Skeletal muscle and aging

Question 1

is a normal age-related decline in muscle strength that occurs at a rate of 1%-5% per year from the age of 30 years; age-related loss in sk mm mass; causes decr of strength and power

Answer 1

sarcopenia

Question 2

What are the functional consequences of sarcopenia?

Answer 2

1. Physical disability
2. Increased risk for falls
3. Increased vulnerability to injury

Question 3

People (> 65 years) with sarcopenia are___ times more likely to be physically disabled than those with normal strength

Answer 3

3. 03

- major cause for the increased prevalence of disability in older adults

Question 4

What most determines gait speed, STS, SMWT, and LLFDI FL

Answer 4

peak power

Question 5

What is the power driven pathway to age associated disability?

Answer 5

1. Health Condition/Muscle Pathology - Loss of FT motor units; FT muscle fiber atrophy
2. Body Function & Structure Level/Impairment - Reduced velocity of movement; Reduced Muscle Force & Power
3. Activity Level/Functional limitation - Slower sit-to-stand; Slower gait speed; 6-min walk test less distance
4. Role Participation/Disability - Change societal role; Self Care; Community Mobility

Question 6

Among the elderly ____ account for 87% of all fractures.

Answer 6

falls

- Fallers had less than ½ of the knee and ankle strength of the non-falling residents

Question 7

When time available to make an appropriate response is short, maximum joint strength may not be as important as abilities to develop joint torque rapidly. What does this mean?

Answer 7

Power is the most important for developing m torque!

Question 8

What is the molecular cause of decrease power?

Answer 8

slower cross-bridge kinetics (myosin binding and realize slower)

Question 9

Why is cardiopulmonary important to consider in regards to sarcopenia?

Answer 9

if you have good cardio fitness, you will have less detrimental effects due to sarcopenia

Question 10

What are general exercise guidelines for older adults?

Answer 10

1. Structure program to the fitness and needs of the older adult
2. Screen for orthopaedic and cardiovascular complications
3. Proper instruction on safe lifting technique is essential

Question 11

What are contraindications to exercise?

Answer 11

1. Osteoporosis – Relative
2. Arthritis – Relative
3. Angina
4. Hypertension
5. Medical history & PAR-Q
6. Examination
7. Risk stratification
8. Supervision and education

Question 12

What are target muscles for strengthening?

Answer 12

Large muscles

1. . Latissimus dorsi
2. Triceps
3. Biceps
4. Quadriceps
5. Hamstrings
6. Hip abductors – adductors
7. Gastrocnemius / soleus
8. Special indications: Hip extensors/ext rotators/abductors for patellofemoral pain
   - this is general conditioning; can change depending on focus of sessions

Question 13

Why are resistance machines with weight stacks preferred?

Answer 13

1. Decreased injury risk to hands, feet, and lower back
2. Smaller weight increments are available
3. Ease of changing weights
4. Resistance applied through full ROM
   - small increments are best!

Question 14

What should the general intensity and progression be with weight training?

Answer 14

Start with lighter weights lifting comfortably through the full ROM –> Weight progressively increased as muscle strength increases

Question 15

What % 1-RM is the minimum intensity be for an untrained individual? what is the equivalent fo this?

Answer 15

60% 1-RM - intensity threshold required for increasing m strength

1. the amount of weight a person can lift correctly 15 times (repetitions)
2. A rating of perceived exertion (RPE) of 12 to 13 (scale is 6-20).
3. The patient would describe this work load as light to moderately hard

Question 16

What % 1-RM is the maximum intensity be for an untrained individual? what is the equivalent fo this?

Answer 16

80% 1-RM

1. the amount of weight a person can lift correctly 8 times (repetitions)
2. A rating of perceived exertion (RPE) of 15 to 17 (scale is 6-20)
3. The patient would describe this work load as hard to very hard

Question 17

What should muscle training intensity be at?

Answer 17

• Weight needed to volitionally fatigue the target muscle group in 8 – 15 reps; this weight corresponds to 60-80% of the 1RM
• Higher intensities, greater strength gains, but results in more musculoskeletal injuries
• Increase the 8 – 15 rep RM in small increments when the client completes the task with ease (easy or hard?) with correct form
• 1 set of 8-15 reps is enough, is safer, and enhances adherence
• lasting strength gains over a 12-16 wk period

Question 18

How many days per week should muscles be trained for strengthening? how long should they rest?

Answer 18

2-3 days per week results in significant strength improvement
24-48 hours of rest for each m group
- 4-5 days per week may result in greater improvement, there is poorer adherence

Question 19

What should the initial program for older adults with physical and functional frailty look like?

Answer 19

1. Start with load below the threshold intensity (less than 60% 1-RM)
2. For first week client/patient completes 15 to 20 repetitions
3. Once the form of the exercise is learned and tolerated, the intensity (load) is increased to the minimum threshold for strength adaptation of 60% 1-RM

Question 20

When should load be increased?

Answer 20

• If more than 15 repetitions can be completed, consider increasing the load by 2%-10%.
• If more than 20 repetitions can be completed, find the load that the client/patient can only move 8 (80% 1-RM) to 15 (60% 1-RM) times

Question 21

When should muscle training be progressed from strength to power?

Answer 21

After patient/client progresses to completing 2 sets of 8 or 15 repetitions of an exercise can begin to train for power.

• Initial loads are 20% 1-RM – progress to 60% 1-RM
• Move as fast as possible concentric phase; Slow and deliberate lowering or eccentric phase

Question 22

What is the recommendation for older adults for CV?

Answer 22

Brisk walking or other CV daily for 30 – 45 minutes