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The purpose of this study was to compare the adaptations in muscular strength, power, and landing forces of young female volleyball players enrolled in two experimental programs: one using smaller formats of the game (SFG) and the other using larger formats of the game (LFG), with a third group serving as a control. This study employed a randomized controlled design, with an 8-week intervention period and pre- and post-intervention evaluations. Fifty-six trained/developmental participants (age: 14.7 ± 0.5 years) voluntarily participated in this study. Each experimental group received additional training twice a week. The SFG group participated in 2v2 and 3v3 formats on smaller courts (covering 2/6 of the court's available zones) with a regular net, while the LFG group played in 4v4 and 5v5 formats on larger courts (covering 4/6 of the court's available zones). Assessments were conducted using force platforms and included the following tests: (i) isometric mid-thigh pull test (IMTP), measuring peak force; (ii) squat jump test (SJ), measuring peak force; (iii) countermovement jump test (CMJ), measuring peak power and landing force; and (iv) drop jump test (DJT), measuring the reactive strength index. Significant differences emerged post-intervention across all outcomes (p < 0.05). The SFG exhibited significantly greater IMTP peak force compared to both the LFG (p = 0.012) and control groups (p = 0.035). Additionally, the SFG showed significantly greater SJ peak force than the LFG (p = 0.036) and control groups (p = 0.023). Regarding CMJ peak power, significantly higher values were observed in the SFG compared to the LFG (p = 0.042) and control groups (p = 0.046). Moreover, the SFG had significantly lower CMJ peak landing force than both the LFG (p = 0.049) and control groups (p = 0.046). Finally, RSI was significantly higher in the SFG than in the LFG (p = 0.046) and control groups (p = 0.036). This study highlights the significant benefits of incorporating 2v2 and 3v3 SFG formats to enhance muscular strength, power, and landing forces in young female volleyball players, contrasting with less effective outcomes observed with 4v4 and 5v5 LFG formats, suggesting potential neuromuscular advantages crucial for improving volleyball performance., (© Journal of Sports Science and Medicine.)

Objective: To evaluate the trends in physical fitness in children and adolescents., Method: The present study focusses on a longitudinal analysis of the single two-legged jump (S2LJ) from children and adolescents, who participated in the DONALD study from 2004 till 2022. P max /body mass (power, surrogate for muscular performance), V max (bounce speed, surrogate for coordination), F max /body mass (force, surrogate for muscular strength) and V max F max / BM (Nerve-Muscle Index, surrogate for jump efficiency) were examined by linear mixed models and propensity-score(PS)-matching analysis., Results: Data from 1,485 measurements from males and 1,445 from females were included. Mean age was 10.9 years for males and 11.4 years for females. The range of the number of repeated S2LJ was 1 to 8, the median was 3. In PS-matching analysis, there was a dose-effect relationship between the test date and the S2LJ parameters in such a way that P max /body mass and F max /body mass decreased with more recent test dates (effect size at a difference in the test date of 1.7 decades: 0.25 - 0.3) whereby V max and V max F max / BM showed no consistent trend., Conclusion: Motor performance in children, assessed by the S2LJ, has decreased over the last two decades, mainly due to lower muscular strength, while motor efficiency and coordination seemed to be unchanged., Competing Interests: The authors have no conflict of interest.

Betaine supplementation, a dietary practice that possesses potential effects on exercise performance, has undergone extensive study. This study aimed to systematically review and meta-analyse betaine supplementation's effects on exercise performance. We searched PubMed, Web of Science, Scopus, and Google Scholar, focusing on studies comparing chronic betaine to a placebo in healthy humans aged 15-60 years, measuring exercise outcomes. Studies with acute betaine supplementation, no control group, or animals were excluded. Quality assessment was done using the Cochrane Risk of Bias Tool, and a random-effects model was employed for the meta-analysis. The review included 17 studies with 317 participants (21% female). The results revealed a significant effect size of 0.47 (95% CI 0.04 to 0.89) for maximal strength (1RM, 3RM, maximal isokinetic or isometric force), particularly in the lower body (SMD: 0.49, 95% CI 0.01 to 0.98). No significant effects were found for upper body strength, cycling sprint power, bench press throws power, or muscular endurance. However, vertical jumping performance improved significantly (SMD: 0.36, 95% CI 0.03 to 0.69) after excluding a low-quality study. In conclusion, betaine supplementation for at least 7 days significantly enhances muscular strength, especially lower body strength, and shows potential in improving vertical jumping performance.

Background: Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs., Objective: To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women., Methods: One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s., Results: A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05)., Conclusions: This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Muscular strength is an important component of physical fitness. We evaluated the relationship between baseline muscular strength and risk of stroke among adults who were aged ≥65 years during follow-up., Methods: We included 7627 healthy adults (mean age = 43.9 years, 86.0% male) underwent a baseline physical examination between 1980 and 1989. Muscular strength was determined by 1-repetition maximum measures for bench press and leg press and categorized into age- and sex-specific tertiles for each measure. Cardiorespiratory fitness (CRF) was assessed via a maximal treadmill exercise test. Those enrolled in fee-for-service Medicare from 1999 to 2019 were included in the analyses. Associations between baseline strength and stroke outcomes were estimated using a modified Cox proportional hazards model. In a secondary analysis, we examined stroke risk by categories of CRF where Quintile 1 = low, Quintiles 2-3 = moderate, and Quintiles 4-5 = high CRF based on age and sex., Results: After 70,072 person-years of Medicare follow-up, there were 1211 earliest indications of incident stroke. In multivariable analyses, the hazard ratio (95% confidence interval (95%CI)) for stroke across bench press categories were 1.0 (referent), 0.96 (0.83-1.11), and 0.89 (0.77-1.04), respectively (p trend = 0.14). The trend across categories of leg press was also non-significant (p trend = 0.79). Adjusted hazard ratio (95%CI) for stroke across ordered CRF categories were 1.0 (referent), 0.90 (0.71-1.13), and 0.72 (0.57-0.92) (p trend < 0.01)., Conclusion: While meeting public health guidelines for muscular strengthening activities is likely to improve muscular strength as well as many health outcomes in older adults, performing such activities may not be helpful in preventing stroke. Conversely, meeting guidelines for aerobic activity is likely to improve CRF and lower stroke risk., (Copyright © 2023. Production and hosting by Elsevier B.V.)

Softball pitchers often pitch several games within a day and over consecutive days during a competitive season. High volumes of pitches thrown can decrease muscular strength, resulting in less proximal force generation and upper extremity compensation to maintain performance. Therefore, the purpose of this study was to assess upper and lower extremity muscular strength after pitching in a simulated game. Fourteen softball pitchers (17.9 ± 2.3 years, 166.4 ± 8.7 cm, 72.2 ± 12.6 kg) completed baseline isokinetic strength assessment for knee, hip, trunk and pitching elbow flexion and extension as well as trunk rotation. Seven days later, participants pitched a simulated game consisting of 105 fastballs prior to repeating all strength assessments. Changes in muscular strength were assessed using paired samples t-tests, with significance set a priori as p ≤ 0.05. Normalised (%BW) stride leg knee extension peak torque was significantly higher (p = 0.020) post-simulated game (75.1 ± 24.6%BW) as compared to baseline (64.0 ± 19.5%BW) and trunk flexion peak torque was significantly higher (p = 0.009) post-simulated game (84.8 ± 47.0%BW) as compared to baseline (63.5 ± 47.1%BW). This study showed an increase in knee extension and trunk flexion strength after an acute bout of pitching. The findings give insight into muscular changes following pitching which can assist in appropriate softball training and recovery.

Purpose: To systematically review and meta-analyse the efficacy of resistance training on quality of life (QOL), fatigue, physical function, and muscular strength in people diagnosed with cancer undergoing chemotherapy., Methods: Electronic databases PubMed, Cochrane Central, CINAHL, SCOPUS and Web of Science were systematically searched for randomised controlled trials (RCTs) that compared the effects of resistance training to control on QOL, fatigue, physical function, and lower-body and upper-body muscular strength in adults undergoing chemotherapy. Standardised mean differences (SMDs) were pooled using a random effects model. Risk of bias was assess using the risk of bias tool for randomised trials (RoB 2)., Results: Seven RCTs encompassing 561 participants were included. The pooled results of seven RCTs showed that resistance training during chemotherapy significantly improved lower-body strength (n = 555, SMD 0.33, 95% CI 0.12 to 0.53, moderate-quality evidence, I 2  = 23%) compared to control. There was no evidence for an effect of resistance training on QOL (n = 373, SMD 0.13, 95% CI -0.15 to 0.42, low-quality evidence, I 2  = 0%), fatigue (n = 373, SMD -0.08, 95% CI -0.37 to 0.22, low-quality evidence, I 2  = 20%), physical function (n = 198, SMD 0.61, 95% CI -0.73 to 1.95, very low-quality evidence, I 2  = 83%), or upper-body strength (n = 413, SMD 0.37, 95% CI -0.07 to 0.80, very low-quality evidence, I 2  = 69%)., Conclusions: Resistance training may improve lower-body strength in patients undergoing chemotherapy treatment compared to control., (© 2024. Crown.)

