Differences in leg muscle activity and body sway between elderly adults able and unable to maintain one-leg stance for 1 min: the effect of hand support.

BACKGROUND: One-leg stance (OLS) training is often used to prevent falls in the elderly. The burden imposed on the supporting lower limb during OLS may differ depending on whether hand support is used, particularly in patients with decreased lower-limb strength. AIMS: Here we examined the effect of hand support on leg muscle activity and body sway during OLS in elderly subjects able to maintain OLS for 1 min unaided [able group (AG), n = 13] and those who were unable to do so [unable group (UG), n = 11]. METHODS: All subjects performed OLS unaided and OLS with front support (OLS-FS) using one hand for 1 min each. We estimated leg muscle activity [mean and maximum % root mean square (%RMS)] and body sway (total, X-axis, and Y-axis path lengths) for both tests. %RMS was calculated according to the results of the maximum voluntary isometric contraction test. RESULT: The overall average mean and maximum %RMS for the tibialis anterior muscle was larger in UG than in AG. In AG, tibialis anterior muscle mean and maximum %RMS and body sway was larger during OLS than during OLS-FS. Total and X-axis path lengths were larger during the first 20 s OLS phase in AG and the first 20 s OLS-FS phase in UG. CONCLUSION: These results highlight the need to differentiate between patients able and unable to perform OLS unaided for training because of differences in leg muscle activity.

Relationship Between Jump Rope Double Unders and Sprint Performance in Elementary Schoolchildren.

According to dynamic analyses of muscle contraction, jump rope is a typical stretch-shortening cycle (SSC) movement. It has been reported that the relationship with SSC is higher in double unders than in single unders (basic jumps); however, the relationship between jump rope and sprint performances has not been extensively studied. To clarify this relationship in elementary schoolchildren, we compared the sprint speed and SSC ability of children who were grouped according to gender and ability. The subjects were 143 elementary fifth and sixth graders (78 boys, 65 girls). The consecutive maximal number of double unders, reactivity index (index of SSC ability) by Myotest, and 20-m sprint time were measured. According to the mean of jump rope records, the children were divided into a superior ability group (more than average + 0.5 SD) and an inferior ability group (less than average - 0.5 SD) for each gender. In both genders, a significant difference was found in the 20-m sprint time between the inferior and superior ability groups. The times for the superior ability groups (boys, 3.75 ± 0.23 seconds; girls, 4.02 ± 0.24 seconds) were excellent compared with the inferior ability groups (boys, 4.17 ± 0.32 seconds; girls, 4.23 ± 0.21 seconds). This effect size was higher in boys (1.44) than in girls (0.93). The reactivity index in the superior ability group was excellent compared with that in the inferior ability group. In conclusion, children who perform better in double unders are also faster during a 20-m sprint run. This tendency may be higher in boys. Classic jump rope training, such as double unders, should be effective as elementary plyometrics for improving the sprint ability of children.

ADJUSTMENT ERRORS IN ASCENDING AND DESCENDING PHASES OF TARGET LEVEL IN CONTROLLED FORCE EXERTION.

Hand grip force adjustment errors to ascending and descending phases of a sinusoidal target force in a controlled force exertion (CFE) test were measured and the laterality of responses evaluated. 75 men (M age = 19.6 yr., SD = 1.6) performed the CFE test after one practice trial by matching handgrip force to target level (5-25% of maximal grip force). The CFE errors in ascending and descending phases of the target force were calculated as the absolute differences between actual force and target force in each phase. There were significantly smaller CFE errors in the ascending phase for both dominant and non-dominant hands, but CFE error for the dominant hand was significantly smaller in both phases. Therefore, error in force exertion in the ascending and descending phases of the target force differed, and laterality influenced error in both phases.

Possibility of stretch-shortening cycle movement training using a jump rope.

