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Muehlbauer, T, Gollhofer, A, and Granacher, U. Association of balance, strength, and power measures in young adults. J Strength Cond Res 27(3): 582-589, 2013-The purpose of this study was to investigate the relationship between variables of static/dynamic balance, isometric strength, and power. Twenty-seven young healthy adults (mean age: 23 6 4 years) performed measurements of static (unperturbed)/dynamic (perturbed) balance, isometric strength (i.e., maximal isometric torque [MIT]; rate of torque development [RTD] of the plantar flexor), and power (i.e., countermovement jump [CMJ] height and power). No significant associations were found between variables of static and dynamic balance (r = -0.090 to + 0.329, p > 0.05) and between measures of static/dynamic balance and isometric strength (r = +0.041 to +0.387, p > 0.05) and static/dynamic balance and power (r = -0.076 to + 0.218, p > 0.05). Significant positive correlations (r) were detected between variables of power and isometric strength ranging from +0.458 to +0.689 (p, 0.05). Furthermore, simple regression analyses revealed that a 10% increase in mean CMJ height (4.1 cm) was associated with 22.9 N.m and 128.4 N.m.s(-1) better MIT and RTD, respectively. The nonsignificant correlation between static and dynamic balance measures and between static/dynamic balance, isometric strength, and power variables implies that these capacities may be independent of each other and may have to be tested and trained complementarily.
Maintaining and increasing walking speed in old age is clinically important because this activity of daily living predicts functional and clinical state. We reviewed evidence for the biomechanical mechanisms of how strength and power training increase gait speed in old adults. A systematic search yielded only four studies that reported changes in selected gait biomechanical variables after an intervention. A secondary analysis of 20 studies revealed an association of r(2) = 0.21 between the 22% and 12% increase, respectively, in quadriceps strength and gait velocity in 815 individuals age 72. In 6 studies, there was a correlation of r(2) = 0.16 between the 19% and 9% gains in plantarflexion strength and gait speed in 240 old volunteers age 75. In 8 studies, there was zero association between the 35% and 13% gains in leg mechanical power and gait speed in 150 old adults age 73. To increase the efficacy of intervention studies designed to improve gait speed and other critical mobility functions in old adults, there is a need for a paradigm shift from conventional (clinical) outcome assessments to more sophisticated biomechanical analyses that examine joint kinematics, kinetics, energetics, muscle-tendon function, and musculoskeletal modeling before and after interventions.
There is growing evidence that aging and muscle fatigue result in impaired postural reflexes in humans. Therefore, the objective of this study was to examine the effects of ankle fatigue on functional reflex activity (ERA) during gait perturbations in young and elderly men. Twenty-eight young (27.0 +/- 3.1 years, n = 14) and old (67.2 +/- 3.7 years, n = 14) healthy active men participated in this study. Fatigue of the plantarflexors and dorsiflexors was induced by isokinetic contractions. Pre and post-fatigue, subjects were tested for their ability to compensate for decelerating gait perturbations while walking on a treadmill. Latency, ERA of lower extremity muscles and angular velocity of the ankle joint complex were analysed by means of surface electromyography and goniometry. After the fatigue protocol, no significant main and interaction effects were detected for the parameter latency in m. tibialis anterior (TA). For both groups, a significant pre to post-test decrease in ERA in TA (P<.001) was observed coming along with increases in antagonist coactivity (P=.013) and maximal angular velocity of the ankle joint (p=.007). However, no significant group x test interactions were found for the three parameters. Ankle fatigue has an impact on the ability to compensate for gait perturbations in young and elderly adults. However, no significant differences in all analysed parameters were detected between young and elderly subjects. These results may imply that age-related deteriorations in the postural control system do not specifically affect the ability to compensate for gait perturbations under fatigued condition.
Background The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults.
Objective The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors.
Data Sources A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013).
Study Selection A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review.
Study Appraisal and Synthesis Methods Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)].
Results The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 %, mean effect size = 0.99; mean balance/functional performance gain = 23 %, mean ES = 0.88) and by PET (mean strength gain = 12 %, mean ES = 0.52; mean balance/functional performance gain = 18 %, mean ES = 0.71).
Limitations Given that the mean PEDro quality score did not reach the predetermined cut-off of >= 6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population.
Conclusions Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.
Background: The contractile history of a muscle or a muscle group can result in an acute enhancement of subsequent muscle force output. This phenomenon is referred to as postactivation potentiation (PAP) and it was frequently substantiated in original research manuscripts, systematic literature reviews, and meta-analyses. However, there is a lack in the literature regarding precise dose-response relations. This literature review describes the main determinants of PAP effects and additionally presents the state of the art regarding the acute effects of PAP protocols on measures of strength, power, and speed in subelite and elite athletes of different sport disciplines. Furthermore, an attempt is made to demonstrate evidence-based information concerning the design of effective PAP protocols.
Methods: Our literature search included the electronic databases Pubmed, SportDiscus, and Google Scholar (1995 - March 2013). In total, 23 studies met the inclusionary criteria for review.
Results: Findings from our literature review indicate that various conditioning activities produce acute PAP effects in subelite and particularly elite athletes. More specifically, conditioning activities that are characterised by multiple sets, moderate to high intensities (60 - 84 % of the one repetition maximum), and rest intervals of 7 - 10 min. following the conditioning activity have the potential to induce short-term improvements in muscle force output and sports performance.
