Age related changes in skeletal muscle mass and function

The loss of muscle mass with age (Sarcopenia) has received growing attention over the past decade. Despite efforts to provide a universal definition with clinically meaningful cut-off points for diagnosis, there is no clear consensus on how to best quantify and assess the impact of loss of muscle mass and function on functional limitations. Whilst most previous studies have used dual energy x-ray absorptiometry (DXA) to quantify this loss, chapter 2 of this thesis shows that DXA underestimates the loss of muscle mass with age in comparison to the gold standard MRI. Muscle mass per se is not enough to determine whether a person has an exceptionally low muscle mass, as it can be readily seen that a healthy tall person will have a larger muscle mass than a small person. Clinicians and researchers thus need an index of muscle mass that takes differences in stature into account and also gives an objective cut off point to define low muscle mass. In Chapter3, we show that femur volume does not significantly differ between young and old. We used this observation to introduce a new index: thigh muscle mass normalised to femur volume, or the muscle to bone ratio. This index allows the examination of the true extent of muscle atrophy within an individual. In previous studies the appendicular lean mass (determined with DXA) divided by height squared appeared to be a relatively poor predictor of functional performance. In Chapter 4, the index introduced in Chapter 3, the muscle to bone ratio, proved to be a somewhat better predictor of functional performance in the overall cohort. This was, however, not true when examining the intra-group relationships. A similar situation applied to the maximal muscle strength. In older adults, the parameter which predicted functional performance best was muscle power per body mass, measured during a counter-movement jump. Chapter 5 shows that part of the larger loss power and force than muscle mass is attributable to a left-ward shift of the torque-frequency relationship, indicative of a slowing of the muscle, and reduction in maximal voluntary activation, as assessed using the interpolated twitch technique in older adults. Chapter 5 also shows that the fatigue resistance during a series of intermittent contractions was similar in young and older adults. However, older adults could sustain a 50% maximal voluntary contraction force longer than young people. Part of this discrepancy maybe due to an age-related slowing of the muscle

The influence of patellar tendon and muscle-tendon unit stiffness on quadriceps explosive strength in man

What is the central question of this study? \ud Do tendon and/or muscle–tendon unit stiffness influence rate of torque development? What is the main finding and its importance? In our experimental conditions, some measures of relative (to maximal voluntary torque and tissue length) muscle–tendon unit stiffness had small correlations with voluntary/evoked rate of torque development over matching torque increments. However, absolute and relative tendon stiffness were unrelated to voluntary and evoked rate of torque development. Therefore, the muscle aponeurosis but not free tendon influences the relative rate of torque development. Factors other than tissue stiffness more strongly determine the absolute rate of torque development. The influence of musculotendinous tissue stiffness on contractile rate of torque development (RTD) remains opaque. In this study, we examined the relationships between both patellar tendon (PT) and vastus lateralis muscle–tendon unit (MTU) stiffness and the voluntary and evoked knee-extension RTD. Fifty-two healthy untrained men completed duplicate laboratory sessions. Absolute and relative RTD were measured at 50 N m or 25% maximal voluntary torque (MVT) increments from onset and sequentially during explosive voluntary and evoked octet isometric contractions (supramaximal stimulation; eight pulses at 300 Hz). Isometric MVT was also assessed. Patellar tendon and MTU stiffness were derived from simultaneous force and ultrasound recordings of the PT and vastus lateralis aponeurosis during constant RTD ramp contractions. Absolute and relative (to MVT and resting tissue length) stiffness (k) was measured over identical torque increments as RTD. Pearson's correlations tested relationships between stiffness and RTD measurements over matching absolute/relative torque increments. Absolute and relative PT k were unrelated to equivalent voluntary/evoked (r = 0.020–0.255, P = 0.069–0.891). Absolute MTU k was unrelated to voluntary or evoked RTD (r ≤ 0.191, P ≥ 0.184), but some measures of relative MTU k were related to relative voluntary/evoked RTD (e.g. RTD for 25–50% MVT, r = 0.374/0.353, P = 0.007/0.014). In conclusion, relative MTU k explained a small proportion of the variance in relative voluntary and evoked RTD (both ≤19%), despite no association of absolute MTU k or absolute/relative PT k with equivalent RTD measures. Therefore, the muscle-aponeurosis component but not free tendon was associated with relative RTD, although it seems that an overriding influence of MVT negated any relationship of absolute MTU k and absolute RTD

Neural adaptations after 4 years vs. 12 weeks of resistance training vs. untrained

