Efficacy of Therapeutic Exercise on Activities of Daily Living and Cognitive Function Among Older Residents in Long-term Care Facilities: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVES: This study aimed to systematically analyze the efficacy of therapeutic exercise on activities of daily living (ADL) and cognitive function among older residents in long-term care facilities. DATA SOURCES: PubMed, Cochrane Central of Register Trials, Physiotherapy Evidence Database, OTseeker, and Ichushi-Web were searched from inception until December 2018. STUDY SELECTION: Databases were searched to identify randomized controlled trials (RCTs) of therapeutic exercise for long-term care facility residents aged 60 years and older, focusing on ADL and cognitive function as outcomes. DATA EXTRACTION: Two independent reviewers extracted the key information from each eligible study. Two reviewers independently screened and assessed all studies for eligibility, extracting information on study participants, details of interventions, outcome characteristics, and significant outcomes. Any discrepancies were resolved by a third reviewer. DATA SYNTHESIS: A total of 11 RCTs with 1280 participants were eligible for analyses. Therapeutic exercise had a significant benefit on ADL (standard mean difference [SMD]=0. 22, 95% confidence interval [CI]: 0.02, 0.42, P=.03). Subgroup analyses indicated that interventions conducted ≥3 days per week [SMD=0.42, 95% CI 0.02, 0.82, P=.04] had a significant benefit on ADL. For cognitive function, group exercise and ≥3 days/week of intervention had a significant benefit (group exercise: mean difference [MD]=3.36, 95% CI 0.91, 5.80, P=.007; ≥3 days/week of intervention: MD=2.28, 95% CI 0.07, 4.49, P=.04). CONCLUSIONS: Therapeutic exercise conducted 3 or more days per week may be effective for improving ADL and cognitive function among older residents in long-term care facilities. This meta-analysis suggested that group exercise for cognitive functions was effective. However, the effective method of intervention delivery for ADL was unclear.

Acute Effects of Low-intensity Isometric Exercise at Long and Short Muscle-tendon Unit Lengths.

Low-intensity training at long muscle-tendon unit lengths with a greater passive force may cause muscle swelling, which may be related to hypertrophy, even if the active force production is lower than that at short muscle-tendon unit lengths. This study compared muscle swelling after low-intensity torque-matched isometric exercises at long and short muscle-tendon unit lengths. Twenty-six volunteers performed isometric knee flexion exercises (30% of maximal voluntary contraction× 5 seconds×10 repetitions×9 sets) either at long or short lengths of the hamstrings (90° hip flexion and 30° knee flexion, or 90° hip and knee flexion, respectively). Active torque was calculated by subtracting passive torque from the total torque generated during exercise. Swelling-induced changes in cross-sectional area was assessed before and after exercise using ultrasonography. There was no between-group difference in the total torque during exercise; however, the active torque was significantly lower in the group trained at long than in the group trained at short muscle-tendon unit lengths. Muscle swelling occurred in both groups. The results suggest that exercise at long muscle-tendon unit lengths can cause similar muscle swelling as exercise at short muscle-tendon unit lengths, even in cases where active torque production is lower than that at short lengths.

Effects of Low-Intensity Torque-Matched Isometric Training at Long and Short Muscle Lengths of the Hamstrings on Muscle Strength and Hypertrophy: A Randomized Controlled Study.

ABSTRACT: Nakao, S, Ikezoe, T, Taniguchi, M, Motomura, Y, Hirono, T, Nojiri, S, Hayashi, R, Tanaka, H, and Ichihashi, N. Effects of low-intensity torque-matched isometric training at long and short muscle lengths of the hamstrings on muscle strength and hypertrophy: A randomized controlled study. J Strength Cond Res 37(10): 1978-1984, 2023-This study investigated the effects of low-intensity torque-matched isometric training on muscle hypertrophy and strengthening at long (LL) and short muscle lengths (SL). Twenty-eight young subjects completed an 8-week hamstring isometric training program (30% of maximal voluntary contraction (MVC) × 5 s × 20 repetitions × 5 sets × 3 times/week) at 30° knee flexion (LL) or 90° knee flexion (SL). The cross-sectional area (CSA) of the hamstrings and MVC were measured before and after the intervention. The active torque because of muscle contraction was calculated by subtracting the passive torque at rest from the total torque (30% MVC). The active torque was significantly lower in the LL training group than in the SL training group (p < 0.01), whereas there was no between-group difference in total torque during training. For CSA and MVC at 30° knee flexion, the split-plot analysis of variance (ANOVA) showed no significant time × group interaction; however, it did show a significant main effect of time (p < 0.05), indicating a significant increase after training intervention. As for MVC at 90° knee flexion, there was a significant time × group interaction (p < 0.05) and a significant simple main effect of time in both the LL (p < 0.01; Cohen's d effect size [ES] = 0.36) and SL (p < 0.01; ES = 0.64) training groups. Therefore, low-intensity isometric training at LL can induce hypertrophy and strengthening, even in cases where the active torque production is lower than that at SL, whereas the training at SL may be more effective for muscle strengthening at SL.

