Associations of serum IL-6 with muscle, bone, and adipose tissue in women.

This cross-sectional study examined the associations between serum interleukin-6 (IL-6) and muscle, bone, and fat parameters in recreationally active women. One-hundred forty-five women (48.7 ± 17.8 years; 164.4 ± 7.1 cm; 66.8 ± 10.7 kg; and 24.7 ± 3.9 kg/m2) underwent dual energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) assessments to determine total and regional muscle, bone, and fat parameters. Muscle performance of the knee extensors was examined via isometric, isotonic, and isokinetic dynamometry assessments, and serum IL-6 was measured via enzyme linked immunosorbent assay. Serum IL-6 was inversely associated with thigh muscle cross-sectional area (mCSA, r = -0.28, p < 0.01); isometric strength (r = -0.19, p < 0.05); hip areal bone mineral density [aBMD] (r = -0.18, p < 0.05); trochanter aBMD (r = -0.23, p < 0.01); total body aBMD (r = -0.20, p < 0.05); cortical volumetric bone density at 38 and 66% tibia (r = -0.18 and r = -0.19, respectively, both p < 0.05), and 66% cortical thickness (r = -0.17, p < 0.05). These associations were present after adjusting for age, BMI, and physical activity. Thigh mCSA was significantly lower in the tertile possessing the greatest IL-6 compared to the lowest tertile (p < 0.01); after adjusting for age, body mass index, and physical activity. Collectively, these observations indicate that IL-6 is inversely associated with skeletal muscle and bone parameters independent of relevant confounders. These observations bolster the prognostic value of serum IL-6.

Sclerostin and Dickkopf-1 Characteristics According to Age and Physical Activity Levels in Premenopausal Women.

We aimed to compare serum concentrations of sclerostin and DKK-1 in young (20-30 yrs, n = 25) and middle-aged (35-45 yrs, n = 25) premenopausal women and based on physical activity (PA) status. PA status was assessed by the International Physical Activity Questionnaire (low-moderate (≤ 2999 MET-min/week) and high (≥ 3000 MET-min/week). Serum sclerostin and DKK-1 levels were measured in fasting morning blood samples by ELISA. Areal bone mineral density (aBMD) was measured by DXA, and non-dominant tibia bone characteristics were assessed by pQCT. After adjusting for total body aBMD, middle-aged women had significantly (p < 0.001) higher (0.54 ± 0.01 ng/mL) serum sclerostin than young women (0.41 ± 0.01 ng/mL), and sclerostin was positively correlated with age (rs = 0.065, p ≤ 0.001) and total PA score (rs = 0.33, p = 0.021). Young women had higher left trochanter aBMD (p = 0.036) than middle-aged women and aBMD variables were higher (all p ≤ 0.043) in the high active group. Middle-aged women had higher 38% cortical vBMD than young women (p = 0.021), otherwise young women had higher values for pQCT variables (all p ≤ 0.036). Sclerostin showed significant correlations (r = 0.32 to 0.58, all p ≤ 0.026) with spine aBMD for the entire cohort and for each age group. Middle-aged women had significant correlations between sclerostin and hip aBMD sites (r = 0.043 to 0.56, all p ≤ 0.031). Sclerostin and cortical vBMD were positively correlated in the entire cohort (r = 0.35 to 0.50; both p < 0.013); split by age group, middle-aged women had positive correlations (r = 0.45 to 0.61 age and, all p ≤ 0.021) between sclerostin and pQCT variables. No significant differences for physical activity were observed for serum DKK-1 concentrations. Serum sclerostin concentrations were positively associated with age and bone characteristics in premenopausal women; however, these findings were not evident for circulating DKK-1. Further research is needed to elucidate the mechanisms for the discordant results in these Wnt inhibitors.

Site-Specific Bone Differences and Energy Status in Male Competitive Runners and Road Cyclists.

