Sarcopenia parameters in active older adults - an eight-year longitudinal study

BACKGROUD

Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population.

METHODS

The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants' overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements.

RESULTS

In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and - 48.5%; p < .001, respectively).

CONCLUSIONS

Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature.

TRIAL REGISTRATION

The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.

Muscle activation during leg-press exercise with or without eccentric overload

PURPOSE

This study sought to investigate the electromyographic activity of the vastus lateralis (VL) muscle during concentric-eccentric exercise using a new concept leg press machine enabling a preset overloading in the eccentric phase.

METHODS

Ten young males familiar with resistive exercise were recruited for this study. Tests were performed on a Leg-press Biostrength® (Technogym S.p.A., Italy). The load was set to 70% and 80% of one-repetition maximum (1-RM). The participants performed 2 sets of 6 repetitions at each relative load with (ECC +) and without (ISOW) an eccentric overload equivalent to 150% of the concentric load. A metronome was employed to maintain the selected cadence. Sets were separated by a 5-min rest. Surface electromyography (EMG) of VL was recorded and integrated (iEMG).

RESULTS

Results showed a higher iEMG in ECC + with respect to ISOW at both intensities (+ 29% for 70% 1-RM, p < 0.01 and + 31% for 80% 1-RM, p < 0.001). No statistically significant differences were detected between concentric and eccentric phase in both ECC + conditions.

CONCLUSIONS

Training with a 150% eccentric overload provides a ~ 30% greater motor unit recruitment of the VL muscle in leg press exercise. Moreover, the results show that the eccentric overloading provided by the Biostrength® machine enables training at the same level of neural activation of the concentric phase. Hence, the derecruitment of motor units, normally observed during the eccentric phase when using conventional training machines, was overcome using the Biostrength® machine; this observation seems particularly important for maximizing neuromuscular responses to strength training.

A double-blind placebo controlled trial into the impacts of HMB supplementation and exercise on free-living muscle protein synthesis, muscle mass and function, in older adults

Age-related sarcopenia and dynapenia are associated with frailty and metabolic diseases. Resistance exercise training (RET) adjuvant to evidence-based nutritional intervention(s) have been shown as mitigating strategies. Given that β-hydroxy-β-methyl-butyrate (HMB) supplementation during RET improves lean body mass in younger humans, and that we have shown that HMB acutely stimulates muscle protein synthesis (MPS) and inhibits breakdown; we hypothesized that chronic supplementation of HMB free acid (HMB-FA) would enhance MPS and muscle mass/function in response to RET in older people.

We recruited 16 healthy older men (Placebo (PLA): 68.5 ± 1.0 y, HMB-FA: 67.8 ± 1.15 y) for a randomised double-blind-placebo controlled trial (HMB-FA 3 × 1 g/day vs. PLA) involving a 6-week unilateral progressive RET regime (6 × 8 repetitions, 75% 1-RM, 3 · wk⁻¹). Deuterium oxide (D₂O) dosing was performed over the first two weeks (0–2 wk) and last two weeks (4–6 wk) with bilateral vastus lateralis (VL) biopsies at 0–2 and 4–6 wk (each time 75 ± 2 min after a single bout of resistance exercise (RE)) for quantification of early and later MPS responses and post-RE myogenic gene expression. Thigh lean mass (TLM) was measured by DXA, VL thickness and architecture (fibre length and pennation angle) by ultrasound at 0/3/6 wk, and strength by knee extensor 1-RM testing and MVC by isokinetic dynamometry (approx. every 10 days).

RET induced strength increases (1-RM) in the exercised leg of both groups (398 ± 22N to 499 ± 30N HMB-FA vs. 396 ± 29N to 510 ± 43N PLA (both P < 0.05)). In addition, maximal voluntary contraction (MVC) also increased (179 ± 12 Nm to 203 ± 12 Nm HMB-FA vs. 185 ± 10 Nm to 217 ± 11 Nm PLA (both P < 0.05); with no group differences. VL muscle thickness increased significantly in the exercised leg in both groups, with no group differences. TLM (by DXA) rose to significance only in the HMB-FA group (by 5.8%–5734 ± 245 g p = 0.015 vs. 3.0% to 5644 ± 323 g P = 0.06 in PLA). MPS remained unchanged in the untrained legs (UT) 0–2 weeks being 1.06 ± 0.08%.d⁻¹ (HMB-FA) and 1.14 ± 0.09%.d⁻¹ (PLA), the trained legs (T) exhibited increased MPS in the HMB-FA group only at 0–2-weeks (1.39 ± 0.10%.d⁻¹, P < 0.05) compared with UT: but was not different at 4–6-weeks: 1.26 ± 0.05%.d⁻¹. However, there were no significant differences in MPS between the HMB-FA and PLA groups at any given time point and no significant treatment interaction observed. We also observed significant inductions of c-Myc gene expression following each acute RE bout, with no group differences. Further, there were no changes in any other muscle atrophy/hypertrophy or myogenic transcription factor genes we measured.

RET with adjuvant HMB-FA supplements in free-living healthy older men did not enhance muscle strength or mass greater than that of RET alone (PLA). That said, only HMB-FA increased TLM, supported by early increases in chronic MPS. As such, chronic HMB-FA supplementation may result in long term benefits in older males, however longer and larger studies may be needed to fully determine the potential effects of HMB-FA supplementation; translating to any functional benefit.

Regional regulation of focal adhesion kinase after concentric and eccentric loading is related to remodelling of human skeletal muscle

AIMS

We assessed focal adhesion kinase (FAK) response to concentric (CON) vs eccentric (ECC) resistance training (RT) at two vastus lateralis (VL) sites, and the relationships between FAK, muscle protein synthesis (MPS) and morphological remodelling.

METHODS

Six young males trained both legs unilaterally 3 times/week for 8 weeks; one leg performed CON RT, the contralateral performed ECC RT. Muscle biopsies were collected after training from VL mid-belly (MID) and distal (distal) sites at 0, 4, 8 weeks. Focal adhesion kinase content and activation were evaluated by immunoblotting. MPS was assessed by deuterium oxide tracer; morphological adaptations were evaluated by ultrasound and DXA.

RESULTS

pY397-FAK 8 weeks levels were ~4-fold greater after ECC at the distal site compared to CON (P < .05); pY397FAK to total FAK ratio was greater in ECC vs CON at 4 (~2.2-fold, P < .05) and 8 weeks (~9-fold, P < .001) at the distal site. Meta-vinculin was found transiently increased at 4 weeks at the distal site only after ECC RT. ECC presented greater fascicle length (Lf) increases (10.5% vs 4%), whereas CON showed greater in pennation angle (PA) changes (12.3% vs 2.1%). MPS did not differ between exercise types or muscle sites at all time points. distal pY397-FAK and pY397-FAK/FAK values correlated to changes in Lf at 8 weeks (r = .76, P < .01 and r = .66, P < .05 respectively).

CONCLUSION

Focal adhesion kinase phosphorylation was greater at 8 weeks after ECC RT and was muscle region-specific. FAK activity correlated to contraction-dependent architectural remodelling, suggesting a potential role of FAK in orienting muscle structural changes in response to distinct mechanical stimuli.

Muscle thickness correlates to muscle cross-sectional area in the assessment of strength training-induced hypertrophy

Muscle thickness (MT) measured by ultrasound has been used to estimate cross-sectional area (measured by CT and MRI) at a single time point. We tested whether MT could be used as a valid marker of MRI determined muscle anatomical cross-sectional area (ACSA) and volume changes following resistance training (RT). Nine healthy, young, male volunteers (24 ± 2 y.o., BMI 24.1 ± 2.8 kg/m² ) had vastus lateralis (VL) muscle volume (VOL) and ACSA_mid (at 50% of femur length, FL) assessed by MRI, and VL MT measured by ultrasound at 50% FL. Measurements were taken at baseline and after 12 weeks of isokinetic RT. Differences between baseline and post-training were assessed by Student's paired t test. The relationships between MRI and ultrasound measurements were tested by Pearson's correlation. After RT, MT increased by 7.5 ± 6.1% (P < .001), ACSA_mid by 5.2 ± 5% (P < .001), and VOL by 5.0 ± 6.9% (P < .05) (values: means ± SD). Positive correlations were found, at baseline and 12 weeks, between MT and ACSA_mid (r = .82, P < .001 and r = .73, P < .001, respectively), and between MT and VOL (r = .76, P < .001 and r = .73, P < .001, respectively). The % change in MT with training was correlated with % change in ACSA_mid (r = .69, P < .01), but not % change in VOL (r = .33, P > .05). These data support evidence that MT is a reliable index of muscle ACSA_mid and VOL at a single time point. MT changes following RT are associated with parallel changes in muscle ACSA_mid but not with the changes in VOL, highlighting the impact of RT on regional hypertrophy.

