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Background: Gait speed declines with increasing age, but it is unclear if gait speed preferentially correlates with leg muscle strength or mass.
Objective: We determined the relationship between gait speed and (1) leg muscle strength measured at 3 lower extremity joints and (2) leg lean tissue mass (LTM) in healthy young (age: 25 years, n = 20) and old (age: 70 years, n = 20) adults.
Methods: Subjects were tested for maximal isokinetic hip, knee, and ankle extension torque, leg LTM by bioimpedance, and gait performance (i.e., gait speed, stride length) at preferred and maximal gait speeds.
Results: We found no evidence for a preferential relationship between gait performance and leg muscle strength compared with gait performance and leg LTM in healthy young and old adults. In old adults, hip extensor strength only predicted habitual gait speed (R-2 = 0.29, p = 0.015), whereas ankle plantarflexion strength only predicted maximal gait speed and stride length (both R-2 = 0.40, p = 0.003). Conclusions: Gait speed did not preferentially correlate with leg muscle strength or leg LTM, favoring neither outcome for predicting mobility. Thus, we recommend that both leg muscle strength and leg LTM should be tested and trained complementarily. Further, hip and ankle extension torque predicted gait performance, and thus we recommend to test and train healthy old adults by functional integrated multiarticular rather than monoarticular lower extremity strength exercises.
Objectives The objective of this systematic review and meta-analysis was to quantify the effectiveness of supervised vs. unsupervised balance and/or resistance training programs on measures of balance and muscle strength/ power in healthy older adults. In addition, the impact of supervision on training-induced adaptive processes was evaluated in the form of dose-response relationships by analyzing randomized controlled trials that compared supervised with unsupervised trials. Data Sources A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SportDiscus to detect articles examining the role of supervision in balance and/or resistance training in older adults. Study Eligibility Criteria The initially identified 6041 articles were systematically screened. Studies were included if they examined balance and/or resistance training in adults aged >= 65 years with no relevant diseases and registered at least one behavioral balance (e.g., time during single leg stance) and/or muscle strength/ power outcome (e.g., time for 5-Times-Chair-Rise-Test). Finally, 11 studies were eligible for inclusion in this meta-analysis. Study Appraisal Weighted mean standardized mean differences between subjects (SMDbs) of supervised vs. unsupervised balance/resistance training studies were calculated. The included studies were coded for the following variables: number of participants, sex, age, number and type of interventions, type of balance/strength tests, and change (%) from pre- to post-intervention values. Additionally, we coded training according to the following modalities: period, frequency, volume, modalities of supervision (i.e., number of supervised/unsupervised sessions within the supervised or unsupervised training groups, respectively). Heterogeneity was computed using I 2 and chi(2) statistics. The methodological quality of the included studies was evaluated using the Physiotherapy Evidence Database scale. Results Our analyses revealed that in older adults, supervised balance/resistance training was superior compared with unsupervised balance/resistance training in improving measures of static steady-state balance (mean SMDbs = 0.28, p = 0.39), dynamic steady-state balance (mean SMDbs = 0.35, p = 0.02), proactive balance (mean SMDbs = 0.24, p = 0.05), balance test batteries (mean SMDbs = 0.53, p = 0.02), and measures of muscle strength/power (mean SMDbs = 0.51, p = 0.04). Regarding the examined dose-response relationships, our analyses showed that a number of 10-29 additional supervised sessions in the supervised training groups compared with the unsupervised training groups resulted in the largest effects for static steady-state balance (mean SMDbs = 0.35), dynamic steady-state balance (mean SMDbs = 0.37), and muscle strength/power (mean SMDbs = 1.12). Further, >= 30 additional supervised sessions in the supervised training groups were needed to produce the largest effects on proactive balance (mean SMDbs = 0.30) and balance test batteries (mean SMDbs = 0.77). Effects in favor of supervised programs were larger for studies that did not include any supervised sessions in their unsupervised programs (mean SMDbs: 0.28-1.24) compared with studies that implemented a few supervised sessions in their unsupervised programs (e.g., three supervised sessions throughout the entire intervention program; SMDbs: -0.06 to 0.41). Limitations The present findings have to be interpreted with caution because of the low number of eligible studies and the moderate methodological quality of the included studies, which is indicated by a median Physiotherapy Evidence Database scale score of 5. Furthermore, we indirectly compared dose-response relationships across studies and not from single controlled studies. Conclusions Our analyses suggest that supervised balance and/or resistance training improved measures of balance and muscle strength/power to a greater extent than unsupervised programs in older adults. Owing to the small number of available studies, we were unable to establish a clear dose-response relationship with regard to the impact of supervision. However, the positive effects of supervised training are particularly prominent when compared with completely unsupervised training programs. It is therefore recommended to include supervised sessions (i.e., two out of three sessions/week) in balance/resistance training programs to effectively improve balance and muscle strength/power in older adults.
