Skip to main content
SpringerLink
Log in

Lower-Extremity Torque Capacity and Physical Function in Mobility-Limited Older Adults

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Skeletal muscle weakness and an increase in fatigability independently contribute to age-related functional decline. The objective of this study was to examine the combined contribution of these deficiencies (i.e., torque capacity) to physical function, and then to assess the functional implications of progressive resistance training (PRT) mediated-torque capacity improvements in mobility-limited older adults.

Design

Randomized controlled trial.

Setting

Exercise laboratory on the Health Sciences campus of an urban university.

Participants

Seventy mobility-limited (Short Physical Performance Battery (SPPB) ≤9) older adults (~79 yrs).

Intervention

Progressive resistance training or home-based flexibility 3 days/week for 12 weeks.

Measurements

Torque capacity was defined as the sum of peak torques from an isokinetic knee extension fatigue test. Relationships between torque capacity and performance-based and patient-reported functional measures before and after PRT were examined using partial correlations adjusted for age, sex, and body mass index.

Results

Torque capacity explained (P<0.05) 10 and 28% of the variance in six-minute walk distance and stair climb time, respectively. PRT-mediated torque capacity improvements were paralleled by increases (P<0.05) in self-reported activity participation (+20%) and advanced lower extremity function (+7%), and associated (P<0.05) with a reduction in activity limitations (r=0.44) and an improved SPPB score (r=0.32).

Conclusion

Skeletal muscle torque capacity, a composite of strength and fatigue, may be a proximal determinant of physical function in mobility-limited older individuals. To more closely replicate the musculoskeletal demands of real-life tasks, future studies are encouraged to consider the combined interaction of distinct skeletal muscle faculties to overall functional ability in older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009 Oct 3;374(9696):1196–208.

    Article  Google Scholar 

  2. Hobbs F. The Elderly Population. Washington, DC: United States Bureau of Census 2000.

    Google Scholar 

  3. Berlau DJ, Corrada MM, Kawas C. The prevalence of disability in the oldest-old is high and continues to increase with age: findings from The 90+ Study. Int J Geriatr Psychiatry. 2009 Nov;24(11):1217–25.

    Article  Google Scholar 

  4. He W, Larsen L. Older americans with a disability: 2008–2012. In: Services USDoHaH, editor. Online 2014.

  5. Jette AM, Branch LG. Musculoskeletal impairment among the non-institutionalized aged. Int Rehabil Med. 1984;6(4):157–61.

    Article  CAS  Google Scholar 

  6. Jette AM, Branch LG, Berlin J. Musculoskeletal impairments and physical disablement among the aged. J Gerontol. 1990 Nov;45(6):M203–8.

    Article  CAS  Google Scholar 

  7. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221–31.

    Article  CAS  Google Scholar 

  8. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995 Mar 2;332(9):556–61.

    Article  CAS  Google Scholar 

  9. Bean JF, Kiely DK, Herman S, Leveille SG, Mizer K, Frontera WR, et al. The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc. 2002 Mar;50(3):461–7.

    Article  Google Scholar 

  10. Reid KF, Naumova EN, Carabello RJ, Phillips EM, Fielding RA. Lower extremity muscle mass predicts functional performance in mobility-limited elders. The journal of nutrition, health & aging. 2008;12(7):493–8.

    Article  CAS  Google Scholar 

  11. Kent-Braun JA, Callahan DM, Fay JL, Foulis SA, Buonaccorsi JP. Muscle weakness, fatigue, and torque variability: effects of age and mobility status. Muscle Nerve. 2014 Feb;49(2):209–17.

    Article  Google Scholar 

  12. Reid KF, Pasha E, Doros G, Clark DJ, Patten C, Phillips EM, et al. Longitudinal decline of lower extremity muscle power in healthy and mobility-limited older adults: Influence of muscle mass, strength, composition, neuromuscular activation and single fiber contractile properties. Eur J Appl Physiol. 2014 Jan;114(1):29–39.

    Article  Google Scholar 

  13. Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. The journals of gerontology Series A, Biological sciences and medical sciences. 2006 Oct;61(10):1059–64.

    Article  Google Scholar 

  14. Lexell J, Taylor CC, Sjostrom M. 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. J Neurol Sci. 1988 Apr;84(2–3):275–94.

    Article  CAS  Google Scholar 

  15. Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994 Jun 23;330(25):1769–75.

