICC, 0.91-0.96). However, positional tolerance showed poor-to-moderate absolute agreement (ICC, 0.37-0.58).

CONCLUSION

We conducted measurements of muscle strength and positional tolerance in healthy participants of various ages, focusing on tasks commonly performed by Korean farmers. The outcomes hold significant value as they offer a pertinent instrument for assessing the appropriateness of workers, thereby carrying implications for rehabilitation objectives, legal evaluations, and work capacity assessments within the agricultural domain.

Skeletal muscle fibre morphology in childhood-insights into myopenia in pediatric liver disease

TAKE-HOME MESSAGE

Skeletal muscle morphology in healthy children changes with age. Liver disease may preferentially affect type II fibres in adults with end-stage liver disease (ESLD). More research is needed on the effects of ESLD on muscle morphology in children.

Physiological mechanisms of muscle strength and power are dependent on the years post obtaining peak height velocity in elite juniors rowers: A cross-sectional study

BACKGROUND

It is not yet known whether the years after peak height velocity (PHV) are associated with the physiological mechanisms of muscle strength and power in Juniors rowers.

OBJECTIVE

To identify the association between years post PHV (YPPHV) with muscle power and strength in Juniors rowers.

METHODS

We tested 235 Brazilian rowing athletes (male: 171, female: 64, Juniors category). We measured: power (indoor rowing over 100-m, 500-m, 2,000-m and 6,000-m) and muscle strength (one repetition maximum (1RM) test in squat, deadlift, bench press and bent row on the bench). Biological maturation was index by age of PHV. The sample was divided into groups considering YPPHV recent (2.5 to 3.9), median (2.51 to 4.9) and veteran (>4.9). We use a Baysian approach to data handling.

RESULTS

When compared to their peers in the recent and median post PHV groups, the male veteran group were superior in muscle power (Absolute: 100-m (BF10: 2893.85), 500-m (BF10: 553.77) and 6,000-m (BF10: 22.31). Relative: (100-m (BF10: 49.9)) and strength (BF10≥10.0 in squat, bench press and deadlift), and in the female the veteran group were superior in test time (500-m, BF10: 88.4).

CONCLUSION

In elite Juniors rowers the increasing YPPHV are associated with muscle power performance in both sexes and muscle strength performance in males.

Physical activity in infancy and early childhood: a narrative review of interventions for prevention of obesity and associated health outcomes

In the context of the childhood obesity epidemic, this narrative review aims to explore opportunities to promote physical activity (PA) between birth and age 5 years as well as the health outcomes associated with PA in early childhood. Although early childhood is an ideal time to promote healthy habits, guidelines for PA have often ignored early childhood given the limited evidence for children <5 years old. Herein we discuss and highlight infant, toddler and preschool age interventions to promote PA and prevent obesity both in the short and long-term. We describe novel and modified interventions to promote improved early childhood health outcomes, encompassing cardiorespiratory, muscle, and bone strengthening components necessary for short-term motor development and long-term health. We call for new research aimed at developing and testing innovative early childhood interventions that may be performed in home or childcare settings, monitored by parents or caregivers.

Creatine kinase is associated with glycated haemoglobin in a nondiabetic population. The Tromsø study

BACKGROUND

Creatine kinase (CK) has been associated with insulin resistance and identified as a risk marker of cardiovascular disease largely by its relationship with hypertension and increased body mass index. This study determined whether CK is a predictor of glycated haemoglobin (HbA1C) in a nondiabetic general population.

METHODS

Associations between CK and the outcome variable HbA1C (%) were performed by variance and multivariate analyses in 11662 nondiabetic subjects defined as HbA1C (%) <6.5 who participated in the population based Tromsø study (Tromsø 6) in Norway.

RESULTS

Abnormal elevated CK was detected in 543/11662 participants (4.66%). Mean HbA1C (%) in the "high CK" group was 5.62 (SD = 0.33) compared to 5.52 (SD = 0.36) in the "normal CK" group, P <0.001. CK increased significantly and linearly with higher levels of HbA1C (%) quartiles in women (P <0.001) and non-linearly in men (P <0.001). In a multivariate analysis, CK was independently associated with HbA1C (%) after adjusting for age, sex, body mass index, blood pressure, glucose, lipids, C-reactive protein, creatinine, alanine transaminase and aspartate aminotransferase. A 1-unit increase in log CK was associated with a 0.17-unit increase in HbA1C (%).

CONCLUSION

These data demonstrate a positive and independent association between CK and glycated haemoglobin in a nondiabetic general population.

A Skeletal Muscle-Centric View on Time-Restricted Feeding and Obesity under Various Metabolic Challenges in Humans and Animals

Nearly 50% of adults will suffer from obesity in the U.S. by 2030. High obesity rates can lead to high economic and healthcare burdens in addition to elevated mortality rates and reduced health span in patients. Emerging data demonstrate that obesity is a multifactorial complex disease with various etiologies including aging, a lifestyle of chronic high-fat diets (HFD), genetic predispositions, and circadian disruption. Time-restricted feeding/eating (TRF; TRE in humans) is an intervention demonstrated by studies to show promise as an effective alternative therapy for ameliorating the effects of obesity and metabolic disease. New studies have recently suggested that TRF/TRE modulates the skeletal muscle which plays a crucial role in metabolism historically observed to be impaired under obesity. Here we discuss recent findings regarding potential mechanisms underlying TRF's modulation of skeletal muscle function, metabolism, and structure which may shed light on future research related to TRF as a solution to obesity.

Association of muscle fiber type with measures of obesity: A systematic review

Obesity derives from an extended period of positive energy imbalance due to a complex interplay of environmental and biological factors. Muscle fiber type and physiology have been hypothesized to affect metabolism and energy expenditure and thus to affect an individual's propensity to gain weight. However, there have been conflicting reports regarding a relationship between muscle fiber type and obesity. Here, we systematically reviewed literature investigating this topic from PubMed, Web of Science, and EMBASE. Of these, 32 articles were included in our final review and analysis. Most studies (22/32) reported a significant relationship between muscle fiber-type proportion and a measure of obesity. Overall, there was a significant negative relationship between the proportion of type I fibers and body mass index (BMI) and a significant positive relationship between the proportion of type IIX fibers and BMI. Moreover, between-group comparisons indicated a greater prevalence of type IIX fibers and a lower prevalence of type I fibers in patients living with obesity relative to lean individuals. These significant relationships were confirmed in a meta-analysis of these data. The causal nature of these associations remains to be evaluated.

