The modulation of force steadiness by electrical nerve stimulation applied to the wrist extensors differs for young and older adults.

PURPOSE: We compared the modulation of force steadiness by different types of electrical nerve stimulation in young (n = 13, 25 ± 4 years) and older (n = 12, 78 ± 5 years) adults. METHODS: The protocol involved four types of isometric contractions with the wrist-extensor muscles at 10% of the maximal force. Three of the contractions involved electrical nerve stimulation that comprised two forms of neuromuscular electrical stimulation (NMES) to evoke muscle contractions and a voluntary contraction with superimposed transcutaneous electrical nerve stimulation (TENS) at an intensity less than motor threshold. RESULTS: The coefficient of variation (CV) for force during voluntary wrist extension was less (P = 0.03) for young (1.82 ± 0.43%) than older adults (2.80 ± 1.08%). The CV for force did not differ between age groups during the three types of electrical nerve stimulation but was reduced relative to the value observed during voluntary wrist extension for older adults. In contrast, the CV for force increased during the voluntary contraction with superimposed TENS for young adults but not for older adults. Moreover, there were significant negative correlations in older adults between the CV for force during the voluntary contraction and its decrease with electrical nerve stimulation. CONCLUSION: Differences in the CV for force between the evoked and voluntary contractions for the two age groups suggest that the variance in common synaptic input to motor neurons during steady voluntary contractions with the wrist extensors is greater for older adults than young adults.

Vitamin D, calcium, and bone status in children with developmental delay in relation to anticonvulsant use and ambulatory status.

Reports of abnormalities in vitamin D, calcium, and bone status associated with anticonvulsant use are inconsistent and difficult to interpret because of widely varying study designs, particularly for ambulatory status. We examined the relative effects of anticonvulsant use and ambulatory status on vitamin D, calcium, and bone status in a large group (n = 338) of children who had either normal motor function (ambulatory) or were nonambulatory and either receiving anticonvulsants or not; all had developmental delays. Data included diet records, serum analyses (calcium and calcidiol), and hand-wrist radiographs evaluated for bone maturation and quality. Data were analyzed by using a general linear models (GLM) procedure. Dietary and biochemical data were compared with those of a group of 34 normal children. There were no differences in calcium or vitamin D intakes among the four study groups; however, a high percentage of intakes was below the recommended dietary allowances for calcium (56%) and vitamin D (70%). Vitamin D intakes were positively associated with serum calcium (P < 0.005) and calcidiol (P < 0.01) concentrations. Analysis of covariance indicated that ambulatory status but neither anticonvulsant use nor their interaction contributed significantly to the prediction of serum calcium (P < 0.009) and calcidiol (P < 0.0001), the Z scores for number of ossified centers (P < 0.008), bone age (P < 0.0001), and bone area (P < 0.003). A strong interaction between anticonvulsant use and ambulatory status was seen for percentage cortical area (P < 0.0008), which was entirely due to anticonvulsant use in nonambulatory children (effect size = 0.98). Results suggest that ambulatory status is more important than was recognized previously in relation to abnormalities in vitamin D, calcium, and bone statuses; that all nonambulatory children may be at risk for low serum calcidiol and osteopenia; and that routine monitoring of risk and consideration of prophylactic vitamin D supplementation are warranted.