Key points Elderly individuals require a prolonged recovery phase in order to return to initial m... more Key points Elderly individuals require a prolonged recovery phase in order to return to initial muscle mass levels following short‐term immobilisation. The cellular mechanisms responsible for the attenuated re‐growth and associated molecular signalling processes in ageing human skeletal muscle are not fully understood. The main study finding was the observation of a less marked muscle mass recovery after immobilisation in elderly compared to young individuals that was paralleled by an elevation in myogenic precursor cell content in young individuals only, whereas the elderly failed to demonstrate any change in myogenic precursor cells. No age‐related differences were observed in the expression of major myogenic regulating factors known to promote skeletal muscle hypertrophy or satellite cell proliferation (IGF‐1Ea, MGF, MyoD1, myogenin, HGF gene products). In contrast, the expression of myostatin demonstrated a more pronounced up‐regulation following immobilisation along with an att...
Background The incidence of colorectal cancer (CRC) increases with age. Older patients are a hete... more Background The incidence of colorectal cancer (CRC) increases with age. Older patients are a heterogeneous group ranging from fit to frail with various comorbidities. Frail older patients with CRC are at increased risk of negative outcomes and functional decline after cancer surgery compared to younger and fit older patients. Maintenance of independence after treatment is rarely investigated in clinical trials despite older patients value it as high as survival. Comprehensive geriatric assessment (CGA) is an evaluation of an older persons’ medical, psychosocial, and functional capabilities to develop an overall plan for treatment and follow-up. The beneficial effect of CGA is well documented in the fields of medicine and orthopaedic surgery, but evidence is lacking in cancer surgery. We aim to investigate the effect of CGA on physical performance in older frail patients undergoing surgery for CRC. Methods GEPOC is a single centre randomised controlled trial including older patients ...
A validated, standardized, and feasible test to assess muscle power in older adults has recently ... more A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit‐to‐stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut‐off points, and minimal clinically important differences (MCID) for STS power measures in older women and men.
American Journal of Physiology-Gastrointestinal and Liver Physiology, 2021
Sarcopenia increases mortality in patients with end-stage liver disease. We show that arm lean ma... more Sarcopenia increases mortality in patients with end-stage liver disease. We show that arm lean mass determined by dual-energy X-ray absorptiometry is a better marker than the traditional appendicular skeletal muscle mass when predicting sarcopenia-related mortality in patients with cirrhosis of different severity. The findings add to the dispute about the optimal method for repeated assessments of skeletal muscle status in patients with cirrhosis and may have implications for clinical decision making.
American journal of obstetrics and gynecology, Jan 23, 2016
Menopause is associated with increased risk of cardiovascular disease and the causal factors have... more Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors contribute to the deterioration of cardiometabolic health in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardiometabolic adaptations to exercise in postmenopausal women add to the adverse health profile. We sought to evaluate risk factors for type 2 diabetes and cardiovascular disease in late premenopausal and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training. A 3-month high-intensity aerobic training intervention, involving healthy, nonobese, late premenopausal (n = 40) and early postmenopausal (n = 39) women was conducted and anthropometrics, body composition, blood pressure, lipid profile, glucos...
Single Muscle Fiber Characteristics of The Oldest-Old Gregory Grosicki, Robert Standley, Kevin Mu... more Single Muscle Fiber Characteristics of The Oldest-Old Gregory Grosicki, Robert Standley, Kevin Murach, Ulrika Raue, Kiril Minchev, Paul Coen, Anne Newman, Steven Cummings, Tamara Harris, Stephen Kritchevsky, Bret Goodpaster, Scott Trappe, FACSM. Ball State University, Muncie, IN. Translational Research Institute for Metabolism and Diabetes, Orlando, FL. University of Pittsburgh, Pittsburgh, PA. California Pacific Medical Center Research Institute, San Francisco, CA. National Institute on Aging, Bethesda, MD. Wake Forest School of Medicine, Winston-Salem, NC. (Sponsor: Scott Trappe, FACSM) Email: gjgrosicki@gmail.com
A decline in physical capacity takes place with increasing age that negatively affects overall ph... more A decline in physical capacity takes place with increasing age that negatively affects overall physical function including work ability and the ability to perform typical activities of daily living (ADL). The overall aim of the present study was to determine the neuromuscular adaptations to long-term (1 year) football and strength training in older untrained adults, and to assess the concurrent effect on functional ADL capacity. Twenty-seven healthy elderly males (68.2 ± 3.2 years) were randomly assigned to 12 months of either recreational football training (FT: n = 10), strength training (ST: n = 9) or served as inactive controls (CON: n = 8). Recreational football training consisted of small-sided training sessions whereas strength training consisted of high intensity exercises targeting the lower extremity and upper body. Maximal thigh muscle strength and rate of force development (RFD) were assessed with isokinetic dynamometry, while postural balance and vertical jumping performance were evaluated using force plate analysis. Furthermore, functional ability was evaluated by stair-ascent and chair-rising testing. A total of nine, nine and seven participants from FT, ST and CON, respectively, were included in the analysis. Both exercise regimens led to substantial gains in functional ability, evidenced by 24 and 18 % reduced stair-ascent time, and 32 and 21 % increased chair-rising performance in FT and ST, respectively (all P < 0.05). Long-term strength training led to increased concentric (14 %; P < 0.01) and isometric (23 %; P < 0.001) quadriceps and isometric hamstring strength (44 %; P < 0.0001), whereas football training mainly resulted in enhanced hamstring strength (18 %, P < 0.05) and RFD (89 %, P < 0.0001). Long-term (1 year) strength training led to increased quadriceps and hamstring strength, whereas the adaptations to football training mainly included enhanced strength and rapid force capacity of the hamstring muscles. Gains in functional ability were observed in response to both training regimens, evidenced by reduced stair-ascent time and increased chair-rising performance. Long-term football exercise and strength training both appear to be effective interventional strategies to improve factors of importance for ADL by counteracting the age-related decline in lower limb strength and functional capacity among old male adults. This could potentially be a way to improve work ability of senior workers.