(1) Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga and the Mediterranean diet on various health outcomes in community-dwelling older adults; (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults randomized to an experimental group ( n = 57) that underwent a combined yoga and Mediterranean diet program and a control group ( n = 59) that did not receive any intervention. Nutritional status was assessed using the Mini Nutritional Assessment, flexibility with the Back Scratch Test and the Chair Sit-and-Reach Test, balance, gait, and fall risk with the Tinetti Scale, and muscle strength with a dynamometer and the 30 s Chair Stand Test; (3) Results: Regarding nutritional status, there were significant differences between the experimental group and the control group (Cohen's d = 0.02). The participants in the experimental group showed greater balance (11.12 ± 3.01 vs. 10.03 ± 2.35, Cohen's d = 0.41 and gait (7.63 ± 1.96 vs. 6.69 ± 2.50, Cohen's d = 0.44) with respect to the control group. In terms of flexibility, the experimental group showed statistically significant improvements in the right arm (Cohen's d = 0.43), left arm (Cohen's d = 0.64), right perineum (Cohen's d = 0.42), and left leg (Cohen's d = 0.37) Finally, in terms of strength, participants in the experimental group experienced statistically significant improvements in grip strength and lower body strength (Cohen's d = 0.39 and 0.81, respectively); (4) Conclusions: The study highlights the potential benefits of a 12-week intervention combining yoga with a Mediterranean diet to improve the health and functional capacities of community-dwelling older adults.

Weaker hamstrings muscular forces and lower ratio of the hamstrings/quadriceps muscular forces in female athletes have been identified as modifiable risk factors for anterior cruciate ligament (ACL) injuries. However, sex differences in athletes' ability to react to visual cues (Choice Visual-Motor Reaction Time: VMRT) and to generate knee muscular forces (rate of force development: RFD) immediately following the visual cues were largely unknown. Therefore, the purpose of the study was to examine sex differences in Choice VMRT and RFD. A total of 50 high school basketball athletes (26F/24 M) participated in the study. Subjects sat in the knee dynamometer chair with their knee secured at 70° of knee flexion and performed knee extension or flexion maximum voluntary isometric contractions immediately after they saw the visual cue: "UP" or "DOWN" arrows, respectively. Choice VMRT was defined as the time between the visual cue and the initiation of muscular force development (>5Newtons). RFD was calculated by dividing the changes in forces over the changes in time at four time points (0-50/100/150/200 ms). Peak muscular forces and RFD were normalized to their body mass. Average of three trials in each direction (flexion and extension) in each leg was used for statistical analyses. Females had significantly slower Choice VMRT (p < 0.001-0.027) and lower knee extension RFD at 100 ms (p = 0.005). In addition, females had significantly higher knee flexion/extension ratio than males in late RFD (150 ms and 200 ms) (p < 0.004). The current study has provided additional sensorimotor characteristics of athletes and sexes in addition to their knee muscular characteristics., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: Low muscular strength is a risk factor for current and future adverse health outcomes. However, whether levels of muscular strength persist, or track, and if there are distinct muscular strength trajectories across the life course is unclear. This study aimed to explore muscular strength trajectories between childhood and mid-adulthood., Design: Prospective longitudinal study., Methods: Childhood Determinants of Adult Health Study participants had their muscular strength (right and left handgrip, shoulder extension and flexion, and leg strength measured by hand-held, shoulder and leg-back dynamometers, and a combined strength score) assessed in childhood, young adulthood and mid-adulthood. The tracking of muscular strength was quantified between childhood and mid-adulthood (n=385) and young- and mid-adulthood (n=822). Muscular strength trajectory patterns were identified for participants who had their muscular strength assessed at least twice across the life course (n=1280)., Results: Levels of muscular strength were persistent between childhood and mid-adulthood and between young- and mid-adulthood, with the highest tracking correlations observed for the combined strength score (childhood to mid-adulthood: r=0.47, p<0.001; young- to mid-adulthood: r=0.72, p<0.001). Three trajectories of combined muscular strength were identified across the life course; participants maintained average, above average, or below average levels of combined muscular strength., Conclusions: Weak children are likely to become weak adults in midlife unless strategies aimed at increasing muscular strength levels are introduced. Whether interventions aimed at increasing muscular strength could be implemented in childhood to help establish favourable muscular strength trajectories across the life course and in turn, better future health, warrant further attention., (Copyright © 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Although animal protein is usually considered to be a more potent stimulator of muscle protein synthesis than plant protein, the effect of protein source on lean mass and muscle strength needs to be systematically reviewed. This study aimed to examine potential differences in the effect of animal vs. plant protein on lean mass and muscle strength, and the possible influence of resistance exercise training (RET) and age. The following databases were searched: PubMed, Embase, Scopus and CINAHL Plus with Full Text, and 3081 articles were screened. A total of 18 articles were selected for systematic review, of which, 16 were used for meta-analysis. Total protein intakes were generally above the recommended dietary allowance at the baseline and end of intervention. Results from the meta-analyses demonstrated that protein source did not affect changes in absolute lean mass or muscle strength. However, there was a favoring effect of animal protein on percent lean mass. RET had no influence on the results, while younger adults (<50 years) were found to gain absolute and percent lean mass with animal protein intake (weighted mean difference (WMD), 0.41 kg; 95% confidence interval (CI) 0.08 to 0.74; WMD 0.50%; 95% CI 0.00 to 1.01). Collectively, animal protein tends to be more beneficial for lean mass than plant protein, especially in younger adults.

Background: Physical fitness is an important indicator of current and future health status. This analysis examines the relationships among child-parent dyads in physical fitness measures., Data and Methods: The analysis is based on biological child-parent dyads from three cycles of the Canadian Health Measures Survey (Cycle 1: 2007 to 2009, Cycle 2: 2009 to 2011, and Cycle 5: 2016 to 2017). Physical fitness components-cardiorespiratory (CRF) (n = 615), muscular strength (n = 1,319) and flexibility (n = 1,295)-were measured at mobile examination centres using standardized fitness tests. Descriptive, correlation and regression analyses were used to examine relationships among child-parent dyads., Results: CRF (R = 0.12), muscular strength (R = 0.23) and flexibility (R = 0.22) measures were weakly correlated among child-parent dyads. Modest increases in the physical fitness levels of children were observed with increases in the fitness rating scores of their parents. According to unadjusted and adjusted regression models, CRF (p< 0.05), muscular strength (p< 0.001) and flexibility (p< 0.001) were positively associated among child-parent dyads. When examined by sex of parent and child, CRF was significantly associated in mother-son dyads only, grip strength was associated in all dyad types except father-son pairings, and flexibility was associated in mother-son and father-son pairings only., Discussion: A significant and positive association was evident in measured physical fitness among parents and children. Some variation in the presence and strength of associations existed according to child and parent sex.

The aim of this study was to analyze the relationship between muscular strength from upper and lower limbs with self-esteem among Chilean schoolchildren, drawing independent associations with body composition indicators. The sample consisted of 1078 schoolchildren. The muscular strength of the upper and lower limbs was evaluated using a digital dynamometer and long jump performance. The general strength index was calculated based on Z-score values. Rosenberg's test was used to determine the level of self-esteem of participants. Body fat and body mass index were employed as body composition indicators. Boys had significantly more upper and lower strength, and a general strength index higher than girls (11.7 vs. 10.6; 109.7 vs. 97.4; 0.19 vs. -0.24, respectively). For boys and girls combined, there were no significant associations between all muscular strength variables and self-esteem. In boys, upper and lower limb strength was positively associated with self-esteem. In girls, no association between muscular strength and self-esteem was found. In both sexes, the general strength index was not associated with self-esteem. Strategies and programs that promote mental health and muscular strength among schoolchildren, specifically in boys, are needed.

