Does quadriceps neuromuscular activation capability explain walking speed in older men and women?
Open accessAbstract
Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults. However, it is unclear to what extent impaired neuromuscular activation independently accounts for decline of mobility function. The hypothesis of this study is that the capability to produce rapid neuromuscular activation during maximal effort leg muscle contractions will be shown to be an independent predictor of mobility function in older men and women after accounting for muscle size and adiposity, body composition and age. Twenty six older men and eighteen older women (aged 70-85years) participated in this study. Mobility function was assessed by the 400-m walk test. Neuromuscular activation of the quadriceps muscle group was assessed by surface electromyography ("rate of EMG rise"). Thigh muscle cross sectional area and adiposity were assessed by computed tomography. In males, univariate regression analysis revealed strong associations between walking speed and a number of predictors including age (p<0.01), muscle area (p<0.01), intermuscular adipose tissue area (p<0.01), and rate of EMG rise (p<0.001). Subsequent multiple regression analysis with all variables accounted for 72% of the variability in walking speed (p<.0001), with age and rate of EMG rise as the dominant variables in the model. In females, univariate analysis showed a significant association only between walking speed and subcutaneous adipose tissue area (p<0.05). Multiple regression analysis accounted for only 44% of the variability in walking speed, and was not statistically significant (p=0.18). The present findings indicate that the capability to rapidly activate the quadriceps muscle group is an important factor accounting for inter-individual variability of walking speed among older men, but not among older women. This research is important for informing the design of assessments and interventions that seek to detect and prevent impairments that contribute to age-related mobility disability.
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Claims the paper makes
12 of 38 cited sources checked · 7 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Rapid neuromuscular activation of the quadriceps during a chair stand appears to contribute to faster walking speed in older adults.
“Rapid neuromuscular activation of the quadriceps muscle group measured during a chair stand appears to contribute to faster walking speed 6.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [6] source
- Premisecitation
Impaired neuromuscular activation is an important factor in the multifactorial etiology of loss of power production.
“Loss of power production has a multi-factorial etiology, and our recent studies indicate that impaired neuromuscular activation is an important factor 4, 5.”
Quote in the paperSubstantial claim2 of 2 sources checked - Premisecitation
Loss of power production capability is an important determinant of the onset and progression of mobility deficits in older adults.
“Considerable evidence now indicates that weakness, and specifically loss of power production capability, is an important determinant of the onset and progression of mobility deficits 1–3.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [1] source
The Discussion (page unavailable) identifies impaired leg power as an important determinant of physical performance in older people who already had mild to moderate mobility limitations. It also calls leg power a proximal determinant on the disablement pathway, but the paper does not establish that loss of power causes the onset or progression of mobility deficits over time. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [2] source
- cites [3] source
- Findingown data
The primary outcome measure of 400-meter walking speed did not differ between older men and women (p=0.99).
“The primary outcome measure of 400m walking speed did not differ between males and females (p=0.99).”
Quote in the paperNot a substantial claim - Findingown data
In older men, age and rate of EMG rise were the dominant variables in the multiple regression model.
“Age and rate of EMG rise were the dominant variables in the model.”
Quote in the paperSubstantial claim
- Findingreasoning
In older men, the association between muscle size and 400-meter walking speed was erased in the multiple regression model.
“However, the association between muscle size and 400m walking speed was erased in the multiple regression model.”
Quote in the paperSubstantial claim - Findingown data
In older men, 400-meter walking speed was moderately correlated with age.
“In men, 400m walking speed was strongly correlated with rate of EMG rise and moderately correlated with age, muscle CSA and IMAT CSA (Table 1a).”
Quote in the paperNot a substantial claim - Findingown data
In older women, a multiple regression model accounted for 44% of the variability in walking speed.
“The multiple regression model for females is shown in Table 2b, and accounted for 44% of the variability in walking speed, though the total model was not statistically significant (p=.18).”
- Also stated in: § Abstract · plain
“Multiple regression analysis accounted for only 44% of the variability in walking speed, and was not statistically significant (p=0.18).”
Quote in the paperNot a substantial claim - Also stated in: § Abstract · plain
- Findingown data
In older men, 400-meter walking speed was moderately correlated with intermuscular adipose tissue cross-sectional area.
“In men, 400m walking speed was strongly correlated with rate of EMG rise and moderately correlated with age, muscle CSA and IMAT CSA (Table 1a).”
Quote in the paperNot a substantial claim - Findingown data
In older men, a multiple regression model including all variables accounted for 72% of the variability in walking speed (p<.0001).
“The multiple regression model for males is show in Table 2a, and accounted for 72% of the variability in walking speed (p<.0001).”
- Also stated in: § Abstract · plain
“Subsequent multiple regression analysis with all variables accounted for 72% of the variability in walking speed (p<.0001), with age and rate of EMG rise as the dominant variables in the model.”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
In older men, 400-meter walking speed was moderately correlated with muscle cross-sectional area.
“In men, 400m walking speed was strongly correlated with rate of EMG rise and moderately correlated with age, muscle CSA and IMAT CSA (Table 1a).”
Quote in the paperNot a substantial claim - Findingown data
Age was an important factor affecting 400-meter walking speed.
“Age was also found to be an important factor affecting 400m walking speed.”