The purpose of this study was to compare the effect of resistance training (RT) duration, including years of exposure, on agonist and antagonist neuromuscular activation throughout the knee extension voluntary torque range. Fifty‐seven healthy men (untrained [UNT] n=29, short‐term RT [12WK] n=14, and long‐term RT [4YR] n=14) performed maximum and sub‐maximum (20‐80% maximum voluntary torque [MVT]) unilateral isometric knee extension contractions with torque, agonist and antagonist surface EMG recorded. Agonist EMG, including at MVT, was corrected for the confounding effects of adiposity (i.e. muscle‐electrode distance; measured with ultrasonography). Quadriceps maximum anatomical cross‐sectional area (QACSAMAX; via MRI) was also assessed. MVT was distinct for all three groups (4YR +60/+39% vs. UNT/12WK; 12WK +15% vs. UNT; 0.001<P≤0.021), and QACSAMAX was greater for 4YR (+50/+42% vs. UNT/12WK; [both] P<0.001). Agonist EMG at MVT was +44/+33% greater for 4YR/12WK ([both] P<0.001) vs. UNT; but did not differ between RT groups. The torque‐agonist EMG relationship of 4YR displayed a right/down shift with lower agonist EMG at the highest common torque (196 Nm) compared to 12WK and UNT (0.005≤P≤0.013; Effect size [ES] 0.90≤ES≤1.28). The torque‐antagonist EMG relationship displayed a lower slope with increasing RT duration (4YR<12WK<UNT; 0.001<P≤0.094; 0.56≤ES≤1.31), and antagonist EMG at the highest common torque was also lower for 4YR than UNT (‐69%; P<0.001; ES=1.18). In conclusion, 4YR and 12WK had similar agonist activation at MVT and this adaptation may be maximised during early months of RT. In contrast, inter‐muscular coordination, specifically antagonist co‐activation was progressively lower, and likely continues to adapt, with prolonged RT

Training-specific functional, neural, and hypertrophic adaptations to explosive- vs. sustained-contraction strength training

Training specificity is considered important for strength training, although the functional and underpinning physiological adaptations to different types of training, including brief explosive contractions, are poorly understood. This study compared the effects of 12 wk of explosive-contraction (ECT, n = 13) vs. sustained-contraction (SCT, n = 16) strength training vs. control (n = 14) on the functional, neural, hypertrophic, and intrinsic contractile characteristics of healthy young men. Training involved 40 isometric knee extension repetitions (3 times/wk): contracting as fast and hard as possible for ∼1 s (ECT) or gradually increasing to 75% of maximum voluntary torque (MVT) before holding for 3 s (SCT). Torque and electromyography during maximum and explosive contractions, torque during evoked octet contractions, and total quadriceps muscle volume (QUADSVOL) were quantified pre and post training. MVT increased more after SCT than ECT [23 vs. 17%; effect size (ES) = 0.69], with similar increases in neural drive, but greater QUADSVOL changes after SCT (8.1 vs. 2.6%; ES = 0.74). ECT improved explosive torque at all time points (17-34%; 0.54 ≤ ES ≤ 0.76) because of increased neural drive (17-28%), whereas only late-phase explosive torque (150 ms, 12%; ES = 1.48) and corresponding neural drive (18%) increased after SCT. Changes in evoked torque indicated slowing of the contractile properties of the muscle-tendon unit after both training interventions. These results showed training-specific functional changes that appeared to be due to distinct neural and hypertrophic adaptations. ECT produced a wider range of functional adaptations than SCT, and given the lesser demands of ECT, this type of training provides a highly efficient means of increasing function

Muscle architecture and morphology as determinants of explosive strength

Purpose Neural drive and contractile properties are well-defined physiological determinants of explosive strength, the influence of muscle architecture and related morphology on explosive strength is poorly understood. The aim of this study was to examine the relationships between Quadriceps muscle architecture (pennation angle [ΘP] and fascicle length [FL]) and size (e.g. volume; QVOL), as well as patellar tendon moment arm (PTMA) with voluntary and evoked explosive knee extension torque in 53 recreationally-active young men. Method Following familiarisation, explosive voluntary torque at 50 ms intervals from torque onset (T50, T100, T150), evoked octet at 50 ms (8 pulses at 300-Hz; evoked T50), as well as maximum voluntary torque, were assessed on two occasions with isometric dynamometry. B-mode ultrasound was used to assess ΘP and FL at 10 sites throughout the quadriceps (2-3 sites per constituent muscle. Muscle size (QVOL) and PTMA were quantified using 1.5T MRI. Result There were no relationships with absolute early phase explosive voluntary torque (≤50 ms), but θP (weak), QVOL (moderate to strong) and PTMA (weak) were related to late phase explosive voluntary torque (≥100 ms). Regression analysis revealed only QVOL was an independent variable contributing to the variance in T100 (34%) and T150 (54%). Evoked T50 was also related to QVOL and θP. When explosive strength was expressed relative to MVT there were no relationships observed. Conclusion It’s likely that the weak associations of θP and PTMA with late phase explosive voluntary torque was via their association with MVT/QVOL rather than as a direct determinant