Systemic chronic diseases coexist with and affect locomotive syndrome: The Nagahama Study.

OBJECTIVES: The concept of locomotive syndrome was proposed to highlight older adults who require nursing care services due to the malfunctioning of their locomotive organs. With the coming of a super-ageing society, there is a growing need to understand the relation between systemic chronic diseases and locomotive syndrome. METHODS: We analysed the second-visit dataset of the Nagahama Study. The association analysis was performed to identify the chronic diseases that were risk factors associated with the occurrence and the progression of locomotive syndrome in both the cross-sectional and longitudinal studies. RESULTS: Hypertension, stroke, coronary heart disease, rheumatoid arthritis, chronic renal failure, osteoporosis, anaemia, and gastroesophageal reflux disease were independently correlated with locomotive syndrome through the deterioration of body pain, social activity, and cognitive function in the cross-sectional study. Multiple chronic diseases had additive effects and significantly increased the risk of locomotive syndrome. In the longitudinal study, osteoporosis and kidney disease were significantly correlated with the worsening of the total GLFS-25 score. CONCLUSIONS: Locomotive syndrome coexisted with various systemic chronic diseases, especially cardiovascular diseases. Osteoporosis and kidney disease were significantly correlated with the progression of locomotive dysfunction. The management of various chronic diseases may be useful to prevent locomotive syndrome and vice versa.

Differences in lower limb muscle strength and balance ability between sarcopenia stages depend on sex in community-dwelling older adults.

AIM: This study aimed to compare motor function between sarcopenia stages with respect to sex in community-dwelling older adults. METHODS: The participants, comprising 2107 community-dwelling older adults (738 men and 1369 women), were classified into 4 groups and the groups were operationally defined-normal, low muscle mass, low physical function, and sarcopenia groups. Lower limb muscle strength and balance ability were assessed for evaluating motor function. To compare motor function between sarcopenia stages, an analysis of covariance adjusted for age and body mass index was performed. RESULTS: Lower limb muscle strengths were significantly lower not only in the sarcopenia group but also in the low muscle mass and low physical function groups than that in the normal group in both men and women. Low hip abductor muscle strength was observed in the low physical function group compared to the low muscle mass group in women, but not in men. Timed Up and Go test results in the sarcopenia and low function groups was lower than in the normal and low muscle mass groups for men and women. One-leg standing in the low physical function group was lower than that in the normal group, only for women. CONCLUSIONS: Reduced motor function was observed not only in older people with sarcopenia but also in older people with only low muscle mass or low physical function, and the decline in lower limb muscle strength and balance ability in the low function group were greater in older women than in older men.

Relationship Between Muscle Swelling and Hypertrophy Induced by Resistance Training.

ABSTRACT: Hirono, T, Ikezoe, T, Taniguchi, M, Tanaka, H, Saeki, J, Yagi, M, Umehara, J, and Ichihashi, N. Relationship between muscle swelling and hypertrophy induced by resistance training. J Strength Cond Res 36(2): 359-364, 2022-Muscle swelling immediately after resistance exercise may be induced by metabolic stress. The accumulation of metabolic stress is considered to promote muscle hypertrophy after several weeks of resistance training (RT). The purpose of this study was to determine the relationship between muscle swelling immediately after the first session of RT and muscle hypertrophy after a 6-week RT using ultrasonography. Twenty-two untrained young men performed knee extension resistance exercise consisting of 3 sets with 8 repetitions at a load of 80% of one repetition maximum for 6 weeks (3 d·wk-1). Muscle thickness of the quadriceps femoris was measured using ultrasonography device at 3 anatomical sites (proximal, medial, and distal sites) of the middle, lateral, and medial part of the anterior thigh. The sum of the muscle thickness at 9 measurement sites was used for analysis. Acute change in muscle thickness immediately after the first session of RT was used as an indicator of muscle swelling. Chronic change in muscle thickness after the 6-week RT was used as an indicator of muscle hypertrophy. A significant increase in muscle thickness was observed immediately after the first session of RT (8.3 ± 3.2%, p < 0.001). After the 6-week RT, muscle thickness increased significantly (2.9 ± 2.6%, p < 0.001). A significant positive correlation was found between muscle swelling and muscle hypertrophy (ρ = 0.443, p = 0.039). This study suggests that the greater the muscle swelling immediately after the first session of RT, the greater the muscle hypertrophy after RT.

