This study evaluated the effects of aging and endurance training on the metabolic responses of trained and sedentary young (age 20-32 yr) and older (age 60-70 yr) men to exercise at the same relative exercise stress (70% of maximal O2 consumption). Plasma growth hormone concentrations at rest were similar in all four groups, but both older groups had an attenuated response to exercise. The older trained men appeared to have avoided the age-associated changes that were evident in their sedentary peers with respect to resting plasma insulin, C-peptide, and norepinephrine concentrations. Plasma glucagon concentrations were lower in both older subject groups at rest. Both sedentary groups decreased their plasma glucose concentrations and increased their plasma glucagon concentrations during exercise, whereas the trained groups had increases in their plasma glucose concentrations but had no change in their glucagon concentrations. Thus, although the concentrations of some hormones at rest and during submaximal exercise are unaffected by aging or by training, others are markedly altered by aging, training, or the interaction of the two. However, it appears that older healthy sedentary men undergo less physiological stress than young untrained men during submaximal exercise at the same relative exercise intensity, and they have no responses that would contraindicate their participation in exercise of the duration and intensity usually prescribed in exercise-training programs.
To examine the effects of 8‐week unsupervised, home‐based inspiratory muscle training ( IMT ) on the balance and physical performance of healthy older adults. Fifty‐nine participants (74 ± 6 years) were assigned randomly in a double‐blinded fashion to either IMT or sham‐ IMT , using a pressure threshold loading device. The IMT group performed 30‐breath twice daily at ~50% of maximal inspiratory pressure ( MIP ). The sham‐ IMT group performed 60‐breaths once daily at ~15% MIP ; training was home‐based and unsupervised, with adherence self‐reported through training diaries. Respiratory outcomes were assessed pre‐ and postintervention, including forced vital capacity, forced expiratory volume, peak inspiratory flow rate ( PIFR ), MIP , and inspiratory peak power. Balance and physical performance outcomes were measured using the shortened version of the Balance Evaluation System test (mini‐ BEST ), Biodex ® postural stability test, timed up and go, five sit‐to‐stand, isometric “sit‐up” and Biering–Sørensen tests. Between‐group effects were examined using two‐way repeated measures ANOVA , with Bonferroni correction. After 8‐week, the IMT group demonstrated greater improvements ( P ≤ 0.05) in: PIFR ( IMT = 0.9 ± 0.3 L sec −1 ; sham‐ IMT = 0.3 L sec −1 ); mini‐ BEST ( IMT = 3.7 ± 1.3; sham‐ IMT = 0.5 ± 0.9) and Biering–Sørensen ( IMT = 62.9 ± 6.4 sec; sham‐ IMT = 24.3 ± 1.4 sec) tests. The authors concluded that twice daily unsupervised, home‐based IMT is feasible and enhances inspiratory muscle function and balance for community‐dwelling older adults.
Objectives This study aimed to explore the impact of the coronavirus disease 2019 (COVID‐19) pandemic on self‐care of individuals living with rheumatoid arthritis (RA). Methods Guided by a constructivist, qualitative design, we conducted one‐to‐one in‐depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized‐controlled trials. An inductive, reflexive thematic analysis approach was used. Results Twenty‐six participants (aged 27–73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self‐care describes how participants took measures to continue self‐care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self‐care. (2) Managing emotions describes resilience‐building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic. Conclusion The insights gained may inform clinicians and researchers on ways to support the self‐care strategies of individuals with RA and other chronic illnesses during and after the COVID‐19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care. Patient or Public Contribution This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.
The inspiratory muscles contribute to balance via diaphragmatic contraction and by increasing intra-abdominal pressure. We have shown inspiratory muscle training (IMT) improves dynamic balance significantly with healthy community-dwellers. However, it is not known how the magnitude of balance improvements following IMT compares to that of an established balance program. This study compared the effects of 8-week of IMT for communitydwellers, to 8-week of the Otago exercise program (OEP) for care-residents, on balance and physical performance outcomes. Nineteen healthy community-dwellers (74 ± 4 years) were assigned to self-administered IMT. Eighteen, healthy care-residents (82 ± 4 years) were assigned to instructor-led OEP. The IMT involved 30 breaths twice-daily at~50% of maximal inspiratory pressure (MIP). The OEP group undertook resistance and mobility exercises for~60 minutes, twice-weekly. Balance and physical performance were assessed using the mini Balance Evaluation System Test (mini-BEST) and time up and go (TUG). After 8-week, both groups improved balance ability significantly (mini-BEST: IMT by 24 ± 34%; OEP by 34 ± 28%), with no between-group difference. Dynamic balance sub-tasks improved significantly more for the IMT group (P < 0.01), than the OEP group and vice versa for static balance sub-tasks (P = 0.01). The IMT group also improved MIP (by 66 ± 97%), peak inspiratory power (by 31 ± 12%) and TUG (by-11 ± 27%); whereas the OEP did not. IMT and OEP improved balance ability similarly, with IMT eliciting greater improvement in dynamic balance, whilst OEP improved static balance more than IMT. Unlike IMT, the OEP did not provide additional benefits in inspiratory muscle function and TUG performance. Our findings suggest that IMT offers a novel method of improving dynamic balance in older adults, which may be more relevant to function than static balance and potentially a useful adjunct to the OEP in frailty prevention.
1The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular responses to 2 maximal eccentric contractions. Fourteen healthy men (22±3 yr) performed single-leg cycling (20 min at ~75% 3 maximal oxygen uptake (VO 2max ); eight 90 s sprints at a 1:1 work-to-rest ratio (5% decrements from 90 to 55% 4 VO 2max ); and ~85% VO 2max until exhaustion) the evening before 100 eccentric knee extensions (1.57 rad
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