Jan Lexell

What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men

In order to study the effects of increasing age on the human skeletal muscle, cross-sections (15 micron) of autopsied whole vastus lateralis muscle from 43 previously physically healthy men between 15 and 83 years of age were prepared and examined. The data obtained on muscle area, total number, size, proportion and distribution of type 1 (slow-twitch) and type 2 (fast-twitch) fibers were analysed using multivariate regression. The results show that the ageing atrophy of this muscle begins around 25 years of age and thereafter accelerates. This is caused mainly by a loss of fibers, with no predominant effect on any fiber type, and to a lesser extent by a reduction in fiber size, mostly of type 2 fibers. The results also suggest the occurrence of several other age-related adaptive mechanisms which could influence fiber sizes and fiber number, as well as enzyme histochemical fiber characteristics.

Aging of human muscle: structure, function and adaptability

With increasing age, human skeletal muscles gradually decrease in volume, mainly due to a reduced number of motor units and muscle fibers, and a reduced size of type 2 fibers. As a result, progressive weakening and impaired mobility occur. High‐resistance strength training is beneficial, even in the very old, and could possibly reverse some of the detrimental effects of age‐related weakness. The importance of exercise for older people affords an excellent opportunity for the medicine community as a major source of information and promotion of physical activity for this rapidly growing segment of the population. In this review, we summarize the current knowledge of the effects of aging on the human neuromuscular system, describe some of the major underlying mechanisms of the aging atrophy and focus on the importance of strength training to improve muscle function in older people.

Distribution of different fibre types in human skeletal muscles. Fibre type arrangement in m. vastus lateralis from three groups of healthy men between 15 and 83 years

The effects of age on the fibre type arrangement in the human muscle m. vastus lateralis were studied. There were 10, 6 and 8 healthy men in the three age-groups with means 24, 52 and 77 years, respectively. For each fascicle considered, the numbers of type 1 (ST) and type 2 (FT) fibres on the boundary and internally, and the numbers of enclosed fibres of either type, were counted. The randomness of the fibre type arrangement was considered in terms of the numbers of enclosed fibres and assessed by a Monte Carlo significance test. Fibre type grouping was shown to increase with increasing age. The proportion of type 2 fibres on the boundary of a fascicle was consistently greater than internally, but the difference was less pronounced in the old group. It is argued that the process of denervation and reinnervation of individual fibres has started before the age of 50, is a major factor in a progressive reduction of fibres with increasing age and is probably caused by a continuous loss of motor neurons in the spinal cord.

Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy.

Several converging lines of contemporary evidence suggest that weakness presents a more serious compromise to movement function in poststroke hemiplegia than spasticity. This review examines the clinical and functional phenomena of weakness in poststroke hemiplegia, currently available evidence identifying physiologic substrates contributing to weakness, and reports of early investigations involving high-resistance training targeted at improving strength and the transfer of strength to improvements in functional capacity. Based on this information, we describe some unsolved problems and indicate some likely lines of development to increase our knowledge regarding how resistance training can be included in effective stroke rehabilitation.

Satellite cells and myonuclei in young and elderly women and men

The overall aim of this study was to assess the effects of aging on the satellite cell population. Muscle biopsies were taken from the tibialis anterior muscle of healthy, moderately active young (age range, 20–32 years; n = 31) and elderly (age range, 70–83 years; n = 27) women and men with comparable physical activity pattern. Satellite cells and myonuclei were visualized using a monoclonal antibody against neural cell adhesion molecule and counterstained with Mayers hematoxylin. An average of 211 (range, 192–241) muscle fibers were examined for each individual. Compared with the young women and men, the elderly subjects had a significantly lower (P < 0.011) number of satellite cells per muscle fiber but a significantly higher (P < 0.004) number of myonuclei per muscle fiber. The number of satellite cells relative to the total number of nuclei [satellite cells/(myonuclei + satellite cells)] was significantly lower in the elderly than in the young women and men. These results imply that a reduction in the satellite cell population occurs as a result of increasing age in healthy men and women. Muscle Nerve 29: 120–127, 2004

Heavy‐resistance training in older Scandinavian men and women: short‐ and long‐term effects on arm and leg muscles