Background
In patients with mild cognitive impairment (MCI), gait instability, particularly in dual-task situations, has been associated with impaired executive function and an increased fall risk. Ginkgo biloba extract (GBE) could be an effective mean to improve gait stability.
Aims
This study investigated the effect of GBE on spatiotemporal gait parameters of MCI patients while walking under single and dual-task conditions.
Methods
Fifty patients aged 50-85 years with MCI and associated dual-task-related gait impairment participated in this randomised, double-blind, placebo-controlled, exploratory phase IV drug trial. Intervention group (IG) patients received GBE (Symfona (R) forte 120 mg) twice-daily for 6 months while control group (CG) patients received placebo capsules. A 6-month open-label phase with identical GBE dosage followed. Gait was quantified at months 0, 3, 6 and 12.
Results
After 6 months, dual-task-related cadence increased in the IG compared to the CG (p = 0.019, d = 0.71). No significant changes, but GBE-associated numerical non-significant trends were found after 6-month treatment for dual-task-related gait velocity and stride time variability.
Discussion
Findings suggest that 120 mg of GBE twice-daily for at least 6 months may improve dual-task-related gait performance in patients with MCI.
Conclusions
The observed gait improvements add to the understanding of the self-reported unspecified improvements among MCI patients when treated with standardised GBE.
The objectives of this study were to (i) describe soccer training (e.g., volume, types), anthropometry, body composition, and physical fitness and (0 compute associations between soccer training data and relative changes of anthropometry, body composition, and physical fitness during a soccer season in female elite young athletes. Seasonal training (i.e., day-to-day training volume/types) as well as variations in anthropometry (e.g., body height/mass), body composition (e.g., lean body/fat mass), and physical fitness (e.g., muscle strength/power, speed, balance) were collected from 17 female elite young soccer players (15.3 +/- 0.5 years) over the training periods (i.e., preparation, competition, transition) of a soccer season that resulted in the German championship title in under-17 female soccer. Training volume/types, anthropometrics, body composition, and physical fitness significantly varied over a soccer season. During the two preparation periods, higher volumes in resistance and endurance training were performed (2.00 <= d <= 18.15; p < 0.05), while higher sprint and tactical training volumes were applied during the two competition periods (2.22 <= d <= 11.18; p < 0.05). Body height and lean body mass increased over the season (2.50 <= d <= 3.39; p < 0.01). In terms of physical fitness, significant performance improvements were found over the soccer season in measures of balance, endurance, and sport-specific performance (2.52 <= d <= 3.95; p < 0.05). In contrast, no statistically significant changes were observed for measures of muscle power/endurance, speed, and change-of-direction speed. Of note, variables of muscle strength (i.e., leg extensors) significantly decreased (d = 2.39: p < 0.01) over the entire season. Our period specific sub analyses revealed significant performance improvements during the first round of the season for measures of muscle power/endurance, and balance (0.89 <= d <= 4.01; p < 0.05). Moreover, change-of-direction speed significantly declined after the first round of the season, i.e., transition period (d = 2.83; p < 0.01). Additionally, significant medium-to-large associations were observed between training and anthropometrics/body composition/physical fitness (-0.541 <= r <= 0.505). Soccer training and/or growth/maturation contributed to significant variations in anthropometry, body composition, and physical fitness outcomes throughout the different training periods over the course of a soccer season in female elite young soccer players. However, changes in components of fitness were inconsistent (e.g., power, speed, strength). Thus, training volume and/or types should be carefully considered in order to develop power-, speed- or strength-related fitness measures more efficiently throughout the soccer season.
