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George J. Salem, Man-Ying Wang and Susan Sigward

In order to obtain joint-specific baseline strength characteristics in older adults, clinicians and researchers must have knowledge regarding the relative stability of the various strength tests (the strength difference between repeated measures) and the number of prebaseline practice sessions required to obtain consistent data. To address these needs, the relative multiple-test stability and reliability associated with lower extremity isokinetic and 1-repetition-maximum (1RM) strength measures were assessed in a sample of older adults (N = 30, 65.2 ± 6.3 years), over 4 weeks (T1-T4). Isokinetic ankle plantar-flexion (30°/s) strength and 1RM ankle plantar-flexion, leg-press, and knee-flexion strength exhibited poor stability between Weeks T1 and T2 but stabilized between Weeks T2 and T3 and Weeks T3 and T4. The measures exhibited low incidence of injury and induced low levels of residual muscle soreness. Findings suggest that the 1RM measures require at least 1 prebaseline training session in order to establish consistent baseline performance and are more reliable than isokinetic ankle plantar-flexion tests.

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George J. Salem, Man-Ying Wang, Stanley P. Azen, Jean T. Young and Gail A. Greendale

The purpose of this investigation was to determine the effects of two doses of a weighted vest on acute lower-extremity gait kinetics in older adults. Peak ankle, knee, and hip net joint moments were quantified in 56 men and women volunteers (73.8 ± 6.9 years old) enrolled in a 6-month physical activity study. At the initial study visit, participants underwent 6 walking trials (3 with vest, 3 without vest) at their normal pace. During the vest-wearing trials, participants wore a vest loaded with either 0% of body weight (BW) (n = 19), 3% of BW (n = 16), or 5% of BW (n = 21). With acute application of the vests, maximum peak plantarflexion moments increased by 5.7% in the 5% BW group compared to the 0% BW group, p < 0.01. Compared to the 0% vest-weight group, knee extension moments increased by 13.8% when 5% BW was applied, p < 0.01; a marginally significant treatment effect was evident in the 3% BW group, p = 0.04. Despite these acute alterations, knee strength and physical performance did not improve when subjects wore the vests 2 hours a day, 4 days a week for 27 weeks, without additional exercise prescription. These findings suggest that: (a) the acute changes in vest-mediated lower-extremity kinetics are not systemic but joint specific and load dependent, and (b) weighted vest prescription should be greater than 5% BW without prescribed exercise, or should include prescribed exercises, to invoke long-term strength and physical performance gains in older adults.

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Sean P. Flanagan, Joo-Eun Song, Man-Ying Wang, Gail A. Greendale, Stanley P. Azen and George J. Salem

The purpose of this investigation was to determine whether increases in internal (muscular) demand would be proportional to increases in the external demand during heel-raise exercise. Seven male (mean age 74.9 ± 4.8 years) and 9 female (mean age 74.4 ± 5.1 years) older adults performed both double-leg heel raises and single-leg heel raises under 3 loading conditions (no external resistance and +5% and +10% of each participant’s body weight). Kinematic and kinetic dependent variables were calculated using standard inverse-dynamics techniques. The results suggest that although the single-heel raise led to increases in peak net joint moments, power, and mechanical-energy expenditure (MEE), it did so at the expense of range of motion and angular velocity. In addition, increasing the external resistance by 5% of participants’ body weight did not elicit significant changes in either the power or the MEE of the ankle joint. These effects should be considered when prescribing these exercises to older adults.

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George J. Salem, Sean P. Flanagan, Man-Ying Wang, Joo-Eun Song, Stanley P. Azen and Gail A. Greendale

Stepping activities when wearing a weighted vest may enhance physical function in older persons. Using 3 weighted-vest resistance dosages, this study characterized the lower-extremity joint biomechanics associated with stepping activities in elders. Twenty healthy community-dwelling older adults, ages 74.5 ± 4.5 yrs, performed 3 trials of forward step-up and lateral step-up exercises while wearing a weighted vest which added 0% body weight (BW), 5% BW, or 10% BW. They performed these activities on a force platform while instrumented for biomechanical analysis. Repeated-measures ANOVA was used to evaluate the differences in ankle, knee, and hip maximum joint angles, peak net joint moments, joint powers, and impulses among both steping activities and the 3 loading conditions. Findings indicated that the 5% BW vest increased the kinetic output associated with the exercise activities at all three lower-extremity joints. These increases ranged from 5.9% for peak hip power to 12.5% for knee extensor impulse. The application of an additional 5% BW resistance did not affect peak joint moments or powers, but it did increase the joint impulses by 4–11%. Comparisons between exercise activities, across the 3 loading conditions, indicated that forward stepping preferentially targeted the hip extensors while lateral stepping targeted the plantar flexors; both activities equally targeted the knee extensors. Weighted-vest loads of 5% and 10% BW substantially increased the mechanical demand on the knee extensors, hip extensors (forward stepping), and ankle plantar flexors (lateral stepping).