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Karlsen A, Cullum CK, Norheim KL, Scheel FU, Zinglersen AH, Vahlgren J, Schjerling P, Kjaer M, Mackey AL. Neuromuscular Electrical Stimulation Preserves Leg Lean Mass in Geriatric Patients. Med Sci Sports Exerc 2020; 52:773-784. [PMID: 31688649 DOI: 10.1249/mss.0000000000002191] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM This study aimed to examine changes in lean mass during hospitalization in geriatric patients and the effect of muscle activation by neuromuscular electrical stimulation. METHODS Thirteen patients (69-94 yr) at a geriatric ward completed tests at hospital admission (days 2-3) and discharge (days 8-10). One leg received daily stimulation of the knee extensors, whereas the other leg served as a control leg. Lean mass was evaluated by dual-energy x-ray absorptiometry scans and muscle thickness by ultrasound scans. Muscle biopsies were collected from both legs at admission and discharge in nine patients and analyzed for fiber size, satellite cell number, and activation and expression of genes associated with muscle protein synthesis and breakdown, connective tissue, and cellular stress. RESULTS The relative decline in leg lean mass and midthigh region lean mass was larger in the control (-2.8% ± 1.5%) versus the stimulated leg (-0.5% ± 1.4%, P < 0.05). Although there were no changes in fiber size or satellite cell number, the mRNA data revealed that, compared with control, the stimulation resulted in a downregulation of myostatin (P < 0.05) and a similar trend for MAFbx (P = 0.099), together with an upregulation of Collagen I (P < 0.001), TenascinC (P < 0.001), CD68 (P < 0.01), and Ki67 (P < 0.05) mRNA. CONCLUSION These findings demonstrate a moderate decline in leg lean mass during a hospital stay in geriatric patients, whereas leg lean mass was preserved with daily neuromuscular electrical muscle activation. At the cellular level, the stimulation had a clear influence on suppression of atrophy signaling pathways in parallel with a stimulation of connective tissue and cellular remodeling processes.
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Moro T, Brightwell CR, Phalen DE, McKenna CF, Lane SJ, Porter C, Volpi E, Rasmussen BB, Fry CS. Low skeletal muscle capillarization limits muscle adaptation to resistance exercise training in older adults. Exp Gerontol 2019; 127:110723. [PMID: 31518665 DOI: 10.1016/j.exger.2019.110723] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/06/2019] [Accepted: 09/03/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Adequate muscle perfusion supports the transport of nutrients, oxygen and hormones into muscle fibers. Aging is associated with a substantial decrease in skeletal muscle capillarization, fiber size and oxidative capacity, which may be improved with regular physical activity. The aim of this study was to investigate the relationship between muscle capillarization and indices of muscle hypertrophy (i.e. lean mass; fiber cross sectional area (CSA)) in older adults before and after 12 weeks of progressive resistance exercise training (RET). DESIGN Interventional study SETTING AND PARTICIPANTS: 19 subjects (10 male and 9 female; 71.1 ± 4.3 years; 27.6 ± 3.2 BMI) were enrolled in the study and performed a whole body RET program for 12 weeks. Subjects where then retrospectively divided into a LOW or HIGH group, based on their pre-RET capillary-to-fiber perimeter exchange index (CFPE). Physical activity level, indices of capillarization (capillaries-to-fiber ratio, C:Fi; CFPE index and capillary-to-fiber interface, LC-PF index), muscle hypertrophy, muscle protein turnover and mitochondrial function were assessed before and after RET. RESULTS Basal capillarization (C:Fi; CFPE and LP-CF index) correlates with daily physical activity level (C:Fi, r = 0.57, p = 0.019; CFPE index, r = 0.55, p = 0.024; LC-PF index, r = 0.56, p = 0.022) and CFPE and LC-PF indices were also positively associated with oxidative capacity (respectively r = 0.45, p = 0.06; r = 0.67, p = 0.004). Following RET, subjects in the HIGH group underwent hypertrophy with significant improvements in muscle protein synthesis and muscle fiber CSA (p < 0.05). However, RET did not promote muscle hypertrophy in the LOW group, but RET significantly increased muscle capillary density (p < 0.05). CONCLUSION/IMPLICATIONS Muscle fiber capillarization before starting an exercise training program may be predictive of the muscle hypertrophic response to RET in older adults. Increases in muscle fiber size following RET appear to be blunted when muscle capillarization is low, suggesting that an adequate initial capillarization is critical to achieve a meaningful degree of muscle adaptation to RET.
