A simple framework to distinguish 'individualistic' from a 'uniform rate' of ageing within or between study populations

Ageing is accompanied by a progressive decline in physiological functions. It is often argued that the rate of ageing differs between people and is 'highly individualistic'. This view is not unequivocally shared, and others have argued that the rate of ageing is rather 'uniform'. Distinguishing conclusively between these views requires longitudinal data, but these are difficult to obtain as they require decades of data collection from individuals. Here, a simple framework is proposed to assess in cross-sectional data whether in a given population the rate is 'highly individualistic' or rather 'uniform'. It is illustrated that an age-related decrease in the standard deviation (SD) of a certain parameter combined with a non-changing coefficient of variation (COVAR) reflects a 'uniform' rate of ageing, whilst an increase or decrease in COVAR with or without a concomitant increase in SD reflects a 'highly individualistic' rate of ageing. This framework is applied to some published data, focussing on muscle strength, power and physical function for the sake of illustration, and it is suggested that most studies do in fact show a 'highly individualistic' rate of ageing, perhaps apart from a 'uniform' rate of ageing in master athletes.

Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults

Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.

Concurrent Validity of Four Activity Monitors in Older Adults

Sedentary behaviour (SB) and physical activity (PA) have been shown to be independent modulators of healthy ageing. We thus investigated the impact of activity monitor placement on the accuracy of detecting SB and PA in older adults, as well as a novel random forest algorithm trained on data from older persons. Four monitor types (ActiGraph wGT3X-BT, ActivPAL3c VT, GENEActiv Original, and DynaPort MM+) were simultaneously worn on five anatomical sites during ten different activities by a sample of twenty older adults (70.0 (12.0) years; 10 women). The results indicated that collecting metabolic equivalent (MET) data for 60 s provided the most representative results, minimising variability. In addition, thigh-worn monitors, including ActivPAL, Random Forest, and Sedentary Sphere-Thigh, exhibited superior performance in classifying SB, with balanced accuracies ≥ 94.2%. Other monitors, such as ActiGraph, DynaPort MM+, and GENEActiv Sedentary Sphere-Wrist, demonstrated lower performance. ActivPAL and GENEActiv Random Forest outperformed other monitors in participant-specific balanced accuracies for SB classification. Only thigh-worn monitors achieved acceptable overall balanced accuracies (≥80.0%) for SB, standing, and medium-to-vigorous PA classifications. In conclusion, it is advisable to position accelerometers on the thigh, collect MET data for ≥60 s, and ideally utilise population-specific trained algorithms.

The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men

PURPOSE

We investigated the combined impact of ageing and obesity on Achilles tendon (AT) properties in vivo in men, utilizing three classification methods of obesity.

METHOD

Forty healthy, untrained men were categorised by age (young (18-49 years); older (50-80 years)), body mass index (BMI; normal weight (≥18.5-<25); overweight (≥25-<30); obese (≥30)), body fat% (normal adipose (<28%); high adiposity (≥28%)) and fat mass index (FMI; normal (3-6); excess fat (>6-9); high fat (>9). Assessment of body composition used dual-energy X-ray absorptiometry, gastrocnemius medialis (GM)/AT properties used dynamometry and ultrasonography and endocrine profiling used multiplex luminometry.

RESULTS

Older men had lower total range of motion (ROM; -11%; P = 0.020), GM AT force (-29%; P < 0.001), stiffness (-18%; P = 0.041), Young's modulus (-22%; P = 0.011) and AT stress (-28%; P < 0.001). All three methods of classifying obesity revealed obesity to be associated with lower total ROM (P = 0.014-0.039). AT cross sectional area (CSA) was larger with higher BMI (P = 0.030). However, after controlling for age, higher BMI only tended to be associated with greater tendon stiffness (P = 0.074). Interestingly, both AT CSA and stiffness were positively correlated with body mass (r = 0.644 and r = 0.520) and BMI (r = 0.541 and r = 0.493) in the young but not older adults. Finally, negative relationships were observed between AT CSA and pro-inflammatory cytokines TNF-α, IL-6 and IL-1β.