The interaction between mechanical loading and energy availability on bone health in male endurance athletes merits further investigation. The purpose of this study was to compare bone status in male competitive runners and road cyclists and to investigate the influence of energy availability (EA) on bone mineral density (BMD). 18 competitive runners and 19 road cyclists (20-50 years) participated in this study. Areal BMD and body composition were assessed by dual energy x-ray absorptiometry. Volumetric bone variables at the 4% and 66% tibia sites were assessed by peripheral quantitative computed tomography. Energy availability (EA, 7-day dietary and exercise logs) and resting metabolic rate (RMR, open circuit spirometry) were measured as indicators of energy status. Bone loading history, calcium intake, and training history were assessed by questionnaires. After adjusting for age, runners had significantly greater (p < 0.05) areal BMD (femoral neck, left total hip), Z-scores (total body, hips sites), total bone mineral content and trabecular variables (bone mineral content, volumetric BMD, bone strength index) at tibia 4% site, and total volumetric BMD at tibia 66% site than the cyclists (p ≤ 0.05). At the tibia 66% site, cyclists had significantly greater (p < 0.05) total area, periosteal circumference, endosteal circumference, and strength-strain index than runners. Energy variables were similar for runners and cyclists; however, RMR and RMR ratio (measured RMR/predicted RMR) were significantly lower in cyclists (p < 0.001). In conclusion, there were site-specific differences in hip and tibia bone characteristics between runners and cyclists. RMR was associated with several bone outcomes; however, EA was not related to bone health in runners or to dual energy x-ray absorptiometry bone variables in cyclists.

Sex-Specific Associations Between Bone-Loading Score and Adiposity Markers in Middle-Aged and Older Adults.

The authors examined sex-specific relationships between fat mass index (FMI), android/gynoid (A/G) fat ratio, relative skeletal muscle mass index, and Bone-Specific Physical Activity Questionnaire derived bone-loading scores (BLSs) in middle-aged and older adults (men, n = 27; women, n = 33; age = 55-75 years). The FMI, A/G fat ratio, and relative skeletal muscle mass index were estimated by dual-energy X-ray absorptiometry. The Bone-Specific Physical Activity Questionnaire was used to assess: (a) BLSpast (age 1 until 12 months before the study visit), (b) BLScurrent (last 12 months), and (c) BLStotal (average of [a] and [b]) scores. Separate multiple linear regression analysis of (a) age, FMI, and relative skeletal muscle mass index and (b) age, height, and A/G fat ratio versus BLS revealed that FMI and A/G fat ratio were negatively associated with BLSpast and BLStotal (p < .05) in women only. Adiposity and, specifically, central adiposity is negatively related to bone-loading physical activity in middle-aged and older women.

Skeletal Health and Associated Injury Risk in Collegiate Female Rowers.

ABSTRACT: Baker, BS, Buchanan, SR, and Bemben, DA. Skeletal health and associated injury risk in collegiate female rowers. J Strength Cond Res 36(4): 1125-1133, 2022-Rowing has been associated with low bone mass and stress fractures. The aim of this study was to compare bone density, geometry, and skeletal asymmetries between competitive female rowers and matched controls and within rowers based on reported injury status, allowing for the calculation of practical injury risk prediction equations. Rowers (n = 24) and controls (n = 24) completed total body, lumbar spine, and and dual femur and radii dual energy x-ray absorptiometry and peripheral quantitative computed tomography scans. One-way analyses of covariance were performed between rowers and controls, and one-way analyses of variance were performed between rowers based on reported rib injury status (injured [n = 11]; injury-free [n = 13]). Logistic regression was used to create prediction models of rowers' injury status. Significance was set at p ≤ 0.05. Rowers were taller, had greater lean mass, less fat mass, and mostly equivalent skeletal measures compared to controls, which were within normal ranges (p < 0.048). Injury-free rowers consumed over 500 mg·d-1 more calcium and were less symmetrical at the 4% tibiae and hips (p < 0.015). The strongest predictive regression model of reported rib injury in rowers comprised calcium intake and the symmetry index of hip strength index (R2 = 0.833; p < 0.001). A more practical model including daily calcium intake and total bone specific physical activity (PA) scores can be used to correctly predict injury status 75% of the time (R2 = 0.750; p = 0.022). This is the first study to provide practitioners an injury prediction model for competitive rowers, reiterating the importance of proper nutrition and auxiliary PA focusing on balanced movement patterns.