Effect of Weight Self-Stigma and Self-Esteem on Aerobic Exercise Capacity in Adult Women with Different Body Compositions

Background: Overweight individuals face weight-related stigmatization, driving self-exclusion from exercise and physical activity. The extent to which weight self-stigma and self-esteem are associated with aerobic capacity remains unclear. Therefore, this study aimed to characterize the cardiopulmonary fitness, weight self-stigma, and self-esteem of overweight women and examine whether weight self-stigma and self-esteem predict cardiopulmonary aerobic capacity. Methods: A cross-sectional study was conducted with 66 women stratified into two groups: a normal weight (NW) group and an overweight (OW) group. The mean body mass indexes and ages of the NW and OW groups were 20.4 ± 0.36 kg/m² and 29.5 ± 0.8 kg/m², and 24 ± 7 years and 21 ± 3 years, respectively. Submaximal exercise testing using the modified Bruce treadmill protocol was conducted to measure the predicted oxygen uptake (VO_{2 peak}) and energy expenditure. The Weight Self-Stigma Questionnaire and the Rosenberg Self-Esteem Scale were used. Results: Significantly lower mean of predicted VO_{2 peak} and higher mean of energy expenditure were reported in the OW group compared with the NW group (25.8 ± 5.3 mL/kg/min vs. 28.7 ± 4.8 mL/kg/min, p = 0.001 and 9.7 ± 1.9 kcal/min vs. 7.5 ± 1.8 kcal, p = 0.03, respectively). There was a significant difference in weight self-stigma and self-esteem between the groups. Regression model analysis indicated that weight self-stigma and self-esteem explained 45% of the variance in the predicted VO_{2 peak}. Conclusion: Strategies enhancing self-esteem and avoiding stigmatization should be embraced to promote fitness and engagement in physical activity among OW women.

Muscle fiber size in healthy children and adults in relation to sex and fiber types

BACKGROUND

In adult males, cross-sectional area (CSA) for type II muscle fibers is generally larger than for type I fibers. In this cross-sectional study the aim was to compare sex-related CSAs of various muscle fiber types during childhood-to-adulthood transition.

METHODS

Percutaneous biopsy samples were obtained from vastus lateralis in 10-y-old children (10 males and 5 females) and in young adults (9 males and 7 females). Fiber types were classified by myofibrillar ATPase and CSAs from NADH-dehydrogenase staining.

RESULTS

Type IIA were larger than type I fibers in adult males, but not in adult females or children (age x sex x fiber type, P < .002). When including all participants, body weight and sex explained 78% of the variation in type IIA CSA but only body weight contributed for type I.

CONCLUSIONS

Sex-specific patterns in CSA of the muscle fiber types appears to develop during the transition from childhood to adulthood.

p38 MAPK in Glucose Metabolism of Skeletal Muscle: Beneficial or Harmful?

Skeletal muscles respond to environmental and physiological changes by varying their size, fiber type, and metabolic properties. P38 mitogen-activated protein kinase (MAPK) is one of several signaling pathways that drive the metabolic adaptation of skeletal muscle to exercise. p38 MAPK also participates in the development of pathological traits resulting from excessive caloric intake and obesity that cause metabolic syndrome and type 2 diabetes (T2D). Whereas p38 MAPK increases insulin-independent glucose uptake and oxidative metabolism in muscles during exercise, it contrastingly mediates insulin resistance and glucose intolerance during metabolic syndrome development. This article provides an overview of the apparent contradicting roles of p38 MAPK in the adaptation of skeletal muscles to exercise and to pathological conditions leading to glucose intolerance and T2D. Here, we focus on the involvement of p38 MAPK in glucose metabolism of skeletal muscle, and discuss the possibility of targeting this pathway to prevent the development of T2D.

Normal range of values for contractility and relaxation parameters of inspiratory muscles in healthy children: An exploratory study

OBJECTIVES

To estimate normal range of values for the contractility and relaxation parameters of inspiratory muscles and compare them by sex, age, nutritional status and level of physical activity in healthy children.

WORKING HYPOTHESIS

We hypothesized that healthy children present similar range of values for the contractility and relaxation parameters of inspiratory muscles.

STUDY DESIGN

Exploratory study conducted between 2017 and 2018.

PATIENT-SUBJECT SELECTION

Healthy children aged 6 to 11 years without history of respiratory, cardiac, cerebrovascular or neuromuscular disease as well as no nasal congestion, influenza or known septum deviation were included.

METHODOLOGY

Anthropometric, spirometry and respiratory muscle strength data were assessed. Maximum rate of pressure development (MRPD), maximum relaxation rate (MRR), time constant of decay curve (τ), contraction time (CT) and half-relaxation time (½ RT) were calculated from the nasal inspiratory pressure curve.

RESULTS

The sample was composed of 110 children (55 boys) with 1.045 as mean z-BMI-score. MRPD range of values was 8.09% to 10.86% rise/10 ms, MRR range of values was 8.09% to 10.86% fall/10 ms, τ range of values was 36.41 to 49.88 ms, CT range of values was 200 to 276 ms, ½ RT range of values was 117.5 to 148 ms and MRPD/MRR range of values was 0.71 to 1.04. The contractility and relaxation parameters did not present significant differences among children when compared by sex, age, nutritional status, or level of physical activity groups (P > .05).

CONCLUSIONS

The contractility and relaxation parameters present similar values among children and they are not influenced by age, sex, nutritional status or physical activity level.

Mechanical Efficiency at Different Exercise Intensities Among Adolescent Boys With Different Body Fat Levels

This study investigated the mechanical efficiency (ME) and associated factors in obese, overweight, and normal-weight adolescent boys during incremental cycle exercise test to exhaustion. Forty-five sedentary adolescent boys (13–14 years old) were separated in three groups according to the percentage of fat mass as follows: 15 normal-weight (NW) (body fat: 16.0 ± 1.9%), 15 overweight (OW) (body fat: 24.0 ± 1.6%), and 15 obese (OB) (body fat: 31.0 ± 3.0%). All groups completed an incremental cycle exercise to exhaustion in which energy consumption (E, W), ME (%), lipid oxidation rate (LO, %), plasma epinephrine and norepinephrine concentrations were determined consecutively at rest and at three intensity levels corresponding to 50 and 75% of each participant’s maximal heart rate (50%HRmax and 75%HRmax) and peak oxygen consumption (V˙O_2peak). During the incremental cycle exercise test, plasma epinephrine, and norepinephrine responses as well as ME determined at 50%HRmax, 75%HRmax, and at VO_2peak stages were significantly lower in OB compared to NW and OW individuals (ps < 0.01). Multiple linear regressions showed that body weight (ß = -0.64, p < 0.001), energy consumption (ß = -0.24, p < 0.05) and lipid oxidation (ß = 0.69, p < 0.01) were significant predictors of ME at 50%HRmax. However, at 75%HRmax and V˙O_2peak, significant predictors of ME were epinephrine (ß = 0.34, ß = 0.49, respectively, ps = 0.01), norepinephrine (ß = 0.26, ß = 0.60, respectively, ps < 0.05) and power output (ß = 0.62, ß = 0.71, respectively, ps < 0.01). These findings suggest that excess in body weight exerts a negative effect on ME at a low intensity by increasing energy consumption for obese and overweight adolescent boys, while at higher intensities (75%HRmax and VO_2peak) the lower ME could be better explained by the lower power output and catecholamine responses that were attenuated among obese and overweight adolescent boys.

