Purpose: To evaluate test-retest reliability of physical fitness measures in hip osteoarthritis (OA) patients and assess longitudinal changes in these parameters following total hip arthroplasty (THA). This study incorporates previously unexamined parameters like V̇O2peak and trunk endurance, alongside physical activity monitoring through accelerometry and self-reported outcomes in 1-year follow-up. Methods: Seventy-eight patients (mean age 74 ± 4.5 years, 81% women) scheduled for THA performed physical fitness tests and accelerometry-measured physical activity. The test battery included muscle strength, motor fitness, and cardiorespiratory fitness. Assessments were conducted at two pre-operative timepoints and at 4-month and 1-year post-operative follow-up. Physical activity was objectively measured using hip-worn triaxial accelerometers. Results were compared with healthy older adults. Statistical analyses included test-retest reliability assessment, between-group comparisons, and longitudinal change analysis using repeated measures ANOVA. Results: Good to excellent test-retest reliability was demonstrated for most fitness parameters. Pre-operatively, hip OA patients showed significant deficits compared to healthy controls in moderate-to-vigorous physical activity (18.7 vs 44.7 min/day) and multiple physical fitness parameters. At 1-year post-op, significant improvements were observed in 23 of 45 measured parameters, including functional mobility (Timed Up and Go: –29%), walking distance (Six-Minute Walk Test: +16%), trunk endurance-strength (+71–82%), shoulder-press (+33%), various leg strength tests (+13–42%), and 4 m max walking-speed (+42%). Moderate-to-vigorous physical activity increased by 63% and daily step count improved from 6,004 to 7,558 steps/day (+26%). Notably, ipsilateral-to-contralateral step height asymmetry decreased from 27% pre-operatively to 8% at 1-year. V̇O2peak demonstrated modest but significant improvement from 22.7 to 23.6 mL/kg/min 1-year postoperatively (+4%). Conclusion: This study highlights significant pre-operative functional deficits in patients with hip osteoarthritis, with substantial improvements observed across multiple performance domains 1-year post-surgery. Notably, patients failed to meet the recommended physical activity guidelines prior to surgery but achieved them post-operatively. The demonstrated reliability of the test battery reinforces its value for both research and clinical applications.

The efficacy of OsteoStrong® (OS) on bone strength is limited, and how it compares to dynamic multicomponent exercise (DME) is unknown. In this randomized controlled trial, the effect of OS on bone material strength index (BMSi) in older women was non-inferior to that of DME. No significant interaction between treatment and time was observed in any measured outcomes, indicating no meaningful difference between the intervention groups. Although the OsteoStrong® intervention met the pre-specified non-inferiority margin compared to the DME group, the lack of efficacy of the DME intervention on BMSi limits the interpretation of this finding. The aim of this study was to investigate whether the effect of using OS was non-inferior to DME for the primary outcome of BMSi in older women. Women aged 65–79 years with osteopenia or osteoporosis were randomized to 9 months of once-weekly OS (20 min) or twice-weekly DME (60 min/session). A total of 194 women (OS, 97; DME, 97), median age 70 years, participated in the trial. The primary outcome was BMSi measured with impact microindentation at the tibia. A pre-specified non-inferiority margin of BMSi −5.2 was applied to determine whether the intervention’s efficacy was not clinically worse than the comparator within an acceptable threshold. The secondary outcomes were bone mineral density (BMD) and bone markers (S-CTX, S-P1NP, S-BALP, and S-sclerostin). At the 9-month follow-up, there were no significant differences between the groups in any of the outcomes. The mean between‑group difference in BMSi was 1.16, with a 95

