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1 EFFECT OF STRENGTH TRAINING ON AGING MUSCLES OF ELDERLY PEOPLE SHINYA KUNG, HARUKA MURAKAMI, SHINO BABA, JUNDONG KIM and MASASHI KAMIOKA Abstract The ability to walk is just as important for the elderly as it is for young people. In fact, in the elderly, decreased mobility limits function in daily life and can lead to more serious situations (e.g., becoming bedridden). The elderly population has increased over the last decade, and many researchers have studied the mobility of the elderly. However, the focus of most studies has been to facilitate recovery of bedridden individuals and prevent the elderly from becoming bedridden, and particularly to prevent fall-induced fractures, which often cause the elderly to become bedridden. However, about 70-80% of the elderly population do not require care, and it is necessary to conduct research on the maintenance of activities of daily living to make it possible for the elderly to work or volunteer. From this perspective, mobility is an important physical factor. Mobility is dependent on muscle activity and it has long been known that aging reduces muscle mass. Therefore, it is feasible to assume that reduced muscle mass leads to decreased ability to walk, and we have proven that there is a close correlation between the two. When presenting the idea of strength training to the elderly, it is appropriate to focus on the maintenance and improvement of mobility, not on the training itself. The results of our research can be summarized as follows: Muscle mass decreases with age, with the legs being affected to a greater degree than the arms. Moreover, muscle atrophy is dependent on weakening of muscle fibers, especially fast-twitch (Type II) fibers. Reduced lower limb muscle mass increases the risk of falling and can decrease walking ability to a degree that can affect daily living activities. In order to improve reduced muscle mass in aging, it is important to use an exercise program that is designed to strengthen fast-twitch fibers, which can be followed even by the elderly. Since walking therapy mostly mobilizes slow twitch fibers, it is not effective in preventing and improving muscle atrophy. It is important to have an exercise program that is designed to mobilize fast-twitch fibers. (Jpn. J. Phys. Fitness Sports Med. 2003, 52 Suppl : 17 `30) key word : aging, muscle mass, fast-twitch fiber, atrophy, strength training