Quote in the paperSubstantial claim - Findingown data
In older women, 400-meter walking speed was moderately correlated only with subcutaneous adipose tissue cross-sectional area.
“In females, 400m walking speed was moderately correlated only with SCAT CSA (Table 1b).”
- Also stated in: § Abstract · plain
“In females, univariate analysis showed a significant association only between walking speed and subcutaneous adipose tissue area (p<0.05).”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
In older men, 400-meter walking speed was strongly correlated with rate of EMG rise.
“In men, 400m walking speed was strongly correlated with rate of EMG rise and moderately correlated with age, muscle CSA and IMAT CSA (Table 1a).”
Quote in the paperSubstantial claim - Findingown data
In older women, a one standard deviation increase in subcutaneous adipose tissue cross-sectional area (3.95 cm2) would be expected to reduce walking speed by approximately −0.16 m/s.
“Specifically, a one standard deviation increase in age (i.e., 4.5 years) or subcutaneous adipose (i.e., 3.95 cm2) would be expected to reduce walking speed by approximately −0.11 m/s and −0.16 m/s, respectively.”
- Also stated in: § DISCUSSION · hedged
“Based on the adjusted parameter estimate from the regression analysis in females, a one standard deviation increase in subcutaneous adipose CSA would be expected to yield a 0.16 m/s reduction in walking speed.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · hedged
- Findingown data
Thigh subcutaneous adipose cross-sectional area was closely associated with BMI in both older men and women.
“We found that thigh subcutaneous adipose CSA was closely associated with BMI in both males and females, suggesting thigh adiposity is a reasonable indicator of whole body adiposity.”
Quote in the paperNot a substantial claim - Findingown data
In older women, a one standard deviation increase in age (4.5 years) would be expected to reduce walking speed by approximately −0.11 m/s.
“Specifically, a one standard deviation increase in age (i.e., 4.5 years) or subcutaneous adipose (i.e., 3.95 cm2) would be expected to reduce walking speed by approximately −0.11 m/s and −0.16 m/s, respectively.”
Quote in the paperNot a substantial claim - Findingown data
In older men, a one standard deviation increase in age (4.3 years) would be expected to change walking speed by approximately −0.07 m/s.
“As indicated by the adjusted parameter estimate, a one standard deviation increase in age (i.e., 4.3 years) or rate of EMG rise (i.e., 0.133 %MVC/ms) would be expected to change walking speed by approximately −0.07 m/s and +0.15 m/s, respectively.”
Quote in the paperNot a substantial claim - Findingown data
In older men, a one standard deviation increase in rate of EMG rise (0.133 %MVC/ms) would be expected to change walking speed by approximately +0.15 m/s.
“As indicated by the adjusted parameter estimate, a one standard deviation increase in age (i.e., 4.3 years) or rate of EMG rise (i.e., 0.133 %MVC/ms) would be expected to change walking speed by approximately −0.07 m/s and +0.15 m/s, respectively.”
- Also stated in: § DISCUSSION · hedged
“Based on the adjusted parameter estimate from the regression analysis in males, a one standard deviation increase in the rate of EMG rise would be expected to yield a 0.15 m/s increase in walking speed.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · hedged
- Findingown data
In older men, muscle size had a significant positive univariate association with rate of EMG rise.
“In males, muscle size had a significant positive univariate association with both rate of EMG rise and 400m walking speed.”
Quote in the paperNot a substantial claim - Findingown data
In older women, the multiple regression model was not statistically significant (p=.18).
“The multiple regression model for females is shown in Table 2b, and accounted for 44% of the variability in walking speed, though the total model was not statistically significant (p=.18).”
Quote in the paperSubstantial claim - Findingown data
In older men, a significant univariate association between intermuscular adipose and 400-meter walking speed was erased in the multiple regression model.
“Our findings indicate that a significant univariate association between intermuscular adipose and 400m walking speed was erased in the multiple regression model, due to the strong influence of rate of EMG rise on walking speed.”
Quote in the paperSubstantial claim - Findingown data
In older women, age and subcutaneous adipose approached significance in the multiple regression model.
“The variables of age and subcutaneous adipose did however approach significance, and the adjusted parameter estimates suggest an important effect on 400m walking speed.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The lower variability of rate of EMG rise in older women likely contributed to its inability to account for inter-individual differences in walking speed.
“It is unclear why rate of EMG rise was less variable in females, but this likely contributed to the inability of rate of EMG rise to account for inter-individual differences in walking speed.”
Quote in the paperSubstantial claim - Interpretationown data
The erasure of the intermuscular adipose association with walking speed in older men was due to the strong influence of rate of EMG rise on walking speed.
“Our findings indicate that a significant univariate association between intermuscular adipose and 400m walking speed was erased in the multiple regression model, due to the strong influence of rate of EMG rise on walking speed.”
Quote in the paperSubstantial claim - Interpretationown data
Thigh adiposity is a reasonable indicator of whole body adiposity.
“We found that thigh subcutaneous adipose CSA was closely associated with BMI in both males and females, suggesting thigh adiposity is a reasonable indicator of whole body adiposity.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The finding of no association between rate of EMG rise and walking speed in older women does not necessarily rule out the importance of neuromuscular activation to mobility function in older women.
“This finding does not necessarily rule out the importance of neuromuscular activation to mobility function in older women.”
