European Journal of Applied Physiology

, Volume 100, Issue 5, pp 553–561 | Cite as

Strength, power output and symmetry of leg muscles: effect of age and history of falling

  • Mark C. Perry
  • Serena F. Carville
  • I. Christopher H. Smith
  • Olga M. Rutherford
  • Di J. Newham
Original Article

Abstract

Risk factors for medically unexplained falls may include reduced muscle power, strength and asymmetry in the lower limbs. Conflicting reports exist about strength and there is little information about power and symmetry. Forty-four healthy young people (29.3 ± 0.6 years), 44 older non-fallers (75.9 ± 0.6 years), and 34 older fallers (76.4 ± 0.8 years) were studied. Isometric, concentric and eccentric strength of the knee and ankle muscles and leg extension power were measured bilaterally. The younger group was stronger in all muscles and types of contraction than both older groups (P < 0.02–0.0001). Strength differences between the older groups occasionally reached significance in individual muscles and types of contraction but overall the fallers had 85% of the strength and 79% of the power of the non-fallers (P < 0.001). Young subjects generated more power than both older groups (P < 0.0001) and the fallers generated less than the non-fallers (P = 0.03). Strength symmetry showed an inconsistent age effect in some muscles and some contraction types. This was similar overall in the two older groups. Both older groups had greater asymmetry in power than the young (P < 0.02–0.004). Power asymmetry tended to be greater in the fallers than the non-fallers but this did not reach significance. These data do not support the suggestion that asymmetry of strength and power are associated with either increasing age or fall history. Power output showed clear differences between age groups and fall status and appears to be the most relevant measurement of fall risk and highlights the cumulative effects on function of small changes in strength in individual muscle groups.

