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老年人下肢 2 周制动后最大爆发力丧失及再训练不完全恢复。

Loss of maximal explosive power of lower limbs after 2 weeks of disuse and incomplete recovery after retraining in older adults.

机构信息

Department of Medicine, University of Udine, Udine, Italy.

Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA.

出版信息

J Physiol. 2018 Feb 15;596(4):647-665. doi: 10.1113/JP274772. Epub 2018 Jan 19.

Abstract

KEY POINTS

Disuse in older adults can critically decrease lower limb muscle power, leading to compromised mobility and overall quality of life. We studied how muscle power and its determinants (muscle mass, single muscle fibre properties and motor control) adapted to 2 weeks of disuse and subsequent 2 weeks of physical training in young and older people. Disuse decreased lower limb muscle power in both groups; however, different adaptations in single muscle fibre properties and co-contraction of leg muscles were observed between young and older individuals. Six physical training sessions performed after disuse promoted the recovery of muscle mass and power. However, they were not sufficient to restore muscle power to pre-disuse values in older individuals, suggesting that further countermeasures are required to counteract the disuse-induced loss of muscle power in older adults.

ABSTRACT

Disuse-induced loss of muscle power can be detrimental in older individuals, seriously impairing functional capacity. In this study, we examined the changes in maximal explosive power (MEP) of lower limbs induced by a 14-day disuse (bed-rest, BR) and a subsequent 14-day retraining, to assess whether the impact of disuse was greater in older than in young men, and to analyse the causes of such adaptations. Sixteen older adults (Old: 55-65 years) and seven Young (18-30 years) individuals participated in this study. In a subgroup of eight Old subjects, countermeasures based on cognitive training and protein supplementation were applied. MEP was measured with an explosive ergometer, muscle mass was determined by magnetic resonance, motor control was studied by EMG, and single muscle fibres were analysed in vastus lateralis biopsy samples. MEP was ∼33% lower in Old than in Young individuals, and remained significantly lower (-19%) when normalized by muscle volume. BR significantly affected MEP in Old (-15%) but not in Young. Retraining tended to increase MEP; however, this intervention was not sufficient to restore pre-BR values in Old. Ankle co-contraction increased after BR in Old only, and remained elevated after retraining (+30%). Significant atrophy occurred in slow fibres in Old, and in fast fibres in Young. After retraining, the recovery of muscle fibre thickness was partial. The proposed countermeasures were not sufficient to affect muscle mass and power. The greater impact of disuse and smaller retraining-induced recovery observed in Old highlight the importance of designing suitable rehabilitation protocols for older individuals.

摘要

要点

老年人的不活动会严重降低下肢肌肉力量,导致活动能力和整体生活质量下降。我们研究了肌肉力量及其决定因素(肌肉质量、单根肌肉纤维特性和运动控制)如何适应年轻人和老年人 2 周的不活动和随后 2 周的体育锻炼。不活动使两组人的下肢肌肉力量都下降;然而,在年轻人和老年人之间观察到单根肌肉纤维特性和腿部肌肉的共同收缩有不同的适应。不活动后进行的 6 次体育训练促进了肌肉质量和力量的恢复。然而,它们不足以使老年人的肌肉力量恢复到不活动前的水平,这表明需要采取进一步的对策来抵抗老年人因不活动而导致的肌肉力量丧失。

摘要

不活动引起的肌肉力量丧失对老年人可能是有害的,严重影响其功能能力。在这项研究中,我们检查了由 14 天的不活动(卧床休息,BR)和随后的 14 天的再训练引起的下肢最大爆发力(MEP)的变化,以评估不活动对老年人的影响是否大于年轻人,并分析这种适应的原因。16 名老年人(Old:55-65 岁)和 7 名年轻人(18-30 岁)参加了这项研究。在老年人的一个子组中,应用了基于认知训练和蛋白质补充的对策。使用爆发力测功计测量 MEP,通过磁共振确定肌肉质量,通过肌电图研究运动控制,并在股外侧肌活检样本中分析单根肌肉纤维。MEP 在老年人中比在年轻人中低约 33%,当按肌肉体积标准化时,仍显著降低(-19%)。BR 显著影响老年人的 MEP(-15%),但不影响年轻人。再训练有增加 MEP 的趋势;然而,这一干预措施不足以恢复老年人的 BR 前值。BR 后仅在老年人中观察到踝关节共同收缩增加,再训练后(+30%)仍保持升高。老年人的慢纤维发生显著萎缩,年轻人的快纤维发生萎缩。再训练后,肌肉纤维厚度的恢复是部分的。所提出的对策不足以影响肌肉质量和力量。在老年人中观察到的不活动的更大影响和较小的再训练引起的恢复表明,为老年人设计合适的康复方案非常重要。

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