Effects of balance training using wobble boards in the elderly

Few studies have examined balance training of elderly people using wobble boards. This study assessed the effects of wobble board balance training on physical function in institutionalized elderly people. This study examined 23 subjects (age 84.2 ± 5.9 years) who lived in a nursing home. The exercise program for the training group comprised balance training standing on a wobble board for 9 weeks, twice a week. In all, 11 training group subjects and 11 control group subjects completed this study. After 9 weeks, standing time on a wobble board, standing time on a balance mat, and maximum displacement distance of anterior-posterior center of pressure in the training group were significantly greater than those of the control group. Frequency analysis revealed that the power spectrum in 0.1-0.2 Hz significantly increased in the training group. These results suggest that wobble board training is effective for elderly people to improve their standing balance, by which they frequently control their center of gravity and maintain a standing posture on unstable surface conditions.     

Down training of the elderly soleus H reflex with the use of a spinally induced balance perturbation.

The purpose of this study was to determine the ability of the elderly central nervous system to modulate spinal reflex output to functionally decrease a spinally induced balance perturbation. In this case, the soleus H reflex was used as the source of perturbation. Therefore, decreasing (down training) of the soleus H reflex was necessary to counteract this perturbation and to better maintain postural control. In addition to assessing the effect of this perturbation on the H reflex, static postural stability was measured to evaluate possible functional effects. Ten healthy young subjects (age: 27.0 +/- 4.6 yr) and 10 healthy elderly subjects (age: 71.4 +/- 5.1 yr) participated in this study. Subjects underwent balance perturbation on 2 consecutive days. On day 1 of perturbation, significant down training of the soleus H reflex was demonstrated in both young (-20.4%) and elderly (-18.7%) subjects. On day 2 of perturbation, significant down training of the soleus H reflex was again demonstrated in both young (-24.6%) and elderly (-21.0%) subjects. Analysis of static stability after the 2 days of balance perturbation revealed a significant 10.1% decrease in the area of sway in elderly subjects. In conclusion, this study demonstrated that healthy, elderly subjects compared with young subjects were equally capable of down training the soleus H reflex in response to a balance perturbation. Furthermore, the improvement in static stability through balance training may provide further evidence that balance can be retrained and rehabilitated in subjects with decreased reflex function.     

Effects of resistance training on the sit-and-reach test in elderly women

The study showed the effects of a 10-week resistance training program on flexibility of elderly women (n = 11) between 62 and 78 years of age. The control group was composed of 8 women (62 to 73 years old) who were physically inactive. Flexibility was evaluated through the sit-and-reach test, performed both before and after the training program. After an initial evaluation, individuals started a training program, which consisted of 8 exercises for the entire body, without the performance of any flexibility exercise. The training program resulted in significant increase (p < 0.001) of flexibility in elderly women (approximately equal 13%). No significant differences were found in the control group. We conclude that weight training without performance stretching exercises does increase flexibility in elderly women.     

Effect of training on the muscle strength and dynamic balance ability of adults with down syndrome

The purpose of this study was to evaluate the effect of training on the muscle strength and dynamic balance ability of adults with Down syndrome (DS). Twenty-five adults with DS were separated into 2 groups. Fifteen subjects (mean age, 24.5 years) constituted the experiment group, whereas 10 subjects (mean age, 24.7 years) were in the control group of the study. Parameters measured were peak torque, isokinetic muscle endurance, and dynamic balance ability. All subjects performed a leg strength test on a Cyber II isokinetic dynamometer. In addition, the subjects' dynamic balance ability was measured by means of a balance deck (Lafayette). The experimental group followed a 12-week training program. As the results indicated, the experimental group showed a statistically significant improvement in all measured values when compared with the control group. It is concluded that adults with DS can improve their physical and kinetic abilities with the application of a systematic and well-designed training program.     

