Assessment of functional sit-to-stand muscle power: Cross-sectional trajectories across the lifespan.

BACKGROUND: The 30-s sit-to-stand (STS) muscle power test is a valid test to assess muscle power in older people; however, whether it may be used to assess trajectories of lower-limb muscle power through the adult lifespan is not known. This study evaluated the pattern and time course of variations in relative, allometric and specific STS muscle power throughout the lifespan. METHODS: Subjects participating in the Copenhagen Sarcopenia Study (729 women and 576 men; aged 20 to 93 years) were included. Lower-limb muscle power was assessed with the 30-s version of the STS muscle power test. Allometric, relative and specific STS power were calculated as absolute STS power normalized to height squared, body mass and leg lean mass as assessed by DXA, respectively. RESULTS: Relative STS muscle power tended to increase in women (0.08 ±â€¯0.05 W·kg-1·yr-1; p = 0.082) and increased in men (0.14 ±â€¯0.07 W·kg-1·yr-1; p = 0.046) between 20 and 30 years, followed by a slow decline (-0.05 ±â€¯0.05 W·kg-1·yr-1 and -0.06 ±â€¯0.08 W·kg-1·yr-1, respectively; both p > 0.05) between 30 and 50 years. Then, relative STS power declined at an accelerated rate up to oldest age in men (-0.09 ±â€¯0.02 W·kg-1·yr-1) and in women until the age of 75 (-0.09 ±â€¯0.01 W·kg-1·yr-1) (both p < 0.001). A lower rate of decline was observed in women aged 75 and older (-0.04 ±â€¯0.02 W·kg-1·yr-1; p = 0.039). Similar age-related patterns were noted for allometric and specific STS power. CONCLUSIONS: The STS muscle power test appears to provide a feasible and inexpensive tool to monitor cross-sectional trajectories of muscle power throughout the lifespan.

Assessment of acute bone loading in humans using [18F]NaF PET/MRI.

PURPOSE: The acute effect of loading on bone tissue and physiology can offer important information with regard to joint function in diseases such as osteoarthritis. Imaging studies using [18F]-sodium fluoride ([18F]NaF) have found changes in tracer kinetics in animals after subjecting bones to strain, indicating an acute physiological response. The aim of this study is to measure acute changes in NaF uptake in human bone due to exercise-induced loading. METHODS: Twelve healthy subjects underwent two consecutive 50-min [18F]NaF PET/MRI examinations of the knees, one baseline followed by one post-exercise scan. Quantification of tracer kinetics was performed using an image-derived input function from the popliteal artery. For both scans, kinetic parameters of KiNLR, K1, k2, k3, and blood volume were mapped parametrically using nonlinear regression with the Hawkins model. The kinetic parameters along with mean SUV and SUVmax were compared between the pre- and post-exercise examinations. Differences in response to exercise were analysed between bone tissue types (subchondral, cortical, and trabecular bone) and between regional subsections of knee subchondral bone. RESULTS: Exercise induced a significant (p < <0.001) increase in [18F]NaF uptake in all bone tissues in both knees, with mean SUV increases ranging from 47% in trabecular bone tissue to 131% in subchondral bone tissue. Kinetic parameters involving vascularization (K1 and blood volume) increased, whereas the NaF extraction fraction [k3/(k2 + k3)] was reduced. CONCLUSIONS: Bone loading induces an acute response in bone physiology as quantified by [18F]NaF PET kinetics. Dynamic imaging after bone loading using [18F]NaF PET is a promising diagnostic tool in bone physiology and imaging of biomechanics.

Assessment of Perfusion and Oxygenation of the Human Renal Cortex and Medulla by Quantitative MRI during Handgrip Exercise.

BACKGROUND: Renal flow abnormalities are believed to play a central role in the pathogenesis of nephropathy and in primary and secondary hypertension, but are difficult to measure in humans. Handgrip exercise is known to reduce renal arterial flow (RAF) by means of increased renal sympathetic nerve activity. METHODS: To monitor medullary and cortical oxygenation under handgrip exercise-reduced perfusion, we used contrast- and radiation-free magnetic resonance imaging (MRI) to measure regional changes in renal perfusion and blood oxygenation in ten healthy normotensive individuals during handgrip exercise. We used phase-contrast MRI to measure RAF, arterial spin labeling to measure perfusion, and both changes in transverse relaxation time (T2*) and dynamic blood oxygenation level-dependent imaging to measure blood oxygenation. RESULTS: Handgrip exercise induced a significant decrease in RAF. In the renal medulla, this was accompanied by an increase of oxygenation (reflected by an increase in T2*) despite a significant drop in medullary perfusion; the renal cortex showed a significant decrease in both perfusion and oxygenation. We also found a significant correlation (R2=0.8) between resting systolic BP and the decrease in RAF during handgrip exercise. CONCLUSIONS: Renal MRI measurements in response to handgrip exercise were consistent with a sympathetically mediated decrease in RAF. In the renal medulla, oxygenation increased despite a reduction in perfusion, which we interpreted as the result of decreased GFR and a subsequently reduced reabsorptive workload. Our results further indicate that the renal flow response's sensitivity to sympathetic activation is correlated with resting BP, even within a normotensive range.

