Effects of multidisciplinary therapy on physical function in Huntington's disease.

OBJECTIVE: The primary objective of this trial was to evaluate the effects of outpatient multidisciplinary therapy, compared to usual care, on measures of physical function and muscle strength in patients with manifest Huntington's disease (HD). METHODS: Twenty-two patients with clinically verified HD were randomized to receive 36 weeks of outpatient multidisciplinary therapy or usual care. Outpatient multidisciplinary therapy comprised 9 months of supervised exercise, cognitive therapy and self-directed home-based exercise. Usual care consisted of standard medical care. Patients were assessed at 0 and 36 weeks by blinded assessors. The primary outcome was changed in mobility as measured by the 10-m Timed Walk Test. Secondary outcome measures included changes in manual dexterity (Timed Nut and Bolt Test), balance (Berg Balance Scale), cardiorespiratory endurance (6-Minute Walk Test) and upper and lower extremity muscle strength (isokinetic and isometric muscle strength and 10 Repetition Sit-to-Stand Tests). RESULTS: Patients receiving outpatient multidisciplinary therapy demonstrated significantly enhanced manual dexterity (P < 0.05) and lower extremity muscle strength (P < 0.05) than patients receiving usual care. No significant differences in mobility, balance, cardiorespiratory endurance and upper extremity strength outcomes were observed between groups after the intervention period. There were no adverse events associated with multidisciplinary therapy. CONCLUSION: Our findings suggest that outpatient multidisciplinary therapy has positive effects on manual dexterity and muscle strength, but no meaningful effects on mobility, balance, cardiorespiratory endurance and upper extremity muscle strength in patients with HD. Larger randomized controlled trials are needed to confirm these preliminary findings.

Differences in salivary hormones and perception of exertion in elite women and men volleyball players during tournament.

BACKGROUND: Sports tournaments induce both psychological and physiological stress, which seems to be different between men and women. Competition induces anticipatory rises in testosterone and cortisol levels, which may affect performance and physical exertion during tournaments. The aim of this study was to compare the changes in salivary cortisol and testosterone concentrations between men and women during an official volleyball tournament and to test potential correlations between changes in these hormones and perceived exertion after match. METHODS: Three matches of each team were assessed in the group stage of the Men and Women South American Volleyball Championship. Salivary cortisol and testosterone levels were measured in the fasting state, before and after each match. The rate of perceived exertion (RPE) was assessed after each match. RESULTS: Fasting cortisol concentrations were higher in women than men (~25%, P<0.001) while fasting testosterone was higher in men than women (~46%, P<0.001). Cortisol concentration increased only after the second match in men (+53.7%, P<0.001). Testosterone concentration was low before and after the third match in men (P<0.001) while it was elevated after the third match in women (P=0.003). The rate of perceived exertion was correlated with the change in testosterone levels due to the matches in both women (r=0.33; P=0.04) and men (r=0.44; P=0.02), which was not observed for cortisol concentrations. CONCLUSIONS: These results indicate that women have higher fasting cortisol, but lower fasting testosterone concentrations than men during a volleyball tournament. Thus, hormonal responses of women and men are different and related to their effort during the matches.

The efficacy of periodised resistance training on neuromuscular adaptation in older adults.

PURPOSE: This study compared the effect of periodised versus non-periodised (NP) resistance training on neuromuscular adaptions in older adults. METHODS: Forty-one apparently healthy untrained older adults (female = 21, male = 20; 70.9 ± 5.1 years; 166.3 ± 8.2 cm; 72.9 ± 13.4 kg) were recruited and randomly stratified to an NP, block periodised (BP), or daily undulating periodised (DUP) training group. Outcome measures were assessed at baseline and following a 22-week resistance training intervention (3 day week-1), including: muscle cross-sectional area (CSA), vertical jump performance, isometric and isokinetic peak torque, isometric rate of force development (RFD), and muscle activation. Thirty-three participants satisfied all study requirements and were included in analyses (female = 17, male = 16; 71.3 ± 5.4 years; 166.3 ± 8.5 cm; 72.5 ± 13.7 kg). RESULTS: Block periodisation, DUP, and NP resistance training induced statistically significant improvements in muscle CSA, vertical jump peak velocity, peak power and jump height, and peak isometric and isokinetic torque of the knee extensors at 60 and 180° s-1, with no between-group differences. Muscle activity and absolute RFD measures were statistically unchanged following resistance training across the entire cohort. CONCLUSIONS: Periodised resistance training, specifically BP and DUP, and NP resistance training are equally effective for promoting increases in muscular hypertrophy, strength, and power among untrained older adults. Consequently, periodisation strategies are not essential for optimising neuromuscular adaptations during the initial stages of resistance training in the aging population.