Sex differences in bone density, geometry, and bone strength of competitive soccer players.

OBJECTIVES: To examine sex differences in bone characteristics in competitive soccer players. METHODS: 43 soccer players (male, n=23; female, n=20), and 43 matched controls (males, n=23; females, n=20), completed the study. Areal BMD (aBMD) of the total body, lumbar spine, and dual femur and tibiae volumetric BMD (vBMD), bone geometry, and bone strength variables (pQCT) were measured. Bone-specific physical activity and training history were assessed. RESULTS: Male soccer players had significantly greater (p≤0.05) total body and hip aBMD, hip strength indices and 4% and 38% tibia variables than females. Regression analyses determined that BFLBM, not sex, was the strongest predictor of bone variables. Female soccer players exhibited significantly greater percent differences from controls for tibiae variables than males (p≤0.05). Soccer players had greater aBMD and hip strength indices than controls (p≤0.040). Soccer-specific asymmetries were found for 38% total area (2.1%) and pSSI (3.8%), favoring the non-dominant leg (both p≤0.017). CONCLUSION: Bone characteristics adjusted for body size were greater in male versus female soccer players. However, body composition variables were more important predictors of bone characteristics than sex. There were no sex differences in the magnitude of limb asymmetries, suggesting skeletal responsiveness to mechanical loading was similar in males and females.

Effects of Blood-Flow Restriction Combined With Postactivation Potentiation Stimuli on Jump Performance in Recreationally Active Men.

Miller, RM, Keeter, VM, Freitas, EDS, Heishman, AD, Knehans, AW, Bemben, DA, and Bemben, MG. Effects of blood-flow restriction combined with postactivation potentiation stimuli on jump performance in recreationally active men. J Strength Cond Res 32(7): 1869-1874, 2018-Whole-body vibration (WBV) and maximum voluntary contractions (MVCs) combined with blood-flow restriction (BFR) to augment postactivation potentiation have yet to be examined. Therefore, the purpose of this investigation was to examine the augmented effects of postactivation potentiation when WBV and MVC are combined with BFR. Twenty men (21.8 ± 2.6 years, 180.5 ± 6.2 cm and 84.5 ± 12.1 kg) completed the study. Participants completed 3 testing sessions in a randomized design that included one of the following: (a) control (CON), (b) WBV and WBV combined with BFR (WBV + BFR), or (c) MVC and MVC combined with BFR (MVC + BFR). Jump height and power were recorded for 3 trials, PRE and POST jump height (cm) mean ± SD for each were as follows: CON 58.9 ± 8.6 and 57.9 ± 8.6, WBV 58.2 ± 8.1 and 59.9 ± 8.1, WBV + BFR 58.7 ± 7.6 and 60.2 ± 8.1, MVC 59.7 ± 7.4 and 60.2 ± 8.6, and MVC + BFR 57.7 ± 7.9 and 59.4 ± 8.1. PRE and POST jump power (W) mean ± SD for each were as follows: CON 1,224.3 ± 221.5 and 1,234.3 ± 189.2, WBV 1,251.1 ± 230.4 and 1,266.1 ± 215.7, WBV + BFR 1,265.8 ± 207.9 and 1,259 ± 223.3, MVC 1,264.7 ± 211.9 and 1,263.5 ± 236.5, and MVC + BFR 1,252.3 ± 222.0 and 1,294.6 ± 256.6. Significant differences were revealed in jump height between the 5 interventions (p < 0.01), WBV (p < 0.01), WBV + BFR (p < 0.01), and MVC + BFR (p < 0.01) revealed significant differences in time but no differences in jump power. In conclusion, the results of this study indicate that WBV, WBV + BFR, and MVC + BFR significantly improve jump height and time in air but not jump power.