    Article  CAS  Google Scholar 

  16. Aniansson A, Hedberg M, Henning GB, Grimby G. Muscle morphology, enzymatic activity, and muscle strength in elderly men: a follow-up study. Muscle Nerve. 1986 Sep;9(7):585–91.

    Article  CAS  Google Scholar 

  17. Frontera WR, Hughes VA, Fielding RA, Fiatarone MA, Evans WJ, Roubenoff R. Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol (1985). 2000 Apr;88(4):1321–6.

    Article  CAS  Google Scholar 

  18. Metter EJ, Conwit R, Tobin J, Fozard JL. Age-associated loss of power and strength in the upper extremities in women and men. J Gerontol A Biol Sci Med Sci. 1997 Sep;52(5):B267–76.

    Article  CAS  Google Scholar 

  19. Thompson LV. Skeletal muscle adaptations with age, inactivity, and therapeutic exercise. J Orthop Sports Phys Ther. 2002 Feb;32(2):44–57.

    Article  Google Scholar 

  20. Woolley S, Topp R, Khuder S, et a. Function: which factors predict ability in OA patients. Biomech in Ger. 1998(17):6–12.

  21. Hughes MA, Myers BS, Schenkman ML. The role of strength in rising from a chair in the functionally impaired elderly. J Biomech. 1996 Dec;29(12):1509–13.

    Article  CAS  Google Scholar 

  22. Allen DG, Lamb GD, Westerblad H. Skeletal muscle fatigue: cellular mechanisms. Physiol Rev. 2008 Jan;88(1):287–332.

    Article  CAS  Google Scholar 

  23. Baudry S, Klass M, Pasquet B, Duchateau J. Age-related fatigability of the ankle dorsiflexor muscles during concentric and eccentric contractions. Eur J Appl Physiol. 2007 Jul;100(5):515–25.

    Article  Google Scholar 

  24. Lindstrom B, Lexell J, Gerdle B, Downham D. Skeletal muscle fatigue and endurance in young and old men and women. J Gerontol A Biol Sci Med Sci. 1997 Jan;52(1):B59–66.

    Article  CAS  Google Scholar 

  25. Senefeld J, Yoon T, Hunter SK. Age differences in dynamic fatigability and variability of arm and leg muscles: Associations with physical function. Exp Gerontol. 2017 Jan;87(Pt A):74–83.

    Article  Google Scholar 

  26. Justice JN, Mani D, Pierpoint LA, Enoka RM. Fatigability of the dorsiflexors and associations among multiple domains of motor function in young and old adults. Exp Gerontol. 2014 Jul;55:92–101.

    Article  Google Scholar 

  27. Englund DA, Price LL, Grosicki GJ, Iwai M, Kashiwa M, Liu C, et al. Progressive resistance training improves torque capacity and strength in mobility-limited older adults. J Gerontol A Biol Sci Med Sci. 2018 Aug 27.

  28. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994 Mar;49(2):M85–94.

    Article  CAS  Google Scholar 

  29. Enright PL. The six-minute walk test. Respir Care. 2003 Aug;48(8):783–5.

    PubMed  Google Scholar 

  30. Sayers SP, Jette AM, Haley SM, Heeren TC, Guralnik JM, Fielding RA. Validation of the Late-Life Function and Disability Instrument. J Am Geriatr Soc. 2004 Sep;52(9):1554–9.

    Article  Google Scholar 

  31. Evans CJ, Chiou CF, Fitzgerald KA, Evans WJ, Ferrell BR, Dale W, et al. Development of a new patient-reported outcome measure in sarcopenia. J Am Med Dir Assoc. 2011 Mar;12(3):226–33.

    Article  Google Scholar 

  32. Glynn NW, Santanasto AJ, Simonsick EM, Boudreau RM, Beach SR, Schulz R, et al. The Pittsburgh Fatigability scale for older adults: development and validation. J Am Geriatr Soc. 2015 Jan;63(1):130–5.

    Article  Google Scholar 

  33. Hunter SK, Critchlow A, Enoka RM. Muscle endurance is greater for old men compared with strength-matched young men. J Appl Physiol (1985). 2005 Sep;99(3):890–7.

    Article  Google Scholar 

  34. Hinman MR, O’Connell JK, Dorr M, Hardin R, Tumlinson AB, Varner B. Functional predictors of stair-climbing speed in older adults. J Geriatr Phys Ther. 2014 Jan–Mar;37(1):1–6.