Quote in the paperSubstantial claim - Interpretationcitation
The outcome that the muscle size association was erased is in agreement with the notion that muscle size may be less important than the capability to properly activate or recruit the muscle, at least for mobility function.
“This outcome is in agreement with the notion that the size of the muscle may be less important than the capability to properly activate/recruit the muscle, at least in the context of mobility function 8.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] source
- Study design and conductreasoning
The study did not account for the potential effect of sex hormones.
“An important sex difference that we did not account for in the present study is the potential effect of sex hormones.”
Quote in the paperNot a substantial claim - Premisecitation
Subcutaneous adipose tissue cross-sectional area may help account for inter-individual variability in rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group.
“Furthermore, IMAT CSA has been implicated as a factor affecting physical function 14, 15 and SCAT CSA may help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group 16, 17.”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Intermuscular adipose tissue cross-sectional area has been implicated as a factor affecting physical function.
“Furthermore, IMAT CSA has been implicated as a factor affecting physical function 14, 15 and SCAT CSA may help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group 16, 17.”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationcitation
The expected 0.16 m/s reduction in walking speed associated with a one standard deviation increase in subcutaneous adipose cross-sectional area in older women is considered a substantial meaningful change.
“This is considered to be a “substantial meaningful” change in walking speed 18.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18] source
- Interpretationcitation
Older women in the study may have experienced a decline in muscle performance due to a drop in hormone levels after menopause, because they were not permitted hormone replacement therapy.
“The participants of this study were not permitted to have received hormone replacement therapy, so the older women may have experienced a decline in muscle performance due to a drop in hormone levels after menopause 34, 35.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [34]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [35]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
Quadriceps rate of EMG rise has a large effect on walking speed in older men, given that a 0.10 m/s change is considered a substantial meaningful change.
“This result suggests that quadriceps rate of EMG rise has a large effect on walking speed, given that a change in speed of 0.10 m/s has been proposed to be a “substantial meaningful” change 18.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18] source
- Interpretationown data
The adjusted parameter estimates for age and subcutaneous adipose in older women suggest an important effect on 400-meter walking speed.
“The variables of age and subcutaneous adipose did however approach significance, and the adjusted parameter estimates suggest an important effect on 400m walking speed.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 13
- May combine two claims. 11
Classified as probably not a substantial claim.
PremisecitationAge-related impairment of neuromuscular activation contributes to weakness in older adults.
“Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [4] source
- cites [5] source
The Abstract (page unavailable) links age-related slowing of neuromuscular activation to older adults’ impaired ability to produce force rapidly. The Discussion (page unavailable) reports an association with dynamic muscle performance, but found no activation-rate difference between healthy middle-aged and older adults. The paper therefore supports a narrower association, not a demonstrated causal contribution to weakness generally or an impairment attributable solely to aging. (LLM, conf=0.86)
Experimental — accuracy not yet measured
May combine two claims.
InterpretationcitationThe finding of a strong association between body composition and mobility function in older women is consistent with prior cross-sectional studies and with studies showing improved walking performance after weight loss.
“The finding of a strong association between body composition and mobility function in females is consistent with prior cross sectional studies 26, 27, as well as with studies showing improved walking performance after weight loss 28, 29.”
Quote in the paperNot a substantial claim3 of 4 sources checked- cites [26] source
- cites [27] source
- cites [28] source
The Introduction (page unavailable) links age-related loss of muscle mass to reduced strength and power and suggests this could diminish walking push-off power. It does not report a strong body-composition–mobility association specifically in older women or improved walking performance after weight loss; the Methods describe walking trials, not a weight-loss intervention. (LLM, conf=0.76)
Experimental — accuracy not yet measured - cites [29] source
Classified as probably not a substantial claim.
PremisecitationMuscle size has previously been linked to mobility deficits and disability in older adults.
“This was a somewhat surprising finding given that muscle size has previously been linked to the presence of mobility deficits and disability in older adults 30–33.”
Quote in the paperSubstantial claim1 of 4 sources checked- cites [30] source
The Methods section describes BMI and physical-activity measures, while the Discussion addresses functional status and fall injuries in older adults. Neither those passages nor searches for muscle size, muscle mass, mobility deficits, and disability found a passage linking muscle size to mobility deficits or disability. Page numbers were not available in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured - cites [31] source
- cites [32] source
- cites [33] source
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThe results are consistent with previously discussed evidence linking neuromuscular activation impairment and mobility deficits.
“The results are also consistent with the previously discussed body of evidence that has reported a link between neuromuscular activation impairment and mobility deficits 6, 7, 19, 20.”
Quote in the paperNot a substantial claim2 of 4 sources checked- cites [6] source
- cites [7] source
- cites [19] source
The Discussion (p. 4) reports improved walking after weight loss, and the Conclusion (p. 6) reports improved walking speed and exertion. Neither passage addresses neuromuscular activation impairment or links it to mobility deficits; searches for those terms and for muscle weakness found no such link in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured - cites [20] source
May combine two claims.
Findingown dataIn older women, subcutaneous adipose tissue cross-sectional area of the mid-thigh was a significant predictor of 400-meter walking speed, but not in older men.
“Subcutaneous adipose tissue CSA of the mid-thigh was a significant predictor of 400m walking speed in females, but not in males.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn older women, rate of EMG rise was less variable and had lower magnitude compared to older men.
