The purpose of this study was to compare the steadiness and discharge rate of motor units during submaximal contractions performed by young and old adults. Subjects performed isometric and slow shortening and lengthening contractions with the first dorsal interosseous muscle. The steadiness of the isometric and slow anisometric contractions was less for the old subjects compared with young subjects, especially at the lower target forces and with the lightest loads. Furthermore, the steadiness of the lengthening contractions was less compared with the shortening contractions for the old subjects. Although the mean discharge rates of motor units were not different for the two groups of subjects, the variability of the discharge rates was greater for the old subjects during the isometric and anisometric contractions. We conclude that a more variable discharge by single motor units probably contributes to the reduced ability of old adults to perform steady muscle contractions.

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The purpose of this study was to compare the steadiness and discharge rate of motor units during submaximal contractions performed by young and old adults. Subjects performed isometric and slow shortening and lengthening contractions with the first dorsal interosseous muscle. The steadiness of the isometric and slow anisometric contractions was less for the old subjects compared with young subjects, especially at the lower target forces and with the lightest loads. Furthermore, the steadiness of the lengthening contractions was less compared with the shortening contractions for the old subjects. Although the mean discharge rates of motor units were not different for the two groups of subjects, the variability of the discharge rates was greater for the old subjects during the isometric and anisometric contractions. We conclude that a more variable discharge by single motor units probably contributes to the reduced ability of old adults to perform steady muscle contractions.

The aim of this study was to assess differences in the behavior of fatigue‐related measures of neuromuscular function between younger (n = 10; 20–35 years) and older (n = 11; >65 years) healthy adults. Measures reflecting changes in voluntary activation, neuromuscular propagation, metabolite build‐up, and excitation‐contraction coupling processes were taken before, during, and after a sustained maximum elbow‐flexion fatigue task. We found a greater role for a failure in voluntary activation (central fatigue) in about half of the older subjects compared with none of the younger subjects to explain the decrease in force‐generating capacity with sustained activity. In contrast, similar behaviors in measures reflecting changes in peripheral mechanisms were noted for the two age groups. These results point to a potential shift in fatigue mechanisms with age, with a greater contribution of central fatigue in some older adults. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 98–106, 2001

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Background and Purpose— Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and gait in stroke rehabilitation inpatients. Methods— A blinded randomized controlled trial studying 59 stroke survivors on an inpatient stroke rehabilitation unit was performed. The treatment group (n=30) received standard stroke rehabilitation therapy plus a program of VR exercises that challenged balance (eg, soccer goaltending, snowboarding) performed while standing. The control group (n=29) received standard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance (performed in sitting). VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period. Objective outcome measures of balance and mobility were assessed before, immediately after, and 1 month after training. Results— Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test, with both groups meeting minimal clinical important differences after training. More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain ( P =0.04) immediately after training. Conclusions— This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes. Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR. Clinical Trial Registration— URL: http://www.ANZCTR.org.au/ . Unique identifier: ACTRN12613000710729.

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The purpose of this study was to compare fatigue-related measures of central and peripheral mechanisms between young and elderly subjects for a task performed with elbow flexor muscles. Ten young and nine elderly subjects performed a sustained submaximal fatigue task at 35% of their maximum voluntary contraction torque. Measures of neuromuscular function, reflecting changes in neuromuscular propagation, voluntary activation, excitation-contraction-relaxation processes, and metabolite buildup, were taken before, during, and after the fatigue task. The main results were the absence of neuromuscular propagation failure in either young or elderly subjects, the presence of central fatigue at the end of the fatigue task in 7 of 9 elderly but only 3 of 10 young subjects, and lesser changes in twitch torque contraction-relaxation variables and electromyographic median frequency in elderly compared with young subjects. The lesser fatigue-related changes in twitch contraction speed and median frequency in elderly compared with young subjects could reflect the increase in type I-to-type II fiber area reported with old age. The presence of significant central fatigue can apparently minimize some of the potential differences present in peripheral fatigue sites.