Effects of strength training on muscle strength characteristics, functional capabilities, and balance in middle-aged and older women

Progressive strength training can lead to substantial increases in maximal strength and mass of trained muscles, even in older women and men, but little information is available about the effects of strength training on functional capabilities and balance. Thus, the effects of 21 weeks of heavy resistance training--including lower loads performed with high movement velocities--twice a week on isometric maximal force (ISOmax) and force-time curve (force produced in 500 milliseconds, F0-500) and dynamic 1 repetition maximum (1RM) strength of the leg extensors, 10-m walking time (10WALK) and dynamic balance test (DYN.D) were investigated in 26 middle-aged (MI; 52.8 +/- 2.4 years) and 22 older women (O; 63.8 +/- 3.8 years). 1RM, ISOmax, and F0-500 increased significantly in MI by 28 +/- 10%, 20 +/- 19%, 31 +/- 34%, and in O by 27 +/- 8%, 20 +/- 16%, 18 +/- 45%, respectively. 10WALK (MI and O, p < 0.001) shortened and DYN.D improved (MI and O, p < 0.001). The present strength-training protocol led to large increases in maximal and explosive strength characteristics of leg extensors and in walking speed, as well to an improvement in the present dynamic balance test performance in both age groups. Although training-induced increase in explosive strength is an important factor for aging women, there are other factors that contribute to improvements in dynamic balance capacity. This study indicates that total body heavy resistance training, including explosive dynamic training, may be applied in rehabilitation or preventive exercise protocols in aging women to improve dynamic balance capabilities.     

Growth hormone enhances effects of endurance training on oxidative muscle metabolism in elderly women

The present study investigated whether recombinant human (rh) growth hormone (GH) combined with endurance training would have a larger effect on oxidative capacity, metabolism, and body fat than endurance training alone. Sixteen healthy, elderly women, aged 75 yr, performed closely monitored endurance training on a cycle ergometer over 12 wk. rhGH was given in a randomized, double-blinded, placebo-controlled design in addition to the training program. GH administration resulted in a doubling of serum insulin-like growth factor I levels. With endurance training, peak oxygen uptake increased by approximately 18% in both groups, whereas the marked increase in muscle citrate synthase activity was 50% larger in the GH group compared with the placebo group. In addition, only the GH group revealed an increase in muscle L-3-hydroxyacyl-CoA dehydrogenase activity. Body weight remained unchanged in both groups, but the GH group showed significant changes in body composition with a decrease in fat mass and an increase in lean body mass. Twenty-four-hour indirect calorimetry performed in four subjects showed a marked increase in energy expenditure with increased relative and absolute fat combustion in the two subjects receiving rhGH. In conclusion, rhGH adds to the effects of endurance training on muscle oxidative enzymes and causes a reduction in body fat in elderly women.     

Effects of stance width on postural movement pattern and anticipatory postural control associated with unilateral arm abduction

We investigated the effects of stance width on postural movement pattern and activation timing of postural muscles during unilateral arm abduction. Thirty-two healthy subjects abducted the right arm at their own timing. Stance width was 0, 9, 18 or 27 cm. Movement angles of leg lateral inclination and trunk lateral flexion to the leg in the frontal plane were analyzed. Based on movement angles at 0 cm width, subjects were classified into three groups: contralateral whole body leaning (CWBLg); ipsilateral trunk flexion (ITFg); and contralateral trunk flexion (CTFg). A high correlation between the movement angles was obtained at 0 cm width (r = 0.82). With increasing stance width, postural movement pattern in the ITFg shifted to patterns characterized by lateral flexion of the trunk toward the side opposite to arm movement, and movement angle of leg-inclination in ITFg and CWBLg decreased. At 0 cm width, left gluteus medius and tensor fascia latae were activated significantly about 40 ms ahead of the right middle deltoid in CWBLg and CTFg, but not in ITFg. However, preceding activation became prominent (about 20 ms) in ITFg for wide stances. Moreover, bilateral activation of the tensor fascia latae was observed in CTFg for all widths.     