Introduction: Several sports demand an early start into long-term athlete development (LTAD) because peak performances are achieved at a relatively young age (e.g., gymnastics). However, the challenging combination of high training volumes and academic demands may impede youth athletes' cognitive and academic performances. Thus, the aims of this study were to examine the effects of a 1-year sport-specific training and/or physical education on physical fitness, body composition, cognitive and academic performances in youth athletes and their non-athletic peers. Methods: Overall, 45 prepubertal fourth graders from a German elite sport school were enrolled in this study. Participating children were either youth athletes from an elite sports class (n = 20, age 9.5 ± 0.5 years) or age-matched peers from a regular class (n = 25, age 9.6 ± 0.6 years). Over the 1-year intervention period, the elite sports class conducted physical education and sport-specific training (i.e., gymnastics, swimming, soccer, bicycle motocross [BMX]) during school time while the regular class attended physical education only. Of note, BMX is a specialized form of cycling that is performed on motocross tracks and affords high technical skills. Before and after intervention, tests were performed for the assessment of physical fitness (speed [20-m sprint], agility [star agility run], muscle power [standing long jump], flexibility [stand-and-reach], endurance [6-min-run], balance [single-leg stance]), body composition (e.g., muscle mass), cognitive (d2-test) and academic performance (reading [ELFE 1–6], writing [HSP 4–5], calculating [DEMAT 4]). In addition, grades in German, English, Mathematics, and physical education were documented. Results: At baseline, youth athletes showed better physical fitness performances (p < 0.05; d = 0.70–2.16), less relative body fat mass, more relative skeletal muscle mass (p < 0.01; d = 1.62–1.84), and similar cognitive and academic achievements compared to their non-athletic peers. Athletes' training volume amounted to 620 min/week over the 1-year period while their peers performed 155 min/week. After the intervention, significant differences were found in 6 out of 7 physical fitness tests (p < 0.05; d = 0.75–1.40) and in the physical education grades (p < 0.01; d = 2.36) in favor of the elite sports class. No significant between-group differences were found after the intervention in measures of body composition (p > 0.05; d = 0.66–0.67), cognition and academics (p > 0.05; d = 0.40–0.64). Our findings revealed no significant between-group differences in growth rate (deltas of pre-post-changes in body height and leg length). Discussion: Our results revealed that a school-based 1-year sport-specific training in combination with physical education improved physical fitness but did not negatively affect cognitive and academic performances of youth athletes compared to their non-athletic peers. It is concluded that sport-specific training in combination with physical education promotes youth athletes' physical fitness development during LTAD and does not impede their cognitive and academic development.
The integration of balance and plyometric training has been shown to provide significant improvements in sprint, jump, agility, and other performance measures in young athletes. It is not known if a specific within session balance and plyometric exercise sequence provides more effective training adaptations. The objective of the present study was to investigate the effects of using a sequence of alternating pairs of exercises versus a block (series) of all balance exercises followed by a block of plyometric exercises on components of physical fitness such as muscle strength, power, speed, agility, and balance. Twenty-six male adolescent soccer players ( 13.9 +/- 0.3 years) participated in an 8-week training program that either alternated individual balance (e. g., exercises on unstable surfaces) and plyometric (e. g., jumps, hops, rebounds) exercises or performed a block of balance exercises prior to a block of plyometric exercises within each training session. Pre- and post-training measures included proxies of strength, power, agility, sprint, and balance such as countermovement jumps, isometric back and knee extension strength, standing long jump, 10 and 30-m sprints, agility, standing stork, and Y-balance tests. Both groups exhibited significant, generally large magnitude (effect sizes) training improvements for all measures with mean performance increases of approximately > 30%. There were no significant differences between the training groups over time. The results demonstrate the effectiveness of combining balance and plyometric exercises within a training session on components of physical fitness with young adolescents. The improved performance outcomes were not significantly influenced by the within session exercise sequence.
The purpose of the present study was to examine the effects of unilateral fatigue of the knee extensors at different movement velocities on neuromuscular performance in the fatigued and non-fatigued leg. Unilateral fatigue of the knee extensors was induced in 11 healthy young men (23.7 +/- 3.8 years) at slower (60A degrees/s; FAT60) and faster movement velocities (240A degrees/s; FAT240) using an isokinetic dynamometer. A resting control (CON) condition was included. The fatigue protocols consisted of five sets of 15 maximal concentric knee extensions using the dominant leg. Before and after fatigue, peak isokinetic torque (PIT) and time to PIT (TTP) of the knee extensors as well as electromyographic (EMG) activity of vastus medialis, vastus lateralis, and biceps femoris muscles were assessed at 60 and 240A degrees/s movement velocities in the fatigued and non-fatigued leg. In the fatigued leg, significantly greater PIT decrements were observed following FAT60 and FAT240 (11-19%) compared to CON (3-4%, p = .002, d = 2.3). Further, EMG activity increased in vastus lateralis and biceps femoris muscle following FAT240 only (8-28%, 0.018 <= p <=.024, d = 1.8). In the non-fatigued leg, shorter TTP values were found after the FAT60 protocol (11-15%, p = .023, d = 2.4). No significant changes were found for EMG data in the non-fatigued leg. The present study revealed that both slower and faster velocity fatiguing contractions failed to show any evidence of cross-over fatigue on PIT. However, unilateral knee extensor fatigue protocols conducted at slower movement velocities (i.e., 60A degrees/s) appear to modulate torque production on the non-fatigued side (evident in shorter TTP values).
