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Eleventh Annual Peter A. Rechnitzer Lecture
Monday May 16, 2005
4:00PM
Rm. 35 South Valley Building
The Centre for Activity and Ageing was founded in 1989 and subsequently incorporated
as the Canadian Centre for Activity and Aging (CCAA) in 1996. The CCAA is affiliated
with the Faculties of Health Sciences (School of Kinesiology), and Medicine
and Dentistry (Department of Physiology and Pharmacology), of the University
of Western Ontario, and with the Lawson Health Research Institute, the research
arm of St. Joseph’s Health Care London, and is located in London, Ontario,
Canada.
Since 1995, the CCAA has hosted an annual lecture series in recognition of
Dr. Peter A. Rechnitzer, the founder and first director of the CCAA. This lecture
series on aging is a major annual event for the CCAA and provides us with the
opportunity to invite internationally recognized scientists who have demonstrated
leadership in their field of study. Previous speakers include D.R. Seals (1995);
J.A. Dempsey (1996); B.J. Whipp (1997); J. Faulkner (1998); B. Saltin (1999);
L.B. Rowell (2000); N.L. Jones (2001); D.A. Cunningham (2002); K.K. McCully
(2003); and A. Young (2004). (See http://www.uwo.ca/actage/rechnitzer/index.htm.)
The Centre was is pleased to have Dr. K.E. Conley present this year’s
Eleventh Annual Peter A. Rechnitzer Lecture on Monday, May 16, 2005, in the
new South Valley Building, Room 35, University of Western Ontario. Dr Conley
is currently Professor of Physiology and Biophysics in the Muscle Metabolism & Systems
Biology Laboratory, Department of Radiology, University of Washington Medical
Center. Dr. Conley’s research group examines the relationship between
muscle contractile properties and the metabolic organization within muscle
across species, including humans. A recent research focus and the topic of
this lecture titled “Age, Exercise and Adaptation: The Mitochondria Link” will
present evidence to suggest that the age-related decline in performance and
aerobic energy production is a result of age-associated changes occurring in
the mitochondria. These changes affect the efficiency of energy output and
thus work and exercise performance in older adults. As well, his research team
is now examining how endurance exercise training can slow or improve exercise
performance and the ability of the mitochondria to provide energy for daily
activity.
Lecture Abstract:
“Age, Exercise and Adaptation: The Mitochondria Link”
Mitochondria are central to energy supply in muscle. The mitochondrial theory
of aging proposes that this organelle is also at the center of aging processes
in the cell. My presentation will focus on how mitochondria link aging, loss
of muscle performance and improvement of function with exercise training.
Our new data point to mitochondrial dysfunction – specifically, the
energetic uncoupling of ATP supply from O2 uptake – as a critical factor
in the loss of aerobic muscle function in elderly humans. This insight was
made possible by innovative optical and magnetic resonance spectroscopic
methods that non-invasively measure energy coupling (ATP/O2) in vivo. We
also found reduced exercise efficiency – the uncoupling of work per
VO2 – in these elderly subjects that paralleled the mitochondrial dysfunction.
We present evidence that the reduced exercise efficiency likely reflects
mitochondrial uncoupling rather than a shift of fiber type properties with
age. Finally, the link between mitochondria and adaptation is demonstrated
by results of an endurance training program. Trained elderly subjects showed
improved mitochondrial coupling, greater exercise efficiency and no change
in muscle fiber type. Thus, mitochondria may be a key factor in the loss
of muscle performance with age but may also be the key to the reversal of
these functional losses with training in elderly muscle.
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Break it down!
The nervous system conducts electrical signals from the brain to muscles.
Here the electrical impulses are converted into mechanical actions that generate
force. Nerves are composed of many subunits that extend from the spinal cord
to the muscle where they branch in order to connect to (innervate) a number
of muscle fibres. Each nerve subunit along with the fibres that it innervates
is called a motor unit.
If the nerve portion of a motor unit ceases to function (due to injury, disease,
programmed cell death, etc.), then the muscle fibres innervated by that unit
will break down unless they are reconnected to the nervous system. This reconnection
is accomplished when a nearby motor unit forms new nerve branches that extend
to re-innervate the abandoned muscle fibres. If this remodelling procedure
is successful, none of the muscle fibres are lost and the mass of the whole
muscle, and its strength, is maintained. It has been hypothesized that aging
impairs the effectiveness of this mechanism for re-innervating abandoned muscle
fibres, ultimately resulting in the loss of muscle mass and strength commonly
associated with older adults.