Adjustments of muscle capillarity but not mitochondrial protein with skiing in the elderly

Downhill skiing in the elderly increases maximal oxygen uptake (VO2max) and carbohydrate handling, and produces muscle hypertrophy. We hypothesized that adjustments of the cellular components of aerobic glucose combustion in knee extensor muscle, and cardiovascular adjustments, would increase in proportion to VO2max. Nineteen healthy elderly subjects (age 67.5 ± 2.9 years) who completed 28.5 days of guided downhill skiing over 3 months were assessed for anthropometric variables, cardiovascular parameters (heart rate, hematocrit), VO2max, and compared with controls (n = 20). Biopsies of vastus lateralis muscle were analyzed for capillary density and expression of respiratory chain markers (NDUFA9, SDHA, UQCRC1, ATP5A1) and the glucose transporter GLUT4. Statistical significance was assessed with a repeated analysis of variance and Fisher's post-hoc test at a P value of 5%. VO2max increased selectively with ski training (+7 ± 2%). Capillary density (+11 ± 5%) and capillary-to-fiber ratio (12 ± 5%), but not the concentration of metabolic proteins, in vastus lateralis were increased after skiing. Cardiovascular parameters did not change. Fold changes in VO2max and capillary-to-fiber ratio were correlated and were under genetic control by polymorphisms of the regulator of vascular tone, angiotensin converting enzyme. The observations indicate that increased VO2max after recreational downhill ski training is associated with improved capillarity in a mainly recruited muscle group.

Associations between muscle strength, spirometric pulmonary function and mobility in healthy older adults

Pathological obstruction in lungs leads to severe decreases in muscle strength and mobility in patients suffering from chronic obstructive pulmonary disease. The purpose of this study was to investigate the interdependency between muscle strength, spirometric pulmonary functions and mobility outcomes in healthy older men and women, where skeletal muscle and pulmonary function decline without interference of overt disease. A total of 135 69- to 81-year-old participants were recruited into the cross-sectional study, which was performed as a part of European study MyoAge. Full, partial and no mediation models were constructed to assess the interdependency between muscle strength (handgrip strength, knee extension torque, lower extremity muscle power), spirometric pulmonary function (FVC, FEV1 and FEF50) and mobility (6-min walk and Timed Up and Go tests). The models were adjusted for age, sex, total fat mass, body height and site of enrolment. Partial mediation models, indicating both direct and pulmonary function mediated associations between muscle strength and mobility, fitted best to the data. Greater handgrip strength was significantly associated with higher FVC, FEV1 and FEF50 (p < 0.05). Greater muscle power was significantly associated with better performance in mobility tests. Results suggest that decline in mobility with aging may be caused by decreases in both muscle strength and power but also mediated through decreases in spirometric pulmonary function. Future longitudinal studies are warranted to better understand how loss of function and mass of the respiratory muscles will affect pulmonary function among older people and how these changes are linked to mobility decline.

Effect of alpine skiing training on tendon mechanical properties in older men and women

Strain is one of the parameters determining tendon adaptation to mechanical stimuli. The aim of this study was to test whether the patellar tendon strain induced during recreational alpine skiing would affect tendon mechanical properties in older individuals. Twenty-two older males and females (67 ± 2 years) were assigned to a 12-week guided skiing programme (IG) and 20 aged-matched volunteers served as controls (CG). Patellar tendon mechanical properties and cross-sectional area (CSA) were measured before and after training, with combined dynamometry and ultrasonography scanning. None of the variables changed significantly in the CG after training. In the IG, tendon stiffness and Young's modulus were increased (respectively, 14% and 12%, P<0.01), without any significant change in tendon CSA. In addition, changes in tendon stiffness were blunted in women (9%) compared with men (19%). Serum IGF-1 concentration tended to be lower in women (-19%, P=0.07). These results demonstrate that the mechanical stimulus induced by alpine skiing is sufficient to elicit adaptive changes in patellar tendon mechanical and material properties in older subjects. Furthermore, the present sex-specific adaptations are consistent with previous reports of lower collagen metabolic responsiveness in women and may be underpinned by anthropometric and metabolic differences.

On muscle, tendon and high heels

Wearing high heels (HH) places the calf muscle-tendon unit (MTU) in a shortened position. As muscles and tendons are highly malleable tissues, chronic use of HH might induce structural and functional changes in the calf MTU. To test this hypothesis, 11 women regularly wearing HH and a control group of 9 women were recruited. Gastrocnemius medialis (GM) fascicle length, pennation angle and physiological cross-sectional area (PCSA), the Achilles' tendon (AT) length, cross-sectional area (CSA) and mechanical properties, and the plantarflexion torque-angle and torque-velocity relationships were assessed in both groups. Shorter GM fascicle lengths were observed in the HH group (49.6+/-5.7 mm vs 56.0+/-7.7 mm), resulting in greater tendon-to-fascicle length ratios. Also, because of greater AT CSA, AT stiffness was higher in the HH group (136.2+/-26.5 N mm(-1) vs 111.3+/-20.2 N mm(-1)). However, no differences in the GM PCSA to AT CSA ratio, torque-angle and torque-velocity relationships were found. We conclude that long-term use of high-heeled shoes induces shortening of the GM muscle fascicles and increases AT stiffness, reducing the ankle's active range of motion. Functionally, these two phenomena seem to counteract each other since no significant differences in static or dynamic torques were observed.

Training-induced changes in structural and mechanical properties of the patellar tendon are related to muscle hypertrophy but not to strength gains

To obtain a better understanding of the adaptations of human tendon to chronic overloading, we examined the relationships between these adaptations and the changes in muscle structure and function. Fifteen healthy male subjects (20+/-2 yr) underwent 9 wk of knee extension resistance training. Patellar tendon stiffness and modulus were assessed with ultrasonography, and cross-sectional area (CSA) was determined along the entire length of the tendon by using magnetic resonance imaging. In the quadriceps muscles, architecture and volume measurements were combined to obtain physiological CSA (PCSA), and maximal isometric force was recorded. Following training, muscle force and PCSA increased by 31% (P<0.0001) and 7% (P<0.01), respectively. Tendon CSA increased regionally at 20-30%, 60%, and 90-100% of tendon length (5-6%; P<0.05), and tendon stiffness and modulus increased by 24% (P<0.001) and 20% (P<0.01), respectively. Although none of the tendon adaptations were related to strength gains, we observed a positive correlation between the increase in quadriceps PCSA and the increases in tendon stiffness (r=0.68; P<0.01) and modulus (r=0.75; P<0.01). Unexpectedly, the increase in muscle PCSA was inversely related to the distal and the mean increases in tendon CSA (in both cases, r=-0.64; P<0.05). These data suggest that, following short-term resistance training, changes in tendon mechanical and material properties are more closely related to the overall loading history and that tendon hypertrophy is driven by other mechanisms than those eliciting tendon stiffening.

Soleus T reflex modulation in response to spinal and tendinous adaptations to unilateral lower limb suspension in humans

AIM

To investigate the influence of tendinous and synaptic changes induced by unilateral lower limb suspension (ULLS) on the tendon tap reflex.

METHODS

Eight young men underwent a 23-day period of ULLS. Muscle cross-sectional area (CSA), torque and electromyographic (EMG) activity of the plantar flexor muscles (normalized to the M wave), Achilles tendon-aponeurosis mechanical properties, soleus (SOL) H and T reflexes and associated peak twitch torques were measured at baseline, after 14 and 23 days of ULLS, and 1 week after resuming ambulatory activity.

RESULTS

Significant decreases in muscle CSA (-9%), in maximal voluntary torque (-10%) and in the associated SOL EMG activity (-16%) were found after ULLS (P < 0.05). In addition to a 36% (P < 0.01) decrease in tendon-aponeurosis stiffness, normalized H reflex increased by 35% (P < 0.05). An increase in the slope (28%, P < 0.05) and intercept (85%, P < 0.05) of the T reflex recruitment curve pointed to an increase in the gain and to a decrease in the sensitivity of this reflex, possibly resulting from the decrease in the tendon-aponeurosis stiffness at low forces. Following ULLS, changes in tendinous stiffness correlated with changes in neuromuscular efficiency (peak twitch torque to reflex ratio) at higher tendon tap forces.

CONCLUSION

These findings point out the dual and antagonistic influences of spinal and tendinous adaptations upon the tendon tap reflex in humans under conditions of chronic unloading. These observations have potential implications for the sensitivity of the short-latency Ia stretch response involved in rapid compensatory contractions to unexpected postural perturbations.