Although jumping rope has been said to be a typical stretch-shortening cycle movement (SSC) from the dynamic analysis of muscle contraction, there are few research reports that focus on this point. Recently, the function of SSC of the legs with respect to the jumping movement has been evaluated using the rebound jump index (RJ-index). This study aimed to examine the possibility of using rope jumping in SSC training by comparing the RJ-index of the rebound jump (standard value) and the 2 different methods of rope jumping. The subjects included 76 healthy young men. Most subjects were involved in routine sports training 2-3 times per week. They performed the rebound jump (5 consecutive vertical jumps) and both a basic and a double-under jump with the jump rope, according to each participant's individual style (rhythm or timing). The RJ-index was calculated using the ground contact time and the jump height. The reliabilities of the RJ-index in the basic (intraclass correlation coefficient: 0.85) and double-under jump (0.92) were high, and the RJ-index of the latter (1.34 ± 0.24) was significantly higher than that of the former (0.60 ± 0.21). In the case of a group with inferior SSC ability, the RJ-index of the rebound jump only showed a significant correlation with the double-under but not with the basic jump. When using the RJ-index (1.97 ± 0.38) of the rebound jump as a criterion, the double-under-using about 70% of the SSC ability-may be effective for reinforcement of SSC ability.

Differences in muscle power between the dominant and nondominant upper limbs of baseball players.

We examined the differences in muscle power between the dominant and nondominant upper limbs of 33 healthy, right-handed, university baseball players (mean age, 20.4 ± 1.1 years) with an average baseball experience >11 years. After measuring maximal voluntary contraction (MVC) of hand grip, elbow flexion, and shoulder internal rotation in both upper limbs, the muscle power of each joint was measured at 40%, 50%, and 60% MVC. No significant differences were observed in the main factors affecting MVC and elbow flexion power loads between dominant and nondominant upper limbs. For handgrip power, load factors at 40% MVC in the dominant hand were lower than those at 60% MVC in the same hand and those at 50% and 60% MVC in the nondominant hand. Significant differences were observed in shoulder internal rotation power between dominant and nondominant upper limbs, with the dominant limb having greater power at all loads. Correlations between muscle power of both upper limbs for handgrip and elbow flexion were significant and moderately high at all loads. For shoulder internal rotation power, the degree of correlation was significant and moderately high at 40% MVC but low to moderate at 50% and 60% MVC. Therefore, baseball players have marked lateral dominance in shoulder internal rotation power unlike handgrip and elbow flexion power, although the relationship between shoulder internal rotation muscle powers of both upper limbs becomes lower with increasing load. The dominance of muscle power of each joint varied even in the same upper limb. It is thus beneficial for baseball players to train with even loads on both arms or adopt simultaneous workout of both arms after adjusting for strength differences.

Reliability and fall experience discrimination of Cross Step Moving on Four Spots Test in the elderly.

OBJECTIVES: To examine the reliability and fall experience discrimination of the Cross Step Moving on Four Spots Test (CSFT) and the relationship between CSFT and fall-related physical function. DESIGN: The reliability of the CSFT was examined in a test-retest format with the same tester. Fall history, fall risk, fear of falling, activities of daily living (ADL), and various physical parameters were measured for all participants. SETTING: A community center and university medical school. PARTICIPANTS: Elderly community-dwelling subjects (N=533; 62 men, 471 women) aged 65 to 94 years living independently. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Time to complete all the CSFT steps required, fall risk score, ADL score, and fall-related physical function (isometric muscle strength: toe grip, plantar flexion, knee extension, hip flexion, hand grip; balance: 1-leg standing time with eyes open, functional reach test using an elastic stick; and gait: 10-m maximal walking speed). RESULTS: The trial-to-trial reliability test indicated good reliability of the CSFT in both sexes (intraclass correlation coefficient =.833 in men, .825 in women). However, trial-to-trial errors increased with an increase in the CSFT values in both sexes. Significant correlations were observed between the CSFT values and scores for most fall-related physical function tests in both sexes. However, the correlation coefficient for all significant correlations was <0.5. Two-way analysis of variance (sex × fall experience) revealed that the fall experience is a significant factor affecting CSFT values; values in fallers were significantly lower than those in nonfallers. The odds ratios in logistic regression analysis were significant in both sexes (men, 1.35; women, 1.48). As determined by the Youden index, the optimal cutoff value for identifying fall experience was 7.32 seconds, with an area under the curve of .676. CONCLUSIONS: The CSFT can detect fall experience and is useful in the evaluation of different fall-related physical functions including muscle strength, balance, and mobility.