We sought to explore this concept by (1) measuring the maximal isometric strength;
(2) measuring the electrical response to nerve stimulation; and (3) estimating
the number of motor units in the tibialis anterior muscle of three groups of
healthy, active men. The tibialis anterior was selected because decreased function
of this muscle is a significant risk factor in falls in the elderly.
Our findings (McNeil et al., Muscle and Nerve, Epub??? Jan 31) showed that
there were significantly fewer estimated numbers of functioning motor units
in the tibialis anterior of men 66 years compared to 27 years of age, and fewer
still in men 82 years of age.
In spite of a significant decrease in the number of motor units during the
four decades between the ages of 27 and 66 (40% decrease over 39 years),
muscle strength and the excitable muscle mass of the tibialis anterior are
maintained until 66 years, most likely through age-related remodelling of
motor units. At some point between 66 and 82 years, the progressive loss
of motor units accelerates (33% decrease over 16 years) and results in a
smaller electrical response to stimulation and lower voluntary maximum isometric
strength (30% decrease), suggesting a loss of muscle mass. These findings
suggest that functional implications related to motor unit loss do not occur
until the numbers of motor units reach a critical threshold.
It is unknown if the rate of motor unit loss can be slowed by increased physical
activity, but numerous studies have demonstrated that weight training can maintain,
or increase, strength and muscle mass even in very old individuals. So, regardless
of the actual mechanism, it is likely that weight training can postpone the
functional limitations that accompany motor unit loss, which in the case of
the tibialis anterior could limit mobility and ultimately lead to falls and
associated fractures. Because weight training the tibialis anterior muscle
typically involves specialized equipment, it may be more practical to exercise
this muscle through activities such as dancing that involve repeated dynamic
heel and toe movements.
Chris McNeil PhD student with
Dr. Charles Rice
Neuromuscular Laboratory
www.paguide.com
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NEW CCAA Community Outreach Website!
www.ccaa-outreach.com
This new website has been designed to 1) provide better public access to the
availability of instructors, trainers and programs in different communities,
and 2) better support CCAA instructors and trainers with easily accessible
documents and opportunities for greater networking and team-building. Through
this website anyone will be able to learn about CCAA programs and on-line courses,
view a course calendar, locate trainers and instructors in their area, and
access archives of research articles and CCAA Newsletters. The member only
access for trainers and instructors will allow members to check their certification
status with access to the forms needed for renewal, have a chat room to network
with other members, and include an archive of client handouts ready to be printed
and photocopied. Additionally, trainers can use this site to post upcoming
courses on the calendar as well as to download forms required for hosting and
teaching. Check us out!
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CORE STRENGTH: Your Foundation for Functional Fitness!
What happens to a car when its wheels are out of alignment? The tires wear
unevenly and control is less than optimal. Gas mileage or energy consumption
will also be poor. This is analogous to what happens in the human body with
insufficient core strength. Posture is compromised and body movement becomes
inefficient and injury prone. However, with core conditioning, posture is improved.
Proper alignment means reduced joint stress with improved safety in activities
of daily living.
The core consists of the muscles found in the trunk and pelvis area. In standing,
squatting, sitting, lifting overhead, walking, or the transition from one position
to another, the role of the lumbo-pelvic region is to: 1) transfer forces to
surrounding tissues, 2) absorb forces, and 3) initiate and control movement.
Optimal upper and lower body performance are both dependent upon core control.
A strong core improves balance and transfers power to the arms and legs.
Core conditioning not only trains the muscle fibres, it also trains the nervous
system to allow for a more synergistic interaction between different muscles.
In functional movement, the stabilizers should be recruited before the prime
movers are. That means before you pick up a heavy object, stabilizing muscles
in the body’s core should already be activated. This will protect your
back and make lifting easier. The more you concentrate on proper core conditioning,
the more you help to facilitate this process. This is why it’s so important
to integrate an awareness of the core into every strength training exercise.
By doing so, you teach the body to engage its core muscles with every action.
With your core muscles supporting your frame, you can also strengthen the outer
musculature more effectively.
The muscles of the trunk can be separated into two main categories: stabilizers
and mobilizers. During movements like sitting or getting up from a chair, the
stabilizing muscles (TVA, multifidus, internal oblique, quadratus lumborum)
contract to stabilize the spine. Research reveals that the transverse abdominus
(TVA) is the only abdominal muscle to show marked increases in activity related
to changes in intra-abdominal pressure (IAP). This has been shown in relation
to voluntary isometric trunk extension (like ascending from a chair) and precedes
contraction of the other trunk muscles. When the TVA contracts and pulls in,
the resulting compression of the abdominal wall helps to stabilize the spine.