This study aimed at examining the effects of plyometric training on stable (SPT) vs. unstable (UPT) surfaces on physical fitness in prepuberal soccer players. Male athletes were randomly assigned to SPT (n = 18; age = 12.7 +/- 0.2 years) or UPT (n = 16; age = 12.2 +/- 0.5 years). Both groups conducted 3 regular soccer training sessions per week combined with either 2 SPT or UPT sessions. Assessment of jumping ability (countermovement jump [CMJ], and standing long jump [SLJ]), speed (10-m, 20-m, 30-m sprint), agility (Illinois agility test [IAT]), and balance (stable [SSBT], unstable [USBT] stork balance test; stable [SYBT], unstable [UYBT] Y balance test) was conducted pre-and post-training. An ANCO-VA model was used to test for between-group differences (SPT vs. UPT) at post-test using baseline values as covariates. No significant differences were found for CMJ height (p > 0.05, d = 0.54), SLJ (p > 0.05; d = 0.81), 10-m, 20-m, and 30-m sprint performances (p > 0.05, d = 0.00-0.24), IAT (p > 0.05, d = 0.48), and dynamic balance (SYBT and UYBT, both p > 0.05, d = 0.39, 0.08, respectively). Statistically significant between-group differences were detected for the USBT (p < 0.01, d = 1.86) and the SSBT (p < 0.01, d = 1.75) in favor of UPT. Following 8 weeks of SPT or UPT in prepuberal athletes, similar performance levels were observed in both groups for measures of jumping ability, speed, dynamic balance, and agility. However, if the goal is to additionally enhance static balance, UPT has an advantage over SPT.
Objectives: Postural control in elderly people is impaired by degradations of sensory, motor, and higher-level adaptive mechanisms. Here, we characterize the effects of a progressive balance training programon these postural control impairments using a brain network model based on system identification techniques. Methods and Material: We analyzed postural control of 35 healthy elderly subjects and compared findings to data from 35 healthy young volunteers. Eighteen elderly subjects performed a 10 week balance training conducted twice per week. Balance training was carried out in static and dynamic movement states, on support surfaces with different elastic compliances, under different visual conditions and motor tasks. Postural control was characterized by spontaneous sway and postural reactions to pseudorandom anterior-posterior tilts of the support surface. Data were interpreted using a parameter identification procedure based on a brain network model. Conclusion: Balance training reduced overactive proprioceptive feedback and restored vestibular orientation in elderly. Based on the assumption of a linear deterioration of postural control across the life span, the training effect can be extrapolated as a juvenescence of 10 years. This study points to a considerable benefit of a continuous balance training in elderly, even without any sensorimotor deficits.
The present study aimed to examine the effects of fatigue and surface instability on kinetic and kinematic jump performance measures. Ten female and 10 male elite volleyball players (18 +/- 2 years) performed repetitive vertical double-leg box jumps until failure. Pre and post fatigue, jump height/performance index, ground reaction force and knee flexion/valgus angles were assessed during drop and countermovement jumps on stable and unstable surfaces. Fatigue, surface condition, and sex resulted in significantly lower drop jump performance and ground reaction force (p0.031, 1.1d3.5). Additionally, drop jump knee flexion angles were significantly lower following fatigue (p=0.006, d=1.5). A significant fatiguexsurfacexsex interaction (p=0.020, d=1.2) revealed fatigue-related decrements in drop jump peak knee flexion angles under unstable conditions and in men only. Knee valgus angles were higher on unstable compared to stable surfaces during drop jumps and in females compared to males during drop and countermovement jumps (p0.054, 1.0d1.1). Significant surfacexsex interactions during countermovement jumps (p=0.002, d=1.9) indicated that knee valgus angles at onset of ground contact were significantly lower on unstable compared to stable surfaces in males but higher in females. Our findings revealed that fatigue and surface instability resulted in sex-specific knee motion strategies during jumping in elite volleyball players.