Early structural adaptations to unloading in the human calf muscles

AIM

The present study investigated the influence of muscle architectural changes on muscle torque during 3-week unilateral lower limb suspension (ULLS).

METHODS

Plantarflexion maximal voluntary contraction (MVC), soleus (SOL), gastrocnemius medialis (GM) and lateralis (GL) muscle volume (VOL), GL fascicle length (L(f)) and pennation angle (theta), physiological cross-sectional area (PCSA), and electromyographic (EMG) activity were assessed in eight healthy men (aged 19 +/- 0 years) after days 14 and 23 of ULLS.

RESULTS

After 14 day of ULLS, MVC and SOL EMG decreased (P < 0.05) by 10% and 29%, respectively, but did not further decline between days 14 and 23. SOL, GM and GL muscle VOL decreased by 5%, 6% and 5%, respectively (P < 0.05), on day 14, and by 7% (SOL), 10% (GM) and 6% (GL) on day 23. In GL, theta and L(f) were reduced by 3% (P < 0.05) and 2% (NS), respectively, on day 14, and by 5% (P < 0.05) and 4% (P < 0.05), respectively, on day 23. Consequently, GL PCSA declined by 3% (P < 0.05) on day 14, but did not further decrease on day 23. Similarly, the 7% (P < 0.05) loss in GL force/PCSA observed on day 14 persisted until the end of the unloading period.

CONCLUSION

These findings suggest that rapid muscle architecture remodelling occurs with lower limb unloading in humans, with changes occurring within 14 days of weight bearing removal. These adaptations, mitigating the decline in muscle PCSA, might protect from a larger loss of muscle force.

From space to Earth: advances in human physiology from 20 years of bed rest studies (1986-2006)

Bed rest studies of the past 20 years are reviewed. Head-down bed rest (HDBR) has proved its usefulness as a reliable simulation model for the most physiological effects of spaceflight. As well as continuing to search for better understanding of the physiological changes induced, these studies focused mostly on identifying effective countermeasures with encouraging but limited success. HDBR is characterised by immobilization, inactivity, confinement and elimination of Gz gravitational stimuli, such as posture change and direction, which affect body sensors and responses. These induce upward fluid shift, unloading the body's upright weight, absence of work against gravity, reduced energy requirements and reduction in overall sensory stimulation. The upward fluid shift by acting on central volume receptors induces a 10-15% reduction in plasma volume which leads to a now well-documented set of cardiovascular changes including changes in cardiac performance and baroreflex sensitivity that are identical to those in space. Calcium excretion is increased from the beginning of bed rest leading to a sustained negative calcium balance. Calcium absorption is reduced. Body weight, muscle mass, muscle strength is reduced, as is the resistance of muscle to insulin. Bone density, stiffness of bones of the lower limbs and spinal cord and bone architecture are altered. Circadian rhythms may shift and are dampened. Ways to improve the process of evaluating countermeasures--exercise (aerobic, resistive, vibration), nutritional and pharmacological--are proposed. Artificial gravity requires systematic evaluation. This review points to clinical applications of BR research revealing the crucial role of gravity to health.

Gastrocnemius muscle-tendon behaviour during walking in young and older adults

AIM

Age-related differences in muscle architectural and tendon mechanical properties have been observed in vivo under static conditions and during single joint contractions. The aim of this study was to determine if there are age-related differences in gastrocnemius fascicle-tendon interactions during a fundamental locomotor task - walking.

METHODS

Eight young adults (YA; 27 +/- 4 years) and eight older adults (OA; 77 +/- 4 years) walked on a treadmill at 1.11 m s(-1) whilst length changes in the gastrocnemius lateralis muscle tendon complex (MTC), fascicles and tendinous tissue (TT) were determined from joint angles, ultrasonography and a geometric MTC model (combining MTC and fascicle measurements) respectively.

RESULTS

There was no age-related difference in lengthening of the MTC during stance. However, the fascicle and TT contribution to MTC lengthening was altered; TT lengthening was larger in OA than in YA (P = 0.05) and fascicle lengthening was less in OA than YA (P < 0.05). There were no differences between groups in MTC, fascicle or TT shortening amplitude during push-off.

CONCLUSION

The observations are consistent with previous reports of increased compliance of TT in older adults.

Early skeletal muscle hypertrophy and architectural changes in response to high-intensity resistance training

The onset of whole muscle hypertrophy in response to overloading is poorly documented. The purpose of this study was to assess the early changes in muscle size and architecture during a 35-day high-intensity resistance training (RT) program. Seven young healthy volunteers performed bilateral leg extension three times per week on a gravity-independent flywheel ergometer. Cross-sectional area (CSA) in the central (C) and distal (D) regions of the quadriceps femoris (QF), muscle architecture, maximal voluntary contraction (MVC), and electromyographic (EMG) activity were measured before and after 10, 20, and 35 days of RT. By the end of the training period, MVC and EMG activity increased by 38.9 +/- 5.7 and 34.8% +/- 4.7%, respectively. Significant increase in QF CSA (3.5 and 5.2% in the C and D regions, respectively) was observed after 20 days of training, along with a 2.4 +/- 0.7% increase in fascicle length from the 10th day of training. By the end of the 35-day training period, the total increase in QF CSA for regions C and D was 6.5 +/- 1.1 and 7.4 +/- 0.8%, respectively, and fascicle length and pennation angle increased by 9.9 +/- 1.2 and 7.7 +/- 1.3%, respectively. The results show for the first time that changes in muscle size are detectable after only 3 wk of RT and that remodeling of muscle architecture precedes gains in muscle CSA. Muscle hypertrophy seems to contribute to strength gains earlier than previously reported; flywheel training seems particularly effective for inducing these early structural adaptations.

Musculoskeletal adaptations to resistance training in old age

Muscle weakness experienced in old age has many detrimental consequences for activities of daily life. Given the serious problems presented by weakness in old age, strategies to prevent or mitigate this process are of paramount importance. In recent years resistance training has emerged as an effective method for increasing strength in the elderly. Despite this, little is known regarding the muscular, neural and tendinous adaptations that occur with resistance training in old age. Hence, we have conducted a series of experiments to investigate these adaptations. We have found increases in maximal isometric and concentric torque by 9-37% after resistance training in older people (65-81 years). Associated with these strength gains were increases in agonist muscle neural drive without any change in the co-activation of antagonist muscles. Resistance training can cause increases in muscle size and also adaptations to the internal muscle structure. Tendons of older adults adapt to resistance training by increasing their stiffness and Young's modulus. In conclusion, many of the musculoskeletal factors characterizing ageing can be at least partially mitigated by resistance training.

Myotendinous alterations and effects of resistive loading in old age

The loss of muscle mass associated with ageing only partly explains the observed decline in muscle strength. This paper provides evidence of the contribution of muscular, tendinous and neural alterations to muscle weakness in old age and discusses the complex interplay between the changes of the contractile tissue with those of the tendinous tissue in relation to the mechanical behavior of the muscle as a whole. Despite the considerable structural and functional alterations, the elderly musculoskeletal system displays remarkable adaptability to training in old age and many of these adverse effects may be substantially mitigated, if not reversed, by resistive loading. The interplay between these muscular and tendinous adaptations has an impact both on the length-force and force-velocity relationships of the muscle and is likely to affect the range of motion, rate of force development, maximum force development and speed of movement of the older individual.

Myotendinous plasticity to ageing and resistance exercise in humans

The age-related loss of muscle mass known as senile sarcopenia is one of the main determinants of frailty in old age. Molecular, cellular, nutritional and hormonal mechanisms are at the basis of sarcopenia and are responsible for a progressive deterioration in skeletal muscle size and function. Both at single-fibre and at whole-muscle level, the loss of force exceeds that predicted by the decrease in muscle size. For single fibres, the loss of intrinsic force is mostly due to a loss in myofibrillar protein content. For whole muscle, in addition to changes in neural drive, alterations in muscle architecture and in tendon mechanical properties, exemplified by a reduction in tendon stiffness, have recently been shown to contribute to this phenomenon. Resistance training can, however, cause substantial gains in muscle mass and strength and provides a protective effect against several of the cellular and molecular changes associated with muscle wasting and weakness. In old age, not only muscles but also tendons are highly responsive to training, since an increase in tendon stiffness has been observed after a period of increased loading. Many of the myotendinous factors characterizing ageing can be at least partly reversed by resistance training.

Metabolic cost, mechanical work, and efficiency during walking in young and older men

AIM

To investigate mechanical work, efficiency, and antagonist muscle co-activation with a view to better understand the cause of the elevated metabolic cost of walking (C(W)) in older adults.