Referred to as postural tone, such constant, low-intensity isometric contractions
help control and maintain the body’s position. Although postural tone
results from an involuntary contraction of the muscles, the muscles must be
conditioned voluntarily to improve their ability for responding automatically
with increased strength and endurance.
Core conditioning involves more than just a standard approach to training
the muscles of the lumbo-pelvic region. In core training, the focus is on pulling
the abdominal wall inwards. This will condition the deep core muscles, not
just the superficial muscles. Consciously pulling the abdominal wall inwards
while exercising other body parts also conditions the core, especially if you
incorporate balance. If it were not for the constant and coordinated contraction
of the muscles in the lumbo-pelvic region then it would be impossible to maintain
proper posture at anytime while sitting, standing or moving. Your foundation
for functional fitness is only as strong as your core.
Jeff Boris
Community Education Coordinator
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Seniors Fitness Instructors Course (SFIC): Catalyst for Safe and Effective
Older Adult Exercise Programming throughout the City of London
In January 2004, the City of London, in cooperation with the Canadian Centre
for Activity and Aging (CCAA), funded a project to update and/or improve the
quality and quantity of physical activity exercise programs for London’s
older adults.
This one-year project incorporated the Seniors Fitness Instructors Course
(SFIC), currently managed through the CCAA. The initial proposal was to ensure
that London had appropriately trained fitness instructors to lead safe and
effective exercise programs for older adults within the community. Over a one-year
period the CCAA implemented training and educational workshops to update the
exercise leadership qualifications of existing exercise leaders, and to facilitate
the development of new exercise programs to under-serviced areas of the city.
Project goals included: training and/or updating existing exercise leaders
from across London, establishing older adult exercise programs in under serviced
areas of the city, and training SFIC master trainers to sustain the project
in year two and beyond.
The City of London accepted our project proposal. The project implementation,
then, occurred in three stages, following the goals outlined in the proposal.
Results:
- Successfully trained eighteen SFIC exercise leaders
- Completed final certification for eight SFIC exercise leaders
- Identified under-serviced areas in London with programs pending
- Established five new exercise programs with certified instructors
- The following older adult exercise classes will begin in 2005: Northwest London
(Hyde Park United Church), Lambeth (Faith Community Christian School), Old
South (Gartshore Estate and an additional location, yet to be confirmed), Central
London (Victoria Park), and East London (Clarke Road S.S.) These classes will
be advertised in the City of London’s Spectrum publication for the
spring and summer issue.
- Two new exercise classes for older adults were implemented in London:
Westmount Shopping Centre and Kinsmen Arena.
Evaluation:
Although the number of instructors trained was 40% less than originally anticipated,
the project implementation prompted the City of London’s requirement
for SFIC certification. By 2005, the goal of the City of London is to ensure
that CCAA-SFIC instructors will lead all Seniors Fitness programs throughout
London. This action of the City will help to support continuity within exercise
programs offered to London’s older adults.
Throughout 2005, eight new exercise programs will be offered in and around
the city of London and many of the city programs currently running will be
lead by instructors trained through this project.
Five out of the six classes confirmed to begin in 2005 were not only identified
and negotiated through this initiative, but have now been confirmed and will
target under-serviced areas throughout London.
Sarah Longford
Assistant Program Coordinator
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HSEP: New Education & Training Materials
The Home Support Exercise Program (HSEP) is a home-based exercise intervention
designed to enhance and maintain the functional fitness, mobility, balance
and independence of homebound older adults. This program has been successfully
delivered by Personal Support Workers through the home care infrastructure
and by volunteers through volunteer-based community programs across Canada,
in the United States and China. The appeal of the HSEP is that it is a cost-effective
and evidence-based program consisting of 10 simple, yet progressive exercises
that are easy to teach and learn.
As part of the education and training materials, a DVD version of the HSEP
video showing older adults performing the series of exercises is now available.
To help remind HSEP clients to do the exercises correctly and consistently,
a magnetic fridge poster will also be available this spring.
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PA Guide (pilot study)
The goal of this study was to develop and conduct a pilot survey of Canada’s
Physical Activity Guide to Healthy Active Living for Older Adults (the “Guide”)
and companion Handbook, measuring the awareness and uptake of these documents
throughout Canada. A selection from three distribution sources including the
national Public Health Agency of Canada’s (formerly with Health Canada)
Call Centre, national organizations (Guide Endorsers), and each provincial/territorial
(P/T) government (excluding Quebec), was used to produce a representative sample
of individuals and organizations to be surveyed. Piloting this evaluation allowed
for validation of the interviews well as the identification of circulation
obstacles and possible remedies for tracking distribution channels to the end
user.
In 1999, the Guide and its companion Handbook were launched nationally, representing
the first ever national guidelines on physical activity for older Canadians.