Functional Connectivity During Handgrip Motor Fatigue in Older Adults Is Obesity and Sex-Specific

The prevalence of obesity in older adults, particularly in females, is increasing rapidly and is associated with declines in both the brain and physical health. Both the obese and the female populations have shown greater motor fatigue than their counterparts, however, the central neural mechanisms for fatigue are unclear. The present study measured fatigue-related functional connectivity across frontal and sensorimotor areas using functional near-infrared spectroscopy (fNIRS). Fifty-nine older adults (30 non-obese and 29 obese) performed submaximal handgrip motor fatigue until voluntary exhaustion. Functional connectivity and cerebral hemodynamics were compared across eight cortical areas during motor fatigue and across obesity and sex groups along with neuromuscular fatigue outcomes (i.e., endurance time, strength loss, and force steadiness). Both obesity- and sex-specific functional architecture and mean activation differences during motor fatigue in older adults were observed, which were accompanied by fatigue-related changes in variability of force steadiness that differed between groups. While primary indicators of fatigue, i.e., endurance and strength loss, did not differ between groups, the motor steadiness changes indicated different neural adaptation strategies between the groups. These findings indicate that obesity and sex differences exist in brain function in older adults, which may affect performance during motor fatigue.

Eccentric Training Improves Body Composition by Inducing Mechanical and Metabolic Adaptations: A Promising Approach for Overweight and Obese Individuals

Skeletal muscle generates force by either shortening (concentrically) or lengthening (eccentrically). Eccentric (ECC) exercise is characterized by a lower metabolic demand and requires less muscle activity than concentric (CON) exercise at the same level of exerted force. However, the specific effect of ECC training vs. CON training on lean and fat mass remains underexplored. The first aim of this paper was to review the available evidence regarding the effects of ECC training on whole body and segmental lean and fat mass and, when possible, compare these with the effects of CON training. The second aim was to provide some insights into the main mechanical, physiological, and metabolic adaptations of ECC training that contribute to its effects on body composition. The third aim was to determine the beneficial effects of ECC exercise on health-related parameters in overweight and obese patients. ECC training is an effective modality to improve lean mass, but when matched for load or work, the difference between ECC and CON trainings seems unclear. A few studies reported that ECC training is also efficient at reducing fat mass. By increasing post-exercise resting energy expenditure, modifying metabolic substrate, and improving both blood lipid profile and insulin resistance, ECC training is a potential exercise modality for individuals with chronic conditions such as those who are overweight and obese. Further investigations using standardized experimental conditions, examining not only segmental but also whole body composition, are required to compare ECC and CON trainings.

High Body Mass Index Is Associated with the Extent of Muscle Damage after Eccentric Exercise

Purpose: The present study aimed to investigate the effects of body mass index (BMI), which is an obesity index, on the change in the muscle damage index after eccentric exercise. Methods: Forty healthy male university students participated in this study and were classified into normal (BMI 18.5⁻22.9 kg/m², n = 20) and high BMI groups (BMI &ge; 25 kg/m², n = 20). For eccentric exercise, a modified preacher curl machine was used. Participants performed two exercise sets with 25 repetitions in each set. With regard to the muscle damage index, maximum strength, muscle soreness, and the creatine kinase (CK) level were measured. Results: Loss of maximum strength, muscle soreness, and the CK level were higher in the high BMI group than in the normal BMI group (p < 0.05, p < 0.05, and p < 0.01, respectively). Conclusions: In conclusion, BMI is one of the potential factors related to muscle damage after eccentric exercise.

Are Prepubertal Children Metabolically Comparable to Well-Trained Adult Endurance Athletes?

It is well acknowledged that prepubertal children have smaller body dimensions and a poorer mechanical (movement) efficiency, and thus a lower work capacity than adults. However, the scientific evidence indicates that prepubertal children have a greater net contribution of energy derived from aerobic metabolism in exercising muscle and reduced susceptibility to muscular fatigue, which makes them metabolically comparable to well-trained adult endurance athletes. For example, the relative energy contribution from oxidative and non-oxidative (i.e. anaerobic) sources during moderate-to-intense exercise, the work output for a given anaerobic energy contribution and the rate of acceleration of aerobic metabolic machinery in response to submaximal exercise are similar between prepubertal children and well-trained adult endurance athletes. Similar conclusions can be drawn on the basis of experimental data derived from intra-muscular measurements such as type I fibre percentage, succinate dehydrogenase enzyme activity, mitochondrial volume density, post-exercise phosphocreatine re-synthesis rate and muscle by-product clearance rates (i.e. H⁺ ions). On a more practical level, prepubertal children also experience similar decrements in peak power output as well-trained adult endurance athletes during repeated maximal exercise bouts. Therefore, prepubertal children have a comparable relative oxidative contribution to well-trained adult endurance athletes, but a decrease in this relative contribution occurs from childhood through to early adulthood. In a clinical context, this understanding may prove central to the development of exercise-based strategies for the prevention and treatment of many metabolic diseases related to mitochondrial oxidative dysfunction (e.g. in obese, insulin-resistant and diabetic patients), which are often accompanied by muscular deconditioning during adolescence and adulthood.

Recovery of upper-body muscle power after short intensive exercise: comparing boys and men

PURPOSE

Boys' lower-body muscle power generation (PO) recovers faster than men's following intensive exercise. The purpose of this study was to examine whether boys differ from adult men in recovering from upper-body muscle power generation following intensive exercise.

METHODS

Fifteen prepubertal boys (M ± SD age 10.6 ± 1.0 years) and 13 men (31.1 ± 5.0 years) performed two upper-body Wingate Anaerobic Tests (WAnT), separated by either 2-min or 10-min recovery intervals. WAnT parameters, pre-and post-WAnT heart rates (HR), and blood lactate ([La]) were measured during recovery from the WAnTs.

