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In humans, it has been proposed that the loss of functional myofibrillar proteins is a significant contributing factor to the strength loss of aging. A number of previous studies have examined the effects of muscle protein degradation on muscle strength using a variety of blocking agents, both specific and non-specific [247, 248]. However, results from these studies have been inconclusive with some reporting no effect and others reporting a significant increase of maximal strength. The majority of the studies to date have used maximal isokinetic strength measurements. These outcome measures are measuring isometric peak torque and a specific measure of maximal muscle strength, whereas the MMT measures maximal voluntary isometric contraction (MVIC) which measures strength at the specific position of the joint. Preregistration studies were performed to test the efficacy of anabolic agents on muscle atrophy and strength [249]. Although the results were inconclusive regarding the efficacy of the putative recovery agent following atrophy, one notable finding was that only direct measurement of muscle strength has been shown to be the best measure of recovery [249]. If striking strength deficits were not observed at the similar time point between putative recovery agents, this could suggest that a sufficient window of opportunity to initiate recovery exists before the muscle becomes atrophic [249]. This is the situation observed in many DM1 patients, who show significant weakness shortly followed by the onset of atrophy [7, 10]. Thus, future research should examine muscle strength using dynamic measurements at different time points. Further investigation of putative recovery agents on the muscle strength after atrophy may be informative.
A sedentary lifestyle is a risk factor for cardiovascular disease [173]. It is also becoming increasingly common due to the contemporary decrease in the traditional risk factors, a major prevention strategy being the maintenance of a healthy lifestyle within society and the workplace [176]. Physical activity is weakly correlated with leisure-based physical activity and strongly correlated with objectively measured physical activity outside the home. Sedentary time correlates very weakly with physical activity and more weakly with leisure-based activity. The optimal levels of physical activity, while being low, are required to positively influence health outcomes [59, 177]. Adults spend more time sitting, and have smaller volumes of physical activity, the longer they live [178]. For older adults, the risk of vascular disease is comparable to that of diabetes, the standard risk factor [179]. d2c66b5586