Can adults with cerebral palsy perform and benefit from ballistic strength training to improve walking outcomes? A mixed methods feasibility study

Background Power bursts of hips and ankle plantar flexors are prerequisites to walking propulsion. However, these power bursts are reduced during gait for persons with cerebral palsy (CP) and mainly in the ankle plantar flexors. Hence, task specific training, such as ballistic strength training, is suggested to increase muscle power in walking but not investigated in adults with CP. Therefore, the aim was to investigate if adults with CP could perform and benefit from ballistic strength training to improve walking, evaluated through physical measures and self-reported measures and interviews. Methods In this mixed methods feasibility study, eight ambulatory adults (aged 24–56) with spastic CP conducted ballistic strength training on a glideboard targeting the ankle plantarflexors two times a week for eight weeks. The feasibility of the training was assessed through objectives described by Orsmond and Cohn. Before and after the intervention, physical measures (6-Minute Walk Test and the eight-item High-level Mobility Assessment Tool) and self-reported measures (Patient Global Impression of Change, Numeric Pain Rating Scale, Fatigue Impact and Severity Self-Assessment, and Walk-12) were collected. After the intervention, semi-structured interviews explored experiences of this training. Results The participants experienced training the ankle plantar flexor as relevant but reported it took about four weeks to coordinate the exercises successfully. Although we observed no changes in the physical performance measures, most participants reported improvements; some felt steadier when standing, walking, and hopping. Conclusion This study demonstrated that ballistic strength training was feasible and suitable in adults with CP. However, guidance and a long (4 weeks) familiarization time were reported necessary to master the exercises. Most participants reported self-experienced improvements, although no physical performance measures improved. Thus, prolonged intervention may be required for perceived physical improvements to emerge. Also, other outcome measures sensitive to power output remains to be investigated.publishedVersio

The effect of grip width on muscle strength and electromyographic activity in bench press among novice-and resistance-trained men

Background: This study compared the muscle activity and six repetition maximum (6-RM) loads in bench press with narrow, medium, and wide grip widths with sub-group comparisons of resistance-trained (RT) and novice-trained (NT) men. Methods: After two familiarization sessions, twenty-eight subjects lifted their 6-RM loads with the different grip widths with measurement of electromyographic activity. Results: Biceps brachii activity increased with increasing grip width, whereas wide grip displayed lower triceps brachii activation than medium and narrow. In the anterior deltoid, greater activity was observed using a medium compared to narrow grip. Similar muscle activities were observed between the grip widths for the other muscles. For the RT group, greater biceps brachii activity with increasing grip width was observed, but only greater activity was observed in the NT group between narrow and wide. Comparing wide and medium grip width, the RT group showed lower triceps activation using a wide grip, whereas the NT group showed lower anterior deltoid activation using a narrow compared to medium grip. Both groups demonstrated lower 6-RM loads using a narrow grip compared to the other grips. Conclusion: Grip widths affect both 6-RM loads and triceps brachii, biceps brachii, and anterior deltoid activity especially between wide and narrow grip widths.publishedVersio

Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: A cluster-randomized controlled trial

Background: Aging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults’ real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care. Methods: This open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80–90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition. Results: Twelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56–64 (6–7 clusters) in RTG and 20–42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9–24%, p = 0.01–0.03) compared to CG. No effects were seen for rate of force development or body composition. Conclusion: This study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care.publishedVersio

Ballistic strength training in adults with cerebral palsy may increase rate of force development in plantar fexors, but transition to walking remains unclear: a case series