RESULTS

Boys' mean power (MP) of the repeated WAnT (WAnT₂) following 2- and 10-min recoveries was 97.3 ± 7.2% and 99.4 ± 3.9%, respectively, compared to MP of the first test (WAnT₁) (p > 0.05 for both tests). In contrast, in men's MP of the WAnT₂ following the 2-min recovery, was significantly lower than that of the WAnT₁ (84.4 ± 6.7%, p = 0.0001). While boys' and men's HR recovery after 2 min differed significantly (p = 0.046), no between-group differences were found following the 10-min recovery. Peak [La] in boys was 37-44% lower than that in men (p = 0.002).

CONCLUSIONS

The faster recovery of PO in boys after supra-maximal upper-body exercise is partially explained by the lower power generated by boys, attributed in part to a lower anaerobic capacity and to the greater relative contribution of aerobic processes to performance and recovery from anaerobic-type tasks. Further research is needed to determine the physiologic, neurologic and biochemical basis of the rapid muscle power recovery in children.

Relationship Between BMI and Fatigability Is Task Dependent

OBJECTIVE

The objective of the current study was to determine the effect of body mass index (BMI) on fatigability of three different muscle groups at four different work intensities.

METHODS

Forty-nine normal-weight, 50 overweight, and 43 obese adults (32.1 ± 9.2 years; 50% males) performed fatiguing handgrip, shoulder flexion, and trunk extension exertions at 20%, 40%, 60%, and 80% of the associated maximum voluntary contractions.

RESULTS

Obese adults demonstrated 22% to 30% shorter endurance times than normal-weight adults, but this was only observed at lower intensities and with larger and more postural muscles of the shoulder and low back. Strength and fatigue-related strength loss remained comparable across BMI groups in both males and females in these task-specific conditions. Obesity was associated with faster progression in perception of effort at low-intensity shoulder and trunk exertions. While males were stronger than females across all muscle groups, females exhibited greater shoulder fatigue resistance than males at lower intensity levels.

CONCLUSION

Findings indicate that the relationship between obesity and fatigability is task dependent.

APPLICATION

These findings provide initial evidence on the impact of obesity on worker capacity. Future work that extends the current investigation to include more occupationally relevant scenarios are needed to facilitate occupational task (re)design and assessment practices, such that altered work capacities of two-thirds of the working population are accommodated.

Dynamic hyperinflation and exercise limitations in obese asthmatic women

Obese individuals and patients with asthma can develop dynamic hyperinflation (DH) during exercise; however, no previous study has investigated DH as a factor associated with reduced exercise capacity in obese asthmatic women. The aim of the present study was to examine the occurrence of DH and exercise limitations in obese asthmatics. Obese grade II [obese group (Ob-G); BMI 35-39.9 kg/m²; n=36] and nonobese [nonobese group (NOb-G); BMI 18.5-29.9 kg/m²; n=18] asthmatic patients performed a cardiopulmonary test to quantify peak V̇o₂ and a submaximal exercise test to assess DH. Anthropometric measurements, quadriceps endurance, and lung function were also evaluated. A forward stepwise regression was used to evaluate the association between exercise tolerance (wattage) and limiting exercise factors. Fifty-four patients completed the protocol. The Ob-G (n = 36) presented higher peak V̇o₂ values but lower power-to-weight ratio values than the NOb-G (P <0 .05). DH was more common in the Ob-G (72.2%) than in the NOb-G (38.9%, P < 0.05). The Ob-G had a greater reduction in the inspiratory capacity (-18 vs. -4.6%, P < 0.05). Exercise tolerance was associated with quadriceps endurance (r = 0.65; p<0.001), oxygen pulse (r = 0.52; p=0.001), and DH (r = -0.46, P = 0.005). The multiple regression analysis showed that the exercise tolerance could be predicted from a linear association only for muscular endurance (r = 0.82 and r² = 0.67). This study shows that dynamic hyperinflation is a common condition in obese asthmatics; they have reduced fitness for activities of daily living compared to nonobese asthmatics. However, peripheral limitation was the main factor associated with reduced capacity of exercise in these patients.NEW & NOTEWORTHY This is the first study to investigate the occurrence of dynamic hyperinflation (DH) in obese asthmatics. Our results demonstrate that obese asthmatics present a higher frequency and intensity of DH than nonobese asthmatics. We also show that physical deconditioning in this population is linearly associated with cardiac (O₂ pulse), respiratory (DH), and peripheral muscle (resistance) limitation. However, multiple linear regression demonstrated that peripheral muscle limitation may explain the exercise limitation in this population.

Potential contributions of skeletal muscle contractile dysfunction to altered biomechanics in obesity

Obesity alters whole body kinematics and joint kinetics during activities of daily living which are thought to contribute to increased risk of musculoskeletal injury, development of lower extremity joint osteoarthritis (OA), and physical disability. To date, it has widely been accepted that excess adipose tissue mass is the major driver of biomechanical alterations in obesity. However, it is well established that obesity is a systemic disease affecting numerous, if not all, organ systems of the body. Indeed, obesity elicits numerous adaptations within skeletal muscle, including alterations in muscle structure (ex. myofiber size, architecture, lipid accumulation, and fiber type), recruitment patterns, and contractile function (ex. force production, power production, and fatigue) which may influence kinematics and joint kinetics. This review discusses the specific adaptations of skeletal muscle to obesity, potential mechanisms underlying these adaptations, and how these adaptations may affect biomechanics.

Longitudinal follow-up of muscle echotexture in infants with congenital muscular torticollis

Unilateral fibrous contracture of the sternocleidomastoid (SCM) muscle is the major pathophysiology in infants with congenital muscular torticollis (CMT). Physical examination is not always sufficient to detect minimal muscle fibrosis in involved SCM muscles.A prospective study for SCM muscle fibrosis in CMT infants by quantifying echotexture and muscle thickness during the course of treatment is highlighted in the study.Convenience samples of 21 female and 29 male infants with CMT, who were 1 to 12 months old, underwent physiotherapy for at least 3 months and were followed for 4.7 ± 0.4 months. All infants had at least 2 clinical assessments and ultrasonographic examinations for bilateral SCM muscles during follow-up. The K value, derived from the difference in echo intensities between the involved and uninvolved SCM muscles on longitudinal sonograms, was used to represent the severity of muscle fibrosis. Bilateral SCM muscle thickness and ratio of involved to uninvolved muscle thickness (Ratio I/U) were obtained simultaneously. Clinical outcome was also recorded.No subjects underwent surgical intervention during follow-up. The K value decreased from 6.85 ± 0.58 to 1.30 ± 0.36 at the end of follow-up (P < 0.001), which reflected the decrease of muscle fibrosis. The Ratio I/U decreased from 1.11 ± 0.04 to 0.97 ± 0.02 during treatment, which was possibly related to the increased uninvolved SCM muscle thickness.In conclusion, echotexture is an efficient indicator for reflecting a wide degree of muscle fibrosis in infants with CMT and is informative during the treatment course.

