The impact of cardiorespiratory fitness on classical cardiovascular disease risk factors in rheumatoid arthritis: a cross-sectional and longitudinal study.

Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). Advanced measures of cardiorespiratory fitness (CRF) are associated with CVD risk factors. The present study aimed to examine whether CVD risk factors can predict clinic-based measures of CRF, using the Siconolfi step test and to determine if exercise can improve RA patients' cardiovascular health. Sixty-five RA patients (46 females, age 58 ± 11 years) completed assessments of CRF, CVD risk factors, body composition and RA characteristics. Ten patients participated in a follow-up 8-week exercise intervention. CRF was low (22 ml kg-1 min-1) and associated with higher diastolic blood pressure (r = - 0.37, p = 0.002), higher global CVD risk (r = - 0.267, p = 0.031) and worse body composition profile (body fat, r = - 0.48, p < 0.001; waist, r = - 0.65, p < 0.001; hip, r = - 0.58, p < 0.001). Regular exercise significantly improved CRF (p = 0.021), lower body strength (p < 0.001), agility (p < 0.001), systolic blood pressure (p = 0.021), body fat (p = 0.018), waist circumference (p = 0.035), hip circumference (p = 0.016), disease activity (p = 0.002), disability (p = 0.007) and QoL (p = 0.004). Elevated diastolic blood pressure and worse body composition profile are strong predictors of clinic-based measures of CRF. CRF is an important determinant of CVD risk and warrants inclusion in the routine assessment of RA patients. Regular exercise can improve CRF and CVD risk factors without any exacerbation of disease activity and should be offered as part of routine care.

Effects of type 1 diabetes, sprint training and sex on skeletal muscle sarcoplasmic reticulum Ca2+ uptake and Ca2+-ATPase activity.

Calcium cycling is integral to muscle performance during the rapid muscle contraction and relaxation of high-intensity exercise. Ca(2+) handling is altered by diabetes mellitus, but has not previously been investigated in human skeletal muscle. We investigated effects of high-intensity exercise and sprint training on skeletal muscle Ca(2+) regulation among men and women with type 1 diabetes (T1D, n = 8, 3F, 5M) and matched non-diabetic controls (CON, n = 8, 3F, 5M). Secondarily, we examined sex differences in Ca(2+) regulation. Subjects undertook 7 weeks of three times-weekly cycle sprint training. Before and after training, performance was measured, and blood and muscle were sampled at rest and after high-intensity exercise. In T1D, higher Ca(2+)-ATPase activity (+28%) and Ca(2+) uptake (+21%) than in CON were evident across both times and days (P < 0.05), but performance was similar. In T1D, resting Ca(2+)-ATPase activity correlated with work performed until exhaustion (r = 0.7, P < 0.01). Ca(2+)-ATPase activity, but not Ca(2+) uptake, was lower (-24%, P < 0.05) among the women across both times and days. Intense exercise did not alter Ca(2+)-ATPase activity in T1D or CON. However, sex differences were evident: Ca(2+)-ATPase was reduced with exercise among men but increased among women across both days (time × sex interaction, P < 0.05). Sprint training reduced Ca(2+)-ATPase (-8%, P < 0.05), but not Ca(2+) uptake, in T1D and CON. In summary, skeletal muscle Ca(2+) resequestration capacity was increased in T1D, but performance was not greater than CON. Sprint training reduced Ca(2+)-ATPase in T1D and CON. Sex differences in Ca(2+)-ATPase activity were evident and may be linked with fibre type proportion differences.

Gastrocnemius muscle-tendon behaviour during walking in young and older adults.

AIM: Age-related differences in muscle architectural and tendon mechanical properties have been observed in vivo under static conditions and during single joint contractions. The aim of this study was to determine if there are age-related differences in gastrocnemius fascicle-tendon interactions during a fundamental locomotor task - walking. METHODS: Eight young adults (YA; 27 +/- 4 years) and eight older adults (OA; 77 +/- 4 years) walked on a treadmill at 1.11 m s(-1) whilst length changes in the gastrocnemius lateralis muscle tendon complex (MTC), fascicles and tendinous tissue (TT) were determined from joint angles, ultrasonography and a geometric MTC model (combining MTC and fascicle measurements) respectively. RESULTS: There was no age-related difference in lengthening of the MTC during stance. However, the fascicle and TT contribution to MTC lengthening was altered; TT lengthening was larger in OA than in YA (P = 0.05) and fascicle lengthening was less in OA than YA (P < 0.05). There were no differences between groups in MTC, fascicle or TT shortening amplitude during push-off. CONCLUSION: The observations are consistent with previous reports of increased compliance of TT in older adults.