Background Persons with cerebral palsy (CP) walk with reduced ankle plantar flexor power compared to typically developing. In this study, we investigated whether a ballistic strength-training programme targeting ankle plantar flexors could improve muscle strength, muscle architecture and walking function in adults with CP. Methods Eight adults (mildly affected CP) underwent eight weeks of ballistic strength training, with two sessions per week. Before and after the intervention preferred walking speed, ankle plantar flexion rate of force development (RFD), maximal voluntary contraction (MVC), muscle thickness, pennation angle and fascicle length were measured. Data are presented for individuals, as well as for groups. Group changes were analysed using the Wilcoxon signed-rank test. Results Data were analysed for eight participants (five women, mean age 37.9 years; six GMFCS I and two GMFCS II). Two participants increased their walking speed, but there were no significant group changes. In terms of muscle strength, there were significant group changes for RFD at 100 ms and MVC. In the case of muscle architecture, there were no group changes. Conclusion In this study, we found that eight weeks of ballistic strength training improved ankle plantar flexor muscle strength but walking function and muscle architecture were unchanged. Larger studies will be needed to obtain conclusive evidence of the efficacy of this training method.publishedVersio

Acute Effects of Elastic Bands as Resistance or Assistance on EMG, Kinetics, and Kinematics During Deadlift in Resistance-Trained Men

The aim of the study was to compare neuromuscular activation, kinetics and kinematics in three variations of the deadlift: (1) free weights, (2) free weights with elastic bands as resistance (bands anchored to the ground) and (3) free weights with elastic bands as assistance (bands attached above the bar). Sixteen resistance-trained men performed one repetition of the three variations as fast as possible using a 2-repetition maximum load in randomized and counterbalanced order. Muscle activation (gluteus maximus, semitendinosus, biceps femoris, erector spinae, vastus lateralis, and vastus medialis), kinematics (average-, peak-, and time to peak velocity), and kinetics (average-, peak,-and time to peak force) were measured during the ascending movement. Resisted and assisted deadlifts led to higher average and peak force outputs (p < 0.001–0.037, ES = 0.29–0.58), and time to peak velocity was shorter when compared to the free weights deadlift (p = 0.005–0.010, ES = 0.83–1.01). However, peak force was achieved faster when using free weights (p < 0.001, ES = 1.58–2.10) and assisted deadlifts had a lower peak velocity compared to resisted and free weights deadlift (p = 0.004–0.046, ES = 0.43–0.60). There were no significant differences in muscle activation between the different conditions (p = 0.082–1.000). In conclusion, the assisted and resisted deadlift produced higher force when compared to free weights. However, free weight and resisted deadlift seem more favorable for the barbell velocity. These findings are of importance for athletes and coaches which should select exercise depending on the goal of the session.publishedVersio

The role of trunk training for physical fitness and sport-specific performance. Protocol for a Meta-Analysis.

The trunk (core) muscles are involved in daily functions (i. e., stabilizing the body in everyday tasks) and force generation of the limbs during athletic tasks such as kicking, throwing, or running. Even though trunk training is a popular means for improving physical fitness and athletic performance, the direct relationship of improved trunk function (i.e., stability, strength, or endurance), fitness and sport-specific performance is not conclusive. The aim of this proposed review is to evaluate the effects of trunk training on physical fitness and sport-specific performance, and to examine potential subject-related (e.g., age, sex) and trunk training-related moderator variables (e.g., training period, training frequency) for performance changes. We will conduct a systematic literature search in Web of Science, MEDLINE (via EBSCO) and SportDiscus. Relevant papers will be screened independently by two reviewers in two stages: (1) title and abstracts and (2) the full text of the remaining papers. A third reviewer will resolve possible disagreements. Data extraction and risk of bias of the included studies will be performed in addition to the PEDro scoring to judge the quality of the studies. A meta-analysis will be conducted to determine the efficacy of trunk training to increase physical fitness and sport-specific performance measures. In addition, subgroup univariate analyses were computed for subject-related (i.e., age, sex, performance level) and training-related moderator variables (i.e., training period, training frequency, training sessions, session duration). The results of this proposed systematic review and meta-analysis will assess the effects of trunk training on physical fitness and sport-specific and identify which subject-related and training-related moderate variables of trunk training modality might be beneficial for performance gains. This knowledge has potential importance for athletes and coaches in sports.publishedVersio

Comparing the effects of variable and traditional resistance training on maximal strength and muscle power in healthy adults: A systematic review and meta-analysis