Low-load resistance training with low relative pressure produces muscular changes similar to high-load resistance training.

INTRODUCTION: This study compares the acute and chronic response of high-load resistance training (HL) to low-load resistance training with low blood flow restriction (LL-BFR) pressure. METHODS: Participants completed elbow flexion with either HL or LL-BFR or nonexercise. In the chronic study, participants in the HL and LL-BFR groups were trained for 8 weeks to determine differences in muscle size and strength. The acute study examined the changes in pretesting/posttesting (Pre/Post) torque, muscle swelling, and blood lactate. RESULTS: In the chronic study, similar changes in muscle size and strength were observed for both HL and LL-BFR. In the acute study, Pre/Post changes in the torque, muscle swelling, and blood lactate were similar between HL and LL-BFR. DISCUSSION: Our findings indicate that pressure as low as 50% arterial occlusion can produce similar changes in muscle mass and strength compared with traditional HL. Muscle Nerve 56: E126-E133, 2017.

Time Course Change in Muscle Swelling: High-Intensity vs. Blood Flow Restriction Exercise.

This study determined the time course for changes in muscle swelling and plasma volume following high (HI) and low-intensity resistance exercise with blood-flow restriction (LI-BFR). Ten male participants (22.1±3.0 yrs) completed three experimental conditions: high-intensity exercise (HI - 80% of 1RM), low-intensity exercise with BFR (LI-BFR -20% of 1RM, and 160 mmHg of BFR), and control (CON - no exercise or BFR). Muscle cross-sectional area (mCSA), muscle thickness, thigh circumference, and percentage change in plasma volume (PV%∆) were measured. mCSA was significantly greater than rest values at 15 min post-exercise (p<0.01) for HI and LI-BFR, and at 75 min post-exercise (p<0.01) for HI. Muscle thickness was significantly greater than rest immediately post-exercise (p<0.01) and 30 min post-exercise (p<0.01) for HI and LI-BFR, and at 60 min post-exercise for HI (p=0.01). Muscle thickness was greater for BFR immediately post-exercise compared to HI (p=0.01) post-exercise. Thigh circumference was significantly greater from rest at 15 min post-exercise (p=0.01) and at 75 min post-exercise for both LI-BFR (p=0.03) and HI (p<0.01). PV%∆ significantly decreased from rest immediately post-exercise for both HI (p<0.01) and LI-BFR (p<0.01). In conclusion, BFR exercise induces changes in muscle swelling and plasma volume similar to those observed at high-intensities.

Effects of age on arterial stiffness and central blood pressure after an acute bout of resistance exercise.

PURPOSE: To investigate the influence of age on arterial stiffness and blood pressure after performing a resistance exercise bout. METHODS: Recreationally active men were separated into young (YG, n = 12, 26.5 ± 3.3 years), middle (MG, n = 14, 49.4 ± 5.7 years), and old (OG, n = 10, 67.4 ± 6.3 years)-aged groups. In a randomized cross-over design, participants performed control and exercise conditions with at least 3 days separating conditions. The exercise condition consisted of leg press, chest press, knee flexion, lat pulldown and knee extension at ~65% one-repetition maximum for three sets of 10 repetitions. Brachial and central blood pressures, augmented pressure, augmentation index, central and peripheral pulse wave velocities were measured prior to each condition and starting at 5 min post-exercise. RESULTS: Brachial systolic blood pressure (SBP) significantly increased similarly after exercise for all age groups (YG, 8 ± 8 mmHg; MG, 5 ± 5 mmHg; OG, 5 ± 6 mmHg; p < 0.05). However, central SBP did not significantly increase for any age group after exercise. Augmentation index significantly increased after exercise only in the YG (11 ± 8%, p < 0.05). Central pulse wave velocity did not significantly increase in any age group after exercise when compared to the control condition. CONCLUSIONS: When performing a whole body moderate resistance exercise bout, acute changes in arterial stiffness and blood pressure appear to be minimally affected by age.