External load influences internal load in resistance training (RT). The purpose of the present study was to compare the total volume-load, perceptual and stress responses during three different RT protocols. Twelve resistance-trained men completed three different RT protocols with the back squat and bench press exercises: (1) power (POW) (5 sets of 6 repetitions at 50%1RM, 2-min of rest), (2) hypertrophy (HYP) (5 sets-to-failure at 75%1RM, 2-min of rest), and (3) strength (STR) (5 sets-to-failure at 90%1RM, 3-min of rest). Volume-load (kg × reps.), session rating of perceived exertion (sRPE), training impulse (TRIMP; reps. × sRPE), cortisol, immunoglobulin A (IgA), lactate, and creatine kinase (CK) were assessed before and/or after the sessions. HYP was the most demanding session in terms of volume-load ( p  < 0.001), TRIMP ( p  < 0.001), cortisol ( p  = 0.001), lactate ( p  < 0.001), and CK ( p  = 0.001). Despite POW exhibited a greater volume-load than STR ( p  = 0.016), the latter exhibiting a greater sRPE ( p  < 0.001), and a greater post-session CK ( p  = 0.05). However, the TRIMP of STR and POW were not statistically different (152 vs. 260 AU; p  = 0.089). These specific responses could be meditated by the presence of muscular failure. When pooling all the sessions, significant correlations were revealed among external and internal stress markers ( r  = 0.35-0.80; p  ≤ 0.05). The use of TRIMP could be recommended as a simple and valid monitoring tool which integrates into a single parameter the internal and the external loads of RT sessions.

Older adults with disease and disability are particularly vulnerable to experiencing more severe consequences of depression. The purpose of the present study is to investigate the relationship between disease comorbidities (number of disease: ND0, 1 disease: ND1 and 2 or more diseases: ND ≥ 2), hand grip strength (low HGS and high HGS), and the prevalence of depression in Korean older adults. Data from the living profiles of older people survey that was conducted by the ministry of health and welfare in Korea were utilized. Data for 6107 females and 4347 males were appropriate for statistical tests. The results demonstrated that depression was more prevalent as ND increased ( p < 0.01). In addition, HGS appeared lower as ND increased in both male ( p < 0.01) and female subjects ( p < 0.01). Furthermore, relative to ND0 and low HGS, ND0 and high HGS showed a ~65% reduction in the prevalence of depression ( p < 0.01). After adjusting for age, the prevalence of depression was reduced by ~60% in the subgroup with ND0 and high HGS relative to ND0 and low HGS ( p < 0.01). These data demonstrate that muscular strength indices such as HGS may be useful when assessing depression in older adults. Further research in this area is warranted.

Lower and upper limb maximum muscular force development is an important indicator of physical capacity. Manual muscle testing, load cell coupled with a signal conditioner, and handheld dynamometry are three widely used techniques for measuring isometric muscle strength. Recently, there is a proliferation of low-cost tools that have potential to be used to measure muscle strength. This study examined both the criterion validity, inter-day reliability and intra-day reliability of a microcontroller-based load cell amplifier for quantifying muscle strength. To do so, a low-cost microcontroller-based load cell amplifier for measuring lower and upper limb maximal voluntary isometric muscular force was compared to a commercial grade signal conditioner and to a handheld dynamometer. The results showed that the microcontroller-based load cell amplifier correlated nearly perfectly (Pearson's R-values between 0.947 to 0.992) with the commercial signal conditioner and the handheld dynamometer, and showed good to excellent association when calculating ICC scores, with values of 0.9582 [95% C.I.: 0.9297-0.9752] for inter-day reliability and of 0.9269 [95% C.I.: 0.8909-0.9533] for session one, intra-day reliability. Such results may have implications for how the evaluation of muscle strength measurement is conducted in the future, particularly for offering a commercial-like grade quality, low cost, portable and flexible option.

Objectives: This study aimed to determine if functional training with blood flow restriction (BFR) has a greater effect on muscle quality indices and performance of older men when compared to functional training without BFR., Materials and Methods: Thirty men (67.7 ± 5.8 years) were randomly assigned to one of the following three groups: functional training (FT), functional training with blood flow restriction (FTBFR), and control (C). Participants in both experimental groups trained three sessions per week for six weeks. The training program included eleven body exercises, which were performed in 2-4 sets of 10 repetitions. FTBFR group wore pneumatic cuffs on their extremities that begun with 50 % of estimated arterial occlusion pressure and increased by 10 % every 2 weeks. Before and after the intervention period, subjects completed a series of tests to assess physical performances along with changes serum muscle quality indices., Results: A significant decrease in serum C-terminal Agrin Fragment (CAF) levels were observed in FT and FTBFR groups (p ≤ 0.05). In addition, the levels of CAF in FTBFR group was significantly lower compared to control group. Moreover, the circulatory levels of N-terminal propeptide type III collagen (P3NP) were reduced significantly in FT and C groups (p ≤ 0.05) but did not statistically differ from baseline in FTBFR group (p > 0.05). These changes were accompanied by significant improvements in dynamic strength, flexibility, static, and dynamic balance in both training groups (p ≤ 0.01)., Conclusions: The finding showed greater improvements in muscle quality indices and functional performance of older men when exercises performed with BFR., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Peak oxygen uptake (VO 2peak ) remains low after lung transplantation (LTx). We evaluated the effect of high-intensity interval training (HIIT) on VO 2peak , muscular strength, health-related quality of life (HRQOL), pulmonary function, and physical function after LTx., Methods: In this randomized controlled trial, 54 participants were enrolled from 6 to 60 months after LTx. The HIIT group (n = 25) followed a supervised HIIT program, consisting of endurance and strength trainings 3 times a week for 20 weeks. The control group (n = 29) received usual care. The primary outcome was a change in VO 2peak measured by cardiopulmonary exercise testing. The secondary outcomes were changes in 1-repetition maximum (1RM) for arm press and leg press, HRQOL (36-Item Short-Form Health Survey [SF-36]), pulmonary function (forced expiratory volume in 1 sec, diffusing capacity of the lungs for carbon monoxide), and physical function (1RM in handgrip, 15-sec stair run, and 30-sec chair stand)., Results: A total of 46 participants completed the study, including 23 of 25 in the intervention group. For the primary outcome, the intention-to-treat analysis revealed a non-significant between-group difference for change in VO 2peak of 0.7 ml/(kg.min) (95% CI = ‒0.3, 1.8) (p = 0.17). The between-group differences for 1RM arm press and leg press and mental aspect of SF-36 were 4.9 kg (95% CI = ‒0.1, 9.9) (p = 0.05), 11.6 kg (95% CI = 0.1, 23.0) (p < 0.05), and 5.7 kg (95% CI = 0.9, 10.4) (p = 0.02), respectively. There were no between-group differences in pulmonary function or physical function. When excluding participants with an attendance of <70% (n = 16), the between-group difference for VO 2peak was 1.2 ml/(kg.min) (95% CI = 0.1, 2.4) (p = 0.032)., Conclusions: HIIT improved muscular strength and HRQOL but did not improve VO 2peak more than usual care after LTx. However, with acceptable adherence, HIIT appears to have beneficial effects on VO 2peak ., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

The aim of the present study was to explore the relations between muscular maximal strength indices and bone parameters (bone mineral density [BMD], hip geometry indices, and trabecular bone score [TBS]) in a group of elderly women. This study included 35 healthy elderly women whose ages range between 65 and 75 yr (68.1 ± 3.1 yr). BMD (in gram per square centimeter) was determined for each individual by dual-energy X-ray absorptiometry at the whole body, lumbar spine (L1-L4), total hip (TH), and femoral neck (FN). L1-L4 TBS and hip geometry indices were also evaluated by dual-energy X-ray absorptiometry. Maximal muscle strength of bench press (1-repetition maximum [RM] bench press), maximal muscle strength of leg press (1-RM leg press), and handgrip were measured using validated methods. 1-RM bench press was positively correlated to TH BMD (r = 0.40; p < 0.05), FN BMD (r = 0.41; p < 0.05), FN section modulus (r = 0.33; p < 0.05), and FN cross-sectional moment of inertia (r = 0.35; p < 0.05). 1-RM leg press was positively correlated to TH BMD (r = 0.50; p < 0.01), FN BMD (r = 0.35; p < 0.05), FN cross-sectional area (r = 0.38; p < 0.05), and TBS (r = 0.37; p < 0.05). Handgrip was correlated only to FN cross-sectional moment of inertia (r = 0.43; p < 0.01). This study suggests that 1-RM bench press and 1-RM leg press are positive determinants of BMD in elderly women., (Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)

Background: The primary purpose of this study was to compare the postoperative muscular strength and functional performance between early versus late bipolar hip arthroplasty (BHA) intervention for femoral neck fracture classified by the duration from the onset to surgery., Methods: Twenty-one patients who could walk at 12 months or more after BHA were enrolled into this study. We examined the muscular strength of hip flexion, extension, abduction, and knee extension of these patients. Time of one-leg standing, timed up and go test, pain grade by visual analog scale, and Barthel index were also evaluated as functional indices. We classified these patients into two groups by the duration from the onset to surgery, namely: within 3 days until BHA (early OP) and more than 4 days (late OP) to compare these indices at the latest follow-up., Results: The mean days until operation were 2.3 days in the early-OP group and 5.9 days in the late-OP group, showing a significant difference between the two groups. Muscular strength and other functional indices were also found to have no significant differences between these two groups., Conclusion: Our study suggests that the delay to operate might not severely compromise the muscular strength around the hip joint for least 1.5 years among ambulatory patients.