CONCLUSIONS

This is the first study to provide evidence of positive adaptations in tendon stiffness and size in vivo resulting from increased mass and BMI in young but not older men, irrespective of obesity classification.

The validity and reliability of the Achilles tendon moment arm assessed with dual-energy X-ray absorptiometry, relative to MRI and ultrasound assessments

Dual-energy X-ray absorptiometry (DXA) in single energy mode has been shown to permit the visualisation of bone and soft tissue, such as the patellar tendon through two-dimensional sagittal imaging. However, there is no validated DXA-based measurement of the Achilles tendon moment arm (d_AT). The aims of this study were: 1) to compare in vivo DXA derived measurements of the d_AT at rest against two previously validated methods: tendon excursion (TE) and magnetic resonance imaging (MRI) at three ankle angles (-5°, 0° and +10°). 2) analyse the intra-day reliability of the DXA method at all ankle angles and compare between methods. Twelve healthy adults (mean ± SD: 31.4 ± 9.5 years; 174.0 ± 9.5 cm; 76.2 ± 16.6 kg) participated in this study, involving test-retest DXA scans, ultrasound scans and one MRI scan. The d_AT was defined as the distance from the centre of the calcaneal-tibial joint axis to the Achilles tendon (AT) muscle-tendon line of action. DXA derived d_AT measures were significantly greater than MRI measurements (19.7-24.9%) and were 45.2% significantly larger than the TE method. The test-retest reliability of the DXA technique at 0° was high [CV = 1.38%; ICC = 0.96] and despite the consistently larger d_AT lengths obtained using DXA, MRI and DEXA data were strongly correlated (r = 0.878, p < 0.001). In conclusion, the DXA technique allowed for highly reproducible in vivo d_AT measurement at rest, which has implications for the calculation of AT forces in vivo and the ability to predict the measurement from one tool to the other, thereby providing a novel basis to contrast existing and future studies.

A spatio-temporal and kinematic description of self-selected walking in adults with Achondroplasia

BACKGROUND

Achondroplasia is characterised by a shorter appendicular limb to torso ratio, compared to age matched individuals of average stature (controls). Despite the well documented shorter leg length of individuals with compared to controls, there are few complete descriptions of gait kinematics reported for the population.

AIM

The aim of this study was to report the spatio-temporal and kinematic characteristics of self-selected walking (SSW) in a group with Achondroplasia (N = 10) and age matched group without Achondroplasia (controls, N = 17).

METHOD

Whole body 3D analysis of both groups was conducted using a 14 camera VICON system. Spatio-temporal and kinematic variables were determined through a Plug-in-Gait model. SSW was obtained from an average of three trials equating to a total of ∼120 m walking.

RESULTS

The group with Achondroplasia were 23 % slower (P < 0.001), had a 29 % shorter stride length (P < 0.001) and a 13 % higher stride frequency (P < 0.001) compared to controls. There were no differences in time normalised temporal measures of left toe off (P = 0.365), right heel contact (P = 0.442) or the duration of double support (P = 0.588) between groups. A number of discrete joint kinematic differences existed between groups, resulting in the group with Achondroplasia having more 'flexed' lower limbs than controls throughout the gait cycle.

CONCLUSION

Differences in absolute spatio-temporal variables between groups is likely due to the shorter leg length of the group with Achondroplasia, while their more flexed position of the lower limbs may facilitate toe-clearance during the swing phase.

A quantitative description of self-selected walking in adults with Achondroplasia using the gait profile score

BACKGROUND

Achondroplasia is characterised by a shorter appendicular limb-to-torso ratio, compared to age matched individuals of average stature (controls). Previous work shows gait kinematics of individuals with Achondroplasia differing to controls, but no global quantification of gait has been made in adults with Achondroplasia.

AIM

The aim of this study was to quantify gait differences between a group of adult males with Achondroplasia and controls during self-selected walking (SSW) using the Gait Profile Score (GPS).