The effect of obesity on the contractile performance of isolated mouse soleus, EDL, and diaphragm muscles

Obesity affects the major metabolic and cellular processes involved in skeletal muscle contractility. Surprisingly, the effect of obesity on isolated skeletal muscle performance remains unresolved. The present study is the first to examine the muscle-specific changes in contractility following dietary-induced obesity using an isolated muscle work-loop (WL) model that more closely represents in vivo muscle performance. Following 16-wk high-calorific feeding, soleus (SOL), extensor digitorum longus (EDL), and diaphragm (DIA) were isolated from female (CD-1) mice, and contractile performance was compared against a lean control group. Obese SOL produced greater isometric force; however, isometric stress (force per unit muscle area), absolute WL power, and normalized WL power (watts per kilogram muscle mass) were unaffected. Maximal isometric force and absolute WL power of the EDL were similar between groups. For both EDL and DIA, isometric stress and normalized WL power were reduced in the obese groups. Obesity caused a significant reduction in fatigue resistance in all cases. Our findings demonstrate a muscle-specific reduction in contractile performance and muscle quality that is likely related to in vivo mechanical role, fiber type, and metabolic profile, which may in part be related to changes in myosin heavy chain expression and AMP-activated protein kinase activity. These results infer that, beyond the additional requirement of moving a larger body mass, functional performance and quality of life may be further limited by poor muscle function in obese individuals. As such, a reduction in muscle performance may be a substantial contributor to the negative cycle of obesity.

NEW & NOTEWORTHY

The effect of obesity on isolated muscle function is surprisingly underresearched. The present study is the first to examine the effects of obesity on isolated muscle performance using a method that more closely represents real-world muscle function. This work uniquely establishes a muscle-specific profile of mechanical changes in relation to underpinning mechanisms. These findings may be important to understanding the negative cycle of obesity and in designing interventions for improving weight status.

Slow, progressive myopathy in neonatally treated patients with infantile-onset Pompe disease: a muscle magnetic resonance imaging study

Background

Patients with infantile-onset Pompe disease (IOPD) can be identified through newborn screening, and the subsequent immediate initiation of enzyme replacement therapy significantly improves the prognosis of these patients. However, they still present residual muscle weakness. In the present study, we used longitudinal muscle magnetic resonance imaging (MRI) to determine whether this condition is progressive.

Materials and methods

A cohort of classic IOPD patients who were diagnosed through newborn screening were treated with recombinant human acid α-glucosidase (rhGAA) and followed prospectively from birth. The trunk (and abdominal wall), pelvis and upper thighs were scanned for muscle MRI every 2–3 years. Seven groups of muscles were individually scored from 0 to 4 based on the extent of their involvement, and the sum was correlated to the clinical manifestations.

Results

Twenty-four MRI scans from a total of 12 neonatally treated IOPD patients were analyzed in the present study. The median age at the time of MRI scanning was 4.2 years (13 days to 9 years). High intensity over the quadriceps on T2-weighted and short-tau inversion recovery images was observed in all scans and was followed by a decrease in muscle mass. Trunk muscle involvement was slower, except in one patient who exhibited progressive psoas atrophy. Among the 10 patients for whom follow-up scans were repeated more than 2 years after the first scan, four patients (40 %) showed increased myopathy severity.

Conclusion

This prospective muscle MRI study provides evidence for the occurrence of slow, progressive muscle damage in neonatally treated IOPD patients during childhood. New treatment strategies are necessary to improve outcomes in these patients.

Electronic supplementary material

The online version of this article (doi:10.1186/s13023-016-0446-7) contains supplementary material, which is available to authorized users.

The impact of obesity on skeletal muscle strength and structure through adolescence to old age

Obesity is associated with functional limitations in muscle performance and increased likelihood of developing a functional disability such as mobility, strength, postural and dynamic balance limitations. The consensus is that obese individuals, regardless of age, have a greater absolute maximum muscle strength compared to non-obese persons, suggesting that increased adiposity acts as a chronic overload stimulus on the antigravity muscles (e.g., quadriceps and calf), thus increasing muscle size and strength. However, when maximum muscular strength is normalised to body mass, obese individuals appear weaker. This relative weakness may be caused by reduced mobility, neural adaptations and changes in muscle morphology. Discrepancies in the literature remain for maximal strength normalised to muscle mass (muscle quality) and can potentially be explained through accounting for the measurement protocol contributing to muscle strength capacity that need to be explored in more depth such as antagonist muscle co-activation, muscle architecture, a criterion valid measurement of muscle size and an accurate measurement of physical activity levels. Current evidence demonstrating the effect of obesity on muscle quality is limited. These factors not being recorded in some of the existing literature suggest a potential underestimation of muscle force either in terms of absolute force production or relative to muscle mass; thus the true effect of obesity upon skeletal muscle size, structure and function, including any interactions with ageing effects, remains to be elucidated.

Investigating mechanisms underpinning the detrimental impact of a high-fat diet in the developing and adult hypermuscular myostatin null mouse

BACKGROUND

Obese adults are prone to develop metabolic and cardiovascular diseases. Furthermore, over-weight expectant mothers give birth to large babies who also have increased likelihood of developing metabolic and cardiovascular diseases. Fundamental advancements to better understand the pathophysiology of obesity are critical in the development of anti-obesity therapies not only for this but also future generations. Skeletal muscle plays a major role in fat metabolism and much work has focused in promoting this activity in order to control the development of obesity. Research has evaluated myostatin inhibition as a strategy to prevent the development of obesity and concluded in some cases that it offers a protective mechanism against a high-fat diet.

METHODS

Pregnant as well as virgin myostatin null mice and age matched wild type animals were raised on a high fat diet for up to 10 weeks. The effect of the diet was tested on skeletal muscle, liver and fat. Quantitate PCR, Western blotting, immunohistochemistry, in-vivo and ex-vivo muscle characterisation, metabonomic and lipidomic measurements were from the four major cohorts.

RESULTS

We hypothesised that myostatin inhibition should protect not only the mother but also its developing foetus from the detrimental effects of a high-fat diet. Unexpectedly, we found muscle development was attenuated in the foetus of myostatin null mice raised on a high-fat diet. We therefore re-examined the effect of the high-fat diet on adults and found myostatin null mice were more susceptible to diet-induced obesity through a mechanism involving impairment of inter-organ fat utilization.

CONCLUSIONS

Loss of myostatin alters fatty acid uptake and oxidation in skeletal muscle and liver. We show that abnormally high metabolic activity of fat in myostatin null mice is decreased by a high-fat diet resulting in excessive adipose deposition and lipotoxicity. Collectively, our genetic loss-of-function studies offer an explanation of the lean phenotype displayed by a host of animals lacking myostatin signalling.