Introduction: Total hip arthroplasty (THA) effectively alleviates pain and improves quality of life in patients with severe hip osteoarthritis (OA). However, there are limited comprehensive longitudinal data on physical function and objectively measured physical activity (PA) patterns after THA. The purpose of this study was to establish the test-retest reliability of physical fitness measures in patients with hip OA and to evaluate changes in physical fitness and activity over time following THA. METHODS:Seventy-eight OA patients (mean age 73.7 ± 4.2 years, 81% women) scheduled for THA underwent comprehensive physical fitness testing and accelerometry-based PA monitoring. Assessments were conducted at two preoperative time points and at 4-month (n = 57) and 1-year postoperative follow-up (n = 48). The test battery included measures of muscle strength, motor fitness, and cardiorespiratory fitness. PA was objectively measured using hip-worn triaxial accelerometers. Self-reported Hip Disability and Osteoarthritis Outcome Score (HOOS) were collected pre- and postoperatively. RESULTS:Good to excellent test-retest reliability was demonstrated across 23 of 24 fitness parameters. At 1-year post-op, significant improvements were observed in 23 of 45 measured parameters, including functional mobility (timed up-and-go: -29%), walking distance (Six-Minute Walk Test: +16%), trunk endurance-strength (+71 to 82%), shoulder press (+32%), various leg strength tests (+13 to 42%), 4-m max walking speed (+42%), moderate-to-vigorous physical activity (+63%) and daily step count from 6,004 to 7,558 steps/day (+26%). Ipsilateral-to-contralateral step height asymmetry decreased from 27% preoperatively to 8% at 1-year follow-up. VO2peak demonstrated a modest but significant improvement from 22.7 to 23.6 mL/kg/min (+4%) 1 year postoperatively. CONCLUSION:This study revealed low fitness and activity levels in patients with severe hip OA before surgery, with marked improvements in physical fitness and activity measurements 1 year after surgery. The high reliability of the comprehensive assessment battery supports its usefulness for both research and clinical practice. These findings contribute to the existing evidence on simple, field-based fitness tests for patients with hip OA, while also offering methodological insights and recovery trajectories. .

Limited research exists on the effects of OsteoStrong on physical function in older women. This randomized controlled trial aimed to evaluate and compare the effects of OsteoStrong (OS) and dynamic multicomponent exercise (DME) on functional outcomes in older women with osteopenia or osteoporosis. A total of 194 women aged 65–79 years with a T-score of ≤–1.0 at the hip and/or spine were randomized to nine months of either OS (once weekly, 20 min) or DME (twice weekly, 60 min). Outcomes included measures of muscle strength (hand grip and back strength), back and trunk endurance, mobility (sit-to-stand tests, gait speed, Timed Up and Go), and balance (one-leg standing time, tandem standing, tandem walking). Measurements were conducted at baseline and again at nine months. Both OS and DME showed significant improvements in grip strength, back strength, isometric trunk flexion endurance, gait speed 30 m (m/sec), 5 sit-to-stand (sec) and 50 sit-to-stand speed (n/sec) with no significant between-group differences. DME resulted in greater improvements in gait speed 30 m (+ 7.1

Introduction: Information on the long-term maintenance of short-term exercise fitness gains measured by field-based tests is scarce in older adults. This study aimed to investigate short- and long-term changes in various physical fitness parameters after an 8-week exercise program. Methods: In this longitudinal study, a total of 265 participants (62% women; mean age 71.4 ± 4.7 years) completed a field-based test battery of 12 fitness tests (22 parameters) at 2 pre-tests and 1 post-test following an 8-week exercise program (2 sessions/week, combining aerobic and strength activities) in 2 consecutive years. The tests assessed muscle endurance, muscle strength, cardiorespiratory fitness, and motor fitness. Results: Significant short-term improvements were observed, e.g., in isometric trunk flexion and extension endurance (21–37%) for both sexes in both years. Lower-body muscular endurance improved in the first year (9–12%) for both sexes, while cardiorespiratory fitness (6-min walk test) improved only for men in both years (3%). No changes were seen in submaximal cycle test heart rates or any balance tests in any year. Most fitness parameters did not significantly decrease during the 9-month inter-intervention period, with a few exceptions in trunk strength and walking distance. Conclusions: This study demonstrates physical fitness improvements in older adults following short-term exercise interventions and that some of these improvements were maintained long term, whereas a few of these physical fitness test improvements decreased significantly over 9 months in older adults.