DESIGN

Whole body motion analysis of 10 adults with Achondroplasia (22 ± 3 yrs) who had not undergone leg lengthening and 17 adult controls (22 ± 2 yrs) was undertaken using a 14 camera VICON system (100 Hz). For each group, fifteen root mean squared Gait Variable Scores (GVS, units °) were computed from lower limb kinematic data and then summed to calculate GPS (°).

RESULTS

The group with Achondroplasia had higher GVSs than controls in 10 of the 15 measures (P < 0.05) with the largest differences found in ankle plantar/dorsiflexion (P < 0.001), knee flexion/extension (P < 0.001), and hip internal/external rotation (P < 0.001). The GPS value of the group with Achondroplasia was 64% higher than controls (11.4° (2.0) v 4.1° (1.8), P < 0.001).

CONCLUSION

Gait is quantitatively different in adults with Achondroplasia compared to controls. The differences in GPS between groups are due to differences in joint kinematics, which are possibly manifested by maintaining toe-clearance during swing. Gait models derived from the anatomy of individuals with Achondroplasia may improve these data.

Morphological and Mechanical Properties of the Human Patella Tendon in Adult Males With Achondroplasia

Achondroplasia is a genetic mutation of fibroblast growth factor receptor resulting in impaired growth plate development in long bones due to lower collagen turnover. Despite the characteristic shorter stature and lower strength in Achondroplasic groups, little is known of the tendon mechanical properties under loading. The aim of this study was therefore to conduct a between measure design of patella tendon (PT) mechanical properties (stress, strain, stiffness and Young's Modulus) in 10 men with Achondroplasia (22 ± 3 years) and 17 male controls (22 ± 2 years). PT mechanical properties were measured during isometric maximal voluntary contraction (iMVC) of the knee extensors using ultrasonography. The Achondroplasic group produced 54% less stress at iMVC than controls (29.4 ± 8.0 v 64.5 ± 14.0 MPa, P < 0.001, d = 3.12). Maximal excursion of the Achondroplasic PT was 22% less than controls at iMVC (7.4 ± 2.1 v 5.5 ± 1.7 mm, P < 0.001, d = 0.99), but there was no difference in strain between groups (13 ± 4 v 13 ± 3%, P > 0.05). Achondroplasic PT were 47% less stiff (748 ± 93 v 1418 ± 101 N·mm⁻¹, P < 0.001, d = 6.89) and had a 51% lower Young's modulus (0.39 ± 0.09 v 0.77 ± 0.14 GPa, P < 0.001, d = 3.46) than controls at iMVC. Achondroplasic PT are indeed more compliant than controls which may contribute to lower relative force production. The causes of higher Achondroplasic PT compliance are unclear but are likely due to the collagen related genetic mutation which causes Achondroplasia.

The Oxygen Consumption and Metabolic Cost of Walking and Running in Adults With Achondroplasia

The disproportionate body mass and leg length of Achondroplasic individuals may affect their net oxygen consumption (V͘O₂) and metabolic cost (C) when walking at running compared to those of average stature (controls). The aim of this study was to measure submaximal V͘O₂ and C during a range of set walking speeds (SWS; 0.56 – 1.94 m⋅s^-1, increment 0.28 m⋅s^-1), set running speeds (SRS; 1.67 – 3.33 m⋅s^-1, increment 0.28 m⋅s^-1) and a self-selected walking speed (SSW). V͘O₂ and C was scaled to total body mass (TBM) and fat free mass (FFM) while gait speed was scaled to leg length using Froude’s number (Fr). Achondroplasic V͘O_2TBM and V͘O_2FFM were on average 29 and 35% greater during SWS (P < 0.05) and 12 and 18% higher during SRS (P < 0.05) than controls, respectively. Achondroplasic C_TBM and C_FFM were 29 and 33% greater during SWS (P < 0.05) and 12 and 18% greater during SRS (P < 0.05) than controls, respectively. There was no difference in SSW V͘O_2TBM or V͘O_2FFM between groups (P > 0.05), but C_TBM and C_FFM at SSW were 23 and 29% higher (P < 0.05) in the Achondroplasic group compared to controls, respectively. V͘O_2TBM and V͘O_2FFM correlated with Fr for both groups (r = 0.984 – 0.999, P < 0.05). Leg length accounted for the majority of the higher V͘O_2TBM and V͘O_2FFM in the Achondroplasic group, but further work is required to explain the higher Achondroplasic C_TBM and C_FFM at all speeds compared to controls.