Effects of passive movement of the arm on respiration in humans

Cyclic passive movements of the right arm at 1Hz induce an increase in pulmonary ventilation in man. This results from an increase in frequency of the respiratory cycles, mainly due to a shortening of the expiratory phase, and from an increase of the instantaneous flow. The delay between the beginning of the arm movements and the onset of the increase in flow is about 450msec.     

Effects of moderate-velocity strength training on peak muscle power and movement velocity: do women respond differently than men?

The effects of a 10-wk unilateral knee extension strength training (ST) program on peak power (PP) and peak movement velocity (PV), at given absolute (force load) and relative (same % of 1 repetition maximum) resistances (loads), were examined in 30 older men [64 yr (7 SD)] and 32 older women [62 yr (6 SD)]. PP increased significantly in both men and women at the same absolute (P < 0.001) and relative loads (P < 0.01) with ST. Men had a significantly greater increase in relative PP than women with ST at 60% (P < 0.01) and 70% (P < 0.001) of 1 repetition maximum when covarying for baseline differences and age. However, when each subject was tested at the same absolute load and when PP was normalized for the muscle volume of the trained knee extensors (i.e., absolute muscle power quality), women increased by 9% (P < 0.05), whereas men did not change. Both men and women increased their absolute PV (P < 0.001) but decreased their relative PV significantly with ST (P < 0.05). However, when baseline values and age were covaried, women had significantly less of a decrease in relative PV quality with ST than men (P < 0.01), although the difference was small. These normalized data suggest that ST-induced increases in PP depend on muscular hypertrophy in men, but not in women, providing further support for the hypothesis developed from our previous report (Ivey FM, Tracy BL, Lemmer JT, NessAiver M, Metter EJ, Fozard JL and Hurley BF. J Gerontol A Biol Sci Med Sci 55: B152-B157, 2000) that improvements in muscle function with ST result from nonmuscle mass adaptations to a greater extent in women than men.     

Effects of oxygen deprivation on incubated rat soleus muscle

Isolated soleus muscle deprived of oxygen produces more lactate and alanine than oxygen-supplied muscle. Oxygenated muscle synthesized glutamine, while anoxic muscle used this amino acid. Oxygen deprivation decreased adenine nucleotides leading to the efflux of nucleosides. Protein synthesis and degradation responded differently to anoxia. Synthesis almost completely ceased, while proteolysis increased. Therefore, protein degradation in soleus muscle is enhanced when energy supplies and oxygen tension are low.     

Modulation of the soleus muscle H reflex caused by ballistic voluntary arm movements in humans

In healthy humans, we studied the influence of conditioning voluntary arm movements on the H reflex induced by transcutaneous stimulation of the tibial nerve and recorded from the soleus muscle. We examined the effects of flexion and extension of the forearm, as well as of finger clenching performed with the maximum rate. Conditioning arm movements were self-induced or realized upon presentation of a visual signal (light flash). We found that the pattern of changes in the H reflex is determined by the position of the subject’s body in the course of tests. The ipsilateral arm flexion in the elbow joint in the standing position resulted in depression of the H reflex lasting about 100 msec from the beginning of the movement, while the effect observed in the lying position (on the couch with the feet hanging free in the air) looked like a facilitation of the reflex lasting about 100 to 200 msec. The direction and dynamics of modifications of the H reflex under conditions of the use of different conditioning movements (forearm flexions/extensions and finger clenching of the ipsilateral arm, as well as contralateral forearm flexions in the elbow joint) were rather similar. We also showed that the observed facilitation of the H reflex began earlier than the voluntary arm movement (40 to 50 msec prior to the beginning). We hypothesize that these conditioning influences result from the action of central motor commands and represent the factor related to anticipatory postural rearrangements. Such rearrangements are directed toward the maintenance of equilibrium of the body in the course of a future movement. These commands depend significantly on the spatial position of the subject’s body. Neirofiziologiya/Neurophysiology, Vol. 40, No. 2, pp. 147–154, March–April, 2008.     