Prevalence and physical characteristics of locomotive syndrome stages as classified by the new criteria 2020 in older Japanese people: results from the Nagahama study.

BACKGROUND: The Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007 for detecting high-risk individuals with mobility limitation. In 2020, the JOA revised the clinical decision limits and introduced LS stage 3, which carried the highest-risk for LS compared to the conventional stages, 1 and 2. The purpose of this study was to characterize the prevalence, comorbidities, and physical characteristics in each LS stage, as per the LS criteria 2020. METHODS: We analyzed 2077 participants (64.9% women; mean age, 68.3 ± 5.4 years) from the Nagahama Study aged ≥60 years. Participants were classified into 4 groups, non-LS and LS stages 1, 2, and 3, based on a 25-question Geriatric Locomotive Function Scale. The prevalence of comorbidities (sarcopenia, osteoporosis, diabetes mellitus, low back pain [LBP], and knee pain) were investigated. Physical characteristics were measured based on the physical performance tests including gait speed, five-times chair-stand, single-leg stand, and short physical performance battery; muscle strength tests including grip, knee extension, hip flexion, and abduction; and body-composition analysis including muscle quantity and quality. Differences in the prevalence of comorbidities between LS stages were tested using the chi-square test. The general linear model was performed for univariate and multivariate analyses with post-hoc test to compare the differences in physical characteristics among the LS stages. RESULTS: The prevalence of LS increased with age, and the mean prevalence of LS stages 1, 2, and 3 were 24.4, 5.5, and 6.5%, respectively. The prevalence of comorbidities, including sarcopenia, osteoporosis, LBP, and knee pain, increased with worsening LS stage. Physical performance tests were significantly different between LS stages 2 and 3; and muscle strength differed significantly between LS stages 1 and 2. Additionally, in terms of body composition analysis, muscle quality but not muscle quantity showed significant differences among all the LS stages. CONCLUSIONS: Our findings suggest that muscle strengthening and dynamic training, including balance training in LS stage 1 and 2, respectively, were needed for preventing the LS progression. Individuals with LS stage 3 should perform dynamic training and muscle strengthening exercises while receiving treatment for comorbidities.

Chronic Effects of a Static Stretching Program on Hamstring Strength.

ABSTRACT: Nakao, S, Ikezoe, T, Nakamura, M, Umegaki, H, Fujita, K, Umehara, J, Kobayashi, T, Ibuki, S, and Ichihashi, N. Chronic effects of a static stretching program on hamstring strength. J Strength Cond Res 35(7): 1924-1929, 2021-This study investigated the effects of a 4-week static stretching (SS) program on isokinetic and isometric knee flexor peak torque and angle of peak torque. Thirty healthy men (age, 22.7 ± 2.2 years) were randomized to receive either of the following: (a) a 4-week stretch intervention for the hamstrings (SS intervention group; n = 15) or (b) no intervention (control group; n = 15). The maximum pain-free knee angle, passive stiffness, which was determined by a slope of torque-angle curve, isometric and isokinetic (at 60°·s-1 and 180°·s-1) peak torque, and angle of peak torque for knee flexors were measured before and after 4 weeks. After 4 weeks, passive stiffness decreased significantly in the intervention group. There were no significant changes in isometric and isokinetic (neither at 60°·s-1 nor at 180°·s-1) peak torque, or angle of peak torque at 180°·s-1. A significantly increased peak extension angle at 60°·s-1 was observed in the intervention group. These results suggest that SS intervention is effective for decreasing musculotendinous unit stiffness of the hamstrings and that an SS program influences the angle of peak torque, whereas no significant changes occur in peak torque. Because a previous study suggests that angle of peak torque is associated with hamstring strain injuries, the results of this study would be helpful when considering the training program for preventing or treating hamstring strain injuries.