Metabolic cost, mechanical work, and efficiency during walking in young and older men.

AIM: To investigate mechanical work, efficiency, and antagonist muscle co-activation with a view to better understand the cause of the elevated metabolic cost of walking (C(W)) in older adults. METHODS: Metabolic, mechanical and electromyographic measurements were made as healthy young (YOU; n = 12, age = 27 +/- 3 years) and older (OLD; n = 20, age = 74 +/- 3 years) men of equivalent body mass and leg length walked on a treadmill at four speeds (ranging from 0.83 to 1.67 m s(-1)). RESULTS: Net (above resting) C(W), determined by indirect calorimetry was 31% higher (average across speeds) in OLD (P < 0.05). The integrity of the passive pendulum like interchange of mechanical energies of the centre of mass (COM(B)), an energy-saving mechanism, was maintained in OLD. Furthermore, total mechanical work, determined from fluctuations in mechanical energy of COM(B) and of body segments relative to COM(B), was not significantly elevated in OLD. This resulted in a lower efficiency in OLD (-17%, P < 0.05). Co-activation, temporally quantified from electromyography recordings, was 31% higher in OLD for antagonist muscles of the thigh (P < 0.05). Thigh co-activation was moderately correlated with C(W) at three speeds (r = 0.38-0.52, P < 0.05). CONCLUSION: Healthy septuagenarians with no gait impairment have an elevated C(W) which is not explained by an elevation in whole body mechanical work. Increased antagonist muscle co-activation (possibly an adaptation to ensure adequate joint stability) may offer partial explanation of the elevated C(W).

Changes in triceps surae muscle architecture with sarcopenia.

AIM: To investigate whether sarcopenia was evenly distributed among the three components of the triceps surae (TS) muscle group. METHODS: Muscle volume (VOL), fibre fascicle length (Lf), pennation angle (theta) and physiological cross-sectional area (PCSA = VOL/Lf) were measured in vivo for the lateral (GL) and medial (GM) heads of the gastrocnemius muscles and for the soleus muscle (SOL), in 15 young males (YM, aged 25.3 +/- 4.5 years) and 12 elderly males (EM aged 73.8 +/- 4.4 years). RESULTS: In the EM, VOL of all three muscles was significantly smaller than in the YM; differences were: 27% for the GL (P < 0.01), 29% for the GM (P < 0.01) and 17% for the SOL (P < 0.05). In total, TS VOL was 22% smaller in EM than in YM (P < 0.01). In the EM, values of theta were significantly smaller than in the YM; by 15-18% for the GL, GM and SOL (P < 0.05). In the EM, Lf of the GM was 16% smaller than in the YM (P < 0.01); no significant differences were found in the other muscles. PCSA of the GL and GM were both found to be smaller in EM by 19% (P < 0.01) and 14.5% (P < 0.05), respectively. No difference was observed in the SOL PCSA between YM and EM. Interestingly, probably because of the prevalent contribution of the SOL to PCSA distribution of each muscle to the TS PCSA, the relative TS PCSA was not different between YM and EM. Furthermore, the Lf/muscle length ratio did not differ between YM and EM. CONCLUSION: The present study shows that the relative PCSA composition of the TS is maintained with ageing and that the PCSA is scaled down harmonically with the decrease in muscle volume and fascicle length. Such observation suggests that the relative contribution of the components of the TS muscle to the total force developed by this muscle group is maintained with ageing.

Effect of 10-day cast immobilization on sarcoplasmic reticulum calcium regulation in humans.