Stimulus tempos and the reliability of the successive choice reaction test.

In ball game sports, players demand agility, which is a quick and adequate reaction to various changing stimuli. We developed a "successive choice reaction test" that evaluates such agility. This test requires subjects to be exposed to successive stimuli. Hence, it is very important to select appropriate stimulus tempos. In addition, it is necessary to examine the reliability of a new test. This study examined adequate stimulus tempos and test reliability. Fifteen healthy university students participated in this study. All the subjects conducted a successive choice reaction test with 3 kinds of tempos (1.3, 1.5, and 2.0 seconds). To examine its reliability, the test was conducted again on another day. It was found that any tempo has a high reliability, that their relationships are close, and insignificant time differences exist among the tempos. In conclusion, the successive choice reaction test was judged to be useful with any of the above tempos.

Relations among dynamic balance tests and a coordination test using center of pressure to pursue a randomly moving target.

The CFP (center of foot pressure) Tracking Test, in which participants pursue a randomly moving target using CFP, is performed in standing position similar to the dynamic balance board and bass dynamic balance tests. The relations among the results of these three tests were examined in 30 young, healthy participants. No significant sex differences were observed between tests. Moderate correlations were observed between the results of the CFP Tracking Test and the balance tests, but not between the two balance tests. The CFP Tracking Test was related to the two balance tests, but evaluates unique abilities other than balance ability.

Postural stability during one-leg stance on an unstable moving platform and its relationship with each leg.

This study examined the laterality of the supporting leg in postural stability during a one-leg stance test on an unstable moving platform and its practice effect. 30 male university students were evaluated using the omnidirection stability index (OSI) during a one-leg stance test on an unstable moving platform (three trials). The leg used when kicking a ball was defined as the manipulation leg (ML) and the supporting leg was defined as the non-manipulation leg (NML). According to the two-way repeated measures analysis of variance (ANOVA; trials x legs), a statistically significant difference was observed only on the leg factor, and OSI values of the second and third trials were less for the ML than the NML. The correlation between both legs was statistically significant but not high. The ML was superior to NML with regard to stability, and no practice effect with trials was evident in either leg.

Analysis of postural stability using foam posturography in patients with persistent postural-perceptual dizziness.

BACKGROUND/OBJECTIVE: Persistent postural-perceptual dizziness (PPPD) is worsened in a standing posture, or by body movement, or visual stimulation. We aimed to evaluate postural stability in PPPD patients using foam posturography and to investigate the dependence on visual and somatosensory input in the standing posture. METHODS: Foam posturography was performed on 53 PPPD patients, and data from the PPPD patients were compared with the data from an age- and sex-matched healthy controls. The PPPD patients were divided into four groups based on the findings of vestibular function tests and the effect of vestibular function on posturographic data was examined. RESULTS: Romberg's ratios were significantly higher in PPPD patients than in controls. The median Romberg's ratios in PPPD patients with normal vestibular function were also higher than those in controls. However, foam ratio was significantly lower in PPPD patients than in controls. The median foam ratios in PPPD patients with vestibular dysfunction were also lower than those in controls. CONCLUSIONS: In a standing posture, PPPD patients may be more dependent on visual input and less dependent on somatosensory input than healthy subjects. Higher dependence on visual and lower dependence on somatosensory input in PPPD may be a feature unaffected by vestibular function.

Effect of L-ornithine hydrochloride ingestion on intermittent maximal anaerobic cycle ergometer performance and fatigue recovery after exercise.