Background: Cirrhosis is the end-stage of progressive fibrosis, in which oxidative stress and inflammation-related pathways can modulate the cellular and tissue events involved in the pathogenesis of liver fibrosis. Dietary intake of antioxidants has been suggested to protect against oxidative damage and related clinical complications. The present study aimed to investigate the potential association of the dietary total antioxidant capacity (dTAC) with anthropometric, functional and biochemical markers, as well as the severity of the disease, in cirrhotic outpatients., Methods: Sixty-two outpatients (38 men and 24 women) with a mean (SD) age of 59.1 (9.9) years were evaluated. Dietary TAC was estimated from a food frequency questionnaire. Aetiology and severity of liver cirrhosis, lifestyle characteristics, occurrence of comorbidities and oedema, and anthropometric, functional and biochemical markers were all assessed., Results: Cirrhotic outpatients with higher dTAC also had higher values of the hand-grip strength (P = 0.029) and arm muscle area (P = 0.027). After adjusting by sex, age, smoking and alcohol intake, the addition of 1 mmol day -1 of dTAC contributed to increase 0.552 kg f -1 in hand-grip strength (P < 0.05). The addition of one mmol day -1 of dTAC contributed to an arm muscle area increase 0.565 cm 2 (P < 0.05) on average., Conclusions: The dTAC was positively associated with hand-grip strength and arm muscle area in cirrhotic outpatients. The implications of the present study are important in clinical practice because a diet rich in antioxidants may be an ally in the control of excessive reactive oxygen species production in cirrhotic outpatients with repercussion on muscle mass and strength., (© 2019 The British Dietetic Association Ltd.)

Background: Physical fitness during childhood is an important indicator of current and future health. This paper provides an overview of the fitness of Canadian children and youth aged 6 to 19 years., Data and Methods: Data are from three cycles of the Canadian Health Measures Survey (CHMS) spanning a 10-year period: 2007 to 2009 (n = 2,081), 2009 to 2011 (n = 2,133) and 2016 to 2017 (n = 2,070). The CHMS is a comprehensive direct health measures survey conducted on a nationally representative sample of Canadians. Descriptive statistics for measures of cardiorespiratory fitness, muscular strength and power, flexibility, and body composition are provided by age group and sex. Physical fitness measures are presented for participants who met and did not meet the physical activity and screen time recommendations., Results: Few changes in the fitness measures occurred over the past decade. Cardiorespiratory fitness decreased between 2007-2009 and 2016-2017 in 8 to 10 (52.1 to. 51.0 mL•kg -1 •min -1 ) and 11 to 14 (50.8 to 49.8 mL•kg -1 •min -1 ) year old boys. Girls generally had lower levels of fitness compared to boys, except for flexibility which was higher in girls. Cardiorespiratory fitness was higher in children and youth who met the current Canadian recommendations for physical activity and screen time. Grip strength was higher in boys who met the current Canadian screen time recommendation., Discussion: Ongoing and periodic surveillance of fitness through the CHMS is important to monitor trends, assess future interventions designed to improve fitness levels at the population level and to increase our understanding of the relationships between fitness and health.

Although vegetarian diets are considered generally protective against chronic disease, nutrient deficiencies, including protein, are possible due to low bioavailability from plant-based sources. The consequences of inadequate dietary protein include reduced lean body mass (LBM) and muscle weakness. This study examined relationships between protein intake, strength, and LBM in 37 underactive vegetarians and recorded the impact of protein supplementation (18 g/day mung bean protein) on these indices utilizing an eight-week, randomized, controlled, feeding trial. Both handgrip and knee flexor and extensor strength were measured at baseline and week eight. At baseline, LBM was significantly related to grams of protein consumed daily. LBM was also correlated to grip strength ( r = 0.569, p < 0.001) and lower body strength ( r = 0.763 to 0.784; p < 0.001). Twenty-five vegetarians completed the feeding trial, including 11 in the protein supplementation group (PRO) and 14 in the control group (CON). At the end of the trial, LBM and strength did not differ significantly between groups. However, the average percent change for grip, flexor, and extensor strength did differ between PRO and CON participants (+2.9 ± 7.2% and -2.6 ± 7.3% respectively, p = 0.05). Thus, there were strong associations between dietary protein, LBM, and strength in vegetarians and an indication that supplementary vegetarian protein increased strength in the absence of exercise and independent of LBM.

Purpose: Low-grade inflammation leads to several metabolic disorders, and adherence to a Mediterranean diet (MedDiet), cardiorespiratory fitness (CRF), and muscular fitness (MF) has been considered important markers of metabolic healthy in youth. We investigated the combined association of adherence to Mediterranean diet, and muscular and cardiorespiratory fitness on high-sensitivity C-reactive protein (hs-CRP) in adolescents., Methods: This is a cross-sectional analysis with 1462 adolescents (625 girls) aged 9-18 years from Colombia and Portugal. MedDiet was assessed by Kidmed questionnaire. Shuttle run test was used to assess CRF. MF was assessed by the standing long-jump and handgrip tests. High-sensitivity assays were used to obtain the hs-CRP level., Results: Logistic regression shows that subjects with a low adherence to MedDiet and LowMF/LowCRF had a similar odds (OR = 2.3; 95% CI 1.2-4.0) as those with an optimal adherence to MedDiet and LowMF/LowCRF (OR = 2.3; 95% CI 1.2-5.0) of expressing high inflammatory profile when compared to those with an optimal adherence to MedDiet and HighMF/HighCRF. In addition, ANCOVA showed that subjects classified as high adherence to MedDiet and HighMF/HighCRF had, on average, the lowest levels of hs-CRP (F (7,1454)  = 2.051 p = 0.04)., Conclusion: The combination of optimal levels of CRF and MF and adherence to MedDiet is associated with lower hs-CRP. However, high MF and CRF seems to counteract the deleterious effect of having a low adherence to the MedDiet on hs-CRP levels.

Objectives: To assess the relationship between muscular strength measures and mortality in outpatient populations with chronic diseases such as cancer, chronic obstructive pulmonary disease, renal disease, and metabolic and vascular diseases, and in critically ill hospitalized patients., Design: A systematic review and random-effects meta-analysis of prospective cohort studies was performed., Setting and Participants: The databases Medline, Embase, Clinical Trial Register, and Cochrane Trial Register were searched from inception until September 30, 2018. The systematic literature review yielded 39 studies with a total of 39,852 participants., Results: Lowest vs highest category of muscular strength revealed a statistically significant increased risk of all-cause mortality with a hazard ratio (HR) and 95% confidence intervals (CI) of 1.80 (95% CI 1.54-2.10). Lower muscular strength was associated with enhanced mortality in patients with cancer (HR 2.40; 95% CI 1.57-3.69), critical illness (HR 2.06; 95% CI 1.33-3.21), renal disease (HR 1.84; 95% CI 1.37-2.47), metabolic and vascular diseases (HR 1.64; 95% CI 1.26-2.14), and chronic obstructive pulmonary disease (HR 1.36; 95% CI 1.16-1.61). Conversely, a 5-kg higher level of muscular strength conferred a reduced risk of overall mortality (HR 0.72; 95% CI 0.59-0.89) and was accompanied by a reduction in mortality in patients with metabolic and vascular diseases (HR 0.52; 95% CI 0.29-0.91), critical illness (HR 0.78; 95% CI 0.61-0.99), and renal disease (HR 0.82; 95% CI 0.73-0.91)., Conclusions and Implications: Muscular strength is inversely associated with mortality risk in various acute and chronic conditions. Future trials should focus on developing validated cut-points for diagnosing low muscular strength and their predictive value for hard end-points., (Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

This article reports a multicity yoga education program (YEP) experiment aimed at improving gait speed, muscular strength, and functional performance in Asian and African older women diagnosed with sarcopenia. Posttest gait speed and muscle strength scale scores were higher, and the six functional performance tests scores were above average for women who were from Asian cities; middle class; currently married; living with spouse, children, or kin; with good self-rated health; who regularly attended the YEP lessons and regularly self-practiced. Instructors' self-practice record was the strongest predictor of higher posttest scores. The YEP is an effective long-term prevention for sarcopenic older women.