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Effekten av to ulike styrketreningsmetoder på satellittceller, cellekjerner, muskelfiberareal og muskelstyrke i knestrekkerne hos eldre

Målet med denne studien var å undersøke ulike cellulære endringer hos eldre mennesker etter 12 uker med trening. 11 selvhjulpne eldre mennesker (70-88 år) trente enten tradisjonell- (n=5) eller funksjonell styrketrening (n=6) tre ganger i uken. En deltager ble ekskludert på grunn av for få gjennomførte treninger. Før og etter treningsintervensjonen ble muskelstyrken målt i et kneekstensjonsapparat, muskeltykkelsen ble målt av m. vastus lateralis ved hjelp av ultralyd, og det ble tatt en muskelbiopsi av m. vastus lateralis for å undersøke satellittceller, cellekjerner og muskelfiberareal

Can supplementation with vitamin C and E alter physiological adaptations to strength training?

Background: Antioxidant supplementation has recently been demonstrated to be a double-edged sword, because small to moderate doses of exogenous antioxidants are essential or beneficial, while high doses may have adverse effects. The adverse effects can be manifested in attenuated effects of exercise and training, as the antioxidants may shut down some redox-sensitive signaling in the exercised muscle fibers. However, conditions such as age may potentially modulate the need for antioxidant intake. Therefore, this paper describes experiments for testing the hypothesis that high dosages of vitamin C (1000 mg/day) and E (235 mg/day) have negative effects on adaptation to resistance exercise and training in young volunteers, but positive effects in older men. Methods/design: We recruited a total of 73 volunteers. The participants were randomly assigned to receiving either vitamin C and E supplementation or a placebo. The study design was double-blinded, and the participants followed an intensive training program for 10–12 weeks. Tests and measurements aimed at assessing changes in physical performance (maximal strength) and physiological characteristics (muscle mass), as well as biochemical and cellular systems and structures (e.g., cell signaling and morphology). Discussion: Dietary supplements, such as vitamin C and E, are used by many people, especially athletes. The users often believe that high dosages of supplements improve health (resistance to illness and disease) and physical performance. These assumptions are, however, generally not supported in the scientific literature. On the contrary, some studies have indicated that high dosages of antioxidant supplements have negative effects on exercise-induced adaptation processes. Since this issue concerns many people and few randomized controlled trials have been conducted in humans, further studies are highly warranted

Muscular HSP70 content is higher in elderly compared to young, but is normalized after 12 weeks of strength training

Purpose: Aging is associated with increased myocellular stress and loss of muscle mass and function. Heat shock proteins (HSPs) are upregulated during periods of stress as part of the cells protective system. Exercise can affect both acute HSP regulation and when repeated regularly counteract unhealthy age-related changes in the muscle. Few studies have investigated effects of exercise on HSP content in elderly. The aim of the study was to compare muscular HSP levels in young and elderly and to investigate how training affects HSP content in muscles from aged males and females. Methods: Thirty-eight elderly were randomized to 12 weeks of strength training (STG), functional strength training (FTG) or a control group (C). To compare elderly to young, 13 untrained young performed 11 weeks of strength training (Y). Muscle biopsies were collected before and after the intervention and analyzed for HSP27, αB-crystallin and HSP70. Results: Baseline HSP70 were 35% higher in elderly than in young, whereas there were no differences between young and elderly in HSP27 or αB-crystallin. After the training intervention, HSP70 were reduced in STG (− 33 ± 32%; P = 0.001) and FTG (− 28 ± 30%; P = 0.012). The decrease in HSP70 was more pronounced in the oldest. In contrast, Y increased HSP27 (134 ± 1%; P < 0.001) and αB-crystallin (84 ± 94%; P = 0.008). Conclusion: Twelve weeks of STG or FTG decreased the initial high levels of HSP70 in aged muscles. Thus, regular strength training can normalize some of the increases in cellular stress associated with normal aging, and lead to a healthier cellular environment in aged muscle cells