L-Ornithine plays an important role in ammonia metabolism via the urea cycle. This study aimed to examine the effect of L-ornithine hydrochloride ingestion on ammonia metabolism and performance after intermittent maximal anaerobic cycle ergometer exercise. Ten healthy young adults (age, 23.8 ± 3.9 year; height, 172.3 ± 5.5 cm; body mass, 67.7 ± 6.1 kg) with regular training experience ingested L-ornithine hydrochloride (0.1 g/kg, body mass) or placebo after 30 s of maximal cycling exercise. Five sets of the same maximal cycling exercise were conducted 60 min after ingestion, and maximal cycling exercise was conducted after a 15 min rest. The intensity of cycling exercise was based on each subject's body mass (0.74 N kg(-1)). Work volume (watt), peak rpm (rpm) before and after intermittent maximal ergometer exercise and the following serum parameters were measured before ingestion, immediately after exercise and 15 min after exercise: ornithine, ammonia, urea, lactic acid and glutamate. Peak rpm was significantly greater with L-ornithine hydrochloride ingestion than with placebo ingestion. Serum ornithine level was significantly greater with L-ornithine hydrochloride ingestion than with placebo ingestion immediately and 15 min after intermittent maximal cycle ergometer exercise. In conclusion, although maximal anaerobic performance may be improved by L-ornithine hydrochloride ingestion before intermittent maximal anaerobic cycle ergometer exercise, the above may not depend on increase of ammonia metabolism with L-ornithine hydrochloride.

Different step-over movement strategies for disturbance stimulations.

This study examined differences in performance when 10 healthy adult participants took steps under three different disturbance stimulations (with opened and closed eyes and with the use of light), with and without an obstacle present. In the voluntary condition, participants recognized the obstacle beforehand and stepped over it quickly; in the light condition, participants recognized the obstacle beforehand and quickly stepped over it after light stimulation; in the closed eyes condition, participants did not recognize the obstacle beforehand, but after opening their eyes when hearing a sound, they quickly stepped over the obstacle. The swing time of the gait was significantly longer in obstacle conditions for all stimulations. The swing time was significantly longer under the closed eyes condition than the light and voluntary conditions. The clearances were significantly higher in order of the closed eyes, light, and voluntary conditions in the presence of an obstacle.

Proposal for a new body sway evaluation method.

This study is aimed at examining body sway factors for 1107 healthy people aged 16 to 69 years and to propose a practical body sway evaluation method. The center of foot pressure measurement was carried out twice for 1 min. with a 1-min. rest. 30 parameters with high reliability selected from 6 domains (distance, distribution of amplitude, area, velocity, power spectrum, and body sway vector) were summarized objectively into 4 body sway factors (unit time sway, front-back sway, left-right sway, and high frequency band power). Factor scores were calculated by the estimate equation and the total standard scores of parameters with high factor loadings. Considering this result, a total standard score for each factor was classified into 4 percentile categories based on percentile rank. Using this classification criteria, body sway scores for each individual were classified into any of the above 4 domains for each factor. It was confirmed that young adults mainly belong to percentile Categories A and B and the elderly mainly belong to percentile Categories C and D. It was found that a great effect on body sway occurred when an individual's conscious condition changed (contracting a cold or after exercise). In conclusion, the body sway of healthy people can be explained by these 4 sway factors. An evaluation of the body sway pattern using the 4 sway factors may enable us to concretely understand individuals' disorders and abnormal states in addition to changes in body sway that occur with aging.

Different gripping intervals in reproducibility of force-decreasing curve and muscle oxygenation kinetics during sustained maximal gripping.

The purpose was to examine the properties and reproducibility of the force-decreasing curve and muscle-oxygenation kinetics measured by near infrared spectroscopy in sustained isometric grip and rhythmic repeated grip measurements using various contraction intervals (2 to 5 sec.). 10 healthy young adults performed both grip tests for 6 min., during which muscle-oxygenation kinetics were measured. The intraclass correlation coefficients of the time to reach the minimum value for oxygenated hemoglobin and myoglobin tended to become lower with longer relaxation time, especially over a 3-sec. interval. Although blood-flow obstruction closely influences the initial decreasing grip force during both grip tests with a 2-sec. interval, the decreasing grip force during rhythmic repeated gripping with over a 3-sec. interval is low. Hence, the physiological mechanism related to rhythmic repeated grip with over a 3-sec. interval may differ from that related to sustained isometric grip and rhythmic repeated grip with a 2-sec. interval.