Mechanical efficiency improvement in relation to metabolic changes in sedentary obese adults

Purpose

Mechanical efficiency (ME) refers to the ability of an individual to transfer energy consumed by external work. This performance indicator is impaired by obesity and is associated with decreased high-intensity exercise performance. However, it is unclear if ME may be improved in response to high intensity training (HIT). This study aimed to determine if ME increases in response to HIT in obese adults and to identify the factors associated with these changes.

Methods

24 obese adults (body mass index=∼33 kg/m²) were randomised into control (n=12) and trained (n=12) groups. Following baseline metabolic, anthropometric, fitness and ME measurements, the participants completed a 6-week exercise intervention that included 18 sessions of six repeats of 6 s supramaximal sprints on an electromagnetically braked cycle ergometer. The metabolic, anthropometric and fitness assessments were repeated postintervention. ME (expressed as a %) was calculated during an incremental maximal cycling test at stages of 25, 50, 75, 100 and 125 W.

Results

ME did not differ across the groups at 25 and 50 W. Following HIT, ME increased significantly at 75, 100 and 125 W (p<0.01, respectively) compared with the control group (p<0.01, respectively). Although no changes in fat-free mass were observed following HIT, the increases in ME at 75, 100 and 125 W correlated positively with both homeostasis model assessment-estimated insulin resistance index decreases (r=0.9; r=0.89 and r=0.88, p<0.01, respectively) and peak power increases (r=0.87, r=0.88 and r=0.9, p<0.01, respectively).

Conclusions

Although there were no changes in the participants’ anthropometric variables, HIT improved ME in obese adults, an enhancement that appears to be related to increases in muscle strength and metabolic adaptations.

The influence of a six-week, high-intensity games intervention on the pulmonary oxygen uptake kinetics in prepubertal obese and normal-weight children

The pulmonary oxygen uptake response is deleteriously influenced by obesity in prepubertal children, as evidenced by a slower phase II response. To date, no studies have investigated the ability of an exercise intervention to ameliorate this. The objective of the study was to investigate the influence of a 6-week, high-intensity, games-orientated intervention on the oxygen uptake kinetic response of prepubertal obese and normal-weight children during heavy-intensity exercise. Thirteen normal-weight and 15 obese children participated in a twice-weekly exercise intervention involving repeated bouts of 6-min high-intensity, games-orientated exercises followed by 2 min of recovery. Sixteen normal-weight and 11 obese children served as a control group. At baseline and post-intervention, each participant completed a graded-exercise test to volitional exhaustion and constant work-rate, heavy-intensity exercise. Post-intervention, obese children demonstrated a reduced phase II τ (pre-intervention: 30 ± 8 cf. post-intervention: 24 ± 7 s), mean response time (pre-intervention: 50 ± 10 cf. post-intervention: 38 ± 9 s) and phase II amplitude (pre-intervention: 1.51 ± 0.30 cf. post-intervention: 1.34 ± 0.27 L·min−1). No changes were evident in the normal-weight children. In conclusion, the present findings demonstrate that a 6-week, high-intensity intervention can have a significant positive impact on the dynamic oxygen uptake response of obese prepubertal children.

Obesity-related differences in neuromuscular fatigue in adolescent girls

PURPOSE

The aim of this study was to investigate the effect of obesity on neuromuscular fatigue in adolescent girls.

METHODS

Twelve lean (13.6 ± 0.8 years) and 12 obese (13.9 ± 0.9 years) girls repeated 5-s maximal voluntary contractions (MVC) of the knee extensors until the generated torque reached 55 % of its initial value. Magnetic stimulations were delivered to the femoral nerve every five MVCs to follow the course of voluntary activation (VA) and potentiated twitch torque (Qtwpot).

RESULTS

Torque reached 55 % of its initial value after 52.6 ± 20.4 and 74.9 ± 22.8 repetitions in obese and lean girls, respectively (p < 0.01). Furthermore, the decline of VA was smaller in obese girls (p < 0.001). In contrast, Qtwpot decreased to a greater extent in obese girls (p < 0.05).

CONCLUSIONS

Obese girls fatigue faster than their lean counterparts. The peripheral factors mainly account for fatigue in obese girls, whereas central factors are mainly involved in lean girls.

The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions

[Purpose]

The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise.

[Methods]

Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise.

[Results]

The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index.

[Conclusion]

CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.

Expanding roles for AMPK in skeletal muscle plasticity

Skeletal muscle possesses a remarkable plasticity and responds to environmental and physiological challenges by changing its phenotype in terms of size, composition, and metabolic properties. Muscle fibers rapidly adapt to drastic changes in energy demands during exercise through fine-tuning of the balance between catabolic and anabolic processes. One major sensor of energy demand in exercising muscle is AMP-activated protein kinase (AMPK). Recent advances have shed new light on the relevance of AMPK both as a multitask gatekeeper and as an energy regulator in skeletal muscle. Here we summarize recent findings on the function of AMPK in skeletal muscle adaptation to contraction and highlight its role in the regulation of energy metabolism and the control of skeletal muscle regeneration post-injury.

Obesity decreases both whole muscle and fascicle strength in young females but only exacerbates the aging-related whole muscle level asthenia

Obesity has previously been associated with greater muscle strength. Aging, on the other hand, reduces muscle specific force (the force per unit physiological cross‐sectional area [PCSA] of muscle). However, neither the effect of obesity on skeletal muscle specific force nor the combined effects of aging and obesity on this parameter are known. This study aimed to describe the interplay between body mass index (BMI)/adiposity, aging, and skeletal muscle specific force. Ninety‐four untrained healthy women categorized by age into young (Y; mean ± SD: 25.5 ± 9.0 years) versus old (O; 64.8 ± 7.2 years) were assessed for body composition, gastrocnemius medialis (GM) muscle volume (V), net maximum voluntary contraction (nMVC), and specific force (SF). The young obese, while demonstrating 71% and 29% (P < 0.001) higher V and nMVC compared to normal BMI individuals, were in fact 26% (P = 0.007) weaker than these, where V was used to scale nMVC (i.e., nMVC/V). The weakness associated with obesity was further exemplified in the 34% (P < 0.001) lower SF relative to normal BMI individuals. Similarly, ≥40% body fat was associated with 60% and 27% (P < 0.001) higher V and nMVC, but 11% and 25% (P < 0.01) lower nMVC/V and SF than <40% body fat. The aging‐related rates of decline in V (−2 cm³/year P < 0.05) and nMVC (−1.2 cm³/year P < 0.05) were highest in obesity defined by BMI. This effect was also seen when segregating by >40% adiposity. Interestingly, however, obesity appeared advantageous to the aging‐related changes in nMVC/V (P < 0.001) and SF (P < 0.001). Unlike previous reports of greater strength in the obese compared with leaner age‐matched counterparts, we in fact demonstrate that the young sedentary obese, are substantially weaker, where the volume of skeletal muscle is used to scale the maximal torque output, or forces are quantified at the fascicular level. The seemingly positive impact of obesity on rate of aging, however, is complex and warrants further investigations.