The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nev... more The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nevertheless, older people have an increased risk of loss of muscle mass and strength and disability post surgery compared to younger adults. Consequently, attempts to counteract these problems seem highly relevant. The number of studies on the effect of perioperative training is still limited. However, there is increasing evidence that strength training commenced early post surgery is safe and effective in regard to restore muscle function in older patients going through acute or elective surgery.
Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally ... more Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally diagnosed and classified according to the American College of Rheumatology criteria, which do not include findings on imaging modalities. We present a case in which non-invasive imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography gave essential information in the diagnostic work-up of large vessel vasculitis in a female presenting with non-specific symptoms. We discuss the role of nuclear medicine imaging in early diagnosis and follow-up of this inflammatory disease, characterized by granulomatous panarteritis of the aorta and its major branches.
Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employee... more Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size, and hypothesized that females with myalgia compared with matched healthy controls have a higher percentage of grossly hypertrophied type I fibers with poor capillarization. Forty-two female office workers with trapezius myalgia (MYA) and 20 healthy matched controls (CON) participated in the study. Standard histochemical methods were used to determine fiber size, fiber type, and capillarization. Type I megafiber were defined as at least twice the size of the median type I fiber size of each individual. The main finding was that MYA had a significantly higher proportion of type I megafibers than CON, in spite of no significant difference in overall type I fiber size. In MYA and CON type I megafibers were located in 46% and 11% of the females, respectively. Capillarization of the overall type I fiber pool was not different between CON and MYA, but was significantly lower in type I megafibers of both groups. The percentage of megafibers was positively related to age and weekly working hours, indicating an effect of long-term exposure. In conclusion, this study shows that trapezius myalgia is associated with a significantly higher percentage of grossly hypertrophied type I muscle fibers with poor capillarization - type I megafibers.
Acute muscle protein metabolism is modulated not only by resistance exercise but also by amino ac... more Acute muscle protein metabolism is modulated not only by resistance exercise but also by amino acids. However, less is known about the long-term hypertrophic effect of protein supplementation in combination with resistance training. The present study was designed to compare the effect of 14 weeks of resistance training combined with timed ingestion of isoenergetic protein vs carbohydrate supplementation on muscle fiber hypertrophy and mechanical muscle performance. Supplementation was administered before and immediately after each training bout and, in addition, in the morning on nontraining days. Muscle biopsy specimens were obtained from the vastus lateralis muscle and analyzed for muscle fiber cross-sectional area. Squat jump and countermovement jump were performed on a force platform to determine vertical jump height. Peak torque during slow (30 degrees s-1) and fast (240 degrees s-1) concentric and eccentric contractions of the knee extensor muscle was measured in an isokinetic dynamometer. After 14 weeks of resistance training, the protein group showed hypertrophy of type I (18% +/- 5%; P < .01) and type II (26% +/- 5%; P < .01) muscle fibers, whereas no change above baseline occurred in the carbohydrate group. Squat jump height increased only in the protein group, whereas countermovement jump height and peak torque during slow isokinetic muscle contraction increased similarly in both groups. In conclusion, a minor advantage of protein supplementation over carbohydrate supplementation during resistance training on mechanical muscle function was found. However, the present results may have relevance for individuals who are particularly interested in gaining muscle size.