“Interestingly, rate of EMG rise in females was less variable and had lower magnitude compared to males (see Figure 1).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationImprovements in lower extremity neuromuscular activation induced by resistance training are linked to increased speed of stair ascent in older adults.
“Furthermore, improvements in lower extremity neuromuscular activation induced by resistance training have been linked to increased speed of stair ascent in older adults 9.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] source
May combine two claims.
InterpretationcitationThe age-related changes in walking speed (0.07 m/s in older men and 0.11 m/s in older women) are considered small meaningful and substantial meaningful, respectively.
“These changes are considered to be “small meaningful” and “substantial meaningful” changes in walking speed, respectively 18.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenComputed tomography scans were analyzed by a single investigator who was blinded to participant identity.
“All CT scans were analyzed by a single investigator who was blinded to the identity of the participants.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductown dataThe results should be interpreted with caution because of the small sample and because only the quadriceps muscle group was assessed.
“Furthermore, caution is warranted when interpreting these results given the small sample and the fact that we assessed only the quadriceps muscle group.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationRapid neuromuscular activation during maximal effort contractions in the quadriceps and plantarflexor groups is positively associated with walking speed and Short Physical Performance Battery score in older adults.
“Similarly, rapid neuromuscular activation during maximal effort contractions in the quadriceps and plantarflexor groups is positively associated with walking speed and Short Physical Performance Battery score 7, 8.”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Interpretationown dataThe capability to rapidly activate the quadriceps muscle group is an important factor accounting for inter-individual variability of walking speed among older men, but not among older women.
“The present findings indicate that the capability to rapidly activate the quadriceps muscle group is an important factor accounting for inter-individual variability of walking speed among older men, but not among older women.”
- Also stated in: § DISCUSSION · boosted
“The primary finding of this study is that neuromuscular activation capability, as quantified by rate of EMG rise of the quadriceps muscle group, is a strong and independent predictor of walking speed in older males, but not in older females.”
- Also stated in: § DISCUSSION · hedged
“In conclusion, our preliminary findings indicate that the capability to rapidly activate the quadriceps muscle group is an important factor accounting for inter-individual variability of 400m walking speed among older men, but not among older women.”
Quote in the paperSubstantial claim- Also stated in: § DISCUSSION · boosted
Classified as probably not a substantial claim. May combine two claims.
PremisecitationRate of EMG rise is positively associated with force production, power production, and mobility function.
“We have previously shown that rate of EMG rise is positively associated with force production, power production and mobility function 7, 8.”
Quote in the paperSubstantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe distribution of error residuals for each multiple regression model was evaluated for normality.
“The distribution of the error residuals for each model was evaluated for normality.”
- Also stated in: § RESULTS · plain
“Each multiple regression model was found to meet the criterion for normality of error residuals.”
Quote in the paperNot a substantial claim- Also stated in: § RESULTS · plain
May combine two claims.
Interpretationown dataThe erasure of the muscle size association with walking speed in older men may be due in part to collinearity between muscle size and rate of EMG rise, and also to the strong association between rate of EMG rise and walking speed.
“Our result may be due in part to the apparent collinearity between muscle size and rate of EMG rise, but also due to the very strong association between rate of EMG rise and walking speed.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationreasoningThis decline in muscle performance may not be well represented by the variables included in the models and could explain a portion of the unexplained variance in 400-meter walking speed.
“This decline in muscle performance may not be well represented by the variables included in our models and could explain a portion of the unexplained variance in 400m walking speed.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningIn the models, age likely acts as a surrogate for a variety of age-related variables that were not quantified.
“In our models, the age variable is likely acting as a surrogate for a variety of age-related variables that we did not quantify, such as potential impairments in aerobic function, sensory function, cognitive function, miscellaneous health conditions, etc.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPlantarflexor rate of EMG rise is strongly associated with walking speed in well-functioning older adults.
“We have previously shown a strong association between plantarflexor rate of EMG rise and walking speed in well-functioning older adults 8.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] source
May combine two claims.
Interpretationown dataThe sex difference in the association between rate of EMG rise and walking speed cannot be explained by differences in functional level, because both older men and women had an average 400-meter walking speed of 1.21 m/s.
“The sex difference cannot be explained by differences in the functional level of each group, as both males and females had an average 400m walking speed of 1.21 m/s.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIntermuscular adipose may affect muscle tissue quality and has previously been linked to mobility function.
“A similar interpretation may apply to intermuscular adipose, which may affect muscle tissue quality and has previously been linked to mobility function 14, 15.”
Quote in the paperNot a substantial claim0 of 2 sources checked
The paper relies on this without support.
The extent to which neuromuscular activation capability accounts for mobility function in older men and women remains unclear.
“However, the extent to which neuromuscular activation capability accounts for mobility function in older men and women remains unclear.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Age standard deviations are reversed between results and discussion
MinorThe results identify 4.3 years as one standard deviation for males and 4.5 years for females. The discussion assigns those values to the opposite sexes.
“a one standard deviation increase in age (i.e., 4.3 years) or rate of EMG rise”
“A one standard deviation increase in age (4.5 and 4.3 years for males and females, respectively)”
Female adiposity is described as significant and only approaching significance
MinorThe discussion calls subcutaneous adipose area a significant predictor in females, but the results say it only approached significance in the multiple regression model. The significant univariate association does not resolve the discrepancy in the discussion's reference to the adjusted regression estimate.