New and Noteworthy: There is a leftward shift of oxygen consumption scaled to total body mass and fat free mass in Achondroplasic adults when walking and running. This is nullified when talking into account leg length. However, despite these scalars, Achondroplasic individuals have a higher walking and metabolic cost compared to age matched non-Achondroplasic individuals, suggesting biomechanical differences between the groups.

Specific force of the vastus lateralis in adults with achondroplasia

Achondroplasia is a clinical condition defined by shorter stature and disproportionate limb length. Force production in able-bodied individuals (controls) is proportional to muscle size, but given the disproportionate nature of achondroplasia, normalizing to anatomical cross-sectional area (ACSA) is inappropriate. The aim of this study was to assess specific force of the vastus lateralis (VL) in 10 adults with achondroplasia (22 ± 3 yr) and 18 sex-matched controls (22 ± 2 yr). Isometric torque (iMVCτ) of the dominant knee extensors (KE) and in vivo measures of VL muscle architecture, volume, activation, and patella tendon moment arm were used to calculate VL physiological CSA (PCSA), fascicle force, and specific force in both groups. Achondroplasic muscle volume was 53% smaller than controls (284 ± 36 vs. 604 ± 102 cm³, P < 0.001). KE iMVCτ was 63% lower in achondroplasia compared with controls (95 ± 24 vs. 256 ± 47 N⋅m, P < 0.001). Activation and moment arm length were similar between groups ( P > 0.05), but coactivation of bicep femoris of achondroplasic subjects was 70% more than controls (43 ± 20 vs. 13 ± 5%, P < 0.001). Achondroplasic subjects had 58% less PCSA (43 ± 10 vs. 74.7 ± 14 cm², P < 0.001), 29% lower fascicle force (702 ± 235 vs. 1704 ± 303 N, P < 0.001), and 29% lower specific force than control subjects (17 ± 6 vs. 24 ± 6 N⋅cm^-2, P = 0.012). The smaller VL specific force in achondroplasia may be attributed to infiltration of fat and connective tissue, rather than to any difference in myofilament function. NEW & NOTEWORTHY The novel observation of this study was the measurement of normalized force production in a group of individuals with disproportionate limb length-to-torso ratios.

The manipulation of strain, when stress is controlled, modulates in vivo tendon mechanical properties but not systemic TGF-β1 levels

Modulators of loading-induced in vivo adaptations in muscle–tendon complex (MTC) mechanical properties remain unclear. Similarly contentious, is whether changes in MTC characteristics are associated with growth factor levels. Four groups were subjected to varying magnitudes of stress/strain: Group 1 trained with the MTC at a shortened position (MTCS; n = 10); Group 2 at a lengthened position (MTCL; n = 11; stress levels matched to MTCS); Group 3 over a wide range of motion (MTCX; n = 11); and Group 4 (n = 10) was the control population (no training). Patella tendon Stiffness (P < 0.001), Young's modulus, and quadriceps torque (P < 0.05) increments (only seen in the training groups), showed MTCL and MTCX groups responses to be superior to those of MTCS (P < 0.05). In addition, MTCL and MTCX better maintained adaptations compared to MTCS (P < 0.05) following detraining, with a pattern of slower loss of improvements at the early phase of detraining in all training groups. There were no significant changes (P > 0.05) in antagonist cocontraction, patella tendon dimensions or circulating transforming growth factor beta (TGF-β1) levels following training or detraining in any of the groups. We conclude that chronically loading the MTC in a relatively lengthened position (which involves greater strains) enhances its mechanical properties, more so than loading in a shortened position. This is true even after normalizing for internal stress. The underlying endocrine mechanisms do not appear to be mediated via TGF-β1, at least not at the systemic level. Our findings have implications with regard to the effectiveness of eccentric loading on improved tendon structural and mechanical properties.