INTRODUCTION:Generalised anxiety disorder (GAD) in older adults involves excessive worry and cognitive challenges. Verbal memory impairments is associated to hippocampal dysfunction, with cortisol and brain-derived neurotrophic factor (BDNF) being important in hippocampal integrity. Research on hippocampal volume and verbal memory in older adults with GAD is limited, with mixed findings. This study investigates verbal memory in older adults with GAD versus healthy controls, and relations with hippocampal volumes. METHODS:Participants included 49 adults with GAD (Mage = 65.82, SD = 3.94) and 49 controls (Mage = 67.73, SD = 4.11). Verbal memory was assessed using the California Verbal Learning Test Long Delay Free Recall, hippocampal volumes via MRI, BDNF from serum, and cortisol via saliva. We fitted a Bayesian multivariate linear regression with bilateral hippocampal volume as outcome measure, and predictors: age, gender, education, intracranial volume, IQ, BDNF, cortisol, SSRI use, CVLT Long Delay Free Recall (LD FR), CVLT Learning, and diagnostic status*CVLT LD FR interaction. RESULTS:A credible interaction showed better verbal memory associated to larger hippocampal volume in controls, but this relationship was attenuated in GAD. BDNF and cortisol were not credibly associated with hippocampal volume. CONCLUSION:Diagnostic status moderates verbal memory and hippocampal volume relations, suggesting a distinct neurocognitive profile in older adults with GAD compared to healthy controls.

Generalized anxiety disorder (GAD) is a severe and prevalent disorder among older adults. Cognitive behaviour therapy (CBT) is recommended treatment for GAD, but older adults benefit less than younger peers. Physical exercise has been suggested to improve treatment efficacy. We aimed to determine the efficacy of augmenting CBT with physical exercise for older adults with GAD. This randomised controlled trial included 50 participants (mean [SD] age 66.52 [4.09] years; 39 [78%] female) with GAD. Participants received individual CBT and were randomised to either physical exercise or telephone attention placebo. The main outcome measure was self-reported worry on the Penn State Worry Questionnaire (PSWQ). Secondary outcome measures were clinician-rated remission and self-reported symptoms of anxiety, depression, and quality of life. Although the interaction between time and condition was statistically nonsignificant, moderation analysis revealed that this interaction was significant for participants with low treatment credibility to CBT at baseline. Participants randomised to physical exercise were five times more likely to achieve reliable long-term worry-reduction than placebo control. We found significant differences in favour of physical exercise for secondary measures of depression and anxiety. Participants with better cognitive inhibition at baseline were more likely to achieve clinician-rated remission. Findings suggest that physical exercise augments CBT for older adults with GAD.

Introduction: Physical fitness is strongly associated with daily physical function, health, and longevity in older adults. Field-based tests may provide a reasonable alternative compared to advanced laboratory testing. Separating postexercise test scores from reactivity measurements requires sufficient test-retest reliability. Postexercise test scores with reliability analyses of field-based fitness tests in older adults are lacking. The present study aimed to examine the test-retest reliability of some novel easily accommodated fitness test measurements and compare pretest scores with postexercise results in these tests along with other field-based fitness tests in older adults. Methods: Totally 1,407 community-dwelling older adults (69% female), (x) over bar = 71.5 +/- 5.0 (65-84 years), performed twelve field-based fitness tests at pretest 1, pretest 2 and a posttest after an 8-week exercise period (twice weekly 1 h of combined strength and aerobic training). T tests, intra-class correlation, limits of agreement, standard error of measurement, and coefficient of variance were performed between pre-1 and pre-2 tests, and repeated measures ANOVA and partial eta squared effect size for postexercise differences for men and women in 5-year age groups ranging from 65 to 84 years. Results: Between pre-1 and pre-2 tests a significant difference was noted in some of the novel fitness test measurements but generally not, e.g., in isometric trunk flexion and step-up height on either leg among all sex and age groups. In most of these novel fitness test measurements, no significant differences occurred between the two pretests. Examples of results from the pre-2 test to the posttest were isometric trunk flexion 45 degrees endurance and isometric trunk extension endurance improved significantly for both sexes in age groups 65-74 years. Women, but not men, improved the maximal step-up height for both legs in most age groups. The speed in the 50 sit-to-stand improved significantly for most age groups in both sexes. Six-min walk distance improved significantly for most age groups in women but among men only in 65-69 years. In the timed-up-and-go test, significant improvements were seen for all age groups in women and in men 70-79 years. No postexercise improvements were generally observed for grip strength or balance. Conclusions: In most of the novel fitness test measures, no significant difference was noted between the two pretests in the assessed sex and age groups. Results after the 8-week exercise period varied between sex and age groups, with significant improvements in several of the twelve studied fitness tests. These findings may be valuable for future projects utilizing easily accommodated physical fitness tests in older adults.