Key points Elderly individuals require a prolonged recovery phase in order to return to initial m... more Key points Elderly individuals require a prolonged recovery phase in order to return to initial muscle mass levels following short‐term immobilisation. The cellular mechanisms responsible for the attenuated re‐growth and associated molecular signalling processes in ageing human skeletal muscle are not fully understood. The main study finding was the observation of a less marked muscle mass recovery after immobilisation in elderly compared to young individuals that was paralleled by an elevation in myogenic precursor cell content in young individuals only, whereas the elderly failed to demonstrate any change in myogenic precursor cells. No age‐related differences were observed in the expression of major myogenic regulating factors known to promote skeletal muscle hypertrophy or satellite cell proliferation (IGF‐1Ea, MGF, MyoD1, myogenin, HGF gene products). In contrast, the expression of myostatin demonstrated a more pronounced up‐regulation following immobilisation along with an att...
Background The incidence of colorectal cancer (CRC) increases with age. Older patients are a hete... more Background The incidence of colorectal cancer (CRC) increases with age. Older patients are a heterogeneous group ranging from fit to frail with various comorbidities. Frail older patients with CRC are at increased risk of negative outcomes and functional decline after cancer surgery compared to younger and fit older patients. Maintenance of independence after treatment is rarely investigated in clinical trials despite older patients value it as high as survival. Comprehensive geriatric assessment (CGA) is an evaluation of an older persons’ medical, psychosocial, and functional capabilities to develop an overall plan for treatment and follow-up. The beneficial effect of CGA is well documented in the fields of medicine and orthopaedic surgery, but evidence is lacking in cancer surgery. We aim to investigate the effect of CGA on physical performance in older frail patients undergoing surgery for CRC. Methods GEPOC is a single centre randomised controlled trial including older patients ...
A validated, standardized, and feasible test to assess muscle power in older adults has recently ... more A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit‐to‐stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut‐off points, and minimal clinically important differences (MCID) for STS power measures in older women and men.
American Journal of Physiology-Gastrointestinal and Liver Physiology, 2021
Sarcopenia increases mortality in patients with end-stage liver disease. We show that arm lean ma... more Sarcopenia increases mortality in patients with end-stage liver disease. We show that arm lean mass determined by dual-energy X-ray absorptiometry is a better marker than the traditional appendicular skeletal muscle mass when predicting sarcopenia-related mortality in patients with cirrhosis of different severity. The findings add to the dispute about the optimal method for repeated assessments of skeletal muscle status in patients with cirrhosis and may have implications for clinical decision making.
American journal of obstetrics and gynecology, Jan 23, 2016
Menopause is associated with increased risk of cardiovascular disease and the causal factors have... more Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors contribute to the deterioration of cardiometabolic health in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardiometabolic adaptations to exercise in postmenopausal women add to the adverse health profile. We sought to evaluate risk factors for type 2 diabetes and cardiovascular disease in late premenopausal and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training. A 3-month high-intensity aerobic training intervention, involving healthy, nonobese, late premenopausal (n = 40) and early postmenopausal (n = 39) women was conducted and anthropometrics, body composition, blood pressure, lipid profile, glucos...
Single Muscle Fiber Characteristics of The Oldest-Old Gregory Grosicki, Robert Standley, Kevin Mu... more Single Muscle Fiber Characteristics of The Oldest-Old Gregory Grosicki, Robert Standley, Kevin Murach, Ulrika Raue, Kiril Minchev, Paul Coen, Anne Newman, Steven Cummings, Tamara Harris, Stephen Kritchevsky, Bret Goodpaster, Scott Trappe, FACSM. Ball State University, Muncie, IN. Translational Research Institute for Metabolism and Diabetes, Orlando, FL. University of Pittsburgh, Pittsburgh, PA. California Pacific Medical Center Research Institute, San Francisco, CA. National Institute on Aging, Bethesda, MD. Wake Forest School of Medicine, Winston-Salem, NC. (Sponsor: Scott Trappe, FACSM) Email: gjgrosicki@gmail.com
A decline in physical capacity takes place with increasing age that negatively affects overall ph... more A decline in physical capacity takes place with increasing age that negatively affects overall physical function including work ability and the ability to perform typical activities of daily living (ADL). The overall aim of the present study was to determine the neuromuscular adaptations to long-term (1 year) football and strength training in older untrained adults, and to assess the concurrent effect on functional ADL capacity. Twenty-seven healthy elderly males (68.2 ± 3.2 years) were randomly assigned to 12 months of either recreational football training (FT: n = 10), strength training (ST: n = 9) or served as inactive controls (CON: n = 8). Recreational football training consisted of small-sided training sessions whereas strength training consisted of high intensity exercises targeting the lower extremity and upper body. Maximal thigh muscle strength and rate of force development (RFD) were assessed with isokinetic dynamometry, while postural balance and vertical jumping performance were evaluated using force plate analysis. Furthermore, functional ability was evaluated by stair-ascent and chair-rising testing. A total of nine, nine and seven participants from FT, ST and CON, respectively, were included in the analysis. Both exercise regimens led to substantial gains in functional ability, evidenced by 24 and 18 % reduced stair-ascent time, and 32 and 21 % increased chair-rising performance in FT and ST, respectively (all P < 0.05). Long-term strength training led to increased concentric (14 %; P < 0.01) and isometric (23 %; P < 0.001) quadriceps and isometric hamstring strength (44 %; P < 0.0001), whereas football training mainly resulted in enhanced hamstring strength (18 %, P < 0.05) and RFD (89 %, P < 0.0001). Long-term (1 year) strength training led to increased quadriceps and hamstring strength, whereas the adaptations to football training mainly included enhanced strength and rapid force capacity of the hamstring muscles. Gains in functional ability were observed in response to both training regimens, evidenced by reduced stair-ascent time and increased chair-rising performance. Long-term football exercise and strength training both appear to be effective interventional strategies to improve factors of importance for ADL by counteracting the age-related decline in lower limb strength and functional capacity among old male adults. This could potentially be a way to improve work ability of senior workers.