Comparative Effects of Vigorous-Intensity and Low-Intensity Blood Flow Restricted Cycle Training and Detraining on Muscle Mass, Strength, and Aerobic Capacity.

Traditional high-intensity aerobic training has been shown to improve muscle protein synthesis and aerobic capacity; however, recent research indicates that low-intensity aerobic training with blood flow restriction (BFR) may have similar effects. The purpose of this study was to compare the effects of vigorous-intensity (VI) cycling vs. low-intensity cycling with BFR (LI-BFR) on muscle mass, strength, and aerobic capacity after training and subsequent detraining. Thirty-one physically active subjects were assigned to one of 3 groups: VI (n = 10, 60-70% heart rate reserve [HRR]), LI-BFR (n = 11, 30% HRR with BFR at 160-180 mm Hg), and no exercise control (n = 10, no exercise). Subjects in VI and LI-BFR cycled 3 times per week for 6 weeks (total 18 sessions). Body composition, muscle mass, strength, and aerobic capacity were measured pre, post, and after 3 weeks of detraining. A group × time interaction (p = 0.019) effect for both knee flexion and leg lean mass was found. For both VI and LI-BFR groups, knee flexion strength was significantly increased between pre and post (p = 0.024, p = 0.01) and between pre and 3 week-post (p = 0.039, p = 0.003), respectively. For the LI-BFR group, leg lean mass was significantly increased between pre and 3 week-post (p = 0.024) and between post and 3 week-post (p = 0.013). However, there were no significant differences between groups for any variables. The LI-BFR elicits an increase in the knee flexion muscle strength over time similar to the VI. An increase in the leg lean mass over time was seen in the LI-BFR, but not in VI and CON.

Effects of exercise with and without different degrees of blood flow restriction on torque and muscle activation.

INTRODUCTION: An unresolved question in resistance training combined with blood flow restriction (BFR) is what percentage of estimated arterial occlusion pressure provides the most robust acute muscular response. METHODS: Forty participants were assigned to Experiments 1, 2, or 3. Each experiment completed exercise protocols differing by pressure, exercise load, and/or volume. Torque was measured pre- and postexercise, and muscle activation was measured pre- and during each set. RESULTS: Pressure and load did not affect torque greatly. Muscle activation increased in all conditions (P < 0.05) and was higher with 30% 1RM compared with 20% 1RM. Pressure appeared to increase muscle activation from 40% to 50% arterial occlusion [66% vs. 87% maximal voluntary contraction (30% 1RM)] but was not further increased with higher pressure. CONCLUSION: Different levels of BFR may alter the acute muscular response to a degree, although higher pressures do not appear to augment these changes.

The effects of resistance exercise with and without different degrees of blood-flow restriction on perceptual responses.

The aim was to compare exercise with and without different degrees of blood-flow restriction on perceived exertion (RPE) and discomfort. Participants were assigned to Experiment 1, 2, or 3. Each completed protocols differing by pressure, load, and/or volume. RPE and discomfort were taken before and after each set. For pressure and RPE, the 20% one repetition maximum (1RM) blood-flow restriction conditions were affected by increasing the pressure from 40% to 50% blood-flow restriction (~12 vs. ~14). This did not appear to happen within the 30% 1RM blood-flow restriction conditions or the higher pressures in the 20% 1RM conditions. The similar RPE between 20% and 30% 1RM to failure was expected given both were to failure. For discomfort, ratings were primarily affected by load at the lowest pressure. Increasing pressure to 50% blood-flow restriction increased discomfort at 20% 1RM (~2.6 vs. ~4). There was a further increase when increasing to 60% blood-flow restriction (~4 vs. ~4.8). The high-load condition had the lowest discomfort, while ratings were highest with 20% 1RM to failure. In conclusion, exercise with blood-flow restriction does not appear to augment the perceptual response observed with low-load exercise to failure.