BACKGROUND:Sarcopenia is thought to be underlined by age-associated anabolic resistance and dysregulation of intracellular signalling pathways. However, it is unclear whether these phenomena are driven by ageing per se or other confounding factors. METHODS:Lean and healthy young (n = 10, 22 ± 3 years, BMI; 23.4 ± 0.8 kg/m2) and old men (n = 10, 70 ± 3 years, BMI; 22.7 ± 1.3 kg/m2) performed unilateral resistance exercise followed by intake of essential amino acids (EAA). Muscle biopsies were collected from the rested and the exercised leg before, immediately after and 60 and 180 min after EAA intake. Muscle samples were analysed for amino acid concentrations, muscle protein synthesis (MPS) and associated anabolic signalling. RESULTS:Following exercise, peak plasma levels of EAA and leucine were similar between groups, but the area under the curve was ~11% and ~28% lower in Young (p < 0.01). Absolute levels of muscle EAA and leucine peaked 60 min after exercise, with ~15 and ~21% higher concentrations in the exercising leg (p < 0.01) but with no difference between groups. MPS increased in both the resting (~0.035%·h-1 to 0.056%·h-1, p < 0.05) and exercising leg (~0.035%·h-1 to 0.083%·h-1, p < 0.05) with no difference between groups. Phosphorylation of S6K1Thr389 increased to a similar extent in the exercising leg in both groups but was 2.8-fold higher in the resting leg of Old at the 60 min timepoint (p < 0.001). Phosphorylation of 4E-BP1Ser65 increased following EAA intake and exercise, but differences between legs were statistically different only at 180 min (p < 0.001). However, phosphorylation of this site was on average 78% greater across all timepoints in Old (p < 0.01). Phosphorylation of eEF2Thr56 was reduced (~66% and 39%) in the exercising leg at both timepoints after EAA intake and exercise, with no group differences (p < 0.05). However, phosphorylation at this site was reduced by ~27% also in the resting leg at 60 min, an effect that was only seen in Old (p < 0.01). Total levels of Rheb (~45%), LAT1 (~31%) and Rag B (~31%) were higher in Old (p < 0.001). CONCLUSION:Lean and healthy old men do not manifest AR as evidenced by potent increases in MPS and mTORC1 signalling following EAA intake and exercise. Maintained anabolic sensitivity with age appears to be a function of a compensatory increase in basal levels of proteins involved in anabolic signalling. Therefore, our results suggest that age per se does not appear to cause AR in human skeletal muscle.