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Affiliation(s)
- Tatiana Moro
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Camille R Brightwell
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Danielle E Phalen
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Colleen F McKenna
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Samantha J Lane
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Craig Porter
- Metabolism Unit, Shriners Hospitals for Children, Galveston, TX, USA; Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Department of Internal Medicine/Geriatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - Blake B Rasmussen
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Christopher S Fry
- Department of Nutrition & Metabolism, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
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Reidy PT, Yonemura NM, Madsen JH, McKenzie AI, Mahmassani ZS, Rondina MT, Lin YK, Kaput K, Drummond MJ. An accumulation of muscle macrophages is accompanied by altered insulin sensitivity after reduced activity and recovery. Acta Physiol (Oxf) 2019; 226:e13251. [PMID: 30632274 DOI: 10.1111/apha.13251] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mechanisms underlying physical inactivity-induced insulin resistance are not well understood. In addition to a role in muscle repair, immune cell populations such as macrophages may regulate insulin sensitivity. AIM The aim of this study was to examine if the dynamic changes in insulin sensitivity during and after recovery from reduced physical activity corresponded to changes in skeletal muscle macrophages. METHODS In this prospective clinical study, we collected muscle biopsies from healthy older adults (70 ± 2 years, n = 12) before and during a hyperinsulinaemic-euglycaemic clamp and this occurred before (PRE) and after 2-week reduced physical activity (RA), and following 2-week of recovery (REC). Insulin sensitivity (hyperinsulinaemic-euglycaemic clamp), skeletal muscle mRNA expression of inflammatory markers, and immunofluorescent quantification of skeletal muscle macrophages, myofibre-specific satellite cell and capillary content were assessed. RESULTS Insulin sensitivity was decreased following reduced activity and rebounded following recovery above PRE levels. We observed an increase (P < 0.01) in muscle macrophages (CD68+ CD206+ : 190 [55, 324]; CD11b+ CD206+ : 117 [28, 205]% change from PRE) and CD68 (2.4 [1.4, 3.4]-fold) and CCL2 (1.9 [1.3, 2.5]-fold) mRNA following RA concurrent with increased (P < 0.03) satellite cells (55 [6, 104]%) in slow-twitch myofibres. Moreover, the distance of satellite cells to the nearest capillary was increased 7.7 (1.7, 13.7) µm in fast-twitch myofibres at RA (P = 0.007). Changes in macrophages were positively associated with increased insulin sensitivity following RA (R > 0.57, P < 0.05). CONCLUSION These findings suggested that a dynamic response of skeletal muscle macrophages following acute changes in physical activity in healthy older adults is related to insulin sensitivity.
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Affiliation(s)
- Paul T. Reidy
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Nikol M. Yonemura
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | | | - Alec I. McKenzie
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Ziad S. Mahmassani
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Matthew T. Rondina
- Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Yu Kuei Lin
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Katie Kaput
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Micah J. Drummond
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
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Moore DR, Kelly RP, Devries MC, Churchward-Venne TA, Phillips SM, Parise G, Johnston AP. Low-load resistance exercise during inactivity is associated with greater fibre area and satellite cell expression in older skeletal muscle. J Cachexia Sarcopenia Muscle 2018; 9:747-754. [PMID: 29761654 PMCID: PMC6104111 DOI: 10.1002/jcsm.12306] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/07/2018] [Accepted: 03/21/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Age-related sarcopenia is accelerated by physical inactivity. Low-load resistance exercise (LLRE) counters inactivity-induced muscle atrophy in older adults, but changes in muscle fibre morphology are unstudied. We aimed to determine the impact of LLRE during short-term inactivity (step-reduction) on muscle fibre size and capillarity as well as satellite cell (SC) content in older skeletal muscle. METHODS Fourteen older (~71 years) male adults underwent 14 days of step reduction (<1500 steps/day) while performing six sessions of LLRE (~30% maximal strength) with one leg (SR + EX) while the contralateral leg served as an untrained control (SR). Seven healthy ambulatory age-matched male adults (~69 years) served as a comparator