Muscle power failure in mobility-limited older adults: preserved single fiber function despite lower whole muscle size, quality and rate of neuromuscular activation.

This study investigated the physiological and gender determinants of the age-related loss of muscle power in 31 healthy middle-aged adults (aged 40-55 years), 28 healthy older adults (70-85 years) and 34 mobility-limited older adults (70-85 years). We hypothesized that leg extensor muscle power would be significantly lower in mobility-limited elders relative to both healthy groups and sought to characterize the physiological mechanisms associated with the reduction of muscle power with aging. Computed tomography was utilized to assess mid-thigh body composition and calculate specific muscle power and strength. Surface electromyography was used to assess rate of neuromuscular activation and muscle biopsies were taken to evaluate single muscle fiber contractile properties. Peak muscle power, strength, muscle cross-sectional area, specific muscle power and rate of neuromuscular activation were significantly lower among mobility-limited elders compared to both healthy groups (P ≤ 0.05). Mobility-limited older participants had greater deposits of intermuscular adipose tissue (P < 0.001). Single fiber contractile properties of type I and type IIA muscle fibers were preserved in mobility-limited elders relative to both healthy groups. Male gender was associated with greater decrements in peak and specific muscle power among mobility-limited participants. Impairments in the rate of neuromuscular activation and concomitant reductions in muscle quality are important physiological mechanisms contributing to muscle power deficits and mobility limitations. The dissociation between age-related changes at the whole muscle and single fiber level suggest that, even among older adults with overt mobility problems, contractile properties of surviving muscle fibers are preserved in an attempt to maintain overall muscle function.

Muscle performance and physical function are associated with voluntary rate of neuromuscular activation in older adults.

BACKGROUND: Muscle power is related to mobility function in older adults, and effective power production requires rapid neuromuscular activation. Accordingly, this study examines the association of neuromuscular activation rate with muscle performance in persons of different age and mobility function. METHODS: Participants were recruited to three experimental groups: middle-aged healthy adults (MH), older healthy adults (OH), and older adults with mobility limitations (OML). OH and OML were primarily differentiated by performance on the Short Physical Performance Battery (SPPB). Muscle performance (acceleration and power) and electromyography (EMG) were recorded during a maximal-effort leg press task at an absolute resistance (260 N) and at a relative resistance (70% of the one-repetition maximum [1 RM]). Neuromuscular activation rate was quantified as pre-movement time (duration between EMG onset and movement onset) and the rate of EMG rise. RESULTS: Pre-movement time, rate of EMG rise, leg press acceleration, and leg press power were lower in OML relative to MH and OH but did not differ between OH and MH, with the exception of power at 70% 1RM. Across all older participants, rate of EMG rise was positively associated with acceleration, power, and the SPPB score. CONCLUSIONS: Slowing of neuromuscular activation rate is associated with compromised dynamic muscle performance, which may contribute to mobility limitations in some older adults. Future research should identify the precise neurophysiological impairments that contribute to declines in neuromuscular activation rate and mobility function with aging.

Lower extremity strength and power asymmetry assessment in healthy and mobility-limited populations: reliability and association with physical functioning.

BACKGROUND AND AIMS: This study assessed the reliability of evaluating asymmetrical strength and power deficits in the lower limbs of healthy middle-aged, healthy older and mobility-limited elders. We also explored the relationship between limb asymmetry and physical functioning. METHODS: We evaluated baseline knee extension strength and power asymmetry data from a cohort of older adults (n=57; 74.2±0.9 yrs, 26 male) who participated in a lower body strength training study (TS) and from a cross-sectional study of community dwelling volunteers. Cross-sectional participants were recruited into: healthy middle-aged (MH) (n=31; 47.4±4.8 yrs, 14 male), healthy older (OH) (n=28; 74.0±3.6 yrs, 16 male) and mobility-limited older (OML) (n=34; 77.8±4.5 yrs, 16 male) groups. Knee extensor strength (1RM) and power asymmetry at 40% and 70% of 1RM were evaluated for test-retest reliability using intraclass correlation coefficients (ICCs). RESULTS: Knee extension 1RM, and peak power at 40% and 70% asymmetry ICCs exhibited excellent to good reliability in the TS and OML groups (TS= 0.8, 0.7 and 0.7, respectively; OML= 0.7, 0.7, and 0.9, respectively) but not in the MH and OH groups. No consistent association between lower limb asymmetry and measures of physical functioning was observed. CONCLUSIONS: Assessment of lower limb strength and power asymmetry is more reliable in mobility-limited elders when compared to healthy middle-aged and older subjects. The relationship of lower limb asymmetry to physical functioning is poor, in contrast to associations between the absolute strength and power of the individual limbs and physical functioning.

Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults.

BACKGROUND: Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activation, may explain differences in leg extension torque and power between healthy middle-aged, healthy older, and mobility-limited older adults. METHODS: Torque, power, and electromyography were recorded during maximal voluntary leg extension trials across a range of velocities on an isokinetic dynamometer. RESULTS: Neuromuscular activation was similar between middle-aged and older healthy groups, with differences in torque and power explained predominantly by muscle size. However, the older mobility-limited group demonstrated marked impairment of torque, power, and agonist muscle activation, with the greatest deficits occurring at the fastest movement velocities. Agonist muscle activation was found to be strongly associated with torque output. CONCLUSIONS: Similar neuromuscular activation between the middle-aged and older healthy groups indicates that impaired voluntary activation is not an obligatory consequence of aging. However, the finding that the mobility-limited group exhibited impaired activation of the agonist quadriceps and concomitant deficits in torque and power output suggests that neuromuscular activation deficits may contribute to compromised mobility function in older adults.

Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial.

BACKGROUND AND AIMS: This study investigated whether high-velocity high-power training (POW) improved lower extremity muscle power and quality in functionally-limited elders greater than traditional slow-velocity progressive resistance training (STR). METHODS: Fifty-seven community-dwelling older adults aged 74.2+/-7 (range 65-94 yrs), Short Physical Performance Battery score 7.7+/-1.4, were randomized to either POW (n=23) (12 females), STR (n=22) (13 females) or a control group of lower extremity stretching (CON) (n=12) (6 females). Training was performed three times per week for 12 weeks and subjects completed three sets of double leg press and knee extension exercises at 70% of the one repetition maximum (1RM). Outcome measures included 1RM strength and peak power (PP). Total leg lean mass was determined using dual-energy X-ray absorptiometry to estimate specific strength and specific PP. RESULTS: During training, power output was consistently higher in POW compared to STR for knee extension (approximately 2.3-fold) and leg press (approximately 2.8-fold) exercises (p<0.01). Despite this, PP and specific PP of the knee extensors increased similarly from baseline in POW and STR compared to CON (p<0.01), and no significant time-group interaction occurred for PP of the leg extensors. However, gains in leg press specific PP were significantly greater in POW compared to both STR and CON (p<0.05). Total leg lean mass did not change within any group. CONCLUSIONS: A short-term intervention of high-velocity power training and traditional slow-velocity progressive resistance training yielded similar increases of lower extremity power in the mobility-impaired elderly. Neuromuscular adaptations to power training, rather than skeletal muscle hypertrophy, may have facilitated the improvements in muscle quality. Additional studies are warranted to test the efficacy of power training in older individuals with compromised physical functioning.