METHODS

Metabolic, mechanical and electromyographic measurements were made as healthy young (YOU; n = 12, age = 27 +/- 3 years) and older (OLD; n = 20, age = 74 +/- 3 years) men of equivalent body mass and leg length walked on a treadmill at four speeds (ranging from 0.83 to 1.67 m s(-1)).

RESULTS

Net (above resting) C(W), determined by indirect calorimetry was 31% higher (average across speeds) in OLD (P < 0.05). The integrity of the passive pendulum like interchange of mechanical energies of the centre of mass (COM(B)), an energy-saving mechanism, was maintained in OLD. Furthermore, total mechanical work, determined from fluctuations in mechanical energy of COM(B) and of body segments relative to COM(B), was not significantly elevated in OLD. This resulted in a lower efficiency in OLD (-17%, P < 0.05). Co-activation, temporally quantified from electromyography recordings, was 31% higher in OLD for antagonist muscles of the thigh (P < 0.05). Thigh co-activation was moderately correlated with C(W) at three speeds (r = 0.38-0.52, P < 0.05).

CONCLUSION

Healthy septuagenarians with no gait impairment have an elevated C(W) which is not explained by an elevation in whole body mechanical work. Increased antagonist muscle co-activation (possibly an adaptation to ensure adequate joint stability) may offer partial explanation of the elevated C(W).

Influence of 90-day simulated microgravity on human tendon mechanical properties and the effect of resistive countermeasures

While microgravity exposure is known to cause deterioration of skeletal muscle performance, little is known regarding its effect on tendon structure and function. Hence, the aims of this study were to investigate the effects of simulated microgravity on the mechanical properties of human tendon and to assess the effectiveness of resistive countermeasures in preventing any detrimental effects. Eighteen men (aged 25–45 yr) underwent 90 days of bed rest: nine performed resistive exercise during this period (BREx group), and nine underwent bed rest only (BR group). Calf-raise and leg-press exercises were performed every third day using a gravity-independent flywheel device. Isometric plantar flexion contractions were performed by using a custom-built dynamometer, and ultrasound imaging was used to determine the tensile deformation of the gastrocnemius tendon during contraction. In the BR group, tendon stiffness estimated from the gradient of the tendon force-deformation relation decreased by 58% (preintervention: 124 ± 67 N/mm; postintervention: 52 ± 28 N/mm; P < 0.01), and the tendon Young's modulus decreased by 57% postintervention ( P < 0.01). In the BREx group, tendon stiffness decreased by 37% (preintervention: 136 ± 66 N/mm; postintervention: 86 ± 47 N/mm; P < 0.01), and the tendon Young's modulus decreased by 38% postintervention ( P < 0.01). The relative decline in tendon stiffness and Young's modulus was significantly ( P < 0.01) greater in the BR group compared with the BREx group. Unloading decreased gastrocnemius tendon stiffness due to a change in tendon material properties, and, although the exercise countermeasures did attenuate these effects, they did not completely prevent them. It is suggested that the total loading volume was not sufficient to completely prevent alterations in tendon mechanical properties.

Changes in triceps surae muscle architecture with sarcopenia

AIM

To investigate whether sarcopenia was evenly distributed among the three components of the triceps surae (TS) muscle group.

METHODS

Muscle volume (VOL), fibre fascicle length (Lf), pennation angle (theta) and physiological cross-sectional area (PCSA = VOL/Lf) were measured in vivo for the lateral (GL) and medial (GM) heads of the gastrocnemius muscles and for the soleus muscle (SOL), in 15 young males (YM, aged 25.3 +/- 4.5 years) and 12 elderly males (EM aged 73.8 +/- 4.4 years).

RESULTS

In the EM, VOL of all three muscles was significantly smaller than in the YM; differences were: 27% for the GL (P < 0.01), 29% for the GM (P < 0.01) and 17% for the SOL (P < 0.05). In total, TS VOL was 22% smaller in EM than in YM (P < 0.01). In the EM, values of theta were significantly smaller than in the YM; by 15-18% for the GL, GM and SOL (P < 0.05). In the EM, Lf of the GM was 16% smaller than in the YM (P < 0.01); no significant differences were found in the other muscles. PCSA of the GL and GM were both found to be smaller in EM by 19% (P < 0.01) and 14.5% (P < 0.05), respectively. No difference was observed in the SOL PCSA between YM and EM. Interestingly, probably because of the prevalent contribution of the SOL to PCSA distribution of each muscle to the TS PCSA, the relative TS PCSA was not different between YM and EM. Furthermore, the Lf/muscle length ratio did not differ between YM and EM.

CONCLUSION

The present study shows that the relative PCSA composition of the TS is maintained with ageing and that the PCSA is scaled down harmonically with the decrease in muscle volume and fascicle length. Such observation suggests that the relative contribution of the components of the TS muscle to the total force developed by this muscle group is maintained with ageing.

In vivo human muscle structure and function: adaptations to resistance training in old age

This study investigated changes in elderly muscle joint angle-torque relation induced by resistance training. Older adults were assigned to either training (n = 9, age 74.3 +/- 3.5 years; mean +/-s.d.) or to control groups (n = 9, age 67.1 +/- 2 years). Leg-extension and leg-press exercises were performed three times per week for 14 weeks. Maximal isometric knee extension torque was measured across the knee joint angle range of movement. Vastus lateralis muscle architecture was examined in vivo using ultrasonography. The vastus lateralis muscle fascicle force was estimated from the measured joint torque, enabling construction of the fascicle length-force relation. Electromyographic (EMG) activity was measured from representative agonist and antagonist muscles. Training altered the angle-torque relation: (a) displacing it by 9-31% towards higher torque values (P < 0.05); and (b) shifting the optimal angle from 70 deg (corresponding torque: 121.4 +/- 61 N m) before to 60 deg (134.2 +/- 57.2 N m; P < 0.05) after training. Training also altered the fascicle length-force relation: (a) displacing it by 11-35% towards higher force values; and (b) shifting the optimal fascicle length from 83.7 +/- 8 mm (corresponding force: 847.9 +/- 365.3 N) before to 93.2 +/- 12.5 mm (939.3 +/- 347.8 N; P < 0.01) after training. The upward displacement of the angle-torque relation was mainly due to a training-induced increase in agonist activation, whilst the shift in the optimal angle was associated with changes in muscle-tendon properties.

In vivo human tendon mechanical properties: effect of resistance training in old age

Recent advances in ultrasound scanning have made it possible to obtain the mechanical properties of human tendons in vivo. Application of the in vivo method in elderly individuals showed that their patellar tendons stiffened in response to a 14-week resistance training program by approximately 65% both structurally and materially. The rate of muscle torque development increased by approximately 27%, indicating faster contractile force transmission to the skeleton. The present findings suggest that strength training in old age can, at least partly, reverse the deteriorating effect of ageing on tendon properties and function.

Muscular adaptations to resistance exercise in the elderly

Neuropathic, metabolic, hormonal, nutritional and immunological factors contribute to the development of sarcopenia. This loss of muscle mass associated with ageing, is a main cause of muscle weakness, but the loss of muscle strength typically exceeds that of muscle size, with a resulting decrease in force per unit of muscle cross-sectional area. Recent evidence suggests that, in addition to a reduction in neural drive and in fibre specific tension, changes in muscle architecture contribute significantly to the loss of muscle force through alterations in muscle mechanical properties. Older muscle, however, maintains a high degree of plasticity in response to increased loading since considerable hypertrophy and a reversal of the alterations in muscle architecture associated with ageing are observed with resistive training.

Effect of aging on human muscle architecture

The effect of aging on human gastrocnemius medialis (GM) muscle architecture was evaluated by comparing morphometric measurements on 14 young (aged 27-42 yr) and on 16 older (aged 70-81 yr) physically active men, matched for height, body mass, and physical activity. GM muscle anatomic cross-sectional area (ACSA) and volume (Vol) were measured by computerized tomography, and GM fascicle length (Lf) and pennation angle (theta) were assessed by ultrasonography. GM physiological cross-sectional area (PCSA) was calculated as the ratio of Vol/Lf. In the elderly, ACSA and Vol were, respectively, 19.1% (P < 0.005) and 25.4% (P < 0.001) smaller than in the young adults. Also, Lf and were found to be smaller in the elderly group by 10.2% (P < 0.01) and 13.2% (P < 0.01), respectively. When the data for the young and elderly adults were pooled together, significantly correlated with ACSA (P < 0.05). Because of the reduced Vol and Lf in the elderly group, the resulting PCSA was found to be 15.2% (P < 0.05) smaller. In conclusion, this study demonstrates that aging significantly affects human skeletal muscle architecture. These structural alterations are expected to have implications for muscle function in old age.