“Subcutaneous adipose tissue CSA of the mid-thigh was a significant predictor of 400m walking speed in females, but not in males. Based on the adjusted parameter estimate from the regression analysis in females”
“The variables of age and subcutaneous adipose did however approach significance”
Cites
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“This was a somewhat surprising finding given that muscle size has previously been linked to the presence of mobility deficits and disability in older adults (Delmonico et al., 2007; Fielding et al., 2011; Janssen et al., 2002; Lauretani et al., 2003).”
Self-citationJanssen, I., Heymsfield, S. B., & Ross, R. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50216.x · Cited by 3,139 · cited 1× · see citing works
“This was a somewhat surprising finding given that muscle size has previously been linked to the presence of mobility deficits and disability in older adults (Delmonico et al., 2007; Fielding et al., 2011; Janssen et al., 2002; Lauretani et al., 2003).”
Meaningful change and responsiveness in common physical performance measures in older adults.
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“10m/s has been proposed to be a “substantialmeaningful” change (Perera et al., 2006).”
InfluentialLauretani, F., Russo, C. R., Bandinelli, S., Bartali, B., Cavazzini, C., Di Iorio, A., Corsi, A. M., Rantanen, T., Guralnik, J. M., & Ferrucci, L. (2003) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00246.2003 · Cited by 1,946 · cited 1× · see citing works
“This was a somewhat surprising finding given that muscle size has previously been linked to the presence of mobility deficits and disability in older adults (Delmonico et al., 2007; Fielding et al., 2011; Janssen et al., 2002; Lauretani et al., 2003).”
The extraction of neural strategies from the surface EMG
Farina, D., Merletti, R., & Enoka, R. M. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01070.2003 · Cited by 1,573 · cited 2× · see citing works
“, 2005) and SCAT CSAmay help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group (Farina et al., 2004; Petrofsky, 2008).”
Visser, M., Goodpaster, B. H., Kritchevsky, S. B., Newman, A. B., Nevitt, M., Rubin, S. M., Simonsick, E. M., Harris, T. B., & Study, F. T. H. A. (2005) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/60.3.324 · Cited by 1,403 · cited 3× · see citing works
“Furthermore, IMAT CSA has been implicated as a factor affecting physical function (Marcus et al., 2010; Visser et al., 2005) and SCAT CSAmay help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group (Farina…”
Attenuation of skeletal muscle and strength in the elderly: the Health ABC Study
Goodpaster, B. H., Carlson, C. L., Visser, M., Kelley, D. E., Scherzinger, A., Harris, T. B., Stamm, E., & Newman, A. B. (2001) · Journal of Applied Physiology · doi:10.1152/jappl.2001.90.6.2157 · Cited by 1,226 · cited 1× · see citing works
“These methods have been described previously (Goodpaster et al., 2001; Kelley et al., 1991).”
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“Thefindingof a strong association betweenbody composition and mobility function in females is consistent with prior cross sectional studies (Vincent et al., 2010; Visser et al., 2002), as well as with studies showing improved walking performance after weight loss (Josbeno et al.”
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“This was a somewhat surprising finding given that muscle size has previously been linked to the presence of mobility deficits and disability in older adults (Delmonico et al., 2007; Fielding et al., 2011; Janssen et al., 2002; Lauretani et al., 2003).”
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“The EMG signal from each muscle was then normalized to its own peak EMG from the MVC trial (Burden, 2010).”
Talbot, L. A., Musiol, R. J., Witham, E. K., & Metter, E. J. (2005) · BMC Public Health · doi:10.1186/1471-2458-5-86 · Cited by 654 · cited 2× · see citing works
“, 2000), including a higher risk of falling throughout the adult lifespan (Talbot et al., 2005).”
Association of Muscle Power With Functional Status in Community-Dwelling Elderly Women
Foldvari, M., Clark, M., Laviolette, L. C., Bernstein, M. A., Kaliton, D., Castaneda, C., Pu, C. T., Hausdorff, J. M., Fielding, R. A., & Singh, M. A. F. (2000) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/55.4.m192 · Cited by 653 · cited 1× · see citing works
“: +1 352 2002; Cuoco et al., 2004; Foldvari et al., 2000).”
Self-citationThe relationship between leg power and physical performance in mobility-limited older people
Md, J. F. B., Kiely, D. K., Herman, S., Leveille, S. G., Mizer, K., Frontera, W. R., & Fielding, R. A. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50111.x · Cited by 605 · see citing works
Self-citationSkeletal muscle fat infiltration: impact of age, inactivity, and exercise
Marcus, R. L., Addison, O., Kidde, J. P., Dibble, L. E., & Lastayo, P. C. (2010) · The Journal of nutrition, health and aging · doi:10.1007/s12603-010-0081-2 · Cited by 449 · cited 3× · see citing works
“Furthermore, IMAT CSA has been implicated as a factor affecting physical function (Marcus et al., 2010; Visser et al., 2005) and SCAT CSAmay help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group (Farina…”
Obesity and mobility disability in the older adult
Vincent, H. K., Vincent, K. R., & Lamb, K. M. (2010) · Obesity Reviews · doi:10.1111/j.1467-789x.2009.00703.x · Cited by 382 · cited 2× · see citing works
“Thefindingof a strong association betweenbody composition and mobility function in females is consistent with prior cross sectional studies (Vincent et al., 2010; Visser et al., 2002), as well as with studies showing improved walking performance after weight loss (Josbeno et al.”