Acute effects of repetitive peripheral magnetic stimulation following low-intensity isometric exercise on muscle swelling for selective muscle in healthy young men.

Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive stimulator that can induce strong muscle contraction in selective regions. This study aimed to measure acute changes in skeletal muscle thickness induced by rPMS following a low-intensity exercise. Fifteen healthy young men performed an isometric knee extensor exercise at 30% of maximum strength consisting of three sets of 10 contractions on their dominant leg. rPMS was then applied on the vastus lateralis (VL) at the maximum intensity of the rPMS device. Muscle thicknesses of the rectus femoris (RF) and VL were measured using an ultrasound device and were compared among baseline, post-exercise, and post-rPMS. There were significant increases in muscle thickness of both the RF and VL post-exercise compared with baseline values (RF: baseline; 24.7 ± 2.4, post-exercise; 25.3 ± 2.4 mm, p = .034, VL: baseline; 27.0 ± 2.8, post-exercise; 27.4 ± 2.8 mm, p = .006). Compared with post-exercise, there was a significant increase post-rPMS in only the VL (VL: post-rPMS; 28.3 ± 2.9 mm, p = .002). These findings suggest that low-intensity isometric exercise can induce acute increases in muscle thickness (muscle swelling) in synergist muscles, and rPMS following exercise can induce further acute muscle swelling via repetitive muscle contraction.

Tenderness of the knee is associated with thinning of the articular cartilage evaluated with ultrasonography in a community-based cohort: The Nagahama study.

OBJECTIVES: This study aimed to elucidate the association between joint line tenderness (JLT) of the knee and knee joint structural changes evaluated with ultrasonography (US) for the early diagnosis of knee osteoarthritis (KOA). METHODS: This cross-sectional study included 121 participants (age 71.7 ± 5.8 years, 75 women) from a community-based population. Bilateral structural changes in the knee joint were evaluated with US, and the presence or absence of JLT was evaluated using a pressure algometer. Logistic regression analysis was performed to evaluate the odds ratios (ORs) of US findings for the presence of JLT. Moreover, when the analysis was limited to knees with pre-/early radiographic KOA, the ORs were also calculated using logistic regression analysis. RESULTS: Among the 242 knees, 38 had medial JLT, which was significantly associated with female sex (OR 11.87) and loss of cartilage thickness of the distal medial femoral condyle (CTh-MFC) (OR 0.12). Among 96 knees with Kellgren-Lawrence grade ≤ 2, 18 knees had medial JLT, which was also significantly associated with loss of CTh-MFC (OR 0.07) and medial osteophytes (OR 2.01). CONCLUSIONS: JLT is significantly associated with thinning of the femoral cartilage and larger osteophytes in elderly patients, even in those with pre-/early radiographic KOA.

Age-related changes in muscle thickness and echo intensity of trunk muscles in healthy women: comparison of 20-60s age groups.

PURPOSE: The objective of this study was to investigate the age-related changes in muscle thickness and muscle echo intensity of trunk in subjects including wide range of age groups. METHODS: The subjects were 112 healthy women (age range 20-60s). The rectus abdominis, external oblique, internal oblique, transversus abdominis, erector spinae, and lumbar multifidus muscles were examined. To confirm the differences among the age groups, the linear mixed effect models were performed. RESULTS: There were significant decreases in muscle thickness of the rectus abdominis and external oblique muscles in the 50s and 60s age groups compared to those in the 20s age group, and a significant decrease in muscle thickness of the erector spinae muscle in the 60s age group compared to those in the 20s age group. However, there was no significant difference among the age groups in muscle thickness of other trunk muscles. There were significant increases in echo intensity of the abdominal muscles in other age groups compared to those in the 20s age group, and significant increases in echo intensity of the back muscles in the age groups over 40 compared to those in the 20s group. CONCLUSION: Our study revealed that muscle quality may be more affected by age than muscle quantity and the effects of aging differ among muscles.

Relationship between ankle plantar flexor force steadiness and postural stability on stable and unstable platforms.