Assessment of muscle function using hybrid PET/MRI: comparison of 18F-FDG PET and T2-weighted MRI for quantifying muscle activation in human subjects.

PURPOSE: The aim of this study was to determine the relationship between relative glucose uptake and MRI T 2 changes in skeletal muscles following resistance exercise using simultaneous PET/MRI scans. METHODS: Ten young healthy recreationally active men (age 21 - 28 years) were injected with 18F-FDG while activating the quadriceps of one leg with repeated knee extension exercises followed by hand-grip exercises for one arm. Immediately following the exercises, the subjects were scanned simultaneously with 18F-FDG PET/MRI and muscle groups were evaluated for increases in 18F-FDG uptake and MRI T 2 values. RESULTS: A significant linear correlation between 18F-FDG uptake and changes in muscle T 2 (R 2 = 0.71) was found. for both small and large muscles and in voxel to voxel comparisons. Despite large intersubject differences in muscle recruitment, the linear correlation between 18F-FDG uptake and changes in muscle T 2 did not vary among subjects. CONCLUSION: This is the first assessment of skeletal muscle activation using hybrid PET/MRI and the first study to demonstrate a high correlation between 18F-FDG uptake and changes in muscle T 2 with physical exercise. Accordingly, it seems that changes in muscle T 2 may be used as a surrogate marker for glucose uptake and lead to an improved insight into the metabolic changes that occur with muscle activation. Such knowledge may lead to improved treatment strategies in patients with neuromuscular pathologies such as stroke, spinal cord injuries and muscular dystrophies.

Energy expenditure comparison between walking and running in average fitness individuals.

Increased energy expenditure (EE) is a key component in maintaining a healthy body mass. Walking and running are 2 common aerobic activities that increase EE above resting values. The purpose of this study was to compare the EE of individuals with average fitness during a walk and run for 1600 meters at 86 m·min(-1) and 160 m·min(-1), respectively. In addition, EE after the walk and run was compared. Fifteen females and 15 males (21.90 ± 2.52 y; 168.89 ± 11.20 cm; 71.01 ± 17.30 kg; 41.51 ± 6.31 ml(-1)·kg(-1)·min(-1)) volunteered to participate. Each participant completed a VO2max test. In addition, oxygen consumption was measured at rest for 10 minutes before exercise, during the walk and run, and after the walk and run for 30 minutes of recovery. EE during exercise was 372.54 ± 78.16 kilojoules for the walk and 471.03 ± 100.67 kilojoules for the run. Total EE including excess postexercise EE was 463.34 ± 80.38 kilojoules and 664.00 ± 149.66 kilojoules for the walk and run, respectively. Postexercise EE returned to resting values 10 minutes after the walk and 15 minutes after the run. Walking and running are both acceptable activities that increase EE above rest and can be performed without the expense of a health club membership and meet adequate kilojoule expenditure according to American College of Sports Medicine guidelines.

MEASUREMENT OF ENERGY EXPENDITURE WHILE PLAYING EXERGAMES AT A SELF-SELECTED INTENSITY.

Exergames have been suggested as a possible alternative to traditional exercise in the general population. The purpose of this study was to examine the heart rate (HR) and energy expenditure (EE) of young adults playing several different exergames, while self-selecting the component of the game to play and the intensity. A total of 117 participants, 18-35 years of age, were evaluated on one of four active video games. Participants were free to choose any component of the given game to play and they played at a self-selected intensity. The average HR and EE during the individual games were compared to resting conditions and to the American College of Sports Medicine (ACSM) guidelines. The HR and EE increased above resting conditions during each game (p<0.05). When the results of all games were combined, the HR was 125.4 ± 20.0 bpm and the average EE was 6.7 ± 2.1 kcal/min. This HR represents an average percent of heart rate reserve of 44.6 ± 14.1, high enough to be considered moderate intensity exercise. If performed for 30 minutes a day, five days per week, the average EE would be 1,005 kcals, enough to meet the ACSM recommendations for weekly EE. Therefore, at least some exergames could be a component of an exercise program.

Fitness Assessment Comparison Between the "Jackie Chan Action Run" Videogame, 1-Mile Run/Walk, and the PACER.