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3 19 高齢 者 の 筋 特 性 と筋 力 トレー ニ ン グ と もな う筋 線 維 の 萎 縮 の メ カニ ズ ム や そ の抑 制 方 法 の 解 明 が 重 要 と な る. 3)後 期 高齢 者(75歳 以 上)の 筋 力 発揮 の特 徴 図3に は,69歳 か ら80歳 まで の 同 一 人 を対 象 に 筋 力 の縦 断 的変 化 の様 相 を示 した.筋 量 に大 き く 依 存 す る ア イソ メ トリ ックや 低 速 度 で の 等 速 性 筋 力 発揮 に お い て,80歳 で は70歳 時 に比 べ て明 らか に 低 値 を示 す.一 方,筋 量 の依 存 度 が 比 較 的 低 く, 筋 線 維 組 成 や 神経 系 の 要 因 の影 響 を よ り強 く受 け る高 速 で の 筋 力発 揮 に お い て,70歳 図2.加 齢 に よ る筋 力 低 下 の 仕 組 み2) か ら80歳 にか け ての 筋 力 低 下 度 は ア イ ソ メ トリ ッ クや低 速 で の 響 を比 較 的 受 け な い.し た が っ て,速 筋 線 維 の選 筋 力 発 揮 に比 べ て 非 常 に 小 さ い の が 特 徴 的 で あ 択 的 な萎 縮 は,筋 量 の低 下 に大 きな影 響 を及 ぼ す. 一方,60歳 以 降 に一 つ の 筋 肉 の 総 筋線 維 数 に 減 少 る.我 々 の デ ー タ に よれ ば,大 腿 部 伸 筋 群 の場 合, 70歳 代 か ら80歳 代 にか け て 男 女 と も約10%の が み られ る こ とが 明 らか に され て い る,し た が っ 断面 積 の低 下 が み られ る.こ の よ うな 筋 量 の 低 下 て,加 齢 に よ る筋 量 の 減 少 は,速 筋 線 維 の 選択 的 が,さ 萎 縮(遅 筋線 維 も速 筋 に比 べ る と割 合 は小 さい が に 日常 生活 で は,よ 萎 縮 す る)と 筋 線 維 数 の 減 少 の 相 乗 効 果 に よ って 会 が 多 い.し た が っ て,低 速 で の 筋 力 低 下 を抑 制 主 に もた ら され る と考 え られ る.そ こで,加 齢 に す る こ とは,高 齢 者 の生 活 機 能 を維 持 増 進 して よる 筋 力 低 下 の仕 組 み の フ ロ ー チ ャ ー トを図2に い くた め の 重 要 な課 題 とい え る. 示 した.筋 力低 下 を引 き起 こす 最大 要 因が 筋 量 の 低 下 で あ る こ とは 間違 い が な い で あ ろ う.な ぜ な らば,筋 力 は 筋 の 横 断 面 積 と比 例 関係 に あ る こ と 筋横 らな る筋 力 低 下 を導 くこ と に な る.一 般 的 り低 速 で の 筋 力 発 揮 をす る機 4)部 位 に よ る筋 力 低 下 に 相 違 が み られ る か? よ く老 化 は足 か ら とい う言 葉 を耳 に す る が,加 か ら,筋 量 の低 下 は筋 力 の低 下 を導 くため で あ る. 齢 に と もな う筋 力 の 低 下 度 は 上 肢 と下 肢 とで は異 また,動 物 実 験 の 結 果 か ら運 動 な どで 活動 量 が増 な る.図4に 加 して も加 齢 に と もな う筋 線 維 数 の 減 少 を抑 制 す 化 を示 した.上 肢 と下 肢 で は,下 肢 の 方 が 約10 る こ とは 困難 で あ る こ とが 示 され て い るの で,老 15%低 下率 が高 くな っ て い る.こ の 差 違 が 生 じる は,加 齢 に よ る上 肢 と下 肢 の 筋力 変 化抑 制 とい う立 場 に立 つ な らば,加 齢 や 不 活 動 に 図3.高 高 齢 者 の 筋 力(9名 の 縦 断 的 デ ー タ) 図4.加 齢 に伴 う上 肢 と下 肢 の 筋 力 変 化3)
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10 26 久 野,村 慣(職 業 や 運 動 歴)に よ り,退 る こ と が 示 さ れ て い る.加 積 の 変 化 は,男 上,馬 行性 萎 縮 を予 防 で き 齢 に よる 大腰 筋横 断 面 子 で は50歳 代 で 初 め て20歳 代 に 比 べ て 統 計 的 に 有 意 に 減 少 し(20歳 代31.2±4.1,50 歳 代25.4±1.9,p<0.Ol),さ ら に そ れ は60歳 で さ ら に 進 む 傾 向 を 示 した(表7).し い こ と に,60歳 お い て は,年 代 前 半,後 か し興味 深 半 お よ び70歳 代 前 半 に か し な が ら,75歳 面 積 の 低 下 が そ れ ら の3群 図14.高 て も50歳 代 に お い て20歳 代 に 比 べ て 統 計 的 に 有 意 に 減 少 し た(20歳 代17.4±2.8,50歳 p<0.01).そ 性 にお い.01,VS20 29歳 代12.9±2.9, の 後 も加 齢 に と も な い 大 腰 筋 横 断 お,こ の大腰筋横断 面 積 に お け る 低下 率 に お け る 性 差 は ほ と ん ど み ら れ な い 傾 向 に あ っ た. 2)大 腰 筋 の横 断 面積 と歩 行 能 力 の 関 係 我 々 が 大 腰 筋 に と く に 着 目 した の は,大 腰筋が 歩 行 動 作 の 主 働 筋 の 一 つ で あ る た め で あ る.大 筋 の 減 少 率(20歳 他 の 筋 群,例 代 に対 し て)は,歩 腰 行 に関 係 す る え ば 大 腿 部 の 筋 群 と 比 べ て み る と, 齢 者 に お け る 筋 力 ト レーニ ン グ 実 施 習 慣 の 有 無 と 大 腰 筋MRI4) 表7.各 **p<0 以上 で は 横 断 と比較 して統 計 的 に 有 意 に 低 値 を 示 し た(p<0.05.表2).女 岡 面 積 は 低 下 傾 向 を 示 し た.な 代 代 間 の 横 断 面 積 に統 計 的 な 差 は 認 め ら れ な か っ た.し 場,金,上 年 代 お よび性 別 の 股 関 節 大腰 筋横 断面 積 の値4)
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