Purpose: The aim of the study was to monitor trends in socioeconomic inequalities in body mass index (BMI), cardiorespiratory fitness (CRF), and muscular strength over several decades in a population of Swedish males aged 18-19 years., Methods: The cohort consists of 1.5 million young men attending military conscript examinations from late 1968 to 2005. Parental education was used as a marker for socioeconomic conditions in the conscripts' families of origin. Changing gradient in BMI, CRF, and muscular strength in sons of parents with higher and lower educational attainment was evaluated during four periods covering 36 years., Results: Over the course of the obesity epidemic, BMI remained higher in conscripts with lesser (vs. higher) parental education. Moreover, the absolute difference in obesity prevalence between groups showed a continuous increase, from .6% to 3.9%, indicating growing inequalities. Regarding fitness, lower CRF was consistently associated with less parental education, but with no clear secular trend in the magnitude of the difference. Finally, social differences in muscular strength changed in direction, from lower strength among conscripts with higher parental education in the initial observation period to lower strength associated with lower parental education in the final decade studied., Conclusions: Among Swedish conscripts entering adulthood, social gradients in BMI and obesity widened continuously between 1968 and 2005. An apparent reversal of the earlier gradient in muscular strength in young men may be related to societal trends in occupational and leisure-time physical activity over the observation period. This cohort is being continually monitored through national registries for obesity-related comorbidities in later life., (Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: Health-related quality of life (HRQOL) in childhood is defined as an individual's subjective perception of the impact of health status on physical, psychological and social functioning. Nowadays, measuring of HRQOL has become an important outcome indicator in evaluating health-care. However, in younger children, the role of cardiorespiratory and other physical fitness components on HRQOL is unclear. The aims of this study were to analyse the association between components of physical fitness and HRQOL, as well as to determine which component of physical fitness was the best predictor of higher HRQOL., Methods: This was a cross-sectional study of 1413 schoolchildren (4 to 7 years old) from Spain. HRQOL was evaluated with the KINDL-R questionnaire for parents. Cardiorespiratory fitness, muscle strength and speed-agility were assessed using the ALPHA-Fitness battery. ANCOVA models were used to assess differences in HRQOL across physical fitness categories, controlling for age and BMI, by gender. Multiple linear regression was used to determine the independent association between the different physical fitness components and HRQOL., Results: Children with high physical fitness levels had better scores in physical well-being, school and total HRQOL score than those who had low physical fitness levels. The best predictor of HRQOL (total score) was muscular strength in boys and speed-agility among girls., Conclusions: Children with high physical fitness levels have higher HRQOL, although the association between components of physical fitness and HRQOL varies according to gender. Improving physical fitness could be a good strategy for improving HRQOL in children.

There is increasing evidence for an association between low muscular strength and depressive symptoms. In this review the existing literature on the association between muscular strength and depression particularly in older people as reported in epidemiological studies is summarized. From the literature search, conducted in PubMed (January 1980-May 2018), 17 papers (8 cross-sectional and 9 longitudinal studies) were selected. All cross-sectional studies reported significantly lower odds of having depressive symptoms with increased levels of muscular strength and this association persisted even after adjusting for several confounders including the level of physical activity. The majority of the longitudinal studies also reported that low muscular strength was independently associated with a higher risk of developing depression but more studies are needed to confirm this evidence. Furthermore, future investigations are needed to explore the exact mechanisms of muscular strength in relation to depression. Low muscular strength is a modifiable factor for depression, which is of great public health interest.

Background: Sedentary behaviors are associated with numerous adverse physiological health outcomes, morbidity and mortality, although with limited knowledge in young adults., Aim: To assess the association between sedentary behavior, muscular strength and body composition in male and female young adult college students., Methods: A cross-sectional pilot study was conducted among 94 college students (20.2 ± 1.6 years, 46 males and 48 females) from a University in the Mid-Atlantic region, US. Students were assessed for sedentary behavior, physical activity and objective physiological variables including lean body mass (LBM), fat% and muscular strength [1-Repetition Maximum (1-RM)]. Descriptive statistics and linear regression analysis were conducted., Results: Sedentary behavior (sitting time ≥ 6 h/day) was prevalent in 69% of females and in 46% of males, p = .036, although most students (84-94%) met the physical activity recommendations. Sitting time inversely correlated with LBM (r = -0.58, p = .01) and trending for positive correlation with fat% in females, whereas in males, sitting time inversely correlated with 1-RM upper body strength (r = -0.46, p = .017). Female students who sat ≥7.5 h/day had approximately 10-fold increased chance of being obese [odds ratio = 9.6, 95% confidence interval (1.5 to 62.7), p = .019] compared to non-sedentary., Conclusions: Although most students were physically active, considerable prevalence of sedentary behavior was observed. The novel findings showed that, sedentary behavior was associated with compromised physiological health determinants of body composition in females and muscular strength in males. Reducing sedentary behavior among active college students could be a public health strategy for health promotion and chronic disease prevention., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The aim of this study was to explore the relationships between physical performance variables and bone parameters such as bone mineral density (BMD), bone mineral content, hip geometry indices, and trabecular bone score in a group of young overweight and obese adult women. Sixty-eight overweight/obese (body mass index ≥25 kg/m 2 ; 25.5-42.4 kg/m 2 ) young women whose ages range from 18 to 35 yr participated in this study. Body composition and bone outcomes were measured by dual-energy X-ray absorptiometry. Maximum oxygen consumption (VO 2 max, in liter per minute) was determined indirectly using a progressive shuttle run test. One-repetition-maximum half-squat was directly measured. Vertical jump was measured and maximum power (P max) of the lower limbs was calculated. Lean mass was positively correlated to whole body (WB) BMD, total hip BMD, femoral neck (FN) BMD, femoral neck cross-sectional area (FN CSA) and femoral neck cross sectional moment of inertia (FN CSMI) (p < 0.05). VO 2 max (in liter per minute) and muscle power were positively correlated to WB BMD, total hip BMD, FN BMD, FN CSA, and FN CSMI (p < 0.05). One-repetition-maximum half-squat was positively correlated with lumbar spine trabecular bone score, WB BMD, FN BMD, FN CSA and FN CSMI (p < 0.05). This study suggests that lean mass, vertical jump, VO 2 max (liter per minute), muscle power and one-repetition-maximum half squat are positive determinants of BMD and hip geometry indices in young overweight and obese women., (Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)

Background: Impaired balance and weak muscle strength are common deficits associated with stroke. Limited research has examined the relationship between balance and strength in people post-stroke., Objective: To investigate the association between balance and muscular strength in people post-stroke., Methods: A total of 11 people with chronic stroke, who were community dwelling and ambulatory, completed balance and strength assessments. A computerized dynamic posturography system was used for Limits of Stability (LOS) test, Sit-to-Stand (STS) test, and the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB). Additionally, a computerized dynamometer was used to assess the isometric muscle strength of flexion/extension in the core (the trunk) and the leg (the hip, knee, and ankle). Pearson correlation analysis was used to investigate the relationship between balance and muscle strength measurements., Results: Endpoint excursion (EPE) (r = .646; p < 0.032) and maximum excursion (MXE) (r = .613; p < 0.045) of LOS test were positively correlated with core and leg strength (C&L). Specifically, both EPE (r = -.792; p < 0.004) and MXE (r = -.623; p < 0.041) in backward direction had strong correlations with C&L. Core strength also showed a positive correlation with EPE of LOS test (r = .636; p < 0.035) while the composite leg strength did not. Lastly, STS and mCTSIB tests did not demonstrate significant associations with muscle strength., Conclusions: The results indicate that the C&L have a strong relationship with the ability to shift body weight in multiple directions, particularly backward, among people post-stroke. However, static balance and STS performance do not appear to be related to muscle strength.

Aim: We investigated whether exercise-mediated acquisition of muscle mass and strength would occur in a concurrent manner in older adults., Methods: A total of 152 community-dwelling older adults (young-old aged 65-74 years, old-old aged >75 years) were allocated into either 8-week comprehensive exercise training or the control group. Participants (n = 136) completed all pre- and post-intervention testing visits (young-old n = 73, old-old n = 63). Older adults in exercise groups were subjected to a series of programmed elastic band and free exercises twice per week at three to five sets of 15-20 repetitions. Body composition, skeletal muscle mass, knee strength (extensors and flexors) and gait-related physical function were evaluated as main variables., Results: As expected, muscular mass and knee strength (both extensors and flexors) were inversely correlated with age in the old-old group (all P < 0.001). However, knee extensor strength was the only lower limb component inversely correlated with age in the young-old group (P < 0.043). Knee extensor strength was significantly increased by exercise training in both the young-old and old-old groups (young old P < 0.042, old-old P < 0.011). Training-induced muscle hypertrophy was observed only in the young-old group (P < 0.025). the correlation of knee extensor strength against gait-related physical function was the greatest, followed by knee flexor strength and muscle mass., Conclusions: The present results showed that age-associated strength decline of the knee extensor occurs earlier compared with the knee flexor during the aging process, and exercise training increases muscular strength without significant changes of muscle mass in older adults aged aged ≥75 years. Geriatr Gerontol Int 2019; 19: 265-270., (© 2019 Japan Geriatrics Society.)