Effect of resistance training on skeletal muscle-specific force in elderly humans

This study assessed muscle-specific force in vivo following strength training in old age. Subjects were assigned to training (n = 9, age 74.3 +/- 3.5 yr; mean +/- SD) and control (n = 9, age 67.1 +/- 2 yr) groups. Leg-extension and leg-press exercises (2 sets of 10 repetitions at 80% of the 5 repetition maximum) were performed three times/wk for 14 wk. Vastus lateralis (VL) muscle fascicle force was calculated from maximal isometric voluntary knee extensor torque with superimposed stimuli, accounting for the patella tendon moment arm length, ultrasound-based measurements of muscle architecture, and antagonist cocontraction estimated from electromyographic activity. Physiological cross-sectional area (PCSA) was calculated from the ratio of muscle volume to fascicle length. Specific force was calculated by dividing fascicle force by PCSA. Fascicle force increased by 11%, from 847.9 +/- 365.3 N before to 939.3 +/- 347.8 N after training (P < 0.05). Due to a relatively greater increase in fascicle length (11%) than muscle volume (6%), PCSA remained unchanged (pretraining: 30.4 +/- 8.9 cm(2); posttraining: 29.1 +/- 8.4 cm(2); P > 0.05). Activation capacity and VL muscle root mean square electromyographic activity increased by 5 and 40%, respectively, after training (P < 0.05), indicating increased agonist neural drive, whereas antagonist cocontraction remained unchanged (P > 0.05). The VL muscle-specific force increased by 19%, from 27 +/- 6.3 N/cm(2) before to 32.1 +/- 7.4 N/cm(2) after training (P < 0.01), highlighting the effectiveness of strength training for increasing the intrinsic force-producing capacity of skeletal muscle in old age.

Effect of strength training on human patella tendon mechanical properties of older individuals

This study investigated the effect of strength training on the mechanical properties of the human patella tendon of older individuals. Subjects were assigned to training (n = 9; age 74.3 +/- 3.5 years, body mass 69.7 +/- 14.8 kg and height 163.4 +/- 9.1 cm, mean +/- S.D.) and control (n = 9; age 67.1 +/- 2 years, body mass 73.5 +/- 14.9 kg and height 168.3 +/- 11.5 cm) groups. Strength training (two series of 10 repetitions at 80 % of five-repetition maximum) was performed three times per week for 14 weeks using leg extension and leg press exercises. Measurements of tendon elongation during a ramp isometric knee extension were performed before and after training and control periods in vivo using ultrasonography. Training caused a decreased tendon elongation and strain at all levels of force and stress (P < 0.01). Baseline tendon elongation and strain at maximal tendon load were 4.7 +/- 1.1 mm and 9.9 +/- 2.2 %, respectively (maximum force: 3346 +/- 1168 N; maximum stress: 40 +/- 11 MPa). After training, these values decreased to 2.9 +/- 1.2 mm and 5.9 +/- 2.4 % (P < 0.01), respectively (maximum force: 3555 +/- 1257 N; maximum stress: 42 +/- 11 MPa). Tendon stiffness increased by 65 % (2187 +/- 713 to 3609 +/- 1220 N mm-1; P < 0.05) and Young's modulus increased by 69 % (1.3 +/- 0.3 to 2.2 +/- 0.8 GPa; P < 0.01). As a result of these changes, the rate of torque development increased by 27 % (482.8 +/- 302.5 to 612.6 +/- 401 N m s-1; P < 0.01) following training. No significant changes occurred in any measured variables in the control group (P > 0.05). This study shows for the first time that strength training in old age increases the stiffness and Young's modulus of human tendons. This may reduce the risk of tendon injury in old age and has implications for contractile force production and the rapid execution of motor tasks.

Effect of ageing on the electrical and mechanical properties of human soleus motor units activated by the H reflex and M wave

This study was designed to investigate the effect of ageing on the mechanical and electromyographic (EMG) characteristics of the soleus motor units (MUs) activated by the maximal Hoffmann reflex (Hmax) and by the direct muscle compound action potential (Mmax). Eleven young (mean age 25 +/- 4 years) and ten elderly (mean age 73 +/- 5 years) males took part in this investigation. The senior group presented lower amplitudes of Mmax (-57 %, P < 0.001) and Hmax (-68 %, P < 0.001) waves compared to the younger population. These were associated with a depression of relative twitch torque of the plantar flexors. The average values of the Hmax/Mmax ratio did not statistically differ between the two populations, despite a tendency for lower values (~23 %) in the senior group. However, the older adults showed a greater relative amplitude of the sub-maximal M wave evoked at Hmax (MatHmax) than did the younger males (young 5 % vs. elderly 29 % of the Mmax, P < 0.01). This finding suggests an increased homogeneity between the excitability threshold of sensory and motor axons. The twitch torque at Hmax (PtH-M) was subsequently calculated by subtraction from the total twitch torque of the mechanical contamination associated with MatHmax. The resulting PtH-M was significantly lower in the elderly (-59 %, P < 0.001). Despite a discrepancy of 20 % between the two groups, the mechanical ratio (PtH-M/PtM; PtM, twitch tension related to the Mmax compound action potential), like the EMG ratio, did not statistically differ between the young and older individuals. Nevertheless, the senior subjects exhibited a higher twitch/EMG ratio for the reflexively activated MUs (PtH-M/Hmax) than the younger individuals (+40 %, P < 0.05). This finding suggests an on-going neuromuscular remodelling, resulting in an increased innervation ratio. The neural rearrangement may be viewed as a compensatory adaptation of the motor system to preserve the mechanical efficiency of the surviving MUs, despite the age-related impairment of the segmental reflex system. This phenomenon is confirmed by the maintenance, with senescence, of the approximately constant values of the twitch/EMG ratio for the entire motor pool (PtM/Mmax).

Effects of short-term, integrated body mass reduction program on maximal oxygen consumption and anaerobic alactic performance in obese subjects

The study investigated the effect of a short-term (3-week) body mass reduction program, combining energy-restricted diet, nutritional education, psychological counselling and aerobic exercise training (DEP-AT) on maximal oxygen consumption (VO2max) and anaerobic alactic performance evaluated with different techniques in obese patients (grade II and III). Fifty-three (14 males, 39 females) obese subjects [average +/- SD body mass index (BMI): 41.6 +/- 4.2 kg/m2] were tested before and after the DEP-AT program characterised by a daily conditioning protocol of aerobic exercise on cycloergometer, treadmill and armergometer for a total duration of 35 min at an intensity corresponding to 50% of individual VO2max during the first week of the program and at 60% in the following 2 weeks. VO2max was determined with the cycloergometric indirect method. Short-term alactic anaerobic performance was evaluated with: a) jumping test (5 consecutive jumps with maximal effort, Bosco technique), b) short sprint running test (8m), and c) stair climbing test (modified Margaria test). The DEP-AT program induced a significant weight loss (-4.57 +/- 1.26%, p < 0.001) and a significant VO2max increase (14.1 +/- 20.5%, p < 0.001). After the DEP-AT program, lower limb alactic anaerobic power output, calculated on a per kg body mass basis, increased significantly both in jumping and in stair climbing (20.1 +/- 24.8%, p < 0.001 and 13.5 +/- 19.75%, p < 0.001, respectively), as well as average horizontal velocity during short sprinting (7.2 +/- 17.6%, p < 0.01). Power output was a major determinant of the motor performance, being significantly correlated with: a) vertical displacement of the centre of gravity (R2 = 0.884, p < 0.001) in jumping test, b) vertical velocity (R2 = 0.348, p < 0.001) in stair climbing test, and c) horizontal velocity (R2 = 0.394, p < 0.001) in short running test. In conclusion, short-term DEP-AT program induces significant improvements in both aerobic capabilities and anaerobic performance, possibly through the combination of a number of contributory mechanisms, such as exercise-mediated training, shift in the balance between parasympathetic and sympathetic activity, a weight-loss dependent shift toward a more favourable region of the muscle power-velocity curve, acquisition of a certain degree of motor skill during the conditioning program, improvement of self-esteem and motivation.

Strength and power changes of the human plantar flexors and knee extensors in response to resistance training in old age

AIM

The aim of the present study was to assess and compare the improvements of muscle strength and power induced by a 16-week resistive programme in a population of 16 older men aged 65-81 years.

METHODS

Training was performed three times per week at an intensity of 80% of one repetition maximum (1RM) and consisted of both calf raise and leg press exercises. Before-, during- and after-training, maximum isometric and isokinetic torques, maximum power, 1RM, muscle cross-sectional area (CSA) and electromyographic activity (EMG) of the plantar flexors (PF) and knee extensors (KE) were examined.