Keywords

Muscle Ageing Falls Strength Power Symmetry 

References

  1. Alexander NB (2001) Falls and gait disturbances. Clin Geriatr Med 9:56–61Google Scholar
  2. Bassey EJ, Short AH (1990) A new method for measuring power output in a single leg extension: feasibility reliability and validity. Eur J Appl Physiol 60:385–390CrossRefGoogle Scholar
  3. Christou EA, Carlton LG (2002) Age and contraction type influence motor output variability in rapid discrete tasks. J Appl Physiol 93:489–498PubMedGoogle Scholar
  4. D’Antona G, Pellegrino MA, Adami RR, Carlizzi CN, Canepari M, Saltin B, Bottinelli R (2003) The effect of ageing and immobilization on structure and function of human skeletal muscle fibres. J Physiol 552:499–511PubMedCrossRefGoogle Scholar
  5. Daubney ME, Culham EG (1999) Lower extremity muscle force and balance performance in adults aged 65 years and older. Phys Therapy 79:1177–1185Google Scholar
  6. Delmonico MJ, Kostek MC, Doldo NA et al (2005) Effects of moderate velocity strength training on peak muscle power and movement velocity; do women respond differently to men? J Appl Physiol 99:1712–1718PubMedCrossRefGoogle Scholar
  7. de Rekeneire N, Visser M, Peila R, Nevitt MC, Cauley JA, Tylavsky FA, Simonsick EM, Harris TB (2003) Is a fall just a fall: correlates of falling in healthy older persons. The health aging and body composition study. J Am Geriatr Soc 51:841–846PubMedCrossRefGoogle Scholar
  8. Delbaere K, Bourgeois (2003) Age-related changes in concentric and eccentric muscle strength in the lower and upper extremity: a cross-sectional study. Isokinet Exerc Sci 11:145–151Google Scholar
  9. De Vita P, Hortobagyi T (2000) Age increases the skeletal versus muscular component of lower extremity stiffness during stepping down. J Gerontol A Biol Sci Med Sci 55:B593–B600Google Scholar
  10. Fisher NM, Perndergast DR, Gresham GE, Calkins E (1991) Muscle rehabilitation: Its effect on muscular and functional performance of patients with knee osteoarthritis. Arch Phys Med Rehabil 72:367–374PubMedGoogle Scholar
  11. Frontera WR, Hughes VA, Fielding RA, Fiatarone MA, Evans WJ, Roubenoff R (2000) Ageing of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol 88:1321–1326PubMedGoogle Scholar
  12. Gehlsen GM, Whaley MH (1990) Falls in the elderly: part II, balance strength and flexibility. Arch Phys Med Rehabil 71:739–741PubMedGoogle Scholar
  13. Grabiner MD, Koh TJ, Lundin TM, Jahnigen DW (1993) Kinematics of recovery from a stumble. J Gerontol 48:M97–M102PubMedGoogle Scholar
  14. Hortobagyi T, Zheng D, Weidner M, Lambert NJ, Westbrook S, Houmard JA (1995) The influence of aging on muscle strength and muscle fiber characteristics with special reference to eccentric strength. J Gerontol A Biol Sci Med Sci 50:B399–B406PubMedGoogle Scholar
  15. Izquierdo M, Ibanez J, Gorostiaga E, Garrues M, Zuniga A, Anton A, Larrion JL, Hakkinen K (1999) Maximal strength and power characteristics in isometric and dynamic actions of the upper and lower extremities in middle-aged and older men. Acta Physiol Scand 167:57–68PubMedCrossRefGoogle Scholar
  16. Kenny RA, Rubenstein LZ, Martin FC, Tinetti ME (2001) Guideline for the prevention of falls in older persons. J Am Geriatr Soc 49:664–672CrossRefGoogle Scholar
  17. Lamoureux E, Murphy, Sparrow WA (2003) The effects of improved strength on obstacle negotiation in community-living older adults. Gait Posture 17:273–283PubMedCrossRefGoogle Scholar
  18. Lark SD, Buckley JG, Bennett S, Jones D, Sargeant AJ (2003) Joint torques and dynamic joint stiffness in elderly and young men during stepping down. Clin Biomech 18:848–855CrossRefGoogle Scholar
  19. Levy DI, Yea AI, Skelton DA, Young A (1994) Strength power and functional ability. In: Passeri M (ed) Geriatrics ‘94 International Association of gerontology European region clinical section. CIC Edizioni International, Rome, pp 85–93Google Scholar
  20. Lindle RS, Metter EJ, Lynch NA et al (1997) Age and gender comparisons of muscle strength in 654 women and men aged 20–93 yr. J Appl Physiol 83:1581–1587PubMedGoogle Scholar
  21. Lord SR, McLean D, Stathers G (1992) Physiological factors associated with injurious falls in older people living in the community. Gerontol 38:338–346CrossRefGoogle Scholar
  22. Lord SR, Rogers MW, Fitzpatrick R (1999) Lateral stability, sensorimotor function and falls in older people. J Am Geriatr Soc 47:1077–1081PubMedGoogle Scholar
  23. Ly LP, Handelsman DJ (2002) Muscle strength and ageing: Methodological aspects of isokinetic dynamometry and androgen administration. Clin Exp Pharmacol Physiol 29:39–47CrossRefGoogle Scholar
  24. Macaluso A, De Vito G (2004) Muscle strength power and adaptations to resistance training in older people. Eur J Appl Physiol 91:450–472PubMedCrossRefGoogle Scholar
  25. MacRae PG, Lacourse M, Moldavon R (1992) Physical performance measures that predict faller status in community-dwelling older adults. J Orthop Sports Phys Therapy 16:123–128Google Scholar
  26. McGibbon CA, Krebs DE, Puniello MS (2001) Mechanical energy analysis identifies compensatory strategies in disabled elders’ gait. J Biomech 34:481–490PubMedCrossRefGoogle Scholar
  27. McKee KJ, Orbell S, Radley KA (1999) Predicting perceived recovered activity in older people after a fall. Disabil Rehabil 21:555–562PubMedCrossRefGoogle Scholar
  28. Melzer I, Benjuya N, Kaplanski J (2004) Postural stability in the elderly: a comparison between fallers and non-fallers. Age Ageing 33:602–607PubMedCrossRefGoogle Scholar