Background: Shilajit is a safe, fluvic mineral complex exudate that is common to Ayurvedic medicine and is composed of fulvic acids, dibenzo-α-pyrones, proteins, and minerals. The purpose of this study was to examine the effects of 8 weeks of Shilajit supplementation at 250 mg·d - 1 (low dose) and 500 mg·d - 1 (high dose) versus placebo on maximal voluntary isometric contraction (MVIC) strength, concentric peak torque, fatigue-induced percent decline in strength, and serum hydroxyproline (HYP)., Methods: Sixty-three recreationally-active men ([Formula: see text] ± SD: 21.2 ± 2.4 yr.; 179.8 ± 6.3 cm; 83.1 ± 12.7 kg) volunteered to participate in this study. The subjects were randomly assigned to the high dose, low dose, or placebo group (each group: n = 21). During pre-supplementation testing, the subjects performed 2 pretest MVICs, 2 sets of 50 maximal, bilateral, concentric isokinetic leg extensions at 180°·s - 1 separated by 2-min of rest, and 2 posttest MVICs. Following 8 weeks of supplementation, the subjects repeated the pre-supplementation testing procedures. In addition, the groups were dichotomized at the 50th percentile based on pre-supplementation MVIC and baseline HYP. Mixed model ANOVAs and ANCOVAs were used to statistically analyze the dependent variables for the total groups (n = 21 per group) as well as dichotomized groups., Results: For the upper 50th percentile group, the post-supplementation adjusted mean percent decline in MVIC was significantly less for the high dose group (8.9 ± 2.3%) than the low dose (17.0 ± 2.4%; p = 0.022) and placebo (16.0 ± 2.4%; p = 0.044) groups. There was no significant (p = 0.774) difference, however, between the low dose and placebo groups. In addition, for the upper 50th percentile group, the adjusted mean post-supplementation baseline HYP for the high dose group (1.5 ± 0.3 μg·mL - 1 ) was significantly less than both the low dose (2.4 ± 0.3 μg·mL - 1 ; p = 0.034) and placebo (2.4 ± 0.3 μg·mL - 1 , p = 0.024) groups., Conclusions: The results of the present study demonstrated that 8 weeks of PrimaVie® Shilajit supplementation at 500 mg·d - 1 promoted the retention of maximal muscular strength following the fatiguing protocol and decreased baseline HYP. Thus, PrimaVie® Shilajit supplementation at 500 mg·d - 1 elicited favorable muscle and connective tissue adaptations.

Background: Functional mobility disability affects more than one in five adults over 70 years and increases to 80% by 90 years. While negative changes in mobility are multifactorial, deleterious body composition changes contribute significantly. Resistance training alters the negative trajectory of physical function as well as increases lean mass among older adults. Recently, high-velocity (HV) resistance training has been indicated as an effective intervention to increase lean mass and functional performance., Aims: The present investigation compared body composition, physical function, and muscular strength changes between HV and LV resistance training programs., Methods: Participants > 65 years (n = 53) were randomly assigned to LV, HV, or active control (AC) group and participated in their respective intervention for 48 weeks., Results: Analysis of covariance revealed no significant body composition changes over time between groups (p > 0.05). Eight-foot up-and-go performance improved in the HV and AC groups (p < 0.05) with no change in the LV group (p > 0.05) over time. Muscular strength increased in both the LV and HV groups within the first 24 weeks, while only in the LV group, muscular strength continued to increase from 24 to 48 weeks (p < 0.05)., Discussion: Resistance training appears to be an effective intervention for improving aspects of physical function and muscular strength; however, no significant changes in body composition were observed over the 48-week intervention., Conclusion: Findings from the current investigation support use of resistance training for improving physical function among community-dwelling older adults.

Objectives: To test the associations of muscular fitness and body mass index (BMI), individually and combined, with clustered cardiovascular disease risk factors in children and adolescents and to analyze the mediator role of BMI in the association between muscular fitness and clustered cardiovascular disease risk factors., Study Design: In total, 239 children (113 girls) and 270 adolescents (128 girls) participated in this cross-sectional study. Height and weight were assessed, and BMI was calculated. A cardiovascular disease risk factors index (CVDRF-I) was created from the combination of the following variables: waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose. Handgrip strength/weight and standing long jump tests were used to assess muscular fitness. A muscular fitness index was computed from the combination of both tests., Results: Muscular fitness index was associated with CVDRF-I in children of both sexes and adolescent boys; however, these associations disappeared after accounting for BMI. BMI was associated with CVDRF-I in both children and adolescents, even after adjusting for muscular fitness (all P < .001). In male and female children and in adolescent boys, the association between muscular fitness and CVDRF-I was mediated by BMI (all P < .001). Because there was no association between muscular fitness and CVDRF-I in adolescent girls, the mediation hypothesis was discarded., Conclusions: BMI is an independent predictor of CVDRF-I in children and adolescents of both sexes. Conversely, the effect of muscular fitness on CVDRF-I seems to be fully mediated by BMI levels in male and female children and in adolescent boys., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The aims of this study were to examine the longitudinal association between muscular fitness (MF) and blood pressure (BP) 2 years later, and to determine whether changes in MF over a 2-year period were associated with BP at follow-up, in adolescents. The sample comprised 734 youths (349 girls) aged from 12 to 18 years. MF was assessed with the standing long jump and handgrip tests. Socioeconomic status, pubertal stage, waist circumference, resting BP, and cardiorespiratory fitness were measured according to standard procedures. Regression analyses showed a significant inverse association between MF at baseline and systolic BP (β = - 0.072; p = 0.032) and rate pressure product (β = - 0.124; p < 0.001) at follow-up, after adjustments for age, sex, height, pubertal stage, and socioeconomic status. However, when analyses were further adjusted for waist circumference and cardiorespiratory fitness, these associations did not remain significant. Adolescents with persistently high and increasing MF exhibited the lowest levels of diastolic BP (F (3, 721)  = 3.814, p = 0.018) and systolic BP (F (3, 721)  = 3.908, p = 0.014) when compared to those with persistent low MF after adjustment for age, sex, height, socioeconomic status, cardiorespiratory fitness, and waist circumference.Conclusion: This study suggests that persistent greater and increasing MF in youth are associated with lower levels of BP across the adolescence. What is Known: • Currently, there is a growing interest on the health benefits of muscular fitness. • Cross-sectional studies have identified an association between muscular fitness and blood pressure in adolescents. What is New: • Changes in muscular fitness during adolescence were associated with systolic and diastolic BP over a 2-year period. • Adolescents with persistently low muscular fitness exhibited the highest levels of diastolic and systolic BP.

Previous studies suggested that reduced muscular strength was one of the potential predictor of prevalence of diabetes mellitus. The purpose of this study was to investigate the association between toe flexor strength (TFS) and handgrip strength (HGS) and the prevalence of diabetes mellitus. Cross-sectional analysis was conducted using data from 1,390 Japanese males (35-59 years). TFS and HGS were measured and medical examinations undertaken. The prevalence of diabetes mellitus was defined as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% (48 mmol/mol), and/or current use of anti-diabetes mellitus drugs. A total of 114 participants had diabetes mellitus. TFS in participants with diabetes mellitus was significantly lower than that in persons not suffering from diabetes mellitus but HGS was not. Odds ratio (OR) and 95% confidence interval (CI) per 1-standard deviation-increase in muscular strength measurements for the prevalence of diabetes mellitus were obtained using a multiple logistic regression model. Prevalence of diabetes mellitus was inversely related to TFS (OR 0.769, 95% CI 0.614-0.963), TFS/body mass (BM) (0.696, 0.545-0.889) and TFS/body mass index (BMI) (0.690, 0.539-0.882) after adjustment of covariates. Such associations were not observed in HGS (OR 0.976, 95% CI 0.773-1.232), HGS/BM (0.868, 0.666-1.133) or HGS/BMI (0.826, 0.642-1.062). These results suggested that poor TFS was associated with an increased prevalence of diabetes mellitus independent of visceral fat accumulation, but HGS was not, in middle-aged males. TFS may be a better marker for the prevalence of diabetes mellitus than HGS.