DHEA enhances effects of weight training on muscle mass and strength in elderly women and men

The plasma levels of dehydroepiandrosterone (DHEA) and its sulfated form (DHEAS) decline approximately 80% between the ages of 25 and 75 yr. Muscle mass and strength also decrease with aging. Published data on the effects of DHEA replacement on muscle mass and strength are conflicting. The goals of this study were to determine whether DHEA replacement increases muscle mass and strength and/or enhances the effects of heavy resistance exercise in elderly women and men. We conducted a randomized, double-blind, placebo-controlled study of the effects of 10 mo of DHEA replacement therapy with the addition of weightlifting exercise training during the last 4 mo of the study (DHEA + exercise group, n = 29; placebo + exercise group, n = 27). DHEA alone for 6 mo did not significantly increase strength or thigh muscle volume. However, DHEA therapy potentiated the effect of 4 mo of weightlifting training on muscle strength, evaluated by means of one-repetition maximum measurement and Cybex dynamometry, and on thigh muscle volume, measured by magnetic resonance imaging. Serum insulin-like growth factor concentration increased in response to DHEA replacement. This study provides evidence that DHEA replacement has the beneficial effect of enhancing the increases in muscle mass and strength induced by heavy resistance exercise in elderly individuals.     

Effects of neck muscle training in women with chronic neck pain: one-year follow-up study

Exercises are commonly recommended for chronic neck pain, but evidence-based guidelines do not explain what types of exercise. The aim of this randomized study was to evaluate the rate of change in neck strength following high- and low-intensity neck muscle training and their effects on pain and disability. One hundred eighty women with chronic neck pain were randomized into a high-intensity strength training group (STG), local muscle endurance training group (ETG), or control group (CG). The neck training consisted of isometric exercises in the STG and dynamic exercises in the ETG. Both groups performed dynamic exercises for the upper extremities. Strength tests, neck pain, and disability indices were evaluated at the baseline, at the follow-ups after 2 and 6 months in the training groups, and after 12 months in all groups. In both groups the greatest gains in neck strength, as well as decrease in neck pain and disability, were achieved during the first 2 months. However, the improvements continued up to 12 months. The STG achieved the greatest strength gains at all follow-ups. The CG showed only minor changes, and significant differences were found in favor of the training groups in all measures. The change in neck pain and disability indices correlated with the isometric neck strength (r = -0.22 [-0.36 to - 0.08] to -0.36 [-0.49 to -0.23]). Neck and shoulder muscle training was shown to be an effective therapy for chronic neck pain, resulting in early improvement in both the strength tests and subjective measures. The results can be maintained and even improved with long-term training.     

Effect of exercise training on insulin binding and glucose metabolism in mouse soleus muscle

Training stimulates glucose uptake and metabolism by muscles independent of a rise in serum glucose. Whether this increased insulin action is associated with enhanced insulin binding in muscles is unknown. We studied the effect of 6 weeks of treadmill running on insulin binding, uptake of 2-deoxy-D-glucose, glycolysis, and glycogenesis by the soleus muscle of Swiss Webster mice. Training was progressively increased. The in vitro studies using intact soleus preparations were done 48 h after the last exercise bout. Training increased insulin binding, insulin-stimulated uptake of 2-deoxy-D-glucose, and glycogenesis but not glycolysis in the soleus. Our data suggest that the enhanced glucose uptake and metabolism in muscles induced by exercise training are associated with an increase in insulin binding.     