PURPOSE: This study was aimed at determining the relationship between ankle plantar flexor force steadiness and postural control during single leg standing on stable and unstable platforms. METHODS: For the thirty-three healthy participants, force steadiness, at target torques of 5%, 20%, and 50% of the maximum voluntary torque (MVT) of the ankle plantar flexors, was measured. Force steadiness was calculated as the coefficient of variation of force. Single leg standing on stable and unstable platforms was performed using the BIODEX Balance System SD. The standard deviation of the anteroposterior center of pressure (COP) displacements was measured as the index for postural control. During both measurements, muscle activities of the soleus were collected using surface electromyography. RESULTS: On the stable platform, the COP fluctuation significantly correlated with force steadiness at 5% of MVT (r = 0.512, p = 0.002). On the unstable platform, the COP fluctuation significantly correlated with force steadiness at 20% of MVT (r = 0.458, p = 0.007). However, the extent of muscle activity observed for a single leg standing on both stable and unstable platforms was significantly greater than the muscle activity observed while performing force steadiness tasks at 5% and 20% of MVT, respectively. CONCLUSION: Postural stability during single leg standing on stable and unstable platforms may be related to one's ability to maintain constant torque at 5% and 20% of MVT regardless of the muscle activity. These results suggest that the required abilities to control muscle force differ depending on the postural control tasks.

Effects of Low-Load, Higher-Repetition vs. High-Load, Lower-Repetition Resistance Training Not Performed to Failure on Muscle Strength, Mass, and Echo Intensity in Healthy Young Men: A Time-Course Study.

Ikezoe, T, Kobayashi, T, Nakamura, M, and Ichihashi, N. Effects of low-load, higher-repetition vs. high-load, lower-repetition resistance training not performed to failure on muscle strength, mass, and echo intensity in healthy young men: A time-course study. J Strength Cond Res 34(12): 3439-3445, 2020-The aim of this study was to compare the effects of low-load, higher-repetition training (LLHR) with those of high-load, lower-repetition training (HLLR) on muscle strength, mass, and echo intensity in healthy young men. Fifteen healthy men (age, 23.1 ± 2.6 years) were randomly assigned to 1 of the 2 groups: LLHR or HLLR group. Resistance training on knee extensor muscles was performed 3 days per week for 8 weeks. One repetition maximum (1RM) strength, maximum isometric strength, muscle thickness, and muscle echo intensity on ultrasonography of the rectus femoris muscle were assessed every 2 weeks. Analysis of variance showed no significant group × time interaction, and only a significant main effect of time was observed for all variables. The 8-week resistance training increased 1RM, maximum isometric muscle strength, and muscle thickness by 36.2-40.9%, 24.0-25.5%, and 11.3-20.4%, respectively, whereas it decreased echo intensity by 8.05-16.3%. Significant improvements in muscle strength, thickness, and echo intensity were observed at weeks 2, 4, and 8, respectively. The lack of difference in time-course changes between LLHR and HLLR programs suggests that low-load training can exert similar effects on muscle mass and characteristics as high-load training by increasing the number of repetitions, even when not performed to failure.

Improvement in muscle strength with low-load isotonic training depends on fascicle length but not joint angle.

INTRODUCTION: In this study we investigate whether low-load isotonic training will elicit greater improvement in muscle strength at the same fascicle length, rather than at the same joint angle. METHODS: Sixteen healthy men (24.1 ± 2.5 years of age) were randomly divided into intervention and control groups. Pre- and posttraining maximum isometric and isokinetic strengths and fascicle lengths of the medial gastrocnemius muscle were measured. Isotonic resistance training at 15 ° to 30 ° ankle plantarflexion at low intensity was conducted for 4 weeks. RESULTS: The maximum isometric and isokinetic strength of the intervention group increased significantly only at 15 ° dorsiflexion and 8 ° to 12 ° dorsiflexion. Fascicle length during maximum voluntary contraction at 15 ° dorsiflexion to 0 ° was similar to fascicle length under training conditions. DISCUSSION: It is possible that the improvement in muscle strength with low-load training depends on fascicle length rather than joint angle. Muscle Nerve 57: 83-89, 2018.

Increase in echo intensity and extracellular-to-intracellular water ratio is independently associated with muscle weakness in elderly women.