Schmitz, A., Silder, A., Heiderscheit, B., Mahoney, J., & Thelen, D. G. (2009) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2008.10.008 · Cited by 347 · cited 1× · see citing works
“Another possible interpretation is that slowing of the rate of EMG rise is indicative of a general deterioration of the nervous system structure/function, which negatively affects control of motor tasks including walking (Monaco et al., 2010; Schmitz et al., 2009).”
Impact of muscle power and force on gait speed in disabled older men and women
Cuoco, A., Callahan, D. M., Sayers, S., Frontera, W. R., Bean, J., & Fielding, R. A. (2004) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/59.11.1200 · Cited by 283 · cited 1× · see citing works
“: +1 352 2002; Cuoco et al., 2004; Foldvari et al., 2000).”
Self-citationLeveille, S. G., Penninx, B. W. J. H., Melzer, D. R., Izmirlian, G., & Guralnik, J. M. (2000) · The Journals of Gerontology Series B · doi:10.1093/geronb/55.1.s41 · Cited by 275 · cited 2× · see citing works
“This could potentially help to explain prior reports of women beingmore susceptible than men to mobility deficits (Gorman & Read, 2006; Leveille et al., 2000), including a higher risk of falling throughout the adult lifespan (Talbot et al.”
SIPILÄ, S., TAAFFE, D. R., CHENG, S., PUOLAKKA, J., TOIVANEN, J., & SUOMINEN, H. (2001) · Clinical Science · doi:10.1042/cs1010147 · Cited by 230 · see citing works
Gender Disparities in Adult Health: An Examination of Three Measures of Morbidity
Gorman, B. K., & Read, J. G. (2006) · Journal of Health and Social Behavior · doi:10.1177/002214650604700201 · Cited by 226 · cited 1× · see citing works
“This could potentially help to explain prior reports of women beingmore susceptible than men to mobility deficits (Gorman & Read, 2006; Leveille et al., 2000), including a higher risk of falling throughout the adult lifespan (Talbot et al., 2005).”
Skeletal muscle density: effects of obesity and non-insulin-dependent diabetes mellitus
Kelley, D., Slasky, B., & Janosky, J. (1991) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/54.3.509 · Cited by 206 · cited 1× · see citing works
“These methods have been described previously (Goodpaster et al., 2001; Kelley et al., 1991).”
MethodRonkainen, P. H. A., Kovanen, V., Alén, M., Pöllänen, E., Palonen, E.-M., Ankarberg-Lindgren, C., Hämäläinen, E., Turpeinen, U., Kujala, U. M., Puolakka, J., et al. (2009) · Journal of Applied Physiology · doi:10.1152/japplphysiol.91518.2008 · Cited by 168 · cited 2× · see citing works
“This study is a secondary analysis of data from a larger research trial whose primary results have been published previously (Clark et al., 2011; Ronkainen et al., 2009).”
Age-Related Modifications of Muscle Synergies and Spinal Cord Activity During Locomotion
Monaco, V., Ghionzoli, A., & Micera, S. (2010) · Journal of Neurophysiology · doi:10.1152/jn.00525.2009 · Cited by 161 · cited 1× · see citing works
“Another possible interpretation is that slowing of the rate of EMG rise is indicative of a general deterioration of the nervous system structure/function, which negatively affects control of motor tasks including walking (Monaco et al., 2010; Schmitz et al., 2009).”
Neuromuscular determinants of maximum walking speed in well-functioning older adults
Clark, D. J., Manini, T. M., Fielding, R. A., & Patten, C. (2013) · Experimental Gerontology · doi:10.1016/j.exger.2013.01.010 · Cited by 133 · cited 5× · see citing works
“We have previously shown that the rate of EMG rise is positively associated with force production, power production and mobility function (Clark et al., 2011, 2013).”
InfluentialSelf-citationThe effect of the subcutaneous fat on the transfer of current through skin and into muscle
PETROFSKY, J. S. (2008) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2008.02.009 · Cited by 119 · cited 2× · see citing works
“, 2005) and SCAT CSAmay help to account for inter-individual variability in the rate of EMG rise due to signal attenuation by adipose tissue between the electrode and the quadriceps muscle group (Farina et al., 2004; Petrofsky, 2008).”
Physical activity and physical function changes in obese individuals after gastric bypass surgery
Josbeno, D. A., Jakicic, J. M., Hergenroeder, A., & Eid, G. M. (2010) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2008.08.003 · Cited by 116 · cited 2× · see citing works
“, 2002), as well as with studies showing improved walking performance after weight loss (Josbeno et al., 2010; Larsson & Mattsson, 2003).”
Neuromuscular contributions to age-related weakness
Clark, D. J., & Fielding, R. A. (2012) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glr041 · Cited by 115 · cited 1× · see citing works
“Loss of power production has a multi-factorial etiology, and our recent studies indicate that impaired neuromuscular activation is an important factor (Clark & Fielding, 2012; Reid et al., 2012).”
Self-citationLarsen, A. H., Puggaard, L., Hämäläinen, U., & Aagaard, P. (2008) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2006.12.008 · Cited by 113 · cited 1× · see citing works
“The results are also consistentwith the previously discussed body of evidence that has reported a link between neuromuscular activation impairment and mobility deficits (Brach et al., 2001; Clark et al., 2011, 2013; Larsen et al., 2008).”