Long-lasting inhibition of the soleus muscle H reflex related to realization of voluntary arm movements in humans

In healthy humans, we recorded the H reflex induced by transcutaneous stimulation of the tibial nerve (recording from the soleus muscle). In subjects in the lying position, we studied changes in the H reflex values after preceding voluntary arm movements realized with a maximum velocity after presentation of an acoustic signal. On the 200th to 300th msec after forearm flexion, long-lasting inhibition of the H reflex developed following a period of initial facilitation and reached the maximum, on average, 700 msec from the moment of the movement. Flexion of the contralateral upper limb in the elbow joint induced deeper inhibition than analogous movement of the ipsilateral arm. Long-lasting clear inhibition of the H reflex developed after arm flexion in the elbow joint but was slightly expressed after finger clenching. After inhibition reached the maximum, its time course was satisfactorily approximated by a logarithmic function of the time interval between the beginning of the conditioning voluntary movement and presentation of the test stimulus. Durations of inhibition calculated using a regression equation were equal to 6.6 sec and 8.5 sec after ipsilateral and contralateral elbow-joint flexions, respectively. Inhibition was not eliminated under conditions of tonic excitation of motoneurons of the tested muscle upon voluntary foot flexion. Long-lasting inhibition of the H reflex was also observed after electrical stimulation-induced flexions of the upper limb. The obtained data indicate that movements of the upper limb cause reflex long-lasting presynaptic inhibition of the soleus-muscle H reflex that can play a noticeable role in redistribution of the muscle tone during motor activity. Neirofiziologiya/Neurophysiology, Vol. 40, No. 3, pp. 221–227, May–June, 2008.     

Combined effects of tenotomy and denervation on the dynamic properties of soleus muscle of the rat

Isometric contraction time (CT), half relaxation time (1/2 RT), tetanus fusion frequency (TFF) and tetanus: twitch ratio (T : t ratio) were measured in the denervated (D) and tenotomized-denervated (TD) Soleus muscle of the rat. In D muscle there was an apparent speeding effect at the 2nd day after denervation, with a significant decrease of CT, which was followed by the usual slowing process of denervated muscle. In TD muscle, denervation was performed a week after tenotomy. Tenotomy "per se" was ineffective in modifying dynamic properties of muscle, but it accentuated the early shortening of CT caused by denervation, while reducing and delaying the subsequent slowing process. The results are discussed in the light of the hypothesis that muscle disuse has a speeding effect which counteracts the slowing effect of denervation, and/or that tenotomy modifies the effects of denervation by changing the pattern of fibrillation development.     

Effects of the beta-adrenoceptor agonist isoprenaline on insulin-sensitivity in soleus muscle of the rat.

The interactions between a beta-adrenoceptor agonist (isoprenaline) and insulin on rates of hexose transport, glucose phosphorylation, glycogen synthesis and glycogenolysis were investigated in the incubated stripped soleus-muscle preparation of the rat. In the presence of 1 microM-isoprenaline, insulin was less effective in stimulating glucose phosphorylation and glycogen synthesis. The stimulation of glycogenolysis by isoprenaline was only slightly decreased even at high (10000 microunits/ml) concentrations of insulin. Insulin-stimulated phosphorylation of 2-deoxyglucose was decreased by isoprenaline. It is suggested that this decrease in the rate of glucose phosphorylation is caused by the observed elevated concentration of glucose 6-phosphate, which inhibits hexokinase activity. This conclusion is supported by the fact that isoprenaline had no effect on the stimulation of 3-O-methylglucose transport by insulin.     

Effects of high-intensity training on muscle lactate transporters and postexercise recovery of muscle lactate and hydrogen ions in women