Our study demonstrates for the first time that at both whole muscle and fascicular levels, high body mass index (BMI) or adiposity categories of obesity are associated with significantly lower skeletal muscle contractile capacity in young adults. Interestingly, the aging effect on obese individuals classified by both BMI and adiposity was foremost observed through the loss of muscle tissue content as well as total muscle strength.

The effects of eccentric exercise on muscle function and proprioception of individuals being overweight and underweight

The aim of this study was to estimate the effect of being overweight or underweight on proprioception at rest and after muscle damaging eccentric exercise. Twelve lean, 12 overweight, and 8 underweight female participants performed an eccentric exercise session using the knee extensor muscles of the dominant leg. Muscle damage indices and proprioception were assessed up to 3 days postexercise. The results indicated that proprioception at baseline of the lean individuals was superior to that of the other 2 groups. The overweight individuals exhibited a smaller knee joint reaction angle to release than did the lean group, whereas the underweight individuals exhibited a larger reaction angle to release than did the lean group. After eccentric exercise, proprioception was affected more in the overweight and the underweight groups than in the lean group. The greater exercise-induced muscle damage appeared in the overweight group, and the deficient muscle mass of the underweight participants could explain in part the greater disturbances that appeared in proprioception in these 2 groups than for the lean counterparts. In conclusion, deviating from the normal body mass is associated with significant disturbances in the proprioception of the legs at rest and after participation in activities involving eccentric actions.

Diet-induced obesity alters skeletal muscle fiber types of male but not female mice

Skeletal muscles are highly plastic tissues capable dramatic remodeling in response to use, disuse, disease, and other factors. Growing evidence suggests that adipose tissues exert significant effects on the basic fiber‐type composition of skeletal muscles. In the current study, we investigated the long‐term effects of a high‐fat diet and subsequent obesity on the muscle fiber types in C57 BLK/6J mice. Litters of mice were randomly assigned to either a high‐fat diet or a control group at the time of weaning, and were maintained on this diet for approximately 1 year. Single fibers were harvested from the soleus and plantaris muscles, and fiber types were determined using SDS‐PAGE. The high‐fat diet mice were significantly heavier than the control mice (39.17 ± 2.7 g vs. 56.87 ± 3.4 g; P < 0.0003), but muscle masses were not different. In male mice, the high‐fat diet was associated with a significantly lower proportion of slow, type I fibers in the soleus muscle (40.4 ± 3.5% vs. 29.33 ± 2.6%; P < 0.0165). Moreover, the proportion of type I fibers in the soleus of male mice was inversely proportional to the relative fatness of the male mice (P < 0.003; r² = 0.65), but no association was observed in female mice. In male mice, the decline in type I fibers was correlated with an increase in type I/IIA hybrid fibers, suggesting that the type I fibers were transformed primarily into these hybrids. The reported trends indicate that type I fibers are most susceptible to the effects of obesity, and that these fiber‐type changes can be sex specific.

Mice were fed a high‐fat diet and subsequently became obese. Obese male mice exhibited a significant decline in slow type I fibers in the soleus muscles, compared with controls. The loss of type I fibers was directly proportional to measures of body fat, suggesting a “dose”‐dependent effect on muscle phenotype.

Oxygen uptake kinetics

Muscular exercise requires transitions to and from metabolic rates often exceeding an order of magnitude above resting and places prodigious demands on the oxidative machinery and O2-transport pathway. The science of kinetics seeks to characterize the dynamic profiles of the respiratory, cardiovascular, and muscular systems and their integration to resolve the essential control mechanisms of muscle energetics and oxidative function: a goal not feasible using the steady-state response. Essential features of the O2 uptake (VO2) kinetics response are highly conserved across the animal kingdom. For a given metabolic demand, fast VO2 kinetics mandates a smaller O2 deficit, less substrate-level phosphorylation and high exercise tolerance. By the same token, slow VO2 kinetics incurs a high O2 deficit, presents a greater challenge to homeostasis and presages poor exercise tolerance. Compelling evidence supports that, in healthy individuals walking, running, or cycling upright, VO2 kinetics control resides within the exercising muscle(s) and is therefore not dependent upon, or limited by, upstream O2-transport systems. However, disease, aging, and other imposed constraints may redistribute VO2 kinetics control more proximally within the O2-transport system. Greater understanding of VO2 kinetics control and, in particular, its relation to the plasticity of the O2-transport/utilization system is considered important for improving the human condition, not just in athletic populations, but crucially for patients suffering from pathologically slowed VO2 kinetics as well as the burgeoning elderly population.

Muscle fiber-type distribution, fiber-type-specific damage, and the Pompe disease phenotype

Pompe disease is a lysosomal storage disorder caused by acid α-glucosidase deficiency and characterized by progressive muscle weakness. Enzyme replacement therapy (ERT) has ameliorated patients' perspectives, but reversal of skeletal muscle pathology remains a challenge. We studied pretreatment biopsies of 22 patients with different phenotypes to investigate to what extent fiber-type distribution and fiber-type-specific damage contribute to clinical diversity. Pompe patients have the same fiber-type distribution as healthy persons, but among nonclassic patients with the same GAA mutation (c.-32-13T>G), those with early onset of symptoms tend to have more type 2 muscle fibers than those with late-onset disease. Further, it seemed that the older, more severely affected classic infantile patients and the wheelchair-bound and ventilated nonclassic patients had a greater proportion of type 2x muscle fibers. However, as in other diseases, this may be caused by physical inactivity of those patients.

Obesity-related differences in muscular capacity during sustained isometric exertions

Over one-third of the world adult population is overweight or obese, and the prevalence continues to increase. Obesity is a risk factor for injury, and the growing prevalence may be associated with increases in the future incidence and cost of injuries. In this study, we examined obesity-related differences in muscular capacity during sustained isometric exertions involving hand grip, shoulder flexion, and trunk extension. Thirty-six young individuals who were obese or not obese (aged 18-29) completed these exertions at fixed levels of absolute loads involving low-moderate levels of effort. Individuals who were obese had an overall ∼20% higher absolute strength, but ∼20% lower relative strength. These differences were most evident in the hand grip and shoulder exertions. Parameters of fitted exponential relationships between endurance time and task demands (as a percentage of strength) were similar in both groups. Perceptual and performance responses were also consistent between groups. Accordingly, we conclude that obesity may not substantially influence muscular capacity for these tasks.