  29. Morris-Chatta R, Buchner DM, de Lateur BJ, Cress ME, Wagner EH (1994) Isokinetic testing of ankle strength in older adults: assessment of inter-rater reliability and stability of strength over six months. Arch Phys Med Rehabil 75:1213–1216PubMedCrossRefGoogle Scholar
  30. Pavol MJ, Owings TM, Foley KT, Grabiner MD (2002) Influence of lower extremity strength of healthy older adults on the outcome of an induced trip. J Am Geriatr Soc 50:256–262PubMedCrossRefGoogle Scholar
  31. Petrella JK, Kim J-S, Tuggle SC, Hall SR, Bamman MM (2005) Age differences in knee extension power contractile velocity and fatigability. J Appl Physiol 98:211–220PubMedCrossRefGoogle Scholar
  32. Phillips SK, Bruce SA, Woledge RC (1991) In mice the muscle weakness due to age is absent during stretching. J Physiol 437:63–70PubMedGoogle Scholar
  33. Porter MM, Vandervoort AA, Kramer JF (1997) Eccentric peak torque of the plantar and dorsiflexors is maintained in older women. J Gerontol A Biol Sci Med Sci 52:B125–B131PubMedGoogle Scholar
  34. Porter MM (1995) Concentric and eccentric knee extension strength in older and younger men and women. Can J Appl Physiol 20:429–439PubMedGoogle Scholar
  35. Poulin MJ, Cunningham DA, Kramer JF, Paterson DH, Vandervoort AA (1992) Eccentric and concentric torques of knee and elbow extension in young and older men. Can J Sport Sci 17:3–7PubMedGoogle Scholar
  36. Robinson BS, Gordon JM, Wallentine SW, Visio M (2004) Relationship between lower-extremity joint torque and the risk for falls in a group of community-dwelling older adults. Physiother Theory Pract 20:155–173CrossRefGoogle Scholar
  37. Roma AA, Chiarello LA, Barker SP, Brenneman SK (2001) Examination and comparison of the relationships between strength, balance, fall history and ambulatory function in older adults. Issues Aging 24:21–30Google Scholar
  38. Roos MR, Rice CL, Connelly DM, Vandervoort AA (1999) Quadriceps muscle strength, contractile properties and motor unit firing rates in young and old men. Muscle Nerve 22:1094–103PubMedCrossRefGoogle Scholar
  39. Runge M Rittweger J Russo C R Schiessl H, Felsenberg D 2004 Is muscle power output a key factor in the age-related decline in physical performance? A comparison of muscle cross-section chair-rising test and jumping power. Clin Physiol Funct Imaging 24:335–340CrossRefGoogle Scholar
  40. Scaf-Klomp W, Sanderman R, Ormel J, Kempen GI (2003) Depression in older people after fall-related injuries: a prospective study. Age Ageing 32:88–94PubMedCrossRefGoogle Scholar
  41. Schwendner KI, Mikesky AE, Holt WS, Peacock M, Burr DB (1997) Differences in muscle endurance and recovery between fallers and non-fallers and between young and older women. J Gerontol A Biol Sci Med Sci 52:M155–M160PubMedGoogle Scholar
  42. Skelton DA, Greig CA, Davies JM, Young A (1994) Strength power and related functional ability of healthy people aged 65–89 years. Age Ageing 23:371–377PubMedCrossRefGoogle Scholar
  43. Skelton DA, Kennedy J, Rutherford OM (2002) Explosive power and asymmetry in leg muscle function in frequent fallers and non-fallers aged over 65. Age Ageing 31:119–125PubMedCrossRefGoogle Scholar
  44. Skelton DA, Young A, Greig CA, Malbut KE (1995) Effects of resistance training on strength, power and selected functional abilities of women aged 75 and older. J Am Geriatr Soc 43:1081–1087PubMedGoogle Scholar
  45. Sorkin JD, Muller DC, Andres R (1999) Longitudinal change in the heights of men and women: consequential effects on body mass index. Epidemiol Rev 21:247–260PubMedGoogle Scholar
  46. Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR (2000) Stair negotiation in older people: a review. J Am Geriatr Soc 48:567–580PubMedGoogle Scholar
  47. Studenski S, Chandler, Duncan PW (1991) Postural responses and effector factors in persons with unexplained falls: results and methodologic issues. J Am Geriatr Soc 39:229–234PubMedGoogle Scholar
  48. Takazawa K, Arisawa K, Honda S, Shibata Y, Saito H (2003) Lower-extremity muscle forces measured by a hand-held dynamometer and the risk of falls among day-care users in Japan: using multinomial logistic regression analysis. Disabil Rehabil 25:399–404PubMedCrossRefGoogle Scholar
  49. Thelen DG, Schultz AB, Alexander NB, Ashton-Miller JA (1996) Effects of age on rapid ankle torque development. J Gerontol A Biol Sci Med Sci 51:M226–M232PubMedGoogle Scholar
  50. Trappe S, Gallagher P, Harber M, Carrithers J, Fluckey J, Trappe T (2003) Single muscle fibre contractile properties in young and old men and women. J Physiol 552:47–58PubMedCrossRefGoogle Scholar
  51. Whipple RH, Wolfson LI, Amerman PM (1987) The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study. J Am Geriat Soc 35:13–20PubMedGoogle Scholar
  52. Wojcik LA, Thelen DG, Schultz AB, Aston-Miller JA, Alexander NB (2001) Age and gender difference in peak lower extremity joint torques and ranges of motion used during single-step balance recovery from a forward fall. J Biomech 34:67–73PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Mark C. Perry
    • 1
    • 2
  • Serena F. Carville
    • 1
    • 3
  • I. Christopher H. Smith
    • 1
  • Olga M. Rutherford
    • 1
  • Di J. Newham
    • 1
  1. 1.Division of Applied Biomedical Research, School of Biomedical and Health SciencesKing’s College LondonLondonUK
  2. 2.School of PhysiotherapyCurtin University of TechnologyPerthAustralia
  3. 3.Academic Department of RheumatologyKing’s College London School of MedicineLondonUK

Personalised recommendations