Comparison of the body-sway characteristics of young adults compared to healthy elderly and elderly with equilibrium disorder.

The study compared body-sway characteristics of 380 young adults, 342 generally healthy elderly without disequilibrium disorders, and a group of 33 elderly with disequilibrium disorders. Center of foot pressure (COP) was measured for 1 min. using an Anima's stabilometer G5500 with a data sampling frequency of 20 Hz. Four high reliability measures were used to evaluate body sway (unit time sway, front-back sway, and a left-right sway, and high frequency band power). Unit time sway, left-right sway, and high frequency band power were significantly larger for the group of elderly with disequilibrium disorders, and smaller for the healthy elderly people and young adults, in that order. Front-back sway was significantly larger in the elderly with disequilibrium disorders and healthy elderly than in young adults. The elderly with disequilibrium disorders had a larger and faster sway than young adults as well as the healthy elderly, particularly in the left-right direction. It appears aging was specifically associated with larger influence on the front-back sway.

Accuracy of simple predictive equations for visceral fat area after 8 weeks of training.

We previously proposed two predictive equations of visceral fat area applicable in a field setting (Demura & Sato, 2007a, 2007b). One uses the fat mass of the trunk measured by bioelectrical impedance as the main predictor (equation 1) and the other uses internal fat mass estimated from several anthropometric variables (equation 2). In this study, we examined the inter- and intra-individual accuracy of estimated values using these equations after 8 weeks of exercise training. Participants were 42 Japanese adults aged 42.7 +/- 10.3 years (22 males, 20 females). Visceral fat area, body composition, and blood biochemistry were measured at baseline and after 8 weeks. There were no significant differences in reference visceral fat area measured by computed tomography and visceral fat area predicted by the equations either at baseline or after 8 weeks, and the values were highly consistent (equation 1: baseline R(2) = 0.829, after R(2) = 0.860; equation 2: baseline R(2) = 0.832; after R(2) = 0.850). No significant relationship was observed between the reference and change in visceral fat area for equation 1 (males: r = 0.272, P > 0.05; females: r = 0.428, P > 0.05), but there was a significant relationship for females with equation 2 (males: r = 0.279, P > 0.05; females: r = 0.474, P <0.05). Our findings indicate that these equations have high inter-individual consistency but low intra-individual consistency with the reference and are of limited use for the longitudinal evaluation of visceral fat area.

Specific factors that influence deciding the takeoff leg during jumping movements.

The definition of the dominant leg (lateral dominance) is not clear, and there has been little reporting related to lateral dominance in the legs. To uncover the practical factors influencing which leg to use as the takeoff leg in 1-legged jumping movements, this study aimed to investigate the subjective dominance side of fundamental movements and to examine the lateral dominance of motor functions between the takeoff leg and non-takeoff leg. The subjects consisted of 27 young men who exercised regularly. They had not trained particularly on unilateral jumping. Fifteen men are the athlete group (left-legged jumpers group [LG]) using a left leg and 12 men are the athlete group (right-legged jumpers group [RG]) using a right leg as determined by a preliminary survey related to takeoff leg during high jump. The fundamental motions of the subjective dominant leg were investigated and the differences between the motor functions of takeoff and lead legs, such as sole shapes, single-leg vertical jump, 20-m hopping, ladder hopping, single-leg balance, and isokinetic strength were examined. It was found that many RG subjects (83%) tended to select the right leg for hopping, and many LG subjects (87%) tended to select the left leg for 1-legged balance. It was suggested that skilled movements show right-leg dominance in both takeoff leg groups. In the LG subjects, the left leg showed a higher value than the right leg in sole shape. The RG subjects showed a higher value in the right leg than in the left leg in a single-leg vertical jump. However, marked dominance was not found in the takeoff leg. The lower limbs may not show marked lateral dominance such as in the upper limbs.