PURPOSE: The changes in muscle composition and its heterogeneity during aging are associated with muscle weakness in elderly persons independent of decreases in muscle mass or muscle thickness (MT). Both the assessment of echo intensity (EI) with ultrasound imaging and the evaluation of the extracellular water/intracellular water (ECW/ICW) ratio with segmental bioelectrical impedance spectroscopy (BIS) are non-invasive and convenient methods and seem valuable for muscle quality determination. However, no previous study has evaluated both EI and the ECW/ICW ratio simultaneously to investigate their relationship to muscle strength. The purpose of the present study was to investigate whether both EI and the ECW/ICW ratio are independently associated with muscle strength in elderly women. METHODS: A total of 179 elderly women with a mean age of 74.1 ± 4.9 years, living independently in the community, were enrolled. The MT and EI of the quadriceps femoris were measured using transverse ultrasound imaging. The ECW/ICW ratio in the upper thigh was calculated from segmental BIS. The maximum knee extensor strength and the presence of knee pain were also assessed. RESULTS: Knee extensor strength showed a significant positive correlation with MT, and significant negative correlations with EI, the ECW/ICW ratio, and age. Stepwise regression analysis revealed that knee extensor strength in elderly women was predicted by MT, EI, and the ECW/ICW ratio. CONCLUSIONS: This study suggests that the simultaneous application of EI and the ECW/ICW ratio is useful in assessing muscle strength, and accurately estimates the changes in muscle quality related to muscle weakness.

Are there different factors affecting walking speed and gait cycle variability between men and women in community-dwelling older adults?

BACKGROUND: Few studies have examined the relationships between walking speed and gait cycle variability, and muscle strength and postural stability, with a focus on gender differences. AIM: The aim of this study was to examine whether there are different factors affecting walking speed and gait cycle variability between men and women in community-dwelling older adults. METHODS: The subjects comprised 712 community-dwelling older adults (252 men, 460 women, aged 68.7 ± 4.8 years). Walking speed and coefficient of variation (CV) of step time at a comfortable walking pace were measured. The maximal isometric strength of six lower limb muscles and postural stability were evaluated. Stepwise regression analysis was performed, using lower limb muscle strength and postural stability as independent variables, to investigate the association with walking speed or CV. RESULTS: For older men, age, body mass index (BMI) and quadriceps setting (QS) strength were significant and independent determinants of walking speed. No variables were identified as significant determinants of CV. For older women, BMI and hip flexion, hip abduction, QS muscle strength were significant determinants of walking speed. Only hip abduction strength was a significant determinant of CV. DISCUSSION: The results of this study suggest that QS strength is related to walking speed in both men and women, whereas hip flexion and abduction muscle strength are related to walking speed, and hip abduction muscle strength is related to gait cycle variability in older women. CONCLUSION: Gender differences exist in factors affecting walking speed and gait cycle variability in community-dwelling older adults.

Changes in Passive Properties of the Gastrocnemius Muscle-Tendon Unit During a 4-Week Routine Static-Stretching Program.

CONTEXT: Static stretching (SS) is commonly performed in a warm-up routine to increase joint range of motion (ROM) and to decrease muscle stiffness. However, the time course of changes in ankle-dorsiflexion (DF) ROM and muscle stiffness during a routine SS program is unclear. OBJECTIVE: To investigate changes in ankle-DF ROM, passive torque at DF ROM, and muscle stiffness during a routine SS program performed 3 times weekly for 4 wk. DESIGN: A quasi-randomized controlled-trial design. PARTICIPANTS: The subjects comprised 24 male volunteers (age 23.8 ± 2.3 y, height 172.0 ± 4.3 cm, body mass 63.1 ± 4.5 kg) randomly assigned to either a group performing a 4-wk stretching program (SS group) or a control group. MAIN OUTCOME MEASURES: DF ROM, passive torque, and muscle stiffness were measured during passive ankle dorsiflexion in both groups using a dynamometer and ultrasonography once weekly during the 4-wk intervention period. RESULTS: In the SS group, DF ROM and passive torque at DF ROM significantly increased after 2, 3, and 4 wk compared with the initial measurements. Muscle stiffness also decreased significantly after 3 and 4 wk in the SS group. However, there were no significant changes in the control group. CONCLUSIONS: Based on these results, the SS program effectively increased DF ROM and decreased muscle stiffness. Furthermore, an SS program of more than 2 wk duration effectively increased DF ROM and changed the stretch tolerance, and an SS program more than 3 wk in duration effectively decreased muscle stiffness.

Association of walking speed with sagittal spinal alignment, muscle thickness, and echo intensity of lumbar back muscles in middle-aged and elderly women.