RESULTS

For the KE and PF, respectively, training resulted in a 29.9 +/- 4.4% (mean +/- SE) and 21.6 +/- 5.4% increase in 1RM (P < 0.001-0.01), a 19.4 +/- 4.3 and 12.4 +/- 4.7% (P < 0.001-0.05) increase in maximum isometric torque, and a 24.1 +/- 6.3 and 33.1 +/- 10.9% (P < 0.05) increase in maximum muscle power, calculated from torque-angular velocity curves. The large increase in torque and power was partly accounted by a significant increase in the CSA of the PF (5.0 +/- 0.7%) and KE (7.4 +/- 0.7%), while no significant changes in integrated EMG activity of vastus lateralis and soleus muscles, and in extrapolated maximum shortening velocity were found. After training, a significant increase in torque/CSA (10.3 +/- 4%, P < 0.05) was found for the KE but not for the PF.

CONCLUSION

Hence, hypertrophy cannot alone justify the increase in torque, and other factors, such as an increase in individual fibre-specific tension (in the case of KE), a decrease in antagonist muscles' coactivation, an improved co-ordination and an increased neural drive of the other heads of quadriceps may have contributed to the increments in strength. The significant increase in muscle power seems particularly noteworthy with respect to daily activities involving the displacement of the body over time, namely, the generation of muscle power.

Influence of simulated microgravity on human skeletal muscle architecture and function

Ten male volunteers underwent a period of prolonged bed rest. Four subjects performed exercise countermeasures 2-3 times per week, while 6 subjects received no countermeasures. After bed rest plantarflexor force declined significantly (P < 0.001) in both exercise (-42%) and control (-55%) groups. The internal architecture of the gastrocnemius medialis (GM) muscle was significantly altered. This was associated with a reduction in fascicle shortening during isometric contraction. Exercise countermeasures partially mitigated the loss of muscle force and function following 90 days of bed rest.

Plantar flexor activation capacity and H reflex in older adults: adaptations to strength training

The purpose of this study was to investigate whether the voluntary neural drive and the excitability of the reflex arc could be modulated by training, even in old age. To this aim, the effects of a 16-wk strengthening program on plantar flexor voluntary activation (VA) and on the maximum Hoffman reflex (H(max))-to-maximum M wave (M(max)) ratio were investigated in 14 elderly men (65-80 yr). After training, isometric maximum voluntary contraction (MVC) increased by 18% (P < 0.05) and weight-lifting ability by 24% (P < 0.001). Twitch contraction time decreased by 8% (P < 0.01), but no changes in half relaxation time and in peak twitch torque were observed. The VA, assessed by twitch interpolation, increased from 95 to 98% (P < 0.05). Pretraining VA, also evaluated from the expected MVC for total twitch occlusion, was 7% higher (P < 0.01) than MVC. This discrepancy persisted after training. The interpolated twitch torque-voluntary torque relationship was fitted by a nonlinear model and was found to deviate from linearity for torque levels >65% MVC. Compared with younger men (24-35 yr), the H(max)- to M(max) ratio and nerve conduction velocity (H index) of the older group were significantly lower (42%, P < 0.05; and 29%, P < 0.001, respectively) and were not modulated by training. In conclusion, older men seem to preserve a high VA of plantar flexors. However, the impaired functionality of the reflex pathway with aging and the lack of modulation with exercise suggest that the decrease in the H(max)- to M(max) ratio and H index may be related to degenerative phenomena.

Effects of a 16-week progressive high-intensity strength training (HIST) on indexes of bone turnover in men over 65 years: a randomized controlled study

The aim of the present study was to evaluate the effects of a 16-week progressive high-intensity strength training (HIST) program on peripheral markers of bone turnover (bone Gla protein, BGP; bone alkaline phosphatase, B-AP; N-terminal propeptide of type I procollagen, PINP; C-terminal cross-linked telopeptide of type I collagen, ICTP) in healthy, elderly men over 65 yr of age. Thirty healthy men (aged 65-81 yr), performing light to moderate daily physical activity, were randomly divided into two groups. Group 1 (no.=16) followed a supervised 16-week progressive HIST program, while subjects of group 2 (no.=14), used as controls, were requested to maintain their habitual level of physical activity for 16 weeks. HIST program consisted of 6 different sets of exercise (2 involving the major muscle groups of the lower limb and 4 involving those of the upper limb). Three sessions/ week, during which 10 repetitions of each exercise set were completed, were performed. Lower limb exercises shifted from 50 to 80% of the one maximal repetition (1 MR) during the first month of the protocol and were thereafter maintained at an intensity of 80% 1 MR throughout the training. Upper limb exercises shifted from 40 to 65% of 1 MR with a similar pattern. All sessions were preceded by 15 min of cycloergometer exercise at 50% of maximal oxygen uptake and by a warm-up of 15 repetitions at 20% of 1 MR of each exercise set. The HIST program did not significantly change BGP (mean SE, before: 15.6 +/- 1.2 microg/l vs after: 16.0 +/- 1.2 microg/l, NS) and PINP levels (before: 44.6 +/- 6.7 microg/l vs after: 43.1 +/- 6.0 microg/l, NS). On the contrary, serum B-AP significantly increased (before: 50.2 +/- 6.1 IU/l vs after: 62.3 +/- 7.0 lU/l, p<0.001) and serum ICTP slightly reduced (before: 4.0 +/- 0.3 microg/l vs after: 3.8 +/- 0.3 microg/l, p<0.05). When bone turnover was expressed as the ratio between bone formation to bone resorption (B-AP/ICTP ratio), a significant improvement in this ratio was found in all subjects of group 1 (before: 12.9 +/- 1.3 lU/microg vs after: 17.3 +/- 1.5 IU/microg, p<0.0001), while no significant changes were observed in Group 2. No significant changes of IGF-I levels were observed after the HIST program (before: 94.9 +/- 9.4 microg/l vs after: 89.9 +/- 9.7 microg/l). No significant changes of BGP, PINP, B-AP, ICTP, B-AP-ICTP ratio and IGF-I levels were observed in controls (group 2) during the 16 weeks of observation. Although the positive effects of a progressive HIST program on B-AP levels and B-AP-ICTP ratio seem promising, the support of bone mass measurement and the determination of other bone markers are requested to better identify exercise protocol (duration, intensity) for elderly people.

Changes in motor control and muscle performance after a short-term body mass reduction program in obese subjects

Two hundred and thirty obese subjects (age: 18-77 yr, BMI: 31.1-65.8 kg/m2) were studied before and after a 3-week body mass reduction (BMR) program, coupling restricted energy diet (1200-1500 kcal/day) with low intensity exercise prescription. It involved 5 days per week (consisting of one-hour dynamic aerobic standing and floor exercise plus 30 min of cycloergometer exercise at 60 W or, alternatively, 4 km outdoor leisure walking on flat terrain) and psychological counseling. One-leg standing balance test (OLSB) and stair climbing test (SCT) were employed to assess motor control and maximal lower limb muscle power, respectively. The BMR program induced a significant weight loss (4.1%; p<0.001), a higher reduction of body mass index (BMI) being observed in males than in females (p<0.001). OLSB performance time increased by 20.5% (p<0.001) after treatment, the improvement being evident in both genders. A 20.8% reduction in SCT time (p<0.05) was also observed and corresponded to a 13.2% increase (p<0.001) in average absolute muscle power and 15.0% increase (p<0.001) in specific muscle power (i.e. the power output per kg of body mass), with no differences between genders. In conclusion, in spite of the moderate reduction of body mass after restricted energy diet and low intensity physical conditioning, significant improvements in motor control and performance, likely to ameliorate the execution of simple daily activities, were observed in obese subjects.

Maximal instantaneous muscular power after prolonged bed rest in humans

A reduction in lower limb cross-sectional area (CSA) occurs after bed rest (BR). This should lead to an equivalent reduction in maximal instantaneous muscular power (W(p)) if the body segments' lengths remain unchanged. W(p) was determined during maximal jumps off both feet on a force platform before and on days 2, 6, 10, 32, and 48 after a 42-day duration BR. CSA of thigh muscles was measured by magnetic resonance imaging before and on day 5 after BR. Before BR, W(p) was 3.63 +/- 0.43 kW or 48.6 +/- 3.3 W/kg. On days 2 and 6 after BR, W(p) was reduced by 23.7 +/- 6.9 and 22.7 +/- 5.4% (P < 0.01), respectively. Thigh extensors CSA (CSAEXT) was 16.7 +/- 4.7% (P < 0.01) lower than before. When normalized per CSAEXT, W(p) was reduced by only 4.8 +/- 4.5% (P < 0.05). By day 48 of recovery, W(p) had returned to baseline values. Therefore, if W(p) is appropriately normalized for CSA of the extensor muscles, the reduction in CSAEXT explains most of the decrease in W(p) decrease after BR. Other factors such as a deficit in neural activation or a decrease in fiber-specific tension may account for only 5% of the W(p) loss after BR.