The aim of the study was to investigate the combined association of adherence to a Mediterranean diet (MedDiet) and muscular fitness (MF) with cardiometabolic health in collegiate students. The present cross-sectional analysis consisted of 1248 (714 females) healthy collegiate students (20.1 &plusmn; 2.7 years old). Adherence to a MedDiet was assessed by a KIDMED (Mediterranean Diet Quality Index) questionnaire. Standing broad jump, standing vertical jump, and isometric handgrip dynamometry were used as indicators of MF. The cardiometabolic profile was assessed using the following components: triglycerides, blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, glucose, and waist circumference. Analysis of covariance shows a significant difference in the cardiometabolic profile of both genders between the high MF/low MedDiet and high MF/optimal MedDiet groups, and the low MF/low MedDiet and low MF/optimal MedDiet groups ( p < 0.001). No difference was found on cardiometabolic profile between high MF/optimal MedDiet and high MF/low MedDiet, both in males and females. Additionally, logistic regression shows that both female (odds ratio (OR) = 2.01; 95% confidence interval (CI): (1.8⁻3.7); p = 0.02) and male (OR = 3.38; 95% CI: (1.9⁻5.8); p < 0.001) participants in the optimal MedDiet/high MF group had the highest odds of expressing a healthier cardiometabolic profile as compared to those in the low MF/low MedDiet group. In conclusion, a combination of high MF levels and optimal adherence to a MedDiet is associated with a healthier cardiometabolic profile; however, high MF levels seem to circumvent the deleterious effects of having a low adherence to a MedDiet., Competing Interests: The authors declare no conflict of interest.

The purpose of this study was to examine whether physical activity (PA) and muscular strength (MS) are related to polypharmacy. Our cross-sectional analysis was based on 711 patients with multimorbidity (MMB), aged 65-94 years, who participated in the KORA-Age study. Participants underwent a face-to-face interview and extensive physical examinations including anthropometric measurements, registration of chronic diseases, determination of health-related behaviors (smoking, alcohol intake, physical activity, etc.), collection of blood samples and measurement of hand-grip strength. PPha was defined as the use of >4 drugs and MMB as having ≥2 of 13 chronic diseases. Prevalence of PPha was 44.6% (n=317), and a significant difference was found in the number of drugs used between participants with and without PPha (7.2±2.1 vs 2.5±1.2, P<.001). Patients in the lower compared to the upper tertile of physical activity had a significantly increased odds to be on PPha (OR: 1.64, 95% CI: 1.05-2.56, P=.031) after controlling for age, gender, BMI, family status, education, alcohol intake, smoking habits, number of diseases, hs-CRP, and telomere length. On the contrary, no significant association between muscular strength and PPha was found (OR: 1.04, 95% CI: 0.66-1.63, P=.873) after multivariable adjustment. Among older persons with MMB, lower levels of physical activity, but not low muscular strength, are associated with higher odds of PPha. Increasing the levels of physical activity appears to be highly recommended in order to potentially reduce the risk of PPha among multimorbid persons aged 65 and older., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To examine the associations of physical fitness (i.e. cardiorespiratory fitness, muscular strength, and speed/agility) with psychological distress and psychological well-being in overweight/obese pre-adolescent children., Design: 110 overweight/obese children (10.0±1.1years old, 61 boys) from the ActiveBrains project (http://profith.ugr.es/activebrains) participated in this cross-sectional study., Methods: Physical fitness was evaluated by the ALPHA battery test. Cardiorespiratory fitness was additionally evaluated by a maximal incremental treadmill. Stress was assessed by the Children's Daily Stress Inventory, anxiety by the State-Trait Anxiety Inventory, depression by the Children Depression Inventory, positive affect and negative affect by the Positive and Negative Affect Scale for Children, happiness by the Subjective Happiness Scale, optimism by the Life Orientation Test, and self-esteem by the Rosenberg Self-Esteem questionnaire. Linear regression adjusted for sex and peak height velocity was used to examine associations., Results: Absolute upper-body muscular strength was negatively associated with stress and negative affect (β=-0.246, p=0.047; β=-0.329, p=0.010, respectively). Furthermore, absolute lower-body muscular strength was negatively associated with negative affect (β=-0.301, p=0.029). Cardiorespiratory fitness, expressed by the last completed lap, and relative upper-body muscular strength were positively associated with optimism (β=0.220, p=0.042; β=0.240, p=0.017, respectively). Finally, absolute upper-body muscular strength was positively associated with self-esteem (β=0.362, p=0.003) independently of sex and weight status (p for interactions >0.3), and absolute lower-body muscular strength was also positively associated with self-esteem (β=0.352, p=0.008)., Conclusions: Muscular strength was associated with psychological distress (i.e. stress and negative affect) and psychological well-being (i.e. optimism and self-esteem) as well as cardiorespiratory fitness was associated with optimism. Therefore, increased levels of physical fitness, specifically muscular strength, could have significant benefits for overweight/obese children psychological health., (Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This study compared spinal alignment, muscular strength, and quality of life (QOL) between women with postmenopausal osteoporosis and healthy volunteers. The results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness., Introduction: Increased spinal kyphosis is common in patients with osteoporosis and negatively impacts quality of life (QOL). Muscular strength is also important for QOL in patients with osteoporosis. However, spinal kyphosis and muscle weakness also occur in healthy individuals with advancing age. The purposes of this study were thus to compare spinal alignment, muscular strength, and QOL between women with postmenopausal osteoporosis and healthy volunteers., Methods: Participants comprised 236 female patients with postmenopausal osteoporosis (mean age, 68.7 years) and 93 healthy volunteer women (mean age, 71.0 years). Body mass index (BMI), angles of spinal kyphosis, back extensor strength, grip strength, and QOL were compared between groups., Results: BMI, back extensor strength, and grip strength were significantly higher in the volunteer group than in the osteoporosis group (p < 0.01). Both thoracic kyphosis and lumbar lordosis were significantly greater in the osteoporosis group than in the volunteer group (p < 0.01). With regard to QOL, the 36-Item Short-Form Health Survey (SF-36) subscale scores of role physical, bodily pain, general health, and role emotional were all significantly lower in the osteoporosis group than in the volunteer group (p < 0.05 each). SF-36 physical component summary (PCS) score was significantly lower in the osteoporosis group than in the volunteer group (p < 0.001). SF-36 PCS score correlated positively with thoracic kyphosis and negatively with BMI only in the osteoporosis group (p < 0.05 each)., Conclusions: These results indicated that lower QOL in osteoporosis patients may be associated with increased thoracic kyphosis, reduced lean muscle mass, and generalized muscle weakness.

Purpose: Our purpose was to compare supramaximal versus submaximal intensity eccentric training performed until volitional fatigue., Methods: Thirty-two young adults (19 males) were randomized into one of three groups: (1) ECC110 performed eccentric (ECC) only contractions at 110% of concentric (CON) 1-repetition maximum (1RM); (2) ECC80 performed ECC only contractions at 80% of CON 1RM; (3) a control group. Training progressed from 3 to 6 sets of unilateral ECC training of the elbow flexors over 8 weeks, with each set performed until volitional fatigue. Elbow flexors muscle thickness (via ultrasound) and 1RM were assessed pre- and post-training. Rating of perceived exertion (RPE) and muscle soreness was self-reported., Results: Both ECC110 (+0.25 cm) and ECC80 (+0.21 cm) showed a greater post-training increase in muscle thickness compared to control (-0.01 cm) (p < 0.05), with no differences between ECC110 and ECC80. ECC80 (+1.23 kg) showed a greater post-training increase in strength compared to control (p < 0.05), while ECC110 (+0.76 kg) had no significant difference post-training vs. control (-0.01 kg). ECC80 had significantly lower average RPE scores than ECC110 (p < 0.05)., Conclusions: Both supramaximal intensity eccentric training and submaximal intensity eccentric training are effective for increasing muscle size, but submaximal eccentric training is perceived to require less exertion than supramaximal training. These findings suggest that submaximal eccentric training may be an ideal strategy to increase muscle size and strength in individuals whose needs warrant training at a lower level of exertion.