    Article  Google Scholar 

  35. Reid KF, Fielding RA. Skeletal muscle power: A critical determinant of physical functioning in older adults. Exercise and sport sciences reviews. 2012 Jan;40(1):4–12.

    Article  Google Scholar 

  36. Bean JF, Leveille SG, Kiely DK, Bandinelli S, Guralnik JM, Ferrucci L. A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more? The journals of gerontology Series A, Biological sciences and medical sciences. 2003 Aug;58(8):728–33.

    Article  Google Scholar 

  37. Chandler JM, Duncan PW, Kochersberger G, Studenski S. Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? Arch Phys Med Rehabil. 1998 Jan;79(1):24–30.

    Article  CAS  Google Scholar 

  38. Ouellette MM, LeBrasseur NK, Bean JF, Phillips E, Stein J, Frontera WR, et al. High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors. Stroke. 2004 Jun;35(6):1404–9.

    Article  Google Scholar 

  39. Bean JF, Olveczky DD, Kiely DK, LaRose SI, Jette AM. Performance-based versus patient-reported physical function: what are the underlying predictors? Phys Ther. 2011 Dec;91(12):1804–11.

    Article  Google Scholar 

  40. Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA. Power training improves balance in healthy older adults. The journals of gerontology Series A, Biological sciences and medical sciences. 2006 Jan;61(1):78–85.

    Article  Google Scholar 

Download references

Acknowledgements

We thank our participants for their time and efforts that made this study possible.

Author information

Authors and Affiliations

  1. Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human, Boston, USA

    Gregory J. Grosicki, D. A. Englund, K. F. Reid & R. A. Fielding

  2. Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    Gregory J. Grosicki, D. A. Englund, K. F. Reid & R. A. Fielding

  3. Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), 11935 Abercorn Street, Savannah, GA, 31419, USA

    Gregory J. Grosicki

  4. The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA

    L. Price

  5. Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA

    L. Price

  6. Astellas Pharma Inc., Northbrook, USA

    M. Iwai & M. Kashiwa

Authors
  1. Gregory J. Grosicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. A. Englund
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Price
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Iwai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Kashiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. F. Reid
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. A. Fielding
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Author Contributions: Conception and design: RAF, KFR, MI, MK. Acquisition of data: DAE, GJG, KFR, RAF. Analysis and interpretation: GJG, LLP, DAE, RAF. Drafting: GJG, DAE. Editing and approving: GJG, DAE, LLP, MI, MK, KFR, RAF.

Corresponding author

Correspondence to Gregory J. Grosicki.

Ethics declarations

Ethical standard: This study was reviewed and approved by the Tufts University Health Sciences Institutional Review Board.

Additional information

Sources of support: Dr. Grosicki reports grants from Astellas Pharmaceuticals Inc, grants from U.S. Department of Agriculture (agreement No. 58-1950-4-003), grants from Boston Claude D Pepper Center (OAIC; 1P30AG031679), grants from National Center for Advancing Translational Sciences (Award Number UL1TR001064), National Institutes of Health, during the conduct of the study. Dr. Englund reports grants from Astellas Pharma Inc, during the conduct of the study. Ms. Price reports other from Tufts University/HNRCA, during the conduct of the study. Dr. Iwai reports personal fees from Astellas Pharma Inc., during the conduct of the study; personal fees from Astellas Pharma Inc., outside the submitted work. Dr. Kashiwa reports personal fees from Astellas Pharma Inc., during the conduct of the study; personal fees from Astellas Pharma Inc., outside the submitted work. Dr. Reid has nothing to disclose. Dr. Fielding reports grants from National Institutes of Health (National Institute on Aging), during the conduct of the study; grants, personal fees and other from Axcella Health, other from Inside Tracker, grants and personal fees from Biophytis, grants and personal fees from Astellas, personal fees from Cytokinetics, personal fees from Amazentis, grants and personal fees from Nestle’, personal fees from Glaxo Smith Kline, outside the submitted work. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the USDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. ClinicalTrials. gov Identifier: NCT03083275.

Sponsor’s Role: Astellas Pharma INC. approved of study procedures and helped to edit and revise the manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grosicki, G.J., Englund, D.A., Price, L. et al. Lower-Extremity Torque Capacity and Physical Function in Mobility-Limited Older Adults. J Nutr Health Aging 23, 703–709 (2019). https://doi.org/10.1007/s12603-019-1232-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-019-1232-8

Key words

Search

Navigation