Aerobic and anaerobic performance before and after a short-term body mass reduction program in obese subjects

The cardiovascular response to an aerobic cycloergometer exercise test (ACET, 15 min at 60 W, 60 rpm) and the maximally attainable muscle power output, assessed by a stair climbing test (SCT), were evaluated in 60 obese patients (41 females and 19 males; age: 18-68 yr; body mass index, BMI: 40.8+/-4.8 kg/m2) before and after a 3-week body mass reduction (BMR) program, entailing integrated energy-restricted diet (1200-1500 kcal/day), low-grade aerobic exercise conditioning and individual and/or group psychological therapy. The daily conditioning protocol (5 days/week) consisted of: 1) 30 min of indoor jogging and dynamic aerobic standing and floor exercises performed with arms and legs, under the guidance of a therapist; 2) 30 min of cycloergometer exercise at 60 W; and/or 3) 4-km outdoor leisure walking on flat terrain. Three weeks of BMR program induced a significant weight loss (-4.5 %; p<0.001), a reduction of systolic (-11+/-14 mmHg, -7.3%,p<0.001) and diastolic (-7+/-9 mmHg, -7.3%,p<0.001) resting arterial blood pressure, as well as a reduction of heart rate at rest (-18.6%,p<0.001), during ACET (-11.3%,p<0.001) and 5 min thereafter (-14.8%,p<0.001). The subjective rating of perceived exertion in terms of breathlessness and general fatigue during ACET, scored on a 0-100 visual analogic scale, was significantly reduced (p<0.001) after BMR program. A 11.2% decrease in SCT time (p<0.001) was also observed, corresponding to a 9.6% increase (p<0.001) in average muscle power (W) and 14.6% increase (p<0.001) in specific muscle power (W.kg(-1)). In conclusion, a combination of energy restricted diet, low intensity aerobic exercise and psychological counselling appears to significantly improve both aerobic and anaerobic performance in morbidly obese subjects. Different factors (ie, reduction of body mass, shift in the balance between parasympathetic and sympathetic activity, a weight-loss dependent shift toward a more favourable region of the muscle power-velocity curve, acquisition of a certain degree of motor skillfulness during the conditioning program, improvement of self-esteem and motivation) might be responsible, alone or in combination, for these short-term positive effects of BMR program.

The interplay of central and peripheral factors in limiting maximal O2 consumption in man after prolonged bed rest

1. The effects of bed rest on the cardiovascular and muscular parameters which affect maximal O2 consumption (VO2,max) were studied. The fractional limitation of VO2,max imposed by these parameters after bed rest was analysed. 2. The VO2,max, by standard procedure, and the maximal cardiac output (Qmax), by the pulse contour method, were measured during graded cyclo-ergometric exercise on seven subjects before and after a 42-day head-down tilt bed rest. Blood haemoglobin concentration ([Hb]) and arterialized blood gas analysis were determined at the highest work load. 3. Muscle fibre types, oxidative enzyme activities, and capillary and mitochondrial densities were measured on biopsy samples from the vastus lateralis muscle before and at the end of bed rest. The measure of muscle cross-sectional area (CSA) by NMR imaging at the level of biopsy site allowed computation of muscle oxidative capacity and capillary length. 4. The VO2,max was reduced after bed rest (-16.6%). The concomitant decreases in Qmax (-30.8%), essentially due to a change in stroke volume, and in [Hb] led to a huge decrease in O2 delivery (-39.7%). 5. Fibre type distribution was unaffected by bed rest. The decrease in fibre area corresponded to the significant reduction in muscle CSA (-17%). The volume density of mitochondria was reduced after bed rest (-16.6%), as were the oxidative enzyme activities (-11%). The total mitochondrial volume was reduced by 28.5%. Capillary density was unchanged. Total capillary length was 22.2% lower after bed rest, due to muscle atrophy. 6. The interaction between these muscular and cardiovascular changes led to a smaller reduction in VO2,max than in cardiovascular O2 transport. Yet the latter appears to play the greatest role in limiting VO2,max after bed rest (> 70% of overall limitation), the remaining fraction being shared between peripheral O2 diffusion and utilization.

In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction

1. Human gastrocnemius medialis architecture was analysed in vivo, by ultrasonography, as a function of joint angle at rest and during voluntary isometric contractions up to the maximum force (MCV). maximum force (MVC). 2. At rest, as ankle joint angle increased from 90 to 150 deg, pennation increased from 15.8 to 27.7 deg, fibre length decreased from 57.0 to 34.0 mm and the physiological cross-sectional area (PCSA) increased from 42.1 to 63.5 cm2. 3. From rest to MVC, at a fixed ankle joint angle of 110 deg, pennation angle increased from 15.5 to 33.6 deg and fibre length decreased from 50.8 to 32.9 mm, with no significant change in the distance between the aponeuroses. As a result of these changes the PCSA increased by 34.8%. 4. Measurements of pennation angle, fibre length and distance between the aponeuroses of the gastrocnemius medialis were also performed by ultrasound on a cadaver leg and found to be in good agreement with direct anatomical measurements. 5. It is concluded that human gastrocnemius medialis architecture is significantly affected both by changes of joint angle at rest and by isometric contraction intensity. The remarkable shortening observed during isometric contraction suggests that, at rest, the gastrocnemius muscle and tendon are considerably slack. The extrapolation of muscle architectural data obtained from cadavers to in vivo conditions should be made only for matching muscle lengths.

Human quadriceps cross-sectional area, torque and neural activation during 6 months strength training

Quadriceps muscle and fibre cross-sectional areas (CSA), torque and neural activation were studied in seven healthy males during 6 months of weight training on alternate days with six series of eight unilateral leg extensions at 80% of one repetition maximum. After training, the quadriceps cross-sectional area increased by 18.8 +/- 7.2% (P < 0.001) and 19.3 +/- 6.7% (P < 0.001) in the distal and proximal regions respectively, and by 13.0 +/- 7.2% (P < 0.001) in the central region of the muscle. Hypertrophy was significantly different between and within the four constituents of the quadriceps. Biopsies of the vastus lateralis at mid-thigh did not show any increase in mean fibre cross-sectional area. Maximum isometric voluntary torque increased by 29.6 +/- 7.9%-21.1 +/- 8.6% (P < 0.01-0.05) between 100 degrees and 160 degrees of knee extension, but no change in the optimum angle (110 degrees-120 degrees) for torque generation was found. A 12.0 +/- 10.8% (P < 0.02) increase in torque per unit area together with a right shift in the IEMG-torque relation and no change in maximum IEMG were observed. Time to peak isometric torque decreased by 45.8% (P < 0.03) but no change in time to maximum IEMG was observed. In conclusion, strength training of the quadriceps results in a variable hypertrophy of its components without affecting its angle-torque relation. The increase in torque per unit area, in the absence of changes in IEMG, may indicate changes in muscle architecture. An increase in muscle-tendon stiffness may account for the decrease in time to peak torque.

Hypertrophic response of human skeletal muscle to strength training in hypoxia and normoxia

The purpose of this study was to test the hypothesis that work-induced skeletal muscle hypertrophy may be reduced by training in chronic hypobaric hypoxia compared to normoxia. Five healthy males [mean age 34.4 (SEM 2.2) years] performed strength training of the elbow flexors for 1 month, at altitude (A) (5050 m) and with the same absolute loads at sea level (SL), 8 months later. The EF cross-sectional area (CSA), determined at mid-arm by nuclear magnetic resonance imaging, increased by 11.3 (SEM 3.7)% (P < 0.05) at A and 17.7 (SEM 4.5)% (P < 0.05) at SL. Isometric maximal voluntary contraction (MVC) increased by 9.5 (SEM 2.6)% (P < 0.05) at A and 13.6 (SEM 2.4)% (P < 0.05) at SL. The CSA and MVC changes in A were significantly smaller than at SL (P < 0.05). Muscle specific tension did not change in either condition. No changes in muscle plus bone or MVC of the untrained, controlateral arm were observed. Thus, although there was no indication of muscle wasting at A, the hypertrophic response of skeletal muscle when trained in chronic hypoxia seemed to be significantly lower than that produced in normoxia. This effect could have arisen either from a direct depression of protein synthesis and/or hormonal changes provoked by hypoxia.