Conclusion: It is recommended that subelite and particularly elite athletes from strength, power, and speed disciplines apply specifically tailored conditioning activities during the acute preparation process for competition to induce performance enhancing PAP effects.
Background: Therapeutic climbing exercises are employed for the treatment of shoulder-and knee-joint injuries. However, there is a void in the literature regarding muscle activation levels during the performance of these exercises. Thus, the purpose of this study was to investigate differences in muscle activation during therapeutic climbing exercises depending on the degree of task difficulty.
Participants/Material and Methods: A sample of 10 healthy subjects (sex: 4 females, 6 males; age: 27 +/- 3 years; climbing experience: 5 +/- 3 years) performed three shoulder girdle (i.e., wide shoulder pull, narrow shoulder pull, shoulder row) and two leg extensor (i.e., ascending frontal, ascending sidewards) exercises. Electromyographic (EMG) data were recorded on the right side for eleven muscles and then normalised using the maximum voluntary contractions for each muscle.
Results: With increasing task difficulty, muscle activity in all but one muscle (i.e., m. trapezius ascendens) increased significantly for the three shoulder girdle exercises. For the two leg extensor exercises, an increase in task difficulty produced a tendency towards yet not significantly higher muscle activity.
Conclusion: Shoulder row was the most effective therapeutic climbing exercise in the ability to activate muscles while showing the highest EMG signals. The absence of significant differences in muscle activity between the two leg extensor exercises indicates their equivalent use for muscle activation during therapy.
Age-related processes in the neuromuscular and the somatosensory system are responsible for decreases in maximal and explosive force production capacity and deficits in postural control. Thus, the objectives of this study were to investigate the effects of resistance training on strength performance and on postural control in seniors. Forty healthy seniors (67 +/- 1 yrs) participated in this study. Subjects were randomly assigned to a resistance training (n = 20) and a control group (n = 20). Resistance training for the lower extremities lasted for 13 weeks at 80% of the one repetition maximum. Pre and post tests included the measurement of maximal isometric leg extension force with special emphasis on the early part of the force-time-curve and the assessment of static (functional reach test) and dynamic (tandem walk test, platform perturbation) postural control. Resistance training resulted I in an enhanced strength performance with increases I in explosive force exceeding those in maximal strength. Improved performances in the functional reach and in the tandem walk test were observed. Resistance training did not have an effect: on the compensation of platform perturbations. Increases in strength performance can primarily be explained by an improved neural drive of the agonist muscles. The inconsistent effect of resistance training on postural control may be explained by heterogeneity of testing methodology or by the incapability of isolated resisiance training to improve postural control.
Background: With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested.
Methods/Design: Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale -International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version (` 3 times 3') that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period.
Discussion: It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose-response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention.
The purpose of this study was to investigate the effects of surface instability on measures of performance and activity of leg and trunk muscles during drop jumps and landings.
Drop jumps and landings were assessed on a force plate under stable and unstable (balance pad on top of the force plate) conditions. Performance measures (contact time, jump height, peak ground reaction force) and electromyographic (EMG) activity of leg and trunk muscles were tested in 27 subjects (age 23 +/- A 3 years) during different time intervals (preactivation phase, braking phase, push-off phase).
The performance of drop jumps under unstable compared to stable conditions produced a decrease in jump height (9 %, p < 0.001, f = 0.92) and an increase in peak ground reaction force (5 %, p = 0.022, f = 0.72), and time for braking phase (12 %, p < 0.001, f = 1.25). When performing drop jumps on unstable compared to stable surfaces, muscle activity was reduced in the lower extremities during the preactivation, braking and push-off phases (11-25 %, p < 0.05, 0.48 a parts per thousand currency sign f a parts per thousand currency sign 1.23). Additionally, when landing on unstable compared to stable conditions, reduced lower limb muscle activities were observed during the preactivation phase (7-60 %, p < 0.05, 0.50 a parts per thousand currency sign f a parts per thousand currency sign 3.62). Trunk muscle activity did not significantly differ between the test conditions for both jumping and landing tasks.
The present findings indicate that modified feedforward mechanisms in terms of lower leg muscle activities during the preactivation phase and/or possible alterations in leg muscle activity shortly after ground contact (i.e., braking phase) are responsible for performance decrements during jumping on unstable surfaces.
Deficiencies in balance and strength are common in children and they may lead to injuries. This study investigated the effects of inline skating exercise on balance and strength performance in healthy children. Twenty 11-12-year-old children (8 girls, 12 boys) were assigned to an intervention (n = 10) or a control (n = 10) group. Participants in the intervention group underwent a 4-week inline skating program (2 times/week, 90 min. each) integrated in their physical education lessons. Balance and strength were measured using the Star Excursion Balance test and the countermovement jump test. As compared to the control group, the intervention group significantly improved balance (17-48%, Cohen's d = 0.00-1.49) and jump height (8%, Cohen's d = 0.48). In children, inline skating is a safe, feasible (90% adherence rate), and effective program that can be integrated in physical education lessons to promote balance and strength.