Background Reliable physical activity measurements in community-dwelling older adults are important to determine effects of targeted health promotion interventions. Many exercise interventions aim to improve time spent sedentary (SED), in light-intensity-physical-activity (LPA) and moderate-to-vigorous-intensity-physical-activity (MVPA), since these parameters have independently proposed associations with health and longevity. However, many previous studies rely on self-reports which have lower validity compared to accelerometer measured physical activity patterns. In addition, separating intervention-effects from reactivity measurements requires sufficient test-retest reliability for accelerometer assessments, which is lacking in older adults. Objectives The study objective was to investigate the reliability of sensor-based PA-patterns in community-dwelling older adults. Furthermore, to investigate change over time of physical activity patterns and examine any compensatory-effect from the eight-week supervised exercise-intervention. Methods An exercise-group (n = 78, age-range:65-91yrs) performed two 1h-exercise sessions/week during eight-weeks. PA-pattern was assessed (using hip-worn accelerometers), twice before and once during the last-week of the intervention. A control-group (n = 43, age-range:65-88yrs) performed one pre-test and the end-test with no exercise-intervention. A dependent-t-test, mean-difference (95%-CI), limits-of-agreement and intraclass-correlation-coefficient-ICC were used between the two pre-tests. Repeated-measures-ANOVA were used to analyze any intervention-effects. Results The exercise-groups´ two pre-tests showed generally no systematic change in any PA- or SED-parameter (ICC ranged 0.75–0.90). Compared to the control group, the exercise intervention significantly (time x group-interaction, p<0.05) increased total-PA-cpm (exercise-group/control-group +17%/+7%) and MVPA-min/week (+41/-2min) and decreased %-of-wear-time for SED-total (-4.7%/-2.7%) and SED-bouts (-5.7%/-1.8%), and SED-bouts min/d (-46/-16min). At baseline level, no significant differences were found between the two groups for any parameter. Conclusions The current study presents a good test-retest-reliability of sensor-based-one-week-assessed-PA-pattern in older-adults. Participating in an 8-week supervised exercise intervention improved some physical activity and sedentary parameters compared to the control group. No compensatory-effect was noted in the intervention-group i.e., no decrease in any PA-parameter or increase in SED at End-test (in %-of-wear-time, min/day or total-PA).

A large majority of Swedish children do not reach the recommended daily activity level. Some, but not all, studies show that extra physical activity may have positive effects on children’s school performance, physical fitness and health. The present purpose was to offer pupils from the 7th to the 8th grade extra aerobic exercise led by physical education teachers and to evaluate the effects on aerobic fitness, muscle strength, school grades and health. The hypothesis was that extra aerobic exercise would improve physical fitness, school grades and health. In the two-year project, 122 pupils aged 13–14 years from three schools constituted an aerobic group with 30 min extra exercise sessions (≥70% maximal heart rate) twice weekly. A control group of 26 pupils was included. All 148 pupils also had regular 60 min physical education lessons (2/week). A moderate to large significant effect size (via partial eta-squared) of the interaction effect for the aerobic group compared to the control group over time was generally seen for aerobic fitness, the muscle strength test with push-ups, school grades in Swedish, English and physical education, and in average school grade for four school subjects combined, thus also including mathematics. Within the aerobic group, significant improvements were also shown for aerobic fitness, endurance and strength of abdominal and leg muscles, and the total physical test index during the two-year project. The control group showed no corresponding improvement in these parameters. Improvements in school grades were generally seen among both sexes in the aerobic group, whereas improvements in physical capacity were distinctly more pronounced among boys and seldom among girls. A similar pattern with significant improvement in several school grades was noted in all three intervention schools, although one of the schools had a distinctly larger proportion of children who immigrated to Sweden. The aerobic group showed significantly higher ratings (with a small to moderate effect size) on several questions about physical self-perception than the control group at the end of the 8th grade. This teacher-led school intervention generated a sustainable project with improvements in physical fitness and school grades. The project might act as an inspiration for other schools to increase physical activity to improve physical fitness and possibly school grades.