Development of a novel Nordic hamstring exercise device to measure and modify the knee flexors’ torque-length relationship

The Nordic hamstring exercise (NHE) has been shown to reduce hamstring injury risk when employed in training programs. This study investigates a novel device to modify the NHE torque-length relationship of the knee flexors, as targeting the hamstrings at a more extended length may have benefits for hamstring strain injury prevention and rehabilitation. 18 recreational male participants completed 3 bilateral NHE repetitions at a conventional 0° flat position, a 10° incline and a 10° decline slope on a novel device (HALHAM°). Measures of peak torque and break-torque angle explored the effect of inclination on the knee flexors’ length-tension relationship. Relative thigh-to-trunk angle and angular velocity of the knee joint were used to assess influence of inclination on technique and exercise quality. Break-torque angle increased when performed at an incline (134.1+8.6°) compared to both the decline (112.1+8.3°, p<0.0001, g=2.599) and standard flat NHE positions (126.0+9.8°, p=0.0002, g=0.885). Despite this, altering inclination did not affect eccentric knee flexor peak torque (decline=132.0+63.1Nm, flat=149.7+70.1Nm, incline=148.9+64.9Nm, F=0.952, p=0.389), angular velocity of the knee joint at break-torque angle (decline=23.8+14.4°, flat=29.2+22.6°, incline=24.5+22.6°, F=0.880, p=0.418) or relative thigh-to-trunk angle at break-torque angle (decline=20.4+10.4°, flat=16.7+10.8°, incline=20.2+11.2°, F=1.597, p=0.207). The report recommends the use of arbitrary metrics such as break-torque angle that can be replicated practically in the field by practitioners to assess proxy muscle length changes i.e. the angular range over which the torque can be produced. Inclination of the Nordic hamstring exercise leads to hamstring muscle failure at longer muscle lengths without reductions in the maximal force exuded by the muscle. Therefore, the NHE performed on an incline may be a more effective training intervention, specific to the proposed mechanism of hamstring strain injury during sprinting that occurs whilst the muscle is rapidly lengthening. Using a graded training intervention through the inclinations could aid gradual return-to-play rehabilitation

Development of a novel Nordic hamstring exercise device to measure and modify the knee flexors’ torque-length relationship

The Nordic hamstring exercise (NHE) has been shown to reduce hamstring injury risk when employed in training programs. This study investigates a novel device to modify the NHE torque-length relationship of the knee flexors, as targeting the hamstrings at a more extended length may have benefits for hamstring strain injury prevention and rehabilitation. 18 recreational male participants completed 3 bilateral NHE repetitions at a conventional 0° flat position, a 10° incline and a 10° decline slope on a novel device (HALHAM°). Measures of peak torque and break-torque angle explored the effect of inclination on the knee flexors’ length-tension relationship. Relative thigh-to-trunk angle and angular velocity of the knee joint were used to assess influence of inclination on technique and exercise quality. Break-torque angle increased when performed at an incline (134.1+8.6°) compared to both the decline (112.1+8.3°, p<0.0001, g=2.599) and standard flat NHE positions (126.0+9.8°, p=0.0002, g=0.885). Despite this, altering inclination did not affect eccentric knee flexor peak torque (decline=132.0+63.1Nm, flat=149.7+70.1Nm, incline=148.9+64.9Nm, F=0.952, p=0.389), angular velocity of the knee joint at break-torque angle (decline=23.8+14.4°, flat=29.2+22.6°, incline=24.5+22.6°, F=0.880, p=0.418) or relative thigh-to-trunk angle at break-torque angle (decline=20.4+10.4°, flat=16.7+10.8°, incline=20.2+11.2°, F=1.597, p=0.207). The report recommends the use of arbitrary metrics such as break-torque angle that can be replicated practically in the field by practitioners to assess proxy muscle length changes i.e. the angular range over which the torque can be produced. Inclination of the Nordic hamstring exercise leads to hamstring muscle failure at longer muscle lengths without reductions in the maximal force exuded by the muscle. Therefore, the NHE performed on an incline may be a more effective training intervention, specific to the proposed mechanism of hamstring strain injury during sprinting that occurs whilst the muscle is rapidly lengthening. Using a graded training intervention through the inclinations could aid gradual return-to-play rehabilitation

Comparative perceptual, affective, and cardiovascular responses between resistance exercise with and without blood flow restriction in older adults