BACKGROUND: Age-related change of spinal alignment in the standing position is known to be associated with decreases in walking speed, and alteration in muscle quantity (i.e., muscle mass) and muscle quality (i.e., increases in the amount of intramuscular non-contractile tissue) of lumbar back muscles. Additionally, the lumbar lordosis angle in the standing position is associated with walking speed, independent of lower-extremity muscle strength, in elderly individuals. However, it is unclear whether spinal alignment in the standing position is associated with walking speed in the elderly, independent of trunk muscle quantity and quality. The present study investigated the association of usual and maximum walking speed with age, sagittal spinal alignment in the standing position, muscle quantity measured as thickness, and quality measured as echo intensity of lumbar muscles in 35 middle-aged and elderly women. METHODS: Sagittal spinal alignment in the standing position (thoracic kyphosis, lumbar lordosis, and sacral anterior inclination angle) using a spinal mouse, and muscle thickness and echo intensity of the lumbar muscles (erector spinae, psoas major, and lumbar multifidus) using an ultrasound imaging device were also measured. RESULTS: Stepwise regression analysis showed that only age was a significant determinant of usual walking speed. The thickness of the lumbar erector spinae muscle was a significant, independent determinant of maximal walking speed. CONCLUSIONS: The results of this study suggest that a decrease in maximal walking speed is associated with the decrease in lumbar erector spinae muscles thickness rather than spinal alignment in the standing position in middle-aged and elderly women.

The effects of a 4-week static stretching programme on the individual muscles comprising the hamstrings.

The aims of this study were to investigate the effects of a 4-week intervention of static stretching (SS) on muscle hardness of the semitendinosus (ST), semimembranosus (SM) and biceps femoris (BF) muscles. Shear elastic modulus was measured by using ultrasound shear wave elastography as the index of muscle hardness. Thirty healthy men (age 22.7 ± 2.2 years) volunteered for this study and were randomly assigned to the SS intervention group (n = 15) or the control group (n = 15). Participants in the SS intervention group received a 4-week stretch intervention for the hamstrings of their dominant leg. Shear elastic moduli of the hamstrings were measured at initial evaluation and after 4 weeks in both groups at a determined angle. In all muscles, the shear elastic modulus decreased significantly after SS intervention. The percentage change in the shear elastic modulus from the value at initial evaluation to after 4 weeks intervention was greatest in the SM. These results suggest that SS intervention has chronic effects on reducing hardness of the hamstring muscle components, especially the SM muscle.

Influences of Fascicle Length During Isometric Training on Improvement of Muscle Strength.

Tanaka, H, Ikezoe, T, Umehara, J, Nakamura, M, Umegaki, H, Kobayashi, T, Nishishita, S, Fujita, K, Araki, K, and Ichihashi, N. Influences of fascicle length during isometric training on improvement of muscle strength. J Strength Cond Res 30(11): 3249-3255, 2016-This study investigated whether low-intensity isometric training would elicit a greater improvement in maximum voluntary contraction (MVC) at the same fascicle length, rather than the joint angle, adopted during training. Sixteen healthy women (21.8 ± 1.5 years) were randomly divided into an intervention group and a control group. Before (Pre) and after (Post) training, isometric plantarflexion MVCs were measured every 10° through the range of ankle joint position from 20° dorsiflexion to 30° plantarflexion (i.e., 6 ankle angles). Medial gastrocnemius fascicle length was also measured at each position, using B-mode ultrasound under 3 conditions of muscle activation: at rest, 30%MVC at respective angles, and MVC. Plantarflexion resistance training at an angle of 20° plantarflexion was performed 3 days a week for 4 weeks at 30%MVC using 3 sets of twenty 3-second isometric contractions. Maximum voluntary contraction in the intervention group increased at 0 and 10° plantarflexion (0°; Pre: 81.2 ± 26.5 N·m, Post: 105.0 ± 21.6 N·m, 10°; Pre: 63.0 ± 23.6 N·m, Post: 81.3 ± 20.3 N·m), which was not the angle used in training (20°). However, the fascicle length adopted in training at 20° plantarflexion and 30%MVC was similar to the value at 0 or 10° plantarflexion at MVC. Low-intensity isometric training at a shortened muscle length may be effective for improving MVC at a lengthened muscle length because of specificity of the fascicle length than the joint angle.