It has been five years since the launch and initial dissemination of the Guide
and Handbook, with over four million copies having been distributed to date.
It seemed timely and appropriate to assess the effectiveness of the distribution
as well as the level of awareness and uptake of these resources by older Canadians
and those working with older adults.
Two telephone interviews were developed to measure the awareness and uptake
of the Guide. The first interview was developed for the Endorser and P/T Governments
with the purpose of identifying:
-
where the Guide was distributed
- the method and volume of distribution
- barriers within the distribution network.
The interview was to be given to the Level I endorser or P/T government and
next to organizations or individuals who were referred by the Level I organization
(level II). Level II represents the next level in the distribution chain and
includes affiliate chapters, member organizations or individuals to whom the
Guide was sent.
The second interview was developed for the End-User, the older adult, and
identified the following:
- whether the Guide was received
- whether it was read and understood
- what components of physical activity could be recalled
- pre- and post- activity level around receipt of the Guide
- whether the information in the Guide was shared with others
- suggestions for improvement of the Guide and the interview questions.
Overall, this pilot study yielded validation information on structured questions
included in the interview (comprehensibility and clarity; logic; relevance).
This process may help aid the evaluation of future national health promotion
initiatives and resources to ensure they are reaching the intended populations
and that the resources are effective for the end user.
Project Investigators:
Dr. Gareth Jones (PI); Dr. Mark Speechley (Co-PI)
Project Coordinator:
Shannon Belfry
Written by: Shannon Belfry, Project Coordinator
For more information please contact Shannon at (519) 661-1633 or skeenor@uwo.ca.
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Where are they now? – Liz Cyarto
At this stage, I'm one year and nine months into my PhD and still on track
to submit in July 2006. Over this period, I've designed and implemented my
Have A Try (HAT) home exercise program and Come Have A Try (CHAT) group exercise
programs, under the supervision of Prof Wendy Brown and Dr Alison Marshall.
HAT and CHAT comprise the same set of 11 resistance exercises (wall squats,
seated row with a Theraband, step-ups) and I'm comparing these two modes of
program delivery in terms of functional outcomes and adherence. A supervised
walking program (CHAT-Walking) forms the comparison group for evaluating the
efficacy of the HAT/CHAT exercises. I started out with 165 participants across
nine study sites (average age 79 years, mostly women). After 20 weeks of intervention,
79% were still participating and 90% returned for follow-up testing. My "oldies" have
been wonderful to work with. I'm just in the preliminary stages of data analysis,
but it appears that all three groups gained functional benefits from HAT/CHAT,
as measured by the Senior Fitness Test. The programs resumed in January and
I'll be conducting final follow-up tests in May. It's been a large project
to manage - at one point I had a team of 12 students helping with assessments
and instructing programs - but the multi-tasking skills I learned at the CCAA
have been helpful. I included some biological measures in this study (such
as insulin and markers of inflammation), which has given me the opportunity
to develop some skills in blood sample analysis (and qualify as a "lab
rat"!). The academics and post-grads have made me feel quite welcome in
the School of Human Movement Studies. I feel fortunate to have been given the
opportunity to study here.
That's enough about my research. Here's some general stuff about living
Down Under. I like living in Brisbane (although I miss Louise and everyone
back home!). The weather is great - the summers haven't been worse than those
I've experienced in July in London. The catch phrase for Queensland is "sunny
one day, perfect the next." I've had no excuses not to keep up with
my running, especially since I've been able to wear shorts and a T-shirt
year-round. Fantastic beaches and rainforest hiking trails are within a couple
of hours drive up or down the coast (not that I've had much time for these
type of pursuits!). But I have started swimming twice a week since there's
a 50-metre outdoor pool right across from my building at uni. It takes me
about 30 min to walk to campus and I've gotten quite used to getting around
without a car. (This is probably a good thing since I've become addicted
to Tim Tams - delicious chocolate-coated biscuits). The Brisbane River basically
divides the city in half and there are catamarans (CityCats) used for public
transport up and down the river, in addition to bus and train networks. I
occasionally drive the School's van out to study sites and I must say that
driving on the "wrong" side of the road (never mind having the
driver's seat on the right side of the vehicle) and negotiating roundabouts
took some getting used to. The US campus is large and generally surrounded
by the river. It has lots of green space, a great pizza place and some beautiful
sandstone buildings that seem to glow at sunset. I should also add that starting
next week, five colleagues in Physical Activity and Health (including both
of my supervisors) and I will get to experience the Brisbane River up close
and personal in a Learn to Row course. Hopefully, by the end of six sessions
we'll have at least learned how to move the boat forward!
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