Effects of an 8-Month Ashtanga-Based Yoga Intervention on Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Study.

Although Yoga has the potential to be an alternative physical activity to enhance bone health, there is a lack of high quality evidence for this type of intervention. The purpose of this randomized controlled trial was to examine the effects of a progressive 8-month Ashtanga-based Yoga program on bone turnover markers (BTM), areal bone mineral density (aBMD) and volumetric bone characteristics in premenopausal women. Thirty-four premenopausal women (35-50 years) were randomly assigned either to a Yoga group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga-based Yoga series 2 times/week with one day between sessions for 8 months, and the session intensity was progressively increased by adding the number of sun salutations (SS). Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone specific physical activity questionnaire (BPAQ) at 2 month intervals for 8 months. Body composition was measured by dual energy x-ray absorptiometry (DXA). Bone formation (bone alkaline phosphatase, Bone ALP) and bone resorption (Tartrate-Resistant Acid Phosphatase-5b, TRAP5b) markers were assessed at baseline and after 8 months. aBMD of total body, lumbar spine and dual proximal femur and tibia bone characteristics were measured using DXA and peripheral Quantitative Computed Tomography (pQCT), respectively. We found that the serum Bone ALP concentrations were maintained in YE, but significantly (p = 0.005) decreased in CON after the 8 month intervention, and there were significant (p = 0.002) group differences in Bone ALP percent changes (YE 9.1 ± 4.0% vs. CON -7.1 ± 2.3%). No changes in TRAP5b were found in either group. The 8-month Yoga program did not increase aBMD or tibia bone strength variables. Body composition results showed no changes in weight, fat mass, or % fat, but small significant increases in bone free lean body mass occurred in both groups. The findings of this study suggest that regular long-term Ashtanga Yoga had a small positive effect on bone formation but did not alter aBMD or tibia bone characteristics in premenopausal women. Key pointsRegular long-term Ashtanga-based Yoga program had a small positive effect on bone formation, but no effects were found on bone resorption.None of the bone density or geometry variables were changed by the 8-month Ashtanga-based Yoga intervention.Future Yoga interventions should focus on longer duration and greater frequency to elicit improvements in bone mineral density.

Vascular adaptations to low-load resistance training with and without blood flow restriction.

PURPOSE: To examine the effects of low-load knee extensor training to fatigue with and without blood flow restriction (BFR) on calf vascular conductance, calf venous compliance, and peripheral arterial stiffness in middle-aged individuals. METHODS: Eleven men (55 ± 8 years) and five post-menopausal women (57 ± 5 years) completed 6 weeks of unilateral knee extensor training with one limb exercising with BFR (BFR limb) and the contralateral limb exercising without BFR (free flow, FF limb). Before and after the training, femoral pulse wave velocity (PWV), calf blood flow (normalized as conductance), and calf venous compliance were measured in each limb. RESULTS: PWV increased following training in both limbs (main effect of time, p = 0.036; BFR limb 8.9 ± 0.8 vs. 9.5 ± 0.9 m/s, FF limb 9.0 ± 1.2 vs. 9.0 ± 1.1; Pre vs. Post). Calf blood flow increased (p = 0.026) in the FF limb (25.0 ± 7.0 vs. 31.8 ± 12.0 flow/mmHg; Pre vs. Post) but did not change (p = 0.831) in the BFR limb (29.1 ± 11.3 vs. 28.7 ± 11.5 flow/mmHg; Pre vs. Post). Calf venous compliance did not change in either limb following training. CONCLUSIONS: These results suggest low-load BFR resistance training to fatigue elicits small increases in peripheral arterial stiffness without eliciting concomitant changes in venous compliance. In addition, unlike low-load knee extensor training without BFR, training with BFR did not enhance calf blood flow.

