Time-course response in serum markers of bone turnover to a single-bout of electrical stimulation in patients with recent spinal cord injury.

The objective of the present repeat-measures study was to determine whether plasma serum levels of testosterone, cortisol, osteocalcin or type I collagen C-telopeptide (CT) are acutely affected following an electro-myostimulation (EMS) bout, and their relation to bone mineral density and muscle mass. Ten men with recent (8 weeks) thoracic spinal cord injury (SCI) (ASIA A) and 10 age-matched able-bodied (AB) men performed one EMS bout on the quadriceps femoris muscle. Blood samples were drawn at basal condition, immediately after EMS, and 15 min, 30 min, 24 h and 48 h post-EMS. Muscle cross-sectional area was measured by magnetic resonance imaging. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. In the SCI group, a significant decrease in testosterone, cortisol and CT together with a significant increase in testosterone/cortisol ratio and osteocalcin/CT ratio was observed after EMS. For the AB subjects, only testosterone and CT decreased significantly following EMS. Muscle size was only related to testosterone/cortisol ratio in the SCI sample (R = 0.659, p < 0.05), whereas BMD did not show any relation to any biomarker. Acute EMS in recent spinal cord injured men seems to induce positive effects on bone turnover biomarkers, and anabolic and catabolic hormones.

Associations between obesity, physical fitness, and urinary incontinence in non-institutionalized postmenopausal women: The elderly EXERNET multi-center study.

OBJECTIVES: To investigate the associations between body composition, fitness level, and urinary incontinence (UI) in 471 non-institutionalized women ≥ 65 years of age. STUDY DESIGN: Cross-sectional study. METHOD: UI was assessed using the International Consultation on Incontinence Questionnaire Short-Form and a specific severity UI item. Anthropometric measurements were obtained using standardized techniques and equipment. Body fat percentage (BF%) was measured by bioelectrical impedance. Physical fitness (PF) was evaluated by a set of 8 tests and a fitness index (FI) was calculated. Active and sedentary behaviors were recorded by standardized questionnaires. RESULTS: UI was reported in 28.5% of the participants. Women with UI showed higher values of body mass index (BMI), BF% and waist circumference (WC) (all p<0.05) compared to urinary continent women, whereas there was a lower fitness index (FI) level in women with UI (p=0.08). Among all fitness capacities, upper body flexibility showed the closest relationship with UI. UI risk increased by 87.0% [95% confidence intervals (1.01-3.17)] in obese women compared to the normal group, according to the BF% while no significant results were found when PF, WC and BMI were included in the model. Mean sitting and walking time per day were 4.3±1.4 and 1.8±0.9 h/d, respectively. CONCLUSION: UI was associated with an excess of fat mass and poor PF, especially upper-body flexibility.

Effects of electromyostimulation on muscle and bone in men with acute traumatic spinal cord injury: A randomized clinical trial.

OBJECTIVE: To study the effect of 14 weeks of electromyostimulation (EMS) training (47 minutes/day, 5 days/week) on both muscle and bone loss prevention in persons with recent, complete spinal cord injury (SCI). DESIGN: Prospective, experimental, controlled, single-blind randomized trial with external blind evaluation by third parties. METHODS: Eight men with recent SCI (8 weeks from injury; ASIA Impairment Scale (AIS) "A") were randomized into the intervention or the control groups. Cross-sectional area of the quadriceps femoris (QF) muscle was quantified using magnetic resonance imaging. Bone mineral density changes were assessed with a dual-energy X-ray absorptiometry. Several bone biomarkers (i.e. total testosterone, cortisol, growth hormone, insulin-growth factor I, osteocalcin, serum type I collagen C-telopeptide), lipid, and lipoprotein profiles were quantified. A standard oral glucose tolerance test was performed before and after the 14-week training. All analyses were conducted at the beginning and after the intervention. RESULTS: The intervention group showed a significant increase in QF muscle size when compared with the control group. Bone losses were similar in both groups. Basal levels of bone biomarkers did not change over time. Changes in lipid and lipoprotein were similar in both groups. Glucose and insulin peaks moved forward after the training in the intervention group. CONCLUSIONS: This study indicates that skeletal muscle of patients with complete SCI retains the ability to grow in response to a longitudinal EMS training, while bone does not respond to similar external stimulus. Increases in muscle mass might have induced improvements in whole body insulin-induced glucose uptake.

Individual responses to combined endurance and strength training in older adults.

PURPOSE: A combination of endurance and strength training is generally used to seek further health benefits or enhanced physical performance in older adults compared with either of the training modes alone. The mean change within a training group, however, may conceal a wide range of individual differences in the responses. The purpose, therefore, was to examine the individual trainability of aerobic capacity and maximal strength, when endurance and strength training are performed separately or concurrently. METHODS: For this study, 175 previously untrained volunteers, 89 men and 86 women between the ages of 40 and 67 yr, completed a 21-wk period of either strength training (S) twice a week, endurance training (E) twice a week, combined training (ES) four times per week, or served as controls. Training adaptations were quantified as peak oxygen uptake (VO2peak) in a bicycle ergometer test to exhaustion and maximal isometric bilateral leg extension force (MVC) in a dynamometer. RESULTS: A large range in training responses, similar to endurance or strength training alone, was also observed with combined endurance and strength training in both ΔVO2peak (from -8% to 42%) and ΔMVC (from -12% to 87%). There were no significant correlations between the training responses in VO2peak and MVC in the E, S, or especially in the ES group, suggesting that the same subjects did not systematically increase both aerobic capacity and maximal strength. CONCLUSIONS: The goal of combined endurance and strength training--increasing both aerobic capacity and maximal strength simultaneously--was only achieved by some of the older subjects. New means are needed to personalize endurance, strength, and especially combined endurance and strength training programs for optimal individual adaptations.