group (COM). Muscle biopsies were taken from the vastus lateralis after 14 days, and immunohistochemical analysis was performed to determine muscle fibre cross-sectional area (CSA), myonuclear content, SC content (PAX7+ cells), and total (C:F) and fibre type-specific (C:Fi) capillary-to-fibre ratios. RESULTS Type I and II fibre CSA was greater in SR + EX compared with SR. Whereas there were no differences across fibre types between SR + EX and CON, type II fibre CSA was significantly lower in SR compared with COM. Type II myonuclear domain was greater in SR + EX compared with COM and SR. Pax7+ cells associated with type I and II fibres were lower in SR compared with SR + EX. Type II PAX7+ cells were also lower in SR compared with COM with a similar trend for type I fibres. There were trends for a lower C:Fi in SR compared with SR + EX for both fibre types with no differences for each compared with COM. CONCLUSIONS Minimal LLRE during a period of decreased physical activity is associated with greater muscle fibre CSA, SC content, and capillarization. These results support the use of LLRE as an effective countermeasure to inactivity-induced alterations in muscle morphology with age.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Ryan P Kelly
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
| | | | | | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adam P Johnston
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
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Reidy PT, McKenzie AI, Brunker P, Nelson DS, Barrows KM, Supiano M, LaStayo PC, Drummond MJ. Neuromuscular Electrical Stimulation Combined with Protein Ingestion Preserves Thigh Muscle Mass But Not Muscle Function in Healthy Older Adults During 5 Days of Bed Rest. Rejuvenation Res 2017; 20:449-461. [PMID: 28482746 DOI: 10.1089/rej.2017.1942] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Short-term bed rest in older adults is characterized by significant loss in leg lean mass and strength posing significant health consequences. The purpose of this study was to determine in healthy older adults if the daily combination of neuromuscular electrical stimulation and protein supplementation (NMES+PRO) would protect muscle mass and function after 5 days of bed rest. Twenty healthy older adults (∼70 years) were subjected to 5 days of continuous bed rest and were randomized into one of two groups: NMES+PRO (n = 10) or control (CON) (n = 10). The NMES+PRO group received bilateral NMES to quadriceps (40 minutes/session, 3 × /day; morning, afternoon, and evening) followed by an interventional protein supplement (17 g). The CON group received an isocaloric equivalent beverage. Before and after bed rest, vastus lateralis biopsies occurred before and after acute essential amino acid (EAA) ingestion for purposes of acutely stimulating mechanistic target of rapamycin (mTORC1) signaling, a major regulator of muscle protein synthesis, in response to bed rest and NMES+PRO. Baseline (pre and post bed rest) muscle samples were also used to assess myofiber characteristics and gene expression of muscle atrophy markers. Thigh lean mass and muscle function were measured before and after bed rest. Five days of bed rest reduced thigh lean mass, muscle function, myofiber cross-sectional area, satellite cell content, blunted EAA-induced mTORC1 signaling, and increased myostatin and MAFbx mRNA expression. Interestingly, NMES+PRO during bed rest maintained thigh lean mass, but not muscle function. Thigh muscle preservation during bed rest with NMES+PRO may partly be explained by attenuation of myostatin and MAFbx mRNA expression rather than restoration of nutrient-induced mTORC1 signaling. We conclude that the combination of NMES and protein supplementation thrice a day may be an effective therapeutic tool to use to preserve thigh muscle mass during periods of short-term hospitalization in older adults. However this combined intervention was not effective to prevent the loss in muscle function.
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Affiliation(s)
- Paul T Reidy
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah
| | - Alec I McKenzie
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah
| | - Preston Brunker
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah
| | - Daniel S Nelson
- 2 Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Katherine M Barrows
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah
| | - Mark Supiano
- 3 Division of Geriatrics, University of Utah , Salt Lake City, Utah.,4 VA Salt Lake City Geriatric Research , Education, and Clinical Center, University of Utah, Salt Lake City, Utah
| | - Paul C LaStayo
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah
| | - Micah J Drummond
- 1 Department of Physical Therapy and Athletic Training, University of Utah , Salt Lake City, Utah.,2 Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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