Hormone responses to an acute bout of low intensity blood flow restricted resistance exercise in college-aged females.

The purpose of this study was to determine whether the acute hormone response to exercise differed between low intensity blood flow restricted resistance exercise and traditional high-intensity resistance exercise in college-aged women. A total of 13 healthy women (aged 18-25 yrs), who were taking oral contraceptives, volunteered for this randomized crossover study. Subjects performed a session of low intensity blood flow restricted resistance exercise (BFR) (20% of 1-RM, 1 set 30 reps, 2 sets 15 reps) and a session of traditional high intensity resistance exercise without blood flow restriction (HI) (3 sets of 10 repetitions at 80% of 1-RM) on separate days. Fasting serum cortisol and growth hormone (GH) and blood lactate responses were measured in the morning pre and post exercise sessions. GH (Change: HI: 6.34 ± 1.72; BFR: 4.22 ± 1.40 ng·mL(-1)) and cortisol (Change: HI: 4.46 ± 1.53; BFR: 8.10 ± 2.30 ug·dL(-1)) significantly (p < 0.05) increased immediately post exercise for both protocols compared to baseline and there were no significant differences between the protocols for these responses. In contrast, blood lactate levels (HI: 7.35 ± 0.45; BFR: 4.02 ± 0.33 mmol·L(-1)) and ratings of perceived exertion were significantly (p < 0.01) higher for the HI protocol. In conclusion, acute BFR restricted resistance exercise stimulated similar increases in anabolic and catabolic hormone responses in young women. Key PointsGrowth hormone and cortisol levels significantly increased after a single bout of low intensity blood flow restricted resistance exercise in young women.There were no significant differences in hormone responses between the low intensity blood flow restricted protocol and the traditional high intensity higher total workload protocol.Low intensity blood flow restricted resistance exercise provides a sufficient stimulus to elicit anabolic and catabolic hormone responses in young women.

Ankle dorsiflexion asymmetry and the relationship with walking performance in people with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a neurological disease characterized by demyelination disrupting the central nervous system. Persons with MS may exhibit symptomatic strength asymmetry (SA) that impacts motor gait and ankle mobility. The purpose of the present study was to investigate ankle dorsiflexion SA in people with MS and its relationship to functional performance. RESEARCH QUESTION: Is their a difference in dorsiflexion SA in MS participants compared to healthy individuals and does it impact functional performance? METHODS: 13 MS participants (EDSS 3.5 + 1.8) and 13 age matched NON-MS participants underwent maximal isometric (MVC) dynamometry testing for ankle dorsiflexion in both limbs to determine SA. Participants performed three functional tasks of walking performance. RESULTS: There was a significant intra-limb MVC difference in the MS group, and significantly greater isometric SA (p < 0.007) and isokinetic SA (p < 0.04) in the MS group compared to healthy individuals. The MS group exhibited significant correlations between outcomes of functional walking performance with isokinetic but not isometric SA. There was no significant correlation between disability status and functional task performance. SIGNIFICANCE: Ankle dorsiflexion SA is negatively correlated with functional performance in MS participants. MS disability status was not a predictor of functional task performance, and symptom testing may be appropriate to assess walking ability in persons with MS.

Age and sex differences in estimated tibia strength: influence of measurement site.