Influence of instruction conditions on the evaluation of muscular endurance based on muscle oxygenation.

Proper instruction is essential for evaluating muscular endurance with high reliability. This study aimed to examine the influence of instruction conditions on the evaluation of rhythmic repeated muscular endurance based on muscle oxygenation kinetics. Fifteen healthy young men performed repeated maximal rhythmic grips for 6 minutes under the following 3 instruction conditions: (1) "Squeeze as hard as you can during 2 seconds freely (Ex1)"; (2) "Squeeze as hard as you can quickly at the cue of a beep every 2 seconds (Ex2)"; and (3) "Squeeze as hard as you can quickly at the cue of a beep every 2 seconds, and then hold the exertion for 1 second (Ex3)". In the start phase of measurement during which larger exertion (above 80% maximal voluntary grip contraction) of grip strength is possible, the exertion values and muscle oxygenation kinetics were not significantly different among the 3 instruction conditions. However, a significant difference was found in muscle oxygenation kinetics after the middle phase (3 minutes) of measurement and also in the peak forces. Particularly, oxygen supply to the skeletal muscle as compared with oxygen consumption was greater in Ex2 than in Ex3. This study found that the evaluated muscle endurance differs considerably under various instruction conditions. The following instruction may be useful in the assessment of muscular endurance: "Squeeze as hard as you can quickly at the cue of a beep and then immediately relax". The present findings suggest that proper instructions are essential in various physical function tests and in the dynamometer handgrip test for occupational therapists and strength and conditioning professionals to obtain accurate measurements.

Examination of useful items for the assessment of fall risk in the community-dwelling elderly Japanese population.

OBJECTIVES: The aim of this study was to select useful items for assessing fall risk in healthy elderly Japanese individuals. METHODS: A total of 965 healthy elderly Japanese subjects aged ≥60 years (349 males 70.4 ± 7.1 years, 616 females 69.9 ± 7.1 years) participated in this study. Of these, 16.6% had suffered from a previous fall. We assumed five fall risk factors: symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character. Eighty-six items were selected to represent these factors. To confirm the component items for each risk factor, we performed factor analysis (principle factor solution and varimax rotation). The high-fall risk response rate was also calculated for each item, and significant differences in this rate were examined between groups of those who had and not had experienced a fall. RESULTS: Useful items were selected using the following criteria: (1) items showing a significant difference in high fall risk response rate between faller and non-faller groups were selected as useful items; (2) items showing low factor loading (<0.4) for any factor were deleted as inappropriate items; (3) the top two items showing a greater amount of the difference in high fall risk response rate among the representative items for each factor. A total of 50 items were selected from each fall risk factor (symptoms of falling, 3 items; physical function, 22 items; disease and physical symptom, 13 items; environment, 4 items; behavior and character, 8 items). CONCLUSIONS: Based on our results, the selected items can comprehensively assess the fall risk of a healthy elderly Japanese population. In addition, the assessment items for physical function comprised items of different levels of difficulty, and these are able to gradually and comprehensively assess physical function.

Reproducibility of controlled force exertion measurements computed by a quasi-random target-pursuit system.

The reproducibility of measurements and measurement error of controlled force exertion was examined based on target-pursuit of quasi-random waveforms. 30 college students were required to match their grip strength to a changing demand value appearing on the display of a personal computer using visual images in the form of four different quasi-random waveforms. The variable was the sum of the differences over time between the demand value and produced grip strength. Intraclass correlation coefficients (ICCs) for measurements one day apart were low or moderate for quasi-random waveform displays, with mean frequencies of 0.01, 0.05, 0.07, and 0.09 Hz (ICCs= .37, .73, .57, and .57, respectively). Measurements at a 1-wk. interval showed statistically significant improvements in performance at all quasi-random waveform frequencies. The total error between test and retest, and the systematic error between tests, remained relatively small as mean frequency increased. Tests that use the quasi-random waveform displays of 0.05 Hz and over can be useful in documenting controlled force exertion.