Objective: To determine the associations between socioeconomic status (SES) and physical fitness in a sample of Colombian youth., Study Design: Prueba SER is cross-sectional survey of schoolchildren in Bogota, Colombia. Mass, stature, muscular fitness (standing long-jump, handgrip), and cardiorespiratory fitness (20-m shuttle run) were measured in 52?187 schoolchildren 14-16 years of age. Area-level SES was categorized from 1 (very low) to 4 (high) and parent-reported family income was categorized as low, middle, or high., Results: Converting measures into z scores showed stature, muscular, and cardiorespiratory fitness were significantly (z?=?0.3-0.7) below European values. Children in the mid- and high SES groups jumped significantly further than groups with very low SES. Differences were independent of sex but became nonsignificant when adjusted for anthropometric differences. Participants in the mid-SES and high-SES groups had better handgrip scores when adjusted for body dimension. There were, however, no significant between-group differences in cardiorespiratory fitness, which was strongly clustered by school and significantly greater in students from private schools., Conclusions: Area-level SES is associated with measures of muscular fitness in Colombian schoolchildren. These associations were largely explained by the large differences in body dimensions observed between SES groups. When area-level SES is considered, there was no evidence that family income influenced fitness. The clustering of outcomes reaffirms the potential importance of schools and area-level factors in promoting fitness through opportunities for physical activity. Interventions implemented in schools, can improve academic attainment; a factor likely to be important in promoting the social mobility of children from poorer families., (Copyright © 2016 Elsevier Inc. All rights reserved.)

A randomized controlled trial was conducted to examine eight weeks of resistance training (RT) with and without time-restricted feeding (TRF) in order to assess nutrient intake and changes in body composition and muscular strength in young recreationally active males. The TRF programme consisted of consuming all calories within a four-hour period of time for four days per week, but included no limitations on quantities or types of foods consumed. The RT programme was performed three days per week and consisted of alternating upper and lower body workouts. For each exercise, four sets leading to muscular failure between 8 and 12 repetitions were employed. Research visits were conducted at baseline, four, and eight weeks after study commencement. Measurements of total body composition by dual-energy X-ray absorptiometry and muscle cross-sectional area by ultrasound were obtained. Upper and lower body strength and endurance were assessed, and four-day dietary records were collected. TRF reduced energy intake by ∼650 kcal per day of TRF, but did not affect total body composition within the duration of the study. Cross-sectional area of the biceps brachii and rectus femoris increased in both groups. Effect size data indicate a gain in lean soft tissue in the group that performed RT without TRF (+2.3 kg, d = 0.25). Upper and lower body strength and lower body muscular endurance increased in both groups, but effect sizes demonstrate greater improvements in the TRF group. Overall, TRF reduced energy intake and did not adversely affect lean mass retention or muscular improvements with short-term RT in young males.

Introduction: Aging is a process that involves a reduction in muscle strength and anabolic hormone concentrations, which impacts significantly on health., Aim: To study the hormone/total strength (H/TS) ratio as a proxy of anabolic insensitivity status in elders, and its relationship with disability, hospitalization, and mortality risk., Design: A total of 1462 persons aged ≥65 years from the Toledo Study of Healthy Aging participated in this study. Serum concentrations of insulin like growth factor 1, total and free testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and 17β-estradiol were measured. Total maximal voluntary isometric strength was obtained (handgrip, shoulder, hip, and knee) using standardized techniques and equipment. Physical activity was recorded by physical activity scale for the elderly questionnaire. Associations of the H/TS ratio with hospitalization and mortality were assessed using logistic regression models, and participants stratified into quartiles for each H/TS ratio., Results: In women, all individual ratio H/TS models showed a strong to moderate increased risk for death and hospitalization. In men, all models revealed a significant positive association of the ratio H/TS with mortality rate but not for hospitalization (P < .01). Participants who have 2 or more H/TS ratios in the worst quartile increased the risk of hospitalization and mortality at least by 2-fold., Conclusions: We demonstrate the main role that muscle function plays in the relationship between the hormonal status and hospitalization and mortality risk; this could be taken into consideration as a way to classify patients for hormonal therapy., (Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Aims: The objective of this study was to evaluate the effect of a training programme based on traditional Greek dance on the jumping ability, muscle strength and lower limb endurance in patients with chronic heart failure (CHF)., Patients and Methods: Forty Greek patients with CHF graded as NYHA ⩽ II and aged 73.2±4.7 years were randomly divided into two groups. Group A ( n=20) participated in a three-month physical rehabilitation programme based on Greek traditional dances, whereas group B ( n=20) remained untrained and served as the control group. All patients were studied before and after the 12-week exercise training programme. At baseline and follow-up the exercise capacity of the patients was evaluated by the six-minute walking test, their lower extremity muscle strength was evaluated by an isokinetic dynamometer and their jumping ability by the Myotest-Pro test, which includes three types of jumps (plyometric, countermovement and squat jumps)., Results: No significant difference was observed between the two groups at the baseline evaluation. At follow-up, group A showed significant improvements in walking distance calculated from the six-minute walking test (10.0% improvement; p<0.05), in lower limb strength (10.32% improvement; p<0.05), and in countermovement jump speed (6.9%; p<0.05) and squat jump speed (5.8%; p<0.05). Group A also increased their jump plyometry height by 13.86% ( p<0.05), their counter jump height by 10.68% ( p<0.05) and their squat jump height by 10.45% ( p<0.05). Group A had a 6.85% ( p<0.05) increased force of counter jump compared with group B., Conclusion: The design and implementation of cardiac rehabilitation programmes using Greek traditional dances in patients with CHF are both safe and effective in improving lower limb function.

Background: Vitamin D deficiency is common among immigrants in the Nordic region. It may lead to osteomalacia with severe musculoskeletal pain. There are reports that vitamin D deficiency without osteomalacia may lead to pain but little is known of the effect of treatment., Objective: To investigate whether a moderate dose of cholecalciferol and calcium improves strength and pain in a group of vitamin D deficient women., Design: Twentyfive immigrant women with vitamin D deficiency diagnosed during pregnancy were treated postpartum with a daily dose of 1,600 IU cholecalciferol and 1,000 mg of calcium. They were examined at the start of treatment and again after 3 months of treatement and the results were statistically compared., Setting: Southern parts of Stockholm., Main Outcome Measures: Serum 25-hydroyvitamin D (25(OH)D), serum-parathyroid hormone (PTH), pain measured by a visual analogue scale (VAS), musculoskeletal strength by performance on a chair stand test (seconds), and bone tenderness by pressure algometer (kilo-Pascal)., Results: Following the treatment, the 21 women attending had lowered cm in VAS, improved musculoskeletal strength, - and 25(OH)D levels were normalized., Conclusions: A moderate dose of vitamin D normalized l vitamin D levels, improved muscular strength and reduced pain in this group of vitamin D deficient immigrant women.

Objectives: This study explored the associations among physical activity, muscular strength, and metabolic risk among children., Methods: The sample included 378 Portuguese children (213 girls; 9-11 years). Moderate-to-vigorous physical activity was assessed by accelerometry and children were classified as active (≥60 min/day) or insufficiently active (<60 min/day). Static strength was expressed as the ratio of handgrip strength/body weight and used to classify children as having high (≥P50) or low (

Background: Deficits in ankle muscle strength and ankle stiffness may be present in those subjects who underwent surgical treatment for an Achilles tendon rupture. The presence of these long-term deficits may contribute to a lower performance during daily activities and may be linked to future injuries., Objective: To compare the ankle passive stiffness and the plantar flexor muscle performance in patients who underwent unilateral surgical treatment of Achilles tendon rupture with nonsurgical subjects., Method: Twenty patients who underwent unilateral surgical treatment of Achilles tendon rupture [surgical (SU) group], and twenty nonsurgical subjects [non-surgical (NS) group] participated in this study. The ankle passive stiffness was evaluated using a clinical test. The concentric and eccentric plantar flexors performance (i.e. peak torque and work) was evaluated using an isokinetic dynamometer at 30°/s., Results: The surgical ankle of the surgical group presented lower stiffness compared to the non-surgical ankle (mean difference=3.790; 95%CI=1.23-6.35) and to the non-dominant ankle of the non-surgical group (mean difference=-3.860; 95%CI=-7.38 to -0.33). The surgical group had greater absolute asymmetry of ankle stiffness (mean difference=-2.630; 95%CI=-4.61 to -0.65) and greater absolute asymmetry of concentric (mean difference=-8.3%; 95%CI=-13.79 to -2.81) and eccentric (mean difference=-6.9%; 95%CI=-12.1 to -1.7) plantar flexor work compared to non-surgical group. There was no other difference in stiffness and plantar flexor performance., Conclusion: Patients who underwent surgical repair of the Achilles tendon presented with long-term (1 year or more) deficits of ankle stiffness and asymmetries of ankle stiffness and plantar flexor work in the affected ankle compared to the uninjured side in the surgical group and both sides on the nonsurgical group., (Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.)