The positive effects of negative work

Increased muscle strength and decreased fall risk in a frail elderly population

Paul C. LaStayo, Gordon A. Ewy, David J Pierotti, Richard K. Johns, Stan L Lindstedt

Research output: Contribution to journalArticle

173 Citations (Scopus)

Abstract

Background. The objective of this study was to determine if a chronic eccentric training intervention, i.e., negative work, could limit or even reverse sarcopenia and its related impairments and functional limitations. Is high-force eccentric training tolerable by elderly people and will it result in improved muscle size, strength, balance, and fall risk? Methods. 21 frail elderly subjects (mean age, 80 years) experienced 11 weeks of lower extremity resistance training. The experimental eccentric (ECC) group (n = 11) performed negative work while exercising on a high-force eccentric ergometer. The active "controls" performed traditional (TRAD) (n = 10) lower extremity resistance exercises (weight training). Muscle fiber cross-sectional area and strength, balance, stair descending abilities, and fall risk were assessed prior to and following this intervention. Results. All ECC subjects who started the negative work intervention completed the study and reported the training to be relatively effortless; they experienced minimal and transient muscle soreness. Both groups experienced a significant increase in muscle fiber cross-sectional area (ECC = 60%, TRAD = 41%). Only the ECC group experienced significant improvements in strength (60%), balance (7%), and stair descent (21%) abilities. The timed up and go task improved in both groups, but only the ECC group went from a high to a low fall risk. Conclusions. These data demonstrate that lower extremity resistance exercise can improve muscle structure and function in those with limited exercise tolerance. The greater strength increase following negative work training resulted in improved balance, stair descent, and fall risk only in the ECC group. Because low energy cost is coupled to high force production with eccentric exercise, this intervention may be useful for a number of patients that are otherwise unable to achieve high muscle forces with traditional resistance exercise.

Original languageEnglish (US)
Pages (from-to)419-424
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume58
Issue number5
StatePublished - May 1 2003

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Frail Elderly
Muscle Strength
Exercise
Lower Extremity
Muscles
Aptitude
Population
Sarcopenia
Exercise Tolerance
Resistance Training
Myalgia
Weights and Measures
Costs and Cost Analysis

ASJC Scopus subject areas

  • Aging

Cite this

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title = "The positive effects of negative work: Increased muscle strength and decreased fall risk in a frail elderly population",
abstract = "Background. The objective of this study was to determine if a chronic eccentric training intervention, i.e., negative work, could limit or even reverse sarcopenia and its related impairments and functional limitations. Is high-force eccentric training tolerable by elderly people and will it result in improved muscle size, strength, balance, and fall risk? Methods. 21 frail elderly subjects (mean age, 80 years) experienced 11 weeks of lower extremity resistance training. The experimental eccentric (ECC) group (n = 11) performed negative work while exercising on a high-force eccentric ergometer. The active {"}controls{"} performed traditional (TRAD) (n = 10) lower extremity resistance exercises (weight training). Muscle fiber cross-sectional area and strength, balance, stair descending abilities, and fall risk were assessed prior to and following this intervention. Results. All ECC subjects who started the negative work intervention completed the study and reported the training to be relatively effortless; they experienced minimal and transient muscle soreness. Both groups experienced a significant increase in muscle fiber cross-sectional area (ECC = 60{\%}, TRAD = 41{\%}). Only the ECC group experienced significant improvements in strength (60{\%}), balance (7{\%}), and stair descent (21{\%}) abilities. The timed up and go task improved in both groups, but only the ECC group went from a high to a low fall risk. Conclusions. These data demonstrate that lower extremity resistance exercise can improve muscle structure and function in those with limited exercise tolerance. The greater strength increase following negative work training resulted in improved balance, stair descent, and fall risk only in the ECC group. Because low energy cost is coupled to high force production with eccentric exercise, this intervention may be useful for a number of patients that are otherwise unable to achieve high muscle forces with traditional resistance exercise.",
author = "LaStayo, {Paul C.} and Ewy, {Gordon A.} and Pierotti, {David J} and Johns, {Richard K.} and Lindstedt, {Stan L}",
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T2 - Increased muscle strength and decreased fall risk in a frail elderly population

AU - LaStayo, Paul C.

AU - Ewy, Gordon A.

AU - Pierotti, David J

AU - Johns, Richard K.

AU - Lindstedt, Stan L

PY - 2003/5/1

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N2 - Background. The objective of this study was to determine if a chronic eccentric training intervention, i.e., negative work, could limit or even reverse sarcopenia and its related impairments and functional limitations. Is high-force eccentric training tolerable by elderly people and will it result in improved muscle size, strength, balance, and fall risk? Methods. 21 frail elderly subjects (mean age, 80 years) experienced 11 weeks of lower extremity resistance training. The experimental eccentric (ECC) group (n = 11) performed negative work while exercising on a high-force eccentric ergometer. The active "controls" performed traditional (TRAD) (n = 10) lower extremity resistance exercises (weight training). Muscle fiber cross-sectional area and strength, balance, stair descending abilities, and fall risk were assessed prior to and following this intervention. Results. All ECC subjects who started the negative work intervention completed the study and reported the training to be relatively effortless; they experienced minimal and transient muscle soreness. Both groups experienced a significant increase in muscle fiber cross-sectional area (ECC = 60%, TRAD = 41%). Only the ECC group experienced significant improvements in strength (60%), balance (7%), and stair descent (21%) abilities. The timed up and go task improved in both groups, but only the ECC group went from a high to a low fall risk. Conclusions. These data demonstrate that lower extremity resistance exercise can improve muscle structure and function in those with limited exercise tolerance. The greater strength increase following negative work training resulted in improved balance, stair descent, and fall risk only in the ECC group. Because low energy cost is coupled to high force production with eccentric exercise, this intervention may be useful for a number of patients that are otherwise unable to achieve high muscle forces with traditional resistance exercise.

AB - Background. The objective of this study was to determine if a chronic eccentric training intervention, i.e., negative work, could limit or even reverse sarcopenia and its related impairments and functional limitations. Is high-force eccentric training tolerable by elderly people and will it result in improved muscle size, strength, balance, and fall risk? Methods. 21 frail elderly subjects (mean age, 80 years) experienced 11 weeks of lower extremity resistance training. The experimental eccentric (ECC) group (n = 11) performed negative work while exercising on a high-force eccentric ergometer. The active "controls" performed traditional (TRAD) (n = 10) lower extremity resistance exercises (weight training). Muscle fiber cross-sectional area and strength, balance, stair descending abilities, and fall risk were assessed prior to and following this intervention. Results. All ECC subjects who started the negative work intervention completed the study and reported the training to be relatively effortless; they experienced minimal and transient muscle soreness. Both groups experienced a significant increase in muscle fiber cross-sectional area (ECC = 60%, TRAD = 41%). Only the ECC group experienced significant improvements in strength (60%), balance (7%), and stair descent (21%) abilities. The timed up and go task improved in both groups, but only the ECC group went from a high to a low fall risk. Conclusions. These data demonstrate that lower extremity resistance exercise can improve muscle structure and function in those with limited exercise tolerance. The greater strength increase following negative work training resulted in improved balance, stair descent, and fall risk only in the ECC group. Because low energy cost is coupled to high force production with eccentric exercise, this intervention may be useful for a number of patients that are otherwise unable to achieve high muscle forces with traditional resistance exercise.

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