Clark, D. J., Patten, C., Reid, K. F., Carabello, R. J., Phillips, E. M., & Fielding, R. A. (2011) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glq153 · Cited by 108 · cited 5× · see citing works
“We have previously shown that the rate of EMG rise is positively associated with force production, power production and mobility function (Clark et al., 2011, 2013).”
InfluentialSelf-citationReid, K. F., Doros, G., Clark, D. J., Patten, C., Carabello, R. J., Cloutier, G. J., Phillips, E. M., Krivickas, L. S., Frontera, W. R., & Fielding, R. A. (2012) · European Journal of Applied Physiology · doi:10.1007/s00421-011-2200-0 · Cited by 100 · cited 1× · see citing works
“Loss of power production has a multi-factorial etiology, and our recent studies indicate that impaired neuromuscular activation is an important factor (Clark & Fielding, 2012; Reid et al., 2012).”
Self-citationStair-ascent performance in elderly women: effect of explosive strength training
Holsgaard-Larsen, A., Caserotti, P., Puggaard, L., & Aagaard, P. (2011) · Journal of Aging and Physical Activity · doi:10.1123/japa.19.2.117 · Cited by 34 · cited 2× · see citing works
“Furthermore, improvements in lower extremity neuromuscular activation induced by resistance training have been linked to increased speed of stair ascent in older adults (Holsgaard-Larsen et al., 2011).”
Larsson, U. E., & Mattsson, E. (2003) · Journal of Rehabilitation Medicine · doi:10.1080/16501970306114 · Cited by 20 · cited 1× · see citing works
“…strong association betweenbody composition and mobility function in females is consistent with prior cross sectional studies (Vincent et al., 2010; Visser et al., 2002), as well as with studies showing improved walking performance after weight loss (Josbeno et al., 2010; Larsson & Mattsson, 2003).”
Brach, J. S., Kriska, A. M., Newman, A. B., & VanSwearingen, J. M. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.12.m767 · Cited by 12 · cited 2× · see citing works
“The results are also consistentwith the previously discussed body of evidence that has reported a link between neuromuscular activation impairment and mobility deficits (Brach et al., 2001; Clark et al., 2011, 2013; Larsen et al., 2008).”
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Hortobágyi, T., Lesinski, M., Gäbler, M., VanSwearingen, J. M., Malatesta, D., & Granacher, U. (2015) · Sports Medicine · doi:10.1007/s40279-015-0371-2 · Cited by 204 · see citing works
“Although even healthy old compared with young adults present with substantial reductions in muscle strength [70], muscle power [71, 72], muscle mass [73], incomplete muscle activation [66], sensory dysfunction [74], balance problems [33], coordination deficits [16], and sub-clinical cognitive [48] and mobility impairm…”
BackgroundBoyer, K. A., Hayes, K. L., Umberger, B. R., Adamczyk, P. G., Bean, J. F., Brach, J. S., Clark, B. C., Clark, D. J., Ferrucci, L., Finley, J. M., et al. (2023) · Experimental Gerontology · doi:10.1016/j.exger.2023.112102 · Cited by 116 · see citing works
“, maximal voluntary torque) is likely to play some role in the alteration of gait with age, looking beyond muscle strength alone to evaluate the impact of changes in structure, composition, and morphology of muscle and tendon [31]; contraction velocity and power [29]; neural drive to muscle [32]; and interactions amon…”
BackgroundSelf-citationHvid, L. G., Strotmeyer, E. S., Skjødt, M., Magnussen, L. V., Andersen, M., & Caserotti, P. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.018 · Cited by 73 · see citing works
Weaker Seniors Exhibit Motor Cortex Hypoexcitability and Impairments in Voluntary Activation
Clark, B. C., Taylor, J. L., Hong, S. L., Law, T., & Russ, D. W. (2015) · The Journals of Gerontology Series A · doi:10.1093/gerona/glv030 · Cited by 63 · see citing works
Walking Speed: A Summary Indicator of Frailty?
Woo, J. (2015) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2015.04.003 · Cited by 47 · see citing works
Age and muscle strength mediate the age-related biomechanical plasticity of gait
Hortobágyi, T., Rider, P. M., Gruber, A. H., & DeVita, P. (2016) · European Journal of Applied Physiology · doi:10.1007/s00421-015-3312-8 · Cited by 46 · see citing works
Barbat-Artigas, S., Carvalho, L. P., Rolland, Y., Vellas, B., & Aubertin-Leheudre, M. (2016) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2016.06.026 · Cited by 27 · see citing works
Komforti, D., Joffe, C., Magras, A., Peller, A., Garbe, E., Garib, R., Trapuzzano, A., Dawson, N., & Stock, M. S. (2021) · Aging Clinical and Experimental Research · doi:10.1007/s40520-020-01596-y · Cited by 25 · see citing works
Mikos, V., Yen, S., Tay, A. E., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0199215 · Cited by 27 · see citing works
Siddique, U., Frazer, A. K., Avela, J., Walker, S., Ahtiainen, J. P., Howatson, G., Tallent, J., & Kidgell, D. J. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101746 · Cited by 25 · see citing works
Effects of Age, Joint Angle, and Test Modality on Strength Production and Functional Outcomes
Thompson, B. J., Whitson, M., Sobolewski, E. J., & Stock, M. S. (2017) · International Journal of Sports Medicine · doi:10.1055/s-0043-121149 · Cited by 18 · see citing works
“, jogging, aerobics) more than 20 min per day, twice per week [16]; did not have uncontrolled hypertension ( > 150/90 mm Hg) [7]; or could not have had their primary physician advise them not to engage in exercise for other medical reasons.”