This study investigated the effects of 10-day lower limb cast immobilization on sarcoplasmic reticulum (SR) Ca2+ regulation. Muscle biopsies were analysed in eight healthy females for maximal rates of SR Ca2+ release, Ca2+ uptake and Ca2+ ATPase activity at control, during immobilization at day 3 (IM 3), day 6 (IM 6) and day 10 (IM 10). Quadriceps muscle cross-sectional area (CSA) and 1-repetition maximum (1RM) leg extension strength were measured to determine the extent of muscle size and strength adaptations. Muscle CSA and strength decreased following 10 days of immobilization (11.8 and 41.6%, respectively, P < 0.01). A decrease in SR Ca2+ uptake rate (analysed per g wet wt) was found at IM 3 (13.2%, P=0.05), with a further decrease at IM 10 (19.8% from control, P < 0.01). At IM 10, a decrease in SR Ca2+ uptake rate (per mg protein) also occurred (19.9%, P < 0.01). Sarcoplasmic reticulum Ca2+ ATPase activity and rate of Ca2+ release were not altered with 10 days of immobilization. This study observed a decrease in SR Ca2+ uptake rate, muscular atrophy and strength loss over 10 days of immobilization in humans.

Sarcoplasmic reticulum function and muscle contractile character following fatiguing exercise in humans.

1. This study examined the alterations in calcium release, calcium uptake and calcium ATPase activity of skeletal muscle sarcoplasmic reticulum in response to a bout of intense dynamic knee extensor exercise, and the relationship between these changes and alterations in muscle contractile characteristics in the human quadriceps. 2. In biopsy samples taken from the vastus lateralis, sarcoplasmic reticulum calcium release and calcium uptake were significantly depressed (P < 0.01 and 0.05, respectively) immediately following the exercise with no alteration in the sarcoplasmic reticulum Ca2+-ATPase activity. 3. A 33 % reduction in the maximum voluntary isometric torque was found following the exercise, with reduced torques from electrically evoked isometric contractions at low frequencies of stimulation (10 and 20 Hz) but not at higher frequencies (50 and 100 Hz). 4. The depressed calcium release was correlated (P < 0.05) with a decreased ratio of torques generated at 20:50 Hz, indicating an involvement in low frequency fatigue; however, no correlations between the muscle relaxation times or rates of change of torque and calcium uptake were observed.

The influence of menstrual cycle phase on skeletal muscle contractile characteristics in humans.

The influence of the different phases of the menstrual cycle on skeletal muscle contractile characteristics was studied in 19 regularly menstruating women. Muscle function was measured when (i) oestrogen and progesterone concentrations were low (menstruation), (ii) oestrogen was elevated and progesterone was low (late follicular phase), and (iii) oestrogen and progesterone were both elevated (luteal phase).Maximal isometric quadriceps strength, fatiguability and electrically stimulated contractile properties were measured. Isokinetic knee flexion and extension strength and fatiguability were also assessed as well as handgrip strength. Menstrual cycle phases were confirmed through measurement of oestrogen, progesterone, follicle stimulating hormone and luteinising hormone. No significant changes were found in any of the muscle function parameters throughout the menstrual cycle (n = 15). The muscle function measurements showed no significant correlations with any of the female reproductive hormone concentrations. These results suggest that the fluctuations in female reproductive hormone concentrations throughout the menstrual cycle do not affect muscle contractile characteristics.

Human skeletal sarcoplasmic reticulum Ca2+ uptake and muscle function with aging and strength training.

This study investigated the adaptations of skeletal muscle sarcoplasmic reticulum (SR) Ca2+ uptake, relaxation, and fiber types in young (YW) and elderly women (EW) to high-resistance training. Seventeen YW (18-32 yr) and 11 EW (64-79 yr) were assessed for 1) electrically evoked relaxation time and rate of the quadriceps femoris; and 2) maximal rates of SR Ca2+ uptake and Ca2+-ATPase activity and relative fiber-type areas, analyzed from muscle biopsies of the vastus lateralis. EW had significantly slower relaxation rates and times, decreased SR Ca2+ uptake and Ca2+-ATPase activity, and a larger relative type I fiber area than did YW. A subgroup of 9 young (YWT) and 10 elderly women (EWT) performed 12 wk of high-resistance training (8 repetition maximum) of the quadriceps and underwent identical testing procedures pre- and posttraining. EWT significantly increased their SR Ca2+ uptake and Ca2+-ATPase activity in response to training but showed no alterations in speed of relaxation or relative fiber-type areas. In YWT none of the variables was altered after resistance training. These findings suggest that 1) a reduced SR Ca2+ uptake in skeletal muscle of elderly women was partially reversed with resistance training and 2) SR Ca2+ uptake in the vastus lateralis was not the rate-limiting mechanism for the slowing of relaxation measured from electrically evoked quadriceps muscle of elderly women.