Older adults and patients with chronic disease presenting with muscle weakness or musculoskeletal disorders may benefit from low-load resistance exercise (LLRE) with blood flow restriction (BFR). LLRE-BFR has been shown to increase muscle size, strength, and endurance comparable to traditional resistance exercise but without the use of heavy loads. However, potential negative effects from LLRE-BFR present as a barrier to participation and limit its wider use. This study examined the perceptual, affective, and cardiovascular responses to a bout of LLRE-BFR and compared the responses to LLRE and moderate-load resistance exercise (MLRE). Twenty older adults (64.3 ± 4.2 years) performed LLRE-BFR, LLRE and MLRE consisting of 4 sets of leg press and knee extension, in a randomised crossover design. LLRE-BFR was more demanding than LLRE and MLRE through increased pain (p ≤ 0.024, d = 0.8–1.4) and reduced affect (p ≤ 0.048, d = −0.5–−0.9). Despite this, LLRE-BFR was enjoyed and promoted a positive affective response (p ≤ 0.035, d = 0.5–0.9) following exercise comparable to MLRE. This study supports the use of LLRE-BFR for older adults and encourages future research to examine the safety, acceptability, and efficacy of LLRE-BFR in patients with chronic disease

Tendinous tissue properties after short and long-term functional overload: Differences between controls, 12 weeks and 4 years of resistance training.

AIM: The potential for tendinous tissues to adapt to functional overload, especially after several years of exposure to heavy resistance training is largely unexplored. This study compared the morphological and mechanical characteristics of the patellar tendon and knee-extensor tendon-aponeurosis complex between young men exposed to long-term (4 years; n=16), short-term (12 weeks; n=15) and no (untrained controls; n=39) functional overload in the form of heavy resistance training. METHODS: Patellar tendon cross-sectional area, vastus-lateralis aponeurosis area and quadriceps femoris volume, plus patellar tendon stiffness and Young's modulus, and tendon-aponeurosis complex stiffness, were quantified with MRI, dynamometry and ultrasonography. RESULTS: As expected long-term trained had greater muscle strength and volume (+58% and +56% vs untrained, both P<0.001), as well as a greater aponeurosis area (+17% vs untrained, P<0.01), but tendon cross-sectional area (mean and regional) was not different between groups. Only long-term trained had reduced patellar tendon elongation/strain over the whole force/stress range, whilst both short-term and long-term overload groups had similarly greater stiffness/Young's modulus at high force/stress (short-term +25/22%, and long-term +17/23% vs untrained; all P<0.05). Tendon-aponeurosis complex stiffness was not different between groups (ANOVA, P = 0.149). CONCLUSION: Despite large differences in muscle strength and size, years of resistance training did not induce tendon hypertrophy. Both short-term and long-term overload, demonstrated similar increases in high force mechanical and material stiffness, but reduced elongation/strain over the whole force/stress range occurred only after years of overload, indicating a force/strain specific time-course to these adaptations. This article is protected by copyright. All rights reserved

What makes long-term resistance-trained individuals so strong? A comparison of skeletal muscle morphology, architecture, and joint mechanics.

The greater muscular strength of long-term resistance-trained (LTT) individuals is often attributed to hypertrophy but the role of other factors, notably maximum voluntary specific tension (ST), muscle architecture and any differences in joint mechanics (moment arm) have not been documented. The aim of the present study was to examine the musculoskeletal factors that might explain the greater Quadriceps strength and size of LTT vs untrained (UT) individuals. LTT (n = 16, age 21.6 ± 2.0 years) had 4.0 ± 0.8 years of systematic knee extensor heavy-resistance training experience, whereas UT (n = 52; age 25.1 ± 2.3 years) had no lower-body resistance training experience for > 18 months. Knee extension dynamometry, T1-weighted magnetic resonance images of the thigh and knee and ultrasonography of the Quadriceps muscle group at 10 locations were used to determine Quadriceps: isometric maximal voluntary torque (MVT), muscle volume (QVOL), patella tendon moment arm (PTMA), pennation angle (QΘP) and fascicle length (QFL), physiological cross-sectional area (QPCSA) and ST. LTT had substantially greater MVT (+60% vs UT, P<0.001) and QVOL (+56%, P<0.001) and QPCSA (+41%, P<0.001) but smaller differences in ST (+9%, P<0.05) and moment arm (+4%, P<0.05), and thus muscle size was the primary explanation for the greater strength of LTT. The greater muscle size (volume) of LTT was primarily attributable to the greater QPCSA (+41%; indicating more sarcomeres in parallel) rather than the more modest difference in FL (+11%; indicating more sarcomeres in series). There was no evidence for regional hypertrophy after LTT