BackgroundCui, C., Hu, Y. S., Wong, R. M. Y., Zhang, N., Guan, Y., & Cheung, W. (2025) · GeroScience · doi:10.1007/s11357-025-01760-0 · Cited by 20 · see citing works
Lower limb muscle quality and phase angle contribute to the reduced walking speed among older adults
Hirano, Y., Yamada, Y., Matsui, Y., Ota, S., & Arai, H. (2022) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.14423 · Cited by 17 · see citing works
Wages, N. P., Mousa, M. H., Clark, L. A., Tavoian, D., Arnold, W. D., Elbasiouny, S. M., & Clark, B. C. (2023) · Calcified Tissue International · doi:10.1007/s00223-023-01123-x · Cited by 16 · see citing works
Relationships between hamstring morphological characteristics and postural balance in elderly men.
Palmer, T. B., Farrow, A. C., & Palmer, B. M. (2020) · PubMed · Cited by 16 · see citing works
Kirk, B., Lieu, N., Vogrin, S., Sales, M., Pasco, J. A., & Duque, G. (2022) · The Journals of Gerontology Series A · doi:10.1093/gerona/glac008 · Cited by 13 · see citing works
Josephson, M., & Knight, C. A. (2018) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2018.11.004 · Cited by 6 · see citing works
Stock, M. S., Thompson, B. J., & Sobolewski, E. J. (2019) · Journal of Science in Sport and Exercise · doi:10.1007/s42978-019-00032-6 · Cited by 4 · see citing works
Le rôle du facteur biologique dans l'altération des monuments historiques en granite (Bretagne)
Galsomies, L. (1995) · HAL · Cited by 4 · see citing works
Comparison of strategies for assessment of rate of torque development in older and younger adults
Tavoian, D., Clark, B. C., Clark, L. A., Wages, N. P., & Russ, D. W. (2023) · European Journal of Applied Physiology · doi:10.1007/s00421-023-05299-w · Cited by 2 · see citing works
“Both cross-sectional and longitudinal studies have suggested that the rrEMG is a key factor in power and may contribute to gait speed and indices of physical function (Clark et al. 2011, 2014; Radaelli et al. 2019).”
Magtouf, E., Peyrot, N., Cherni, Y., Chortane, O. G., Jolibois, J., Rahmani, A., & Maktouf, W. (2024) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk9040261 · Cited by 4 · see citing works
Hetherington‐Rauth, M., McCulloch, C. E., Kritchevsky, S. B., Newman, A. B., Hepple, R. T., Coen, P. M., Goodpaster, B. H., Shankaran, M., Hellerstein, M., Evans, W. J., et al. (2026) · Age and Ageing · doi:10.1093/ageing/afag088 · Cited by 4 · see citing works
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Self-citationMagtouf, E., Peyrot, N., Cherni, Y., Chortane, O. G., Jolibois, J., Rahmani, A., & Maktouf, W. (2024) · Preprints.org · doi:10.20944/preprints202407.0762.v1 · Cited by 1 · see citing works
Qual a influência da arquitetura muscular na funcionalidade de idosos? uma revisão da literatura
Pompeo, K. D., Guadagnin, E. C., dos Santos, P. F., da Rocha, E. S., & Rodrigues, R. (2021) · Kinesis · doi:10.5902/2316546465775
Wang, C., Fang, C., Wang, R., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-7514175/v1
- Authors
- Clark, D. J., Reid, K. F., Patten, C., Phillips, E. M., Ring, S. A., Wu, S. S., & Fielding, R. A.
- Affiliations
- Tufts University (US)
- University of Florida Health (US)
- Malcom Randall VA Medical Center (US)
- University of Florida (US)
- Corresponding author
- Clark, David J.
- ORCID
- Venue
- Experimental Gerontology
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 55
- Pages
- 49-53
- ISSN
- 0531-5565 (ISSN-L)
- PMC
- PMC4039086
- OpenAlex
- W2082428097
- Cited by
- 27
- References
- 33
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 3
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Experimental Gerontology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging (AG-18844 to RAF)
- Boston Claude D. Pepper Older Americans Independence Center (1P30AG031679)
- U.S. Department of Agriculture (58-1950-0-014)
- NIH Infrastructure Grant (1R24HD065688-01A1)
- U.S. Department of Veterans Affairs Office of Rehabilitation Research and Development (B7176W)
- University of Florida Claude D. Pepper Older Americans Independence Center (2P30AG028740)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- neuromuscular activation, quadriceps, walking speed, older adults, mobility function, intermuscular adipose tissue, subcutaneous adipose tissue, muscle cross-sectional area, sex differences
- MeSH terms
- Aged, Aged, 80 and over, Aging, Electromyography, Exercise Test, Female, Humans, Male, Muscle Contraction, Neuromuscular Junction, Sex Characteristics, Walking, Quadriceps Muscle
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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