Isokinetic torques and kicking maximal ball velocity in young soccer players

The purpose of this study is to assess if there is any correlation between isokinetic testing and field performance of young soccer players. The isokinetic peak torques of the knee extensor muscles in sitting position (TKE), and those of the hip flexor muscles in standing position (THF) were measured in 24 junior soccer players. Four angular velocities (omega = 1.05, 3.14, 4.19, 5.23 rad.s-1 or 60, 180, 240, 300 deg.s-1) were used for the knee extensors and three (1.05, 3.14, 4.19 rad.s-1) for the hip flexors. On the field the subjects were asked to kick a stationary soccer ball as fast as possible against a barrier and the mean linear velocity over a 10 m path (v) was measured. TKE of the non dominant limb were higher than those of the opposite one at the three highest omega (p < 0.05). On the contrary the THF of the dominant limbs were higher than those of the controlateral, at the two highest omega. When the ball was kicked by the dominant or non dominant limbs, the mean values and standard deviations (+/- SD) of v were 23.6 (+/- 2.5) and 21.4 (+/- 2.6) m.s-1. Torques and v were always positively correlated to each other; however, only in few cases was this relationship statistically significant. In conclusion the isokinetic torques do not seem to be good predictors of v, one of the several factors which determine the global performances of the soccer players.

Growth hormone (GH) treatment in GH-deficient adults: effects on muscle size, strength and neural activation

The effects of 6 months of recombinant growth hormone (GH) treatment (0.5 IU kg-1 per week) on muscle size, strength and neural activation (EMG) was studied in eight adults with childhood onset GH deficiency (GHD). Before treatment, height, body mass (BM) and lean body mass (LBM) of the GHD subjects were significantly lower (P < 0.01) from those recorded in eight healthy controls, while no significant differences were found between the body mass index (BMI) of the two populations. Thigh muscle + bone cross-sectional area (CSAM+B) and lower limb muscle plus bone volume (LLVM+B) of the GHD patients were 66.1 +/- 13.7% and 47.6 +/- 6.8% of those recorded in the controls (P < 0.01), whereas no difference in CSA/height2 was found between the two groups. By contrast, LLVM+B/height3 was 82.0 +/- 19.0% that of the controls (P < 0.05). Similarly, quadriceps muscle strength (MVC) of the GHD patients was 63.2 +/- 12.4% that of controls (P < 0.01), while no significant differences in the force per unit area (F/CSA) and per body mass (F/BM) were found. After 6 months of GH treatment LBM increased by 6.0 +/- 4.2% (P < 0.02), CSAM+B by 14.5 +/- 12.7% (P < 0.01) and LLVM+B by 10.1 +/- 7.3% (P < 0.01), absolute differences from the normals still persisting. However, the LLVM+B/height3 of the GHD patients after treatment was no longer significantly different from that of the controls. Quadriceps MVC increased by 9.8 +/- 12.0% (P < 0.02), differences from the controls being still significant, whereas the F/CSA and F/BM did not change. A right shift of the integrated EMG/Force relation, with no change in the maximal integrated EMG (iEMG) activity, was observed in the patients after treatment. In conclusion, the current study shows that adults with childhood onset GHD have a reduced skeletal muscle mass and strength which seem to be positively influenced by 6 months of GH treatment.

Determinants of peak muscle power: effects of age and physical conditioning

The relationships between absolute peak muscle power (Wpeak), muscle cross sectional area (CSAtot, i.e. the sum of both thigh and calf CSA) and muscle high energy phosphate concentration (adenosine 5'-triphosphate [ATP] and phosphocreatine concentrations [PC]) were studied in 47 subjects classified into five groups: A, 10 sedentary (S) subjects aged 20-35 years; B, 9 S aged 35-50 years; C, 9 S aged more than 50 years; D, 13 children aged 8-13 years; and E, 6 athletes (top level volleyball players) aged 24 (SD 3) years. The Wpeak was measured during a maximal vertical high jump off both feet on a force platform. The CSAtot was measured anthropometrically. The [ATP] and [PC] were determined by 31Phosphorus nuclear magnetic resonance spectroscopy. The Wpeak decreased with age, was 65% lower in D than in A, and 43% higher in E than in A. The CSAtot did not vary with age, was 45% smaller in D than in A, and 15% greater in E than in A. The [ATP] and [PC] were essentially the same in all groups. The changes observed in Wpeak were only partially accounted for by changes in CSAtot. Therefore, in addition to the variables investigated, other factors appear to have been involved in the determination of Wpeak with increasing age and training. An important role may be played by hormonal, particularly at puberty, and neural factors.

Assessment of human knee extensor muscles stress from in vivo physiological cross-sectional area and strength measurements

The physiological cross-sectional areas (CSAp) of the vastus lateralis (VL), vastus intermedius (VI), vastus medialis (VM) and rectus femoris (RF) were obtained, in vivo, from the reconstructed muscle volumes, angles of pennation and distance between tendons of six healthy male volunteers by nuclear magnetic resonance imaging (MRI). In all subjects, the isometric maximum voluntary contraction strength (MVC) was measured at the optimum angle at which peak force occurred. The MVC developed at the ankle was 746.0 (SD 141.8) N and its tendon component (Ft), given by a mechanical advantage of 0.117 (SD 0.010), was 6.367 (SD 1.113) kN. To calculate the force acting along the fibres (Ff) of each muscle, Ft was divided by the cosine of the angle of pennation and multiplied for (CSAp.sigma CSAp-1), where sigma CSAp was the sum of CSAp of the four muscles. The resulting Ff values of VL, VI, VM and RF were: 1.452 (SD 0.531) kN, 1.997 (SD 0.187) kN, 1.914 (SD 0.827) kN, and 1.601 (SD 0.306) kN, respectively. The stress of each muscle was obtained by dividing these forces for the respective CSAp which was: 6.24 x 10(-3) (SD 2.54 x 10(-3)) m2 for VL, 8.35 x 10(-3) (SD 1.17 x 10(-3)) m2 for VI, 6.80 x 10(-3) (SD 2.66 x 10(-3)) m2 for VM and 6.62 x 10(-3) (SD 1.21 x 10(-3)) m2 for RF. The mean value of stress of VL, VI, VM and RF was 250 (SD 19) kN m-2; this value is in good agreement with data on animal muscle and those on human parallel-fibred muscle.

Effect of aging on human adductor pollicis muscle function

The effect of aging on the voluntary and electrically evoked contractile properties of the human adductor pollicis muscle was investigated in 70 healthy male subjects aged 20-91 yr, 10 subjects for each decade. Maximum isometric voluntary force declined significantly (range of P values less than 0.001-0.05) after the age of 59 yr, dropping by the eighth decade to 57.6% of the level recorded in the second decade. A significant shift (P range less than 0.001-0.05) to the left of the frequency-force curve after ulnar nerve supramaximal stimulation at 1, 10, 20, 30, and 50 Hz was observed in the most elderly group (greater than 80 yr) compared with the youngest group (20-29 yr). Maximum relaxation rate dropped by 48.7% from the second to the eighth decade. The decrease became significant (P range less than 0.05-0.001) with the sixth decade. Isometric endurance, evaluated during 30 s of stimulation at 30 Hz, showed a linear (P less than 0.001) increase with age. Aged muscle is thus weaker, slower, and tetanized at lower fusion frequencies but, paradoxically, more resistant to static fatigue.

The effect of range of motion and isometric pre-activation on isokinetic torques

The effect of an increased angle of excursion and isometric pre-activation on isokinetic torques of knee extensors was investigated in five male subjects, mean age 35.0 years, SD 9.6. Peak torque and isoangular torque at 0.52 rad from full knee extension (FKE) were measured when contractions were carried out at 3.14, 4.19 and 5.24 rad.s-1 starting: 1) from a standard knee angle (SA) of 1.57 rad from FKE, 2) from the same starting angle as SA, plus an isometric preload (P) equivalent to 25% of isometric maximal voluntary contraction and 3) from an increased angle of knee flexion (IA), 2.09 rad from FKE plus P. Surface integrated electromyograms (iEMG) of the vastus lateralis muscle in SA and IA + P were also recorded. The IA + P had the effect of increasing peak torque, as compared to SA, on average by 12.0%, SD 7.5% (P less than 0.001) at 3.14 rad.s-1, 19.5%, SD 5.5% (P less than 0.001) at 4.19 rad.s-1, 21.6%, SD 10.7% (P less than 0.001) at 5.24 rad.s-1 and of increasing mean iEMG by 15.7%, SD 7.0% (P less than 0.001) at 5.24 rad.s-1. The IA + P also had the effect of increasing the angle from FKE at which peak torque occurred: from means of 0.80 rad, SD 0.11 to 1.00 rad, SD 0.07 at 3.14 rad.s-1, from 0.65 rad, SD 0.11 to 0.92 rad, SD 0.09 at 4.19 rad.s-1 and from 0.60 rad, SD 0.11 to 0.88 rad, SD 0.11 at 5.24 rad.s-1 (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)