Purpose The aim of this study was to validate the submaximal Ekblom-Bak test (EB-test) and the Åstrand test (Å-test) for an elderly population. Methods Participants ( n = 104), aged 65–75 years, completed a submaximal aerobic test on a cycle ergometer followed by an individually adjusted indirect calorimetry VO 2 max test on a treadmill. The HR from the submaximal test was used to estimate VO 2 max using both the EB-test and Å-test equations. Results The correlation between measured and estimated VO 2 max using the EB method and Å method in women was r = 0.64 and r = 0.58, respectively and in men r = 0.44 and r = 0.44, respectively. In women, the mean difference between estimated and measured VO 2 max was − 0.02 L min −1 (95% CI − 0.08 to 0.04) for the EB method and − 0.12 L min −1 (95% CI − 0.22 to − 0.02) for the Å method. Corresponding values for men were 0.05 L min −1 (95% CI − 0.04 to 0.14) and − 0.28 L min −1 (95% CI − 0.42 to − 0.14), respectively. However, the EB method was found to overestimate VO 2 max in men with low fitness and the Å method was found to underestimate VO 2 max in both women and men. For women, the coefficient of variance was 11.1%, when using the EB method and 19.8% when using the Å method. Corresponding values for men were 11.6% and 18.9%, respectively. Conclusion The submaximal EB-test is valid for estimating VO 2 max in elderly women, but not in all elderly men. The Å-test is not valid for estimating VO 2 max in the elderly.

Intake Of Essential Amino Acids Stimulates Mtorc1 Signaling And Inhibits Autophagy Following Glycogen-depleted Resistance Exercise

One of the purposes of footwear is to assist locomotion, but some footwear types seem to restrict natural foot motion, which may affect the contribution of ankle plantar flexor muscles to propulsion. This study examined the effects of different footwear conditions on the activity of ankle plantar flexors during walking. Ten healthy habitually shod individuals walked overground in shoes, barefoot and in flip-flops while fine-wire electromyography (EMG) activity was recorded from flexor hallucis longus (FHL), soleus (SOL), and medial and lateral gastrocnemius (MG and LG) muscles. EMG signals were peak-normalised and analysed in the stance phase using Statistical Parametric Mapping (SPM). We found highly individual EMG patterns. Although walking with shoes required higher muscle activity for propulsion than walking barefoot or with flip-flops in most participants, this did not result in statistically significant differences in EMG amplitude between footwear conditions in any muscle (p > 0.05). Time to peak activity showed the lowest coefficient of variation in shod walking (3.5, 7.0, 8.0 and 3.4 for FHL, SOL, MG and LG, respectively). Future studies should clarify the sources and consequences of individual EMG responses to different footwear.

Ankle joint angle influences hamstring fine-wire and high-density electromyography activity in ramp isometric knee flexions

"Effect of footwear on plantar flexor fine-wire electromyography activity in walking." Footwear Science, 11(sup1), pp. S120–S121

Ankle plantar flexor muscles are active in the stance phase of walking to propel the body forward. Increasing walking speed requires increased plantar flexor excitation, frequently assessed using surface electromyography (EMG). Despite its popularity, validity of surface EMG applied on shank muscles is mostly unclear. Thus, we examined the agreement between surface and intramuscular EMG at a range of walking speeds. Ten participants walked overground at slow, preferred, fast, and maximum walking speeds (1.01 ± 0.13, 1.43 ± 0.19, 1.84 ± 0.23, and 2.20 ± 0.38 m s-1, respectively) while surface and fine-wire EMG activities of flexor hallucis longus (FHL), soleus (SOL), medial gastrocnemius (MG) and lateral gastrocnemius (LG), and tibialis anterior (TA) muscles were recorded. Surface and intramuscular peak-normalised EMG amplitudes were compared for each muscle and speed across the stance phase using Statistical Parametric Mapping. In FHL, we found differences around peak activity at all speeds except fast. There was no difference in MG at any speed or in LG at slow and preferred speeds. For SOL and LG, differences were seen in the push-off phase at fast and maximum walking speeds. In SOL and TA, surface EMG registered activity during phases in which intramuscular EMG indicated inactivity. Our results suggest that surface EMG is generally a suitable method to measure MG and LG EMG activity across several walking speeds. Minimising cross-talk in FHL remains challenging. Furthermore, SOL and TA muscle onset/offset defined by surface EMG should be interpreted cautiously. These findings should be considered when recording and interpreting surface EMG of shank muscles in walking.