The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nev... more The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nevertheless, older people have an increased risk of loss of muscle mass and strength and disability post surgery compared to younger adults. Consequently, attempts to counteract these problems seem highly relevant. The number of studies on the effect of perioperative training is still limited. However, there is increasing evidence that strength training commenced early post surgery is safe and effective in regard to restore muscle function in older patients going through acute or elective surgery.
Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally ... more Large vessel vasculitis, including giant cell arteritis and Takayasu arteritis, is traditionally diagnosed and classified according to the American College of Rheumatology criteria, which do not include findings on imaging modalities. We present a case in which non-invasive imaging with 18F-fluorodeoxyglucose positron emission tomography/computed tomography gave essential information in the diagnostic work-up of large vessel vasculitis in a female presenting with non-specific symptoms. We discuss the role of nuclear medicine imaging in early diagnosis and follow-up of this inflammatory disease, characterized by granulomatous panarteritis of the aorta and its major branches.
Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employee... more Trapezius myalgia - chronic pain from the upper trapezius muscle - is frequent in female employees in monotonous stressful jobs, potentially due to chronic overload of type I muscle fibers. In this study, we investigated the intra-individual distribution of trapezius muscle fiber size, and hypothesized that females with myalgia compared with matched healthy controls have a higher percentage of grossly hypertrophied type I fibers with poor capillarization. Forty-two female office workers with trapezius myalgia (MYA) and 20 healthy matched controls (CON) participated in the study. Standard histochemical methods were used to determine fiber size, fiber type, and capillarization. Type I megafiber were defined as at least twice the size of the median type I fiber size of each individual. The main finding was that MYA had a significantly higher proportion of type I megafibers than CON, in spite of no significant difference in overall type I fiber size. In MYA and CON type I megafibers were located in 46% and 11% of the females, respectively. Capillarization of the overall type I fiber pool was not different between CON and MYA, but was significantly lower in type I megafibers of both groups. The percentage of megafibers was positively related to age and weekly working hours, indicating an effect of long-term exposure. In conclusion, this study shows that trapezius myalgia is associated with a significantly higher percentage of grossly hypertrophied type I muscle fibers with poor capillarization - type I megafibers.
Acute muscle protein metabolism is modulated not only by resistance exercise but also by amino ac... more Acute muscle protein metabolism is modulated not only by resistance exercise but also by amino acids. However, less is known about the long-term hypertrophic effect of protein supplementation in combination with resistance training. The present study was designed to compare the effect of 14 weeks of resistance training combined with timed ingestion of isoenergetic protein vs carbohydrate supplementation on muscle fiber hypertrophy and mechanical muscle performance. Supplementation was administered before and immediately after each training bout and, in addition, in the morning on nontraining days. Muscle biopsy specimens were obtained from the vastus lateralis muscle and analyzed for muscle fiber cross-sectional area. Squat jump and countermovement jump were performed on a force platform to determine vertical jump height. Peak torque during slow (30 degrees s-1) and fast (240 degrees s-1) concentric and eccentric contractions of the knee extensor muscle was measured in an isokinetic dynamometer. After 14 weeks of resistance training, the protein group showed hypertrophy of type I (18% +/- 5%; P < .01) and type II (26% +/- 5%; P < .01) muscle fibers, whereas no change above baseline occurred in the carbohydrate group. Squat jump height increased only in the protein group, whereas countermovement jump height and peak torque during slow isokinetic muscle contraction increased similarly in both groups. In conclusion, a minor advantage of protein supplementation over carbohydrate supplementation during resistance training on mechanical muscle function was found. However, the present results may have relevance for individuals who are particularly interested in gaining muscle size.
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