Variability in peripheral quantitative computed tomography (pQCT) measurement sites and outcome variables limit direct comparisons of results between studies. Furthermore, it is unclear what estimates of bone strength are most indicative of changes due to aging, disease, or interventions. The purpose of this study was to examine age and sex differences in estimates of tibia strength. An additional purpose of this study was to determine which tibia site or sites are most sensitive for detecting age and sex differences in tibia strength. Self-identifying Caucasian men (n=55) and women (n=59) aged 20-59yr had their tibias measured with pQCT from 5% to 85% of limb length in 10% increments distal to proximal. Bone strength index, strength strain index (SSI), moments of inertia (Ip, Imax, and Imin), and strength-to-mass ratios (polar moment of inertia to total bone mineral content [BMC] ratio [Ip:Tot.BMC] and strength strain index to total BMC ratio [SSI:Tot.BMC]) were quantified. There were significant (p<0.01) site effects for all strength variables and strength-to-mass ratios. Site×sex interaction effects were significant (p<0.05) for all strength variables. Men had greater (p<0.01) values than women for all strength variables. Sex differences in Ip, Imax, Ip:Tot.BMC, SSI, and SSI:Tot.BMC ratios were the smallest at the 15% site and peaked at various sites, depending on variable. Site×age interactions existed for Imax, Ip:Tot.BMC, and SSI:Tot.BMC. There were significant age effects, Imax, Ip:Tot.BMC, and SSI:Tot.BMC, as values were the lowest in the 20-29 age group. Age and sex differences varied by measurement site and variable, and larger sex differences existed for moments of inertia than SSI. Strength-to-mass ratios may reflect efficiency of the whole bone architecture.

Acute bone marker responses to whole-body vibration and resistance exercise in young women.

Whole-body vibration (WBV) augments the musculoskeletal effects of resistance exercise (RE). However, its acute effects on bone turnover markers (BTM) have not been determined. This study examined BTM responses to acute high-intensity RE and high-intensity RE with WBV (WBV+RE) in young women (n=10) taking oral contraceptives in a randomized, crossover repeated measures design. WBV+RE exposed subjects to 5 one-minute bouts of vibration (20 Hz, 3.38 peak-peak displacement, separated by 1 min of rest) before RE. Fasting blood samples were obtained before (Pre), immediately after WBV (PostVib), immediately after RE (IP), and 30-min after RE (P30). Bone alkaline phosphatase did not change at any time point. Tartrate-resistant acid phosphatase 5b significantly increased (p<0.05) from the Pre to PostVib, then decreased from IP to P30 for both conditions. C-terminal telopeptide of type I collagen (CTX) significantly decreased (p<0.05) from Pre to PostVib and from Pre to P30 only for WBV+RE. WBV+RE showed a greater decrease in CTX than RE (-12.6% ± 4.7% vs -1.13% ± 3.5%). In conclusion, WBV was associated with acute decreases in CTX levels not elicited with RE alone in young women.

Differences in tibia morphology between the sound and affected sides in ankle-foot orthosis-using survivors of stroke.

OBJECTIVE: To examine differences in tibia and proximal femur morphology between the affected and sound limbs in ankle-foot orthosis (AFO)-using survivors of stroke. DESIGN: Observational study. SETTING: A university bone density laboratory. PARTICIPANTS: Ambulatory, AFO-using survivors of stroke (N=9; age range, 55-74y; poststroke duration, 13.5±4.4y; AFO use, 6.5±1.4y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Total body and hip areal bone mineral density (aBMD) and bone mineral content (BMC) were assessed by dual-energy x-ray absorptiometry. The 4%, 38%, and 66% sites of both tibias were measured with peripheral quantitative computed tomography for total, cortical, and trabecular volumetric BMD (vBMD) and BMC. Bone geometry, bone strength index (BSI), strength strain index (SSI), and minimum and maximum rotated moments of inertia (Imin, Imax) were determined. RESULTS: Total hip and trochanter BMC and aBMD were 7% to 19% greater on the sound side (P<.05). Total BMC and vBMD were 2% to 21% greater (P<.05) on the sound limb, depending on site. Trabecular BMC and vBMD and BSI values were 19%, 21%, and 31% higher (P<.05) on the sound limb at the 4% site. Cortical BMC and vBMD (P<.05), and cortical thickness (P<.01) were greater on the sound side at the 38% and 66% sites. Cortical area and bone strength (SSI, Imin) were greater (P<.05) at the 66% site. Endosteal circumferences were greater on the affected side (P<.01). CONCLUSIONS: Interlimb differences in bone characteristics after a stroke persist despite returning to ambulatory status with AFO use.