The short‐ and long‐term effects of heavy‐resistance training (85% of one‐repetition maximum (RM)) on elbow flexion and knee extension dynamic and isokinetic strength and on morphology in the biceps brachii and vastus lateralis muscles were evaluated during 1 year in 35 Scandinavian men and women, aged 70–77 years, 12 of whom formed a control group. After the first 11 weeks of training (n=23; 3 times/week) elbow flexion and knee extension dynamic strength (1 RM) had increased [mean±SD] 49%±16 and 163%±75, respectively, with no significant difference between men and women. For the following 27 weeks, strength was maintained with one training session per week (n=12) but dropped without training (n=11). After the final 11 weeks of training (n=11; 3 times/week), strength had further increased 32%±16 in both the arm and the leg. Isokinetic strength measurements (Cybex II; 30%s) revealed similar but smaller gains than for dynamic strength. Muscle biopsies (n=20) taken at the start and after the first 11 weeks of training showed a significant increase in the area of both type 1 and type 2 fibers in the biceps brachii muscle and a positive significant correlation between the percentage increase in the proportional area of type 2 fibers in the vastus lateralis muscle and the percentage increase in knee extension dynamic muscle strength. In conclusion, older Scandinavian men and women have a high capacity both to improve and to maintain muscle strength, some of which is mediated through an adaptation in the muscle fiber type population.

Evidence for Nervous System Degeneration with Advancing Age

Human skeletal muscle undergoes major structural and functional changes with advancing age. A progressive degeneration of the nervous system is now considered a major factor underlying these alterations. This review will briefly describe the changes that occur in the human motor unit with increasing age and focus specifically on the changes that relate to a degeneration of the nervous system.

The occurrence of fibre-type grouping in healthy human muscle: a quantitative study of cross-sections of whole vastus lateralis from men between 15 and 83 years

SummaryMethods that objectively assess the muscle fibre-type arrangement may improve the detection of fibre-type grouping, a diagnostic sign of a denervation and reinnervation process. To distinguish between a diseased and a normal muscle, there is a need for quantitative data on the fibre-type arrangement in healthy human muscles at different ages. In this study, cross-sections were prepared of whole autopsied vastus lateralis muscle from 24 previously physically healthy men, aged 15 to 83 years. The arrangements of type 1 and type 2 fibres were assessed in terms of the number of enclosed fibres in individual fascicles throughout each muscle. Recent improvements to the enclosed fibre method were used to define measures of randomness which facilitated the combination of several sample areas and the quantification of the fibre-type arrangements. Segregation was typical for young muscles, randomness was most common between 30 and 50 years of age, while some fibre-type grouping was considered “normal” in old muscles. The arrangements of type 1 and type 2 fibres were quantitatively similar, irrespective of the age of the individual. The results imply that the fibre population changes considerably during a lifetime, and that it undergoes a continuous denervation and reinnervation process with normal ageing. Because of its importance, age should be accommodated in the analysis of a muscle sample, irrespective of the statistical model and method used.

Reliability of isokinetic ankle dorsiflexor strength measurements in healthy young men and women

The purposes of this study were: (i) to determine the test-retest reliability of isokinetic ankle dorsiflexor strength measurements in young healthy adults using the Biodex dynamometer, and (ii) to examine several statistical measures for the interpretation of reliability. Thirty men and women (mean age 23 +/- 3 years) performed three maximal concentric contractions at 30 degrees/s, 60 degrees/s, 90 degrees/s, 120 degrees/s and 150 degrees/s. Reliability of peak torque, work and torque at a specific time were assessed by calculating the intraclass correlation coefficient (ICC 2,1), Pearson product moment correlation coefficient (r), standard error of the measurement (SEM), method error (ME) and coefficient of variation (CV), and by plotting the differences between observations against their means. Isokinetic tests of ankle dorsiflexor strength in healthy young adults using the Biodex dynamometer were highly reliable (ICC 0.61-0.93). It is recommended that test-retest reliability analyses include the ICC and assessments of measurement errors (SEM, ME or CV), as well as graphs to indicate any systematic variations in the data.

Distribution of different fibre types in human skeletal muscles. I. Method for the preparation and analysis of cross-sections of whole tibialis anterior

SummaryThe aim of this study was to examine whether small biopsy specimens are representative of the whole human skeletal muscle or whether the different fibre types are unevenly distributed at different depths of the muscle. Ten micrometre thick cross-sections of whole human tibialis anterior were prepared using LKB PMV Cryo-Microtomes with a stroke length of 160 to 480 mm and the sections were stained for myofibrillar ATPase according to a modified procedure. The total and relative number of different fibres (Types 1 and 2) was determined in every 9th mm2 of the section. The data obtained were analysed by means of a computer program, which allowed assessment of bivariate data in the form of contour plots.The total number of fibres varied greatly between individuals (from 96 000 to 162 000; five individuals). The relative number of different fibres varied systematically in all individuals as a function of depth in the muscle. There was a gradual, often dramatic, relative increase in Type 2 fibre occurrence from the surface of the muscle (about 10–25%) towards the deeper regions (30–50%), the maximum being approximately along a line slightly posterior to the middle of the muscle. Additionally, superficial peaks were seen in places. In conclusion, the fibre type distribution in the tibialis anterior is not random. These results point to the importance of defining biopsy depth.