OBJECTIVE: The purpose of this study was to examine whether a correlation existed among the scores of the "Jackie Chan Studio Fitness(™) Action Run" active videogame (XaviX(®), SSD Company, Ltd., Kusatsu, Japan), the 1-mile run/walk, and Progressive Aerobic Cardiovascular Endurance Run (PACER) aerobic fitness tests of the FITNESSGRAM(®) (The Cooper Institute, Dallas, TX) in order to provide a potential alternative testing method for days that are not environmentally desirable for outdoor testing. SUBJECTS AND METHODS: Participants were a convenience sample from physical education classes of students between the ages of 10 and 15 years. Participants (n=108) were randomly assigned to one of three groups with the only difference being the order of testing. The tests included the "Jackie Chan Action Run" active videogame, the 1-mile run/walk, and the PACER. Testing occurred on three different days during the physical education class. Rating of perceived exertion (RPE) was reported. RESULTS: Significant correlations (r=-0.598 to 0.312) were found among the three aerobic fitness tests administered (P<0.05). The RPE for the "Jackie Chan Action Run" was lower than the RPE for the 1-mile run/walk and the PACER (3.81±1.89, 5.93±1.77, and 5.71±2.14, respectively). CONCLUSIONS: The results suggest that the "Jackie Chan Action Run" test could be an alternative to the 1-mile run/walk and PACER, allowing physical education teachers to perform aerobic fitness testing in an indoor setting that requires less space. Also, children may be more willing to participate in the "Jackie Chan Action Run" based on the lower RPE.

The Addition of a Video Game to Stationary Cycling: The Impact on Energy Expenditure in Overweight Children.

INTRODUCTION: The prevalence of obesity in children has reached epidemic proportions with over 37% of children aged 6-11 years in the U.S. being classified as "at risk for overweight" or "overweight." Utilization of active video games has been proposed as one possible mechanism to help shift the tide of the obesity epidemic. PURPOSE: The purpose of this study was to determine if riding a stationary bike that controlled a video game would lead to significantly greater energy expenditure than riding the same bike without the video game connected. METHODS: Twenty children, 7-14 years old, with a BMI classification of "at risk for overweight" or "overweight" participated in this study. Following familiarization, energy expenditure was evaluated while riding a stationary bike for 20 minutes. One test was performed without the addition of a video game and one test with the bike controlling the speed of a car on the video game. RESULTS: Oxygen consumption and energy expenditure were significantly elevated above baseline in both conditions. Energy expenditure was significantly higher while riding the bike as it controlled the video game (4.4 ± 1.2 Kcal·min(-1)) than when riding the bike by itself (3.7 ± 1.1 Kcal·min(-1)) (p<0.05). Perceived exertion was not significantly different between the two sessions (p>0.05). CONCLUSION: Using a stationary bike to control a video game led to greater energy expenditure than riding a stationary bike without the video game and without a related increase in perceived exertion.

Active Video/Arcade Games (Exergaming) and Energy Expenditure in College Students.

Video games have become increasingly popular among young adults. The purpose of this pilot study was to determine if interactive video/arcade games, requiring physical activity to play, increase the energy expenditure (EE) and heart rate (HR) of young adults enough to elicit a training response. Thirteen male and female participants 26.6 ± 5.7 years of age were in the study. Participants were familiarized with equipment and allowed to practice with three games: (1) moving and striking lighted pads, (2) riding a bike to increase the pace of a race car, and (3) boxing against a video simulated opponent. A portable metabolic cart and HR monitor were attached to participants to measure baseline and exercise values. Participants could play any of the three games for 30 minutes while metabolic and HR data were collected. Exercise data were compared to baseline measures, and the 3 games were compared for EE. Paired sample t-tests showed baseline and exercise values differed for HR (t(12) = -18.91, p < 0.01), and EE (t(12) = -15.62, p < 0.01). The boxing game provided the highest VO2 (17.47 ± 4.79 ml·kg(·-1)min(-1)). Participants achieved 60% or better of their HR reserve (162.82 ± 10.78 beats·min(-1),) well within the ACSM guidelines for a training HR. Caloric expenditure during the 30-minute exercise session (226. 07 ± 48.68) is also within the ACSM recommendations for daily physical activity. Thus, interactive video/arcade games that require physical activity to play can be utilized as part of an overall aerobic exercise program.

Active Video Games and Energy Expenditure in Overweight Children.

The prevalence of overweight in children has increased significantly in recent years. Frequent television viewing and the playing of video games have often been linked to the high prevalence of overweight. The purpose of this study was to determine if overweight children, given access to active video games, will play them at an intensity that will significantly increase energy expenditure. Twenty-three children, classified as "at risk for overweight" or "overweight," participated in this study. After a 10-minute baseline period in which the children watched a cartoon, the participants played the Jackie Chan Fitness Studio® (Xavix, Hong Kong) games for 30 minutes while rotating through the games as desired and resting whenever needed. Energy expenditure significantly increased from a mean at baseline of 1.15 ± 0.32 kcal/min to 4.08±1.18 kcal/min during the 30-minutes that the participants were given access to the games (p <.001). The total energy expenditure during the 30-minute time frame was 122.30 ± 35.40 kcal. The energy expenditure varied between individuals, with a low value of 75.00 kcal to a high of 205.86 kcal. Although a modest level of energy expenditure, this level of exertion could contribute to an overall weight control program in children.