Mechanical efficiency during a cycling test is not lower in children with excess body weight and low aerobic fitness

OBJECTIVE

The aims of this study were to assess the association between (i) body weight status and mechanical efficiency (ME); and (ii) ME and aerobic fitness in children aged 8-10 years.

DESIGN AND METHODS

The sample included 464 prepubertal children (258 boys). A total of 288 were normal-weight (NW); 84 overweight (OW); and 92 obese (OB). Subjects performed an incremental maximal cycling test with indirect calorimetry. MEcrude (%) was calculated for the first five stages of the protocol (25, 50, 75, 100, and 125 W) as follows: work produced, in watts total energy consumption, in watts(-1) · 100(-1). For MEnet, resting energy consumption was subtracted from total energy consumption. Energy consumption was calculated as follows: (4.94 · respiratory exchange ratio + 16.04) · VO2, in ml · min(-1) · 60(-1).

RESULTS

MEcrude was significantly higher in NW compared to OW and OB children and in OW compared to OB children at 25, 50, 75, 100, and 125 W. In contrast, MEnet did not differ significantly among NW, OW, and OB children. No statistically significant association was found between crude or net ME and peak oxygen consumption (VO2 peak; in ml · kg(-1) · min(-1)); therefore, the ability to transfer chemical energy to mechanical work is maintained in children aged 8-10 years old regardless of body weight status and aerobic fitness. Moreover, higher values of MEcrude during exercise are explained by elevated oxygen consumption at rest and not by energy consumed during physical activity.

CONCLUSIONS

These results highlight that prepubertal children are equally efficient since they are able to perform a physical task such as cycling using the same proportion of energy regardless of their body weight status.

Repeated bout effect was more expressed in young adult males than in elderly males and boys

This study investigated possible differences using the same stretch-shortening exercise (SSE) protocol on generally accepted monitoring markers (dependent variables: changes in creatine kinase, muscle soreness, and voluntary and electrically evoked torque) in males across three lifespan stages (childhood versus adulthood versus old age). The protocol consisted of 100 intermittent (30 s interval between jumps) drop jumps to determine the repeated bout effect (RBE) (first and second bouts performed at a 2-week interval). The results showed that indirect symptoms of exercise-induced muscle damage after SSE were more expressed in adult males than in boys and elderly males, suggesting that the muscles of boys and elderly males are more resistant to exercise-induced damage than those of adult males. RBE was more pronounced in adult males than in boys and elderly males, suggesting that the muscles of boys and elderly males are less adaptive to exercise-induced muscle damage than those of adult males.

Biomechanics of lower limb haemophilic arthropathy

Intermittent joint bleeding and potential arthropathy remain a concern for patients and those responsible for haemophilic care. Monitoring the status of haemophilic joints is a current challenge. Evaluation of bone and soft tissue with radiological imaging together with clinical joint scoring is often used to monitor haemophilic arthropathy and may not be sufficiently sensitive to early changes in joint morphology. Recently an interest in the biomechanical status of haemophilic joints has emerged. Biomechanics is defined as the interdiscipline that describes, analyses and assesses movement in relation to biological and physical principles. This review considers the biomechanical evaluation of haemophilic joint status of the lower limb with particular reference to the evaluation of muscle atrophy, muscle strength, range of motion and gait as well as the relationship to haemophilic arthropathy. In raising the need for increased clinical awareness, this review highlights the need to establish test-retest and inter-rater reliability and ensuring that comparative studies are undertaken with age-matched unaffected peer groups.

Exercise guidelines in pregnancy: new perspectives

In 2002, the American College of Obstetricians and Gynecologists published exercise guidelines for pregnancy, which suggested that in the absence of medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women. However, these guidelines did not define 'moderate intensity' or the specific amount of weekly caloric expenditure from physical activity required. Recent research has determined that increasing physical activity energy expenditure to a minimum of 16 metabolic equivalent task (MET) hours per week, or preferably 28 MET hours per week, and increasing exercise intensity to ≥60% of heart rate reserve during pregnancy, reduces the risk of gestational diabetes mellitus and perhaps hypertensive disorders of pregnancy (i.e. gestational hypertension and pre-eclampsia) compared with less vigorous exercise. To achieve the target expenditure of 28 MET hours per week, one could walk at 3.2 km per hour for 11.2 hours per week (2.5 METs, light intensity), or preferably exercise on a stationary bicycle for 4.7 hours per week (∼6-7 METs, vigorous intensity). The more vigorous the exercise, the less total time of exercise is required per week, resulting in ≥60% reduction in total exercise time compared with light intensity exercise. Light muscle strengthening performed over the second and third trimester of pregnancy has minimal effects on a newborn infant's body size and overall health. On the basis of this and other information, updated recommendations for exercise in pregnancy are suggested.

Gas exchange kinetics in obese adolescents. Inferences on exercise tolerance and prescription

A functional evaluation of skeletal muscle oxidative metabolism was performed in a group of obese adolescents (OB). The various components of pulmonary O(2) uptake (Vo(2)) kinetics were evaluated during 10-min constant-load exercises (CLE) on a cycloergometer at different percentages of Vo(2max). The relationships of these components with the gas exchange threshold (GET) were determined. Fourteen male OB [age 16.5 ± 1.0 (SD) yr, body mass index 34.5 ± 3.1 kg·m(-2)] and 13 normal-weight, age-matched nonathletic male volunteers (control group) were studied. The time-constant (τf) of the fundamental component and the presence, pattern, and relative amplitude of the slow component of Vo(2) kinetics were determined at 40, 60, and 80% of Vo(2max), previously estimated during an incremental test. Vo(2max) (l/min) was similar in the two groups. GET was lower in OB (55.7 ± 6.7% of Vo(2max)) than in control (65.1 ± 5.2%) groups. The τf was higher in OB subjects, indicating a slower fundamental component. At CLE 60% (above GET in OB subjects, below GET in control subjects) a slow component was observed in nine out of fourteen OB subjects, but none in the control group. All subjects developed a slow component at CLE 80% (above GET in both OB and control). Twelve OB subjects did not complete the 10-min CLE 80% due to voluntary exhaustion. In nine OB subjects, the slow component was characterized by a linear increase in Vo(2) as a function of time. The slope of this increase was inversely related to the time to exhaustion. The above findings should negatively affect exercise tolerance in obese adolescents and suggest an impairment of skeletal muscle oxidative metabolism. Also in obese adolescents, exercise evaluation and prescription at submaximal loads should be done with respect to GET and not at a given percentage of Vo(2max).