The purpose of this study was to investigate the effects of high-intensity interval training (3 days/wk for 5 wk), provoking large changes in muscle lactate and pH, on changes in intracellular buffer capacity (betam(in vitro)), monocarboxylate transporters (MCTs), and the decrease in muscle lactate and hydrogen ions (H+) after exercise in women. Before and after training, biopsies of the vastus lateralis were obtained at rest and immediately after and 60 s after 45 s of exercise at 190% of maximal O2 uptake. Muscle samples were analyzed for ATP, phosphocreatine (PCr), lactate, and H+; MCT1 and MCT4 relative abundance and betam(in vitro) were also determined in resting muscle only. Training provoked a large decrease in postexercise muscle pH (pH 6.81). After training, there was a significant decrease in betam(in vitro) (-11%) and no significant change in relative abundance of MCT1 (96 +/- 12%) or MCT4 (120 +/- 21%). During the 60-s recovery after exercise, training was associated with no change in the decrease in muscle lactate, a significantly smaller decrease in muscle H+, and increased PCr resynthesis. These results suggest that increases in betam(in vitro) and MCT relative abundance are not linked to the degree of muscle lactate and H+ accumulation during training. Furthermore, training that is very intense may actually lead to decreases in betam(in vitro). The smaller postexercise decrease in muscle H+ after training is a further novel finding and suggests that training that results in a decrease in H+ accumulation and an increase in PCr resynthesis can actually reduce the decrease in muscle H+ during the recovery from supramaximal exercise.     

ACTN3 genotype is associated with increases in muscle strength in response to resistance training in women.

The alpha-actinin 3 (ACTN3) gene encodes a protein of the Z disk of myofibers, and a polymorphism of ACTN3 results in complete loss of the protein. The ACTN3 genotype (R577X) has been found to be associated with performance in Australian elite athletes (Yang N, MacArthur DG, Gulbin JP, Hahn AG, Beggs AH, Easteal S, and North K. Am J Hum Genet 73: 627-631, 2003). We studied associations between ACTN3 genotype and muscle size [cross-sectional area of the biceps brachii via magnetic resonance imaging (MRI)] and elbow flexor isometric (MVC) and dynamic [1-repetition maximum (1-RM)] strength in a large group of men (N = 247) and women (N = 355) enrolled in a 12-wk standardized elbow flexor/extensor resistance training program of the nondominant arm at one of eight study centers. We found no association between ACTN3 R577X genotype and muscle phenotype in men. However, women homozygous for the ACTN3 577X allele (XX) had lower baseline MVC compared with heterozygotes (P < 0.05) when adjusted for body mass and age. Women homozygous for the mutant allele (577X) demonstrated greater absolute and relative 1-RM gains compared with the homozygous wild type (RR) after resistance training when adjusted for body mass and age (P < 0.05). There was a trend for a dose-response with genotype such that gains were greatest for XX and least for RR. Significant associations were validated in at least one ethnic subpopulation (Caucasians, Asians) and were independent of training volume. About 2% of baseline MVC and of 1-RM strength gain after training were attributable to ACTN3 genotype (likelihood-ratio test P value, P = 0.01), suggesting that ACTN3 is one of many genes contributing to genetic variation in muscle performance and adaptation to exercise.     

Effective tempo of the step test for dynamic balance ability in the elderly

This study aimed to examine the reliability and sex- and age-related differences of step tests with stipulated tempos as well as to clarify useful test parameters and tempos. One hundred forty elderly people and fifty young adults conducted tapping and stepping tests, matching the tempo provided by a metronome. Both tests involve movements where the subject touches a sheet with both the right and left hands or right and left legs at a designated spot. Evaluation parameters were the time difference between the beep sound and the time at which the sheet was touched in both tests as well as two-leg support and one-leg support times in the step test. The trial-to-trial reliability of the parameters in both tests was high. The time differences of both 40 bpm tests in the elderly were larger in males than in females. In the step test, the time difference and two-leg support times of the elderly were larger, in the order of 40, 60, and 120 bpm, and the one-leg support time was less in 40 bpm than 60 bpm or 120 bpm. The one-leg support time of the young subjects was larger, in the order of 40, 60, and 120 bpm. A significant age-related difference was found in the 40 bpm and 60 bpm test, and the time difference and two-leg support time were larger in the elderly while the one-leg support time was larger in the young subjects. The time difference at 40 bpm in the elderly was larger in the step test than in the tap test. There was no significant difference between both tests in the young subjects. In conclusion, the step test with the slow tempo, because it requires a long one-leg support phase, is effective for evaluating dynamic balance in the elderly. The time difference and two-leg and one-leg support times are effective evaluation parameters of the step test.